Dr Catherine Vanier is an analyst, member and former president of Espace Analytique Paris. Currently she is the President of Enfance en Jeu, an association for research in paediatrics, psychoanalysis, and pedagogy and is a psychoanalyst in the neonatology service of the Hôpital Delafontaine in Saint Denis. Her numerous articles and books include The Broken Piano: Lacanian Psychotherapy with Children (Other Press, 1999) and Premature Birth (Karnac, 2015). She was awarded the Knight of the Legion of Honour in 2010.
Psychoanalysis with Children
The eight-year-old Julien arrives to our first meeting dragged, pushed and pulled by his mother because he refuses to enter my consulting room. She’s holding him firmly by the arm and although he seems to be struggling with all his might, biting and kicking her, she does not let go. “You won’t get away,” she tells him, “I’ve had enough of this.” The father is looking on without a word. He seems both fascinated and slightly terrified by the scene.
Once the mother has finally pinned Julien down in an armchair facing me, he gives up and decides to sulk in silence. The mother goes on complaining about her son, about his tantrums and fits of anger, his constant disobedience both at home and at school. When I turn to the father, he simply warns me: “You’re wasting your energy,“ he says, “there’s nothing to be done, those two are inseparable, they adore and hate each other at the same time. You’ll simply exhaust yourself if you try to change anything.”
While both Freud and later Maud Mannoni said that “child psychoanalysis is psychoanalysis,” we nevertheless notice its specificities each and every day.
First the fundamental difference, namely that parents make appointments for their children. This already raises a question: Who is asking for what? Even before they enter my consulting room, Julien and his mother are a perfect illustration. Julien does not want to come in, but his mother warns him that he will not get away and that she won’t let go of him. She is very happy to have a son who is stronger than others. “He’s got character, there’s no question about that,” she says, “it’s exhausting but he has an answer for everything. Better than being like his father. I wouldn’t have liked to have such a mousy son like my husband.” She’s proud to show the jouissance she derives from her son and she has no intention of giving it up. Hence she will go into great lengths to keep him locked inside the deliciously violent bodily closeness that exists between them. As to the father’s demand, when he warns the analyst that she is bound to lose the fight, he is no doubt asking her, which is often the case, to feel depressed instead of him, to relieve him of the burden of his depression and to comfort him in the idea that, in his position, there really is nothing he can do. And finally, Julien is simply asking not to be here: he does not want to be dragged by his mother to a psychoanalyst every week and would rather watch the cartoons that are on at exactly the same time as his session.
Although it is true that even when we are working with adults the demand is not always easy to identify, with children the matter is obviously all the more complicated. The demand does not always concern the child for whom the appointment is made – sometimes the question is of the mother or the father, or of another family member.
I am thinking of a six-year-old girl, who came to her first appointment with her parents. She explained to me that she had no reason to come, that “everything was fine.” The parents seemed worried, but she did not understand why. And neither did I. Something must have been the matter because they had made the appointment, but what? Seeing that the parents were really quite concerned, I suggested they come see me alone the following week, so that we could speak about their difficulties together. While we were speaking, the little girl’s eight-years-old sister had been sitting in the waiting room. After the family had left, I found a picture next to her chair, which she had drawn during her younger sister’s appointment and carefully left out for all to see. It was a drawing of a shipwreck; with a large S. O. S. spelled in capital letters. After speaking to the parents, I therefore suggested seeing the older daughter. The demand had in fact come from her.
A child can be asking for help in a number of ways. They can be calling for help directly for themselves, but equally well for one of their loved ones. A child’s symptom is often connected to the issues of their parents. For example, a child can become hyperactive in order to treat his mother’s depression. He or she can be hypermature in order to protect her, hyper-demanding so as to keep her busy, a great communicator if she has difficulties communicating. He or she can also become extremely well behaved in order to reassure her and satisfy her narcissism. Or in yet another case, the child may be constantly falling ill, calling for help by drawing attention to his or her physical symptoms, so that not only they are taken care of and receive treatment but so does the mother, as if by proxy, like a kind of reversed Munchhausen syndrome.
