Introduction
In the practice of providing psychological assistance to children and adolescents, specialists often encounter requests related to resolving current issues that emerge at specific developmental stages and are primarily linked to interpersonal relationships and social interactions. These issues may arise in both typically developing children and adolescents as well as those with mild developmental deviations. Commonly observed interpersonal difficulties include emotional problems, peer interaction challenges, strained relationships with parents, behavioral disorders, and issues of self-perception.
A range of approaches has been developed to address these challenges. Among them, various forms of cognitive-behavioral therapy (CBT) have gained the greatest popularity. Other methods based on psychodynamic and humanistic paradigms, as well as art therapy, play therapy, and narrative approaches, have also been applied. Most handbooks on child and adolescent psychotherapy emphasize the importance of accounting for the specific features of their psychological development. However, this consideration is usually mentioned only in passing and lacks thorough theoretical elaboration. The issue at hand goes beyond developmental age norms: these interpersonal difficulties are simultaneously products of development and factors capable of altering the trajectory of a child’s psychological growth.
Typically, psychological issues that manifest during certain life stages are difficult to strictly distinguish from developmental deviations. This is especially true for so-called mild developmental anomalies—such as dysfunctions in particular cognitive functions, attachment disorders, learning difficulties, or specific emotional response patterns. For instance, difficulties in constructing speech-motor programs may hinder peer communication, provoke aggressive behavior or social withdrawal, and thereby exacerbate the initial developmental concern. This creates a pathological developmental cycle that intensifies the original issue. Even in the context of normative development, relationship and interaction problems may act as triggers for pathological changes in the child’s mental health.
This leads to the necessity of a methodological synthesis between perspectives on psychological development and the mechanisms underlying the emergence of current psychological difficulties. In other words, it is essential to simultaneously address both developmental tasks and acute psychological problems, recognizing how the latter shape the child’s social developmental context.
Achieving this synthesis requires an appropriate conceptual framework and developmental theory. In our view, cultural-historical psychology offers such a framework. However, practical applications of this approach have traditionally focused on forming of the psyche and correcting its abnormal development. Areas related to child psychotherapy—especially those targeting personal issues, emotional experiences, and the child’s relationships with others—remain underexplored within this tradition.
Our research on symbolically mediated interactions and social relationships in children and adolescents, both typically developing and those with mild developmental disorders, conducted using the experimental-genetic method, has revealed key developmental patterns and mechanisms. These findings enabled the development of effective psychological correction techniques (Polyakov, 2022). These techniques have proven applicable and beneficial in practical work with children and their families, particularly in addressing interpersonal, emotional, behavioral, and self-related difficulties. Based on this work, we have formulated an approach rooted in cultural-historical psychology, which we term the subject-symbolic approach.
Theoretical basis
One of the central concepts underlying the described approach is the category of subject–subject relationships, which manifest in the child’s interactions with others. This category makes it possible to bridge two perspectives: (1) addressing developmental difficulties that are shaped by the nature of these relationships and (2) resolving the contextual psychological challenges that arise at specific stages of development. Within cultural-historical psychology, subject–subject relationships represent the foundational mechanism behind all major transformations of the child’s psyche, brought about through participation in social practices—including psychological support. We conceptualize these relationships as symbolically mediated, subjectively meaningful connections between two or more subjects, expressed through their shared experience and actions.
The application of this category entails several important consequences for psychological practice with children and their families:
(a) Psychological support primarily targets the correction or construction of subject–subject relationships within the child’s immediate social environment, most often with parents. Accordingly, family-based interventions are essential when addressing intrafamilial relationships. Peer-related challenges must also be considered in their broader interpersonal context.
(b) Transforming these relationships directly influences the mechanisms of psychological development. Relationship difficulties should be understood in terms of their potential to foster or inhibit development. This developmental impact serves as the core criterion for evaluating whether relationships are normal or deviant.
(c) Many psychological issues are the child’s and environment’s shared reaction to the child’s individual psychophysiological characteristics. These responses represent a form of co-experienced affective engagement with those features.
The issue of co-being and development raises a phenomenological question: in what form does one subject exist for another—how is the child perceived by others (primarily parents or caregivers) and how do others exist for the child? At the psychological level, how does the Other act in the child’s inner world, and vice versa? This prompts us to engage the problem of consciousness. Within cultural-historical theory, consciousness is understood as a functional organ of the psyche that enables individuals to construct meaningful relationships with the world; it develops ontogenetically through subject–subject interaction and is mediated by cultural forms—namely, signs and symbols (Vygotsky, 1982, 1983a; Leontiev, 1983; Zinchenko, 2006).
