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Sperling, M. (1967). School Phobias—Classification, Dynamics, and Treatment. Psychoanal. St. Child, 22:375-400.

(1967). Psychoanalytic Study of the Child, 22:375-400

School Phobias—Classification, Dynamics, and Treatment

Melitta Sperling, M.D.

SUMMARY

This paper is an attempt to study school phobias comprehensively. It was undertaken in the hope that a fuller understanding of some etiological, dynamic, and therapeutic factors might enable us to deal more effectively with these problems. I consider school phobia to be a neurosis characterized by fixation to the anal-sadistic phase of development, persistence of ambivalence, narcissism, and magical

thinking (fantasy of omnipotence), and more closely related to the compulsion neuroses than to anxiety hysteria.

I have divided the phobias into acute and chronic and into induced and common (traumatic) school phobia. In the induced type, the traumatization is insidious and results mainly from a pathological parent-child relationship. In the common type, the acute onset follows a trauma or a series of traumata and resembles a traumatic neurosis with the presenting symptom of school phobia.

The indications for the type of treatment to be chosen depend upon the differential diagnosis and the age of the child at the onset of the school phobia, whether in prelatency, latency, or at puberty or adolescence. These factors determine whether the child or the parent(s) should be treated and, if both are to be treated, whether the parent should be treated prior to or concomitantly with the child, whether by the same or by a different therapist, and whether by psychoanalysis or short-term psychoanalytic psychotherapy. I questioned the value of symptomatic treatment and the emphasis on quick return of the school-phobic child to school without treating the total neurosis, of which the school phobia is one manifestation.

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