Journeys in Psychoanalysis: the Selected Works of Elizabeth Spillius

Downloaded by [New York University] at 03:54 14 August 2016 Journeys in Psychoanalysis

Spanning six decades, this collection, Journeys in Psychoanalysis: The selected works of Elizabeth Spillius, traces the arc of her career from anthropology and entering psychoanalysis ‘almost by accident’, to becoming one of her generation’s leading scholars of Melanie Klein. Born in 1924 in Ontario, Canada, Elizabeth arrived at the London School of Economics for postgraduate studies in the 1950s and soon embarked on a groundbreaking study of family life in the East End of London that produced a PhD and her fi rst book, Family and Social Network, under her maiden name Elizabeth Bott. Published by the Tavistock Institute in 1957, it remains one of the most infl uential works published on the sociology of the family. These papers are a testament to the luminous intellect and understated compassion that Elizabeth has always brought to her work. They vividly map not just the evolution of Elizabeth’s career but the development of Melanie Klein’s thought, often drawing in compelling fashion on the writer’s own experiences with her patients. Each is written with the clarity and concision that makes diffi cult concepts eminently comprehensible to psychoanalysts, psychoanalytic psychother- apists and laymen alike.

Elizabeth Spillius studied general psychology at the University of Toronto (1945), social anthropology at the University of Chicago, the London School of Economics and the Tavistock Institute of Human Relations (1945–1957) and psychoanalysis at the Institute of Psychoanalysis in London (1956 to the present). She is esteemed for her clinical work and her teaching, and has published a wealth of books and

Downloaded by [New York University] at 03:54 14 August 2016 papers. Her work remains profoundly infl uential on how psychoanalysts of today approach post-Kleinian thinking. Among her long list of achievements, Elizabeth was general editor of the Routledge series, the New Library of Psychoanalysis, from 1988 to 1998, and was editor of Melanie Klein Today, Volumes 1 and 2. In 2010 she was made a Distinguished Fellow of the British Psychoanalytical Society. World Library of Mental Health series

The World Library of Mental Health celebrates the important contributions to mental health made by leading experts in their individual fi elds. Each author has compiled a career-long collection of what they consider to be their fi nest pieces: extracts from books, journals, articles, major theoretical and practical contributions, and salient research fi ndings. For the fi rst time ever the work of each contributor is presented in a single volume so readers can follow the themes and progress of their work and identify the contributions made to, and the development of, the fi elds themselves. Each book in the series features a specially written introduction by the contributor giving an overview of their career, contextualizing their selection within the development of the fi eld, and showing how their own thinking developed over time.

Rationality and Pluralism – The selected works of Windy Dryden By Windy Dryden

The Price of Love – The selected works of Colin Murray Parkes By Colin Murray Parkes

Attachments: Psychiatry, Psychotherapy, Psychoanalysis – The selected works of Jeremy Holmes

Downloaded by [New York University] at 03:54 14 August 2016 By Jeremy Holmes

Passions, Persons, Psychotherapy, Politics – The selected works of Andrew Samuels By Andrew Samuels

Towards a Radical Redefi nition of Psychology – The selected works of Miller Mair Edited by David Winter and Nick Reed Journeys in Psychoanalysis The selected works of Elizabeth Spillius

Elizabeth Spillius Downloaded by [New York University] at 03:54 14 August 2016 First published 2015 by Routledge 27 Church Road, Hove, East Sussex, BN3 2FA and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Elizabeth Spillius The right of Elizabeth Spillius to be identifi ed as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copy- right, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Spillius, Elizabeth Bott, 1924- , author. [Works. Selections] Journeys in psychoanalysis : the selected works of Elizabeth Spillius / Elizabeth Spillius. p. ; cm. -- (World library of mental health) Includes bibliographical references. I. Title. II. Series: World library of mental health series. [DNLM: 1. Klein, Melanie. 2. Psychoanalysis--Collected Works. 3. Psychoanalytic Theory--Collected Works. WM 460] RC504 616.89Ј17--dc23 2014038112 ISBN: 978-0-415-83517-6 (hbk) Downloaded by [New York University] at 03:54 14 August 2016 ISBN: 978-1-315-72029-6 (ebk) Typeset in Sabon by Saxon Graphics Ltd, Derby CONTENTS

Introduction 1

1 Conjugal roles and social networks 3

2 Clinical refl ections on the negative therapeutic reaction 25

3 Clinical experiences of projective identifi cation 33

4 Varieties of envious experience 45

5 Kleinian thought: overview and personal view 62

6 On formulating clinical fact to a patient 90

7 Developments in Kleinian technique 101

8 Freud and Klein on the concept of phantasy 113

9 Psychoanalysis and psychotherapy: learning to understand oneself in contrast to being understood by another 128

10 On becoming a British psychoanalyst 134

11 Recognition of separateness and otherness 153 Downloaded by [New York University] at 03:54 14 August 2016 12 Melitta and her mother 168

13 Ten drawings by one of Melanie Klein’s child patients 179

Index 183 7KLVSDJHLQWHQWLRQDOO\OHIWEODQN Downloaded by [New York University] at 03:54 14 August 2016 INTRODUCTION

People remind me occasionally that I come from a Canadian academic family, which is true but slightly misleading. My father, Edward Alexander Bott, came from a very poor family and when he fi nished high school (Canadian for secondary school) he worked hard for four years and saved all the money he could before applying to university – although whether to study psychology or philosophy, I’m not sure. My mother’s family was rather different. Her father was the headmaster of a secondary school in a small Ontario town and a man whom everyone loved, myself included. My grandmother was intensely ‘proper’, very religious and very keen on looking for sin, especially in me (I heard that my father eventually told her to stop this). She did not let my mother go to university – she thought the institution was immoral – and so my mother spent some years touring small Ontario towns teaching women how to de-bone chickens before cooking them. Eventually my mother persuaded her father to allow her to go to university, where she met my father. In the fi nal examinations she stood fi rst – and won the Governor General’s gold medal – and my father stood second. He didn’t seem to mind, I was told. I was the youngest of three girls, and the only one who enjoyed school, probably because I did quite well. By the time I was ready to go to the University of Toronto the war had begun, and there were more young men at university than usual. I think this was because one did not have to join the army if one went to university. Most of them – especially Erving Goffman, who was in my year – were very intelligent and left wing. I learned a lot from Erving and his friends at university. We were taught by a clever young man from Chicago called Raymond Birdwhistell and I felt I was being rescued at last from psychology – my subject. I thought sociology was probably just as bad. Both seemed to be based on questionnaires – ‘Are you happy? Answer 1–5. Unhappy? Sometimes unhappy?’ etc. I thought it was just silly. Erving and his friends got me started on Durkheim, Marx, Radcliffe-Brown and Malinowski. At the end of university I won a scholarship and went with Erving to the University of Downloaded by [New York University] at 03:54 14 August 2016 Chicago. He went to the Sociology Department, I went to something called Human Development, which threatened to be as bad as the questionnaires. Then more or less by accident I found myself getting to know a working-class family and writing about them for Allison Davis, who was completing his PhD and was to become an important fi gure in psychology and anthropology. This was a man I liked a lot. He knew a great deal about how people lived and thought, and he encouraged me to write. I said fi ne, but next time I didn’t want to study a family without their knowing it – I felt it was all wrong, doing it secretly, and he agreed, much to my relief. 2 Introduction

By this time I had decided that I wanted to study anthropology, but found that most of the anthropology professors were boring and unimaginative – how judgemental I was! But there was one I really liked, and he took me aside for a quiet bit of advice, saying that I was never going to like American anthropology and so I should give it up and go to England where everybody thought the way I did. (I didn’t believe that bit, of course.) But I wrote a letter to the head of the Anthropology Department at the London School of Economics and asked if they had any scholarships etc. that I could apply for. After a very long time he wrote back to me saying there were no scholarships, but he could offer me a low-paid job. I was thrilled. So Erving and I set off, me for London and Erving for the Shetland Islands, where he was going to do ﬁ eld work for his next book after Interaction Ritual. We remained friends for many years until his sad, early death. At the LSE, an American professor said that I should visit the Tavistock Institute, not the Clinic, he said, be sure you go to the Institute, so I did. I arrived at 11am and was interviewed by the senior staff until 5pm. It appeared that the Institute was going to receive a large grant of money to study ordinary families, and they were looking for ﬁ eld workers, and so I was taken on. We worked very hard, my companions and I, but we had a very good time, and eventually I wrote a book about some of the families (Family and Social Network). From the early period I particularly recall John Harvard Watts for his noble struggles at Tavistock Publications to get me to love and admire well-written English. It was about this time that I met people from Routledge and I am very grateful for the way everyone helped and encouraged me. I owe a great deal to Kate Hawes especially for introducing me to Routledge, and later for asking me to compile other books, including the present one. There are certain people who will always be with me: Eric Trist of the Tavistock Institute, Queen Salote Tupou of the Kingdom of Tonga, Latai Vea, also of Tonga, where my husband and I lived from 1957 to 1960, and, slightly later, Edmund and Celia Leach, who brought anthropology and English literature vividly alive for me in a way I will never forget. More recently I would most especially like to thank my son Alex Spillius, his wife Sarah Strickland and my daughter Sisifa Spillius; all three have helped me in many ways, but especially in the preparation of this book for publication. I would like to thank the Melanie Klein Trust for supporting my work on the Melanie

Downloaded by [New York University] at 03:54 14 August 2016 Klein Archive, on the New Dictionary of Kleinian Thought and other projects. I feel deeply indebted to all my teachers, patients, supervisees, colleagues and friends – among them Wilfred Bion, Hanna Segal, Herbert Rosenfeld, Betty Joseph, Ruth Riesenberg-Malcolm, John and Deborah Steiner, Ron Britton, Athol Hughes, Edna O’Shaughnessy, Michael Feldman and many others – who have all helped me learn how to become – and to love being – a psychoanalyst. Elizabeth Spillius London, 2014 CHAPTER 1

CONJUGAL ROLES AND SOCIAL NETWORKS1

The original version of this chapter was published in Human Relations, vol. 8: 345–384, 1955. It was reprinted in a shortened version in Eric Trist and Hugh Murray (eds), 1990, The Social Engagement of Social Science, Volume 1 – The Socio-Psychological Perspective, University of Pennsylvania Press, Philadelphia, USA, pp. 323–350.

This paper will give an account of the sociological results of an intensive interdis- ciplinary study of 20 London families. It will be confi ned to one problem: how to interpret the variations occurring in the way husbands and wives performed their conjugal roles. A joint conjugal role-relationship is one in which husband and wife carry out many activities together, with a minimum of task differentiation and separation of interests. Husband and wife not only plan the affairs of the family together, but also exchange many household tasks and spend much of their leisure time together. A segregated conjugal role-relationship is one in which husband and wife have a clear differentiation of tasks and a considerable number of separate interests and activities; they have a division of labour into male tasks and female tasks; they expect to have different leisure pursuits; both have their own friends outside the home. Yet these are only differences of degree. All families must have some division of labour between husband and wife; all families must have some joint activities. Early in the research, it seemed likely that these differences in segregation of roles were related to forces in the social environment and an effort was made to explain them in terms of social class. This attempt was not very successful. Most husbands in joint conjugal role-relationships were professionals, but there were several working-class families that had relatively little segregation and several professional families in which segregation of roles was considerable. An attempt was also made to relate degree of segregation to the type of local area in which the family lived, since the families with most segregation lived in homogeneous areas of low population turnover, whereas those with predominantly joint role-relationships lived in

Downloaded by [New York University] at 03:54 14 August 2016 heterogeneous areas of high population turnover. Once again, there were several exceptions. But there was a more important diffi culty in these attempts to correlate segregation of conjugal roles with class position and type of local area. The research was not designed to produce valid statistical correlations. Our aim was to study the interrelation of various social and psychological factors within each family considered as a social system. Attempts at rudimentary statistical correlation did not make clear how one factor affected another. Attempts to correlate segregation of conjugal roles with factors selected from the generalised social environment of the family did not yield a meaningful interpretation. I turned to look more closely at the immediate environment of the families, that is, at their external relationships with friends, neighbours, relatives, clubs, shops, places of work, etc. This approach proved to be more fruitful. 4 Conjugal roles and social networks The external social relationships of all families appeared to assume the form of a network rather than an organised group. In an organised group, the component individuals make up a larger social whole with common aims, interdependent roles and a distinctive sub-culture. In network formation some but not all of the component individuals have social relationships with one another. They do not form an organised group and the component external units do not make up a larger social whole; they are not surrounded by a common boundary. Although all the research families belonged to networks rather than to groups, there was considerable variation in the connectedness of these networks. By ‘connectedness’ I mean the extent to which the people known by a family know one another independently of the family. I use the term ‘dispersed network’ to describe a network in which there are few relationships amongst the component units, and the term ‘highly connected network’ to describe a network in which there are many such relationships. A detailed examination of the research data reveals that the degree of segregation of conjugal roles is related to the degree of network connectedness. Those families with a high degree of segregation in role-relationships had a highly connected network; many of their friends, neighbours and relatives knew one another. Families with a relatively joint role-relationship between husband and wife had a ‘dispersed’ network; few of their relatives, neighbours and friends knew one another. There were many degrees of variation between these two extremes. On the basis of our data, I should therefore like to put forward the following hypothesis: the degree of segregation in the role-relationship of husband and wife varies directly with the connectedness of the family’s social network. The more connected the network, the more segregation between the roles of husband and wife. The more dispersed the network, the less segregation between the roles of husband and wife. If one is to understand segregation of conjugal roles, one should examine the effect of the family’s immediate social environment of friends, neighbours, relatives and institutions. The question remains, however, as to why some families should have highly connected networks whereas others have dispersed networks. In part, network connectedness depends on the family themselves. One family may choose to introduce their friends, neighbours and relatives to one another, whereas another may not. One family may move around a great deal so that its network becomes dispersed, whereas another family may stay put. But these choices are limited and shaped by a number of forces over which the family does not have direct control. At this point the total social environment becomes relevant. The economic and occupational system, the structure of formal institutions, the ecology of cities and many other factors affect the connectedness of networks, and limit and shape the decisions that families make. Factors associated with social class and neigh- Downloaded by [New York University] at 03:54 14 August 2016 bourhood composition affect segregation of conjugal roles through direct action on the internal structure of the family, but indirectly through their effects on its network. Conceptually, the network stands between the family and the total social environment. The connectedness of a family’s network depends, on the one hand, on certain forces in the total environment and, on the other, on the personalities of the members of the family and on the way they react to these forces.

Methods of collecting data2 Although this paper will be devoted primarily to discussion of the effect of external social relationships on the role-relationship of husband and wife, the research as a whole was designed to investigate families not only sociologically but also Conjugal roles and social networks 5 psychologically. The research techniques accordingly consisted of a combination of the fi eld-work method of the social anthropologist, in which the group under investigation is studied as a working whole in its natural habitat in so far as this is possible, and the case-study method in which individuals are studied by clinical interviews. No attempt was made to use statistical procedures. The families studied were ‘ordinary’, in the sense that they did not come to us for help with personal or familial problems, and they were usually able to cope themselves with such diffi culties as they had. We sought them out, they did not come to us. In order to simplify the task for comparison, only families with young children were selected. In order further to restrict the number of variables, only English families of Protestant background were selected. All 20 families lived in London or Greater London, but they were scattered all over the area and did not form an organised group. Although the families resembled one another in phase of marriage and in national and religious background, they varied considerably in occupation and in socio-economic status; the net incomes of the husbands after tax ranged from £325 to £1,500 (at 1953 values). Much diffi culty was encountered in contacting suitable families, and the effort to fi nd them taught us a good deal about the way families are related to other social groups. The 20 families were eventually contacted through the offi cials of various service institutions, such as doctors, hospitals, schools, local political parties and through friends of the family. Introductions were most successful when the contact person was well known and trusted by both husband and wife, and the most satisfactory channel of contact was through friends of the family. After the contact person had told a prospective family about the research and had got their agreement to an explanatory interview by one of the research staff, one of the fi eld workers visited the family at their home to describe what the research was about and what it would involve for the family. The fi eld worker explained the background of the research, the content of the interviews, and the time they would take, and made it clear that the family could withdraw at any time, that the material would be treated with professional discretion and that if we wished to publish any confi dential material that might reveal the couple’s identity, we should consult them beforehand. The research staff also undertook to pay any expenses that the couple might incur as a result of the investigation. Although the provisional and explanatory nature of the fi rst interview was always emphasised, we found that most of the couples who got that far had usually decided to take part in the research before they met the fi eld worker, chiefl y on the basis of what the contact person had told them. We have no systematic information about couples who were consulted but decided not to participate. After a family had agreed to take part, the fi eld worker paid several visits to Downloaded by [New York University] at 03:54 14 August 2016 them at home in the evening for joint interviews with the husband and wife. He or she also went at least once on the week-end to meet the children and observe the whole family together. There were thirteen home interviews on the average, the range being from eight to nineteen. Each home interview began with half an hour of casual chatting followed by more focussed discussions on particular topics during which notes were taken. The topics discussed were kinship, family background and personal history until marriage; the fi rst phase of the family from marriage until the birth of the fi rst child; an account of family life at the time of interviewing, including a daily, weekly and yearly diary; a description of external social relationships with service institutions such as schools, church, clinic, doctor, with voluntary associations and recreational institutions, and more informal relationships with friends, neighbours and relatives; an account of the division of 6 Conjugal roles and social networks labour between husband and wife in overall planning, in the economic support of the family, in domestic tasks and in child care; and fi nally, questions about values and ideology concerning family life, social class, money and fi nancial management, and general political, social and religious matters. These topics were used as a general guide by the fi eld worker; their order and the form of questioning were left to our discretion. Usually he or she raised a topic, and the couple carried on the discussion themselves with occasional additional questions. The discussion frequently wandered away from the assigned topic, but little attempt was made to restrict such digressions, since all the behaviour of husband and wife towards one another and towards the fi eld worker was held to be signifi cant data. In addition to the interviews with the 20 families, discussions about families in general were held with various persons, particularly doctors, who had considerable knowledge of family life. Discussions were also held with various organised groups such as Community Centres and Townswomen’s Guilds. These groups had no direct connection with the families we interviewed, and in most cases they were composed of considerably older people, usually women. These discussions were therefore not directly relevant to the analysis of the research families, but they provided useful information on the norms of family life. In a public, group situation, especially one which lasts for only one session, people seem much more willing to talk about norms than to discuss their actual behaviour.

Classiﬁ cation of families If families are classifi ed according to the extremes of the two dimensions of conjugal role-segregation and network connectedness, four patterns are logically possible: segregated conjugal role-relationship associated with a highly connected network; segregated conjugal role-relationship associated with a dispersed network; joint conjugal role-relationship associated with a highly connected network; and joint conjugal role-relationship associated with a dispersed network. Empiri- cally, two of these patterns, the second and third, did not occur. There were no families in which a highly segregated conjugal role-relationship was associated with a dispersed network; there were no families in which a joint conjugal role- relationship was associated with a highly connected network. Six of the research families were clustered in the fi rst and fourth patterns. There was one family that conformed to the fi rst pattern, a high degree of conjugal role- segregation combined with a highly connected network. There were fi ve families that conformed to the fourth pattern, a joint conjugal role-relationship associated with a dispersed network. These six families represent the extremes of the research set. There were nine families that were intermediate in degree of conjugal role- Downloaded by [New York University] at 03:54 14 August 2016 segregation and similarly intermediate in degree of network connectedness. Finally there were fi ve families that appeared to be in a state of transition both with respect to their network formation and with respect to their conjugal role-relationship. Among the 20 families, there was thus some clustering at certain points along a possible continuum from a highly segregated to a very joint conjugal role-relationship, and along a second continuum from a highly connected to a dispersed network. The families did not fall into sharply separated types so that divisions are somewhat arbitrary, but for convenience of description, I shall divide the families into four groups (shown in Table 1.1): 1) highly segregated conjugal role-relationship associated with highly connected network; 2) joint conjugal role-relationship associated with dispersed network; 3) intermediate degrees of conjugal role-segregation and network connectedness, and 4) transitional families. No claim is made here that Conjugal roles and social networks 7 these are the only patterns that can occur; further research would probably reveal others. In the following discussion I shall be chiefl y concerned not with these divisions, but rather with the fact that the order according to degree of conjugal role- segregation follows the order according to degree of network connectedness, and I shall attempt to show the mechanisms by which this relationship operates.

Table 1.1 Relationship among conjugal segregation, type of network and type of occupation*

Families in descending order Type of network Type of occupation of conjugal segregation

Newbolt close-knit semi-skilled manual Mudge medium-knit semi-skilled manual Dodgson (changing reluctantly transitional (move already semi-skilled manual from highly segregated to made) more joint) Barkway transitional (contemplating clerical move) Redfern transitional (about to move) semi-professional Baldock medium-knit skilled manual Apsley medium-knit professional Wraith (becoming more joint) transitional (several moves professional already made) Appleby medium-knit skilled manual clerical Fawcett medium-knit clerical Butler (changing eagerly from transitional (move already skilled manual highly segregated to more joint) made) Thornton medium-knit semi-professional Hartley medium-knit semi-professional

Downloaded by [New York University] at 03:54 14 August 2016 Salmon medium-knit semi-professional Jarrold medium-knit skilled manual Bruce loose-knit clerical Denton loose-knit professional Bullock loose-knit professional Woodman loose-knit semi-professional Daniels loose-knit semi-professional

*All names are fi ctitious 8 Conjugal roles and social networks Highly segregated conjugal role-relationship associated with highly connected network The research set contained only one family of this type – the Newbolts (Ns). They had been married four years when the interviewing began and had two small children. In the following discussion, I shall describe their actual behaviour, indicating the points at which they depart from their norms.

External social relationships Mr. N had a semi-skilled manual job at a factory in an East End area adjacent to the one in which they lived. He said that many other men in the local area had jobs at the same place, or were doing the same sort of work at similar factories and work- shops nearby. Mrs. N did not work, but she felt that she was unusual in this respect. Most of the neighbouring women and many of her female relatives had jobs; she did not think there was anything morally wrong with such work, but she said that she had never liked working and preferred to stay at home with the children. Mr. N said that he thought it was best for her and the children if she stayed at home, and added that he felt it was a bit of a refl ection on a man if his wife had to go out to work. The Ns used the services of a local hospital and a maternity and child welfare clinic. They expected to send their children to the local elementary school. They were also in touch with the local housing authority because they were trying to fi nd a new fl at. These various service institutions were not felt to have any particular relationship to one another, except in the sense that they were all felt to be foreign bodies, not really part of the local life. Mrs. N was a little bit afraid of them, particularly of the hospital and of doctors. On one occasion, while waiting with her baby and the fi eld worker in an otherwise empty hospital room for a doctor to attend to the baby, she said in a whisper, ‘My husband says that we pay for it [the hospital services, through National Health subscriptions] and we should use it, but I don’t like coming here. I don’t like hospitals and doctors, do you?’ To the Ns, the local area was defi nitely a community in the social sense, a place with an identity of its own and a distinctive way of life. They spoke of it with great pride and contrasted it favourably with other areas. ‘It has a bad name, they say we are rough, but I think it’s the best place there is. Everyone is friendly … there is no life in the West End compared with the East End. They drink champagne and we drink beer. When things are la-di-da you feel out of place.’ They took it for granted that the other inhabitants had similar feelings of local pride and loyalty. Both the Ns had grown up in the same area, as had most of their relatives and friends. Trips outside the area were like adventures into a foreign land, especially for Mrs. N, and Downloaded by [New York University] at 03:54 14 August 2016 very few informal social relationships were kept up with people outside the area. Physical distance was felt to be an almost insuperable barrier to social contact. Physically, the area was far from ideal as a place to live. The houses were old- fashioned, inconvenient and crowded. The Ns were faced with a diffi cult choice of whether to move out of London to a modern fl at on a new housing estate, or to stay put in cramped quarters, in the old familiar local area with their friends and relatives. They knew of several other young couples who were faced with a similar dilemma. Group discussions at a local community centre and the research of the Institute of Community Studies indicated that many local residents feel this to be an important social and personal problem (Young, 1954). The Ns felt that their neighbours were socially similar to themselves, meaning that they had the same sort of jobs, the same sort of background, the same sort of Conjugal roles and social networks 9 outlook on life. Because the Ns had grown up in the area, as had many of their relatives and neighbours, they knew a very considerable number of local people, and many of the people they knew were acquainted with one another. Their social network was highly connected. In fact there was considerable overlap of social roles; instead of there being people in three or four separate categories – friend, neighbour, relatives and colleague – the same person frequently fi lled two, three or even four of these roles simultaneously. The Ns took it for granted that Mr. N, like other husbands in their social circle, would have some form of recreation with men away from home. In his case it was football, although the most common form of recreation was felt to be drinking and visiting in the local pub, where many husbands spent an evening or two a week with their friends; quite frequently some of these men were friends of old standing, men who had belonged to the same childhood gang and others were work colleagues. Mr. N had kept in touch with one or two friends of his childhood; he also played football and went to matches with some of his colleagues; he mentioned that several of his friends knew one another. Mrs. N knew a bit about these men, but she did not expect to join in their activities with her husband. She had a nodding acquaintance with the wives of two or three of these men, and occasionally talked to them when she was out shopping. Mrs. N also had her own separate relationships in which her husband did not expect to join. She knew many of her female neighbours, just as they knew one another; she took it for granted that a friendly relationship with a neighbour would be dropped if the woman moved away. Neighbours saw one another on the landings, in the street, in shops, occasionally over a cup of tea inside the fl at or house. They talked over their own affairs and those of other neighbours. Neighbours frequently accused one another of something – of betraying a confi dence, of taking the wrong side in a children’s quarrel, of failing to return borrowed articles, of gossip. One has little privacy in such a situation. But if one wants to reap the rewards of companionship and receive small acts of mutual aid, one has to conform to local standards and one has to put up with being included in the gossip. Indeed, being gossiped about is as much a sign that one belongs to the neighbourly network as being gossiped with. If one refuses to have anything to do with one’s neighbours one is thought odd, but eventually one will be left alone; no gossip, no companionship. With the exception of visiting relatives and an occasional Sunday outing with the children, the Ns spent very little of their leisure time in joint recreation; even though they could have got their relatives to mind the children for them, they rarely went out together. There was no joint entertaining of friends at home. From time to time Mr. N brought a friend home and Mrs. N made tea and talked a bit to the

Downloaded by [New York University] at 03:54 14 August 2016 friend; female neighbours often dropped in during the evening to borrow something, but they did not stay long if Mr. N was there. There was no planned joint entertaining in which Mr. and Mrs. N asked another husband and wife to spend an evening with them. Such joint entertaining as existed was carried on with relatives, not with friends. Poverty does not explain the absence of joint entertaining, for the Ns considered themselves to be relatively well off. It did not seem to occur to them that they might spend their surplus money on entertainment of friends; they felt that such money should be spent on furniture, new things for the children or large gatherings of relatives at weddings, funerals and christenings. There was much visiting and mutual aid between relatives, particularly by the women. The Ns had far more active social relationships with relatives than any other research family, and there was also a great deal of independent contact by their relatives with one another in addition to their contacts with the Ns 10 Conjugal roles and social networks themselves. The network of kin was highly connected, more so than those of neighbours or friends. The women were more active than the men in keeping up contacts with relatives, with the result that the networks of wives were more highly connected than the networks of their husbands. Although husbands were recognised to be less active in kinship affairs, Mr. N paid occasional visits to his mother, both by himself and with Mrs. N. There were some activities for which joint partic- ipation by husband and wife was felt to be desirable. At weddings, funerals and christenings, there were large assemblages of relatives, and it was felt to be important that both husband and wife should attend. Recent and prospective weddings, twenty-fi rst birthday parties and christenings formed an important topic of discussion throughout the interviews with the Ns. In a group discussion, a man living in the same local area as the Ns and having a similar sort of family life and kinship network summed up the situation by saying, ‘Men have friends. Women have relatives.’ For Mrs. N, there was no independent category of friend; friends were either neighbours or relatives. She had had a succession of girl friends in her adolescence, but she said that she did not see so much of them since they had all got married and had had children. She always described them as girl friends, not as friends. Both Mr. and Mrs. N used the term friend as if it applied only to men; the term neighbour, on the other hand, seemed to refer only to women. Mr. N looked rather shocked when I asked him if he saw much of the neighbours. Later on in the group discussion, the same man observed, ‘Women don’t have friends. They have Mum.’ In Mrs. N’s case the relationship between herself and her mother was indeed very close. Her mother lived nearby and Mrs. N went to visit her nearly every day, taking her children along with her. She and her mother and her mother’s sisters also went to visit Mrs. N’s maternal grandmother. Together these women and their children formed an important group, helping one another in household tasks and child care, and providing aid for one another in crises. Within the network of relatives there was a nucleus composed of the grandmother, her daughters, and her daughters’ daughters; the relationships of these women with one another were suffi ciently intense and distinctive to warrant the term ‘organised group’ in the sense defi ned above. Mrs. N’s female relatives provided some of the domestic help and emotional support that, in other research families, a wife expected to get from her husband. Mrs. N felt tremendously attached to her mother emotionally. She felt that a bad relationship between mother and daughter was unnatural, a complete catastrophe. She would, I feel sure, have been deeply shocked by the seemingly cold and objective terms in which many of the women in the other research families analysed their mothers’ characters. The close tie with the mother is not only a source of help, however; it may also be a potential source of friction, Downloaded by [New York University] at 03:54 14 August 2016 for if her husband and her mother do not get along well together a young wife is likely to feel torn by confl icting loyalties. Mrs. N felt that she was particularly fortunate in that her husband and her mother liked each other. There was considerable segregation between Mr. and Mrs. N in their external relationships. Mrs. N had her network and Mr. N had his. The number of joint external relationships was comparatively small. At the same time, there were many links between their networks: the husbands of some of Mrs. N’s neighbours were men who were colleagues of Mr. N, some of Mrs. N’s relatives also worked at the same place as Mr. N, and in a general way, his family was known to hers even before Mr. and Mrs. N got married. The connectedness of the combined networks of Mr. and Mrs. N was high compared to that of the families to be discussed below. But the Ns’ total network was sharply divided into the husband’s network Conjugal roles and social networks 11 and the wife’s network. Furthermore, her network was more highly connected than his: many of the relatives and neighbours with whom she was in contact saw one another independently of her, whereas there were fewer independent links between Mr. N’s colleagues, his football associates and his friends from childhood.