Sometimes we need a great many sessions to see past the symptom that prompted the initial consultation, and to find out who in fact is making the demand and of what kind. Once we have understood this, we need time for the demand to be formulated. It takes time for the child to realize that he or she is being offered to see someone who believes that underneath the symptom there is a question. The point is not to give the child answers or educating them but to hear their question without trying to “normalize” them. Such intervention would only increase the distance between us; it would only “segregate” the child further in the name of morality or education. A psychoanalyst mustn’t treat the child as an “object of care” to be re-educated or cured, but simply to listen to his or her search for answers. In any case, the little metaphysician is always constructing his own theories, by asking himself: What is my place in the family? Who am I for the Other? What does the Other want from me? What makes him happy, how can I fill his lack? The child’s questions emerge as a reaction to the enigma of the Other’s desire.
But because in child psychoanalysis it is the parents who make the appointment, it is very difficult for the analyst not to react to their initial demand, which has nothing to do with the demand of the child. The parents’ demand could indeed most often be summed up as: “Please fix this problem, so that we don’t have to speak about it anymore.”
I am reminded of a little five-year-old girl named Julia. Her parents made the appointment because, as they claimed, she had become a “monster” after the birth of her younger sister. She was constantly trying to hurt the baby and ignored the parents’ prohibitions against her attacks. “She has become so naughty that we’re afraid of her. We thought that someone else could get her back on the right track and that we wouldn’t have to talk about it anymore.” But that was precisely what I was suggesting that we do that day – speak about it! Julia listened attentively, not saying a word. Rather than about prohibitions, we spoke at length about the grief connected with the birth of a new baby and about her parents’ fears, which echoed family issues from their own childhood. During the conversation, Julia’s mother became very emotional, crying as she spoke about herself and her own sister. At the end of the session, I asked Julia if she wanted to come again on her own, so that we could speak about what seemed to be making her so unhappy. She said: “Yes, I would like to come. I understand what your job is: you’re a ‘translator’ for the parents.”
Naturally, children won’t ask to come back if they think that we are simply going to serve the parents’ cause. They only ask to come because they attribute to us a unique kind of knowledge, which is related to the questions they are themselves asking. This knowledge concerns them personally and has nothing to do with what grown-ups usually expect from them.
As early as in 1920, Freud explained that the analytic treatment could not be undertaken for the benefit of a third party: “Parents,” he said, “demand that their nervous and unruly child be cured. By a healthy child they mean one who gives his parents no difficulties, but only pleasure. The doctor may succeed in curing the child, but after that it goes its own way all the more decidedly, and the parents are now more dissatisfied than even before.” [i]
We need the entire period of what we call “preliminary sessions” in order to put in place analytic work with a child, based on the different transferences, different demands and their elaborations. Maud Mannoni said that in order to begin an analysis, a child must first be sure that he is not simply serving the parents’ interests. Yet the problem is that often children are asking to do precisely that: to fill the Other’s lack, to satisfy him in order to be loved! “Man’s desire is the Other’s desire,” Lacan teaches us, “namely, that it is qua Other that man desires.”[ii] “The subject, […] begins in the locus of the Other, in so far as it is there that the first signifier emerges.”[iii]
If we decided to only begin analytical work when the child’s demand has been clearly articulated, it would be a little bit like waiting for him to finish his analysis first, in order to take him on. How could a child express, straight away and from the position of a subject, a demand that would be distinct from the demand of the parents? No, what brings a child to us is primarily his symptom and that is where our work must begin.
Right at the beginning, Julien told me that he was miserable at school. He was about to be definitely dismissed and sent off to a special institution for “disturbed” children. His behavioural problems had been separating him from his classmates in a very painful way. “They don’t want me anymore,” he told me, “they hate me! It’s the others: the other children and the teacher are after me. They want to attack me. I have to fight for myself. There’s nothing I can do, I don’t want them to say that I am crazy.” And there we have Julien’s symptom – he’s pretending to be crazy. “Dangerous to himself and to others,” the psychiatrist of the school’s orientation committee had said. Several sessions later, the mother told me about her younger brother, Julien’s uncle, a schizophrenic whom she had been caring for and who had now been sectioned in a psychiatric hospital. As for the father, he spoke about his difficulties with his wife, about her great psychological fragility and his fear that she might have a breakdown if he comes between her and his son.
