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Psychoanalytic Treatment - Case Study Example

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The Piggle" is an account of a child psychoanalysis which was written by David Winnicott, in 1977, and has been republished many times. The Piggle in question is a two year old called Gabrielle, part of a family who have recently experienced the birth of a second daughter…
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Psychoanalytic Treatment
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Download file to see previous pages At the time of the beginning of the writing, he was in his late 60's. Despite this, and the rather difficult demands which travelling to see the doctor placed on Piggle and her parents, the patient herself often demanded to see the doctor, and from an early fate, she talked to him (and he to her) as though Winnicott was a familiar part of the family; Winnicott himself described the parent's visits, and Gabrielle's later insistence on seeing him, as "Psychoanalysis on Demand" (Winnicott, 1991 page XV). This treatment system is relies upon the patient's own demands for help, as and when it is required by them. Winnicott also noted the problems with this system, particularly where the patient cannot be accommodated:
The difficulties of being available to the patient, while not simply a puppet to be called on a whim, may present and interesting dilemma, as the system does depend on the whims of the patient, but Winnicott felt that this was a better solution to the needs of the patient than a weekly session "of doubtful value, falling between the two stools and preventing really deep work from being done" (Winnicott, 1991, page 3).
The progress of Winnicott's treatment of Gabrielle, with an apparently happy outcome is a very interesting tale from a psychoanalytical perspective. Firstly, Winnicott did not see Gabrielle in a series of fixed sessions, but according to Gabrielle's own desires, and Winnicott describes their last session as "More like a visit from a friend to a friend" (Winnicott, 1991, page 195). Secondly, the treatment appeared to satisfy the parents, who received back the child they had seemingly lost; and Gabrielle herself seemed very satisfied with the treatment, and the troubles which she had had at the beginning were apparently ended through the analysis. This, of course, was not a course proscribed by the doctor; indeed, three years seems a very much longer period than that taken by Freud in the treatment of his patients; and no-one would suggest that the return-visit by Dora, for example, was the visiting of a friend to a friend.
The gradual development of the girl, from someone who clearly exhibited a number of anxiety responses, including bad dreams and depression, to a schoolgirl who was seen at the age of 5 as very happy, at age 8 as 'very competent at her work" (Winnicott, page 200), and with what were seen as proper feminine ambitions: to be a teacher, to grow plants; however, and her parents consider that

Her inner independence of judgement, and also perhaps a way
Of being in touch with people on many wave-lengths, make
Me wonder whether thesatisfying experience of being
Understood on a deep level may not be continuing.
(Winnicott, page 200).

However, her conceptions about what were actually happening in the analysis may not have been that of an adult patient; Gabrielle clearly did not feel "Under Analysis", instead, she described her visits to the doctor as occurring when he was writing his autobiography, and that "He used to write and I used to play" (Winnicott, page 201). It may be an interesting question to consider whether the child benefited so much from psychoanalysis as the chance to play and talk away from her ...Download file to see next pagesRead More
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