Building a truer self with Alex: a dialogue between authors about clinical case material

One of the challenges of psychoanalytic therapy with young children is finding more adaptive channels for the symbolic expression of bodily and feeling states expressed in motoric, sensory or visceral forms. The following case study, written in the format of a dialogue between the first and second authors as the article was being prepared, depicts processes of psychic transformation in twice weekly psychoanalytically-oriented psychotherapy with a 5 year old boy as he tried to linguistically integrate and represent his negative feelings and anxieties. Initially his emotions were aroused in pre-symbolic form dominated by sensory and somatic experiences that were disconnected from objects, events and words. The authors each reflect on Alex’s therapy experience as well as the specific kinds of therapeutic interventions that provided the opportunity for containing and transforming Alex’s emotional life. They conclude that as Alex’s threatening emotions were linked to objects and events in the play, a substantial emotional growth took place towards a shift to a greater capacity to comfortably maintain a “Truer Self”