Conjugal role-segregation The previous description reveals considerable segregation between Mr. and Mrs. N in their external relationships. There was a similar segregation in the way they carried out their internal domestic tasks. They took it for granted that there should be a clear-cut division of labour between them, and that all husbands and wives in their social circle would organise their households in a similar way. One man said in a group discussion: ‘A lot of men wouldn’t mind helping their wives if the curtains were drawn so people couldn’t see.’ Although the Ns felt that major decisions should be made jointly, in the day-to-day running of the household he had his jobs and she had hers. He had control of the money and gave her a housekeeping allowance of £5 a week. Mrs. N did not know how much money he earned, and it did not seem to occur to her that a wife would want or need to know this. Although the Ns said that £5 was the amount most wives were given for housekeeping, Mrs. N had great diffi culty in making it cover all the expenses of food, rent, utilities and fi ve shillings’ saving for Christmas. She told Mr. N whenever she ran short, and he left a pound or two under the clock when he went out the next morning. She said that he was very generous with his money and she felt that she was unusually fortunate in being spared fi nancial quarrels. Mrs. N was responsible for most of the housework and child care, although Mr. N did household repairs and helped to entertain the children on week-ends. Mrs. N expected that he would do some of the housework if she became ill, but this was usually unnecessary because her mother or her sister or one of her cousins would come to her aid. Indeed, these female relatives helped her a great deal, even with the everyday tasks of housework and child care.

Attitudes towards the role-relationship of husband and wife Mr. and Mrs. N took it for granted that men had male interests and women had female interests and that there were few leisure activities that they would naturally share. In their view, a good husband was one who was generous with the housekeeping allowance, did not waste money on extravagant personal recreation, helped his wife with the housework if she got ill, and took an interest in the children. A good wife was a good manager and an affectionate mother, a woman Downloaded by [New York University] at 03:54 14 August 2016 who kept out of serious rows with neighbours and got along well with her own and her husband’s relatives. A good marital relationship was one with a harmonious division of labour, but the Ns placed little stress on the importance of joint activities and shared interests. It is diffi cult to make any defi nite statement on the Ns’ attitudes towards sexual relations, for they did not come to the Institute for clinical interviews. Judging from Mrs. N’s references to such matters when Mr. N was absent, it seems likely that she felt that physical sexuality was an intrusion on a peaceful domestic relationship rather than an expression of such a relationship; it was as if sexuality were felt to be basically violent and disruptive. The fi ndings of clinical workers and of other research workers suggest that among families like the Ns, there is little stress on the importance of physical sexuality for a happy marriage (Slater and Woodside, 1951). 12 Conjugal roles and social networks Joint conjugal role-relationships associated with dispersed networks There were fi ve families of this type. All the husbands had professional or semi- professional occupations. Two of the husbands had been upwardly mobile in occupation relative to their fathers. All fi ve families, however, had a well-established pattern of external relationships; they might make new relationships, but the basic pattern was likely to remain the same. Similarly, all had worked out a fairly stable division of labour in domestic tasks.

External social relationships The husbands’ occupations had little intrinsic connection with the local areas in which they lived. All fi ve carried on their work at some distance from the area in which their homes were located, although two did some additional work at home. But in no case was there any feeling that the occupation was locally rooted. Whether or not wives should work was considered to be a very controversial question by these families. Unless they were very well off fi nancially – and none of these fi ve families considered themselves to be so – both husband and wife welcomed the idea of a double income, even though much of the additional money had to be spent on caring for the children. But money was not the only consideration; women also wanted to work for the sake of the work itself. It was felt that if she desired it, a woman should have a career or some sort of special interest and skill comparable in seriousness to her husband’s occupation; on the other hand, it was felt that young children needed their mother’s care and that ideally she should drop her career at least until the youngest child was old enough to go to school. But most careers cannot easily be dropped and picked up again several years later. Two of the wives had solved the problem by continuing to work; they had made careful (and expensive) provision for the care of their children. One wife worked at home. One planned to take up her special interest again as soon as her youngest child went to nursery school, and the fi fth wife was already doing so. These husbands and wives maintained contact with schools, general practitioners, hospitals and in some cases local maternity and child welfare clinics. Most of them also used the services of a solicitor, an insurance agent and other similar professional people. Unlike the fi rst type of family, they did not feel that service institutions were strange and alien; it did not bother them when they had to go out of their local area to fi nd such services, and they were usually well informed about service institutions and could exploit them effi ciently. They were not afraid of doctors. There was no strict division of labour between husband and wife in dealing with service institutions. The wife usually dealt with those institutions that Downloaded by [New York University] at 03:54 14 August 2016 catered for children, and the husband dealt with the legal and fi nancial ones, but either could take over the other’s duties if necessary. These husbands and wives did not regard the neighbourhood as a source of friends. In most cases husbands and wives had moved around a good deal both before and after marriage, and in no case were they living in the neighbourhood in which they grew up. Four were living in areas of such a kind that only a few of the neighbours were felt to be socially similar to the family themselves. The fi fth family was living in a suburb that the husband and wife felt to be composed of people socially similar to one another, but quite different from themselves. In all cases these husbands and wives were polite but somewhat distant to neighbours. In order to have become proper friends, the neighbours would have had not only to be socially similar to the family themselves, but also to share a large number of tastes Conjugal roles and social networks 13 and interests. Establishing such a relationship takes a long exploratory testing, and the feeling seems to have been that it was dangerous to make the test with neighbours since one ran the risk of being pestered by friendly attentions that one might not want to return. Since many of the neighbours probably had similar feelings, particularly when the neighbourhood was socially heterogeneous, it is not surprising that intimate social relationships were not rapidly established. Since these families had so little social intercourse with their neighbours, they were very much less worried than the fi rst type of family about gossip and conformity to local norms. Indeed, in the circumstances one can hardly say that there were any specifi - cally local norms; certainly there was not the body of shared attitudes and values built up through personal interaction since childhood that was characteristic of the local area inhabited by the Ns. The children were less discriminating than their parents. Unless restricted by their parents, they played with anyone in the street. This caused some of the parents a certain amount of anxiety, particularly when they felt that the area was very heterogeneous. Other parents adopted the view that mixing with children of other social classes was a good thing. In any case, all parents relied on their own infl uence and on the education of the children to erase any possibly bad effects of such contact. It seemed very diffi cult for these families to fi nd the sort of house and local area in which they wanted to live. They wanted to own a reasonably cheap house with a garden in central London, a house within easy reach of their friends, of plays, concerts, galleries and so forth. Ideally they wanted a cheap, reliable cleaning- woman-cum-baby-sitter to live nearby, possibly even with the family if they could afford it. Only one family had achieved something approaching this aim. The others were making do with various compromises, impeded by lack of money as well as by the scarcity of suitable houses. For these families, friends were felt to provide the most important type of external relationship. Not all of each family’s friends knew one another; it was not usual for a large number of a family’s friends to be in intimate contact with one another independently of their contact with the family. The network of friends was typically dispersed (unconnected). Husband and wife had usually established friendships over a period of years in many different social contexts – at school, during the course of their professional training, in the Services, at various jobs and very occasionally even because of living in the same neighbourhood. Their friends were scattered all over London, sometimes all over Britain. Because the network of friends was so dispersed, their social control over the family was dispersed and fragmented. The husband and wife were very sensitive to what their friends thought of them, but since the friends had so little contact with one another, they were not likely to present a unifi ed body of public opinion. Amongst all the different bits of Downloaded by [New York University] at 03:54 14 August 2016 advice they might receive, husband and wife had to make up their own minds about what they should do. They were less persecuted by gossip than the fi rst type of family, but they were also less sustained by it. Their friends did not form a solid body of helpers. In marked contrast to the Ns, nearly all of the husband’s and wife’s friends were joint friends; it was felt to be important that both husband and wife should like a family friend, and if a friend was married, then it was hoped that all four partners to the relationship would like one another. Exceptions were tolerated, especially in the case of very old friends, but both husband and wife were uncomfortable if there was real disagreement between them over a friend. Friendship, like marriage, required shared interests and similar tastes, although there was some specialisation of interests among different friends. For example, one couple might be golfi ng 14 Conjugal roles and social networks friends whereas others might be pub and drinking friends; still others were all- round friends, and it was these who were felt to be the most intimate. Joint entertainment of friends was a major form of recreation. Even when poverty made invitations to dinner or parties impracticable, friends were still asked over jointly even if only for coffee or tea in the evening. It was considered provincial for husbands to cluster at one end of the room and wives at the other; everyone should be able to talk to everyone else. These husbands and wives usually had enough shared interests to make this possible. Many of them were highly educated, so that they had a common background of general topics, but even those who lacked such education usually made an attempt to talk about matters of general interest. After these couples had had children, it had become increasingly diffi cult for them to visit their friends since they often lived at a considerable distance and most of them were also tied down by young children. Considerable expense and trouble were taken to make such visiting possible. It was obvious that friends were of primary importance to these families. There were usually other forms of joint recreation besides visiting friends, such as eating in foreign restaurants, going to plays, the cinema and concerts. After children were born, there had been a marked drop in external joint recreation in preference for things that could be done at home. Going out had become a special occasion with all the paraphernalia of a baby-sitter and arrangements made in advance. These fi ve families had far less contact with their relatives than the Ns. Their relatives were not concentrated in the same local area as themselves, and in most cases were scattered all over the country and did not keep in close touch with one another. They formed a dispersed network. It was felt that friendly relations should be kept up with parents, and in several cases the birth of the children had led to a sort of reunion with parents. It seems likely that becoming a parent facilitates a resolution of some of the emotional tensions between adult children and their own parents, particularly between women and their mothers. It is possible that in some cases the arrival of children may exacerbate such tensions, but none of these fi ve families had had such an experience. There are of course some obvious practical advantages in increased contact with parents; they are usually very fond of their grandchildren, so that they make affectionate and reliable baby-sitters. If they live close enough to take on this task their services are greatly appreciated. Among the families with dispersed networks, there was not the tremendous stress on the mother–daughter relationship that was described for Mrs. N, although women were usually rather more active than men in keeping up kinship ties. There were also fewer confl icts of loyalty; it was felt that if confl icts arose between one’s parents and one’s spouse, one owed one’s fi rst loyalty to one’s spouse. Unless special interests, particularly fi nancial interests, were operating among relatives, there was no very Downloaded by [New York University] at 03:54 14 August 2016 strong obligation towards relatives outside the parental families of husband and wife. Even towards siblings there was often very little feeling of social obligation. These families were very much less subject to social control by their relatives than the Ns, partly because they saw less of them, but also because the network of kin was dispersed so that its various members were less likely to share the same opinions and values. In brief, the networks of these families were less highly connected than that of the Ns: many of their friends did not know one another, it was unusual for friends to know relatives, only a few relatives kept in touch with one another, and husband and wife had very little contact with neighbours. Furthermore, there was no sharp segregation between the wife’s network and the husband’s network. With the exception of a few old friends and some colleagues, husband and wife maintained joint external relationships. Conjugal roles and social networks 15 Conjugal role-segregation As described above, these families had as little segregation as possible in their external relationships. There was a similar tendency towards joint organisation in domestic tasks and child care. It was felt that effi cient management demanded some division of labour, particularly after the children had been born; there had to be a basic differentiation between the husband’s role as primary breadwinner and the wife’s role as mother of young children. But in other respects such division of labour as existed was felt to be more a matter of convenience than of inherent differences between the sexes. The division of labour was fl exible, and there was considerable helping and interchanging of tasks. Husbands were expected to take a very active part in child care. Financial affairs were managed jointly, and joint consultation was expected on all major decisions. Husbands were expected to provide much of the help that Mrs. N was able to get from her female relatives. The wives of these families with dispersed networks were carrying a tremendous load of housework and child care, but they expected to carry it for a shorter time than Mrs. N. Relatives sometimes helped these wives, but only occasionally; they usually lived at some distance so that it was diffi cult for them to provide continuous assistance. Cleaning women were employed by four families and a children’s nurse by one; all families would have hired more domestic help if they could have afforded it. In spite of their affection for their children, all fi ve couples were looking forward to the time when their children were older and the burden of work would decrease. So far as they could see ahead they did not expect to provide continuous assistance to their married children. In the case of Mrs. N and other wives with highly connected networks, the burden of housework and child care is more evenly distributed throughout the lifetime of the wife; when she is a girl she helps her mother with the younger children; when she herself has children, her mother and other female relatives help her; when she is a grandmother she helps her daughters.

Attitudes towards the role-relationship of husband and wife Among the families with dispersed networks, there were frequent discussions of whether there really were any psychological or temperamental differences between the sexes. These differences were not simply taken for granted as they were by the Ns. In some cases, so much stress was placed on shared interests and sexual equality (which was sometimes confused with identity, the notion of equality of complementary opposites being apparently a diffi cult idea to maintain consistently) that one sometimes felt that the possibility of the existence of social and temperamental Downloaded by [New York University] at 03:54 14 August 2016 differences between the sexes was being denied. In other cases, temperamental differences between the sexes were exaggerated to a point that belied the couple’s actual joint activities and the whole pattern of shared interests that they felt to be so fundamental to their way of life. Quite frequently the same couple would minimise differences between the sexes on one occasion and exaggerate them on another. Sometimes these discussions about sexual differences were very serious; sometimes they were witty and facetious; but they were never neutral – they were felt to be an important problem. Such discussions may be interpreted as an attempt to air and to resolve the contradiction between the necessity for joint organisation with its ethic of equality on the one hand, and the necessity for differentiation and recognition of sexual differences on the other. ‘After all,’ as one husband said, to conclude the discussion, ‘vive la difference, or where would we all be?’ 16 Conjugal roles and social networks It was felt that, in a good marriage, husband and wife should achieve a high degree of compatibility, based on their own particular combination of shared interests and complementary differences. Their relationship with each other should be more important than any separate relationship with outsiders. The conjugal relationship should be kept private, and revelations to outsiders, or letting down one’s spouse in public, were felt to be serious offences. A successful sexual relationship was felt by these couples to be very important for a happy marriage: it was as if successful sexual relations were felt to prove that all was well with the joint relationship, whereas unsatisfactory relations were indicative of a failure in the total relationship. In some cases one almost got the feeling that these husbands and wives felt a moral obligation to enjoy sexual relations, a feeling not expressed or suggested by the Ns. The wives of these families seemed to feel that their position was rather diffi cult. They had certainly wanted children, and in all fi ve cases they were getting a great deal of satisfaction from their maternal role. But at the same time, they felt tied down by their children and they did not like the inevitable drudgery associated with child care. Some were more affected than others, but most of them complained of isolation, boredom and fatigue. ‘You must excuse me if I sound half-witted. I’ve been talking to the children all day’ was not an uncommon remark. These women wanted a career or some special interest that would make them feel that they were something more than children’s nurses and housemaids. They wanted more joint entertainment with their husbands and more contact with friends. These complaints were not leveled specifi cally at their husbands – indeed in most cases they felt that their husbands were doing their best to make the situation easier –but against the social situation in which they found themselves and at the diffi culty of satisfying contradictory desires at the same time. One wife summed it up by saying, ‘Society seems to be against married women. I don’t know, it’s all very diffi cult.’ It may be felt that the problem could be solved if such a family moved to an area that was felt to be homogeneous and composed of people similar to themselves, for then the wife might be able to fi nd friends among her neighbours and would feel less isolated and bored. It is diffi cult to imagine, however, that these families could feel that any local area, however homogeneous by objective criteria, could be full of potential friends, for their experience of moving about in the past and their varied social contacts make them very discriminating in their choice of friends. Further, their dislike of having their privacy broken into by neighbours is very deeply rooted; it diminishes after the children start playing with children in the neighbourhood, but it never disappears entirely.

Downloaded by [New York University] at 03:54 14 August 2016 Intermediate degrees of conjugal role-segregation and network connectedness There were nine families of this type in the research set. There was considerable variety of occupation amongst them. Four husbands had professional or semi- professional occupations very similar to the occupations of the second type of family described above. It was in recognition of the fact that these four families were similar in occupation but different in conjugal role-segregation from the second set of families that I concluded that conjugal role-segregation could not be attributed to occupational level alone. Of the fi ve remaining husbands, one was a clerical worker, three had manual occupations similar in general level to that of Mr. N, and one changed from a highly skilled manual job to an offi ce job after the interviewing was completed. Conjugal roles and social networks 17 There was considerable variation among these nine families in conjugal role- segregation. Some tended to have a fairly marked degree of segregation, approaching that of the Ns, whereas others were closer to the second set of families in having a relatively joint role-relationship. These variations in degree of segregation of conjugal roles within the nine intermediate families did not follow exactly the order according to occupational level. If the occupations of the husbands are arranged in order from the most joint to the most segregated conjugal role-relationship, the order is as follows: manual worker, professional, professional, clerical worker, professional, manual worker, professional, manual worker, manual worker. The variations in degree of segregation follow more closely the variations in degree of network connectedness. The families with the most dispersed networks had the most joint role-relationships, and the families with the most connected networks had the most conjugal role-segregation. The families with the most dispersed networks were those who had moved around a great deal so that they had established relationships with many people who did not know one another. For brevity of description, I shall treat these nine intermediate families collec- tively, but it should be remembered that there were variations in degree amongst them, and that both network connectedness and conjugal role-segregation form continua so that it is somewhat arbitrary to divide families into separate types.

External social relationships The data suggest two possible reasons for the intermediate degree in the connectedness of the networks of these families. First, most of them had been brought up in families whose networks had been less connected than that of the Ns, but more connected than that of the second set of families. With one exception these couples had moved around less than the second type of family both before and after marriage, so that more of their friends knew one another; several had had considerable continuity of relationships since childhood, and they had not developed the pattern of ignoring neighbours and relying chiefl y on friends and colleagues that was described as typical of families with very dispersed networks. Secondly, these families were living in areas where they felt that many of the neighbours were socially similar to themselves. In four cases these were suburban areas; in fi ve cases they were mixed working-class areas in which the inhabitants were felt to be similar to one another in general occupational level although they worked at different jobs. Five families were living in or near the area where one or both of the partners had lived since childhood. In two of the remaining four cases, the area was similar to the one in which husband and wife had been brought up. In two cases, the present area differed considerably from the childhood area of one or Downloaded by [New York University] at 03:54 14 August 2016 other partner, but the couple had acclimatised themselves to the new situation. If the husband and wife were living in the area in which they had been brought up, each was able to keep up some of the relationships that had been formed before marriage. This was also true of the Ns. The intermediate families differed from the Ns chiefl y in that their jobs, and in some cases their education, had led them to make relationships with people who were not neighbours. Many neighbours were friends, but not all friends were neighbours. Even in the case of families in which one or both partners had moved to the area after marriage, each partner was able to form friendly relationships with at least some of the neighbours, who were in most cases felt to be socially similar to the couple themselves. Husband and wife were able to form independent, segregated relationships with neighbours. In particular, many of the wives spent a good deal of their leisure time during the day 18 Conjugal roles and social networks with neighbouring women. Husband and wife also joined local clubs, most of these clubs being unisexual. (Voluntary associations appear to thrive best in areas where people are similar in social status but do not know one another well; the common activity gives people an opportunity to get to know one another better.) In local areas inhabited by the intermediate families, many of the neighbours knew one another. There was not the very great familiarity built up over a long period of continuous residence as for the Ns, but there was not the standoffi shness described as typical of the families with very dispersed networks. The intermediate families had networks of neighbours that were midway in degree of connectedness, and the husbands and wives were midway in sensitivity to the opinions of neighbours – more susceptible than the second set of families, but better able to maintain their privacy than the Ns. Husbands and wives had some segregated relationships with neighbours, but they could also make joint relationships if all four partners liked one another. Some relationships were usually kept up with friends who had been made outside the area. Couples usually tried to arrange joint visits with these friends. These friends usually did not become intimate with the neighbours, however, so that the network remained fairly dispersed. Relations with relatives were much like those described above for the second set of families. But if the relatives were living in the same local area as the family, there was considerable visiting and exchange of services, and if the relatives lived close to one another, the kinship network was fairly well connected. The networks of these families were thus less highly connected than that of the Ns, but more highly connected than that of the second set of families. There was some overlapping of roles. Neighbours were sometimes friends; some relatives were both neighbours and friends. The overlapping was not as complete as it was with the Ns, but there was not the complete division into separate categories – friend, neighbour, relative – that was characteristic of the second set of families. The networks of husband and wife were less segregated than those of the Ns, but more segregated than those of the second set of families.

Conjugal role-segregation In external relationships, husband and wife had some joint relationships, particularly with relatives and with friends, and some segregated relationships, particularly with neighbours and local clubs. In carrying out household tasks and child care, there was a fairly well-defi ned division of labour, a little more clearly marked than in the second type of family, more fl exible than in the case of the Ns. Husbands helped, but there was a greater Downloaded by [New York University] at 03:54 14 August 2016 expectation of help from neighbours and relatives (if they lived close enough) than among the second set of families.

Attitudes towards the role-relationship of husband and wife Although there were variations of degree, considerable stress was placed on the importance of shared interests and joint activities for a happy marriage. In general, the greater the stress that was placed on joint organisation and shared interests, the greater was the importance attached to sexual relations. Like the families with dispersed networks, the intermediate families stressed the necessity for conjugal privacy and the precedence of the conjugal relationship over all external relationships, but there was a greater tolerance of social and temperamental differences Conjugal roles and social networks 19 between the sexes, and there was an easier acceptance of segregation in the activities of husband and wife. Wives often wanted some special interest of their own, other than housework and children, but they were able to fi nd activities such as attending evening classes or local clubs that could be carried on without interfering with their housework and child care. And because, in most cases, they felt that at least some of the neighbouring women were similar to themselves, they found it relatively easy to make friends among them, and they had people to talk to during the day. They complained less frequently of isolation and boredom than did the wives in families with very dispersed networks.

Transitional families There were fi ve families in varying states of transition from one type of network to another. Two phases of transition can be distinguished: families who were in the process of deciding to move from one local area to another, a decision that was requiring considerable restructuring of their networks, and somewhat de-socialised families who had radically changed their pattern of external relationships and had not yet got used to their new situation. There were other families who had gone through the process of transition and had more or less settled down to the pattern typical of families with dispersed or intermediate networks.

Families in the process of deciding to move There were two such families. Both had relatively highly connected networks, and both had been socially mobile and were contemplating moving to suburban areas, which would be more compatible with their new social status. In both cases this meant cutting off old social ties with relatives and neighbours and building up new ones. One couple seemed to feel too bound to the old network to make the break; they also said they did not want to lower their current standard of living by spending a lot of money on a house. The second family moved after the interviewing was completed, and a brief return visit suggested that they would in time build up the intermediate type of network and conjugal role-segregation.

Somewhat de-socialised families There were three families of this type. All three had been brought up in highly connected networks similar to the Ns, and all had moved away from their old areas and the people of their networks. For such a family, any move outside the area is a drastic step. This contrasts with the intermediate families who are not too upset by Downloaded by [New York University] at 03:54 14 August 2016 moving, provided that they move to an area of people who are felt to be socially similar to themselves. One family had been very mobile occupationally, although they had moved primarily because of the requirements of the husband’s occupation rather than to fi nd a neighbourhood compatible with their achieved status. They were living in relative isolation, with very few friends, almost no contact with neighbours and very little contact with relatives, most of whom were living at a considerable distance. They seemed to be a bit stunned by the change in their immediate environment. They had some segregated interests, but they felt that joint organisation and shared interests were the best basis of a conjugal relationship. The other two families were working-class and had not been occupationally mobile. They were particularly important to the conceptual analysis of conjugal 20 Conjugal roles and social networks role-segregation for, although they were similar to the Ns in occupational level and in general cultural background, their conjugal role-relationship was more joint. It was their relatively dispersed networks that distinguished them from the Ns. These two families had moved to a different local area because they could not fi nd suitable accommodation in their old neighbourhoods. They also wanted the amenities of a modern fl at, and since their parents had died and many of their relatives had moved away, they felt that their main ties to the old local area were gone. Both seemed to feel that they were strangers in a land full of people who were all strangers to one another, and at fi rst they did not know how to cope with the situation. They did not react to their new situation in exactly the same way. In both cases, husband and wife had turned to one another for help, especially at fi rst, but for various personal reasons, one husband and wife were making a concerted effort to develop joint activities and shared interests, whereas the other couple did not take to the idea of a joint role-relationship with any enthusiasm. In the fi rst case, husband and wife tried to develop more joint relationships with friends, but this was diffi cult for them because they had had so little practice; they did not know the culture of a joint role-relationship, and their new acquaintances were in a similar predicament so that they got little external support for their efforts. The husband tried to get his wife to join in his club activities, but the structure of the club was such that her activities remained somewhat segregated from his. The husband helped his wife extensively with household tasks and child care, although he continued to plan the family fi nances. In the second case, the husband busied himself with his work and friends and spent a great deal of time on various committees with other men; his wife was becoming isolated and withdrawn into the home. They had more joint organisation of domestic tasks than they had had before; she urged him to help her because her female relatives lived too far away to be of much assistance. In both cases, however, nothing could really take the place of the old networks built up from childhood, and both couples felt a good deal of personal dissatis- faction. The husbands were perhaps less drastically affected, since they continued to work at their old jobs and their relationships with colleagues gave them considerable continuity. Both husband and wife often blamed their physical surroundings for their malaise, and they idealised their old local areas. They remembered only the friendliness and forgot the physical inconvenience and the unpleasant part of the gossip. On the whole, although one family had carried the process further than the other, both seemed to be developing a more joint division of labour than that which they had had before, and it seemed likely that they would eventually settle down in some intermediate form of network connectedness and conjugal role-segregation. The research set did not contain any families who had moved in the other direction, that is, from a dispersed to a more connected network. But personal knowledge of Downloaded by [New York University] at 03:54 14 August 2016 families who had been accustomed to a dispersed network and were having to come to grips with a fairly highly connected one suggests that this type of change is also felt to be somewhat unpleasant. The privacy of husband and wife is encroached upon, and each is expected to take part in segregated activities, a state of affairs that they regard as provincial. These families could have refused to enter into the local network of social relationships, but in most cases they felt that the husband’s career required it.

