Cognitive ego psychology and the psychotherapy of learning disorders

Violence today appears to be ubiquitous: it even enters the clinical session, deeply internalized within child victims who were exposed to often unspeakable horror. Violence and its pernicious, horrific effects are observed in the streets, schools, parks, playgrounds, and homes of some inner-city communities. This article introduces the use of Anna Freud's Diagnostic Profile system with an inner-city child who, at the age of four, witnessed his mother fatally stab his father with a kitchen knife and at age eleven was assessed and treated by the author. Clinicians may wonder whether any kind of therapy could ever undo the serious fixations, regressions, developmental arrests, and integrate trauma-shattered ego functions observed in children exposed to visual horror and affective terror. Application of the Profile may offer some direction with these children: a panoramic view of their painful mood, their hypervigilance and distrust, fears, separation and annihilation anxieties, nightmares (with murder imagery), developmental anomalies and arrests is presented with clarity and force. The therapist uses countertransference responses to monitor the affect tolerance in the child and to determine the appropriate dosages of awareness the child can integrate from one moment to the next. The therapist also serves as the child's external stimulus barrier and explores feelings about media-driven portrayals of violence, stereotypes, and inner-city children and youths. The unsurpassed utility of the Profile as a diagnostic system that documents vital economic, dynamic, structural, genetic and adaptive-coping information about the child is discussed in detail as is the Profile's added benefit of possibly guarding against misdiagnosis and charting a course for psychotherapy in difficult city-violence trauma cases.

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Dyslexia and Self-Control

Migden¹

1998

The Psychoanalytic Study of the Child

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Dyslexia and the self-control problems that frequently accompany it are viewed from an ego psychoanalytic perspective. Dyslexia is conceptualized as resulting from an ego deficit in language processing; this deficit is seen as contributing to the ADHD-type symptoms often seen in dyslexic children. Lacking certain crucial components of linguistic competence, the dyslexic child is therefore also lacking a basic tool of impulse control. As a result, this child may exhibit a type of language deficit based impulsivity that has dynamic characteristics which are diagnostically significant. In addition, the ego deficit associated with dyslexia affects and interacts with unfolding drives, especially during the oedipal phase; unlike the more normal child, whose newly ascendant language skills help to inhibit oedipal fantasies and impulses, the dyslexic youngster is prone to a marked intensification of oedipal concerns, especially as these interact with actual experiences of failure. The treatment implications of these issues are discussed.

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Cognitive ego psychology and the psychotherapy of learning disorders

Abstract: The single most common referral problem in middle childhood and adoles-

Cited by 3 publications

References 29 publications

Directions in psychoanalysis☆

Directions in psychoanalysis☆

Post-Traumatic Stress and Coping in an Inner-City Child

Dyslexia and Self-Control

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