The little puppet: working with autistic defences in mother-infant psychotherapy

This paper outlines a constellation around birth in our society that is related to advanced western medicine and the way that families move around the globe. It describes a brief therapy with a three-year-old child who was diagnosed as autistic, and a mother who resorted to 'heroic' defences against the anxiety of being unsupported in a strange country. The therapist undertook to process the catastrophic experiences of the birth as expressed in the child's play and transform the accompanying monstrous fantasies into human experiences and thoughts. By providing a maternal container for both mother and child, the therapist was able to dissolve the couple's negative enmeshment and help create a space in the mother's mind in which she could process her own feelings, and thereby process and understand the child's feelings and communications.