The relationship between conjugal role-segregation and network connectedness Connected networks are most likely to develop when husband and wife, together with their friends, neighbours and relatives, have all grown up in the same local Conjugal roles and social networks 21 area and have continued to live there after marriage. Husband and wife come to the marriage each with his or her own highly connected network. It is very likely that there will be some overlap of their networks; judging by the Ns’ account of their genealogy, one of the common ways for husband and wife to meet each other is to be introduced by a person who is simultaneously a friend of one and a relative of the other. Each partner makes a considerable emotional investment in relationships with the people in his network; each is engaged in reciprocal exchanges of material and emotional support with them; each is very sensitive to their opinions and values, not only because the relationships are intimate, but also because the people in the network know one another and share the same values so that they are able to apply consistent informal sanctions to one another. The marriage is superimposed on these pre-existing relationships. As long as the couple continue to live in the same area, and as long as their friends, neighbours and relatives also continue to live within easy reach of the family and of one another, the segregated networks of husband and wife can be carried on after marriage. Some rearrangement is necessary; the husband is likely to stop seeing some of the friends of his youth, particularly those who work at a different place and go to different pubs and clubs; after children are born, the wife is likely to see less of her former girl friends and more of her mother and other female relatives. But apart from these readjustments, husband and wife can carry on their old external relationships, and they continue to be very sensitive to external social controls. In spite of the conjugal segregation in external relationships, the overlapping of the networks of husband and wife tends to ensure that each partner fi nds out about the other’s activities. Although a wife may not know directly what a husband does with his friends away from home, one of the other men is likely to tell his wife or some other female relative who eventually passes the information on, either directly or through other women. Similarly any defection on the part of the wife is likely to be made known to her husband. Because old relationships can be continued after marriage, both husband and wife can satisfy some of their personal needs outside the marriage, so that their emotional investment in the conjugal relationship need not be as intense as in other types of family. Both husband and wife, but particularly the wife, can get outside help with domestic tasks and with child care. A rigid division of labour between husband and wife is therefore possible, since each can get outside help. The segregation in external relationships can be carried over to activities within the family. Networks become dispersed when people move around from one place to another, or when they make new relationships that have no connection with their old ones. If both husband and wife have moved around a good deal before marriage, Downloaded by [New York University] at 03:54 14 August 2016 each will bring an already dispersed network to the marriage. After the marriage they will meet new people as well as some of the old ones, and these people will not necessarily know one another. Their external relationships are relatively discon- tinuous both in space and in time. Such continuity as they possess lies in their relationship with each other rather than in their external relationships. In facing the external world, they draw on each other, for their strongest emotional investment is made where there is continuity. Hence their high standards of conjugal compatibility, their stress on shared interests, on joint organisation, on equality between husband and wife. They must get along well together, they must help one another as much as possible in carrying out familial tasks, for there is no sure external source of material and emotional help. Since their friends and relatives are physically scattered and few of them know one another, the husband and 22 Conjugal roles and social networks wife are not stringently controlled by a solid body of public opinion, but they are also unable to rely on consistent external support. Through their joint external relationships they present a united front to the world and they reaffi rm their joint relationship with each other. No external person must seriously menace the conjugal relationship; joint relationships with friends give a source of emotional satisfaction outside the family without threatening their own relationship. In between these two extremes are the intermediate and transitional families. In the intermediate type, husband and wife have moved around a certain amount so that they seek continuity with each other and make their strongest emotional investment in the conjugal relationship. At the same time, they are able to make some segregated relationships outside the family and they are able to rely on considerable casual help from the people outside the family, so that a fairly clearly defi ned division of labour into male tasks and female tasks can be made. The transitional families illustrate some of the factors involved in changing from one type of network to another. Husbands and wives who change from a connected to a dispersed network fi nd themselves suddenly thrust into a more joint relationship without the experience or the attitudes appropriate to it. The eventual outcome depends partly on the family and partly on the extent to which their new neighbours build up relationships with one another. An intermediate form of network connectedness seems to be the most likely outcome. Similarly, in the case of families who change from a dispersed to a more highly connected network, their fi rst reaction is one of mild indignation at losing their privacy, but in time it seems likely that they will tend to develop an intermediate degree of network connectedness and conjugal role-segregation.

Factors affecting the general features of urban familial networks All the research families maintained relationships with external people and institutions – with a place of work, with service institutions such as schools, church, doctor, clinic, shops; with voluntary associations such as clubs, evening classes, and recreational institutions; they also maintained more informal relationships with colleagues, friends, neighbours and relatives. It is therefore incorrect to describe urban families as ‘isolated’, indeed, no urban family could survive without its network of external relationships. Urban families are not, however, contained within organised groups, for although they have many external relationships, the institutions and persons with which they are related are not linked up with one another to form an organised group. Furthermore, although individual members of a family frequently belong to groups, the family as a whole does not. There are marginal cases, such as the situation arising when all the Downloaded by [New York University] at 03:54 14 August 2016 members of the family belong to the same church or go to the same general practitioner, but in these cases the external institution or person controls only one aspect of the family’s life and can hardly be said to ‘contain’ the family in all its aspects. In the literature on family sociology, there are frequent references to ‘the family in the community’, with the implication that the community is an organised group within which the family is contained. Our data suggest that the usage is misleading. Of course every family must live in some sort of local area, but very few urban local areas can be called communities in the sense that they form cohesive social groups. The immediate social environment of urban families is best considered not as the local area in which they live, but rather as the network of actual social relationships they maintain, regardless of whether these are confi ned to the local area or run beyond its boundaries. Conjugal roles and social networks 23 Small-scale, more isolated, relatively closed local groups provide a marked contrast. This type of community is frequently encountered in primitive societies, as well as in certain rural areas of industrialised societies. A family in such a local group knows no privacy; everyone knows everyone else. The situation of the urban family with a highly connected network is carried one step further in the relatively closed local group. The networks of the component families are so highly connected and the relationships within the local group are so clearly marked off from external relationships that the local population can properly be called an organised group. Families are encapsulated within this group; their activities are known to all, they cannot escape from the informal sanctions of gossip and public opinion, their external affairs are governed by the group to which they belong. In many small-scale primitive societies, the elementary family is encapsulated not only within a local group but also within a corporate kin group. In such cases, the conjugal role-segregation between husband and wife becomes even more marked than that described above for urban families with highly connected networks. Marriage becomes a linking of kin groups rather than preponderantly a union between individuals acting on their own initiative. These differences between the immediate social environment of families in urban industrialised societies and that of families in some small-scale primitive and rural communities exist, ultimately, because of differences in the total economic and social structure. The division of labour in a small-scale society is relatively simple; the division of labour in an industrial society is exceedingly complex. In a small-scale, relatively closed society, most of the services required by a family can be provided by the other families in the local group and in the kin group. In an urban industrialised society, such tasks and services are divided up and assigned to specialised institutions. Whereas a family in a small-scale, relatively closed society belongs to a small number of groups each with many functions, an urban family exists in a network of many separate, unconnected institutions each with a specialised function. In a small-scale, relatively closed society the local group and the kin group mediate between the family and the total society; in an urban industrialised society there is no single encapsulating group or institution that mediates between the family and the total society. One of the results of this difference in the form of external relationships is that urban families have more freedom to govern their own affairs. In a small-scale, relatively closed society, the encapsulating groups have a great deal of control over the family. In an urban industrialised society, the doctor looks after the health of individual members of the family, the clinic looks after the health of the mother and child, the school educates children, the boss cares about the individual as an employee rather than as a husband, and even friends, neighbours and relatives may Downloaded by [New York University] at 03:54 14 August 2016 disagree among themselves as to how the affairs of the family should be conducted. Social control of the family is split up among so many agencies that no one of them has continuous, complete governing power. Within broad limits, a family can make its own decisions and regulate its own affairs. The situation may be summed up by saying that urban families are more highly individuated than families in relatively closed communities. I feel that this term describes the situation of urban families more accurately than the more commonly used term ‘isolated’. By ‘individuation’ I mean that the elementary family is separated off, differentiated out as a distinct, and to some extent autonomous, social group. The individuation of urban families provides one source of variation in role performance. Because families are not encapsulated within governing and controlling groups, other than the nation as a whole, husband and wife are able, within broad 24 Conjugal roles and social networks limits, to perform their roles in accordance with their own personal needs. These broad limits are laid down by the ideal norms of the nation as a whole, many of which exist as laws and are enforced by the courts. But informal social control by relatives and neighbours is much less stringent and less consistent than in many small-scale societies, and much variation is possible. The networks of urban families vary in degree of connectedness, namely in the extent to which the people with whom the family maintains relationships carry on relationships with one another. These variations are particularly evident in informal relationships between friends, neighbours and relatives. These differences are associated with differences in degree of conjugal role-segregation, which varies directly with the connectedness of the family’s social network. Conceptually, the network stands between the family and the total social environment. Such variations are made possible by the complexity and variability of the economic, occupational and other institutional systems that create a complex of forces affecting families in different ways and permitting selection and choice by the family. The connectedness of a family’s network is a function, on the one hand, of a complex set of forces in the total environment and, on the other, of the family members themselves and their reaction to these forces.

Notes 1 A shortened version of the original – Human Relations, 8: 345–384, 1955. 2 For an account of fi eld techniques see Robb (1953) and Bott (1957, Chapter 2).

References Bott, E. 1957. Family and Social Network (2nd edition, 1971). London: Tavistock Publications. Robb, J.H. 1953. ‘Clinical Studies in Marriage and the Family: A Symposium on Methods. IV: Experiences with Ordinary Families’, British Journal of Medical Psychology, 26: 215–221.

Downloaded by [New York University] at 03:54 14 August 2016 Slater, E. and M. Woodside. 1951. Patterns of Marriage. London: Cassell. Young, M. 1954. ‘The Planners and the Planned – The Family’, Journal of the Town Planning Institute, 40: 134–138. CHAPTER 2

CLINICAL REFLECTIONS ON THE NEGATIVE THERAPEUTIC REACTION

This paper was ﬁ rst published in the Bulletin of the European Psychoanalytic Feder- ation in 1980, no. 15, pp. 31–39. It was also published in Encounters with Melanie Klein: Selected Papers of Elizabeth Spillius, eds P. Roth and R. Rusbridger (2007), London: Routledge, pp. 120–139.

When Freud fi rst discussed the negative therapeutic reaction in The Ego and the Id he gave both a clinical description of it and a psychological explanation. In this paper I want to suggest that the clinical phenomenon and the psychological explanation may not be as intrinsically connected as Freud thought. Freud does not give actual case material, but his clinical description is as follows:

There are certain people who behave in a quite peculiar fashion during the work of analysis. When one speaks hopefully to them or expresses satisfaction with the progress of the treatment, they show signs of discontent and their condition invariably becomes worse. One begins by regarding this as defi ance and as an attempt to prove their superiority to the physician, but later one comes to take a deeper and juster view. One becomes convinced, not only that such people cannot endure any praise or appreciation, but that they react inversely to the progress of the treatment. Every partial solution that ought to result, and in other people does result, in an improvement or a temporary suspension of symptoms produces in them for the time being an exacerbation of their illness; they get worse during the treatment instead of getting better. They exhibit what is known as a ‘negative therapeutic reaction’. (Freud, 1923, p. 49)

Freud had already touched on a similar sort of phenomenon in one of his papers on character, ‘Those Wrecked by Success’ (Freud, 1916). Freud’s explanation of the negative therapeutic reaction is that it occurs because of an unconscious sense of guilt, or need for punishment. Indeed, he drew attention Downloaded by [New York University] at 03:54 14 August 2016 to the clinical phenomenon mainly because he thought it provided evidence for the usefulness of the concept of the superego. This is how he puts it:

In the end we come to see that we are dealing with what may be called a ‘moral’ factor, a sense of guilt, which is fi nding its satisfaction in the illness and refuses to give up the punishment of suffering. We shall be right in regarding this disheartening explanation as fi nal. But as far as the patient is concerned this sense of guilt is dumb; it does not tell him he is guilty; he does not feel guilty, he feels ill. This sense of guilt ex presses itself only as a resistance to recovery which it is extremely diffi cult to overcome. (Freud, 1923, pp. 49–50) 26 Clinical refl ections on the negative therapeutic reaction He discusses this theme further in ‘The Economic ProbIem of Masochism’ (1924) and in ‘Analysis Terminable and Interminable’ (1937) and relates it to moral masochism and the destructive or death instinct. From Freud’s original thesis two main lines of thought have developed, the fi rst concentrating on the clinical phenomenon and the second on the psycho logical explanation. The main authors of the fi rst group are Abraham (1919), Horney (1936), Klein (1957) and Rosenfeld (1975); all these authors emphasise the role of envy and/or narcissism in the negative therapeutic reaction. The main author of the second line of development is Joan Riviere (1936). She relates the negative therapeutic reaction to the patient’s fear that progress in analysis and in life will make him aware of the desolate state of his attacked and unrestored internal objects and that he will feel intolerable guilt and pain. Bion (1953) and Segal (1956) give relevant clinical material. Riviere, like Freud, focusses on guilt and depression, but her explanation of the role of guilt in the negative therapeutic reaction is somewhat different, because Freud regards the negative therapeutic reaction as an expression of guilt, whereas Riviere regards it as a defence against guilt. Recently there has been an increasing number of American papers about the negative therapeutic reaction which follow, more or less, the second line of development in that they deal with patients who are dominated by un conscious guilt and moral masochism. Only a few of these papers give specifi c clinical material, but it is my impression that these depressed and sado-masochistic patients show many types of resistance and negativism in addition to the negative therapeutic reaction. (See: Feigenbaum, 1934; Gero, 1936; Eidelberg, 1948; Bernstein, 1957; Brenner, 1959; Olinick, 1964 and 1970; Loewald, 1972; Valenstein, 1973; Asch, 1976; Spiegel, 1978.) The fact that these two separate lines of thought have developed from Freud’s original formulation already suggests that the clinical phenomenon and the psychological explanation may not be as closely associated as he thought. I want to go further, to suggest that the clinical phenomenon Freud described is usually found to be associated with envy and narcissism, whereas unconscious guilt is likely to give rise to many sorts of generalised resistance and negative reaction, of which the negative therapeutic reaction is only one. Further, when patients dominated by unconscious guilt do show a negative therapeutic reaction, it is likely to be much disguised and defended against. I will fi rst discuss Freud’s clinical defi nition of the negative therapeutic reaction and then describe two clinical examples of it. The fi rst case fi ts Freud’s clinical description but not his psychological explanation; the second fi ts his psychological explanation but is not so clear-cut an instance of the clinical phenomenon. Downloaded by [New York University] at 03:54 14 August 2016

Freud’s clinical deﬁ nition of the negative therapeutic reaction Freud’s clinical defi nition is unfortunately imprecise, which has allowed the term to be interpreted in many ways. Several authors bemoan a current trend to use the term in a very general way, often to mean any sort of intractable resistance that the analyst fi nds great diffi culty in coping with (Olinick, 1964; Sandler et al., 1970; Loewald, 1972; Baranger, 1974). Every now and again an analyst suggests that we should stick to Freud’s original defi nition (or to the particular author’s interpretation of Freud’s original defi nition) but these injunctions have not had much effect, for the trend towards loose usage continues. Several analysts have also pointed out that negative responses by the patient are a function of the interaction between Clinical refl ections on the negative therapeutic reaction 27 patient and analyst, not just a function of the patient’s psychopathology (e.g. Langs, 1976); some analysts are very critical of the concept because they think it is used as an excuse for bad technique (Reich, 1933; Salzman, 1960). I do not want to discuss this aspect of the concept further except to say that I think the loose usage and misuse of the concept have been caused not only by imprecision in the original defi - nition but also by the tendency to assume rather than to investigate the causal connection between the clinical phenomenon and the psychological explanation. There are three elements in Freud’s original clinical description. First, the analyst speaks hopefully about the progress of treatment, or there is a partial solution which in other patients would lead to improvement. This part of the defi nition is crucial because it outlines the situation in which the negative therapeutic reaction occurs. Freud’s description is somewhat unsatisfying, for what is to happen if the analyst does not speak hopefully about the progress of treatment, and who is to say that the patient should have improved or that another patient would have improved in similar circumstances? I think it helpful to add that there should be some tacit or explicit recognition of progress by the patient himself. Of course using the patient’s own defi nition of progress does not free the situation from problems of judgement, for patients can be as mistaken, secretive and defensive about their own progress as analysts can be. But I think this criterion is of some help in distinguishing the negative therapeutic reaction from other forms of resistance. Second, the patient goes back on his progress in some form or other, usually including a worsening of symptoms. This element of ‘backtracking’ also distinguishes the negative therapeutic reaction from other forms of resistance. In emphasising the sequence of these two elements – the patient’s own defi nition of progress followed by going back on it – I follow Klein, who de scribed the sequence as characteristic of envy, which she regards as intrinsic to the negative therapeutic reaction (Klein, 1957, pp. 184 and 222). This stress on envy, especially unconscious envy, is her distinctive contribution to the analysis of the negative therapeutic reaction. Third, there is an element of attack on the analyst. Freud thinks this attack is not the real issue, for he says that the explanation about unconscious guilt is ‘a deeper and juster view’, implying that the attack on the analyst is a by-product rather than an intrinsic part of the negative therapeutic re action. Klein, on the contrary, stresses the attack on the analyst as a central component of the negative therapeutic reaction. I think the actual clinical examples given in the literature support her view, as do the two clinical examples I describe. In one of my cases the attack was open; in the other it was heavily defended against, but in both cases the attack was defi nitely there. In brief, then, I am defi ning the negative therapeutic reaction as a sequence of Downloaded by [New York University] at 03:54 14 August 2016 behaviour in which a tacit or explicit recognition of progress by the patient is followed by a worsening of his condition and an open or disguised attack on the analyst.

Case material First patient. An openly expressed negative therapeutic reaction by a patient who was not dominated by unconscious guilt. The material of the fi rst patient is very similar to that of patients described by Rosenfeld in his papers on the negative therapeutic reaction (1975) and ‘delusional narcissism’ (1971), except that my patient was less ill than most of those described by Rosenfeld. Rosenfeld’s formulation of this sort of negative therapeutic reaction is that an omnipotent, arrogant aspect of the self makes an envious attack on the 28 Clinical refl ections on the negative therapeutic reaction analyst and on a trusting, infantile part of the self which has been allowing progress to occur in the form of letting itself be helped by the analyst; the usual state of affairs in this type of patient is that the trusting, infantile part of the self is dominated by the omnipotent, arrogant aspect of the self, thus achieving a form of narcissistic self-suffi ciency. Here is the material of my patient. He was the eldest of three children of a Catholic family in a Latin country. He worked as a biologist and suffered, among other things, from diffi culty in realising his considerable talent, especially in designing and following through original research. However, for some months before the bit of material I want to report, he had been effectively at work completing his fi rst independent research project. From time to time he realised, though rather incidentally, that his analysis was helping him to become more effective and constructive in his work. Eventually he fi nished his research and several people complimented him on it. He began to feel worse and worse. The research was no good, he said, not truly creative or original; he did not belong anywhere; he felt utterly inert; he was fed up with me and analysis because I was not helping him to feel more alive in himself. In one session he had a sudden fantasy, which he described as grandiose, of developing his so-called ‘small’ re search into a major undertaking, with a special grant from an American foundation, a large staff of assistants, housed in a special wing of a new univer sity building, etc. I said he was telling me this plan in a way designed to lure me into making some sort of punitive interpretation about omnipotence as if he wanted me to belittle and ignore both the validity of his research and the work we had done together to make the doing of it possible. He proceeded to talk about something else as if he had not heard what I had said. He was being as lofty towards me, in other words, as he was in his research plan. In the next session he reported the following dream. He was on his way home to his own country for a holiday. On the way he saw an accident but no one was badly hurt. Once home, he heard from a casual acquaintance that his close friend Mario had got married. Mario had not invited the patient to the wedding, and he felt dreadfully left out. He woke feeling life was not worth living and nothing was enjoyable. He was utterly incapable of taking pleasure in anything. Most of his associations centred around his opinion that Mario was someone probably incapable of marriage or any kind of deep relationship. I said I thought Mario represented that part of himself that had been incapable of any sort of relationship with me, but that in recent months this Mario aspect of himself had come into contact with me more and more, which he described in the dream as a marriage. It was even producing ‘children’ in the form of his research. I suggested that the non-Mario part of himself felt terribly left out of the growing alliance between Mario and me and it had been trying to re-assert its control over Downloaded by [New York University] at 03:54 14 August 2016 both of us. He thought about this and then said he could not see why he should feel so left out by his getting better. After a short silence he said that Mario’s mother was an immaculate, attractive woman, very nice to all Mario’s friends, and in fact she had hinted to the patient that she wished Mario were more like the patient. He thought Mario’s mother wanted Mario to be successful and to get married, but only to prove that she was a successful mother, not for Mario’s sake. I said he seemed to be saying that my growing relationship with the Mario aspect of himself was not to be trusted because I only wanted Mario to grow up and develop so that I could congratulate myself on being a successful analyst. In subsequent sessions he was gradually able to recognise himself in the qualities he attributed to me and to Mario’s mother – especially his narcis sistic Clinical refl ections on the negative therapeutic reaction 29 self-centredness and his grudging attitude towards his own and my enjoyment of the analysis and of his success.

Second patient. A woman dominated by unconscious guilt, but showing a hidden and defended form of negative therapeutic reaction. This patient suffered from the sort of unresolved depression and moral masochism that Freud and many later authors think characteristic of patients who exhibit the negative therapeutic reaction. Although she was cooperative in the analysis, she was at this time locked in recurrent attacks of self-punishment, persecution, remorse and identifi cation with damaged internal objects, especially her mother. Clearly defi ned negative therapeutic reactions were not characteristic of her material. It was much more usual for her to nip a negative therapeutic reaction in the bud, so to speak, by not having enough therapy for there to be a negative reaction about it. Even the instance of negative therapeutic reaction I describe here was at fi rst diffi cult to identify. Some time before the sessions I want to describe I had had a minor illness. In the fi rst session the patient described a dream in which there had been an ill woman; the patient realised that she could not help the woman very much herself; the right person to ask to help the woman was her boss, who was a highly qualifi ed person but not overly conscientious. I interpreted this as a move towards recognition that in spite of his defi ciencies father was the right person to look after and repair damage to mother, that the patient could not do it all herself. (It was her internal parents we were talking about; her real parents had died years before.) I also suggested that she felt I was the ill woman who needed looking after and whose care and cure she was trying to relinquish control of. Right near the end of the hour the patient told me she had received a minor promotion at work. She managed to say it in such an offhand way that I almost overlooked it. In the next session, a Friday, she felt bleak and had a memory of feeling utterly desolate when she had been sent away to boarding school. At fi rst I did not think of her desolation as a negative therapeutic reaction, for she had already played down her bit of success so much that I had not realised she was tacitly thinking of it as success. At fi rst I linked her desolation with the weekend, though that did not seem to make sense of the extent of her feel ing. Then I suggested she was feeling more grown up, in that she was trying to give up her insistence that she was the one who had power over me by looking after me, but that made her feel abandoned, as she had felt when she had been thought grown up enough to be sent away to school. I said she was warning me that she could not stand yesterday’s minor successes, either the success at work or in analysis; she had to fail now as she had at school. But I still felt there was something about this session I did not under- Downloaded by [New York University] at 03:54 14 August 2016 stand. (What I did not see until several weeks later, when the theme came up again, was that she was also feeling overwhelmed and con fused by an identifi cation with an ill, fragile mother who experienced every bit of growth by her child as an abandonment of her.) On Monday she was in a very different mood, rather excited. She had had three dreams. In the fi rst she met one of my male patients, who found her sexually interesting. I interpreted this as her way of getting control of her feeling that I had abandoned her at the weekend to be with my partner. In the second dream one of her former university professors told her about a new university department that was opening nearby where she might do a special course. In the third dream a junior colleague was telling her that she was overexcited. Eventually I suggested that she was my junior colleague warning me that if I was able to open a new 30 Clinical refl ections on the negative therapeutic reaction department for her so that she could enjoy a bit of success, she would get overexcited, and the excitement would turn into triumph directed against me and her analysis. With some reserva tions she agreed with this. I said she evidently felt she could not enjoy any success without its turning into a triumph. On Tuesday she felt desolate again and on Wednesday she was once again excited, as she had been on Monday. I did not see it at the time, but I think she was repeating the sequence of the ‘low’ session and the ‘high’ session in order to show me that there was a lot I had failed to understand. I think the ‘low’ response had two roots. The fi rst was that unconsciously she felt guilty because she felt she had attacked her mother by improving, which meant leaving her; she punished herself by identifying with this fragile, attacked mother who could not let her grow up and ‘go to school’. Second, the ‘low’ response was a way of avoiding making an envious, resentful attack against me for threatening to help her grow up. The excited, rather seductive mood of the ‘high’ sessions was more an expression of triumph over me for having missed the meaning of the ‘low’ sessions than an expression of triumph because of her improvement the week before.

Discussion If one compares these two patients, it is clear that the fi rst gave a much more direct expression of the negative therapeutic reaction than the second, al though I think both reactions fi t the defi nition I have given above. The fi rst patient was openly envious and resentful about his own progress and my contribution to it, even though he was not actually conscious of being envious. His progress hurt him, and he could only just bear to recognise it. Contrary to Freud’s thesis, however, he did not suffer acutely from uncon scious guilt or moral masochism. At this stage of his analysis he was mainly persecuted by his internal objects rather than concerned or guilty about them, for he was projecting into them the envy and self-centredness that he could not recognise in himself. The second patient, on the other hand, was dominated by guilt and unresolved depression. According to Freud’s formulation she should have been a clear case of the negative therapeutic reaction, but in fact her reaction was much less open than that of the fi rst patient. It consisted of defences against envy and destructiveness

rather than open expressions of them, and although she got ‘worse’ in the low sessions it was not easy at fi rst to relate her depressed feeling to the preceding recognition of progress. She was more depressive than the fi rst patient and it was her capacity for concern for her objects that prevented her from making an openly envious attack. She had loved her fragile mother and could not accept her own wishes to attack her. Similarly she had strong positive feelings about me and had Downloaded by [New York University] at 03:54 14 August 2016 diffi culty in recognising her wish to attack me. She spared me and her mother by attack ing herself. But she was not only trying to spare her objects when she did herself down; she was also trying to avoid accepting responsibility for her own enviousness and aggressiveness. In trying to avoid pain and responsibility by attacking herself she of course caused more damage than if she had made a direct attack in the fi rst place; she kept her mother fragile and she also made it hard for me to fi nd out what was going on, especially when she com pounded the confusion by getting triumphant over misleading me. My general conclusion from these two cases, from my practice as a whole, and from the literature is that open expressions of negative therapeutic reaction are likely to be a prominent and recurrent feature in patients of narcissistic and envious character structure, but that in patients who suffer from unresolved depression, Clinical refl ections on the negative therapeutic reaction 31 especially persecutory depression (Klein, 1957), the negative therapeutic reaction is likely to be heavily disguised, as in the case of my second patient. General resistance, negativism and avoidance of success are more typical of such patients than is the sharp backtracking of the negative therapeutic reaction. Freud’s clinical phenomenon and his psycho logical explanation, in other words, are not as closely linked as he thought. What, then, is one to conclude about the negative therapeutic reaction? Is it a useful concept? I think it is, for it alerts the analyst to the presence of an acute confl ict about progress, whatever the character structure of the patient. It may be, of course, that a patient reacts negatively not to progress in analysis and in life but to mistakes by the analyst and deprivation in his life, a possibility that should be explored as openly as possible by analyst and patient together. Assuming that the progress is genuine and the interpretations reasonably accurate, an openly expressed negative therapeutic reaction means the patient is protesting about the disturbance of his status quo and the indignity of being helped by an analyst, which is, after all, hardly surprising. In mild and transitory forms it is surely very common. But what of patients dominated by unconscious guilt? Should one describe their chronic resistance, failure to thrive and avoidance of success as negative therapeutic reaction? You will have read Dr SandIer’s paper and noted that he thinks it most unwise to widen the concept of negative therapeutic reaction to include chronic resistance of this sort. In a way I agree, for there is an obvious empirical difference between the open negative therapeutic reaction and chronic resistance. Nevertheless one cannot escape a feeling that Freud was right in saying that unconscious guilt stops patients from getting better. In the long run, chronic resistance and the negative therapeutic reaction are not so very different from each other. Patients who suffer from unconscious guilt get stuck in their illness and misery; very occasionally they improve a bit and allow themselves to recognise the improvement, and then they have to resort to a relatively open negative therapeutic reaction to restore their status quo. Usually, however, they express a sort of hidden negative therapeutic reaction all the time, which is unconsciously designed to prevent open improvement with the result that an open negative therapeutic reaction is unnecessary. And so, in conclusion, where Freud suggested one clinical phenomenon, I would suggest two: an open and a hidden negative therapeutic reaction. And where Freud suggested one explanation I would suggest two: envy and narcis sism associated with the open negative therapeutic reaction, and unconscious guilt associated with the hidden negative therapeutic reaction.

Downloaded by [New York University] at 03:54 14 August 2016 References ABRAHAM, K. (1919) A particular form of neurotic resistance against the psycho-analytic method. In Selected Papers on Psycho-Analysis. London: Karnac, 1988, pp. 303–311. ASCH, S.S. (1976) Varieties of negative therapeutic reaction and problems of technique. J. Amer. Psychoanal. Assoc., 24: 383–407. BARANGER, W. (1974) Discussion of a paper by H.B. Vianna, A peculiar form of resistance to psychoanalytical treatment. Int. J. Psycho-Anal., 55: 445–447. BERNSTEIN, I. (1957) The role of narcissism in moral masochism. Psychoanal. Quart., 26: 358–377. BION, W.R. (1953) Notes on the theory of schizophrenia. In Second Thoughts. London: Heinemann, 1967, pp. 23–35. BRENNER, C. (1959) The masochistic character: Genesis and treatment. J. Amer. Psychoanal. Assoc., 7: 197–225. 32 Clinical refl ections on the negative therapeutic reaction

EIDELBERG, L. (1948) A contribution to the study of masochism. Chapter II of Studies in Psychoanalysis. New York: Nervous and Mental Disease Monographs, pp. 31–40. FEIGENBAUM, D. (1934) Laughter betraying a negative therapeutic reaction. Psychoa nal. Quart., 3: 367–370. FREUD, S. (1916) Some character-types met with in psycho-analytic work. (II) Those Wrecked by Success. S.E. 14: 316–331. —— (1923) The Ego and the Id. S.E. 19: 3–66. —— (1924) The economic problem of masochism. S.E. 19: 157–170. —— (1937) Analysis terminable and interminable. S.E. 23: 209–253. GERO, G. (1936) The construction of depression. Int. J. Psycho-Anal., 17: 423–461. HORNEY, K. (1936) The problem of the negative therapeutic reaction. Psychoanal. Quart., 5: 29–44. KLEIN, M. (1957) Envy and Gratitude. Writings, Vol. 3, Envy and Gratitude and Other Works. London: Hogarth Press and the Institute of Psycho-Analysis, 1975, pp. 176–235. LANGS, R. (1976) The negative therapeutic interaction. The Therapeutic Interaction, 2, New York: Jason Aronson, pp. 136–139. LOEWALD, H.W. (1972) Freud’s conception of the negative therapeutic reaction, with comments on instinct theory. J. Amer. Psychoanal. Assoc., 20: 235–245. OLINICK, S.L. (1964) The negative therapeutic reaction. Int. J. Psycho-Anal., 45: 540–548. —— (1970) The negative therapeutic reaction: Report on Scien tifi c Proceedings. J. Amer. Psychoanal. Assoc., 18: 655–672. REICH, W. (1933) Character Analysis (tr. Theodore Wolfe). London: Vision Press, 1950. RIVIERE, J. (1936) A contribution to the analysis of negative therapeutic reaction. Int. J. Psycho-Anal., 17: 304–320. ROSENFELD, H. (1971) A clinical approach to the psychoanalytic theory of the life and death Instincts: An investigation into the aggressive aspects of narcissism. Int. J. Psycho-Anal., 52: 169–178. —— (1975) Negative Therapeutic Reaction. Chapter 7 of P. Giovac chini (ed.) Tactics and Techniques in Psychoanalytic Therapy, 2. New York: Jason Aronson, pp. 217–228. SALZMAN, L. (1960) The negative therapeutic reaction. In Masserman, J.H., Psychoanalysis and Human Values. New York: Grune and Stratton, pp. 303–313. SANDLER, J., Dare, C., and Holder, A. (1970) The negative therapeutic reaction. Chapter 8 of The Patient and the Analyst. London: George Allen and Unwin, pp. 84–93. Downloaded by [New York University] at 03:54 14 August 2016 SEGAL. H. (1956) Depression in the schizophrenic. Int. J. Psycho-Anal., 37: 339–343. SPIEGEL, L.A. (1978) Moral masochism. Psychoanal. Quart., 47: 209–236. VALENSTEIN, A.F. (1973) On attachment to painful feelings and the negative therapeutic reaction. Psychoanal. Study Child., 28: 365–392. CHAPTER 3

CLINICAL EXPERIENCES OF PROJECTIVE IDENTIFICATION

This paper was ﬁ rst published in R. Anderson (ed.) (1992) Clinical Lectures on Klein and Bion, London: Routledge, pp. 59–73.

I am grateful to several colleagues, particularly John Steiner, for helpful discussions of this chapter. In this chapter I describe briefl y the way Klein’s introduction of the concept of projective identifi cation has led to developments in technique. I focus mainly on work in England and mainly on that of Kleinian analysts, even though the concept has undoubtedly infl uenced the clinical approach of many other analysts and one cannot say that the concept ‘belongs’ to any particular school. I will concentrate on my own clinical experiences of projective identifi cation and on the way these experiences have led me to abandon fi xed expectations and rigid defi nitions in favour of trying to be prepared to experience whatever forms of projection, introjection, and counter-transference come to life in a session. Klein introduced the concept of projective identifi cation in 1946 in her paper ‘Notes on some schizoid mechanisms’, which was her fi rst and major attempt to describe conceptually what she called the ‘paranoid-schizoid position’, a constellation of anxieties, defences and object relations which she had come to think were characteristic of early infancy and of the deepest and most primitive layers of the mind. I cannot begin to do justice to the complexity and subtlety of the experiences Klein describes in this most seminal of her papers. Projective identifi cation was by no means the central theme of the paper. Klein describes it as one among several defences against primitive paranoid anxiety, and her discussion of it occupies only a few sentences. She says:

Together with these harmful excrements, expelled in hatred, split-off parts of the ego are also projected onto the mother, or, as I would rather call it, into

Downloaded by [New York University] at 03:54 14 August 2016 the mother. These excrements and bad parts of the self are not meant only to injure but also to control and take possession of the object. Insofar as the mother comes to contain the bad parts of the self, she is not felt to be a separate individual but is felt to be the bad self. Much of the hatred against parts of the self is now directed towards the mother. This leads to a particular form of identifi cation which establishes the prototype of an aggressive object relation. I suggest for these processes the term ‘projective identifi cation’. (Klein 1946: 8)

Even this defi nition is not entirely accurate, for Klein makes it clear in the course of her paper that the individual has phantasies of projecting good as well as bad feelings, so that the object is then felt to be good and the infant or patient then 34 Clinical experiences of projective identifi cation takes in a good object, which helps with the task of integration. But both in Klein’s work and that of subsequent analysts the emphasis has been on the projection of bad feelings that the infant or patient cannot contain. It was Klein’s view that the most basic and primitive anxiety of the paranoid- schizoid position is a fear of annihilation from within the personality and that, in order to survive, the individual projects this fear into the external object as a defensive measure. In the view of the infant (or patient) this makes the external object bad, and the object is then likely to be attacked. But often the idea of the external object, somewhat distorted by projection, gets taken inside the personality and the infant (patient) then feels that he is being attacked by an internal persecutor. Klein assumes that in early infancy and in the most primitive layers of the adult mind, there are extreme fl uctuations between good and bad, with an attempt to keep them separate. Splitting, projection, introjection, and denial are the main defences of the primitive mode of functioning characteristic of the paranoid- schizoid position. It is clear that Klein thought that normal splitting and the projective identifi cation associated with it were necessary parts of development, and that without them the basic differentiation between good and bad and between self and other would not get fi rmly established so that the groundwork for the later depressive position would be impaired. In the depressive position self and other come to be clearly distinguished, the individual recognizes that the loved person and the hated attacked person are one and the same, and he begins to accept responsibility for his attacks. Klein often speaks of ‘excessive’ projective identifi cation in which the self is depleted by constant efforts to get rid of parts of the self, although she does not give a very clear idea of what exactly it is that leads to excessive projective identifi cation in some cases and not in others. It is clear too that she thought of projective identifi cation as the patient’s phantasy. She did not think that the patient literally put things into the analyst’s mind or body. It was also her view that if the analyst was infl uenced by what the patient was doing to him it was evidence that there was something the analyst was not coping with, which meant that he needed to have more analysis himself; she had similar views about counter-transference, and did not welcome the extension of the term to mean the analyst’s emotional response to the patient, a usage that Paula Heimann introduced in 1950. Klein thought that such extension would open the door to claims by analysts that their own defi - ciencies were caused by their patients. It is still generally accepted, at least by British Kleinian analysts, that projective identifi cation is a phantasy not a concrete act, but it is now accepted that patients can behave in ways that get the analyst to feel the feelings that the patient, for one reason or another, cannot contain within himself or cannot express in any other way except by getting the analyst to have Downloaded by [New York University] at 03:54 14 August 2016 the experience too (cf. Rosenfeld 1971; Segal 1973; Sandler 1976a, 1976b, 1987b; Sandler and Sandler 1978; Joseph 1985, 1987; Spillius (ed.) 1988: 81–86). Klein’s colleagues, especially Rosenfeld, Bion, Segal, Money-Kyrle and Joseph, began using the idea of projective identifi cation almost at once, though the actual term was not used very much until about the mid-1950s, and few papers were written specifi cally about the concept itself at this time. (For examples of use of the concept see Segal 1950, Rosenfeld 1952, Bion 1957 and especially Bion 1959.) The concept gives an intellectual guideline for understanding and analysing the way the patient perceives the analyst, and gradually it has become part of the Kleinian focus on the analyst–patient relationship, particularly in understanding how the object relationships of the past, which in the present are part of the patient’s internal world, are lived out in the analytic relationship. Clinical experiences of projective identifi cation 35 In the 1950s, in a brilliant series of papers, Bion substantially added to the usefulness of the concept of projective identifi cation by making a distinction between normal and pathological projective identifi cation (1957, 1958, 1961, 1962a, 1962b, 1970). He brought the object, the mother or the analyst, into the conception of the process of projective identifi cation more than Klein had done. Following Klein, Bion thinks that when the infant feels assaulted by feelings he cannot manage, he has phantasies of evacuating such phantasies into his primary object, his mother. If she is capable of understanding and accepting the feelings without her own balance being too much disturbed, she can ‘contain’ the feelings and behave in a way towards her infant that makes the diffi cult feelings more acceptable to him. He can then take them back into himself in a form that he can manage better. If the process goes wrong, however – and it can go wrong either because the infant projects overwhelmingly and continuously or because the mother cannot take in very much distress – the infant resorts to increasingly intense projective identifi cation, and eventually may virtually empty out his mind so as not to have to know how unbearable his thoughts and feelings are. By this time he is on the road to madness, and his mother is also likely to be suffering intense distress. Bion’s distinction between normal and pathological projective identifi cation and his formulation of the container/contained model have led to considerable development in technique. Although everyone agrees with Klein that the patient should not be blamed for the analyst’s defi ciencies of understanding, we are now much more prepared to believe that patients attempt to arouse in the analyst feelings that they cannot tolerate in themselves but which they unconsciously wish to express and which can be understood by the analyst as communication. Bion gives a brief example: he felt frightened in a session with a psychotic patient and then interpreted to his patient that the patient was pushing into Bion his fear that he would murder Bion; the atmosphere in the session became less tense but the patient clenched his fi sts, whereupon Bion said that the patient had taken the fear back into himself and now was (consciously) feeling afraid that he might make a murderous attack (Bion 1955). Similarly, Money-Kyrle gives a description of a patient attacking him in a way that he could not easily understand and interpret, and it was not until after the session that he could disentangle his own contribution from his patient’s so that in the next session he could make an appropriately ‘containing’ interpretation (Money-Kyrle 1956). Rosenfeld (1971; 1987), who had particularly studied projective identifi cation in psychotic and borderline patients, stresses the importance of disentangling the many possible motives for it: communication, empathy, avoiding separation, evacuating unpleasant or dangerous feelings, taking possession of certain aspects of the mind of the other. (This last type has subsequently been called ‘acquisitive’ projective identifi cation by Britton Downloaded by [New York University] at 03:54 14 August 2016 (1989) and ‘extractive introjection’ by Bollas (1987).) Riesenberg-Malcolm (1970) describes the way she became aware of a patient’s conscious perverse phantasy by feeling herself under pressure to be an audience for it, and indeed thus to be virtually a participant in it. O’Shaughnessy, especially in a paper called ‘Words and working through’ (1983), describes how projective identifi cation can be an essential process of communication of experiences that a patient cannot capture in words. Thus, unlike Klein, we are now explicitly prepared to use our own feelings as a source of information about what the patient is doing, though with an awareness that we may get it wrong, that the process of understanding our response to the patient imposes a constant need for psychic work by the analyst (see especially Brenman Pick 1985 and King 1978), and that confusing one’s own feelings with the patient’s is always a hazard. 36 Clinical experiences of projective identifi cation Building on Bion’s ideas, Joseph further stressed the way patients attempt to induce feelings and thoughts in the analyst, and try, often very subtly and without being aware of it, to ‘nudge’ the analyst into acting in a manner consistent with the patient’s projection (Joseph 1989). Compare also Sandler’s concept of ‘actualization’, a less colloquial term for the same process (1976a). Joseph gives many detailed examples. A masochistic patient, having in unconscious phantasy projected into his analyst a sadistic aspect of himself or of an internal object, will act in a manner that unconsciously tries to induce the analyst to make slightly sadistic interpretations. An apparently passive patient will try to get the analyst to be active. An envious patient will describe situations of which the analyst might well be expected to be envious. The analyst’s aim is to allow himself or herself to experience and respond internally to such pressures from the patient enough to become conscious of the pressure and of its content so that he can interpret it, but without being pushed into gross acting out (Joseph 1989). Some degree of acting out by the analyst, however, is often inevitable in the early stages of becoming aware of what the patient is feeling, a point further stressed by O’Shaughnessy (1992). I shall not attempt to describe the great proliferation of papers on projective identifi cation that has developed since the 1960s, especially in the United States; Malin and Grotstein 1966; Jacobson 1967; Ogden 1979, 1982; Kernberg 1975, 1980, 1987; Meissner 1980, 1987; Grotstein 1981; Sandler 1987a gives a relevant collection of papers on the topic, and Hinshelwood (1989) gives a detailed discussion of Kleinian and later usages. Much of the American discussion has concerned the motive for projective identifi cation (evacuation, gaining control, acquisition, avoiding separation) and with making a distinction between projection and projective identifi cation, though I think that such a distinction is impossible to maintain or even to secure agreement on. In Britain, as I have described, I think there are what one might call three clinical ‘models’ of projective identifi cation: Klein’s own usage, in which the focus is on the patient’s use of projective identifi cation to express wishes, perceptions, defences; Bion’s container/contained formulation; and Joseph’s usage, close to Bion’s, in which the analyst expects that patients will constantly bring pressure to bear on the analyst, sometimes very subtly, sometimes with great force, to get the analyst to act out in a manner consistent with the patient’s projection. Historically the distinctions between these models are important, but clinically we now expect that all three may well be operative at the same time. Even when the analyst feels himself to be little affected by his patient’s projection, for example, a more detailed look at the material may reveal expressions that he missed and pressures he was not fully open to; the analyst is always affected to some degree by his patient’s projection, there is always some ‘nudging’ by the patient to push the analyst into action, and inevitably there is Downloaded by [New York University] at 03:54 14 August 2016 usually some acting out by the analyst, however slight. The issue that is most important to the patient and in the analyst–patient interaction may vary widely from one clinical occasion to another, and all the models of projective identifi cation I have described may be important in getting to the heart of the matter. I will try now to illustrate with material from three patients the three models I have described in order to show how all three models can be useful in understanding the crucial points of interaction in a session.

Mr A In this session I was using the idea of projective identifi cation rather as I think Klein might have done. I thought my patient’s perception of me was distorted by his Clinical experiences of projective identifi cation 37 unconscious phantasy of projecting aspects of himself and his internal objects into me. This involved in particular his inability to enjoy anything for its own sake. Mr A was the eldest of three children of a Catholic family in a Latin country. He had a long-standing sense of grievance because he felt his parents preferred the other children, and indeed it seemed likely to me that he had been somewhat deprived emotionally as a child. He sought analysis because of work diffi culties and a sense of meaninglessness in his life. After much struggle in the analysis, he had completed his fi rst independent research project – he is a biologist – and it had been well received by his colleagues. But then he began to feel worse and worse, saying that his research was not really creative or original, he did not belong anywhere, he felt utterly inert, he was fed up with me and with analysis because he felt so dead. In one session he had a sudden phantasy, which he described as ‘grandiose’, of developing his so-called small research into a major undertaking with a grant from America etc., etc. I said he was telling me this plan in a way designed to lure me into making some sort of punitive interpretation about his omnipotence as if he wanted me to belittle and ignore both the validity of his research and the work we had done together to make it possible. He proceeded to talk about something else as if he had not heard what I had said – he was being as lofty towards me, in other words, as he was in his research plan. In the next session he reported the following dream. He was on his way home to his own country for a holiday. On the way he saw an accident but no one was badly hurt. Once home, he heard from a casual acquaintance that his close friend Mario had got married. Mario had not invited the patient to the wedding, and he felt dreadfully left out. He woke feeling life was not worth living. He was utterly incapable of taking pleasure in anything. Most of his associations centred around his opinion that Mario was probably incapable of marriage or any kind of deep relationship. I said I thought Mario represented that part of himself that had been incapable of any sort of relationship with me, but that in recent months this Mario aspect of himself had come into contact with me more and more, which he described in the dream as a marriage. It was even producing ‘children’ in the form of his research. I suggested that the non-Mario part of himself felt very much left out of the growing alliance between Mario and me and it had been trying to re-assert its control over both of us. He thought about this and then said he could not see why he should feel so left out by his getting better. After a short silence he said that Mario’s mother was an immaculate, attractive woman, very nice to Mario’s friends, and in fact she had hinted to the patient that she wished Mario were more like the patient. He thought Mario’s mother wanted Mario to be successful and to get married, but only to Downloaded by [New York University] at 03:54 14 August 2016 prove that she was a successful mother, not for Mario’s sake. I said he seemed to be saying that my growing relationship with the Mario aspect of himself was not to be trusted because I only wanted Mario to grow up and develop so that I could congratulate myself on being a successful analyst. In subsequent sessions he was gradually able, at least partially, to recognize himself in the qualities he attributed to me and to Mario’s mother – especially his grudging attitude towards his own and my enjoyment of the analysis and of his success. On the surface, as I have said, I was using the idea of projective identifi cation in this session rather in the way Klein defi nes it. My patient was projecting into me his own incapacity to enjoy his success so that I, like Mario’s mother, was perceived as wanting to help him for my own sake, not his. I found this easy to understand and did not sense much change in my usual analytic state of mind. But looking at 38 Clinical experiences of projective identifi cation the material more closely, one can see other levels in it, closer to the sort of thing Bion and Joseph describe. You remember that in the fi rst part of the dream he saw an accident but no one was badly hurt; he was going home for a holiday. In the session of the day before there had been an ‘accident’, a ‘collision’ type of interpretation when I had said he was trying to lure me into attacking him, a collision which he had totally ignored in the session just as, in the dream, he was going on holiday, that is, he was leaving me behind. In other words, I think he had experienced this interpretation as somewhat attacking and humiliating in spite of the care with which I thought I had phrased it. And in fact I think I was feeling more attacked by his devaluation of me and of his analysis than I realized, and more attacking in return than I knew. I was coping with his contempt and depreciation by going ‘correct’ on him, freezing into analytic propriety. This meant that everything I said was more or less appropriate but lacked empathy because it lacked awareness of his unconscious attempt to project his humiliation into me and to nudge me into attacking him in retaliation. Behind my easy adoption of Klein’s usage, in other words, lay a potential for looking at the material from the perspective of Bion’s and Joseph’s usages. It took some time for me to realize that his getting me to feel despised was just as important a projection, and perhaps even more useful for understanding his experience, than knowing about his projection of his inability to enjoy his and my success.

Mrs B This session was dramatic and painful – no question of maintaining my usual analytic stance on this day. In phantasy the patient was projecting a painful internal situation into me and acting in such a way as to get me to experience it while she got rid of it. Mrs B had to be perfect and was extremely scathing towards herself if she was not. She had managed these perfectionist aspirations by never really trying so that she could always maintain she would have succeeded if she had tried. Or she attributed her success or failure to ‘fate’, accident and so on. She had considerable learning diffi culties and in analysis had a tendency not to listen. She also had a very cruel streak which usually showed itself only in dreams and phantasies. She had had a very diffi cult experience of separation in early childhood; the session I shall describe occurred shortly before an unusually long holiday break, which she was going to make even longer by going away for an additional few days herself, for the most ‘realistic’ of reasons. Some form of acting out at breaks was not unusual for her, and we had discussed and interpreted her response to it some weeks before the session I shall describe. After these interpretations there followed two or three Downloaded by [New York University] at 03:54 14 August 2016 weeks of ‘ordinary’ sessions, and then gradually she became fed up and critical of herself, her analysis, and me, and I felt I did not fully understand why. In the particular session I shall describe she came about ten minutes late and was silent for a long time. Eventually, on the basis of the quality of the silence, I said she gave the impression of feeling very negative and angry. Again there was a long silence. At the end she launched into a description of a lot of inconveniences and minor grievances, mainly at work. She said it was a peculiar twist that analysis stirs things up in such a way that all these minor complaints turn into an attack here. I said she wanted me to regard them as minor complaints, but … No, she said, only to know the difference between major and minor. (There was utter contempt in her voice.) There was a short silence, then she said, ‘I don’t know Clinical experiences of projective identifi cation 39 whether it’s you or me, but in the past ten days it seems to me you just totally and utterly keep missing the point.’ (Her tone was exceedingly scathing.) ‘Yesterday you apparently didn’t notice it was so painful for me to admit that I fi nd analysis and everything you do so terribly uninteresting. I can’t stand it.’ I waited a bit, then started to speak, but she broke in, ‘Don’t talk! [almost screaming]. You’re just going to repeat what I said, or you’re going to alter it. You don’t take things in, you don’t listen to what I say, or you listen and you just want to hear it the way you want it to be and you distort it.’ (There could hardly be a better description of what she did to my interpretations, but interpreting projection directly is not usually helpful, especially when a patient is in a fl ight of paranoia.) (I was fi nding it hard to think, and I knew that my own self-doubt and feeling that I was a bad analyst were getting powerfully stirred up by her accusations. But I managed one small thought, which was that she must be feeling inadequate too, and that my leaving had a lot to do with it. Then came a second thought, that she hates herself for being cruel even though she gets excited by it. It felt to me as if I was like a damaged animal making her feel guilty, and she wanted to stamp me out.) I said she couldn’t bear for me to know how painfully attacking she is, how much she wants to hurt me, how cruel she feels; but she also can’t stand it if I don’t know, don’t react. It means she is unimportant. ‘Can’t you realize,’ she screamed, ‘that I am totally and utterly uninterested in you! I don’t care! I only care about myself. Take your pain to your analyst. Well, it’s not my fault if you haven’t got one.’ What I said, after quite a long pause, was that I thought she felt I treated her cruelly, with complete scorn and indifference, as if she was boring and utterly uninteresting, and that was why I was leaving her. She felt that the only way she could really get this through to me was by making me suffer in the same way. There was another long silence. Then she said, ‘None of this alters my being tired and having too many things to do.’ (She sounded like a slightly mollifi ed but still petulant child.) ‘I suppose’, she went on, ‘I am in a childish rage with you. I never could attack my parents, so I have to make up for it now.’ I thought this reference to the past, although probably true, was a way of evading what was happening now. I said I thought nothing felt right to her. If she felt she hurt me, it made her feel so cruel that she couldn’t bear herself, and she got furious with me for being the cause of her attack. But if I wasn’t hurt she felt ignored, as if she had no power or importance at all. She then repeated the last part of this interpretation almost as if she had not heard me and that it was her own idea; that is, she said if she didn’t hurt me it meant she was a nothing. She then talked very indignantly about being left on her Downloaded by [New York University] at 03:54 14 August 2016 own. I said she thought I was cruel for leaving her on her own so arbitrarily and that she therefore had a right to attack me in kind. But she also felt I was leaving her because she was so attacking. She muttered that at least someone ought to notice that leaving was happening, as if implying that I was ignoring it. I said I thought she felt I was ignoring the time of the session as well as the holiday, and in fact it was time to stop now. I would hardly present this as an ideal session, but I think it is an example of the way a patient may have an unconscious phantasy of projecting an experience into the analyst and may act in a way that makes the analyst feel it. I felt utterly trodden on, mistreated, immobilized. This is I think how she felt (unconsciously) about my leaving her, and how she had felt at the time of her traumatic abandonment by her parents in her childhood. 40 Clinical experiences of projective identifi cation What particular thing was it, I asked myself later, that had made her so unable to express herself symbolically in this session, so intent on doing it instead of thinking it? I think it was a combination of my holiday and my self-doubt that led to her acting out in the transference. These were the ‘minor’ and ‘major’ complaints whose difference she angrily thought I should have known. The holiday had started the process off. (‘Someone ought to notice that leaving is happening.’) In a sense my holiday was her ‘minor’ complaint, though with her background no holiday could really be considered minor. My holiday meant that she was going to be left, as she said of me, with no analyst to take her pain to; it was my fault. She replied in kind by extending the holiday herself. As I described briefl y at the beginning, I made several interpretations about this process, which had happened in various forms on many previous occasions. Then the holiday topic was dropped for some time, after which she had gradually become more critical and attacking on a variety of topics not seemingly connected with the holiday break, and I began to be puzzled and then to be assailed by misgivings about the way I was working. She sensed my self-doubt, and I think felt unconsciously that she had injured me so badly that I was not standing up for myself properly and had become persecut- ingly beyond repair. This was her major complaint. My self-doubt was, I believe, very similar to her feelings of unlovableness when her parents had left her. It was also very similar to the picture she painted of her parents, who had cruelly left her but felt very guilty and self-critical about it. Failure, damage, and imperfection were rampant in both of us. Her answer was to get the worst of it into me and then attack and abandon me. She became the cruel me who was leaving her and the cruel parents who had left her, and I became the stupid, miserable child fi t only for abandonment. In this session I made some use, though imperfectly, of Bion’s and Joseph’s approaches to projective identifi cation. What hindered me from linking my own self-doubt with my patient’s feelings of worthlessness was the factor so nicely described by Money-Kyrle many years ago (1956):

How exactly a patient does succeed in imposing a phantasy and its corresponding affect upon his analyst in order to deny it in himself is a most interesting problem. … A peculiarity of communications of this kind is that, at fi rst sight, they do not seem as if they had been made by the patient at all. The analyst experiences the affect as being his own response to something. The effort involved is in differentiating the patient’s contribution from his own. (Money-Kyrle 1956: 342) Downloaded by [New York University] at 03:54 14 August 2016 Bion makes the same point, perhaps a little less explicitly.

