When she was 12 years old, Claire was referred to a Child Guidance Clinic because she was a non-reader and was disruptive in school. Testing by an educational psychologist revealed no specific deficits that might account for her lack of educational progress. However, there had been a great deal of loss and illness in Claire's family. Her father had died some years previously, and her mother, a depressed and fragile woman, struggled to care for Claire and her severely disabled older brother.

Claire's assessment comprised three individual sessions with an educational psychotherapist. In stories, drawings and approaches to tasks, Claire showed she felt responsible for people close to her as if her own angry feelings may have damaged or destroyed them. She drew a picture of her family with the use of a ruler in an attempt at rigid control as if allowing herself free expression might be disastrous. She depicted herself with her hands behind her back a typical feature of children who feel guilty about their hostile impulses. Claire worried about breaking the point of her pencil and messing up her exercise book. When attempting to read a word Claire watched her psychotherapist closely to see how she reacted to mistakes. It seemed likely that in the classroom Claire's behaviour might be similar.

It was clear that the learning situation aroused anxiety in Claire and that manipulating symbols such as letters or words felt risky. She confused destructive fantasies with the healthy aggression needed to learn to 'tackle' a word or 'break it down' into its component parts. Since there was clearly an emotional component to Claire's failure to read, the chosen treatment was educational psychotherapy.

Emotional and cognitive development are intimately connected. Like Claire, many children who are referred to children's mental health agencies are failing to learn at school. Some may have suffered trauma such as abuse, exile or bereavement and simply stopped learning. Others may have had inadequate early experiences of attachment and never really made a start.

In order to learn, children need to feel safe enough to accept the powerlessness of not knowing. For those whose internal or external worlds are dangerous, this may feel too risky. These children cannot make effective use of conventional special needs provision in school which does not address the underlying emotional conflict. They often fail to acquire basic skills. Their self-esteem suffers and this can find expression in disruptive or withdrawn behaviour. Teachers are aware of 'something underneath' that needs to be addressed before these children can begin to learn and it seems that, because of their symbolic nature, reading and writing are often the chosen arena for the expression of emotional conflict.

The technique of educational psychotherapy grew out of the work of the late Irene Caspari, Principal Psychologist in the Department of Children and Parents at the Tavistock Clinic in the 1960s, and her courses on the psychological aspects of learning difficulties. Caspari developed an intervention with children which combined skilful teaching with insights derived from psychoanalysis. At the same time, unknown to Caspari, Anna-Marit Sletten Duve in Norway was exploring a similar approach. Both women independently discovered that if a child could be helped to express and make sense of the 'something underneath' that stopped their learning, then the educational and emotional problems could be disentangled.

^TOP