In his Note on the Child, written to Jenny Aubry, Lacan explains: “A child’s symptom is a response to what is symptomatic in the family structure… The symptom can represent the truth of the parental couple.”[iv]
As we know, a symptom has two aspects:
- First, it carries a grain of true speech, which may have been diverted one or two generations earlier and remains trapped in the symptom. In the case of children it is the parents who unknowingly hold the key to it; hence we can only work with children if we are also working with the parents.
- In addition to the dimension of meaning, the symptom also has a second register, which concerns the jouissance that has been locked away in it. This jouissance may go beyond the pleasure principle and bring satisfaction even though it does not give pleasure.
This is the first thing that both child analysis and adult analysis have in common: the initial consultation is prompted by a symptom, although the subject is not at all ready to give up on the jouissance it allows him and not at all aware to what extent it is fuelled by this jouissance. If the truth lies on the side of the parental couple, what about jouissance? Does it belong to the child or the parents? Is it a shared jouissance, if we assume that the child also takes part in the jouissance of his parents? Exactly like for the adult, for the child, too, giving up on this jouissance means gaining access to a desire marked by separation. When speaking about child psychoanalysis, can we also say, as it is the case with adults, that the analyst, as the subject supposed to know, completes the symptom? And at the end of child analysis, are we able to identify the fantasy and the object-cause of desire?
We mustn’t forget that the time of child analysis concerns a period when this fantasy is being elaborated. Does the fantasy have the same status for the child as it does for the adult; is it already constituted? Most likely, the treatment will be directed towards this construction, because by enabling a separation it lets the child constitute an object which structures the fantasy, thus giving the child, in the play of presence-absence, access to desire.
The function of desire is to limit jouissance.
Remember Shakespeare’s King Lear. The play starts with the king’s decision to give up his kingdom in favour of his three daughters. In exchange, he asks them to tell him how much they love him. The two older daughters try to outdo each other in the most outrageous flattery. The youngest daughter, Cordelia, can only say: “I love your majesty according to my bond; nor more, nor less.”[v]
Furious, the king disinherits her and divides the kingdom not into three, but only into two parts. The two older daughters take over, Lear goes mad and the two daughters eventually kill each other. Cordelia says nothing, wants nothing. A nothing cannot be divided; it cannot be converted into money. The father cannot choose to give his all – Cordelia reminds him of what necessarily escapes us when we are speaking about desire.
At the end of the play, Lear regains his kingdom and is reunited with Cordelia, yet both of them die. A wind of folly blows over the plot of King Lear, perhaps more so than over any other of Shakespeare’s plays. It shows us how the entire family is shaken when the symbolic logic of filiation is reversed.
In child analysis, this is often precisely what we find. We’ve seen it so many times: a little girl who becomes her mother’s mother; a little boy who is acting as the master of the family, while his own father is sidelined; parents who in their insatiable demand for love become children themselves.
Lear wants to be treated as a king; he wants to be told that he is loved. “The old fool believes he is lovable,” Lacan says.[vi]
In his article discussing the play, Alain Vanier writes: “The demand is also a question about the Other’s desire, a question the subject asks in complete ignorance, since what he refuses to accept is castration as desire’s very condition.” [vii] Indeed, Lear no longer wants to carry the burden of being the king, but he would like to keep the title and love, the jouissance proper to his position. When at some point he is insulted by a servant, he flares up: “But do you know who I am?” “Yes sir,” the servant answers, “you’re my lady’s father.” It is now through his daughter that Lear is given an identity – and here again we hear the truth from the mouth of the fool, who tells Lear: “It’s having made your daughters your mothers that has driven you mad.” The generational order has been reversed and the phallic function is no longer represented.
This is what Alain Vanier emphasizes: “Undermining the symbolic order… also undermines desire as a defence against jouissance. Desire necessitates the channeling of jouissance by means of the phallic function; once the latter no longer operates, another jouissance, without limits, enters the scene. The fun and games of the beginning of the play give way to destruction, which takes over and, ravaging all the characters, ends in death.”
This corresponds exactly to what we most often see in child psychoanalysis.
Chloé was five years old and she came to see me because of serious constipation, which required regular hospitalizations. Any organic cause having been ruled out, the hospital paediatricians eventually referred her to me.
