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(1949). Bulletin of the Menninger Clinic. XII, 1948: Some Considerations Regarding Psychotherapy with Psychotic Children. Sibylle Escalona. Pp. 126–134.. Psychoanal Q., 18:264-265.

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Psychoanalytic Electronic Publishing: Bulletin of the Menninger Clinic. XII, 1948: Some Considerations Regarding Psychotherapy with Psychotic Children. Sibylle Escalona. Pp. 126–134.

(1949). Psychoanalytic Quarterly, 18:264-265

Bulletin of the Menninger Clinic. XII, 1948: Some Considerations Regarding Psychotherapy with Psychotic Children. Sibylle Escalona. Pp. 126–134.

Escalona reports on seventeen psychotic children, so diagnosed by the children's division of the Menninger Clinic. Their symptomatology included speech disorders, circular and autistic logic, bizarre preoccupations, low frustration tolerance, excessive fantasying and a lack of integrative capacity. Escalona found that all these children had been to some extent atypical and disturbed since earliest infancy. They showed either exceptional remoteness or irritability or both toward their mothers who felt puzzled by the children from the beginning. In many instances the maternal attitudes seemed to be entirely adequate but the child's reactions eventually caused some pathological behavior in the parent. These findings contradict our usual conception of the etiology of emotional problems in children.

In treating these patients two different types of therapy were used. Some children were treated with the usual psychoanalytic approach in that they were permitted to develop a strong relationship to the therapist which then made past traumatic events and unconscious material accessible so that they could be interpreted to the child. Another method of treatment might be called suppressive, in that it discouraged the expression and acting out of fantasies and provided gratification only in more realistic pursuits. This treatment was only possible when a positive transference was maintained and here the transference was not interpreted. Escalona found that neither approach was entirely successful. The children treated by the expressive type of therapy gained insight, but either failed to change or would relapse as soon as therapy was terminated. With suppressive therapy some clinical improvement could also be obtained, but the underlying psychotic process


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remained untouched and a pseudo adjustment occurred. The author states that at this time treatment of the psychotic child is often unsatisfactory and we will have to learn more about the nature of these illnesses before we can hope for adequate therapeutic results.


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Article Citation

(1949). Bulletin of the Menninger Clinic. XII, 1948. Psychoanal. Q., 18:264-265

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WARNING! This text is printed for the personal use of the subscriber to PEP Web and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoever.