| List of illustrations | p. xiii |
| Acknowledgements | p. xv |
| Introduction | p. 1 |
| The plan of the book | p. 4 |
| A particular element in descriptive work: attention to moments of gladness and curiosity | p. 5 |
| Brief note on the table and figures | p. 6 |
| Levels of therapeutic work and levels of pathology: the work of calibration | p. 7 |
| Introduction | p. 7 |
| The continuum of technique from the top level down | p. 11 |
| Elaboration of the state of mind of the patient relevant for work at the three levels | p. 14 |
| Conclusion | p. 24 |
| Explanatory level conditions | p. 27 |
| Some emotional conditions for the development of two-tracked thinking: the sense of agency and the sense of abundance | p. 29 |
| Introduction | p. 29 |
| The development of two-tracked thinking and observation of Alice | p. 32 |
| Observation of Paul | p. 35 |
| Observation of Angela | p. 40 |
| Summary and clinical implications | p. 41 |
| Obstructions to and developments toward sequential thinking: some connections between phantasy, thinking and walking | p. 43 |
| Introduction | p. 43 |
| A word about definition: phantasies and thoughts or phantasying/ thinking? | p. 45 |
| A correspondence between motility and thinking, and the need to include the temporal along with the spatial dimension in work with three children | p. 47 |
| Technical implications | p. 51 |
| Discussion and conclusion: the development of walking and of language | p. 52 |
| Making links and making time: steps toward the de-compression of thoughts and the establishment of links between thoughts | p. 55 |
| Introduction | p. 55 |
| The temporal shaping of reality: a modulating presence | p. 56 |
| Bion on the relationships between thoughts | p. 57 |
| Daniel and the conjunctive link | p. 59 |
| The 'and' link in play: an ordinal link | p. 60 |
| Discussion: play and syntax | p. 61 |
| Conclusion | p. 63 |
| Descriptive level conditions | p. 65 |
| The equal role of delight and frustration in the development of a sense of reality | p. 67 |
| Introduction | p. 67 |
| Psychoanalytic theories of frustration | p. 68 |
| When frustration is too great: the problem of 'tenible surprises' | p. 71 |
| Can some apparent 'defences' against frustration be seen rather as attempts to overcome or regulate frustration and disturbance? | p. 72 |
| Pleasure, safety and delight as necessary to emotional health | p. 74 |
| Pleasurable states as active, accompanied by thought and provoking of thought | p. 75 |
| Conclusion | p. 77 |
| Moral imperatives and rectifications in work with tormented and despairing children: wishes or needs? | p. 78 |
| Introduction | p. 78 |
| Developments in psychoanalytic theory | p. 79 |
| Technical implications of developments in psychoanalytic theory | p. 79 |
| The grammar of projective identification: technique with wishes versus needs | p. 80 |
| The patient and my unmasking interpretations | p. 82 |
| Discussion: four considerations | p. 86 |
| Conclusion | p. 89 |
| Motiveless malignity: problems in the psychotherapy of patients with psychopathic features | p. 90 |
| Introduction | p. 90 |
| A child with psychopathic features | p. 91 |
| Some clinical differentiations between neurotic, borderline and psychopathic states of mind | p. 93 |
| Technical problems with patients with psychopathic features | p. 95 |
| A second example of a child with psychopathic features: Billy | p. 97 |
| Discussion and conclusion: four technical issues | p. 100 |
| Issues of narcissism, self-worth and the relation to the stupid object: devalued or unvalued? | p. 102 |
| Introduction | p. 102 |
| Definition of narcissism | p. 103 |
| Some background history of the move to an internal two-person psychology regarding narcissism | p. 104 |
| The question of narcissistic psychopathology in children | p. 105 |
| Three sub-types of narcissism | p. 106 |
| The developmental trajectory in narcissism and some further technical issues | p. 110 |
| Three sub-types of apparent narcissism and the question of technique | p. 111 |
| Conclusion: consequences of recovery and further technical issues | p. 115 |
| Types of sexual transference and countertransference in work with children and adolescents | p. 116 |
| Introduction | p. 116 |
| A brief history of psychoanalytic ideas on childhood sexuality | p. 116 |
| The question of the normal erotic transference and counter-transference | p. 120 |
| An example of perverse sexuality in a child | p. 122 |
| Disordered sexuality | p. 124 |
| The normal sexual self and questions of technique: that is, use of our countertransference responses to these | p. 125 |
| Childhood sexuality: the question of the parental object's role | p. 127 |
| A clinical example of delayed Oedipal development | p. 128 |
| Conclusion | p. 129 |
| Under-integrations and integrations at the paranoid-schizoid level | p. 130 |
| Introduction: Bick's controversial views on unintegration | p. 130 |
| Can all apparent unintegrations be seen as the result of disintegrating processes acting upon prior integrations? | p. 131 |
| Do unintegrated states exist at all? The question of the degree of cohesiveness of the early ego | p. 132 |
| Is unintegration the primary and earliest phase of development? Do Bick's ideas challenge the views of Klein and the developmentalists? | p. 134 |
| Is integration a necessary precondition for object-relatedness? | p. 134 |
| What else remains of value in the Bick argument? Do some needs take priority over others? | p. 135 |
| The question of integration at the paranoid-schizoid level | p. 136 |
| Modes of early pre-depressive and pre-Oedipal integrations and integrators: technical implications | p. 137 |
| Conclusion | p. 143 |
| Intensified vitalizing level | p. 145 |
| Play and the imagination: where pathological play may demand a more intensified response from the therapist | p. 147 |
| Introduction | p. 147 |
| The issue of the importance of play and the imagination | p. 148 |
| Psychoanalytic theories of phantasy and play | p. 150 |
| The significance of play and the imagination for introjection and thinking | p. 151 |
| Infant studies: the importance of playing 'with' | p. 152 |
| The continuum of levels of symbol formation | p. 153 |
| A clinical example of a patient at a fourth position below or beyond a symbolic equation: technical implications for working with meaningless play | p. 155 |
| A clinical example of apparently transitional play which was in fact at times closer to a symbolic equation, at other times more addictive and frenzied | p. 156 |
| The problem of perverse play: a fifth position on the symbolism | |
| continuum | p. 158 |
| Discussion: can we still be psychoanalytically minded and play with the child, or even innovate and rouse the desire to play? | p. 160 |
| Conclusion | p. 162 |
| Finding the wavelength: tools in communication with children with autism | p. 163 |
| Introduction | p. 163 |
| Normal infant development and proto-language | p. 165 |
| Language and triadic skills involving visual regard | p. 165 |
| Therapeutic implications of impairments in communication: getting on the right developmental wavelength | p. 167 |
| Joseph | p. 168 |
| Discussion and conclusion | p. 172 |
| Further reflections: countertransference, the paranoid and schizoid positions, and some speculations on parallels with neuroscience | p. 174 |
| Introduction: the level of mental disturbance and mental illness in children and adolescents | p. 174 |
| Re-examining the paranoid-schizoid position | p. 174 |
| The danger of 'manualizing' psychotherapy | p. 177 |
| Countertransference | p. 178 |
| Further examples of intensified work | p. 178 |
| Some possible parallels with neuroscience | p. 181 |
| A technical parallel | p. 183 |
| The transference | p. 184 |
| The setting | p. 185 |
| Appendix | p. 187 |
| Bibliography | p. 190 |
| Index | p. 207 |
| Table of Contents provided by Ingram. All Rights Reserved. |
