Sixteen children and adolescents with extreme short stature secondary to hypopituitarism were compared to a matched group of physically healthy peers on a variety of psychological tests assessing general adjustment, body image, sex role development, sex-related fantasy, and reactions to frustration. With the exception of their reactions to frustrations, the psychological adjustment of children with hypopituitarism compared favorably with that of normal children. Children with hypopituitarism typically perceived less adaptive, mature solutions to frustrating situations than did peers of average stature. Anticipatory guidance for children with extreme short stature might help facilitate more adaptive responses to the difficult and inevitable frustrations imposed by short stature. Evaluations of intervention directed toward the enhancement of coping skills and life adjustment of children with small stature due to hypopituitarism is seen as a focus for future research with this population.
How can a psychoanalyst account for and recount the process of understanding the therapeutic endeavor? What happens in those moments, co-created by patient and analyst, when the consultation room comes "alive" in ways that defy easy or simplistic answers? How does an analyst come to understand psychoanalytic treatment as a bidirectional, dyadic, dynamic, interactively regulated relationship? Understanding the psychoanalytic treatment process from a disciplined, yet spontaneous, nonlinear perspective is the focus of this chapter. The overarching treatment process will be considered through the presentation of vignette of a treatment with a school-aged child.
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