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Published on: September 19, 2019
[Psychoanalytic therapy for a child with somnambulism: a case report]
Jiang Xixi1, Zhu Yuncheng2, J I Weidong1
1Shanghai Changning Mental Health Center, Shanghai 200335, China.
Insights
Sleepwalking (somnambulism) in children, often linked to separation anxiety, can be effectively treated with individualized psychotherapy. This approach offers a non-medicinal option for managing sleepwalking symptoms in pediatric cases.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Child Psychology
Background:
- Somnambulism, or sleepwalking, is a disorder of arousal characterized by partial wakefulness during sleep.
- No consistently effective therapies or medications exist for treating pediatric somnambulism.
Observation:
- A 4.5-year-old girl experienced nightly somnambulism episodes coinciding with separation anxiety disorder.
- Symptoms persisted for a week before intervention.
Findings:
- A 5-stage intervention, including diagnosis, trust-building, information gathering, supervision, and psychotherapy, resolved the child's somnambulism within a week.
- Behavioral observation and guardian reports provided insights into the sleepwalking episodes, viewed as a form of dream expression.
Implications:
- Early intervention with psychotherapy may be a viable treatment for childhood somnambulism.
- Psychotherapy can potentially reduce the manifestation of unconscious desires during sleepwalking episodes.
- This case highlights psychotherapy as an alternative to pharmacotherapy for pediatric sleepwalking.
Abstract:
Somnambulism is defined as a state of dissociated consciousness triggered by impaired arousal, which results in partial wakefulness and partial sleep. No effective therapy or medication has been available for treating children with somnambulism. Herein we present a case in a 4.5-year-old girl, who presented with somnambulism associated with separation anxiety disorder every night in a week. The girl received formal assessment and appropriate interventions, and the symptoms disappeared within a week. The treatment was carried out in 5 stages: diagnosis of the disease, establishment of trust, information collection, supervision, and individualized psychotherapy. Although dreams in childhood can be difficult to interpret, close observation of the behaviors in sleepwalking, as a special form of dream, in addition to the more precise description by the guardians, still provides useful clues to understand those dreams. For children with somnambulism, early intervention with psychotherapy can significantly decrease the false revival of the unconscious desires, and thus may serve as a treatment option other than medications.
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