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.

New York, 9 May 2020

The Child, Language, and the Psychoanalyst

Even though psychoanalysis with children is psychoanalysis, as both Freud and Mannoni pointed out, we see the specificities of this work and the handling of the treatment on a daily basis. During the initial consultation the child most often articulates no demand and says nothing. And since, just like in adult psychoanalysis, the demand is motivated by the symptom, most of the time it is his parents who speak about what has disrupted the family or social order, leading them to the consulting room. The psychoanalyst listens to the parents’ complaint — but it is only by speaking to the child himself that she can hear the child differently and offer him a reading that can reveal the question asked, on the one hand, by the parents and, on the other hand, the child. We must speak, but not just in any way and not just from any odd place. We know that even before birth, a whole network of signifiers linked to the family constellation have already assigned the child a particular place, one he can most often simply accept. His symptom, as Lacan puts it, is thus only a “forced choice”. Yet the child’s own desire cannot be reduced to the symptom. In order for him to grow up and move forward, we will have to let him escape the Other’s desire to some degree, to give up on trying to complete the Other and instead access a desire of his own. If the analyst’s desire would lead her to assume the same place, the place where the demand would be, as it is the case for the parents, to make the symptom simply go away, she would immediately be put in the parental position. This would obviously be of no use to the child. The analyst’s speech instead tries to shift the little patient away from his place of the object, of the child of jouissance, in order to enable him to become a subject. Ultimately, what unites psychoanalysis with children and psychoanalysis with adult is, precisely, the psychoanalytic ethics.   

The analyst working with a child is most often quickly positioned by the little patient as the subject supposed to know, a big non-barred “A”. But we have to offer another type of encounter in order to help the child access castration. It is important that when working with a child, we try to remain, as much as possible, free from our one fantasy or “jouissance”. This is a difficult position to hold, which makes psychoanalysis with children such a complicated task. Françoise Dolto often said that in this case it was so imperative for the analyst to maintain “a rightful place” that it made psychoanalysis with children even more difficult.

As Alain Vanier has emphasised, the specificity of child psychoanalysis is to allow our little patient to move from the real towards the imaginary and the symbolic, while adults must journey in the opposite direction, going from the symbolic and the imaginary towards the real.

Regarding the neuroses: In his Note on the Child, written for Jenny Aubry, Lacan argues: “The child’s symptom is located in the position of a response to what is symptomatic in the family structure. In this context, a symptom, which is the fundamental fact of analytic experience, can be defined as representing the truth. A symptom may represent the truth of the family couple. This is the most complex case, but it is also the one that is most open to our intervention.”[i]

Taking some distance from the Other’s desire means that the child no longer “is” a symptom but “has” a symptom. This will allow him to construct, in the course of the sessions and by means of the different signifiers he brings through playing or drawing (just like adults bring their dreams), a (hi)story that is not already predetermined and a myth that can be his own. To make this movement possible, the analyst of course offers to listen, but also to speak and put forward a deciphering of what the child is bringing, in his drawings or play material. I should point out that this deciphering is most often not an interpretation but rather an intervention in the transference.

The analyst, whom the little patient sees as an odd kind of grown-up, does not stay silent or outside the play or drawing – just like in the Squiggle Game, he or she participates. It was in this sense that Winnicott described the analytical sessions with children as a space of creativity and invention, unique for each child and each encounter. When we speak about playing, we do not mean a game. Winnicott also reminds us that a game, which follows preestablished rules, does not rely on imagination and creativity, and therefore does not have the same therapeutic function for children. However, if playing is in itself therapeutic, why not just leave the child playing alone in his room? What does the analyst’s presence contribute? Sometimes we hear analysts who say that, for example, they might play board games with a child, so that he or she accepts the idea of losing and gives up a certain omnipotence. But in that case, are we not in the domain of pedagogy – in any case not the field of analysis, which is the field of speech? Playing in the analyst’s presence enables the emergence of signifiers we can identify and later, throughout the following sessions, make visible to the child from what we tell him.


To illustrate this, I would like to return to my work with Jeremy, but from a different perspective. I have already spoken about him in my first book[iii], but this time I will try to use the material to highlight, in a different way, the place of language, the analyst’s interventions and the question of the direction of the treatment, while giving you some more details.

