Imprisoned Pain and Its Transformation

In this chapter Anne Alvarez describes how supervision with Sydney Klein played a decisive part in transforming her understanding of the importance of the grammar of interpretation-that not all interpretations have to unmask hidden desires on the negative side but, rather, can help the evolving process of growth and understanding. This is particularly important in borderline patients in whom such unmasking interpretations may be ego-depleting in that they do not take into account the immediate meaning of the child's communication.

Joan Symington is a child psychiatrist and psychoanalyst. She was consultant Child Psychiatrist at the Royal Free Hospital, London, for ten years. Having trained at the British Psycho-Analytic Association, she now works in Sydney and is a training analyst of the Australian Psychoanalytical Society. She has published articles on infant observation and psychoanalysis and she is the co-author with her husband Neville of the book 'The Clinical Thinking of Wilfred Bion'.

Introduction -- Moral imperatives in work with borderline children: the grammar of wishes and the grammar of needs -- Unconscious phantasy and knowledge: a case study -- Catastrophe, containment, and manic defences -- The significance of perversion: to prevent intimacy -- Shadow lives: a discussion of Reading in the Dark, a novel by Seamus Deane -- On using an alphabet: recombining separable components -- Some reflections on comparing obsessional neurosis and autism -- The anal organization of the instincts: a note on theories past and present -- When the bough breaks: working with parents and infants -- Observing babies and supporting the staff -- Projective identification: the analyst's involvement -- Psychic turbulence -- The concept of the envious/jealous superego -- Frozen pain