A funny thing happened on the way to the 2003 Annual Psychology of the Self Conference. At a pre-conference workshop - "We Were All Once Children: How Child Analytic Therapy Informs Adult Treatment" a roomful of adult analysts came to listen to a 'child' presentation in order to inform, expand, and broaden their work with their adult patients. How could a case given by Iris Hilke of Germany followed by discussions given by Rosalind Chaplin-Kindler of Toronto and Jackie Gotthold of New York, moderated by Mark Smaller of Chicago enrich, enliven and challenge the clinical and theoretical thinking of both the adult and child therapists in attendance.

As the psychoanalytic field at large struggles with the task of articulating the dimensions of the co-constructed, non-linear, dynamic, dyadic patient-analyst relationship, child therapists can, in fact, be leaders and contributors to this on-going exploration. Developments in non-linear dynamic systems theory, infant research and the understanding of the primacy of mutual regulations in interactions have led us to this sophisticated reexamination of the relational and curative processes. As a panel of child therapists we wonder why, in this line of inquiry, does the field, for the most part skip from infancy to adulthood.

The dynamic, non-sequential treatment process runs in parallel verbally and non verbally with differing degrees of emphasis for adults and children. As analysts working with children we attempted to demonstrate in this workshop how we gain access to our young patients' subjective experiences, how we understand those experiences in a contextual manner, and how we communicate that understanding to them in the service of therapeutic change and developmental unfolding. We demonstrated how we respect and facilitate attachment such that a co-constructed therapeutic relational realm emerges. We illustrated all this within the verbal and non-verbal dimension of the process, emphasizing the role of communication in the procedural realm. And, finally, we were able to draw the parallel and highlight the relevance for adult therapists.

Dr. Hilke presented an elegant and moving treatment of a small girl who entered treatment when she was three. In Dr. Hilke's words, the case is an example of how psychotic and/or borderline states develop early in childhood. In the initial meetings with the child, we learn that the child responds to Dr. Hilke's overtures by shrieking 'NICHT', hence the name "Miss Nicht". While the first session consists of pain inducing shrieks of NICHT, the second session evolves into a delicate and cautious finger dance, yielding a sense of hope and possibility for the treatment.

Adult analysts love these stories. Often their responses are wistful - "could I be able to know when to wiggle my fingers in session and call it analysis" or relieved - "glad I don't have to listen to shrieks or wiggle my fingers and understand what that means." However, as our panel presentations and later discussions revealed there is no magic in the child treatment room. Our working spontaneously verbally and non-verbally is as careful and theoretically bound as it is in the adult consultation room. As Rosalind Kindler noted, the treatment presented was replete with examples of subtle cross-modal, non-verbal spontaneously enacted interactions. We might hope that exposure to these techniques and tales of treatments could contribute to an increase in our capacities as analysts, adult, child or both, for spontaneity, an expanded repertoire of responsiveness, and a variety of possible, creative ways of engaging our patients.

Dr. Gotthold went on to note, child therapists have always worked with these principles. The ongoing struggle to explicate these principles, the integration of explicit and implicit processing of relational and inner experiences, will enable all of us to further illuminate the treatment process for both adult and child patients in a more sophisticated manner.

Kids teaching grown ups is scary and intimidating. It is hoped that the adult analysts who attended the panel left with an enhanced repertoire of tools with which to find meaning in their patients' communications.