‘Peek-a-boo. How can you be there?’ Analytic work with a severely traumatised two-and-a-half-year-old girl

Abstract

This paper traces the analytic work with a severely traumatised two-and-a-half-year-old girl Phoebe, whose early life was marked by chronic abuse and a violent murder she witnessed a few months prior to the beginning of treatment. Bringing the trauma in the room in a dissociative form, in line with post-traumatic stress disorder presentation, was Phoebe's unconscious means of communicating her pre-verbal encounters by projecting onto me the rage, shock and helplessness of her predicament. Thus, countertransference responses were a helpful window into her internal world, which was governed by cataclysmic losses and primitive states of fear. The importance of containment of the complex feelings aroused in the work and protecting against potential re-enactment of the abusive elements the patient, the family and often the professional network brought in the therapy is highlighted. The author hopes that this paper will encourage the offering of psychoanalytic psychotherapy to traumatised children particularly the under fives.

Keywords:

• trauma
• violence
• abuse
• neuroplasticity
• affect-regulation
• PTSD
• somatic dissociation
• countertransference