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Psychoanalytic literature has often overlooked the child's participation in organized sports, which often can facilitate or impede not only expression of aggression and narcissism, but enhance or skew the growth of the child's superego and ego ideal. Specific outcomes are largely determined by the experience and knowledge of the parents, the coaches, and sports organizations for latency-aged youth. Sports participation facilitates a major step forward in psychic development, that is, an agreed-upon adherence to a set of rules and regulations, monitored by an official embodying the final word regarding rules and their infractions. This paper is an attempt to delineate the role of sports in the life of the latency child, the parents who become involved, the coaches who teach and supervise, and the social and individual milieu within which sports take place. All these contribute to common goals: the engendering of good sportsmanship and the encouragement of psychic growth, particularly regarding how aggression and narcissism contribute to the development of superego and ego ideals. The fate of aggression and narcissism in superego and ego ideal development is influenced to a large degree by the nature, orientation, and motivations of all involved in sports for the latency-aged.

Many medical procedures, while necessary and appropriate, may be experienced by a child or adolescent as a trauma, with the medical personnel considered as perpetrators in collusion with the parents. The medical procedures and the conditions requiring them are seldom the focus of routine history-taking or therapeutic process. Nevertheless, the long-range effects of these events may have serious and adverse effects on future development and psychopathology. The author presents several clinical examples.