Jeremy was a little boy of seven. When he first came to see me, I could already hear him shouting in the lobby of the building, crying and screaming outside the door, and finally, once he entered my waiting room, throwing himself on the floor in complete desperation. I approached him and tried to talk to him. I told him who I was, explained he had an appointment with me, that I didn’t want to keep him from being angry, but that it would be better to go and speak in my office. He agreed to come, although he still went on screaming. On entering my consulting room, his mother explained that he had been screaming like that since the morning, when he had seen a fire-eater on TV. She said he had always been terribly afraid of fire, of storms and fireworks. I closed the door and tried to calm Jeremy down. I said: “That man can’t come in here. He won’t be spitting fire in the office. We can’t see him. We can’t see the light.” I drew the curtains, so as to screen the July sun previously filling the room. The semi-darkness seemed to reassure Jeremy. He relaxed slightly. He continued sobbing, but his eyes dried and he was no longer screaming. I then tried to tell him that due to the circumstances of our meeting, I didn’t know anything about his life, I had had no time to speak with his mom or try to understand anything besides his panic. He looked at me, surprised.

“What a funny way for us to meet, Jeremy!”

The boy then smiled and went over to my desk, grabbing some markers and paper.

“Wait,” he told me, “I’m going to tell you about the fire.”

He then drew a house and a man. He said:

“The man got lost. He couldn’t find his house, because he had an accident. His car went into the water. There is a clown in the water. He was laughing. He has a red nose. Bang! – he got hit. He got lost in the pond. He’s dead, he’s not well. He has ice [glace][iv] on top of him. There were too many accidents. They had accidents before him and now he can’t escape anymore. It’s all screwed up. The car went splash from the accident, the light. I’ll also draw the fire and the smoke.”

Jeremy looked up to me and asked me, again starting to cry:

“Take off your glasses, take them off!”

I took off my glasses.

“So,” Jeremy said. “I’ve told you about the clown. Now I’m going to go, that’s all.”

It was only after quite a few more sessions that I realised that, in fact, everything had already been there in the first session. However, on that day, all I was able to see apart from Jeremy’s fear was the fire. I told him so and asked if he would like me to see his mother.

“No, no, not mommy, I don’t want her to see.” He again started panicking. “I don’t want her to see it. No!”

It would have been easier to bring his mother in, but it seemed to me that doing so might compromise my work with Jeremy.

I asked him: “Would you like to come again, so that together we can try to understand what happened to that man and the clown?”

“Yes,” Jeremy said, “I’ll come again.”

Leaving the office, he passed in front of the mirror in the corridor. He stopped, transfixed.

“Look at my clown, look at my clown!”

He was jumping up and down, laughing and crying, looking extremely anxious. He waved his hands before his eyes and shrieked:

“Look at him! Look at him!”

Mother tried to intervene, but he told her:

“No, not you, not you!”

He threw himself on the floor, kicking his mother and started screaming again.

“No, please, don’t start all over again,” his mother pleaded.

He got up, opened the front door and pushed his mother violently. Through the racket, she shouted:

“But did you give him another appointment?”

“Yes, we’ve made another appointment.”

Jeremy left, taking his mother and his clown with him. The door closed behind them and I was left there disconcerted, feeling like I had no idea what had just happened.

When Jeremy returned for the second session, he came calmly all the way to the door. His mother was visibly relieved that they had made it into the waiting room without any trouble. He again told me:

“Take off your glasses.”

He grabbed the markers and paper and drew a man. He told me:

“The man got lost in the ice/glass. Like the glass in your glasses. The man can’t get out anymore. Look at my feet [my desk is made of glass and Jeremy could see his feet underneath]. Look, they are also imprisoned in the ice. The man is lost, he has no house, he doesn’t speak. The clown threw him into the ice. Huge eyes are looking at him.”

He then glanced at the window and began to sob.

“Close the curtains. They mustn’t look.”

I drew the curtains and asked him who was not supposed to look. He whispered to me, afraid he might be overheard:

“The spider’s eyes, they’re as big as mountains. She comes at night, she’s poisoned, she’s as big as a man.

