The potential of the therapeutic relationship in dealing with learning disabled children

Abstract

This study is an exploratory investigation into the intrapsychic experiences of three learning disabled children whom have been in psychoanalytic therapy. The research used open-ended interviews to focus on the child, the therapist and the parent's experience of the therapeutic relationship. As there has been limited research in this area, the research searched for tentative, common experiences. A qualitative methodology was used as a means to elicit the essential meanings held by the participants, without initially presuming what they might be. The aim of the research was description and conceptualisation, rather than hypothesis testing. The methodology that was applied was an interpretative method that followed hermeneutic phenomenology principles. The results of this study add to the growing literature on the importance of the relationship factors in the child, mother and the therapist experience of the psychotherapy process. Results indicate a positive working relationship with the mother. This relationship was seen to work in a reciprocal manner and enhanced the effectiveness of the therapy. The working alliance with the mother appeared to be an intervention in its own right. The research indicated that the learning disabled children's relationship with their mothers impacted on their emotional well being. The lack of containment and lack of confidence from the mothers resulted in an insecure relationship with their child. Consequently, the mothers needed guidance, assistance and reassurance. The research confirms that learning disabled children are not emotionally limited, however it often takes time to explore their emotional experiences. In examining the participant's experience, it is of interest to note that family dynamics and family relationships were consistently the most important theme in the therapy. Family circumstances appeared to shape the child's and the mother's concerns. Themes of guilt, pity and contempt were evident in both the mother's and the therapist experience of the therapy process in relation to the child. The findings are largely confirmatory of other research studies that have outlined the impact of a learning disability on self-esteem. The use of the enmeshed and preoccupied defence styles emerged as a way of coping for the learning disabled child. Finally, the therapy was found to assist the learning disabled child with making sense of their environments and emotional experiences. The therapy by providing a containing and holding space for the mother and child, not only improved relationships but also enabled the child to develop a stronger sense of self. Possible directions for future research of the psychoanalytical therapeutic work with learning disabled children are discussed.