In our first meeting, Chloé’s parents told me that she also suffered from another symptom: she had trouble sleeping. “She fights against sleep,” her mother put it, “it is as if she doesn’t want to let go, as if she’s scared. Sometimes it takes her two hours to fall asleep. Close to seven o’clock in the evening, her entire behaviour changes. As soon as the night falls and she knows she’ll have to go to bed, she becomes nervous and irritable, she isn’t the same little girl anymore.” During daytime, Chloé seemed perfectly fine, she was lively and cheerful, the picture of a problem-free child. Her language, drawings and attitude resembled a child of seven years old, rather than a five-year-old. Still, it was Chloé herself who had asked to come, because of a symptom she described as: “I don’t like it when the night falls, it makes me really scared.” When I offered her to return on her own, so we could speak about this fear, she answered: “Yes okay, I will come. My tummy hurts when I’m scared.”
When she came alone to our next meeting, I was surprised by her demeanour. She walked in sucking her thumb, looking sad and lost. This was not at all the same little girl I had seen the previous week with her mother. She quickly found papers and markers and, very methodically, began to make doodles and scribbles. Without saying a word, she drew spirals of all colours one over another, her hasty work resembling the drawings of two-year-old. I let her draw for some time, but then, feeling pressed for time, I said: “Perhaps you could tell me what is it that you’re drawing?” It was of course a stupid question, a perfect example of what one should not do. Chloé made no mistake, she gave me a dark look and immediately put me back to my place by saying: “Be quiet, can’t you see you’re keeping me from working!” She was of course right. Like Freud’s hysterical patients, children are fortunately always there to call us to order, but we must be able to understand the lesson. How indeed could we undertake a treatment of a child, or even an adult, unless we can tolerate regression? “By means of demand, the whole past begins to open up, right down to earliest infancy,”[viii] Lacan says. It is always a question of regression, whether we are dealing with children or adults. For Winnicott too, regression lies at the very heart of the psychoanalytic treatment and it is precisely what we must work with. On that day, Chloé and I ended our session in silence: she seemed satisfied with the way I showed her that I had understood her message. Leaving, she said: “You know, the teacher said that this week I have again made a lot of progress.”
And, thanks to her, the following Wednesday I, too, made some progress, because I kept quiet and listened. She was no longer sucking her thumb, but she kept making one doodle over another, without saying a word. All of a sudden, she chose one of them and pointed to it, saying: “Look, it’s the Venus of Milo!” I must have looked rather surprised, so she explained: “But can’t you see, she has no arms. Her arms wouldn’t hold, so they fell off. My mom has a Milo in her bedroom, I’ll go fetch her in the waiting room and she’ll tell you.” When she came in, the mother indeed confirmed that she had a little statue in her room, a reproduction of the famous Venus de Milo. “I don’t know why,” she said, “I have always loved that statue. I would always take it with me whenever I moved. I had it already as a young girl.” During the same session, Chloé’s mother also told me that she was three months pregnant and very anxious. To have Chloé, she had to stay in bed from the fourth until the ninth month. She knew that her pregnancies “didn’t hold” – she “lost” the child each time. After two miscarriages at the beginning of her marriage and just before having Chloé, she had been pregnant with a baby whom she lost in the sixth month. “He was stillborn,” she explained, “it was a boy and I at least insisted that we bury him. Sometimes we go visit his grave.”
The mother used the French word for “grave”, tombe. Likewise, Chloe would say that “the night falls [tombe],”, “I can’t push because ‘it’ falls [tombe] into the loo,” or “I don’t want to fall [tomber] asleep.”
In the course of the treatment, the little girl was gradually able to associate all these phrases with the visits of her little brother’s grave at the cemetery. Lacan teaches us that analysis is a practice of the signifier: throughout the treatment, we are following the vicissitudes of a vital signifier. For Chloé, this leading question was death, associated with the experience of loss. A child’s excessive “holding on” to the mother’s desire always has a slight taste of death, of annihilation, of being swallowed up by the other. For Chloé, nothing could really “hold,” nothing was solid enough and loss could therefore only be deadly. Like an automatic bank transfer, her fantasy was firmly connected to her mother’s, whose complicated family history turned around the question of castration, transmitted in a particular way. At the end of our sessions, the mother would speak about her own mother in the presence of her little daughter. She talked about the reassurance she derived from Chloé, who mothered and protected her. The arms of the Milo Venus couldn’t hold, they fell off, but “in the beginning they were really there.” The mother began to understand the unbearable nature of the signifier tomber [“to fall” but also, phonetically, “a grave”], as well as her fear that when Chloé grows up, she too will “drop her” [laisser tomber]. It was only when the mother could speak about her experience of the death of her son that Chloé seemed slightly able “detach” herself from her.