Importantly, not all experience fully embodies consciousness. L.S. Vygotsky linked the origin and operation of consciousness to intersubjective relations expressed in external interaction. He regarded perezhivanie (lived experience) as the unit of analysis that refracts both the self and the Other (Veresov, 2016; Vygotsky, 1983a, 2001): “Every higher psychological function was external because it was social before it became internal, that is, psychological; it was originally a social relation between two people” (Vygotsky, 1983a, p. 145). Perezhivanie reflects the child’s relationship with the environment (Vygotsky, 1984, 2001). Regarding the connection between perezhivanie and consciousness, he writes: “To be conscious of one’s experiences means nothing other than possessing them as objects (stimuli) for other experiences. Consciousness is the experience of experiences, just as perezhivanie is the experience of objects” (Vygotsky, 1982, pp. 88–89). This highlights the reflexive character of consciousness—its capacity to respond to psychological experience, rooted in actual interactions with others.
F.E. Vasilyuk and T.D. Karyagina emphasize that not every experience qualifies as perezhivanie—only those in which the subject (the self) enters into a relation with the experience (Vasilyuk & Karyagina, 2017). N.E. Veraksa likewise emphasizes that it is impossible to build or modify a child’s relationship with the surrounding world or to master cultural tools without engaging with perezhivanie (Veraksa, 2024). In his account of the “crisis of age seven,” Vygotsky demonstrated that the child’s social situation of development —i.e., relationships with others emerging at a given stage—can be analyzed through perezhivanie (Vygotsky, 1984). The structural dimension of consciousness and perezhivanie is further elaborated in the works of Vygotsky, Leontiev, and Zinchenko, who consistently underscore the importance of meaning as the link between subject and world (Vygotsky, 1982, 1983b, 1984, 2001; Zavershneva, 2015; Zinchenko, 2006; Leontiev, 1983; Polyakov, 2022a, 2022b).
Thus, working with conscious perezhivaniya becomes the key to transforming the child’s subject–subject relationships with others—thereby modifying the child’s social developmental situation. This, in turn, alters the subjective significance of life events and changes the child’s emotions and behavior. In practice, it is critical to address not only the child’s perezhivaniya, but also those of their immediate social circle—especially parents. This opens the possibility for mutual recognition, emotional attunement, and the real presence of the Other as a subject. In many cases, problems brought forth by families can be addressed by enabling the child and parents to recognize each other’s perezhivaniya. In this context, relationships and consciousness represent two dimensions of the same psychological reality. By working with conscious experience, we restructure the child’s relationships with others.
Conscious experience (perezhivanie) is mediated through the use of cultural forms—signs and symbols. We distinguish between signs and symbols based on the type of experience they address and the psychological capacities required to master them (Polyakov, 2022a, 2022b). A sign is considered a cultural form that represents subject–object relations and instrumental activity within consciousness. A symbol, in contrast, functions as a cultural form that expresses unique subject–subject relations—a form of co-existence that makes individual subjective realities intelligible.
Thus, the conscious awareness and restructuring of subject–subject relationships and interactions requires the use of symbolic forms in working with children and their families. We argue that it is important to differentiate between various symbolic forms according to their psychological functions in the structure of consciousness and their role in supporting the formation of the individual as a subject engaged in relationships with others (Polyakov, 2022a, 2022b). For example, when working with identity-related difficulties in children aged 9–10 and older, the use of autobiographical narratives has proven effective (Nurkova, 2022; Polyakov, 2022a; White, 2007).
In order to address a child’s psychophysiological traits and the perezhivaniya associated with them, we apply the concept of the psychological structure of the defect, initially proposed by L.S. Vygotsky, developed by V.I. Lubovsky, and further elaborated in our work (Vygotsky, 1983b; Lubovsky, 2018; Polyakov, 2024). This concept refers to a hierarchically organized model of atypical psychological development in which a central defect (a primary impairment or characteristic) generates a wide array of secondary manifestations, as well as the subject’s psychological response to it. This model is essential for revealing the mechanism underlying a given psychological difficulty and for identifying the main targets of psychological support.
Let us illustrate the above with a clinical case, which we will continue to develop throughout this article.
The parents of an 8-year-old girl with preserved intellectual abilities sought help for autoaggressive behavior — the child was hitting, scratching and verbally demeaning herself. The aim of psychological support in such cases is not merely to eliminate the behavior but to uncover the psychological mechanism behind its emergence. This necessitates a thorough consideration of the psychophysiological traits of both parties in the relational dynamic (particularly the mother and child) as well as an exploration of the symbolic expression of their perezhivaniya regarding the situation. The girl was characterized by heightened emotional sensitivity, especially attunement to her mother’s emotions. Combined with the mother’s anxiety over the child’s emotional well-being, this formed a particular interactional cycle within the “parent–child” system. The child’s constant awareness of her mother’s worry—and her belief that she was the cause of that worry — led to self-rejection.
