“How Can I Trust You When I Know You Can Die?” Surviving the Death of an Analyst in a Child Analysis

This reflection on the initial stages of treatment of a latency girl whose previous analyst died offers some insights into inner workings of mourning in children. The mourning process intersects in complex ways with a developmental stage, object constancy, unconscious phantasies, and conscious ideas about life and death. Clinical material illustrates some challenges that emerge in the transference-countertransference matrix when working with a child who lost both her primary object (the mother) and her transference object (the analyst). The reality of the analyst's death emphasizes that for a child patient the analyst is always a transference object and a real object at once.