In parallel to her mother, Chloé spent some time making little figures, which constantly lost their heads, arms and legs, and each time she would ask, desperately: “But why won’t it hold?” Then she began to draw babies, Venuses with or without arms, as well as a few little daddies, shyly outlined in the four corners of the paper. When her father came with her, he complained about how little he seems to mean to his daughter. “She’s only interested in her mother,” he said, “she won’t leave her, she never wants to go anywhere with me and when I suggest something to do, she refuses. It took a lot of negotiation for her to agree that I come with her today. She’s very stubborn with me, never wants to give in to anything and she has completely disarming anger fits, so that in the end it’s always me who gives in.”
Yet in spite of all he was able to stand his ground because he did manage to come with his daughter at least every other time. A few sessions later, Chloé had just begun spreading modelling clay on my desk, when she suddenly stopped and asked, looking terribly worried: “Where’s your blue pen?”
CM: “What blue pen? I’ve never had a blue pen.”
Chloé: “But you did, you did, you had one and you’ve lost it. It must have fallen somewhere, yes, it must have fell down.” She tried looking under the desk, then got up, visibly anxious.
Chloé: “You had it before, I’m sure, where is it? Is it lost? Your pen writes in black, before it was a much nicer blue. They took it from you.”
It took some time before Chloé finally accepted the obvious: I’ve never had such a pen. Her face changed and fear turned into sadness. “This is not funny,” she said, “you must be sad that you don’t have a blue pen.” When I answered that I have indeed come to that conclusion some time ago, she asked: “But your pen, how does it write? Not as well as a blue one?” I said it wrote differently, that another colour was okay, too. With this fallen pen, I became part of a network of signifiers, just as the father’s position was transformed precisely because he would not “let go” of his daughter [again the word tomber], regularly bringing her to our meetings. From this moment, a relationship of transference was established: from here, I could speak to Chloé about difference and she could understand me, without a need for interpretation in the classical sense of the term. In fact, in child psychoanalysis that type of interpretation often seems superfluous. Like in the analysis of adults, interpretation is more likely to be found in the way sessions are punctuated or a particular word is stressed or reintroduced; we interpret by making a comment about a drawing as if it was a dream, i.e. always based on the child’s own associations. There are no ready-made interpretations of children’s drawings, just like there is no predefined interpretative key to dreams.
This difference can also be seen in the sessions including the parents. Speaking to the child in front them can have an effect of interpretation for the parents, just like addressing the parents can allow the child to understand something that concerns him or her directly.
The most important thing is to listen. To listen and to follow what we can identify as part of the child’s process of constructing a myth. Listening completes the circuit of speech. Like in adult analysis, the essential thing is that the message finds its recipient.
In the following session, Chloé was again drawing and she told me a story: “It’s a little girl with a bubble over her head. It’s to show you that she’s dreaming. In the bubble there are some very beautiful jewels, she’s thinking about them all the time because she’d like to have them.” Next to the little girl she drew a cave guarded by monsters. “See, the jewels are in the cave, she’d like to get them, but she can’t because the monsters are guarding the entrance, so she’s thinking about the jewels and she thinks that they’re lost.” I suggest: “She’s lost something she’d never had.” Chloé answers: “Yes, it’s like the doll that I wanted in the shop window. We saw it last Saturday with daddy, but wouldn’t buy it for me. Even though I don’t have it, I’m still thinking about it.”
Losing something one does not have brings us to another register than the fallen arms of the Milo Venus. The child possesses these objects in her thoughts, in her imagination, but symbolically they have been lost. Does this not indicate that the little girl’s subjective position has changed?
At this time, a year after the beginning of her analysis, the symptom of constipation finally disappeared and Chloé was also able to “drop” her problems with sleeping. She began to enjoy playing with her mother’s jewellery and dressing up as a princess, and she made a firm decision to marry her daddy.
