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Drawings from a dying child : a case study approach Bertoia, Judi

Abstract

Only in the past two decades have adults become aware that terminally ill children do know at some level when they are dying. This research used a case study format to investigate the changes in how one child dying of leukemia viewed herself. Specifically, it looked for symbolic and emotional themes which emerged in the material, including Decathexis (separation) and Rebirth. Each of twenty-eight drawings created by this child was analyzed in-depth for content by the researcher. Convergent material from hospital records and a parent journal supplemented the stories and teacher notes accompanying the drawings. Six experts from three countries also categorized each drawing for images of Decathexis and Rebirth. Initially, themes of threats, dreams, trickery and intuition appeared along with fear and sadness. Once the child seemed to clearly understand that she would die, these changed to fading and distancing images, indicative of separation. There was a slight increase in images supporting themes of resignation and happiness. Physical deterioration and resistance appeared throughout the series as distortions of a girl and dilapidated and edged houses. Themes of a new home and travel also appeared throughout. The classification by experts according to Decathexis and Rebirth resulted in unanimous agreement on twenty-five per cent of the pictures and two thirds of the experts agreed on the placement of eighty-six per cent of the pictures. It would appear that on one level the child knew from the beginning that she would die, but at another level she resisted that knowledge for a time. As clear awareness of death was developing, defensive themes such as trickery and dreaming appeared in stories which accompanied the drawings. However, the images, themes and convergent material suggest that she reconciled the dual awareness levels and worked towards acceptance of her fate.

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