Now the experience of counter-transference appears to me to have quite a distinct quality which should enable the analyst to differentiate the occasion when he is the object of a projective identifi cation from the occasion when he is not. The analyst feels he is being manipulated so as to be playing a part, no matter how diffi cult to recognize, in somebody’s (sic) else’s phantasy – or he would do if it were not for what in recollection I can only call a temporary loss of insight, a sense of experiencing strong feelings and at the same time a belief that their existence is quite adequately justifi ed by the objective situation without recourse to recondite explanation of their causation. (Bion 1952: 446) Clinical experiences of projective identifi cation 41 And Sandler describes the process too:

I want to suggest that very often the irrational response of the analyst, which his professional conscience leads him to see entirely as a blind spot of his own, may sometimes be usefully regarded as a compromise-formation between his own tendencies and his refl exive acceptance of the role which the patient is forcing on him. (Sandler 1976b: 46)

Mr C In this session I was looking out for the way the patient was subtly inducing me to feel and act in accordance with his expectations. In the middle of the session this worked reasonably well and he shifted from being preoccupied and uninterested to being emotionally involved. But by the end I forgot about interpreting his attempts to get me to act out and actually did some acting out instead. This patient was the child of wealthy but very preoccupied parents who saw to it that he was physically cared for (there was a succession of servants) but seemed to have had very little awareness that he might have emotional needs. The patient imagines that he lived in a little secluded world of his own, sitting in his corner playing with his toys, quite happy and self-suffi cient. Later he spent a lot of time outside playing with the village boys until he was sent away to boarding school. I got no impression of his consciously protesting against parental neglect. He stressed, on the contrary, the cultural duty of respecting and honouring parents, which he had always done. He was almost always very polite to me, and, although he missed many sessions because of his work, when he did come he was punctilious about coming on time. He thought it very odd that I might expect him to be in any way disturbed by holidays or weekends, or even to notice them. Only ends of sessions sometimes bothered him; why should he have to stop just when he had got interested in something? He was often silent and preoccupied in sessions. He arrived on a Friday saying he had been sitting outside in his car making phone calls on his car phone and couldn’t leave his thoughts about them and concentrate on the session. He went on to say that really most of the sessions here were useless, nothing happened, but then sometimes something really did happen and was very important to him, but it was always when he felt that he was really here. It was like a dream world almost, then, the thing I’ve called his world of freedom. Silence. I said, ‘Where is that dream world now?’ He answered literally. He never remembers dreams well. He always knows he has them but can’t remember them. This time he was having one and his little Downloaded by [New York University] at 03:54 14 August 2016 daughter woke him – it was a dream about his dogs. They were puppies. He bent down to pat one and it nipped him, in fact tried to bite him quite hard. He patted the puppy on the head again and said to someone, ‘Would you believe it, that little puppy really daring to bite me like that!’ There was a lot more but he can’t remember. He went back to talking about how he couldn’t stop thinking about his phone calls and his busy weekend. He told me what he was going to do during the weekend. I found my mind starting to wander to my weekend. (This was my clue to what was happening – I was feeling an impulse to fi t in with a nudge from my patient. He was the busy preoccupied father, I was the child who was managing his lack of interest in me by thinking about my weekend, my toys in my corner. I was the puppy.) I said that he was leaving me and felt he couldn’t be here, he was too busy with his own concerns. I said I thought he expected me to get involved in my own thoughts 42 Clinical experiences of projective identifi cation quite happily and just leave him to get on with whatever he was thinking and planning. He was silent for quite a long time. Then he said that what I had said reminded him of a friend of his who is an inventor. This inventor says that he was very much left on his own in childhood, and he was so desperately lonely that he took to inventing things so as to drive away his loneliness. But he (my patient) was never lonely. He liked being alone. He didn’t feel badly that his parents were so busy and didn’t notice him. I said: Similarly he doesn’t feel badly when I leave him, as I was doing today, as it was Friday. On the contrary, he felt that it was he who was leaving me, and he expected me not to feel badly over his being so busy and not noticing me. He expected me to be happy in my little world and not to mind that he didn’t notice me. Silence. (I felt that now he was here and thinking about what was happening.) I waited for quite a long time, then said that I thought he felt he took advantage of his parents’ neglect, that he felt he liked being in his little private world just as he expected me to like being in mine. But somehow he was also encouraging me to protest, to be a brave little puppy and give him a bite. He had given me a little pat on the head and thought it would be brave of me to protest. Silence. You mean it might have been braver if I had? I said I thought he did believe that, though he didn’t often let himself be aware of it. He sighed. It was nearly the end of the session. I felt I was losing his attention. And then he gave me a bite. ‘Oh,’ he said, ‘I didn’t tell you. I won’t be here on Monday, I’m going hang gliding. That Italian professor wants me to leave it, I don’t want to help him. It’s the competition, I don’t want to miss it. I suppose I should. He’s so crazy he needs me to help.’ I said I thought he felt I was so crazy that I needed him to come to his session on Monday to look after me. He laughed. ‘But you know it’s the time of year for my hang gliding,’ he said. I said it was time to stop now. In this session, as I hope is clear from the material, I was watching out not only for how he perceived me, but also for the way he was trying to induce me to act in accordance with his expectations, as indeed I started to do when I found my mind wandering to my own weekend, but I was able to make interpretative use of that ‘nudge’ and my incipient response to it. But at the end I found myself acting out his expectation instead of interpreting it. When he made his little dog bite – ‘Oh, I didn’t tell you, I won’t be here on Monday, I’m going hang gliding’ – I snapped back at him, gave him a little bite of my own – ‘You feel I’m so crazy that I need you to come back on Monday to look after me’. He was amused, as he had been in the dream when the puppy snapped at him, and I lost the chance to interpret that before my Downloaded by [New York University] at 03:54 14 August 2016 remark, just for a moment he was allowing himself to be the puppy and letting me be the parent whom he was biting. But perhaps what was more important was that my jokeyness interfered with the seriousness of the interchange. Whether he was biting me or I was biting him did not matter so much as the fact that for a little bit of time in the session we had been in emotional contact instead of each of us living in separate worlds, and my irony minimized the fact that this contact between us was being lost, a point I was able to come back to, however, in subsequent sessions.

In conclusion I have described sessions with three patients illustrating slightly different ways of using the idea of projective identifi cation clinically: Klein’s way, which focusses on Clinical experiences of projective identifi cation 43 the effect of projective identifi cation on the way the patient perceives the analyst; Bion’s way, which includes Klein’s usage but focusses also on the way the patient’s actions induce the analyst to feel what the patient unconsciously wants him to feel; and Joseph’s extension of Bion’s usage to examine continuously the way the patient constantly but unconsciously ‘nudges’ the analyst to act out in accordance with the patient’s internal situation. Joseph and Bion have extended Klein’s model by emphasizing the interaction between patient and analyst. I think, however, that trying to make sharp distinctions between the use of one model rather than another is not likely to be any more productive clinically than the effort to distinguish projection from projective identifi cation. Without being very much aware of it, the analyst is likely to use all three models for trying to understand the reality of a session and, similarly, further examination of sessions may reveal that use of one of the other models might have revealed more.

References Bion, W.R. (1952) ‘Group dynamics: a re-view’, International Journal of Psychoanalysis, 33: 235–47. Bion, W.R. (1955) ‘Language and the schizophrenic’, in New Directions in Psychoanalysis, London: Tavistock Publications, 220–39. Bion, W.R. (1957) ‘The differentiation of the psychotic from the non-psychotic personalities’, International Journal of Psychoanalysis, 38: 266–75. Bion, W.R. (1958) ‘On arrogance’, International Journal of Psychoanalysis, 39: 144–46. Bion, W.R. (1959) ‘Attacks on linking’, International Journal of Psychoanalysis, 40: 308–15. Bion, W.R. (1961) Experiences in Groups, London: Tavistock Publications; and New York: Basic Books. Bion, W.R. (1962a) ‘A theory of thinking’, International Journal of Psychoanalysis, 43: 306–10. Bion, W.R. (1962b) Learning from Experience, London: Heinemann. Bion, W.R. (1970) Attention and Interpretation, London: Tavistock Publications. Bollas, C. (1987) The Shadow of the Object: Psychoanalysis of the Unthought Unknown, London: Free Association Books. Brenman Pick, I. (1985) ‘Working through the counter-transference’, International Journal of Psychoanalysis, 66: 157–66. Britton, R. (1989) ‘Projective identifi cation: communication or evasion?’ Unpublished paper given at the British Psychoanalytical Society. Grotstein, J.S. (1981) Splitting and Projective Identifi cation, New York: Jason Aronson. Hinshelwood, R.D. (1989) A Dictionary of Kleinian Thought, London: Free Associations Press. Jacobson, E. (1967) Psychotic Confl ict and Reality, London: Hogarth Press. Joseph, B. (1985) ‘Transference: the total situation’, International Journal of Psychoanalysis, 66: 447–54. Joseph, B. (1987) ‘Projective identifi cation: some clinical aspects’, in J. Sandler (ed.) Projection, Downloaded by [New York University] at 03:54 14 August 2016 Identifi cation, Projective Identifi cation, Madison, CT: International Universities Press, 65–76. Joseph, B. (1989) Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, M. Feldman and E. Bott Spillius (eds), London: Routledge. Kernberg, O. (1975) Borderline Conditions and Psychological Narcissism, New York: Jason Aronson. Kernberg, O. (1980) Internal World and External Reality, New York: Jason Aronson. Kernberg, O. (1987) ‘Projection and projective identifi cation: developmental and clinical aspects’, in J. Sandler (ed.) Projection, Identifi cation, Projective Identifi cation, Madison, CT: International Universities Press. King, P. (1978) ‘Affective response of the analyst to the patient’s communication’, International Journal of Psychoanalysis, 59: 329–34. Klein, M. (1946) ‘Notes on some schizoid mechanisms’, in The Writings of Melanie Klein, vol. 3, Envy and Gratitude and other Works, London: Hogarth Press, 1–24. 44 Clinical experiences of projective identifi cation

Malin, A. and Grotstein, J.S. (1966) ‘Projective identifi cation in the therapeutic process’, International Journal of Psychoanalysis, 47: 43–67. Meissner, W.W. (1980) ‘A note on projective identifi cation’, Journal of the American Psychoanalytic Association, 28: 43–67. Meissner, W.W. (1987) ‘Projection and projective identifi cation’, in J. Sandler (ed.) Projection, Identifi cation, Projective Identifi cation, Madison, CT: International Universities Press, 27–49. Money-Kyrle, R.E. (1956) ‘Normal counter-transference and some of its deviations’, International Journal of Psychoanalysis, 37: 360–66. Ogden, T. (1979) ‘On projective identifi cation’, International Journal of Psychoanalysis, 60: 357–73. Ogden, T. (1982) Projective Identifi cation and Psychotherapeutic Technique, New York: Jason Aronson. O’Shaughnessy, E. (1983) ‘Words and working through’, International Journal of Psychoanalysis, 64: 281–89. O’Shaughnessy, E. (1992) ‘Enclaves and excursions’, International Journal of Psychoanalysis, 73: 603. Riesenberg-Malcolm, R. (1970) ‘The mirror: a perverse sexual phantasy in a woman seen as a defence against a psychotic breakdown’, in E. Bott Spillius (ed.) Melanie Klein Today, vol.2, Mainly Practice, London: Routledge (1988), 115–37. Rosenfeld, H.A. (1952) ‘Notes on the psycho-analysis of the superego confl ict of an acute schizophrenic patient’, International Journal of Psychoanalysis, 31: 111–31. Rosenfeld, H.A. (1971) ‘Contribution to the psychopathology of psychotic states: the importance of projective identifi cation in the ego structure and object relations of the psychotic patient’, in P. Doucet and C. Laurin (eds) Problems of Psychosis, vol. 1, The Hague: Excerpta Medica, 115–28. Rosenfeld, H.A. (1987) Impasse and Interpretation, London: Tavistock Publications Sandler, J. (1976a) ‘Dreams, unconscious fantasies and “identity of perception”’, International Review of Psychoanalysis, 3: 33–42. Sandler, J. (1976b) ‘Countertransference and role responsiveness’, International Review of Psychoanalysis, 3: 43–47. Sandler, J. (1987a) Projection, Identifi cation, Projective Identifi cation, Madison, CT: International Universities Press. Sandler, J. (1987b) ‘The concept of projective identifi cation’ in Projection, Identifi cation, Projective Identifi cation, Madison, CT: International Universities Press. Sandler, J. and Sandler, A.M. (1978) ‘On the development of object relationships and affects’, International Journal of Psychoanalysis, 59: 285–96. Downloaded by [New York University] at 03:54 14 August 2016 Segal, H. (1950) ‘Some aspects of the analysis of a schizophrenic’, International Journal of Psychoanalysis, 31: 268–78. Segal, H. (1973) An Introduction to the Work of Melanie Klein, 2nd edn, London: Hogarth Press. Spillius, E. Bott (ed.) (1988) Melanie Klein Today, vol.1, Mainly Theory, and vol. 2, Mainly Practice, London: Routledge.

CHAPTER 4

VARIETIES OF ENVIOUS EXPERIENCE

This is a somewhat revised version of ‘Varieties of envious experience’ which appeared in the International Journal of Psychoanalysis, 1993, vol. 74, pp. 1199–1212. Revised August 2000, 2005. It was also published in Encounters with Melanie Klein: Selected Papers of Elizabeth Spillius, eds P. Roth and R. Rusbridger (2007), London: Routledge.

Envy is disturbing – a disturbing feeling and a disturbing concept in psychoanalysis. Freud’s idea of penis envy has aroused anger in many women, especially feminists. Klein’s idea of constitutional envy evoked a storm of protest by many analysts. In this paper I discuss envy as defi ned and used by Klein herself and by later Kleinian analysts, but I also describe clinically two ways of experiencing and expressing envy that I think show qualitative as well as quantitative differences. I then describe a model of the conscious and unconscious feelings accompanying processes of giving and receiving, because I believe that these processes are central to understanding envy and because I have found them to be clinically useful. Freud was the fi rst analyst to use the concept of envy both in the idea of penis envy and in the idea that the members of a group can forgo their envious rivalry with one another in a common idealisation of the group leader (Freud 1921). Abraham (1919) uses the idea of envy to explain a destructive attack that certain patients make on psychoanalytic work. Eisler (1922) notes that envy derives from the ‘oral instinct’. In 1932 in ‘Jealousy as a mechanism of defence’ Joan Riviere regarded pathological jealousy as a defence against unconscious oral envy of the parents in coitus. Melanie Klein, however, was the fi rst analyst to make the concept of envy central to her psychoanalytic theory. Klein had used the idea of envy in much of her earlier work (Klein 1929; 1932; 1945; 1952; 1955) but towards the end of her life she wrote about it much more systematically in Envy and Gratitude (1957). ‘I consider’, she writes, ‘that envy is an oral-sadistic and anal-sadistic expression of destructive impulses, operative from the beginning of life, and that it has a constitutional basis’ (Klein 1957: 176). A little later she describes it as ‘the angry feeling that another person possesses and

Downloaded by [New York University] at 03:54 14 August 2016 enjoys something desirable – the envious impulse being to take it away or spoil it’ (p. 181). In her view it is a manifestation of death instinct, which she thinks of as an instinctual, internal destructive force felt as fear of annihilation. Klein distinguishes with care between envy, greed and jealousy. Greed she defi nes as ‘an impetuous and insatiable craving, exceeding what the subject needs and what the object is willing and able to give … its aim is destructive introjection; whereas envy (aims) … also to put badness … into the mother … in order to spoil and destroy her’ (Klein 1957: 181). Jealousy she describes as a three-person situation in which the ‘love that the subject feels is his due has been taken away, or is in danger of being taken away, from him by his rival’ (Klein 1957: 181). These three states of mind are frequently found in close association. Greedy acquisition can be a defence against being aware of envy of those who have or who are what 46 Varieties of envious experience one wishes one had or was oneself. Analysts are familiar with the sort of patient who makes insatiable demands on the analyst but rubbishes whatever he is given – a mixture of greed and envy. The jealous lover is often driven less by love than by envious hatred of his lover’s capacity to arouse the love of another. And in everyday English the words ‘jealousy’ and more rarely ‘envy’ are often used where ‘admiration’ would be appropriate, as for example in statements such as ‘I am jealous (or envious) of your lovely garden’. Even Shakespeare (Othello c. 1603) has Iago describe the crucial element of jealousy in terms that are an excellent description of the core of envy:

Oh! Beware, my Lord, of jealousy; It is the green-ey’ed monster which doth mock The meat it feeds on. (III, iii, 165–167)

Thus in literary and everyday usage the terms envy and jealousy overlap, vary in meaning, and have a large penumbra of associations. These varying and overlapping usages are enshrined in the Oxford English Dictionary. Klein’s defi nition of envy is well within the dominant traditional usage, though it emphasises the malignant aspects. There are diffi culties, however, in treating much-used words like envy and jealousy as technical terms, as Klein does, for people are sure to add the various associated and overlapping meanings. According to Segal (personal communication), Klein developed her ideas about envy in the course of analysing three particularly diffi cult patients. Jaques (1969) adds that some of Klein’s evidence for envy and for its early nature derived from her work with ‘Richard’, a ten-year-old patient who, after acknowledging a particularly helpful bit of the analytic work, often used to attack and belittle it; these attacks appeared particularly often in the context of Richard’s feeling that Klein and his mother possessed the feeding ‘breast’ which was giving mental nour- ishment not only to him but also to others (Klein 1960). More generally Klein thought that envy was a major motive for the sort of negative therapeutic reaction that sometimes sets in after helpful work has been acknowledged by the patient. (See also Rosenfeld 1975 and Chapter 2 of the present book, ‘Clinical refl ections on the negative therapeutic reaction’.) She was impressed too by the intense pain and depression that many patients experienced when attempting to integrate their conscious positive feeling towards the analyst with their increasing awareness of making envious attacks on what they had experienced as their analyst’s goodness. She gives several moving examples of such struggles in Envy and Gratitude. Klein lays especial emphasis on the fact that envy leads to psychic attacks on the experience of the goodness of the object, which, if unchecked, lead to great diffi - Downloaded by [New York University] at 03:54 14 August 2016 culty in taking in and learning. Because envy leads to attacks on the individual’s sense of the goodness of the object, it is likely to result in confusion between the object’s goodness and badness, which impairs processes of differentiation and of the development of rational thought (see also Rosenfeld 1947 and 1950). Klein thinks that envious attacks on the goodness of the object, which are much more diffi cult to acknowledge than attacks on badness, are likely to lead to a premature development of guilt before the individual is able to stand the pain of it, leading to confusion between depressive guilt (Klein 1935) and paranoid-schizoid persecution (Klein 1946), and sometimes to confusional states. In satisfactory development, by contrast, Klein says that a deep-rooted relation with a good object is built up and internalised, and then the child can withstand temporary states of envy, hatred and grievance which arise even in children who are loved and well mothered. Varieties of envious experience 47 Klein does not assert, as is sometimes thought, that envy is entirely constitutional. As she puts it:

In speaking of an innate confl ict between love and hate, I am implying that the capacity for both love and for destructive impulses is, to some extent, constitutional, though varying individually in strength and interacting from the beginning with external conditions. (Klein 1957: 180, my italics)

Or again:

Furthermore, whether or not the child is adequately fed and mothered, whether the mother fully enjoys the care of the child or is anxious and has psychological diffi culties over feeding – all these factors infl uence the infant’s capacity to accept the milk with enjoyment and to internalise the good breast. (Klein 1957: 179)

The experience and expression of envy, and indeed of love and hate in general, occur and develop in relationships with objects, so that one can never meet the constitutional component unmodifi ed by experience. Nor can one tell, from the perspective of the consulting room, how much of a patient’s envy is constitutional, how much has developed because of his experiences with objects, or how much is the result of the process of interaction between the two. What one can tell from the way he behaves in the consulting room is what his envy is like in his internal world now, how severe it is, how it expresses itself in relation to his analyst, and what defences he uses. Klein’s paper on envy provoked a storm of disagreement in the British Psycho- analytical Society, chiefl y on the grounds that it was preposterous to regard such pernicious attacks on goodness as inherent in human nature; that the death instinct, of which envy was an expression, was not a viable concept; that Klein ignored the environment; that what she described as envy in infants could better be described as ‘eagerness’; that she was attributing to infants thoughts of which they were not capable; that her theory of envy was a theory of despair, scientifi cally unproved; and that Kleinians’ preconceived theoretical expectations of envy were leading them to fi nd confi rmation of intractable, vicious and destructive envy in all their patients’ clinical material. These criticisms were voiced in a symposium on envy and jealousy which was held by the British Psychoanalytical Society in 1969; the main critical paper, by Walter Joffe, was published in 1969; other unpublished criticisms were made by Downloaded by [New York University] at 03:54 14 August 2016 Winnicott, Khan, Gillespie, King, Bonnard, Heimann and Limentani. Much of the discussion focussed on whether or not envy was constitutional, and there was little examination of the clinical material Klein described or her particular use of the concept of envy in elucidating it. Another assumption seemed to suffuse this discussion, namely, that if envy proved to be intractable in analysis it was probably inherited. I think this assumption is questionable. Indeed, it was questioned at the Envy and Jealousy Symposium in which Rosenfeld maintained that there was no reason to assume that inherited dispositions were immutable and impervious to analysis. Further, we know that early infant/caregiver exchanges can have profound emotional effects which are diffi cult to change, and there is no reason to assume that envy that proves to be intractable in analysis should not have been affected by early infant/caregiver exchanges, whatever its constitutional basis. The discussion 48 Varieties of envious experience of the Envy and Jealousy Symposium was also complicated by the fact that many speakers were tacitly emphasising other aspects of the traditional usages of the term envy in addition to the ones focussed on by Klein; all the participants were infl uenced by the presence of complex theoretical issues which have still not been fully clarifi ed or agreed: the relationship to one another of the concepts of instinct, mental state, affect, character trait and object relationship. Joffe and other British colleagues have not been the only critics of Klein’s use of the concept of envy. In 1958 Elizabeth Zetzel said that ‘[t]he hypothesis developed in Envy and Gratitude suggests that Melanie Klein is moving further away from, rather than towards the mainstream of contemporary psychoanalysis’ (Zetzel 1958). In 1961 Guntrip expressed dismay at Klein’s treatment of envy as ‘unmotivated and ultimate, and as a basic manifestation of death instinct’ (1961: 344). More recently (1992) Earl Hopper writes that ‘[t]he critique (in the Envy and Jealousy Symposium of 1969) was telling, if not devastating, and remains so’. Feldman and De Paola, too, are critical of Klein’s idea of envy because she speaks of it ‘alternately as a feeling or as an impulse … not maintain(ing) a consistent approach to the problem of its (psychic) category’ (Feldman and De Paola 1994: 221). I believe that most of the antagonism to Klein’s idea of envy is based on her assertion that it has a constitutional basis, which many critics have taken to mean that she thinks envy is an instinctual impulse rather than a feeling. Even one, at least, of Klein’s inner circle questioned her closely about this aspect and its implications. In a letter of 18 April 1956 Joan Riviere wrote to Klein:

In your letter you mention your Envy paper as again showing that you connect object-relations with instincts: here what I am going to say is not criticism or doubt, I am hoping you will make it clearer in the book how ‘innate envy’ can arise. The idea is not clear in itself. It implies an object-relation before birth – a diffi cult proposition to many people. If that is what you mean, it is new in theory, and you need to discuss it fully and give your evidence for it. The diffi - culty is expressed in Bowlby’s letter to you about it, which is circularized, and it should not be ignored. You may be perfectly right, as you so often have been; but in scientifi c work the conclusion should be worked out on the basis of evidence, or else it should be put forward as a speculation, which Freud did about the L & D instincts, though giving all the evidence he could. (Riviere 1956)

It is typical of Klein’s unfussy and rather unsystematic approach to theory that she saw no problem in the idea of something starting off as an instinctual impulse and interacting with experience to become a feeling, and, indeed, when she expanded Downloaded by [New York University] at 03:54 14 August 2016 her 1955 paper on envy (Klein 1955) into her book Envy and Gratitude (Klein 1957), she did make much clearer how she used her idea of envy in clinical work – not that that stopped the criticisms of its instinctual basis, however. In spite of criticisms of the concept of envy, most Kleinian analysts have continued to treat the concept as a cornerstone of their theory and their clinical approach even though few papers have been specifi cally written about it (but see Segal 1964; Joseph 1986; Etchegoyen et al. 1987; Brenman 1990; Lussana 1992). The fact that so many of the criticisms of Klein’s concept of envy came from non- Kleinians perhaps increased the feeling among Kleinian analysts that stress on envy was a distinctive sign of their identity, but they also adopted the concept because of its immense clinical usefulness. One of the hard-won clinical understandings arising from Klein’s insight about envy is that in some patients envy can be Varieties of envious experience 49 extremely destructive both to the individual himself and to his objects, including his analyst. In severe cases it is as if envy holds the patient in thrall; the patient feels that his convictions and his defensive system are infi nitely preferable to his tentative positive relationship with the analyst as a good object, and he attacks this relationship remorselessly especially when he feels the analyst has been helpful (see especially Rosenfeld 1971; Joseph 1982). Klein assumes that a propensity for envy is present from birth, a view that is consistent with her idea that some form of self/object differentiation and some rudimentary form of object relationship is present from the beginning. This assumption, too, has been much criticised, especially by Winnicott and other psychoanalysts who assume that the neonate does not distinguish between self and non-self. (Feldman and De Paola, 1994, give a sensitive hypothetical reconstruction of the development of envious feelings starting from this hypothesis of un-differentiation at birth.) We cannot of course know what pre-verbal infants think – nor, for that matter, what anyone thinks except by inference – but Klein’s assumption is consistent with certain observations of babies, some systematic and ‘scientifi c’ (Stern 1985: 10), some much more casual. A very young baby, for example, characteristically did not take hold of the nipple readily; his father, watching him, said, ‘He only takes hold of it if he thinks he has come across it by accident. I don’t think he likes to feel he really needs it.’ The father was assuming, taking it for granted really – and probably also reading his own feelings into the baby – that his baby would not like having to get too much involved with this ‘other’, this ‘not-me’ thing that fed him. It was clear too that the father did not think his baby’s behaviour was ‘bad’, only that he was perhaps precociously independent and did not like acknowledging his need for help. Both parents were sympathetic to their baby and his expressions of envy or proto-envy, an important attitude for analysts as well as parents. Klein and her colleagues assume that when an individual approaches the depressive position (Klein 1935, 1940) he experiences his object in a much more fully developed way. The object is known to be needed by the individual, but is also known to have an independent existence, to be both good and bad, loved and hated, to have relationships with others. The stage is set for much more explicit awareness of envy and jealousy. And in the case of patients’ fl uctuations between the depressive and the paranoid-schizoid positions in the analytic situation, it is when they approach the depressive-position mode of thinking, with its tendency towards integration and awareness of the object’s separateness, that envy is likely to be experienced most acutely, sometimes consciously, and retreat to the defences of the paranoid-schizoid position may ensue. All contemporary Kleinians consider envy to be an important and clinically useful concept, although there is some variation in defi nition and usage. Some Downloaded by [New York University] at 03:54 14 August 2016 Kleinian analysts defi ne envy and death instinct in even more generalised and forceful terms than Klein herself used. John Steiner, for example, thinks of death instinct and envy as forces whose aim is to reduce differentiation and diminish structure, especially structure that involves differences between subject and object. Any difference may be attacked by envy, but goodness is its special target. He places much stress on the ‘malignant destructiveness of envy, which is anti-life, anti-creativity, and anti-growth and development’ (Steiner 1992 and personal communications). To those who hold this view, degrees of envy are recognised, but the idea that there might be qualitatively different sorts of envy or even different subjective experiences of envy is not really a meaningful idea; envy, if consciously experienced at all, is thought to be experienced by the individual as a bad, destructive attack on an object recognised to be good. This usage is probably more 50 Varieties of envious experience restricted than Klein’s own usage, but it has become a hallmark of the current approach of many Kleinian colleagues. Some other Kleinian analysts, however, perhaps most notably Britton (1998: 58 and personal communications), think of envy as less intrinsic and fi xed. In his terms envy is ‘molecular’ rather than ‘atomic’. In his notion of development individuals struggle not so much with different balances of life and death instinct as with different balances of allergy to and attraction to ‘otherness’. He fi nds the developmental and clinical signifi cance of envy essential and convincing, but he does not fi nd its description in infancy as an irreducible, malignant element to be satisfactory. He thinks that Bion’s minus-K (Bion 1962) rather than envy in itself might be a factor underlying what Britton calls ‘psychic atopia’, meaning an antipathy to knowing anything that is different, a counterpart in the psychic constitution to the somatic immune system. And whatever the unknown constitutional basis of envy and of psychic atopia may be, it is my assumption (and I think Brit- ton’s) that envy and gratitude evolve in myriads of infant/caregiver, child/caregiver, and later person/person exchanges, conscious and unconscious, whose exact nature we cannot know from the perspective of the consulting room. All that we can investigate in the consulting room is the role that envy plays in the internal world of the patient and in his exchanges with his analyst. I used to think that envy was only destructive to the individual and to those around him when it was unconscious and split off, and that in analysis it would become conscious, arouse guilt, and gradually become integrated with more positive dispositions. I soon found, however, that this fi rst expectation was too simple. In some patients envy appears to be experienced consciously, but without arousing the individual’s guilt or remorse. In all the clinical examples given by Klein in Envy and Gratitude, in one of Segal’s (1964), and most of Joseph’s (1986), the examples of envious reactions are of the fi rst type described above: envy was mainly unconscious and usually well contained. It rarely expressed itself directly, though its unconscious operation led to inhibition, sometimes severe inhibition, of the patient’s creativity in work and in personal relationships. Conscious envy emerged late in the analysis in the case of these patients, at moments when the patient was feeling the analytic work to be deeply helpful, and the patient experienced acute mental pain and a sort of circum- scribed depression as he integrated the awareness of his envy into his picture of himself. When this sort of envy is relatively mild I think of it as ‘ordinary envy’. To the sort of patient I have in mind, this ordinary envy is ego-dystonic, or, perhaps more accurately, consciousness-dystonic; his envy is usually unconscious and intense guilt is aroused if the individual becomes fully aware of it. In such cases, analyst and patient are using the same defi nition of envy. Like Britton, and like the Downloaded by [New York University] at 03:54 14 August 2016 father described above watching his baby’s approach to the breast, I assume that everyone tends to be somewhat allergic to otherness, especially to goodness in others. Ordinary envy may become malignant, but some degree of it is universal. But in some of my patients, and in a few reported cases including some of Joffe’s (1969) and one of Segal’s (1964), and in many of the ‘social’ examples described by Schoeck (1969) and Berke (l986), envy is very obvious to the outside observer and is conscious at least to some degree to the person expressing it. I use the term ‘impenitent’ for this sort of envy; in everyday usage such envy is often called ‘grievance’ and for ease of understanding I use this term as equivalent to ‘impenitent’ envy. I assumed at fi rst that ‘impenitent’ envy, being virtually or actually conscious, would be less severe than the cases of ordinary, ego-dystonic envy described by Klein and others. In fact, however, I have found that this is rarely so. Varieties of envious experience 51 In my experience there is a considerable range in severity and destructiveness in both ways of experiencing envy. Further, there may well be other ways of experiencing envy. Several colleagues have suggested that severely manic and schizophrenic patients use other modes than the two I have described. Nevertheless it is the ‘ordinary’ and ‘impenitent’ modes that I have chiefl y encountered in my practice and that I want to discuss in this paper. According to the Oxford English Dictionary envy may be felt when the individual compares himself with someone superior in happiness, reputation or the possession of anything desirable. In my view envy is especially likely to be felt when the individual has to depend on someone who is experienced as this sort of superior person, and all envious patients defend themselves to some extent against being aware of such dependence. The person whose envy is ego-dystonic directs defences against becoming aware that envy may be the basis of his behaviour, especially his various forms of attack on good objects. In the analysis of this sort of patient and this sort of envy, analyst and patient have the same or potentially the same defi - nition of envy: it is a destructive attack on a good object. If the ordinarily envious individual becomes aware of his envy he feels guilty and unhappy. The impenitently envious person, however, is consciously aware of his envy, but he does not suffer from conscious guilt and a sense of responsibility for his envy; he thinks it is the envied person’s fault that he, the envier, feels envy. The analyst may feel that his impenitently envious patient is making a destructive attack on a good object, but the patient thinks he is making a legitimate attack on an envied object who deserves to be hated. Splitting the object into ‘good’ and ‘bad’ is a common defence by a person who experiences impenitent envy: the perceived goodness of the object is held to be the proper possession of the envier; the perceived badness of the object is held in contempt or is angrily attacked. This sort of impenitent envy without guilt is also described by Kernberg as typical of the narcissistic personality disorder, especially when this disorder takes the form of pathological narcissism or antisocial personality disorder (Kernberg 1984: 193, 197, and 303; Kernberg 1989: 559). Impenitent envy is particularly clearly described by Dennis Carpy in an unpublished paper called ‘Fantasy versus reality in childhood trauma: Who’s to blame?’ Aggrieved people frequently have a belief that they have been unfairly treated and are entitled to redress. In analysis this emerges as a belief, at times as an insistence, that the analyst must agree with the patient, that only then will the patient feel really understood, only then can he be cured. The patient offers the analyst what Michael Feldman describes as a ‘deal’: ‘You agree about the rightfulness of my grievance and I will let you help me’ (Feldman, unpublished paper on grievance, and personal communication; Britton, personal communication; Kohon, 2000.) Downloaded by [New York University] at 03:54 14 August 2016 A frequent aspect of the defensive arrangements of an impenitently envious person is that he feels unconsciously that he is profoundly unlovable and inferior, qualities which he projects into others towards whom he feels superior. Thus the person with impenitent envy and a persistent sense of grievance tends to fi nd himself in a world in which some people are unfairly superior to him while others are justifi ably inferior. Such patients remind one of Milton’s Satan (Paradise Lost, 1667) with his abandoning of hope, good and remorse, and his welcoming of evil and power:

