DISEASE
Child Work in the Time of Pandemic On the seashore of endless worlds, we play —Rabindranath Tagore A recent conversation about my clinical work with children during this pandemic reminded me that most psychoanalysts are frightened to work with children. When a child comes to us in our office, we take the risk of following him to a place before words, to being taken far away from any kind of knowing, and this can be frightening. Children, once they learn how to talk, know in some sense, in the way only analysts also know, that nobody knows anything. Both the child and the analyst are displaced in relation to knowledge; for the analyst, of course, it is only at the moment of listening that the rigor of knowledge is suspended, so she can proceed in the act of creating something new. The suspension of knowledge that occurs in childhood is very precious, but it’s not naive. Children are experts on the truths of uncertainty. Psychoanalysts, on the other hand, are generally less comfortable with
Olga POZNANSKY
trusting the unknown and have invented for themselves all sorts of frameworks to deal with their discomfort. Today, we are working under special conditions in the time of isolation and confinement when video and phone have replaced physical presence. It is a difficult and sometimes impossible way to work, especially with children. We have to improvise as we go into the space that is new for us and try to make sense of how working in this way affects our patients. The current moment creates a crisis in our clinical “know-how” that offers us an opportunity to “forget” about how to do things and to invent something new. It was, of course, Freud (1909/1955) who said that children are first philosophers who have the freedom to think, which is inevitably lost in the encounter with the inadequacy and impotence that are the side effects of growing up. Children have access to the “know-how” that is not identified with previous knowledge and experience. And through their fresh look to-
Laurel Nakadate, Providence, RI 25
DIVISION | R E V I E W
SUMMER 2020
ward the world, they have much to teach us about how to situate ourselves clinically in this moment that does not yet have a psychoanalytic past. The first month following the imposed restrictions threw my child practice into disarray. I was caught off guard by the breakdown of the usual analytic frame and the loss of space of the office, disoriented in my role, and not knowing what to do. I could no longer play and draw with my child patients as we did in the office. Questions about what kind of work is possible under such conditions demanded that I alter the parameters, with minimal forewarning, to find a way to reinvent the frame for each child patient to ensure that we could continue our work. It was a kind of doing in advance of any kind of knowing. In the beginning, the object of the child’s love, the mother, or someone who is doing the work of the mother, is there most of the time. It is only after a while that the child can do without the mother and work with the representation of the absent
