Key concepts developed at the Portman Clinic

Child psychotherapists working at the Portman Clinic are in the privileged position of being highly valued by the adult psychotherapists and psychoanalysts, and presentations from members of the 'Child Team' at the Clinic's weekly discussion meetings have always been greatly appreciated. The Core Complex, Portman 'lore' and other thoughts on working with young people at the Portman Clinic are explained below. This way of thinking does not condone physical violence, of course, or lay blame on victims of abuse; it helps us to understand how violence becomes an integral part of a relationship which cannot exist without it. To avoid increasing the patient's anxieties and breaching their much-needed defences, we have to be extremely careful about what we say and especially how we say things, as the patient will so easily feel intruded upon, controlled, neglected, dismissed, humiliated and criticized. I'd been sharing a room with another child psychotherapist where there was such a toy cupboard, which I'd originally been very sniffy about, but it proved enormously helpful when I started seeing an 8-year-old boy whose mother worried about his aggressive outbursts at home and compulsive dressing-up in girls' clothes. As I tried to explore his discomfort with me, it emerged that he found all verbal communication difficult. This is in itself could often help professionals when we also offered psychoanalytic understanding in ordinary language about how the patient's offending behaviour was their attempted unconscious 'solution' to the terrors, anxieties and conflicts in their internal world