The therapeutic process focused on transforming the mother’s attitude toward the child’s emotional state and her ways of responding to it. This, in turn, brought about changes in the child’s emotional expression, her self-perception, and, as a consequence, improved the mother’s emotional well-being as well.
The central idea of the subject–symbolic approach
The central principle of the subject–symbolic approach lies in offering psychological support to the child and their caregivers, aimed at restructuring subject–subject relationships and interactions through the conscious exploration of the meaning-laden symbolic representations of emotional experience.
This approach is directed toward fostering and supporting the child’s subjectivity, understood as the awareness and enactment of meaningful relationships with the world — above all, with significant others. The subject–symbolic approach facilitates the mutual understanding of the meaning behind symbolic manifestations of subject–subject relations between the child and their parents.
The external manifestations of the subject (child, caregiver, peer), along with the underlying affective components of experience, are viewed as symbolic forms that express what is subjectively significant for the individual and represent their relationships with the world, especially with others.
This method addresses children and adolescents between the ages of 6 and 19, as well as their parents.
Returning to our earlier case:
In analyzing the girl’s autoaggressive behavior, it was essential to determine what this behavior meant to her. We came to understand that it reflected a negative self-perception—she believed she was "bad"—and symbolized her subjective experience of the relationship with her mother, in which she felt responsible for her mother’s distress. The mother, in turn, experienced anxiety and helplessness, unable to alleviate her daughter's suffering, while overvaluing the child’s emotional comfort. This example underscores the importance of assisting both participants in their relationship to recognize the symbolic meaning of their respective experiences.
A key element of the approach is the involvement of as many direct participants in the child’s relational system as possible. This enables them to "see" and recognize one another, to understand what lies behind external behaviors, emotional reactions, and verbal expressions, and to more rapidly externalize and reflect upon the underlying relational issues. Joint work thus acts as a catalyst for transformation.
It is precisely the work with the symbolic representation of experience within consciousness that provides the foundation for psychological practices aimed at addressing behavioral, emotional, interpersonal, and intrapersonal difficulties. Through symbolic forms, experiences are objectified, becoming accessible for reflection by both the individual and their social environment. It should be noted that such experiences often underlie learning difficulties in school-age children, deviant behavior in adolescents, and represent one of the most critical factors in atypical development.
At the core of perezhivanie lies the subjective significance—or meaning—of lived experience. It is always unique and individual. However, uncovering that meaning requires attending to its sensory–expressive components: movements, sensations, mental imagery, thoughts, the affective tone of emotions, impulses toward action, and more. These components are significant not in themselves, but as means for revealing meaning.
The meanings of experience may be directed toward the Other or toward oneself and may vary widely. Each perezhivanie, shaped by the subject’s individuality, contains conflicts arising from misalignments between the positions of participants in a relationship. These conflicts define the personal significance of future transformation and create motivation for the subject’s active engagement in that transformation.
Conflicts may arise from contradictions between the child’s capacities and desires, between what is meaningful to the child and what is important to the parent, or between the child’s wishes and the adult’s demands. For example:
- a child wants to be accepted by peers but is excluded;
- a student disrupts lessons while adults demand rule compliance;
- an adolescent is overwhelmed by anxiety and a sense of inadequacy, which the parents find perplexing;
- a child rages at their own helplessness while doing schoolwork;
- a child tries to express their distress, but parents refuse to believe them.
Importantly, the position of the Other may be external (i.e., the real behavior of another person) or internalized by the child. In the latter case, the drama unfolds on the internal plane of the child’s consciousness. In essence, the child’s developmental drama is closely tied to the discrepancy between who they are and how close others perceive — and expect — them to be. This is why psychological support must help both the child and their caregivers become aware of how they see each other and who the child really is.
In psychological practice, it is crucial to consider not only the content and meaning of the conflict for each party but also their respective responses. The way a conflict is responded to determines whether it becomes a source of developmental difficulty or of personal growth.
A subject’s response may take various forms:
- the conflict may be unrecognized, ignored or avoided;
- it may be overcompensated through excessive achievement;
- the desire underlying the conflict may be suppressed;
- the child may conform to the expectations of adults or peers, suppressing personal aspirations;
- aggression may emerge in response to seemingly insurmountable contradictions;
- or the conflict may be accepted and actively worked through.
These responses themselves often become the focus of therapeutic work with both child and caregivers.
