‘I caught you!’ Part 2: enriching the external reality

ABSTRACT

This paper describes and explores the second part of the therapeutic treatment of a young boy who was diagnosed with autism, aged two. In the previous paper, his intensive psychoanalytic psychotherapy and his mind’s growth were covered. In this paper, his non-intensive psychotherapy, parent work, a home-enrichment programme, a structured personality assessment (including use of the WISC-III UK), and mainstream integration will be reported on. The aim of this account is to argue that differential diagnosis is essential for complex cases where there is early neglect and abuse in the child’s developmental history. A psychoanalytic approach that includes personality assessment is suggested to accompany, and even at times replace, the more widely used medical and behavioural assessment methods. It is argued that this can be more comprehensive and helpful in getting to the bottom of the child’s psychological and developmental difficulties, and so can aid in planning effective treatment and support.

KEYWORDS:

• non-intensive psychotherapy and autism
• home enrichment programme
• mainstream integration
• personality assessment
• Bal-A-Vis-X

Acknowledgements

I would like to especially thank Gokce Cansever who introduced me to David Rapaport’s ways of conducting and analysing psychodiagnostics in the 1990s. My gratitude also goes to Anne Alvarez who guided me thoughtfully, and with immense expertise and care, throughout Tao’s treatment as my supervisor. With great sorrow Branca Pecotic passed away close to the end stage of this work. Branca’s contribution in engaging the family into psychoanalytic thinking and supporting the parents in their role was essential in creating the basis for Tao’s individual psychotherapy. Without them, I could not have written this paper, even though I am solely responsible for this work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The name and the identifying details of the child and his family have been changed for the purpose of confidentiality. The parents were asked at the time of the therapy to give their written permission for possible presentation or publication of the work with the condition of their identities being disguised. Also, the mother (Nuwa) was shown the paper before publication for final consent. Tao was 18 by the time this paper was finalised and has read it as well. Tao as well as Nuwa accepted the paper’s publication, saying that they wanted other children in a similar predicament to benefit from the therapeutic approach.

2. ‘Bal-A-Vis-X’ is a series of Balance/Auditory/Vision exercises of varied complexity, all of which are deeply rooted in rhythm. Exercises are done with sand-filled bags and racquetballs, sometimes while standing on a balance board. A purposeful movement incorporates multiple midline crossings in three dimensions, rhythmic and auditory-based exercises, enabling the entire mind-body system to experience a pendulum’s natural, symmetrical flow. As a result, improvements in balance, hearing, vision, and brain/body integration can be achieved.

Additional information

Notes on contributors

Sheila Levi

Sheila Levi is a senior child and adolescent psychotherapist, adult psychoanalyst, and chartered clinical psychologist. She works full time in private practice, leads mother-infant observation seminars, and supervises student dissertations at Birkbeck University on an MSc course, having done so for many years. Sheila previously worked for 15 years as a Highly Specialised Clinical Psychologist in Barnet, Enfield & Haringey Mental Health Trust Tier 3-4 services. This included work in adult services for asylum seekers and refugees and learning difficulties, and in child and adolescent mental health services (CAMHS) with high risk, complex needs adolescents, and with children, adolescents and their families with moderate to severe learning difficulties and neurodevelopmental disorders. Coming from an ego psychology background through her clinical psychology training at Bogazici University-Istanbul/Turkey, she chose to do her analytic trainings in the UK due to her interest in integrating object relations theory with theory of mind thinking. She has managed several applied psychoanalytic community projects in Turkey, Israel, and London. Her Ph.D./MPhil dissertation was on empirical testing of Freudian castration anxiety concept through studying the psychological effects of circumcision on Turkish – Muslim boys. She specialises in psychodiagnostic and complex case studies, and has presented in various national, international conferences and scientific meetings in the UK. She has previously published papers and book chapters.