He continued:

“You see, that’s the clown who threw the man in the ice, in order to take revenge.”

I asked him who the man was.

“It’s the other one,” he answered.

He continued:

“The clown is in the water, in the words-ice, he can’t move, he can’t speak, he can’t get out.”

I asked him:

“The words-ice, is it like a prison? A prison of words that can’t be spoken?”

“Yes, he should live in a country called Speechland, but here he can’t speak, he’s screwed. That’s all. I’ll come again.”

“And what about your mom, she’s in the waiting room. Last time you didn’t want me to speak to her.”

He said: “I don’t want her to come in.”

I returned to my desk and put the drawing facedown. I told Jeremy that maybe he did not want her to see what happens in the office or hear what we were saying. He nodded. I suggested that we would go see mom in the waiting room. Very pleased, Jeremy grabbed my hand and dragged me to the door, putting my hand on the doorknob. When we arrived in the waiting room, he immersed himself in a book and made himself comfortable. He only lifted his head once during our conversation. This is what the mother told me.

Jeremy was now in Second Grade, but according to his teachers, even though he had no problems learning, he disrupted his class by his chaotic and sometimes aggressive behaviour. He was constantly playing the clown, sometimes laughing for no reason and making all kinds of gestures, waving his arms and legs like a broken puppet. He made the children laugh and they were very fond of him, but he often refused to join in the activities, including drawing. The principal was not sure whether she would be able to keep him in the school.

He had a terrible fear of the light and the fire. Aged two, he had been diagnosed with autism, but then made great progress and began to speak very well and very rapidly. The mother was told that the diagnosis must have been a mistake. Yet he suffered from different manias and moments of panic; he never answered questions directly and sometimes reacted to people and things quite chaotically, with no obvious reason. “He constantly seems scared”, his mother told me, “and he makes us scared. We don’t dare take our eyes off him. We’re constantly trying to calm him down, reassure him, or sometimes simply convince him to please stop crying – all in vain.”

Jeremy’s mother also told me that she had been in analysis for two years. She said that now she understood the difficult situation her son found himself in at birth. The year before, she had prematurely given birth to another little boy, also named Jeremy. The child only lived for a few days. The second Jeremy had been conceived, the mother said, on the same day that the first Jeremy should have been born.

“For me,” she said, “this whole story was an eighteen-month-long pregnancy.” At the time, she was very sad and depressed, constantly thinking about and missing her dead child. The second Jeremy was born at term and was a healthy baby. He was quiet, without any problems, apart from sometimes not wanting to finish his bottle. “He always had to be asked,” his mother said, “but I only had him, I only had eyes for him.”

Jeremy was one when his mother again became pregnant. She was happy. She remembers that during this third pregnancy she was finally beginning to enjoy life again and felt less depressed. She began to forget about  the first Jeremy. She was no longer afraid. She thought that another child would be good for her. In her third month of pregnancy, she was alone at home with Jeremy, when she suffered a miscarriage. She started bleeding. “I was losing so much blood I thought I was going to die.” In panic, she called the emergency number and was taken straight to the hospital. She took Jeremy with her; he witnessed the whole drama. He couldn’t have been left alone at home. It was night-time; Jeremy was scared and crying. There was also the noise of the sirens and the flashing lights of the ambulance car. The mother herself was too panicked to try and calm him down. In her mind, this was when Jeremy started to withdraw and suffer from his dreadful fits of anger. During the same period, Jeremy’s father asked for a divorce and left Paris. Since then, mother had been living alone with her son. She now wanted him to also do some analytic work to help him to live better. Hearing his mother cry, Jeremy lifted his head from his book and snuggled up against her.

“You mustn’t cry, mommy, the man was thrown into the ice.”

“See,” his mother said to me, “he’s always talking nonsense.”

Jeremy then got up, ran to the corridor and pressed himself against the mirror.

“Look at the clown, look at the clown!”

He looked desperate. At that very moment, I suddenly understood how unbearably shipwrecked he was. He was trying to drown himself in the mirror. So I went and stood between the mirror and him, between himself and the image of the mad person. With my back to the mirror and facing him, I prevented him from seeing the clown in the glass. Astonished, he stopped gesturing and asked me:

“Where’s the clown?”

