"Am I a tractor or a cannon? – The internal reality of insane"" children"""

The internal reality of a child plays a key role in his actions and behaviour. The unnecessary pathologising of his meaningless behaviour by doctors or parents may lead to degradation of his internal experience that may consequently decrease the reflection and understanding of his mental processes and states. The ability to control emotional states and impulses is conditioned by the acquisition of metalization. Mentalization includes sensing, reflecting, and controlling of ones mental states and impulses that are vital for the development of adaptive social functioning, healthy personality and mental condition. The process of metalization evolves in specific conditions of a early mother-child relationship, ideally within a secure attachment. If this process fails, it can be started and promoted by individual psychotherapy of the child, in combination with the psychotherapy of the parents at best. During individual psychoanalytically oriented psychotherapy the child and the parent can learn to reflect and resolve his emotional states at a symbolical representational level, rather then through acting out or through compensatory narcistic structures and immature defensive mechanisms. The therapeutic relationship with the challenged child or adolescent may be internalised as a new emotional experience where a patient can feel himself as a valuable and meaningful human being, whose thoughts, emotions and actions make sense.