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Downey, W.T. (2002). Little Orphan Anastasia, Part Two: Developmental Growth, Love, and Therapeutic Change. Psychoanal. St. Child, 57:218-244.

(2002). Psychoanalytic Study of the Child, 57:218-244

Little Orphan Anastasia, Part Two: Developmental Growth, Love, and Therapeutic Change

Wayne T. Downey, M.D.

This is the second paper on a project that was undertaken to explore the opportunities and difficulties that might be encountered in writing about an ongoing child analytic case. For many reasons having to do with confidentiality and with the risks of reaching premature conclusions amid the normal confusions of the analytic process psychoanalysts generally write only after a case has been completed. Our project has sought to explore whether, as was the case with early psychoanalytic writings, the exercise of recording and synthesizing material gleaned from fresh open-ended psychoanalytic process might be accompanied by a more supple, informed, and nuanced clinical understanding. The first paper deals with two main questions. First, how could an infant survive and grow in the grim circumstances of a Siberian orphanage? Secondly, how do we understand the ways in which analytic technique interacted with Anastasia's extreme defensive activity to unstick her disorder of relatedness? Anastasia was born sickly. She was placed at

two months in an orphanage where she developed a stool withholding disorder along with an attachment disorder. She was partially socialized in the home of the American parents who adopted her at nine months of age. However great gaps persisted between her intelligence and the use of her imagination and the torment and rage accompanying her infrequent bowel movements. Anastasia entered child analysis at age five and a half. The first paper described Anastasia's recovery from encopresis early in her child analysis and her subsequent struggle to overcome the psychological sequelae if her anti-dyadic state of relatedness. This paper will ponder some of the viscissitudes of transference and development that accompanied Anastasia's emerging capacity for love as she continued to overcome her alienation from her body and from significant others in her outside world. It will re-examine ways of thinking about object relationships and new objects to further understand Anastasia's recovery process.

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