He looked very intrigued. I answered:

“The little boy I can see in front of me is Jeremy. Jeremy is seven years old and he does not talk any nonsense.” He calmed down and left with his mother, with a serious expression, lost in thought.

From this day on and during all of our following sessions, Jeremy never brought in anything so violent anymore. He would come calmly, agreed with me speaking to his mother regularly, on the condition of always doing so in the waiting room. His father only came twice, but both times were very important for Jeremy.

In these first two sessions, we see Jeremy set the scene and introduce the characters. In the foreground of the drawing, the clown imprisoned in the ice, in the mirror, preventing Jeremy from recognizing himself when looking in the mirror, preventing him from being named. In this mirror, he has no access to the symbolic, only to the imaginary. No doubt his mother had seemed too “bewildering” to him and looking at her he could not see the Other looking back at him. She did not allow for nomination to take place. Most likely, when looking at him she could only see the dead child whose given name he shared? Therefore, in the eyes of his mother he could then also only see the Jeremy of his nightmares, imprisoned in a glass cage, his nose bleeding from his constant vain attempts to free himself. Through this metaphoric sliding, Jeremy’s brother, or rather his double, had been transformed into a broken clown. Had Jeremy been able to look at his mother and she at him, an alienation could have been produced, which would have simultaneously allowed him to find himself – but failing that, he could not construct himself fully, and remained prey to ghosts and the unnameable.

          In a later session, Jeremy explained to me that the clown was dangerous, prone to attack, yet was also the victim of prior accidents. This same clown took revenge by dragging the boy figure into the mirror prison, where death imposed silence. It was no doubt because I had thwarted the clown, by cutting Jeremy off from his hypnotising image, that the boy was finally able to separate the first Jeremy from the second. I named him, I told him that his words had a meaning. He calmed down, as if he had to be protected from his own gaze, but also from the gaze of the deadly spider described to me in the first session. This contemplative jouissance — an absolute, devouring and possessive gaze — put the child in grave danger. Jeremy staged a terrifying spectacle, replaying it again and again. He occupied an empty space: the only choice open to him was trying to fill in the lack of his depressive mother, who herself has no words to exchange with him, her only focus being to care for his needs. “Jeremy has never lacked for anything. I took very good care of him when he was a baby”, she told me. “The satisfaction of need appears […] only as a lure in which the demand for love is crushed,” Lacan writes.[v]

In the following sessions, the man, the main character, was always imprisoned in the ice alongside the clown: both in Jeremy’s drawings and in the stories he was telling me, using some of the figures he found in the toy basket. I kept commenting on what he was saying and doing, trying to put words to everything he might be feeling.

He told me: “There was a very big storm with fire and light. The lady saved the little boy from being crushed. But it is very cold inside the ice.”

I then asked him:

“What’s inside the ice?”

“But you know,” Jeremy said, “that’s where children are buried.”

During this entire first period, the themes remained always the same, with death as the guiding thread.

The boy-man and the clown were imprisoned in the water glass-ice. The clown’s nose was bleeding as he kept banging it desperately against the glass-ice, trying to get out. For Jeremy, the clown’s red nose was simply the mark of a wound. He explained: “He hit his nose on the glass, he’s bleeding, the red is scary.” There were always cars, accidents and houses abandoned after the accidents. These associations and his anxiety made me think of the blood of the miscarriage Jeremy had witnessed, the sirens of the ambulance and the flashing red light on top of it. And so I returned to the story his mother had told me in his presence.

I asked Jeremy: “Do you remember when your mom told me that you were in the ambulance, with all the red lights and a lot of noise? She was bleeding a lot and you were both scared.”

When Jeremy first came with his father, the latter told me that he was not seeing his son very often, because he felt so guilty for having left his mother, who was very unwell after the death of their first child, the other Jeremy. Father said he still often thought of this child: had he not died, perhaps him and his wife wouldn’t have separated, he said. After this session, father began to see Jeremy more often and Jeremy became calmer. Father wrote and called, and even started taking Jeremy for weekends more regularly. Following this first meeting with his father, Jeremy also began to make real progress at school. His teacher now told the parents: “I’ve always known he was very intelligent. It was just his behaviour in class that was a problem. The instructions seemed to make no sense to him, and he couldn’t control himself. Now he seems to enjoy doing the exercises together with the other children.”

