ABSTRACT
The notion of the development of thinking is central to psychotherapeutic work carried out with young people with learning disabilities. In this chapter I will introduce you to a young woman, Jennie, aged 14, who at the start of therapy, presents with extreme anxiety. Jennie is helped by once weekly psychodynamic psychotherapy carried out over two years. My clinical work is in¯uenced by psychoanalytic theories put forward by Freud, Klein and Bion. In particular, Freud (1917) suggests that it is the work of the clinician to help a person know more about themselves by making what is currently held in the unconscious available to the conscious mind. Jennie has a moderate learning disability, which for her means that she ®nds it dif®cult to make sense of what others mean by their words and actions, and it is dif®cult for Jennie to understand and convey her thoughts and feelings to others. Retrospectively (in that at the start of therapy this is not known but unconscious), I am able to say that what Jennie needs to `know more about herself', is awareness about her disability. Disability inevitably means difference and difference is painful. A central task of any work with a young person with a disability is to be brave enough to speak of this disability and to speak of this in a timely and sensitive manner.