In his notes to Jenny Aubry, Lacan says that the symptom can sometimes represent the truth of the parental couple, while in others cases, which he describes as more complex, it is directly correlated with the mother’s fantasy. The child becomes “the mother’s object and its function is no longer anything but to reveal the truth of this object.”
Can we think of Chloé’s transformation as a movement from one subjective position to another? Is it not true that at the beginning, every baby is its mother’s “object a” and if it remains in this position, the Oedipal passage will be compromised? By putting the child back on the Oedipal track, the analyst articulates these two structural moments.
In Chloé’s case, what made this articulation possible? What was it that had an effect on her? She must have been able to hear something about her mother’s place and desire, which then allowed her to position herself slightly differently. This registering which lead to a subjective shift was made possible in the encounter between herself, her mother and the analyst. And in the position where she located me as the subject supposed to know, she no doubt also understood that I, too, assumed that there was a subject in her. Contrary to her mother, I made a supposition that the mother found unbearable, namely of her daughter’s castration.
Can we therefore assume that in transference, the analyst can function as a supplement, taking on a vital function which, in that particular moment of the child’s life, the mother was unable to fulfil?
As Alain Vanier said during a 1989 W.A.I.P.A.D. conference, the mother supposes that there is a subject in her baby: “Such a supposition implies a place, that of the Other, where the supposition can sustain itself. The supposed subject is held by the mother. […] The subject is already there in the mother, who imagines it as separated and thus brings it into existence, since the subject is supposed to know.”[ix]
Can the analyst, who is in the position of a subject supposed to know, therefore imply to the child that he believes in his existence as a subject separated from his mother? Can he help the mother understand that she can let go of her child and not die? Is this what allows us to reshuffle the cards?
The question of the symptom’s jouissance is key. Some parents, such as Julien’s mother, come to show the analyst the phallic enjoyment they derive from their child. In doing so they challenge us: whatever you do, just don’t change anything. The children know that they have been given a mission and like good therapists, or to keep peace in the family, they will do anything to prevent analysis. And as we know, nothing at all can happen unless the parents can give up, at least minimally, the jouissance their child brings them. This again shows the necessity of including parents in our work. Sometime parents have other demands: they come to complain of, or rather to file a complaint against a child who refuses to be sufficiently dazzling and therefore fails to add lustre to the parents themselves. In other words, such a child gives them no jouissance, instead putting himself in the position of controlling their jouissance, as well as the jouissance of others (teachers, doctors, etc.). Such as child is refusing to give what is asked of him; in this way he is trying to dominate the Other, to impose his will on him, to deprive him as much as he sees fit. We see many children who are trying to survive in this way, by temporarily controlling the Other’s jouissance. In order to let go of their symptoms, they must first consent to be cured of their refusal to be cured. Yet in certain cases, we see that the reasons for the refusal are extremely valid – this is why analysts are always slightly suspicious when it comes to the idea of a cure. For both children and grownups, the symptom is often a form of self-therapy; however, with children the situation is more complicated because symptoms are directly linked to the parents’ unconscious.
Chloé constructed a new fantasy, as well as, in a sense, a new symptom, which was less directly attached to her mother’s fantasy. It seems that this change in her relationship to castration allowed her to give up on her previous jouissance, as well as that of her mother, with the promise, firmly associated with the Oedipal complex, that it may come later. Letting go of this form of jouissance then gave her access to desire.
We must often look for the child’s unconscious in the unconscious of the parents; the treatment is directed towards helping the child find the fantasmatic meaning that he or she acquired for the mother at birth. What does the infant represent for his parents in terms of their own history? When a child is born, he encounters the parents’ unconscious projections and can respond to them through behavioural problems or through disease, potentially putting both his biological as psychic life in danger. As early as 1964, Maud Mannoni described the infant as being caught up in the maternal fantasy; Lacan’s notes to Jenny Aubry date from 1967 or 1969 (there is some debate about this).
Today, our work is based on this question of fantasy, of both the parents and the child. What makes our work particularly difficult is the link between the two and in this sense we can agree with Françoise Dolto, who said that nothing was more difficult than child psychoanalysis. The art of conducing analysis with children is certainly not a child’s play!
