Some reflections about being locked out of the consulting room*

ABSTRACT

Many child psychotherapists are familiar with the experience of being locked out of the consulting room by child patients, and the peculiar challenges this poses to the clinician’s sense of competence and hopefulness in the child’s capacity for change. In this paper, I describe how this discomfiting experience developed in my work with David, who had suffered institutional neglect in a foreign orphanage before being adopted by a British couple. I will discuss how my understanding of David persistently locking me out evolved over time, and will suggest that the consulting room, for David, came to represent a maternal object, which he had to take exclusive possession of at all costs. Paradoxically, the door between us became necessary to separate and connect us; this gave me some insight into David’s early experience and the institutional doors, both literal and figurative, which had protected his carers from fully confronting his pain. Real psychological development for David, however, only seemed possible after an unsolicited and abrupt move to another building for our work together. I will suggest that our making this transition together enabled me to identify with David’s internal sense of homelessness and thus to break through the doors between us, which had been convenient for us both. I will also suggest that the consistency of the analytic frame had hitherto been experienced by David, paradoxically, as an impoverished, unstimulating environment, redolent of his time in the orphanage, which had left him in a state of stupor (A previous version of this paper was presented at the ‘Relating to the Other’ Association of Child Psychotherapists Conference 2018.).

KEYWORDS:

• Setting
• adoption
• latency
• hopelessness
• countertransference

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Notes on contributors

Hillel Mirvis

Hillel Mirvis is a child psychotherapist based at Barnet CAMHS (West). He qualified at IPCAPA in 2015, and has since developed an interest in psychotherapy with Looked After Children and disturbed adolescents. He is on the Training Advisory Group at IPCAPA.