ABSTRACT
Psychoanalytic psychotherapy of children involved out of the combination of psychoanalytic psychology, the direct observation of young children, and the study of the child’s immediate and larger social environment, primarily the family and the school. Anna Freud, with her pioneering work in child psychoanalysis, was the singularly most influential person in the development of psychoanalytic psychotherapy with children. This meant not only the application of psychoanalytic theory to the understanding of the child’s psychopathology, but that the principles which guided the individual treatment of the child were also derived from psychoanalytic adult treatment principles. The indiscriminate application of psychoanalytic treatment principles to children whose emotional difficulties were not the expression of internalized conflicts and their neurotic solutions but rather related to structural defects and/or developmental arrests led to considerable disappointment with the results of individual treatment of children. Therefore, in 1976, Anna Ornstein published another approach derived from the concept of psychoanalytic self psychology. For a better understanding she discussed the effect of the theory of treatment on technical considerations, for example, of the collaborative technic and the family treatment technic. Realizing the fact that the relationship between child and family is reciprocal and interpenetrating she developed the conceptual integration of intrapsychic and interpersonal factors and a theory of psychoanalytic therapy with children with intensive involvement of the caregiving environment. She conceptualized the treatment of a symptomatic child and his emotional environment as evolving within a single process – in a “therapeutic milieu” in which the contact between child and caretaker has to be reestablish as well as the parental empathy for the child’s anxieties, conflicts, and narcissistic vulnerabilities. The therapeutic aim is to untangle the unhealthy knot to facilitate the resolution of the child’s conflict which is only possible in a sense of secure connectedness with the emotional environment for continuing the developmental progress.
