Starting Treatment with Children and Adolescents by Tuber Steven;Caflisch Jane;

Author:Tuber, Steven;Caflisch, Jane;
Language: eng
Format: epub
Publisher: Taylor & Francis Group

7 A 9-Year-Old Girl

This session is with the same child discussed in Chapter 4 but a month later, during which time the child suffered a serious injury that caused her to miss several weeks of treatment. The injury was not at all life threatening, but serious enough to have warranted emergency room care.

F: (She notices that I am using a different tape recorder.) And the other one?

T: Which other one?

F: (Inaudible) for tape?

T: Oh, because I used another one last time, huh?

F: (She starts arranging the pieces so we can play Connect Four.) You think this is going to fall down? (She wants to know if I can guess if the pieces will fall all the way down to the table.)

The session begins with the patient alert and focused. She notices a change in the tape recorder and begins playing a game (Connect Four) in which the possibility of the checkers all falling down unexpectedly is suggested. A parallel with her sudden injury seems likely. The emergence of this parallel creates an interesting set of questions for the therapist: How conscious is this connection to the patient? Would it be useful to make the connection explicit, or would it be better to let her expand on her play to see where it goes? Although it may be difficult for a beginning therapist to wait to comment on such a connection, it nevertheless seems vital to stand back and let the child do her work. One reason to wait lies in knowing that it is so early in the session that there is much time to let the play unfold and gather affective depth. A second reason for waiting is grounded in the idea that if the child is aware, even unconsciously, that she is bringing her injury to her play, then she will present in a manner authentic to her, giving a far more meaningful feel to the process that unfolds during the session.

T: Which one?

F: This.

T: Hmm. Should I guess?

F: Your turn. Okay. Go!

The child anxiously wants the therapist to place her checker in the slot so that it can fall through and does not want her to guess ahead of time as that would presumably spoil the “shock” of the checker falling. I would be inclined to voice the “experience” of the checker: “Whoa, here I am the checker about to drop down the slot. Will I fall but get safely caught, or will I crash? It's a worried feeling not to know.” This at least sets a frame for reflecting on an affective experience of falling without warning.

T: Hmm, yes!

F: It fell. You are black.

T: Oh, I am black. Okay. Aha, let me see. … Where should I put my token? Ohhh. I know that you know all the tricks for Connect Four!

F: Oh really, if I go here. Here.

T: Yeah.

F: One, two, three, four.

T: Ah, I see. Hmmm. So that is a possibility, and another possibility is that you would try to get me here. (I point to three tokens that are lined up.

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