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Language, communication, and transference in child analysis. I. Selective mutism: the medium is the message
Journal of the American Psychoanalytic Association
|January 1, 1996
Summary
Selective mutism, a childhood psychiatric condition, involves severe communication disruption. Psychoanalytic therapy adapted to limited communication facilitated significant developmental change in a young child.
Area of Science:
- Child and Adolescent Psychiatry
- Psychoanalysis
- Developmental Psychology
Background:
- Selective mutism is a psychiatric disorder characterized by a child's inability to speak in specific social situations, often limited to close family.
- This case study examines the complex interplay between selective mutism and a child's overall character structure, impacting verbal and nonverbal communication.
Observation:
- The study details analytic material from a 4 1/2-year-old child with selective mutism.
- The child's mutism was deeply integrated into his character, disrupting not only speech but also play and other forms of nonverbal communication.
Findings:
- Psychoanalytic techniques were modified to accommodate the severe communication limitations.
- Despite communication barriers, transference dynamics allowed for the revival of developmental conflicts.
- The adapted analytic work in the transference led to substantial positive changes in the child.
Implications:
- Modified psychoanalytic approaches can be effective even with severely communication-impaired children.
- Understanding the embedded nature of selective mutism within character structure is crucial for treatment.
- Transference-focused work remains a powerful tool for facilitating change in pediatric psychiatric conditions.