So farewell hope, and with hope farewell fear, Farewell remorse: all good to me is lost; Evil be thou my Good. (Book 4: 108–110) 52 Varieties of envious experience Like Carpy, however, I have found that in cases of impenitent envy and grievance, defences are used not only to maintain and enhance the sense of grievance but also to evade acknowledging the acute pain and sense of loss, sometimes fear of psychic collapse, that would come from realising that what one wants is a good object but really feels that one does not have it or has not had it. Such recognition of loss would mean having to face the acute feelings of conscious envy not only of the good object one should have had, but also of the self one should have been but will never be, and to acknowledge realistically the actual qualities of the objects one has had, such as they are and were. Feeling perpetual grievance and blame, however miserable, is less painful than facing such losses. Better to hate than to mourn. Viewed from this angle, impenitent envy is a form of narcissistic defence. ‘Envy and narcissism’, as Segal said at the Symposium on Envy and Jealousy in 1969, ‘can be seen as two sides of the same coin.’ Defences against envy are multiple, and frequently reinforce one another, especially in the case of impenitent envy, to form what has been called a ‘defensive’ or ‘pathological’ organisation (Rosenfeld 1971; O’Shaughnessy 1981; Steiner 1985, 1993). Looked at singly, the main defences against envy, as described by Klein and elaborated by her colleagues are: (1) Denigration of the good qualities of the object, which will then provoke less admiration and dependency (Klein 1957; Segal 1964; Joseph 1986); (2) Projection of envy so that the individual sees himself as a non- envious person surrounded by envious destructive people (Klein 1957; Joseph 1986); (3) Idealisation of the envied object so that comparisons with oneself become irrelevant (Klein 1957; Joseph 1986); or it may take the form of denigration of the envied object and idealisation of some other object; or some aspects of the envied object may be denigrated and others idealised; (4) Identifi cation with the idealised object or idealised aspects of the object through projection and introjection so that the individual feels that he is the possessor of the admired attributes of the envied object (Klein 1952: 68–69; Rosenfeld 1964: 71; Sohn 1985); (5) Stifl ing feelings of love and correspondingly an intensifying of hate, sometimes expressing itself as indifference or emotional withdrawal (Klein 1957; Rosenfeld 1969). (6) A form of masochistic defence in which the individual feels himself to be omnipotently hopeless so that the envied object, who cannot cure the individual’s despair, is proved to be worthless (Joseph 1982; 1986).

Examples of ‘ordinary’ and ‘impenitent’ envy I want now to describe sessions with two patients which illustrate the expression of ordinary and impenitent envy. In the sessions I shall describe, both patients somewhat resented the fact that recent analytic sessions had been helpful, and both expressed some degree of negative therapeutic reaction. Mrs A’s envy is ego- or Downloaded by [New York University] at 03:54 14 August 2016 consciousness-dystonic and, although she was considerably upset when she became aware of it as in the sessions I report, her envy is not pervasive or deeply destructive. Mrs B feels impenitent envy, and, although she would not be described as deeply disturbed or fragmented, I think she is considerably more troubled by envy than Mrs A. Her defences are more complex but also less effective than those of Mrs A. She constantly feels how unfair it is that other people have qualities and advantages that make her feel envious.

Ordinary envy: Mrs A Mrs A mistakenly came to her session 15 minutes early. While waiting to start the session I was puzzled, for Mrs A was generally punctual. Was she in an unusual Varieties of envious experience 53 state of eagerness? In a panic? Was it connected with yesterday’s apparently ‘good’ session? Once the session began she explained that she hadn’t realised at fi rst that she had come early, and she had felt angry with me for keeping her waiting. Then she realised what had happened and felt very embarrassed, as if she was caught in the act of spying on me. She had found it reassuring while she was waiting to hear me talking to the woman who cleans my house. It meant that I was involved in all the sounds of domesticity. ‘Because you too make pretty much the same sort of sound’, I said, ‘so it means you and I are alike.’ She agreed and went on to tell me that she had found yesterday’s session particularly helpful, that she had understood many things that she hadn’t thought of before. I said she was very grateful for this but it also seemed possible that it had made her feel that she couldn’t provide for herself the sort of understanding that I had, so she regained her balance by arranging to hear me in my domestic role in which I was reassuringly similar to her. She thought briefl y, agreed, saying that it wasn’t very nice. Then she talked about one of her colleagues with whom she is having a lot of diffi culty because he says that one of his bosses is ‘past it’ and hardly worth bothering about. ‘Oh dear’, she said. ‘You seem to have started listening to what you were saying and translating it’, I said. ‘Yes, and it seems to be that I’m saying you’re “past it”. Even worse.’ She paused, and then went on to tell me that a close friend of her brother had rung last night and how important it was because they have been somewhat estranged. Then she told me a long, harrowing and extremely interesting story about the heroism of this brother’s friend during the recent revolutions in Eastern Europe. For some time I was completely caught up in listening to the story, then began to think about why I had got so involved in it, and wondered whether it was possible that her telling of the story had something to do with the situation we had been talking about earlier. Eventually I said I thought she was worried I might think she was past it, and she was regaining her balance, this time by telling me a very interesting and dramatic story which she thought I would fi nd utterly absorbing. It was a way of arranging things so that she felt she was the one who had the valuable stuff and I was the one who was being enriched by it – she was the giver, I the receiver, reversing the roles she felt we’d been in yesterday. ‘I’ve suddenly remembered a dream,’ she said. ‘It was pretty dreadful. I was with my sister. All my crowns fell off my teeth. I was trying to push them back on but

Downloaded by [New York University] at 03:54 14 August 2016 even the stumps were falling out. I was a wreck. Then I saw an old friend walking past with her back very straight. She looked very regal, wearing a kaftan. Father used to tell me off for not walking with my back straight.’ I said that she’d remembered the dream almost at the end of the session so that if I talked about it I would be pronouncing on it in the sort of regal manner that she felt was characteristic of her sister. I thought she felt that in the dream the repair work we had being doing had fallen to pieces, that there wasn’t even a foundation for it. It wasn’t clear whether she felt my supposed repair work was attacking her teeth, or she was attacking the work we had been doing together, but it did seem that I was queening it over her and she was a wreck. Refl ecting on the session after she had left, it seemed to me that as the session proceeded she had gradually moved closer to a more explicit recognition of making an envious attack. 54 Varieties of envious experience

Mrs A’s next session She went back to the dream at once. She agreed, with some discomfort, that her self-attack was really an attack on the work we had been doing. The straight- backed old friend, it emerged, was her view of me in which I was made out to be haughty and regal rather than helpful. Further, she thought she had wanted to be like this sort of person herself, hardly a compliment to the analytic enterprise. Then she talked in detail and with pain and seriousness about the diffi culty she has in getting hold of things in herself that she really doesn’t like. As time went on in successive sessions, she realised that her envious attacks on me and on her own progress were not as deeply spoiling as she feared. She became more objective about my vices and virtues and more forgiving towards herself for her periodic impulses of envious attack. Very gradually, too, she became less inclined to blame herself endlessly for what she felt to be her mother’s defects.

Impenitent envy: Mrs B Before the sessions I shall report, Mrs B had had several sessions in which she felt I had understood something particularly painful that she had undergone.

Session 1 She seemed to be in a bad mood. She said her students hadn’t turned up so she’d cancelled her seminar. Then she’d had a piano lesson and felt it had gone well; it made her furious that she was dependent on something external like that. Furious also, I said, that she’d felt better during yesterday’s session, another external something she perhaps felt dependent on. She said I could add her mother’s visit. It went well and that made her disgruntled too. Silence. Then she said she’d had a dream but didn’t propose to tell me. The atmosphere was heavy with resentment. I waited for quite a long time and then said I thought she didn’t want me to have the pleasure of working with her to understand the dream. ‘I suppose not’, she said. A long silence, then she said, ‘Having said I won’t tell you, here it is.’ Dream. ‘I’m with my grandmother. She was dancing with me in a lively fashion. I was half enjoying it but half afraid she would have a heart attack and die.’ She said she couldn’t make much sense of it. Then she spent quite a long time explaining that her grandmother had a weak constitution, a constitutional defect. After a pause she talked about a woman colleague whose marriage looked very Downloaded by [New York University] at 03:54 14 August 2016 trendy and successful but she thought it was all a great strain on the couple and their children. She herself and her husband are the same – everything looks fi ne on the surface but things aren’t really right. ‘As in the dream’, I said, ‘in which your grandmother looked full of life, but seems to have been unaware of the fact that she might have a heart attack and die at any moment.’ I went on to say that I thought she had similar mixed feelings about me. I looked all right on the surface, she’d been told I was a respected training analyst etc., but what sort of strain was going on under that supposedly trendy exterior? What sort of strain was the dance between us putting on us? Would I be overwhelmed and she’d be blamed? Silence. ‘You mean because of my telling you about feeling troubled yesterday. Yes, perhaps.’ Varieties of envious experience 55 I waited some time, then said that, like her grandmother in the dream, I thought my patient felt I was unaware of the danger I was in. She thought I was idealising my energy and my dancing partnership with her, just as her colleague at work idealised her trendy marriage. So there was a constitutional weakness in me that she knew about and I didn’t. There was a longish pause. Then she said that there was something ridiculous about her grandmother in the dream. ‘You’re right. I’ve just realised there is something I’ve been feeling about you that is ridiculous. It’s about your garden. It makes me think you’re silly. Why did you choose a house that is overlooked? At fi rst I thought it must be some American custom – you’re so urbanised you don’t care about being overlooked. Anyway, so long as you only had a mess out there it didn’t matter, there was nothing to see. But now you’ve put in grass and plants. Surely you must realise there is no point in doing that when you’re overlooked. It’s silly.’ Normally I would have explored her choice of my garden a bit further, but it was getting near the end of the session. I said the garden was her analysis. So long as it was barren and a mess, she could overlook it and it didn’t matter. But now I was aspiring to grow things in her analysis with her, and it made her furious. It made her feel overlooked, resentful, shut out, and she dealt with it by thinking she was the one overlooking me, superior. I was unaware of this and silly. ‘Yes,’ she said, ‘and you overlook that there is something in me that is going to spoil everything – my inheritance, my bad constitution.’ (This was said with a mixture of grievance and contempt, as if she did not have to carry any responsibility for spoiling everything because it was her bad constitution that was to blame, and I was too stupid to have seen this.) I said she put it cogently, triumphantly. She felt I deserved to be put down. And, as in the dream, she felt I was a slightly absurd, vulnerable granny, oblivious of the dance of death she was doing with me, and oblivious too, perhaps, of her fear that she would get blamed for the terrible outcome it might have. (In addition to the three meanings of ‘overlook’ in this interchange, namely, (1) to see into or over; (2) to ignore; and (3) to look down upon, there is another meaning according to the Oxford English Dictionary which is ‘to look with the evil eye’, a concept very close to envy. I doubt very much, however, whether my patient knew this; certainly I did not know it at the time.)

Mrs B’s next session She felt marvellous and sounded absolutely triumphant. Three good students had appeared and she assigned them all to her own seminar. She didn’t see why her colleagues should expect to share in her decision. After all, their work wasn’t any Downloaded by [New York University] at 03:54 14 August 2016 better than hers just because they had PhDs. I said she felt she was not only the equal of her colleagues with PhDs, but also the equal of me who had a PhD. She had become me, or, rather, the impressive PhD aspects of me. Gradually in the course of the session it became clear that her image of me was increasingly split. The incompetent granny me was being denigrated more and more, and was arousing in my patient not a sense of responsibility but the persecutory guilt that Klein describes. The PhD me was exalted, idealised; she had taken it over and had become identifi ed with it to the extent that she was almost talking as if she had a PhD herself. Certainly she was as good as me. Eventually, though not in this session, her spell of narcissistic self-suffi ciency collapsed into futility and hopelessness, which she felt I could do nothing to help. 56 Varieties of envious experience It became clearer that she found it very diffi cult indeed to bear the intense pain of the loss of all the good experience that she wished she had had, good experience that had in part been denied her by others, but that she herself had also spoiled. Looking back now on these sessions of Mrs B’s, I think there was something that had been particularly provoking to her in the sessions before the ones I have reported. In these earlier sessions she had felt very troubled and felt I had understood this not only in the sense of interpreting her pain in a way that made sense to her but also in the sense of registering her pain empathically. But my patient is very threatened by this sort of empathic understanding, which I think is too close to the love she longs for but must not let herself know she wants. She deals with such emotions by denigration: empathy is a sign of weakness, even lack of insight. To her, goodness is weak, inferior, unsafe, even persecuting. Strength is cruel, superior, safe. Something that is good cannot be strong and vice versa. Kernberg (1984: 299) describes the same sort of belief but in much more pathological types of character than Mrs B. Mrs B has a sense of grievance against her parents for being weak, and in the session she had a sense of grievance against me for being a ‘weak granny’ who might easily be overwhelmed and she, Mrs B, would be blamed. Perhaps my capacity to see that she felt I was a weak granny provoked an even greater sense of grievance. Certainly she did not see my capacity to see this as a strength that could help her. Only my (irrelevant) PhD was impressive and desirable. Envy in both Mrs A and Mrs B can be described as relatively mild compared, say, to some of the cases described by Segal (1964 and personal communication), Steiner (personal communication), Kernberg (1984, 1989) and Schoeck (1969). Of the two patients I have described, I found Mrs B’s envy somewhat more severe and diffi cult to work with than Mrs A’s. Both patients were provoked by ‘good’ sessions which made them feel dependent, but Mrs B was more humiliated than Mrs A. Both picked on something to idealise and identify with, but Mrs A’s identifi cation (with the old friend in the kaftan) was transitory, Mrs B’s (taking over my PhD) was more insistent. Mrs A’s denigration of me was slight, Mrs B’s was more intense. But in this respect there was a difference of kind as well as degree. To Mrs A, I remained a basically good fi gure whom she discovered, to her chagrin, that she was attacking for what she thought were base reasons; Mrs B felt that when I was attacked by her ‘constitutional defect’, I was damaged and became a bad persecuting fi gure, and she would be blamed for something she really should not have had to be responsible for. The splitting between the good me and the bad me was more profound in Mrs B than in Mrs A. But the main difference was that, whereas Mrs A’s defences worked tentatively and singly, Mrs B’s worked together to make a strong system that maintained her view of herself as someone with a legitimate grievance and justifi able envy. Downloaded by [New York University] at 03:54 14 August 2016 Because it is comparatively mild as well as consciousness-dystonic, the ‘ordinary’ envy of my fi rst patient, Mrs A, is easier for both her and me to deal with than the sort of grievance and impenitent envy with which Mrs B makes herself so miserable. I fi nd that the doctrines of the Catholic Church recognise something like this difference – hardly surprising as the Church has had nearly 2000 years of trying to understand the nature of goodness and sin. Envy, corresponding roughly to the sort of envy of my fi rst patient, is one of the seven deadly sins: envy, pride, avarice, lust, anger, gluttony, sloth. But there is another type of envy, called ‘envy of another’s spiritual good’, which is much more serious and is one of ‘the six sins against the Holy Ghost’: envy of another’s spiritual good, presumption, despair, resisting the known truth, obstinacy in sin, fi nal impenitence. These six more serious sins ‘do not arise from mere frailty or ignorance, but are generally accompanied with so Varieties of envious experience 57 much malice and such wilful obstinacy to the Spirit of God and the known truth that they who are guilty of them are seldom converted’ (Hart 1916: 370–71). It is of some interest that both patients described their childhoods in similar terms. Both felt they had over-busy and chronically preoccupied parents who were basically unhappy, and both patients thought they had missed out on the love and attention they wished they had had. If anything, Mrs A felt even more left out than Mrs B because she felt that her mother greatly preferred some of the other children to her. But Mrs A had a profound feeling of concern and responsibility about both parents, particularly her mother; she worried about her and wished more than anything that analysis would show that her mother had really loved her after all. Mrs B respected those members of her family whom she felt were strong and successful and felt ashamed of those whom she thought were weak. As I have described above, she closely associated weakness with goodness and ineffectu- alness, and all three were unsafe and contemptible. I believe that she despised weakness in others because she believed unconsciously that she herself was weak, inferior and unlovable. Perhaps her greatest diffi culty was in mourning not only the loss of the ideal parents she would like to have had but also the loss of the ideal self that she would like to have been. I do not of course know what the parents of Mrs A and Mrs B were actually like, and the very different outcome in my two patients’ expectations of life makes one aware of the enormous complexity of the interplay of psychic and material reality, and aware, too, of how cautious one needs to be in assuming that in analysis one can discover historical as distinct from remembered truth. I do not think it would be right to assume that Mrs B’s parents were ‘worse’ than Mrs A’s; I simply do not know. Nor would it be correct even to say that Mrs B thought they were worse. What is clear is that in analysis, Mrs A was better able than Mrs B to mourn the loss of the good parents (and the good analyst) that she would like to have had. One could describe the way Mrs A expressed envy in the session I report as envy in the depressive position, whereas the way Mrs B expressed envy, at least on this occasion, could be characterised as envy largely in the paranoid-schizoid mode, a defensive retreat to persecutory anxiety and schizoid defences. I do not mean that Mrs A’s sort of envy is the only type that is found in the depressive position: it can often be more severe, as shown in the cases described by Klein and others, and it may be different at different periods in an analysis. Nor do I think it would be right to assert that impenitent envy is the only form of envy that one encounters in patients who are enmeshed in the pathology of the paranoid-schizoid position. Rather than characterise the comparison between ordinary and impenitent envy solely in terms of the paranoid-schizoid and depressive positions, however, I want to describe in greater detail a model that I have gradually constructed of the factors Downloaded by [New York University] at 03:54 14 August 2016 which I think mitigate envy or exacerbate it. My model centres on the perceived relation between giver and receiver, partly because it is this relation that one sees especially clearly in analysis, as in infancy, but also because it is the relation in which envy is particularly likely to be aroused. One crucial factor seems to me to be the conscious and unconscious feelings of the giver about giving, and the way these feelings are perceived or misperceived, consciously and unconsciously, by the receiver. Already it must be apparent that my model is potentially highly complex. Presumably there is some ‘factual’ reality about the nature of the giving and receiving, but this reality is enormously complicated by the conscious and unconscious feelings and perceptions of both giver and receiver, and it is these psychic realities that are especially important in the experience of envy. 58 Varieties of envious experience Let us suppose that the giver takes pleasure in giving, and, further, that he is not, for example, giving in order to establish superiority over the receiver. Let us suppose too that the receiver is able to perceive this accurately and to realise also that the giver knows that he, the receiver, might resent being given to, like the father described above observing his baby’s approach to the breast. In this type of giving and this type of perception by the receiver, it is likely to be easier for the receiver to acknowledge envy and to feel positive feelings as well; in particular, the receiver may feel able to give something back to the giver in the form of feeling pleasure as well as some resentment about being given to. If the giver can recognise and accept this return gift, this gratitude, a benign circle may be set up in which both parties give something of value to each other. The receiver’s capacity to be given to is a return gift to the original giver. Goodness in the other becomes bearable, even enjoyable. The receiver introjects and identifi es with an object who enjoys giving and receiving, and an internal basis for admiration can develop, and hence emulation of the generous giver becomes possible. Let us suppose, by contrast, that the giver takes little pleasure in giving or is actually hostile or inconsistent towards the receiver, or that he feels consciously or unconsciously that the receiver is making unreasonable demands or draining his resources unfairly; or suppose that the giver gives eagerly and with pleasure but only in order to demonstrate his superiority over the receiver. Or, further, let us suppose that he gives reluctantly and unwillingly because he is trying to conceal the fact that he feels what he gives is bad. And, still further, let us suppose that the giver’s lack of genuine pleasure and generosity is accurately perceived by the receiver. In any of these examples, envy is likely to be exacerbated. Pleasure in receiving cannot easily develop, and the receiver will not readily feel grateful. The receiver is likely to feel resentful and to give as little as possible back to the original giver. The original giver, deprived of gratitude, gives less, or more aggressively, and the deprivation/envy circle continues. So, somewhat paradoxically, envy is likely to be greatest when the giving object is felt to give little or badly. The receiver takes in and identifi es with a giver-object who does not enjoy giving and receiving, and the vicious circle is perpetuated internally. Genuine emulation becomes very diffi cult, and is likely to involve splitting, projection and a takeover of the giver’s power, like Mrs B’s identifi cation with my PhD. The contrast I have drawn so far is of course much too simple. It takes some account of the giver’s motives and mode of giving, but it assumes that the receiver perceives and interprets these modes correctly. In reality, however, the receiver may make many types and degrees of misperception and misinterpretation. The giver may give with pleasure and in good faith, for example, but the receiver may misinterpret the gift as an attempt by the giver to establish superiority. A giver Downloaded by [New York University] at 03:54 14 August 2016 may have a reasonable expectation of gratitude for a gift generously given, but the receiver may be so resentful that the giver has the capacity to give whereas he, the receiver, cannot supply the good thing for himself that he reacts with hatred, contempt, conventional politeness or simply ignores that the gift has been given – all of these being forms of spoiling. Or – another example – the giver may give diffi - dently because of a conviction, conscious or unconscious, that what he has to give is really bad, and the receiver may misperceive this as stinginess, superiority or indifference. The immediately preceding examples of misperception have concerned cases where the giver’s emotions are basically good but the receiver misinterprets them. But there are also cases of ‘bad’ giving which the receiver misconstrues as good. It took some years of analysis, for example, before Mrs A could realise that I had made a bad interpretation or that I should have made a particular interpretation Varieties of envious experience 59 but had failed to do so; it took still longer before she could tell me immediately that I was wrong instead of waiting until the next session. I have not tried to exhaust the possible variations, and it is obvious that there can be very complex interactions of giving, receiving, further response by the original giver, and yet further response by the receiver. One has only to think of an hour or two in the life of a mother and baby or a session or two in the course of an analysis to realise how complex these interchanges can be. Several colleagues with whom I have discussed this paper have assumed I was saying that the model of giving and receiving I have described could be used to describe the role of the ‘environment’ in shaping the development of envy in childhood. This is true only in the most general sense, in that whatever potential for envy an infant may have had, the giving/receiving exchanges with caregivers will have had an effect on it. But from the perspective of the consulting room I do not think any patient and analyst can determine what really happened in the infancy of a particular patient, nor even, in many cases, what the patient thinks happened, for the crucial interchanges cannot be remembered. Even the interchanges of later childhood will have been affected by earlier and largely unconscious templates of giving and receiving and by the retrospective projection of the state of giving and receiving in the adult patient’s inner world in the present. Thus I think one must be very cautious in attempting to make causal explanations of envy in terms of the effects of past experience. I think, for example, that I have a fairly clear picture of the role of ‘ordinary’ ego-dystonic envy in Mrs A’s current life and the role of grievance in Mrs B’s life, but if I were asked to explain the ultimate cause of the differences between them I do not think I could answer. I have devised and used my model of giving and receiving to describe how envy works in the inner world of these two patients in the present and in their analyses. The model might be useful in developmental observations of children, and I fi nd it useful to keep it in mind when refl ecting on my patients’ early experiences, but the imaginary and tentative nature of these refl ections must always be kept in mind.

References ABRAHAM, K. (1919) ‘A particular form of neurotic resistance against the psycho-analytic method’, in Selected Papers on Psycho-Analysis, trans. D. Bryan and A. Strachey (1942), London: Hogarth Press. BERKE, J.H. (1986) The Tyranny of Malice, London: Summit Books. BION, W.R. (1962) Learning from Experience, London: Heinemann. BRENMAN, E. (1990) Unpublished paper on Envy, given at a Tavistock Lecture Series on The Seven Deadly Sins.

