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Malliani, G.G. (1984). Some Reflections on the Containment of Anxieties in a Paediatric Ward. J. Child Psychother., 10(2):159-174.

(1984). Journal of Child Psychotherapy, 10(2):159-174

Some Reflections on the Containment of Anxieties in a Paediatric Ward

Gabriella Grauso Malliani

This paper is an account of my work as a playleader on the isolation ward of the Hospital for Sick Children (Great Ormond Street). I wrote it several years ago, at the end of my first year in the Observation Course at the Tavistock Clinic.

I consider that my work as a playleader has been very relevant for my subsequent development and work as a child psychotherapist. It has helped me to learn to grasp and use some basic psycho-analytic ideas and concepts in a non psycho-analytic setting. I hope that the following observations and reflections might be of interest and use to others working in non psycho-analytic settings.

Cohen Ward

The isolation ward (Cohen Ward) is divided into two sections. One of them, Cohen D, is mainly allocated to children with skin problems. Some of them are kept in separate cubicles, but there is a large room with several beds and a common playroom where the children can play together and carry out several activities. When well enough, children can leave the ward and join all the other children from different wards in the hospital playcentre.

The Isolation Ward

The Cohen C side can be considered the real isolation ward and it is here that I have been working. It consists of eight cubicles and there are strict rules to be followed by everybody. On entering each cubicle one has to wear a white gown and mask. Once inside, hands have to be washed with antiseptic soap, which is repeated on leaving the cubicle, gown and mask being left in the cubicle's waste basket. Everything taken inside the cubicle cannot be taken out until the child's discharge, when fumigation takes place and things can be used again. The whole atmosphere on the ward is very “isolated” and distressing. The child is confined to his bed, completely cut off from the external world, even in his physical relation to nurses and people, and subjected to the white asepsis of shapeless bodies and masked faces.


Although the hospital includes in its staff a fair number of nursery nurses, there is a group of playleaders, appointed by the Save the Children Fund, who work under the supervision of Mrs. L, the playleaders’ co-ordinator. They come mostly from a teaching background and work both in the central play-centre and on different wards. Some months before, the hospital incorporated them in its staff, handing over to Mrs.

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