After my meeting with his father, Jeremy, who still continued to talk about the house and the man, began drawing a second house. “The second house,” he told me, “is very fragile. It will be destroyed.” And the man in these drawings was propping up the second house with his arms, as if it needed his support. The man propping up the house was shaped like a cross. While drawing, Jeremy told me: “Look, his body is like a cross”. A body as a cross, sacrificed to the Other’s jouissance? Perhaps without Jeremy’s support, his mother would really have been dead? I then suggested to Jeremy that the little boy could spend his time on something else than this house. After all, he could also be playing, he could find out that he had friends. He could also go to one house, and then another, and see if this house would manage to fix itself on its own.

Some months later, at the beginning of a session, Jeremy’s mother told me that he was not doing very well. He had been sleeping badly and was very worried, because his nanny’s husband, whom he was very fond of, had suddenly died.

Jeremy told me:

“The doctor treated his nose, but I think it turned red because he went into the ice. Or not — nanny told me he’d gone to heaven.”

He asked me:

“But why can’t we go to heaven? Daddies and mommies, they bury their boy in the ice. Do you know when I will die? When is Jeremy going to die?”

“It’s true,” I told him, “sometimes it’s better for people to be really dead. To die at last, so that others can go on living their lives.”

I talked to him about his older brother, who unlike Jeremy had not been strong enough to live. Jeremy drew a clown and commented:

“It’s a clown who had caught all the world’s ills. The man does not catch them. But he catches a lot of problems and he’s constantly afraid to fall into the ice.”

After this session, Jeremy would no longer stop in front of the mirror in the corridor. Every time we said goodbye, he would simply say: “Well, the clown is there.” However, he no longer needed to play the clown, or even go look at him. This time, he had truly been separated from it. When his nanny’s husband died, Jeremy, who was very upset, attended the funeral. At the cemetery, he asked to see the tomb of his dead brother, where his parents had always refused to take him, out of fear of traumatising him.

 For Jeremy, the nanny’s husband was quite dead and buried. For the first time he understood that the dead were not going to return. His “uncle”, as he called him, was resting in peace. He was no longer imprisoned in the mirror. Before the funeral, Jeremy had not been quite sure, but now he finally accepted it.

In the treatment of this child, each step forward seems to have been connected not so much to interpretations, which, I think, would have been of little use. What mattered was the staging of a scene of his inner theatre and his extraordinary fantasy life, which I would comment on each time. The same play scene, repeated during each session, allowed his history to finally be inscribed and become meaningful. Jeremy needed many sessions before the themes of the clown and the man became exhausted, before the meaning of the glass-ice that had to be broken in order to escape the world of the dead became clear, before the glass-ice, water and the mirror finally stopped their metonymical sliding, in which he had been lost. In the course of the analysis, he staged his own history. Session after session, he used the transference to find a point of anchoring, enabling him to write his own theory, his own myth.

In the last part of his analysis, Jeremy started making the man from the picture and other little figures from modelling clay. On leaving the session, he headed to the mirror to adjust his bowtie. He could finally see himself, find himself and assume his own image. Lacan writes: “It suffices to understand the mirror stage in this context as an identification, in the full sense analysis gives to the term: namely, the transformation that takes place in the subject when he assumes an image”[vi]

The man was now getting ready to travel to a faraway land. He had built a fantastic ship, apparently helped by a siren with magical powers. It was going to be a long and terribly dangerous voyage, an odyssey. The preparations were often interrupted by formidable enemies who had to be defeated. The countries that he was to travel through, once his ship would be at sea, were full of perils and traps, but Jeremy, the hero of the story, would always overcome thanks to his courage and tenacity. The man would continue his journey – he could no longer go back. Jeremy said:

“Maybe it’s a problem that he can’t go back”, he asked me. “An old woman told a child: ‘I don’t want to see you here anymore. You’re grown up and it’s time to leave.’ And so maybe now the boy wants to go to the men’s village, to the country called Speechland?”