The encounter with a family refers the analyst to his or her own unanalysed psychic content. He must work with his own unconscious. This is of course equally true when we are working with adults, but with children we must also be able to tolerate the parents’ violence. The death wishes aimed at the child are most often unconnected to the real child. They concern the parents’ imaginary other – what within them has remained in abeyance and is now projected upon the child.
How can we sustain transference when archaic and hateful impulses take over? The child may be caught up between a demand for fusion and a reaction of horror against the analyst, who can all of a sudden be brutally rejected. In order for the fantasy to become articulated for both the child and the parents, the analyst must be able to tolerate this kind of transference. The limits of treatment then also become the limits of what the he or she is able to hear, of the position he or she can presume to occupy.
In the case of psychotic or autistic children, this violence can trigger depressive or persecutory reactions. The body will be involved even more so than in the work with adults. What is in fact speaking to the analyst when a child does not speak? When dealing with children and their families, some transformations also necessarily occur on the side of the analyst and of his real. “I wanted to skin him alive,” one of my adult patients said about the analyst of her autistic son. And sometimes this is the kind of transference that we are exposed to, with the child’s mother playing a key role in the framework of the treatment, as the person who brings the child to the sessions and who is present in his daily life. This is a different kind of control than what we hear about from our adult patients.
And it is precisely where we find the key specificity of child psychoanalysis: the transference is not the same. It is rawer and crueller, complicated by the presence of the parents and by their own transferences. After all, isn’t it true that after having worked with children for a number of years, many analysts eventually give up? What is it that is so violent in this practice, so directly linked to our own childhood? If the analyst cannot bear the encounter, the direction of the treatment can take on a defensive quality and the different transferences can no longer be symbolized. Lacan emphasizes this when he says that “there is no other resistance to analysis than that of the analyst himself.”[x] In our work with children this is all the more obvious.
The analyst must be able to bear the encounter with the “good part” of what remains unanalysed, as Lacan says. Not only is the analyst not “out of passion’s reach,” but in his seminar on Transference, Lacan adds that “the better he is analyzed, the more it will be possible for him to be frankly in love or frankly in a state of aversion, of repulsion with regard to the most elementary modes of relationships of bodies between one another, with respect to his partner.”[xi] “He is possessed by a desire stronger than the one that is in question, namely to get to the heart of the matter with his patient, to take him in his arms, or to throw him out the window….”[xii]
In child psychoanalysis, which brings with it all kinds of slip-ups and excesses, this stronger desire of the analyst faces a particularly difficult test. Trying to avoid it, we can take refuge in siding with the parents, or in taking a pedagogical or caring approach. Alternatively, we can adopt a dogmatic discourse, which effectively prevents us from hearing what the child is trying to get across. Freud, who only saw little Hans once, left us to fend entirely for ourselves. Various kinds of ready-made recipes are therefore all the more attractive because the “stronger desire” we are dealing with, which lies beyond phallic jouissance, touches upon the desire for death, no doubt all the more present in the archaic violence of analyses with children. This is why it is so tempting for the analyst to hide behind some sort of a technique or method. However, with children we can avoid neither our own desire, nor the risk of having to come up with something new. The analyst himself must find out what the theory does not tell him. No knowledge can foreclose the question of the direction of the treatment; the subversive function of analysis brings it right back into the space created between the analyst and the child.
Winnicott said that truth is neither on the side of the patient, nor the side of the analyst. In this sense we might say that each session is a new squiggle. The reason that the child does not take his drawings away at the end of the session is precisely that they belongs to this in-between space: in terms of both their form and what is said about them, they are a joint production of the unconscious of the child and that of the analyst.
Human beings, Freud said, are neither keen nor particularly able to hear the truth. They do like letting themselves be challenged by madness or put into question. This truth struggling to articulate itself only emerges between the analyst and the child in the intermediary space of transference. As Maud Mannoni puts this, “the first meeting with a psychoanalyst is an encounter with the patient’s own lie.”
“What remains unspoken, left in silence, can produce,” Françoise Dolto said. These “dead things” manifest in the child as symptoms. However, what we are trying to hear is what lies beyond the symptom and has to do with the personal question of the subject who speaks. The analyst lends his ear to what in the subjectivity has been hampered, to where the questions raised concern life, death, madness, sex and the generational order. He or she listens in the place where truth can emerge and allow the speaking subject to gain greater authenticity of being. Hence, the direction of the treatment remains the same, whether we are dealing with adults or children, or even with adults having again become children.