Let us return to the parent–child case to further illustrate this.
The mother’s realization that her own behavior was reinforcing the child’s self-rejection and aggression catalyzed a transformation in how she responded to her daughter’s emotional expressions. Initially, the girl “tested” this new relational stance — crying, hitting herself — to see whether her mother’s attitude had truly changed. Over time, she calmed down, reassured by the fact that her mother no longer responded with distress.
Previously, the mother’s deepest need had been to ensure her child’s emotional and physical well-being, while the child’s emotional safety depended on sensing the mother’s calmness. The change in their mutual responsiveness was what brought about the shift in the girl’s emotional state and behavior.
In another example, a mother sought help for her 10-year-old son’s disruptive behavior at school, refusal to complete homework, and disobedience at home. The boy exhibited provocative behavior in class and passively resisted his mother’s demands. She adopted a strict stance, emphasizing obedience and social norms.
The child perceived the attitude of both his teachers and his mother as limiting his autonomy and right to self-determination. His behavior served as a symbolic protest against this relational dynamic.
Becoming aware of this underlying conflict prompted both mother and child to reconsider their roles and behaviors. The mother’s need to exert control and the son’s need for autonomy had previously collided; understanding this helped them begin to transform their relationship.
Thus, within the subject–symbolic approach, work is centered on subject–subject relationships as they appear in the lived experience of participants and are expressed in their mutual interactions. The goal is to bring about changes in these relationships such that all participants recognize, accept, and account for one another’s subjectivity. Such relationships activate the core mechanisms of normal child development.
Methods of psychological support in the subject–symbolic approach
The application of support methods within the subject–symbolic approach should not be equated with a rigid technology. First, the choice of method, its form, content, and sequence depend largely on the child’s and family’s own initiative and preferences. One child may respond best to working with autobiographical narratives, another to modeling with clay, and a third to the use of metaphors. What is essential is that the subject generates or selects symbolic forms that express their experience — rather than relying solely on prefabricated symbols designed by the psychologist (the latter being acceptable only in exceptional cases). It is worth noting that many psychotherapeutic approaches commonly provide therapists with “ready-made” metaphors for client work (Stoddard & Afari, 2021).
Second, the same method can serve diverse goals and be adapted to the specifics of a given case. Thus, the subject–symbolic approach adapts its working methods to each individual situation, shaped by the family’s request, the nature of the issue, the child’s developmental level, family dynamics, and the stage of work. It avoids the use of fixed therapeutic protocols—predefined sequences of interventions—which are often associated with problem-oriented approaches. Rather than focusing on problems alone, the subject–symbolic approach focuses on the child and the family as relational subjects. The goal is to foster developmental interaction with the child.
The overarching aim of support is to promote mutual awareness of lived experience (perezhivanie) between the child and their social environment. More concretely, the following changes in awareness may occur:
- the adult’s recognition and acceptance of the child’s needs, emotional experiences, and innate (individual) traits and capabilities (e.g., parents may underestimate the depth of their child’s emotional life or believe the child is being manipulative);
- the child’s understanding of their own needs and the possibilities for meeting them;
- the adult’s clarification or revision (when necessary) of their relational position toward the child, including expectations and their implementation;
- the adult’s (and sometimes the child’s) recognition of interactional cycles that perpetuate the problem—and their subsequent revision;
- the adult’s awareness of the child’s developmental potential and the conditions required to support it, including a reevaluation of their idealized developmental expectations (e.g., viewing an ideal child as fully obedient may contradict the child’s actual development);
- the child’s awareness and resolution of internal contradictions in their worldview (e.g., a 9-year-old girl, following joint work with her anxious mother, who feared her daughter’s obsessive protective rituals, remarked: “These are just thoughts in my head, so they’re not real—and I don’t need to worry about them”);
- the adult’s recognition and resolution of intra-familial conflicts rooted in unresolved personal issues (e.g., contradictory unconscious attitudes toward the child in one or both parents).
To structure the support process, the following stages can be identified:
- Analysis of the child’s and adult’s lived experiences and their underlying meanings—revealing the nature of the conflict (collision);
- Clarification of the initial and desired psychological states of the child or their relationships with others;
- Identification of each party’s response to the conflict and support in recognizing and accepting it;
- Search for constructive ways to resolve the conflict (collision) or pathways to the desired state, from both the child’s and adult’s perspectives;
- Mastery of these constructive strategies by the child and/or caregivers;
- Consolidation of change: real-life application, anticipation of future scenarios, and planning for further action.
The sequence and necessity of these stages are not fixed and may vary based on context. At times, mutual recognition of the core issue by parent and child is sufficient. In other cases, this insight reveals deeper layers. Sometimes, a full progression through all stages is required.
