Bannerman-Haig, Sara (2017) Switching the light on: Can intensive psychoanalytical psychotherapy enable a child diagnosed with developmental delay to become unstuck? Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust/University of East London. Full text available

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Abstract

This research is a qualitative single-case study focusing on a child diagnosed with global developmental delay who was ‘stuck’ in their development. The aim of the research was to investigate whether they could be moved along the developmental trajectory by receiving an intervention of intensive thrice-weekly psychoanalytical psychotherapy treatment. The research question was: can intensive psychoanalytical psychotherapy enable a child diagnosed with developmental delay to become unstuck? The data was collected from the therapist’s observations of sessions as recorded in the detailed write-up of their process notes. Ten sessions were selected for analysis from the first year of treatment, and three sessions from the second year. The main methods employed for data analysis were thematic analysis and matrix methodology. Three themes were identified by this indepth analysis. The first was ‘finding a voice: language development’, the second ‘play and space – peekaboo’, and the third and final theme was ‘the body: feelings, evacuation and physical holding’. The research results demonstrated that development did shift, and that the patient became less stuck and was able to move along their developmental trajectory. More specifically, the findings showed that language developed substantially, from only six words in the first analysed session and one-word sentences to sentences of four, five or more words and interactional conversational language. It was evident that the development of language opened up the patient’s world relationally, and that they were much more able to communicate and get their emotional needs met. The research illustrated increased awareness of others, a growing sense of time and place in which the present, past and future were more understood, and a place in which sequencing and linking began to occur. Thus the patient was able to shift from a flat, two-dimensional world to a livelier, curious, three-dimensional world in which the notion of a third began to exist and the beginnings of Oedipal development emerged. The development enabled the patient to look around more; the world became a bigger and more interesting and accessible place. The patient began to manage other developmental issues such as anxiety about separation and object constancy, and to develop an understanding that the therapist would return after a gap or break. A more reliable object relationship developed. Holding another in mind during absences was achieved, and anxiety was alleviated. There was a clear shift from using non-verbal communication such as acting out and projective identification to being able to use their language acquisition, to stay with a thought and use thinking. The results showed an increased sense of self and a stronger identity. There was evidence of mental growth and of more of an internal psychic structure, as well as of a notion of play and a developed use of symbolism, and developmental milestones were negotiated and worked through. The conclusion reached is that the research has provided evidence of the benefit of long-term intensive psychoanalytical psychotherapy for this patient group that supports other work in the field of global developmental delay.

Item Type:	Thesis (Professional Doctorate)
Additional Information:	Thesis submitted in partial fulfilment of the requirements of the Tavistock and Portman NHS Foundation Trust and the University of East London for the degree of Professional Doctorate in Child Psychoanalytic Psychotherapy
Uncontrolled Keywords:	Professional Doctorate in Child Psychoanalytic Psychotherapy, Qualitative Study, University of East London
Subjects:	Children, Young People and Developmental Pyschology > Child Development Children, Young People and Developmental Pyschology > Child Psychotherapy Research, Tests, Assessments > Psychotherapy Research
Department/People:	Children, Young Adult and Family Services Research
URI:	https://repository.tavistockandportman.ac.uk/id/eprint/1834

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