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The Silent Child


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Table of Contents

Introduction -- Introduction -- "The sound of silence" -- "Milo was a normal boy" -- Communicating without words -- Young Children -- The musings of babies: reflective thinking, emotion, and the re-integration of the good object -- A baby's "broken bridge" to the parents -- Evolving patterns of parental containment of a young child communicating through not eating or speaking -- The child who has not yet found words -- Young People -- Extended family explorations using dreams, drawings, and play when the referred child does not speak -- Inpatient care of a child who does not walk, talk, or eat -- Collaborating, containing, and inspiring confidence: physiotherapy with a child who does not talk, walk, or eat -- The silent child in school: teaching a child who does not talk, walk, or eat -- "Compelled to die": psychotherapy with a girl who does not talk, walk, or eat -- Countertransference in the psychoanalysis of a silent adolescent boy -- A journey through family therapy with a non-speaking child -- Opaque silence in groups -- Creative Activities for Non-Speaking Children -- The creative group experience -- Roar and rumpus: engaging non-speaking children through stories and songs

About the Author

Jeanne Magagna was Head of Psychotherapy Services at Great Ormond Street Hospital for Children for twenty-two years. She currently works at Ellern Mede Centre for Eating Disorders in London. She received professional qualifications as a child, adult and family psychotherapist and a doctorate the Tavistock Clinic. Jeanne is the vice-president and joint coordinator of training for the Centro Studi Martha Harris Tavistock model trainings in Florence and Venice. She edited Universals of Psychoanalysis and jointly edited Psychotherapy with Families and Intimate Transformations: Babies with their Families (Karnac Books, 2004). Her special interest is applying the understandings of infant observation to work with children suffering from communication difficulties and anorexia nervosa.


'The silent child who has turned away from life represents a challenge to those dedicated professional teams who seek to bring her (or him) back into the world of relationships, learning, and healthier development. This significant book advocates, at all times, a multidisciplinary approach, recognising that no single profession can work with the children and their families. It also underlines the need to use the imagination, coupled with vitality and a sense of hope in order to reach children and young people who have refused to walk, to talk, or to eat. Teams need to work closely and honestly together, in order first to understand, and then to be of use in bringing these desperate young people back into a more ordinary developmental path. This remarkable book is essential reading for teams and individuals working in eating disorder units, adolescent psychiatric units, and in Child and Adolescent Mental Health teams, who are trying to work with this group of young people. The book is moving testament to the efforts of individual professionals and teams where the struggle to work effectively and collaboratively is severely tested by children who are "pervasive refusers", and where the greatest success is achieved by being watchful of their own emotional responses and impulses, which are used as a central guide to states of mind and perceptions of the young people in their care.'- Trudy Klauber, Dean of Postgraduate Studies, Tavistock and Portman NHS Foundation Trust 'This is a most valuable and welcome book that combines insightful and compassionate understanding of the situations of children who do not speak with a rich variety of practical examples of effective work. It is creatively compiled and edited by Jeanne Magagna, who uses her extensive knowledge and experience of this challenging work, both from her clinical practice and through supervision of a range of professionals. The book is striking in many ways, not least because it is written by clinicians from a number of disciplines who are directly and actively involved in working day to day with children who do not speak and sometimes also do not eat or walk, and with the children's families. These clinician-authors bring a strong, most helpful practice-based perspective, including how they manage the effect of the work on themselves so that they can continue in a positive and therapeutic way. It is essential reading for all engaged in this work.'- Hilary Davies, Family Therapist, formerly from Great Ormond Street Hospital, London, England'Anyone who has worked with children and adolescents knows how difficult it is when they will not speak or play. This invaluable publication addresses this issue with a wonderful clarity, suggesting ways of thinking and working that are imaginative and thought provoking. Magagna and the other authors, through their thoughtful and delicate use of interpretation (or not interpreting), display a technical virtuosity, which will engage and excite all workers in this area. A must-read book!'- Peter Blake, Child and Adolescent Psychotherapist, Director of Training of Institute of Child and Adolescent Psychotherapy, Sydney, Australia'Many words come to mind for The Silent Child - multidisciplinary, international, comprehensive, and passionate. Many dedicated professionals are represented among the authors - psychotherapist, counsellor, psychologist, psychiatrist, teacher, therapeutic care worker, physiotherapist, and artist - some bringing years of clinical experience, others the fresh perspective and energy of the trainee. All contribute to a broad understanding of what it is like to be that child or young person in hospital, in the therapy group, in the family, and in the classroom. Written by a parent and professionals from the United Kingdom, Israel, the United Arab Emirates, and the United States. Securely based in a sensitive attunement to the needs of the infant in the preverbal year, the authors reveal great empathy for children and adolescents who are in retreat, not speaking, not eating, not thinking, and constructive support for their parents and helpers. The various chapters show what can be done to enter the child's state of mind through sitting with the quality of silence, imagining, playing, drawing, writing, and moving creatively with the child. They discuss the therapists' need to listen, share their experiences in work discussion groups, and fi nd the words to connect to and release the child from the prison of silence.'- Jill Savege Scharff MD, Co-founder, International Psychotherapy Institute, Chevy Chase, Maryland; Clinical Professor of Psychiatry, Georgetown University, Washington DCContributors: Jeanne Magagna, Nancy L. Bakalar, Melanie Bladen, Sarah Dixon, Alex Dubinsky, Jo Guiney, Bryan Lask, Natalie Le Clezio, Tara Pepper-Goldsmith, Cynthia Rousso, Ankur Sharma, Michelle Scott, Naomi Simon, David Wood, Charlotte Wormald

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