ABSTRACT
This chapter considers some factors that are of particular significance in therapeutic work with adolescents who have learning disabilities of varying degrees of severity. These factors include sexuality, restriction of independent mobility, and very low self esteem. The chapter suggests that the question of the extent to which these young people experience themselves as different from their non-disabled peers underlies the therapeutic work, and that the issue of sameness and difference appears in a variance of forms according to the seriousness and the nature of the disability. The chapter focuses on some clinical material drawn from patients seen for individual psychotherapy. It talks about an 18-year-old young woman with a moderate learning disability and an eating disorder. The chapter also discusses a 16-year-old girl with Down's Syndrome, with a history of neglect, many changes of placement and sexual abuse, and concludes with some thoughts about a 13–year-old girl with a physical as well as a learning disability.