To conclude, let me tell you a story of one of these first meetings. That morning, I had an appointment with Marguerite. When I entered the waiting room, a man and a woman approached me. “We made the appointment for Marguerite, could we talk to you for a moment?” Thinking that these must be the little girl’s parents, I asked them to step into my office. They explained that they were a brother and a sister and they had come to ask me to speak to Marguerite, their eighty-two-year-old mother. They were at their wit’s end. She had just been sent back home from already the third retirement home they had found for her that year. “What are we going to do? She’s terrible,” they said, “we are too busy to keep her with us, the retirement home was a good solution but they keep calling us in because she’s so wicked, she’s really mean to people and the doctors there say that it’s all in her head. Physically she’s doing really well, but she’s always been difficult, even dad said so before he died. Of course we will pay for her sessions, will you agree to see her to sort her out?”
I was listening to the two distraught adults complaining, as I had already heard hundreds of parents complain, after they had sent their difficult children to a boarding school and came to ask the analyst to make them behave. The same words, the same distress, the same symptoms. The siblings told me that Marguerite was in the waiting room and that she had agreed to speak with me. When she came in, she looked slightly worried. She was a fragile-looking old lady, lively and mischievous. She said: “My children can’t stand me anymore. It’s true, I give them a lot of grief. But it serves them right! They shouldn’t have sent me to a home and I’m not going to stop just to make them happy. I’m bored and so I must be a bit naughty.”
I asked her what kind of naughtiness we were talking about and she answered: “Oh, it’s nothing too serious, I ate a box of chocolates my roommate got for Christmas, I had an argument with one of the staff and a bit of fun when I blocked the entrance to the dining hall with my cane. You know, all those old people tripping over, I could have died laughing, but over there they weren’t too amused because of their hip bones.”
Marguerite also told me about her eventful life: her childhood in state care, the war and her participation in the French resistance, her activism as a suffragette in 1946, her painful and passionate love affairs. “It’s true, I’ve never told anyone about my whole life,” she said, “the young ones don’t have the time to listen to me and the old ones are too senile to understand, but I’ve made up my mind now. I didn’t agree to come here, so you make me see some reason, as my children would want it. I’m long past the age of reason! But it’s not to tell you my life story, either. No, I’d like to see some change. I’d like to be able to make friends now and to understand why I have always so enjoyed being wicked.”
[i] Freud, S. (1920). “The Psychogenesis of a Case of Female Homosexuality.” Int. J. Psycho-Anal., 1:127.
[ii] Lacan, J. (2000). “The Subversion of the Subject and the Dialectics of Desire.” Écrits. Transl. by Bruce Fink. New York: Norton, p. 690.
[iii] Lacan, J. (1998). The Seminar, Book XI, The Four Fundamental Concepts of Psychoanalysis. Transl. by Alan Sheridan. New York: Norton, p. 198.
[iv] Lacan, J. (1982) “Deux notes sur lʼEnfant”, Ornicar ? revue du Champ Freudien 37 (1986), p. 13-14. [Transl. KV]
[v] Shakespeare, W. (1972). King Lear. London: Penguin Books. Act I :1, 95-96.
[vi] Lacan, J. (1997). The Seminar, Book VII, The Ethics of Psychoanalysis. Transl. by Dennis Porter. New York: Norton, p. 305.
[vii] Vanier, A. “Nothing will come of nothing.” Psychologie Clinique, forthcoming.
[viii] Lacan, J. (2006). “The Direction of the Treatment and the Principles of its Power. (1958)” Écrits. Transl. by Bruce Fink. New York City: Norton, p. 516.
[ix] Vanier, A. (2007). “Clinical experience with psychotic mothers and their babies.” In Caldwell, L. (Ed.) Winnicott and the Psychoanalytic Tradition: Interpretation and Other Psychoanalytic Issues. London: Karnac Books, p. 72.
[x] Lacan, J. (2006). “The Direction of the Treatment and the Principles of its Power. (1958)” Écrits. Op. cit., p. 497.
[xi] Lacan, J. (1961). Seminar Book VIII : Transference. Transl. by Cormac Gallagher. Lesson of 8 March 1961. Unpublished.