Downloaded by [New York University] at 03:54 14 August 2016 THE BRITISH PSYCHO-ANALYTICAL SOCIETY (1969) Unpublished Symposium on Envy and Jealousy. BRITTON, R. (1998) Belief and Imagination, London: Routledge. CARPY, D. ‘Fantasy vs. reality in childhood trauma: Who’s to blame?’ Unpublished paper. EISLER, M.J. (1922) ‘Pleasure in sleep and the disturbed capacity to sleep’, International Journal of Psychoanalysis, 3: 30–42. ETCHEGOYEN, O.R.H., LOPEZ, B.M. and RABIH, M.M. (1987) ‘On envy and how to interpret it’, International Journal of Psychoanalysis, 68: 49–61. FELDMAN, E. and DE PAOLA, H. (1994) ‘An investigation into the psychoanalytic concept of envy’, International Journal of Psychoanalysis, 75: 217–234. FELDMAN, M. (n.d.) Unpublished paper on grievance. FREUD, S. (1921) Group Psychology and the Analysis of the Ego, Standard Edition, 21: 67–143. GUNTRIP, H. (1961) Personality Structure and Human Interaction, London: Hogarth Press. HART, C. (1916) The Student’s Catholic Doctrine, London: Burns Oates and Washbourne Ltd. 60 Varieties of envious experience

HOPPER, E. (1992) Unpublished contribution to a discussion of an earlier version of the present paper given at the British Psycho-Analytical Society, 18 November. JAQUES, E. (1969) ‘Contribution to a discussion of envy’, Unpublished paper contributed to the Symposium of the British Psycho-Analytical Society on Envy and Jealousy. JOFFE, W.G. (1969) ‘A critical survey of the status of the envy concept’, International Journal of Psychoanalysis, 50: 533–545. JOSEPH, B. (1982) ‘Addiction to near-death’, International Journal of Psychoanalysis, 63: 449–456; reprinted in E.B. Spillius (ed.) Melanie Klein Today, vol. 1, Mainly Theory (1988), London: Routledge, pp. 311–323; and in M. Feldman and E.B. Spillius (eds), Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph (1989), London: Routledge, pp. 127–138. —— (1986) ‘Envy in everyday life’, Psychoanalytic Psychotherapy, 2: 13–22; reprinted in M. Feldman and E.B. Spillius (eds), Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph (1989), London: Routledge, pp. 181–191. KERNBERG, O. (1984) Severe Personality Disorders, New Haven: Yale University Press. —— (1989) ‘The narcissistic personality disorder and the differential diagnosis of antisocial behavior’, Psychiatric Clinics of North America, 12: 553–570. KLEIN, M. (1929) ‘Personifi cation in the play of children’, in The Writings of Melanie Klein, vol. 1, Love, Guilt and Reparation and Other Works 1921–1945 (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 199–209. —— (1932) ‘An obsessional neurosis in a six-year-old girl’, Chapter 3 of The Psycho- Analysis of Children, vol. 2 of Writings (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 35–57. —— (1935) ‘A contribution to the psychogenesis of manic-depressive states’, International Journal of Psychoanalysis, 16: 145–174; reprinted in Writings, vol. 1, Love, Guilt and Reparation and Other Works 1921–1945 (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 262–289. —— (1940) ‘Mourning and its relation to manic-depressive states’, International Journal of Psychoanalysis, 21: 125–153; reprinted in Writings, vol. 1, Love, Guilt and Reparation and Other Works 1921–1945 (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 344–369. —— (1945) ‘The Oedipus complex in the light of early anxieties’, International Journal of Psychoanalysis, 26: 11–33; reprinted in Writings, vol. 1, Love, Guilt and Reparation and Other Works 1921–1945 (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 370–419. —— (1946) ‘Notes on some schizoid mechanisms’, International Journal of Psychoanalysis, 27: 99–110; reprinted with some revisions in M. Klein, P. Heimann, S. Isaacs and J. Riviere (eds), Developments in Psychoanalysis (1952), London: Hogarth Press, pp. 292–310; the 1952 version is reprinted in Writings, vol. 3, Envy and Gratitude and Other Works (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 1–24. —— (1952) ‘Some theoretical conclusions regarding the emotional life of the infant’, in M. Klein, P. Heimann, S. Isaacs and J. Riviere (1952) Developments in Psychoanalysis, London: Downloaded by [New York University] at 03:54 14 August 2016 Hogarth Press, pp. 198–236; reprinted in Writings, vol. 3, Envy and Gratitude and Other Works (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 61–93. —— (1955) ‘Envy’, in J. Mitchell, (ed.) The Selected Melanie Klein (1986), London: Penguin, pp. 211–229. —— (1957) Envy and Gratitude, in Writings, vol. 3, Envy and Gratitude and Other Works (1975), London: Hogarth Press and the Institute of Psychoanalysis, pp. 176–235. —— (1960) The Narrative of a Child Analysis, Writings, vol. 4 (1980), London: Hogarth Press and the Institute of Psychoanalysis. KOHON, G. (2000) ‘Dreams, acting out and symbolic impoverishment’, in No Lost Certainties to be Recovered, London: Karnac Books, pp. 73–86. LUSSANA, P. (1992) ‘Envy’, Rivista di Psicoanalisi, 38: 122–153. O’SHAUGHNESSY, E. (1981) ‘A clinical study of a defensive organization’, International Journal of Psychoanalysis, 62: 359–369. Varieties of envious experience 61

RIVIERE, J. (1932) ‘Jealousy as a mechanism of defence’, International Journal of Psychoanalysis, 13: 414–424; reprinted in J. Riviere, The Inner World and Joan Riviere (1991), A. Hughes (ed.), London: Karnac Books. —— (1956) Unpublished letter to Melanie Klein in the Melanie Klein Archive, C18, Wellcome Institute for the History and Understanding of Medicine. ROSENFELD, H. (1947) ‘Analysis of a schizophrenic state with depersonalization’, International Journal of Psychoanalysis, 28: 130–139; reprinted in H. Rosenfeld, Psychotic States: A Psycho-Analytical Approach (1965), London: Hogarth Press and the Institute of Psychoanalysis, pp. 13–33. —— (1950) ‘Notes on the psychopathology of confusional states in chronic schizophrenias’, International Journal of Psychoanalysis, 31: 132–137; reprinted in H. Rosenfeld, Psychotic States: A Psycho-Analytical Approach (1965), London: Hogarth Press and the Institute of Psychoanalysis, pp. 52–62. —— (1964) ‘On the psychopathology of narcissism: A clinical approach’, International Journal of Psychoanalysis, 45: 332–337; reprinted in H. Rosenfeld, Psychotic States: A Psycho-Analytical Approach (1965), London: Hogarth Press and the Institute of Psychoanalysis, pp. 169–179. —— (1969) Unpublished contribution to the discussion at the Symposium of the British Psycho-Analytic Society on Envy and Jealousy. —— (1971) ‘A clinical approach to the psychoanalytical theory of the life and death instincts: An investigation into the aggressive aspects of narcissism’, International Journal of Psychoanalysis, 52: 169–178; reprinted in E.B. Spillius (ed.) Melanie Klein Today, vol. 1, Mainly Theory (1988), London: Routledge, pp. 239–255. —— (1975) ‘The negative therapeutic reaction’, in P. L. Giovacchini (ed.) Tactics and Techniques in Psychoanalytic Therapy, vol. 2, pp. 219–228. SCHOECK, H. (1969) Envy: A Theory of Social Behaviour, trans. M. Glenny and B. Ross, London: Secker and Warburg. SEGAL, H. (1964, 2nd edition 1973) Introduction to the Work of Melanie Klein, London: Heinemann. —— (1969) Unpublished contribution to the discussion of the Symposium of the British Psycho-Analytical Society on Envy and Jealousy. SOHN, L. (1985) ‘Narcissistic organization, projective identifi cation, and the formation of the identifi cate’, International Journal of Psychoanalysis, 66: 201–213; reprinted in E.B. Spillius (ed.), Melanie Klein Today, vol. 1, Mainly Theory (1988), London: Routledge, pp. 271–292. STEINER, J. (1985) ‘The interplay between pathological organizations and the paranoid- schizoid and depressive positions’, International Journal of Psychoanalysis, 66: 201–213; reprinted in E.B. Spillius (ed.) Melanie Klein Today, vol. 1, Mainly Theory (1988),

Downloaded by [New York University] at 03:54 14 August 2016 London: Routledge, pp. 324–342. —— (1992) Unpublished opening of the discussion of an earlier version of the present paper given at the British Psycho-Analytical Society, 18 November. —— (1993) Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Borderline Patients, London: Routledge. STERN, D. (1985) The Interpersonal World of the Infant, New York: Basic Books. ZETZEL, E. (1958) ‘Review of Klein’s Envy and Gratitude’, Psychoanalytic Quarterly, 27: 409–412. CHAPTER 5

KLEINIAN THOUGHT Overview and personal view

This paper was originally published in Psychoanalytic Inquiry, 1994, vol. 14, no. 3, Contemporary Kleinian Psychoanalysis, pp. 324–364.

I. Developments in Klein’s thinking Of crucial importance in Klein’s work is that it began in the study and treatment of children. Klein was not the fi rst analyst to treat children, having been preceded by Freud and the father of Little Hans and by Hug-Hellmuth; Anna Freud had started analytic work with older children at about the same time as Klein though along rather different lines. But Klein invented an analytic way of using the technique of play, which gave even very young children under three years of age a suitable medium for expressing their thoughts and feelings, a medium which could easily be combined with their developing capacity to express themselves in language. The invention of this new technique uncovered new data and slowly gave Klein an unshakeable conviction in the reality of the clinical facts she was discovering. I fi nd the clinical material of her early papers about children absolutely compelling. These papers were among the fi rst things I read in psychoanalysis, and certainly the fi rst that seemed real. Rita, Trude, Peter, Ruth, Fritz, Felix all became persons in a new but somehow familiar world. Later I found it puzzling that many of my analytic colleagues found Klein very hard to read and her theory sometimes even preposterous. Her style is not particularly felicitous and I had diffi culties with the more ‘theoretical’ papers, but each of the early clinical papers seemed to me like a good anthropological monograph – social anthropology being my profession at this time. There were vivid data, just enough theory to make sense of the data, sudden jumps of imagination and theoretical understanding that led on to the next paper. I did not fi nd her clinical descriptions or her theory hard to understand; unconscious phantasy, internal objects, early sadistic superego, psychotic anxiety, a world of utterly good and utterly bad Downloaded by [New York University] at 03:54 14 August 2016 objects, attacking one’s mother’s insides, desperate wishes to repair the damage – it all seemed familiar, deeply consonant with a vague unformulated sense of things I might have felt as a child. Perhaps I found her work convincing because I knew very little about psychoanalysis and had no prior attachment to other theories. Indeed, it was reading Klein that stimulated me to read Freud – long overdue – and I found the same sense of discovery of something half-known already. Then came Bion, and gradually many other psychoanalysts, but none had the impact of these fi rst three. All her life, in spite of the controversies and furore raging around her, Klein thought of her work as following in the footsteps of Freud, as an extension of his work. And indeed, in my view too, there is a consistent allegiance throughout Kleinian thought 63 Klein’s work to what she regarded as the essential spirit of Freud’s approach and technique. But she was an innovator. She regarded the play of a child as the counterpart to the free association of adults. In this play Klein was fully prepared to enact many (though not all) of the roles suggested to her by the child in order to arrive at an understanding of the child’s motives and feelings. She was critical in 1927 of Anna Freud for introducing educational elements into child analysis and for emphasising the positive transference and not interpreting the negative transference (Klein 1927a). The descriptions of Klein’s technique with adults years later in 1943 (King and Steiner 1991: 635–638) and in 1952 (Klein 1952a, ‘The origins of transference’) are basically very similar to her technique as she described it in 1927, and she clearly thought that both were closely based on Freud. (Anna Freud, however, thought otherwise. See King and Steiner 1991: 629–634.) Klein was an innovator in ideas as well as in the technique of child analysis. I fi nd it convenient to divide her work into two phases. Up until 1935 she was basically working within the theoretical framework of Freud and Abraham, though she made many changes in it, some of them inadvertent. After 1935, with the two papers on the depressive position (1935, 1940), the paper on the paranoid-schizoid position (1946), and Envy and Gratitude (1957), she developed a new theory of her own. (For a general introduction to the work of Klein, see Segal 1974. See also Hinshelwood 1989, Meltzer 1978, Caper 1988. Petot in 1990 and 1991 gives a detailed textual analysis of the development of Klein’s thought. Greenberg and Mitchell (1983) discuss her position as an object-relations/drive-structure theorist. Kernberg (1969) and Yorke (1971) present critical reviews.)

A. The ﬁ rst period of Klein’s work, 1920–1935 The work of this period is innovative, complex and piecemeal. Klein was discovering new data and working out new conceptualisations of it so quickly that her formulations were bound to be inconsistent, especially as she was holding fast at the same time to the libidinal phases theory of Freud and Abraham (Freud 1905; Abraham 1924). I have found it convenient to summarise her work during this period under a number of conceptual headings, which, in keeping with her explosion of fi ndings and ideas at this time are somewhat unconnected with one another. Further, some are descriptions of her fi ndings and ideas, whereas others are my own inferences about her approach. Some of the ideas of this early period were retained throughout all her work, others were dropped or reformulated. (For a chronological account of this early period, see especially the Editor’s notes in The Writings of Melanie Klein (1975), and Petot (1990 and 1991).) Downloaded by [New York University] at 03:54 14 August 2016 1. Freud’s drives and Klein’s drives During this early period Klein seems not to have seen any difference between her conception of drives and Freud’s. But imperceptibly she was making an important conceptual shift. Where Freud thinks of drives as biological forces which become almost fortuitously attached to objects through post-natal experiences, for Klein drives are inherently attached to objects. During this period she had not yet wholly rejected the idea of primary narcissism (which she did later (1952a), but she was moving in that direction. Even in the early years hers is an object relations theory. Further, she conceives of the individual’s own body not as the source of biological drives but as the medium by which the psychological drives of love and hate – mostly hate was explored in these early years 64 Kleinian thought – are expressed (Greenberg and Mitchell 1983). Hence Klein’s approach is simultaneously a drive theory and an object relations theory, though her ‘drives’ are becoming increasingly psychological rather than biological, and the role of anxiety in affecting their expression becomes increasingly important as her work develops.

2. Phantasy Klein hardly mentions phantasy conceptually and gives little sign of realising that she was using the concept differently from Freud. Freud uses the term in several ways, but in his central usage phantasy is resorted to when an instinct is frustrated (1911). For Klein, unconscious phantasy accompanies gratifi cation as well as frustration, but, further, it is the basic stuff of all mental processes; it is the mental representation of instincts. This view was not formally stated conceptually, however, until Susan Isaacs’ paper ‘The nature and function of phantasy’, fi rst given in 1943 during the Controversial Discussions (King and Steiner 1991) and later published (1952). It is Klein’s view that phantasising is an innate capacity, and that the content of phantasies, although infl uenced by experiences with external objects, is not entirely dependent on them. She thinks that hate is innate; later she would stress that love too is innate. Throughout this early period it is implicit that Klein believes that the infant also has innate unconscious knowledge, however hazy, of objects – breast, mother, penis, womb, intercourse, birth, babies – although she does not state this unequivo- cally until much later (but see 1927b: 175–176).

3. Internal objects and the inner world Klein vastly develops the concept of the ‘inner’ world of internal objects, once again, in this early period, without much conceptual emphasis. In her early clinical work with children she was powerfully struck by the fact that the internal images of parents were (very) much more ferocious than the actual parents appeared to have been. Gradually she developed a conception of internal objects and the inner world as built up through the mechanisms of introjection and projection which she believes operate from the beginning of life. Thus the inner world is not a replica of the external world; experiences of the external world help to shape the inner world, and the inner world affects the individual’s perception of the external world. Unlike Freud, Klein does not restrict the idea of ‘internal object’ or superego to the single internalisation of parental fi gures after the passing of the Oedipus complex. (See Hinshelwood 1989 and Greenberg and Mitchell 1983 for detailed descriptions of Downloaded by [New York University] at 03:54 14 August 2016 internal objects.)

4. The early superego and the Oedipus complex Klein thinks that the children she treated showed clear signs of an early and very sadistic superego (as well as a more developed conscience) which did not correspond to their real parents and which Klein thinks is based on their own sadistic phantasies. (Freud acknowledged this statement of Klein’s in Civilization and its Discontents, 1930: 130.) Klein dates the Oedipus complex progressively earlier and earlier, fi nally linking it to weaning. At times, like Freud, she links the development of the superego to the Oedipus complex; at others she says that the fi rst introjected object can assume superego functions. Kleinian thought 65 5. Sadism and psychotic anxiety In her very fi rst papers Klein emphasised libidinal drives and their expression in unconscious phantasy in every activity (see especially Petot’s discussion, 1990). Klein here means ‘libidinal’ not in the general sense of ‘loving’ or ‘life-giving’, but in the sense of sexuality, involving a somewhat ruthless pursuit in phantasy of sexual aims. Soon afterwards she began, with characteristic enthusiasm, to explore a new terrain, that of aggression and destructiveness, which at this period she almost always called ‘sadism’. Until Freud’s Beyond the Pleasure Principle (1920) and even later, aggression was generally neglected in psychoanalysis as a phenomenon in its own right; it was usually spoken of as a component of the libidinal instinct. In this early period and indeed throughout her work Klein thinks that the mother’s breast, her body and parental intercourse are the main targets for the projection in phantasy of destructive impulses. This means that the breast, the mother and parental intercourse come to be felt as cruel persecutors, and they are then aggressively attacked. During this early period Klein developed the concept of the ‘combined object’ – the phantasy of a hostile mother containing a hostile penis. Sadistic phantasies arouse intense anxiety, which Klein feels can be the basis of childhood psychosis and of adult mental illness. She develops, in this connection, a new conception of obsessional neurosis as a defence against early psychotic anxiety instead of regarding it as a regression to a fi xation point in the anal phase of libidinal development (see especially Klein 1932: 149–175). Klein’s concentration on sadism must certainly have been affected by the change in Freud’s theory of instincts outlined in Beyond the Pleasure Principle (1920) and by Abraham’s work on oral and anal sadism (1924), but I think the main reason for her stress on it came from her clinical work with children, for she found that the children she analysed had extremely ruthless sadistic phantasies about which they characteristically felt very guilty. She then extends her ideas backwards to construct a theory of sadism in infancy, and she thinks of sadism as an important root of the epistemophilic instinct. Towards the end of this phase of her work she begins to distinguish descriptively between anxiety and guilt. But she makes little use of the idea of love during this early period. And in spite of her emphasis on sadism, it is not until 1932 in The Psycho-Analysis of Children that she begins to use Freud’s idea of the death instinct, and to mention the confl ict between life instinct and death instinct. Even so, she does not really use the idea of the confl ict conceptually until the later phase of her work.

6. The epistemophilic instinct and symbolism Downloaded by [New York University] at 03:54 14 August 2016 In her very earliest papers Klein talks about the epistemophilic instinct as rooted in libido and expressed in all the child’s activities. Gradually she comes to think of sadism as a crucial element in the urge to know. She thinks the infant feels the mother’s body to be the source of all good (and bad) things, including the father’s penis, and in phantasy the child attacks the mother’s body both out of frustration and in order to get possession of her riches. Such phantasied sadistic attacks arouse anxiety, which can be a spur to development. Combined with phantasies of projecting sadism into the mother, anxiety about attacks on her body means that her body is felt to become dangerous. The child is then constantly impelled to fi nd new and less dangerous objects, to make new equations, a process which forms the basis of symbolism and the development of interest in new objects. Klein makes it clear too that such equations are what gives life to children’s play, and that the 66 Kleinian thought same processes are the basis of transference. If anxiety about attacking the mother’s body becomes excessive, it leads to inhibition, neurosis, and in very severe cases to psychosis, as in the case of ‘Dic’’ discussed in ‘The importance of symbol-formation in the development of the ego’ (1930).

7. The development of the boy and the girl Here Klein puts forward new ideas of development, emphasising the importance of the phantasied sadistic attacks on the mother’s body described above, with their accompanying fear of retaliation and the formation of a severe superego. She thinks that both boys and girls go through a ‘feminine phase’ in which, out of frustration by the mother and fear of her retaliation for their attacks on her, they turn away from the mother to seek satisfaction from the father and his penis; the phantasied relation with the mother during this phase is one of identifi cation in which the child ‘becomes’ the mother in order to take her place with the father (1928), a fore- runner of at least one form of Klein’s later idea of projective identifi cation (1946). In girls this phase is the basis of future femininity, in boys it is normally overcome as Oedipal desires increase. Klein thinks the girl has a lasting fear of damage to the inside of her body because of the sadistic attacks she has made on her mother, and that this is for girls the counterpart of castration anxiety in boys. In The Psycho- Analysis of Children (1932) Klein further discusses the complexities of the development of the boy and the girl, stressing, like some other female analysts of the period, the girl’s awareness of her vagina. In the later phase of her work Klein revised some of her early views on sexual development (1945). Klein’s views on sexual development have interested certain analysts and some feminists, but so far none of her British colleagues has focussed on her work in this area.

8. Phases In her theoretical formulations of this period Klein stuck to the idea of the phases of the libido outlined by Freud (1905) and to the further divisions within them propounded by Abraham (1924), but it is beginning to be apparent that she thinks that anal and phallic phantasies may occur alongside oral ones. One gets the impression that in her clinical observations she largely disregarded the phases, which creates a certain discordance between her theory and her clinical reports.

9. The effect of external parents In spite of developing an object-relational theory rather than a solely biological- Downloaded by [New York University] at 03:54 14 August 2016 drive theory, Klein does not stress conceptually the actual external parents’ personalities and behaviour as part of her theoretical system. She frequently mentions the importance of parents, and her clinical work shows that she related children’s behaviour and phantasies to the behaviour and character of the actual parents (see especially Part 1 of The Psycho-Analysis of Children 1932 and later The Narrative of a Child Analysis 1960b), but in her theory, especially in the early period, she tends to stress the role of parents as correctives and mitigating factors modifying the anxieties arising from the child’s inherently sadistic phantasies. In the later period of her work she explicitly states the importance of the environment (1935: 285; 1952c: 94, 98; 1955: 141n3; 1957: 175, 185n2, 229–230; 1959: 248–249; 1963: 312). But it is clear even in the later period that Klein thinks that, even though the character and behaviour of parents is extremely important in shaping Kleinian thought 67 the child’s development, the child’s constitution is also an extremely important factor and the child himself is a very active agent. This view of Klein’s has frequently been mistaken as meaning that she thinks the parents (the ‘environment’) are unimportant, and she has been much criticised for it.

10. Klein’s approach to Freud’s theories Klein appears not to have been explicitly interested in the more abstract aspects of Freud’s theories, especially his early theories. The idea of the System Unconscious with its own special logic of the primary process does not seem to have caught her imagination; she left it to her colleagues to point out that many of the qualities of the System Unconscious are worked into her concept of unconscious phantasy. She does not distinguish between ideas and feelings that are descriptively unconscious from those that are dynamically unconscious. Perhaps because her early work was not rooted in the topographical model, she does not make a point of the fact that Freud’s development of the structural approach in place of the earlier topographical model meant a major change in his basic model of the mind. Her theoretical ideas begin from the structural model of Freud’s The Ego and the Id (1923), though she uses his terms somewhat differently and her use of the structural model differed from his because she incorporated her ideas about object relations as an integral part of it. The superego, as described above, is for her earlier and more complex than for Freud. Her idea of the ‘id’ is not so rooted in biology as Freud’s. In the case of the ego, Klein never really distinguishes between the ego and the self, and throughout her work she uses the terms interchangeably, though of course Freud often did this too. Klein does not seem to have realised how important in Freud’s thinking was the change from conceiving of anxiety as dammed-up libido to thinking of anxiety as a signal. Even in the early period of her work she was beginning to think of anxiety as a response to destructive forces within the personality.

B. Klein’s new theory: the paranoid-schizoid and depressive positions, 1935–1960 The work Klein had done up until 1932, piecemeal and incomplete, was followed by a great leap of imagination which brought her previous work into a new and more integrated synthesis. This was not occasioned by a new method such as the play technique as her earlier work had been; it involved the forming of new thoughts about already known clinical facts and partly worked-out concepts. It is a remarkable achievement of theoretical formulation, perhaps surprising and even mysterious in that Klein was never preoccupied with theory-building as an end in itself. Downloaded by [New York University] at 03:54 14 August 2016 The new theory consists of the delineation of two sets of anxieties, defences and object relations which Klein calls the ‘paranoid-schizoid position’ and the ‘depressive position’. It has not been easy for other analysts to understand, and many, especially in the United States, have not considered it important or plausible enough to be worth the effort. In Britain, much of Europe, and South America, however, the theory has had considerable infl uence, and it is the theory of this later period that has been the basis for most of the developments worked out by Klein’s contemporary and later colleagues. The theory is expounded in four main papers: ‘A contribution to the psychogenesis of manic-depressive states’ (1935); ‘Mourning and its relation to manic- depressive states’ (1940); ‘Notes on some schizoid mechanisms’ (1946); and Envy and Gratitude (1957). A concise statement of the theory is given in ‘Some 68 Kleinian thought theoretical conclusions regarding the emotional life of the infant’ (1952b), though of course without including the concept of envy. The new theory makes two main changes in the conceptions I have described above as typical of the fi rst period of Klein’s thought. I believe that these changes are both necessary for the formation of the new theory but also, somewhat paradoxically, are a consequence of it. First, she reformulates her earlier descriptions of sadism and aggression in terms of an interaction of life and death instincts as expressed in love and hate. In her view of the death instinct Klein follows Freud quite closely, especially when she is making formal theoretical defi nitions of it; in clinical contexts she often speaks of ‘destructive instincts’ or ‘aggressive instincts’ and sometimes ‘self-destructive instincts’ without explaining each time the way in which such instincts are derived from the death instinct. In keeping with her view that instincts are inherently attached to objects, Klein’s formulation of the death instinct is more clinically directed and less biological and philosophical than Freud’s. Where Freud thinks that the unconscious contains no idea of death or annihilation (1923: 57; 1926: 129), Klein thinks that ‘there is in the unconscious a fear of annihilation of life’ (1948: 29). For Klein, this fear of annihilation is the primary anxiety, more basic than birth anxiety, separation anxiety, castration anxiety. Where Freud attributes the defl ection of the death instinct to ‘the organism’, Klein attributes it to the ego (1948: 28–30; 1957: 190–191; 1958: 237). Klein thinks that part of the death instinct is projected into the primal object, the breast, which thereby becomes a persecutor, while part is retained within the personality; some of this remaining internal death instinct is turned against the persecuting object as aggression (1946: 4–5; 1958, p. 238n). Like Freud (1923: 54) she thinks that some of the internal death instinct is bound by libido, but she also thinks that some of it remains unfused and continues to be an active source of anxiety to the individual about being annihilated from within. Accompanying her reformulation of sadism and aggression in terms of their derivation from death instinct, Klein increases her use of the idea of love, libido and of the conception of the good object as the core of normal ego development. Klein had noted the interplay of love and hate in the late 1920s and early 1930s, but at that time she did not make much conceptual use of it. In the later period this interplay becomes central to her new conceptions of the paranoid-schizoid and depressive positions. The second major change after 1935 is that Klein reduces her adherence to Freud’s and Abraham’s conception of instinctual phases in favour of a theory of development based on changing modes of internal (and external) object relations. She continues to think that oral expressions of love and hate come fi rst, but she Downloaded by [New York University] at 03:54 14 August 2016 thinks that they overlap with, rather than are sequentially followed by, anal, urethral, phallic and genital modes of expression. Instead of phase, in her new theory she speaks of ‘position’, that is, an organisation of typical anxieties, defence mechanisms and object relations. She thinks that in infancy the paranoid-schizoid position is the fi rst of the two positions to be attained, and is then followed by the depressive position, but she uses the word ‘position’ rather than ‘phase’ to emphasise that throughout childhood and indeed also in later life there is fl uctuation between the two positions (1952b). Positions, as she conceives of them, are thus not phases which one passes through and leaves behind. This changed conception made it possible for some of her colleagues, especially Bion, to loosen the connection with literal developments in infancy still further, to the point where the positions are conceived as ‘states of mind’ regardless of the chronological age Kleinian thought 69 at which they are experienced. This emphasis has helped many analysts to look for moment-to-moment shifts in a session from integration and depressive anxiety towards fragmentation and sometimes persecution rather than looking only for major shifts of character and orientation. The paranoid-schizoid position. At fi rst Klein used the term ‘paranoid position’; later she added the word ‘schizoid’ in recognition of Fairbairn’s work (1941, 1944) on splitting of the ego and its relation to schizoid states. Klein thinks that the normal paranoid-schizoid position occurs in the fi rst three months of infancy and is characterised by persecutory anxiety, that is, fear of annihilation from within and, because the feared malignancy is in phantasy projected outwards, from without as well. She assumes that the infant experiences sensations as ‘caused’ by malevolent or benevolent objects. Thus hunger in her view is likely not to be just an experience of ‘no-food-is-here’ but to be something like ‘that object is starving me to death’, or ‘something terrible is attacking me’. A feeling of comfort would be attributed to the benign motive of a good object. It is clear that Klein thinks infants distinguish between self and object, between me and not-me, from birth, though the distinction is based on perceptions shaped by phantasy and by phantasied attributions of motive, and are thus, presumably, very different from the perceptions that would be made by an adult observer. Of course any phrasing of such early perceptions in words is misleading. Susan Isaacs assumes that these very early events are fi rst experienced as sensations, then gradually draw upon plastic images – visual, auditory, kinaesthetic, touch, smell, taste – before becoming linked up with words (Isaacs 1952). The concern in this very early period is for oneself, not yet for one’s object. Klein assumes that anxiety about being annihilated from within is dealt with by splitting and projection. The infant splits his good from his bad feelings and in phantasy projects both into objects felt to be external, ‘not me’, so that both the ego (self) and object are split. The infant thus lives in a world in which he and some of his objects are extremely bad whereas other objects and other aspects of himself are extremely good. Emotions are labile; good rapidly changes into bad and vice versa, and there is no recognition of the fact that the good and the bad object are the same person. The infant thus lives in a world of ‘part’ objects, in the sense that what would to an outside observer be one object is to the infant at least two (good and bad). Further, Klein assumes that the fi rst object is a part object, the breast, but in Klein’s view this ‘breast’ is not just a purveyor of food, a satisfi er of instinct; it is the source of love, of life itself. She tacitly assumes that in early infancy anatomical part-objects are normally perceived and treated as if they were whole objects and that whole objects may be treated as if they were parts. Full recognition of the identity of objects as wholes and of oneself as a whole in her view comes later, in the depressive position. Downloaded by [New York University] at 03:54 14 August 2016 Klein uses the term ‘projective identifi cation’ to describe a complex set of processes by which part of the self is split off and projected into an object to which the individual reacts as if the object were the self or the part of the self that has been projected into it. The individual who projects in this way will then in phantasy introject the object as coloured by what he has projected into it. It is through such constant interplay that the inner world of self and internal objects is built up. Splitting, projection and introjection are the characteristic mental mechanisms of the paranoid-schizoid position, accompanied by idealisation, denigration and denial. Omnipotence of thought is characteristic of the paranoid-schizoid position. Klein notes that when projection is excessive, objects and the self become fragmented, but in her 1946 paper she does not explain why projection should be excessive in some individuals and much less pronounced in others. 70 Kleinian thought Klein thinks that failure to work through the persecutory anxiety and tendency to split of the paranoid-schizoid position are basic pre-conditions for paranoid and schizophrenic illness. In later papers Klein makes important additions. In Envy and Gratitude (1957) she states that a more than usually marked degree of primary envy, which she regards as a constitutional factor, leads to a pathological paranoid-schizoid position. Because envy attacks the good object, it arouses a premature experience of depressive anxiety about damage to the good object, and interferes with the primal differentiation between good and bad in the object and in the self. Hence it is likely to result in confusion and in very severe cases to confusional states (see also Rosenfeld 1950). Such a breakdown of normal splitting leads to diffi culty in working through the paranoid-schizoid position and in proceeding to a normal experience of the depressive position. In a late paper (1958) Klein suggests that the bad objects of the paranoid- schizoid position are not the most terrifying objects; the most terrifying fi gures are split off into an area of the deep unconscious which remains apart from the normal developmental processes that give rise to the superego. She does not, however, fully work out this idea or integrate it with her other work. The depressive position. Klein believes that at about three to six months the infant’s object relations change from relation to a part-object to relation to a whole object. Although she does not explicitly say so, Klein seems to base this dating on the well-known observation that at some time between three and six months infants begin to look more ‘human’ and to behave in a much more integrated way. Klein supplements this sort of casual observation with more systematic observations by Ribble (1944). Klein made her own observations of infants (1952c) but these are examples based on her theoretical formulations rather than raw data from which her formulations were derived. In Klein’s view of the depressive position the good and the bad mother are seen to be the same person; the infant begins to feel that the good mother he loves has been damaged by the attacks he has made and continues to make on the bad mother, for they are one and the same. This realisation is extremely painful and gives rise to what Klein calls ‘depressive anxiety’ as distinct from the persecutory anxiety of the paranoid-schizoid position. It consists of a mixture of concern for the object, fear of its being damaged beyond repair, guilt and a sense of responsibility for the damage one has done. The individual is afraid of losing his object and has a strong urge to repair the damage. The actual state of the external object is extremely important; if the mother appears to be damaged, the child’s guilt and despair are increased. If she appears well, or at least able to empathise with her child’s problems about her state, the child’s fear of his destructiveness is decreased Downloaded by [New York University] at 03:54 14 August 2016 and trust in his reparative wishes is increased. The idea of reparation, already introduced in ‘Infantile anxiety situations refl ected in a work of art and in the creative impulse’ (1929), now becomes a key concept. The pain of the new integration is sometimes so great that it leads to defences characteristic of the depressive position such as manic and obsessional reparation, denial, triumph and contempt. If these defences fail, the individual may retreat temporarily or for longer periods to the defences characteristic of the paranoid-schizoid position. The favourable outcome of the depressive position is the secure internalisation of the good object, which in Klein’s view becomes the ‘core of the ego’, the basis of security and self-respect. The individual’s future mental health and capacity to love depend on this internalisation. Failure to achieve it constitutes the psychic basis of manic-depressive illness. Kleinian thought 71 In her 1940 paper Klein also adds normal mourning to the phenomena of the depressive position. Mourning in later life reactivates the depressive position of infancy and indeed leads for a time to a feeling of losing all internal goodness. Mourning that is successfully worked through leads to a deeper and stronger estab- lishment of the good internal object. In her new theory Klein makes a crucial and most interesting link between the Oedipus complex, Freud’s ‘nuclear complex of the neuroses’, and the depressive position. She maintains that the onset of the depressive position coincides with the beginning of the Oedipus complex, and says that the sorrow about feared loss of good objects in the depressive position is the source of the most painful Oedipal confl icts, for attacks on one’s Oedipal rival are simultaneously attacks on one’s loved object (Klein 1940: 345; 1952b: 110; 1957: 196; 1958: 239). In later papers Klein makes additions to some of her early fi ndings; among several others she notes that the dreaded combined object of her earlier work is modifi ed, in the depressive position, by a conception of internal and external parents in a happy relation with each other (1952b). She revises her earlier views of the Oedipus complex (1945). She notes too that transitory experiences of depressive anxiety and guilt can occur in relation to part objects in the paranoid-schizoid position (1948, 1960a). The delineation of the paranoid-schizoid and depressive positions, combined with the role of early envy in exacerbating the diffi culties of the paranoid schizoid position, comprise Klein’s fi nal theoretical statement, integrating most of her earlier ideas into a new constellation. The concepts of the paranoid-schizoid position and the depressive position have proved to be exceedingly rich, so much so that their expressions and implications are still being explored.

