This paper is a case study that is the result of a research project that involved using psychoanalytic observation to reflect on a series of counselling sessions. It provides a description of the work and shares some of the psychoanalytically-informed themes that emerged from the experience. The subject of the case is David, a boy who had lost one brother to cystic fibrosis and who had another brother with the disease. David was free from the condition but in crisis. The themes that emerge from reflecting on the sessions helped to illuminate the use of defences to manage the anxiety inherent in the situation for David and the experience of living with the constant, unrelenting theme of death in a young life.

中文翻译：

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健康兄弟姐妹的困境：对患有慢性疾病的家庭中处于危机中的“健康儿童”的咨询关系的精神分析反思

本文是一个案例研究，它是一个研究项目的结果，该项目涉及使用精神分析观察来反思一系列咨询会议。它提供了对工作的描述，并分享了一些从经验中出现的精神分析主题。案件的主体是大卫，他的一个兄弟因囊性纤维化而失去了一个兄弟，而另一个兄弟患有这种疾病。大卫摆脱了这种状况，但处于危机之中。反思会议所产生的主题有助于阐明如何使用防御措施来管理大卫在这种情况下固有的焦虑，以及在年轻的生命中不断地、无情地生活在死亡主题中的经历。