ABSTRACT Many child psychotherapists are familiar with the experience of being locked out of the consulting room by child patients, and the peculiar challenges this poses to the clinician’s sense of competence and hopefulness in the child’s capacity for change. In this paper, I describe how this discomfiting experience developed in my work with David, who had suffered institutional neglect in a foreign orphanage before being adopted by a British couple. I will discuss how my understanding of David persistently locking me out evolved over time, and will suggest that the consulting room, for David, came to represent a maternal object, which he had to take exclusive possession of at all costs. Paradoxically, the door between us became necessary to separate and connect us; this gave me some insight into David’s early experience and the institutional doors, both literal and figurative, which had protected his carers from fully confronting his pain. Real psychological development for David, however, only seemed possible after an unsolicited and abrupt move to another building for our work together. I will suggest that our making this transition together enabled me to identify with David’s internal sense of homelessness and thus to break through the doors between us, which had been convenient for us both. I will also suggest that the consistency of the analytic frame had hitherto been experienced by David, paradoxically, as an impoverished, unstimulating environment, redolent of his time in the orphanage, which had left him in a state of stupor (A previous version of this paper was presented at the ‘Relating to the Other’ Association of Child Psychotherapists Conference 2018.).

中文翻译：

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关于被锁在诊室之外的一些思考*

摘要 许多儿童心理治疗师都熟悉被儿童患者关在诊室之外的经历，以及这对临床医生的能力感和对儿童改变能力的希望带来的特殊挑战。在这篇论文中，我描述了这种令人不安的经历是如何在我与大卫的工作中发展起来的，大卫在被一对英国夫妇收养之前曾在外国孤儿院遭受机构忽视。我将讨论我对大卫持续将我拒之门外的理解是如何随着时间的推移而演变的，并会建议大卫的咨询室来代表一个母性对象，他必须不惜一切代价独家拥有。矛盾的是，我们之间的门成为分隔和连接我们的必要条件；这让我对大卫的早期经历以及从字面上和比喻上保护他的照顾者免于完全面对他的痛苦的机构大门有了一些了解。然而，对于大卫来说，真正的心理发展似乎只有在我们主动和突然搬到另一栋大楼一起工作之后才有可能。我会建议我们一起进行这种转变，使我能够认同大卫内心的无家可归感，从而打破我们之间的大门，这对我们俩都很方便。我还要指出，大卫迄今为止所经历的分析框架的一致性，矛盾的是，作为一个贫穷的、没有刺激的环境，让人想起他在孤儿院的时光，