ABSTRACT
This chapter is concerned with an attempt at understanding the psychological component in a child’s severe developmental delay. I first saw this boy, whom I will call Paul, when he was three years old. It seemed clear that he was capable of symbolisation and his obstinate fascination with gaining access to enclosed space suggested that the representations of his phantasy life contributed to his lack of cognitive and emotional development. I thought that one should attempt psychotherapy, and not abandon Paul to a future of very severe retardation. After some months when he was seen together with his mother as they refused to separate, he started twice-a-week individual psychotherapy.
