In keeping with the 2019 theme of IAPSP’s conference in Vancouver, Engaging Difference and Sameness: Pathways to Empathic Dialogue, the Child and Adolescent Initiative hosted a presentation in which Keren Tamir of Israel presented a case of a child growing up in a multi-cultural family, attempting to navigate her sameness and difference with her parents and their respective ethnicities. Denise Davis of Chicago discussed the case. A brief summary of these two presentations follows:

Keren Tamir, an art therapist, presented eight year old Alin, the daughter of a Russian immigrant mother and an Israeli Sephardic father who entered treatment because of her parents’ concern that she was suicidal (an overture to escape through a window) and because of her difficulty forming peer relationships. Her strict, rigid, anxious mother and depressed, needy father had little empathic grasp of Alin’s internal life. Keren provides an exquisite example of utilizing sensitive, engaged creative play therapy in order to access Alin’s longings for warmth and softness, to understand her yearning for the freedom to be herself and ultimately help her parents tune in empathically to the meaning of behaviors that irritate and anger them. Ultimately, Alin, in a decisive expression of her emerging consolidating self speaks of her history of being carted around from treatment to treatment. Wondering if it is not she that is defective she suggests, “Maybe there is something wrong with Mother.” This ushers in the beginning of conjoint treatment for Alin and her mother in which Alin clearly articulates her needs and because of Keren’s already established and connected relationship with mother, her mother hears her and incorporates more flexible responsiveness into her parenting of Alin. Mother tells Keren that she has taught her a new language, “the language of emotions.” The treatment nears termination just when the father dies, and Keren finds a way of advocating for Alin’s to have the treatment extended. Keren who feels physically more similar to her Sephardic father wishes to look like her European mother, a clear bid for acceptance. Yet, she also implores her mother to recognize her self as part of an Israeli, not a Russian culture. In other words, Alin demands to be recognized for all of the parts of her self and through the treatment with Keren, both Alin and her mother grow. Treatment ends with Keren and Alin creating a toy house together for Keren to take with her. It is a home of warmth and softness inhabited by dolls that are both strong and flexible.

Denise Davis’ discussion illuminated the ways that self psychology informed both the process of the treatment as well as an understanding of the patient. Alin reveals three wishes to Keren in the first session-to be red-haired (like her European mom), to have a powerful fairy, and to be better at playing with others. An expression of her selfobject longings, Alin’s wishes tell us that she hopes to be the girl that would garner a mirroring response from mother, to have the strength and power of an idealized other by her side and to feel the sense of belonging inherent in twinship experiences. Alin’s art belies her loneliness as well as the forward edge of experience-she draws an old tree that no one cuts down and will not die. Alin has preserved the early, unresponded-to self that she refuses to give up on. It is preserved until someone like Keren comes along to tend to it, recognize it and rejuvenate it. And this is just what happens in a treatment in which, like the dream catcher that Keren and Alin create “according to Alin’s own design” is designed by Alin’s emerging self, under Keren’s expert guidance. Finally, Keren engages the dyad of mother and daughter, and in doing so exemplifies Anna Ornstein’s model of family therapy. The therapist, through empathic immersion in the child’s play, understands the child’s symptomatic behavior in order to translate it to the parents to enhance their empathic grasp of their child, setting the wheels of development back in motion.

The Child and Adolescent Initiative looks forward to more opportunities, both on line and at conferences to illustrate the importance of applying a self psychological lens to child and adolescent psychotherapy. The C&A Initiative maintains a list serve throughout the year on which members can post questions or share ideas related to child and adolescent psychotherapy. For questions, please email drdmsw@gmail.com.