To illustrate the way in which the mode of approach which I have attempted to describe works out in individual cases, I want to take the problem of the withdrawn child.

All psychiatrists working with children are agreed that one type of case presents difficulties of a very special kind: that is the child, of whatever age, from whom it is impossible to obtain a response. These children and young people neither like nor dislike their therapists; they give either a polite and superficial answer to all questions or attempts to elicit from them any kind of material, or they make no response whatever. I was very interested in Dr. Annell’s paper on the use of narcotics for the treatment of these children, and I think I can offer some suggestions to account for the low proportion of children in her series who responded to this method.

Now it is generally believed by therapists that the operative mechanism in these cases is that of ‘jamming! – i.e. the impingement upon one another of two instinctual drives acting with equal force in opposite directions. The problem in such a situation is to separate the components of this ‘jam’ so that at least part of one of these forces becomes detached and available for the child to use.