Categories and examples of methods in the subject–symbolic approach
Within the subject–symbolic framework, the methods of psychological support can be provisionally divided into two groups:
- Methods aimed directly at identifying and transforming subject–subject relationships and the child’s interactions with parents or peers, as well as clarifying the caregiver’s position;
- Methods focused on fostering the awareness of one’s own experiences in both children and caregivers (Polyakov, 2022b).
Methods in Group One include:
- Symbolization of experience: The child and caregivers create symbolic representations of their experiences in each other’s presence—reflecting interpersonal relationships, emotional states, and self-perceptions. This may include storytelling, metaphorical descriptions, drawing, sculpting, or representing both troubling and desired (goal) states. These methods help disclose the unique meanings embedded in inner experiences (memories, sensations, movements, mental images, events), making them intelligible to significant others. For example, in the case of the girl with autoaggressive behavior, her mother constructed a metaphorical image of the “ideal mother” as Moominmamma (from Tove Jansson’s stories)—a figure representing emotional containment and calm, which the mother felt she was failing to embody.
- Graphical and verbal modeling of interactional cycles: Cycles of relational dynamics contributing to or alleviating the problem are explored through drawings, diagrams, or descriptive dialogue. In the case above, the mother created a visual model of how her worry and sense of helplessness, mirrored by the child’s emotional hypersensitivity, reinforced the daughter’s self-negativity — forming a closed loop. Recognizing this helped the mother respond more calmly to her daughter’s emotions, which in turn improved the child’s self-confidence and emotional regulation.
- Joint description of shared experiences: Child and caregiver (or peer) collaboratively reflect on a specific event or behavior, aiming to understand and acknowledge each other’s perspectives.
- Identification of valuable personal qualities: Working with the child’s lived experience, the psychologist helps uncover strengths — even those masked by “negative” traits such as anxiety, passivity, impulsivity, or cognitive limitations. These insights are shared with the child and caregivers to reframe aspects of the self that had previously been rejected.
Methods in Group Two include:
- Position-shifting (decentering): The subject is encouraged to view events from the Other’s perspective—such as imagining a parent's view of their own behavior or engaging with an imagined interlocutor.
- Symbolic transformation of experience: Autobiographical memories are reinterpreted or “reconfigured” imaginatively. The child may use metaphors, drawings, or sculpting to represent a desired (goal) state that contrasts with a problematic one. For instance, the previously described 10-year-old boy, who exhibited provocative behavior, defined himself as “irresponsible” and sculpted a fragile dandelion to represent this self-perception: “It’s small and doesn’t matter to me.” When asked to create a contrasting image of “responsibility,” he sculpted a water lily, explaining: “It floats far from the shore, and no one touches it.” This metaphor helped the boy and his mother recognize his resistance to excessive and rigid control over his behavior.
- Objectification through dissociation: Underrecognized or rejected emotional states are externalized and treated as separate from the self, allowing for greater awareness and coping. The child is shown that they are not identical to their limitations or emotions. For example, anger or anxiety may be described as an external entity: “What does your anger look like? What does it make you do? How do you act when it’s not there?”
- Exaggeration of symbolic expression: Certain expressive gestures, intonations, or phrases may be amplified or repeated to help the subject become aware of the deeper meanings they carry.
- Distancing from experience: The child may be invited to observe their own emotions “from the outside,” as if watching a film, reducing their intensity and enabling reflective insight.
Conclusion
The subject–symbolic approach in counseling children and their families opens new avenues for applying cultural-historical psychology to the domain of psychological support — particularly in addressing behavioral and emotional difficulties, interpersonal conflicts, and self-related problems in children with typical development as well as those with mild developmental deviations. This approach emphasizes the value of developing the child’s subjectivity and seeks to create conditions that facilitate the child’s mastery of cultural forms of relating to others and engaging in social interaction.
The approach is grounded in the idea that the formation of the child as a cultural subject is possible only within particular relationships with other subjects — relationships that unfold in symbolic forms of interaction and are represented in lived experience (perezhivanie). Perezhivanie manifests in intentional actions and behavior and is structured by subjective meaning, which integrates sensory experience and reflects an invisible bond with other subjects.
The goal of psychological support, therefore, is not simply to achieve emotional comfort or correct behavior, but to help the child and their caregivers become aware of what is meaningful to the child and to respond to it in light of the child’s development as a cultural subject. The subject–symbolic approach facilitates mutual awareness of experience between children and their parents through engagement with its symbolic representation — enabling them to see and accept each other as subjects of relationship and thus laying the foundation for the child’s normal development.