1. A group of clinical features constituting a vulnerable child syndrome is reported and described in 25 children with a history of an illness or accident from which they recovered although the parents were expecting a fatal outcome.
2. This paper describes a study of this group based on the hypothesis that children who are expected by their parents to die prematurely often react with a disturbance in psychosocial development and in the parent-child relationship.
3. Outstanding clinical features include difficulty with separation, infantile behavior, bodily overconcerns, and school underachievement.
4. Predisposing factors and determinants of the symptomatology are discussed along with suggestions for management and prevention.
Children in clinical psychoanalysis are able to resolve conflicts and move ahead developmentally. This therapeutic process is facilitated by the psychoanalyst's understanding of the child, reflected in multi-faceted and thoughtful clinical technique. We review aspects of the analyses of four developmentally deviant children who were engaged in child psychoanalysis because of ego disturbances that impaired their ability to learn. These clinical analyses are used to exemplify three intertwined processes related to the therapeutic action of child psychoanalysis: therapeutic alliance, transference, and the role of the child analyst as a real person. These processes were expressed in and were influenced by the emergence of particular types of play in which the children explored complex issues in their lives. Along with other aspects of psychoanalytic technique, including interpretation, the analyses of these four children illustrate the therapeutic meanings of play in child psychoanalysis.
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