I told him that yes, perhaps it would be good if he could find this men’s village. He said, “But it’s such a long and difficult journey.”

Final act, final scene. Jeremy was worried.

“That’s it, over there. I can see the country. There’s a terrible light and storm. Over there is the village of men. And I can also see, look, I’ll draw him for you, a daddy who says: ‘Come on, it’s fun in the village of men’.”

At the curtain fell, Jeremy turned to me and said, with a smirk:

“Do you remember when I was little and was afraid of the light?” Those were his last words during our sessions.

The field of psychoanalysis is the field of speech: when a child is playing or drawing in a session, of course we do not leave him alone, as if he was playing in his own room or drawing at his desk at home. We put words to all that he is doing and ask him, in the transference, for associations with each drawing, the way an adult would work with a dream. We comment on each play scene, for example, we wonder about the role he would like to play in the story he invents while playing or in the picture he draws for us at a particular moment. We try to think and imagine, and often ask about how he might be feeling, in order to reformulate it using different words, so that the child can hear something else in it, something that will help him construct himself. Sometimes we suggest other ways in which a story or a drawing could develop. For example, we might ask: “And if there was something else the character could do or say, would that be less scary? What would he think about that?” The child is not alone in the sessions and his playing, pictures and words are addressed to the analyst. In this sense, the drawing becomes a co-creation, a bit like the squiggle. Each intervention and even each session are always caught up in the transference and in a sense are always squiggles.

Jeremy made great progress in analysis. His case shows us that the child-subject is not only the desire of the Other, but that he can also create his own reference points. Depending on what the analyst he encounters says or doesn’t say, the child will be able to rethink his own choice. In the child’s play we can of course find traces of the family discourses, but we can also find what the child himself has been able to do with them, by offering him to take a step away from this discourse. However, this side-stepping is something that we must propose ourselves, rather than staying silent. Regarding the clown, I would for example sometimes ask Jeremy different questions, encouraging him to find other solutions to his problem. “And what would happen if the clown decided he didn’t want to leave the ice? Would there be less red? Would we be less afraid of him?” In the following sessions, Jeremy saw himself when observing himself in the mirror. My intervention was an act — placing myself in front of him to prevent him from seeing the mirror — but I also intervened through speech, by encouraging him to imagine a different scenario.

As Melanie Klein used to say, transference with children is possible and is different from a simple repetition. Even though the transference is caught up in the period of the child’s infantile neurosis, it is not purely a repetition. It is an act: through drawing, telling a story, through speaking. We intervene at the very moment his infantile neurosis is being constructed. And as long as the analyst speaks and speaks from the right place — i.e., not the one of the knowing adult who represents the superegoic or educational order, for example — if the analyst is in the right position, the child does not simply speak to a “subject supposed” to know from whom he wants something, but he will take the risk of producing a knowledge hitherto impossible. At this moment in childhood, this process is not a reproduction or even the lifting of repression, but the child’s personal production that enables him to elaborate the fantasy, so that infantile neurosis resumes its course, often once a myth has been constructed. Hence the importance of the analyst speaking to the child from a different place than that of an adult who necessarily must know. By supporting the child’s attempts to identify the signifiers of his own history, we can help him on his journey of construction.

Today, I simply wanted to offer you a testimony of this very specific clinical work. Of course, it evokes the whole question of the direction of the treatment and the analyst’s desire in working with children, but we will no doubt have other opportunities to discuss these together in the future.

[i] Lacan, J. (2018). Notes on the Child. Translated by Russell Grigg. The Lacanian Review, 4: 13-14.


[iii] Mathelin, C. (1999). The Broken Piano: Lacanian Psychotherapy with Children. New York, NY: Other Press.

[iv] In listening to this case, please keep in mind that the French word glace can mean ‘ice’, ‘glass’ or ‘mirror’.

[v] Lacan, J. (2006). The Direction of the Treatment and the Principles of its Power (1958) in Écrits, translated by Bruce Fink. New York, NY: Norton, p. 524/627.

[vi] Lacan, J. (2006). The Mirror Stage as Formative of the I Function. In Écrits, op. cit., p. 76/84.