Editorial

The three papers in this issue illustrate the different methods whereby case material can be generated to elucidate emerging theories. The first paper uses the traditional psychoanalytic clinical method of describing in detail the treatment of a patient, using the author’s experience and observation to illustrate her ideas. In the second paper, whilst also describing a case in detail, the author uses more formal case study qualitative research methodology in which psychotherapy sessions and semi-structured interviews were conducted with the patient and were audio-recorded, transcribed and analysed by thematic analysis. In the third paper, however, instead of using clinical material, the author introduces an intriguing twist by using the story of a fictional character, instead of a patient, to inform and develop key psychoanalytic concepts.

The first two papers in this issue offer psychoanalytic contributions to the understanding and treatment of individuals with learning disability (LD), who represent a neglected and vulnerable population within our society. Both papers focus on the deleterious role of trauma, drawing on the seminal work with people with learning disability of the psychoanalyst Valerie Sinason. She described how children who are pervasively exposed to trauma develop what she termed ‘secondary handicap’ – an unconscious lowering of their intelligence which develops as a defence against their perceived difference from others, and is superimposed on their primary handicap of information-processing impairment and adaptation that is diagnostic of LD (Sinason, 2010).

In ‘The disabling effects of trauma in a time of austerity: Implication for the practice and theory of child psychotherapy’, Tamsin Cottis describes her work as a child psychotherapist in London primary schools over the past decade with children identified as having special needs whose potential has been impeded due to their exposure to significant trauma. Drawing on the case studies of two children, who are doubly traumatised in being from another country and experiencing extreme poverty, she shows how children with challenging behaviours may be helped with child psychotherapy in school settings. Cottis’ passionate paper emphasises how these children’s difficulties arose not solely from trauma within the family, but were also due to economic and social circumstances, in the explicit UK government programme of austerity of recent years, and the increase in racism following the results of the 2016 referendum in voting for the UK to leave the European Union.

The second paper focusses on trauma in the families of individuals with learning disability. Where those tasked to care for children with LD have also been affected by trauma – either the same adverse events affecting both carer and child, or earlier trauma in the former – the relationship between them may become damaged, perpetuating the traumatic cycle. In ‘Complex PTSD in relatives of people with ID: An illustrative clinical case study from South Africa’, Ockert Coetzee describes his psychotherapeutic treatment of a mother who suffered with severe PTSD stemming from her experience of intimate partner violence, which compromised her capacity to respond emotionally to a daughter with learning difficulties and challenging behaviours. His patient’s tendency to withdraw and dissociate from her daughter’s manic behaviours only served to exacerbate the distant relationship between them. Therapy enabled her to work through her trauma and associated feelings of guilt that her daughter was also exposed to it. Like the first paper, Coetzee also highlights the social and political context of the work in a country suffering high rates of violence and limited mental health resources.

The final paper is ambitious in its scope in revisiting Melanie Klein’s theory of projective identification in the light of queer theory to propose an updated conceptualisation of the Oedipus Complex. In ‘We need to talk about Fabian: Klein’s “lost” theory of projective identification and the social construction of gender/queer objects’ Jeremy Clarke focuses on Klein’s little-known paper ‘On identification’ (Klein, 1955) in which she explores a novel set in Paris by the American author, Julien Green, If I were you. Leaving the drama of Oedipus in Ancient Thebes, Klein uses the fantasies and adventures of the main character, Fabian Especel, to illustrate the mechanisms of projective identification and her theory of object relations. Clarke’s paper itself reads like a novel in its pursuit of Klein’s and Fabian’s adventures, the suspenseful development of its ideas, and the excitement of its conclusions, and whilst at times the concepts presented are complex and challenging, it represents a valuable contribution to contemporary psychoanalytic theories of sexuality, gender and identity.