We are at an important moment in the history of child psychotherapy, facing a number of challenges inside and outside the clinic as we find our place in the current world of services for children and young people. Some of the challenges of working as a child psychotherapist today are reflected upon in the papers in this volume, together with insights into organisational and clinical ways forward that integrate psychoanalytic thinking with that of other disciplines, for example contemporary development research. In our opening paper, Jo Russell examines some gaps between psychoanalytic theory and clinical practice in relation to what she calls ‘a dissociative internal landscape’. For children and young people with such inner worlds, she found, Klein’s traditional analysis of the deepest anxiety through interpretations, examination of resistances and persistent tracing of the transference seemed to be inflammatory. One is reminded of Anne Alvarez’s patient, for whom ‘some of [her] interpretations seemed to make him more mad’ (1997, p. 762). Russell traces the relational roots of such a presentation, weaving together development research, attachment theory and psychoanalytic thinking in a sensitive and illuminating account of the kind of psycho-biological history which establishes a dissociative inner landscape. She suggests that in these cases we need an approach which responds to the dysregulating bodily presence of relational trauma, while holding onto the crucial psychoanalytic tool of articulating the negative transference at a time and in a way that feels useful for the child in the room. The paper contrasts the notion of reality and believability with the notion of truth, in the context of a child’s traumatic and chaotic relational world. The understanding is that for these children, the only way of communicating the truth of contradictory and mutually exclusive aspects of relational experience may be through enacting wildly different self states. The containing work of searching for meaning, for relationship between contradictory states, has traditionally been part of the child psychotherapy offer in a multidisciplinary team. Andrew Briggs’ paper, given at the ACP conference in June 2017, explores the impact on our profession of the loss, as he sees it, of this containing role, in a world where: ‘Complexity is not recognised. The relationship context for patient symptoms and treatment is not recognised’. He suggests that there has been a loss of containment for us too, in the losing of what has been a favoured position, and he links this to the predicament of Milton’s Satan in Paradise Lost, and furthermore to the idea of Bion’s -K anti-meaning drive as the outcome of a fracture in the container-contained relationship. The paper offers a powerful account of inter-relating levels of thinking about the organisation in terms of life and death instinct theory, and Teresa Bailey’s commentary is welcome in offering a rather different, and ultimatelymore optimistic, perspective on it. She focuses on the role of the senior child psychotherapist in offering containment and, potentially, a degree of mediation between the clinician and the organisation. She JOURNAL OF CHILD PSYCHOTHERAPY 2018, VOL. 44, NO. 2, 147–149 https://doi.org/10.1080/0075417X.2018.1501720

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我们正处于儿童心理治疗史上的一个重要时刻，当我们在当前为儿童和年轻人提供服务的世界中找到自己的位置时，我们面临着诊所内外的许多挑战。本卷的论文反映了当今作为儿童心理治疗师工作的一些挑战，以及对将精神分析思维与其他学科（例如当代发展研究）相结合的组织和临床方法的见解。在我们的开篇论文中，乔·罗素 (Jo Russell) 研究了精神分析理论与临床实践之间与她所谓的“分离的内部景观”相关的一些差距。对于拥有这样内心世界的儿童和年轻人，她发现，克莱因通过诠释对最深层焦虑的传统分析，对抵抗力的检查和对移情的持续追踪似乎是炎症性的。人们想起了安妮·阿尔瓦雷斯 (Anne Alvarez) 的病人，对她来说，“[她] 的某些解释似乎让他更加生气”（1997，第 762 页）。罗素追溯了这种陈述的关系根源，将发展研究、依恋理论和精神分析思维编织在一起，对那种建立了分离的内在景观的心理生物学历史进行了敏感而有启发性的说明。她建议，在这些情况下，我们需要一种方法来应对关系创伤的失调身体存在，同时坚持关键的精神分析工具，以对房间里的孩子感觉有用的方式一次阐明负面移情。在儿童创伤性和混乱的关系世界的背景下，本文将现实和可信度的概念与真理的概念进行了对比。理解是，对于这些孩子来说，传达关系经验中相互矛盾和相互排斥的方面的真相的唯一方法可能是通过表现出截然不同的自我状态。寻找意义、寻找矛盾状态之间的关系的包含工作传统上是多学科团队中儿童心理治疗的一部分。安德鲁·布里格斯 (Andrew Briggs) 在 2017 年 6 月的 ACP 会议上发表的论文探讨了在他看来，这种包含作用的损失对我们职业的影响，在这个世界中：“复杂性不被认可。患者症状和治疗的关系背景未被识别”。他暗示我们也失去了遏制，失去了有利的位置，他将这与弥尔顿在《失乐园》中的撒旦的困境联系起来，此外与比恩的 -K 反-意味着作为容器包含关系破裂的结果的驱动。这篇论文从生死本能理论的角度对有关组织的相互关联水平的思考提供了有力的说明，欢迎 Teresa Bailey 的评论提供一个完全不同的、最终更乐观的观点。 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 她专注于高级儿童心理治疗师在提供遏制方面的作用，并可能在临床医生和组织之间进行一定程度的调解。她的儿童心理治疗杂志 2018 年卷。44，没有。2, 147–149 https://doi.org/10.1080/0075417X.2018。