Speech and psychic structure: a reconsideration of their relation

Issues in the therapy of hearing children with deaf parents

The psychiatric literature on deaf children is sparse. Even less attention has been paid to the more common situation of the hearing child raised by deaf parents. Such a child is deprived of the parents' hearing and often the parents' speech. The oldest hearing child in the family often takes on the role of family interpreter which may be a source of both pride and resentment. This can contribute to role reversal leading to a frustration of the child's dependency needs and bitter sibling rivalry. Other problems may result from the parents' ambivalence towards their child. The available literature is surveyed and case illustrations are provided. Suggestions to therapists working with similar families are made.

The use of dreams in psychotherapy with deaf patients

Dreams and, in one case, hallucinations were elicited during the course of brief reparative psychotherapy with a clinic population of largely lower-middle- and lower-socioeconomic-class deaf patients with varying diagnoses, and used in the treatment. Results show that (1) deaf patients can be trained to increase their capacity for self-observation and self-reporting; (2) cognitive skills and abstract abilities were sufficiently developed so that unconscious material could be interpreted meaningfully; (3) this technique facilitated insight into unconscious intrapsychic conflicts; (4) better integration of personality and greater autonomy and object constancy were achieved through clarification of the conflicts; (5) a spectrum of emotional disorders including depressive symptoms was found, akin to patients who are hearing.