Irene, a nine year old psychotic girl, has suffered during the separationindividuation fase traumatic experiences of such frequency and severity that these can reasonably be understood to be primary importance in the causation of her disturbance.
The generalized hypotonia which Irene showed on childneurological examination is a common feature in children with early infantile autism; a still unknown organic factor therefore may also play a role in the causation of childhood psychosis.
Irene's symptomatology was characterized by
1 fears of annihilation,
2 confusion of her selfrepresentation with that of inanimate objects,
3 symbolization of the object in the non-human,
4 primary process thinking.
It seems that Irene's egodevelopment did not pass beyond the stage of experiencing the 'holding environment' as inanimate.
Through therapy it became clear that Irene has not succeded in making a clear and definite distinction between the experience of pleasure or unpleasure.
The residential setting has to function as an auxiliary ego.