ABSTRACT
An extension of a psychoanalytical psychotherapeutic approach to the field of mental and multiple handicap has begun to offer significant contributions in this area. In this chapter, the author describes the history of psychoanalytic involvement in work with mental disability, and examines the nature of 'secondary handicap', distinguishing between mild secondary handicap and what the author defines as 'opportunist' handicap. Individual psychoanalytical psychotherapy with the mildly and severely handicapped has been a scarce but valuable treatment ever since psychoanalysis began. The growth of the Tavistock Clinic Mental Handicap Psychotherapy and Psychology Research Workshop since it was first founded by psychologist and psychoanalyst Neville Symington eight years ago has been considerable. This distinction between primary and secondary handicap dispenses with the older view expressed by Doll that there was a difference between true subnormality and the 'pseudo-mentally-deficient' whose intelligence is blocked by background and emotions.
