Clinical notes on a case of transvestism in a child

Abstract

This clinical presentation describes the therapeutic process of a 5-year-old male child presenting as a main symptom quasi-delusional feminine enactments starting at an early age, which persisted for most of his ve-year treatment. This symptom was understood in terms of an attempt at restitution, itself the result of being confronted with an autistic structure stemming from a series of traumatic incidents during the oral phase: his mother's pregnancy, abortion, depression and subsequent three-month absence at the end of his rst year of life. The clinical material, drawings included, illustrates the interplay of oral, anal and phallic levels, with enactment predominant in sessions. The oral traumatic situation initially led to anal-manic play, then to quasi-delusional female personi cations in sessions, later surfacing as an annihilating 'black hole'. All the above issued into a broad enacted phallic-genital unfolding that dramatised an oral-genital primal scene, in the course of which he managed to structure his male identity. Near the end of the analytic process the analysand reworked the 'stages' of the link to the analyst. To end, based on the clinical material, the respective participation of the early and the late Oedipus complex is examined.

Contacting a 19 month‐old mute autistic girl: A clinical narrative

“…This presentation, jointly with our four previously published clinical accounts (Busch de Ahumada, 2003;Busch de Ahumada and Ahumada, 2005, 2009, backs our conviction that psychoanalysis carried along Tustin's technical lines, subject to the above emphasized proviso that treatment starts quite early, most preferably in the first three years of life which are our prime 'window of opportunity', is the treatment of choice for autistic spectrum disorders.…”

Is the nature of psychoanalytic thinking and practice (e.g., in regard to sexuality) determined by extra‐analytic, social and cultural developments?

“…These patients don't fit the assumption that homosexuality is a free choice; rather they fit the Kleinian notion of homosexuality as a defense against psychotic impulses and anxieties (Etchegoyen, 1999): in these patients it was a powerful defense essential for psychic integrity. In this line of thinking, Busch de Ahumada (2003) presents a case of a 5 yearold boy who carried out extensive quasi-delusional female impersonations: these transgender enactments were carried out in order to restore contact in an autistic structure and they fully resolved in treatment.…”