ABSTRACT
The chapter describes some psychoanalytically oriented consultations with multidisciplinary teams working with damaged children and adolescents. The author emphasises the necessity for the provision of a sufficiently safe environment for the open discussion of the anxieties encountered by staff in their everyday contact with the children and their parents, and goes on to describe some of the specific kinds of anguish encountered and explored in the group. These are conceptualised along the lines of the two broad categories of anxiety identified by Melanie Klein as pain and fear on the one hand, and, on the other, pain and loss. Particular challenges include the necessary inflicting of pain while treating injuries, the pain of rejection by the young person, and the need to ‘shoulder inadequacy’. The inevitable defences mobilised by this task, and against it, are discussed, as well as the potential of such work for emotional growth.
