The three papers in this issue illustrate the different methods whereby case material can be generated to elucidate emerging theories. The first paper uses the traditional psychoanalytic clinical method of describing in detail the treatment of a patient, using the author’s experience and observation to illustrate her ideas. In the second paper, whilst also describing a case in detail, the author uses more formal case study qualitative research methodology in which psychotherapy sessions and semi-structured interviews were conducted with the patient and were audio-recorded, transcribed and analysed by thematic analysis. In the third paper, however, instead of using clinical material, the author introduces an intriguing twist by using the story of a fictional character, instead of a patient, to inform and develop key psychoanalytic concepts. The first two papers in this issue offer psychoanalytic contributions to the understanding and treatment of individuals with learning disability (LD), who represent a neglected and vulnerable population within our society. Both papers focus on the deleterious role of trauma, drawing on the seminal work with people with learning disability of the psychoanalyst Valerie Sinason. She described how children who are pervasively exposed to trauma develop what she termed ‘secondary handicap’ – an unconscious lowering of their intelligence which develops as a defence against their perceived difference from others, and is superimposed on their primary handicap of information-processing impairment and adaptation that is diagnostic of LD (Sinason, 2010). In ‘The disabling effects of trauma in a time of austerity: Implication for the practice and theory of child psychotherapy’, Tamsin Cottis describes her work as a child psychotherapist in London primary schools over the past decade with children identified as having special needs whose potential has been impeded due to their exposure to significant trauma. Drawing on the case studies of two children, who are doubly traumatised in being from another country and experiencing extreme poverty, she shows how children with challenging behaviours may be helped with child psychotherapy in school settings. Cottis’ passionate paper emphasises how these children’s difficulties arose not solely from trauma within the family, but were also due to economic and social circumstances, in the explicit UK government programme of austerity of recent years, and the increase in racism following the results of the 2016 referendum in voting for the UK to leave the European Union. The second paper focusses on trauma in the families of individuals with learning disability. Where those tasked to care for children with LD have also been affected by trauma – either the same adverse events affecting both carer and child, or earlier trauma in the former – the relationship between them may become damaged, perpetuating the traumatic cycle. In ‘Complex PTSD in Psychoanalytic Psychotherapy, 2019 Vol. 33, No. 3, 157–158, https://doi.org/10.1080/02668734.2019.1698225

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社论

本期的三篇论文阐述了可以通过使用案例材料来阐明新兴理论的不同方法。第一篇论文使用传统的心理分析临床方法来详细描述患者的治疗，并利用作者的经验和观察来说明她的想法。在第二篇论文中，虽然还详细描述了一个案例，但是作者使用了更为正式的案例定性研究方法，其中对患者进行了心理治疗和半结构式访谈，并通过主题分析进行了录音，转录和分析。但是，在第三篇论文中，作者没有使用临床材料，而是通过使用虚构人物的故事代替了患者来讲述和发展关键的精神分析概念，从而引入了一种有趣的转折。本期的前两篇论文为了解和治疗学习障碍者（LD）提供了精神分析方面的帮助，这些学习障碍者代表了我们社会中被忽视和脆弱的人群。这两篇论文都侧重于创伤的有害作用，借鉴了精神分析家瓦莱丽·辛纳森（Valerie Sinason）有学习障碍的人的开创性工作。她描述了普遍遭受创伤的儿童如何发展她所说的“继发性障碍”，即一种无意识的智力下降，这种智力的发展是对他们与他人的感知差异的防御，并叠加在他们的信息处理障碍和伤害的主要障碍上。对LD的诊断具有适应性（Sinason，2010）。在紧缩时期的创伤致残影响中：Tamsin Cottis描述了她在伦敦小学从事儿童心理治疗师的工作，这对儿童心理治疗的实践和理论产生了影响，在过去的十年中，儿童被确定为有特殊需要，由于其暴露于严重的创伤而使其潜力受到阻碍。她以两个孩子的案例研究为例，这两个孩子由于来自另一个国家而遭受了极大的折磨，并且生活在极端贫困中，她展示了具有挑战性行为的孩子如何在学校中接受儿童心理治疗的帮助。科蒂斯（Cottis）热情洋溢的论文强调，这些孩子的困难不仅是由家庭内部的创伤引起的，而且是由于经济和社会环境所致，这是近年来英国政府实施的紧缩政策所明确规定的，种族主义的增加，以及2016年公投英国脱欧的投票结果。第二篇论文集中于学习障碍者家庭的创伤。如果那些负责照料LD儿童的人也受到创伤的影响（或者是影响照料者和儿童的相同不良事件，或者是前者的较早创伤），则他们之间的关系可能会受到破坏，从而使创伤周期永久化。在《心理分析心理治疗中的复杂PTSD》中，2019年第1期。33，第3号，157-158，https：//doi.org/10.1080/02668734.2019.1698225 如果那些负责照料LD儿童的人也受到创伤的影响（或者是影响照料者和儿童的相同不良事件，或者是前者的较早创伤），则他们之间的关系可能会受损，从而使创伤周期永久化。在《心理分析心理治疗中的复杂PTSD》中，2019年第1期。33，第3号，157-158，https：//doi.org/10.1080/02668734.2019.1698225 如果那些负责照料LD儿童的人也受到创伤的影响（或者是影响照料者和儿童的相同不良事件，或者是前者的较早创伤），则他们之间的关系可能会受损，从而使创伤周期永久化。在《心理分析心理治疗中的复杂PTSD》中，2019年第1期。33，第3号，157-158，https：//doi.org/10.1080/02668734.2019.1698225