Winnicott's Squiggle Game is a game of free pictorial associations that enable the child and the therapist to create meaning out of seemingly random drawings. It is a game with no rules in which children find themselves expressing ideas and sharing associations that are often surprising to them. Winnicott pays close attention to how themes unfold in the course of the game and what the symbolic representations of each drawing can be. And he is highly attentive to the children's history, how they communicate their internal states, and the manner in which they engage in the game and respond to his presence. For Winnicott, the goal of the game is not to reach a diagnosis about a child, but to create a space in which a child feels free to express themselves and to derive meaning from their own squiggles.
In this paper the authors emphasize the usefulness of a modern two-systems concept of the superego to explain the tenacity of sadomasochistic pathology and underlying omnipotent beliefs. Internal superego validation of omnipotence becomes an available, dependable reinforcement, rendering the pathology more resistant to change from outside sources in relationship or treatment. The authors suggest that attention to open-system functioning generates additional techniques for addressing persistent self-defeating and self-destructive functioning and fosters growth of an open-system superego.
The complexity of the child and adolescent psychoanalytic process and situation, which has a broader field than adult analysis, contributes to more pervasive, varied, and intense emotional, subjective reactions in the analyst than when analyzing adults. This array of reactions raises debates about defining countertransference in analytic work with children. A broad definition of countertransference is suggested, one that includes all the analyst's conscious and unconscious reactions to the child, important others of the child with whom the analyst interacts, and features of the analytic situation. This broader field comprises the total situation of countertransference in child analysis. Indirect countertransference as described by Racker, in particular, is increased because of the larger number of individuals in the patient's life to whom the child analyst is exposed. Their physical presence exerts a more direct impact on the analyst's own internal world and external behavior than occurs with the others in an adult patient's life who generally exist to the analyst in only a symbolic, representational manner. In addition, the ongoing developmental process in which the child is engaged, while participating in the analytic process, affects the way the child brings material and can stimulate previous developmentally related experiences in the analyst. It also leads the child to use the analyst as a developmental object, not solely as a facilitator of insightfulness. Clinical vignettes are offered to illustrate the total situation of countertransference.
