Consider the following clinical situation. A severely deprived 8-year-old girl, whose

plight had been repeatedly unseen and unheard by the authorities, was eventually

fostered, but with poor case management leaving her vulnerable to further abuse. Several

foster homes later she was placed with a foster family who were able to make a

commitment to her and who fought for her to have therapy. In one of her sessions she

spent a great deal of time and effort repeatedly trying to build a tent using a blanket and

parts of the furniture in the room, in ways that would obviously fail. She couldn’t

accomplish this task on her own for straightforward mechanical reasons and yet she kept

trying to achieve the impossible. She kept on and on trying to build a space that she could

physically get inside, in a heartbreakingly futile way, and several times asked the

therapist to help, but in a controlling and rather bullying manner which the therapist felt

he could not agree to. Finally in desperation the child shouted at the therapist who had

quietly observed these efforts, ‘Why won’t you help me?’