Authenticity and survival working with children in chaos

Abstract

This article considers two kinds of clinical presentation involving chaotic aggression and destruction, when defences break down. The first set of case material is taken from art therapy work with a neglected and deprived child, traumatised through physical abuse, in a context of domestic violence. The second set of case material is taken from work with an entangled child on the autistic spectrum. It is primarily Tustin's ideas about entangled/confusional children that are used in this second example (Tustin, 1992). In treatment, the therapist needs to facilitate their becoming real in an authentic way and remain real to clients herself when under intense pressure. The word authentic is being used to describe the child within, who is hidden by a carapace of defence. Art therapy can offer an intermediary arena of potential containment if a transitional space can be established. Both chaos and the importance of the first image to emerge after such a stage will be considered.