II. Developments by Klein’s colleagues in Britain A central feature since the 1950s in Britain has been a decline in the amount of psychoanalysis of children by Kleinian analysts, although child psychotherapy has developed rapidly as a profession. Analysts who continue to work with children are especially interested in trying to bring together developments in child analysis with technical developments that have been worked out with adults. Interest shifted fi rst to analysis of psychotic patients, especially evident in the papers of Bion, Rosenfeld and Segal in the 1950s. Work with such patients has continued, though fewer papers have been written about psychotic patients since the 1950s, and the number of papers involving borderline and narcissistic patients has greatly increased. Many developments have occurred through continued work with these and other types of patient: refi nements in the concept of projective identifi cation; development of new theories of thinking; new ideas about the paranoid- Downloaded by [New York University] at 03:54 14 August 2016 schizoid and depressive positions; and developments in technique. (My discussion of these topics is closely based on the introductions I have already written to the various sections of Melanie Klein Today, 1988.)

1. Studies of psychosis Working with psychotic patients gave many of the analysts who undertook it a deep conviction that the thinking of psychotic patients could be comprehensible and that Klein’s ideas about the anxieties and defences of the paranoid-schizoid position were profoundly useful in understanding the way very disturbed infantile object relations inhabit the inner world of the psychotic patient and that these relations could be understood as they were lived out in the relationship with the analyst. 72 Kleinian thought This work led Segal and Bion to develop ideas about the process of thinking, and Rosenfeld to productive studies of many topics including confusional states, homosexuality in relation to paranoia, narcissism and borderline states (see Rosenfeld 1965 and 1987).

2. Projective identiﬁ cation Although Klein defi ned the term ‘projective identifi cation’ almost casually, and was apparently always somewhat doubtful about its value because of the ease with which it could be misused (Segal 1982), the term has gradually become the most popular of her concepts; the only one that has been widely accepted and discussed by psychoanalysts generally, even though this discussion is sometimes incompatible with Klein’s conception. As I have described elsewhere (1988: 81–86, 1992) there has been much discussion about whether the term should be used to refer only to instances where the recipient is emotionally affected by the projection. In my view such restriction would be most unwise, for it would greatly limit the usefulness of the concept and is in any case totally contrary to the way Klein herself used it. I think the term is best kept as a general concept broad enough to include both cases in which the recipient is emotionally affected and those in which he is not. It might be useful, however, to have distinguishing adjectives to describe various subtypes of projective identifi cation; ‘evocatory’ might be used to describe the sort where the recipient is put under pressure to have the feelings appropriate to the projector’s phantasy. Most of the other questions that have developed in the use of the concept are best answered in the same way, that is, by using the concept as a general term within which various subtypes can be differentiated. The many motives for projective identifi cation – to control the object, to acquire its attributes, to evacuate a bad quality, to protect a good quality, to avoid separation (Rosenfeld 1971) – all are most usefully kept under the general umbrella. It is perhaps unfortunate that Bion did not develop a special term for the behaviour the individual uses to induce the other person to behave in accordance with his phantasies of projective identifi cation. Especially when analysing psychotic patients, Bion spoke in very concrete language because that was the way his patients thought; thus he would say, for example, ‘You are pushing your fear of murdering me into my insides’ (Bion 1955: 220–239). This led for a time to a fashion, especially among relatively inexperienced analysts, of speaking conceptually of phantasies actually being concretely put into the analyst’s mind. Such usage has been sharply criticised by Sandler (1987), who uses the useful terms ‘actualisation’ and ‘role-responsiveness’ to describe the processes by which individuals behave so as to Downloaded by [New York University] at 03:54 14 August 2016 get their object to feel and behave in a way that will satisfy the projector’s unconscious wish (1976a, 1976b, Sandler and Sandler 1978). The current practice among British Kleinian analysts, partly because of the criticisms of Sandler and others, and especially because of the work of Betty Joseph (1989), is to distinguish conceptually between projective identifi cation as a phantasy and the behaviour unconsciously used by the individual to get his object to behave in accordance with it. Another change in thinking about projective identifi cation is that the term used to be used almost entirely to characterise a very pathological, primitive defence. It continues to be used in that way when the patient being described is functioning mainly at the level of the paranoid-schizoid position, but it is also used to describe less pathological attributions of self and internal objects to external objects, attributions that are the basis of empathy and characteristic of the depressive position. Kleinian thought 73 This distinction between ‘normal’ and pathological projective identifi cation has occurred largely through the work of Bion (1962a, 1962b, 1963).

3. Work on symbolism, thinking and experiencing Two of Klein’s ideas have been important starting points for later work on thinking. The fi rst is her theory of symbols described above and the second is the idea of projective identifi cation. In a seminal paper on symbol formation developed from Klein’s ideas about symbolism, Hanna Segal distinguishes between symbol formation in the paranoid- schizoid position, which she calls symbolic equation, and symbol formation in the depressive position, which she calls symbolism proper (Segal 1957). In symbolic equations the symbol is confused with the object to the point of being the object; her example is a psychotic man who could not play the violin because it meant masturbating in public. In such a state of mind his ego was confused with the object through projective identifi cation; it is the ego which creates the symbol; therefore the symbol is also confused with the object. In the depressive position, where there is greater awareness of differentiation and separateness between ego and object and recognition of ambivalence towards the object, the symbol, a creation of the ego, is recognised as separate from the object. It represents the object instead of being equated with it, and it becomes available for use to displace aggression and libido away from the original objects to others, as Klein described in her symbolism paper (1930). Bion uses the idea of projective identifi cation in developing a theory of thinking that has had a profound effect on the conceptual and technical repertoire of many analysts (1967a, 1962b, 1963, 1965). In this body of work Bion suggests three models for understanding the process of thinking. The fi rst model is similar to Segal’s idea of an unconscious phantasy being used as a hypothesis for testing against reality (Segal 1964). In Bion’s formulation of it, a ‘pre-conception’, of, for example, a breast, is mated with a realisation, that is, an actual breast, which gives rise to a conception, which is a form of thought. He thinks of the pre-conception as part of the individual’s inherent mental equipment, an idea that has affi nity with Freud’s inherited phantasies (1916–1917), with Klein’s notion that the infant has an innate idea of the mother and the breast (1952c and 1959), and the developmental psychologists’ idea of predesigning (Stern 1985). In the second model, a pre-conception encounters a negative realisation, a frustration; that is, no breast is available for satisfaction. What happens next depends on the hypothetical infant’s capacity to stand frustration. Klein had pointed out Downloaded by [New York University] at 03:54 14 August 2016 that in earliest experience an absent, frustrating object is felt to be a bad object. Bion took this idea further. If the infant’s capacity for enduring frustration is high, the ‘no-breast’ perception/experience is transformed into a thought, which helps to endure the frustration and makes it possible to use the ‘no-breast’ thought for thinking; that is, to make contact with, and stand, his persecution. Gradually this capacity evolves into an ability to imagine that the bad feeling of being frustrated is actually occurring because there is a good object which is absent and which may or may not return. If, however, capacity for frustration is low, the ‘no-breast’ experience does not develop into the thought of a ‘good breast absent’; it exists as a ‘bad breast present’; it is felt to be a bad concrete object which must be got rid of by evacuation, that is, by omnipotent projection. If this process becomes entrenched, true symbols and thinking cannot develop. 74 Kleinian thought The third model has come to be called the formulation of the container and the contained (Bion 1962b; see also O’Shaughnessy 1981a). In this model the infant has some sort of sensory perception, need, or feeling which to him feels bad and which he wants to get rid of. He behaves in a way ‘reasonably calculated to arouse in the mother feelings of which the infant wishes to be rid’ (Bion 1962a). The projective identifi cation in itself is an omnipotent phantasy, but it also leads to behaviour that arouses the same sort of feeling in the mother. If the mother is reasonably well-balanced and capable of what Bion calls ‘reverie’, she can accept and transform the feelings into a tolerable form which the infant can reintroject. This process of transformation Bion calls ‘alpha function’. If all goes reasonably well, the infant reintrojects not only the particular bad thing transformed into something tolerable, but also, in time, the function itself, and thus he has the embryonic means within his own mind for tolerating frustration and for thinking. Symbolisation, a ‘contact barrier’ between conscious and unconscious, dream thoughts, concepts of space and time can develop. The process can, of course, go wrong, either because of the mother’s incapacity for reverie or the infant’s envy and intolerance of the mother being able to do what he cannot. If the object cannot or will not contain projections – and here the real properties experienced in the external object are extremely important – the individual resorts to increasingly forceful projective identifi cation. Reintrojection is effected with similar force. Through such forceful reintrojection the individual develops within himself an internal object that will not accept projections, that is felt to strip the individual greedily of all the goodness he takes in, that is omnis- cient, moralising, uninterested in truth and reality testing. With this wilfully misunderstanding internal object the individual identifi es and the stage may be set for psychosis. Of all Bion’s ideas, the notions of container and contained and alpha function have been the most widely accepted and more or less well understood. Their adoption has led to a less pejorative attitude towards patients’ use of projective identifi cation and to a better conceptualisation of the distinction between normal and pathological projective identifi cation. The container/contained model of the development of thinking has lessened the divide between emotion and cognition. Further, to Bion, the external object is an integral part of the system. As described above, Klein has often been accused, wrongly I think, of paying no attention to the environment. Bion shows not only that the environment is important, which Klein also stated, but how it is important. The importance of the environment had been stressed by many other British analysts (e.g. Rayner 1991), especially Fairbairn (1941, 1944), Bowlby (1944, 1951), Winnicott (1945, 1950–1955, 1952, 1956, 1960); and Rodman (Ed.) (1987: 89–93; 144–146), before Bion’s formulation of Downloaded by [New York University] at 03:54 14 August 2016 the container/contained model of thinking. The distinctive feature of Bion’s construction is that it uses the ideas of projection and introjection to formulate a conception of the internal dynamic involved in the mutual interaction of the container and the contained. He puts a particular emphasis on mental understanding: mental understanding by the other, in his view, is what makes it possible for the individual to develop mental understanding in himself and thus to move towards having a mind of his own and an awareness of the minds of others. Further, he focusses attention not only on the effect of the container on the contained, but also of the contained on the container. His is an ‘internal’ notion, very much concerned with the modifi cation of thoughts and feelings by thinking. It is a model that he describes rather than an empirical description; it can be applied not only to a mother giving meaning to an infant’s fear, or to an envious infant developing an Kleinian thought 75 envious superego, the particular mother/baby examples Bion describes, but to many other forms of interaction, including of course the analytic process. In ‘A theory of thinking’ (1962a), and indeed in his later work, Bion did not do as much as he might have to link his three models of thinking. It is surely repeated experiences of alternations between positive and negative realisations that encourage the development of thoughts and thinking. And the return of an absent mother gives rise to a particularly important instance, repeated many times in childhood (and in analysis), of a mother taking in and transforming, or failing to transform, the bad-breast-present experience. In subsequent work (1962b) Bion further elaborates the model of container/ contained and thinking as an emotional experience of getting to know oneself or another person, which he designates as ‘K’, in distinction from the more usual psychoanalytic preoccupations with love (L) and hate (H). He also describes the evasion of knowing and truth, which he calls ‘minus K’. He says that K is as essential for psychic health as food is for physical well-being. In other words, K is synonymous with Klein’s epistemophilic instinct, though in a more elaborated form. Bion also develops the idea of fl uctuation between the paranoid-schizoid and depressive positions, which he represents by the sign Ps<---->D, as a factor in the development of thinking (1963). This movement back and forth from the paranoid- schizoid to the depressive position was originally pointed out by Klein herself, but Bion focusses on the dimension of dispersal/disintegration (Ps) on the one hand and integration (D) on the other, ignoring for the time being the other elements of the paranoid-schizoid and depressive constellations as described by Klein. Further, Bion’s formulation draws attention to the positive aspects of the paranoid-schizoid chaos, to the need to be able to face the possibility of a catastrophic feeling of disintegration and meaninglessness. If one cannot tolerate the dispersal and threatened meaninglessness of the paranoid-schizoid position, one may of course break down; or one may push towards integration prematurely or try to hold on to a particular state of integration and meaning past its time (c.f. Eigen 1985). Bion’s work on thinking is used by many analysts and is still being developed and explored, particularly in Britain by O’Shaughnessy (1981a, 1992) and Britton (1989, 1992b). Elsewhere (1988, vol. 1: 158; 1989: 107–109) I have briefl y described Esther Bick’s theory that there is in infantile development a phase of ‘unintegration’ and ‘adhesive identifi cation’ which precedes the processes of projection and introjection so crucial to Klein’s theory of the paranoid-schizoid and depressive positions and to Bion’s theories of thinking (Bick 1968, 1986; see also Anzieu 1989). Although many of Bick’s students have used some of her ideas in clinical work, only Meltzer (1975; Meltzer et al. 1975), Tustin (1972, 1981, 1990), and Ogden (1990) have Downloaded by [New York University] at 03:54 14 August 2016 attempted to incorporate her ideas into their conceptual system.

4. The positions and the concept of pathological organisation The depressive position has continued to be a central conception, though changes have occurred in ideas about it, sometimes through careful clinical and conceptual analysis (J. Steiner 1992) and sometimes without people realising they were occurring. In her own descriptions Klein stresses the integration of part objects – breast, face, hands, voice, smell – to form the whole object; she also stresses the integration of the goodness and badness of the object and of the subject’s own love and hate. These features have been retained, but use of the idea of the depressive position in the study of borderline, psychotic and very envious patients has led to a 76 Kleinian thought gradual and increasing emphasis on recognition of the object’s separateness and independence as another hallmark of the depressive position. (Jean-Michel Quinodoz [1991] has written specifi cally on this topic and its connection with loneliness.) Studies of thinking and artistic endeavour have also shown the very close, indeed, intrinsic relationship that exists between the depressive position, symbolic thought and creativity (Segal 1952, 1957, 1974, 1991). A third aspect of the depressive position that has received even more stress than Klein gave it is the intrinsic connection between the Oedipus complex and the depressive position (Britton 1989, 1992a; O’Shaughnessy 1989). As described above, Klein herself drew attention to this connection; I believe that the increased stress on the intrinsic nature of the connection between the Oedipus complex and the depressive position has come about because of the focus on recognition of the object’s separateness as a crucial aspect of the depressive position. Once the other person is perceived to be separate, he (or she) is felt to have a life of his own which the subject does not control; the relationship with a third object is the essence of one’s primary object’s ‘life of his own’. Further explorations of psychosis, addiction, sexual perversion, perverse character structure, but especially studies of narcissism and borderline states, have led to refi nements in the understanding of the paranoid-schizoid position and the relation between the paranoid-schizoid and depressive positions. Klein herself made a distinction between the normal paranoid-schizoid position (1946) and the pathological developments that occur when primary envy is very strong (1957). Bion took this further, outlining, especially in the container/contained model of thinking, the processes that can lead to pathology in the paranoid-schizoid position. In his model he mentions two factors: defi ciencies in the mother’s capacity for reverie, and overwhelming envy in the infant. He implies that other factors in the hypothetical infant may be involved, but envy is the only one he discusses. Grad- ually the idea of an ‘organisation’ of interlocking defences has been evolved to order the clinical phenomena encountered, especially those involved in narcissistic and borderline states. Many authors have contributed to the development of the concept, and the word ‘organisation’ has been in use for some time, fi rst as ‘defensive organisation’ (Riviere 1936; O’Shaughnessy 1981b), also as ‘narcissistic organisation’’ (Rosenfeld 1971; Sohn 1985), more recently by John Steiner as ‘pathological organisation’ (1982, 1987, 1992). In addition, a great many other analysts have used the idea without using the term (Spillius 1988, vol. 1: 195–202); obviously they have infl uenced one another though evidently without being aware at the time of having a common theme. There are two main strands of thought in the idea of the pathological organisation. The fi rst is the dominance of a bad self over the rest of the personality; Downloaded by [New York University] at 03:54 14 August 2016 many authors point out a perverse, addictive element in this bondage, indicating that it involves sado-masochism, not just aggressiveness. The second strand is the idea of development of a structured pattern of impulses, anxieties and defences which root the personality somewhere between the paranoid-schizoid and depressive positions. This pattern allows the individual to maintain a balance, precarious but strongly defended, in which he is protected from the chaos of the paranoid-schizoid position, that is, he does not become frankly psychotic, and yet he does not progress to a point where he can confront and try to work through the problems of the depressive position with their intrinsic pain as well as their potential for creativity. There may be shifting about and even at times the appearance of growth, but an organisation of this sort is really profoundly resistant to change. The defences appear to work together to make a rigid system which does not Kleinian thought 77 develop the fl exibility characteristic of the defences of the depressive position, and efforts by the individual to make reparation, so characteristic of the depressive position, are usually too narcissistic to bring lasting resolution. There is considerable variation in the psychopathology of pathological organisations, but the analyses of these patients tend to get stuck, either to be very long, only partially successful, or sometimes interminable. The various authors are concerned with the question of whether the destructiveness of these organisations is primary or defensive. Often it is both, and indeed it is implicit in the work of many of the authors that the organisations they discuss are compromise formations, that is, they are simultaneously expressions of inherent destructiveness and systems of defence against it.

5. On technique Strong feelings are experienced about the technique as well as the ideas of Klein and her colleagues. Analysts who are sympathetic to her point of view fi nd the technique rigorously psychoanalytic. Those who are unsympathetic fi nd it unem- pathically rigid.

(a) Basic features of Klein’s technique As Segal notes (1967) the basic features of Kleinian technique are closely derived from Freud (1911–1915): rigorous maintenance of the psychoanalytic setting so as to keep the transference as pure and uncontaminated as possible; an expectation of sessions fi ve times a week; emphasis on the transference as the central focus of analyst–patient interaction; a belief that the transference situation is active from the very beginning of the analysis; an attitude of active receptivity rather than passivity and silence; interpretation of anxiety and defence together rather than either on its own; emphasis on interpretation, especially the transference interpretation, as the agent of therapeutic change. There is also an emphasis on the totality of transference. The concept is wider than the expression in the session towards the analyst of attitudes towards specifi c persons and/or incidents of the historical past. Rather the term is used to mean the expression in the analytic situation of the forces and relationships of the internal world. The internal world itself is regarded as the result of an ongoing process of development, the product of continuing interaction between unconscious phantasy, defences and experiences with external reality both in the past and in the present. The emphasis of Klein and her successors on the pervasiveness of transference is derived from Klein’s use of the concept of

Downloaded by [New York University] at 03:54 14 August 2016 unconscious phantasy. She conceives of unconscious phantasy as underlying all thought, rational as well as irrational, rather than there being a special category of thought and feeling which is rational and appropriate and therefore does not need analysing and a second kind of thought and feeling which is irrational and unreasonable and therefore expresses transference and needs analysing. Klein and her successors believe that when patients regress, analytic care should continue to take the form of a stable analytic setting containing a correct interpretive process; the analyst should not attempt to recreate or alter infantile experiences in the consulting room through non-interpretive activities. Even in the development of play technique with children Klein adhered to these principles, except that play as well as talk was the medium of expression. Similarly, in work with psychotic patients, some changes enforced by the patient have been contained without loss of overall method. 78 Kleinian thought

(b) Developments in technique Certain changes of emphasis have taken place in Kleinian technique in the last thirty years or so, partly through belonging to a psychoanalytic society in which there are other points of view, and partly through constant exploration, through being prepared to discard existing accepted procedure. Developments in technique and in ideas have gone along together, each infl uencing the other. Most of these changes have developed piecemeal and without anyone being very much aware of them at the time; they have been ‘in the air’ rather than the product of conscious striving. (i) The interpretation of destructiveness. Both Klein and her colleagues have often been accused of overemphasising the negative. Certainly Klein was very much aware of destructiveness and of the anxiety it arouses, which was one of her earliest areas of research, but she also stressed, both in theory and practice, the importance of love, the patient’s concern for his objects, of guilt and of reparation. Further, in her later work especially, she conveys a strong feeling of support to the patient when negative feelings were being uncovered; this is especially clear in Envy and Gratitude (1957). It is my impression that she was experienced by her patients not as an adversary but as an ally in their struggles to accept feelings they hated in themselves and were therefore trying to deny and obliterate. I think it is this attitude that gave the feeling of ‘balance’ that Segal says was so important in her experience of Klein as an analyst (Segal 1982). Certainly that sort of balance is something that present Kleinian analysts are consciously striving for. In this respect some of the authors of early clinical papers in the 1950s and 1960s, many of them given to the British Society but not published, took a step backwards from the work of Klein herself, especially from her later work. This was also a period when stated ‘belief in the death instinct’ was tacitly used, in my opinion, as a sort of banner differentiating Kleinians from the other groups of the British Society. (Perhaps other groups used their opposition to the idea of the death instinct in similar fashion.) Since that time there has been a change, not in the emphasis on destructiveness and self- destructiveness, which have continued to be considered of central importance both clinically and theoretically, but in the way they are analysed, with less confron- tation and more awareness of subtleties of confl ict among different parts of the personality over them. This change has been infl uenced not only by the work of Bion but also by Rosenfeld’s continued stress on the communicative aspect of projective identifi cation and by Joseph’s emphasis on the need for the analyst to become aware of subtleties of the patient’s internal confl ict over destructiveness and thus to avoid joining the patient in sado-masochistic acting out. Although the actual term ‘death instinct’ is now probably used less frequently than it was thirty years ago, there is basic agreement on its importance. There are Downloaded by [New York University] at 03:54 14 August 2016 two emphases, not mutually exclusive. One idea is that individuals with a particularly strong tendency towards inherent destructiveness and self-destructiveness tend to attack or to turn away from potentially life-giving relationships, wishing to oblate any awareness of desire that would impinge on their static and apparently self- suffi cient state. Another idea, closely related, emphasises what Rosenfeld, following Freud, calls ‘the silent pull of the death instinct’, which promises a Nirvana-like state of freedom from desire, disturbance and dependence (Rosenfeld 1987). Both Joseph and Segal also stress the confl ict among different parts of the personality over the voluptuous lure of withdrawing into despair, masochism and perversion. There are differences in the extent to which analysts believe that marked tendencies to attack positive relationships and/or to withdraw into self-suffi ciency are innate or acquired, inherent or defensive. In my view this is a false opposition. Kleinian thought 79 From the perspective of treating a particular patient, I think it is impossible to tell what is innate, what has been acquired through interaction with others and what is the continuing product of that interaction. What one can tell is how deep-rooted the patient’s negative tendencies are in the present analytic situation, but this does not tell one whether the deep-rootedness is innate or acquired. And, of course, it is part of the analyst’s job to tease out how much his own behaviour may exacerbate his patient’s negative tendencies. It is equally important for the analyst to avoid an attitude of blame, whether it be blame of the patient, of his innate tendencies, or of his primary objects, for an attitude of blame, whatever its target, disturbs the analyst’s active but impartial curiosity. (ii) The language of interpretation. Klein developed her very concrete, vivid language of part objects and bodily functions in work with small children for whom it was meaningful and appropriate. Extrapolating backwards, she assumed that infants feel and think in the same way, and, further, that this is the language of thinking and feeling in everyone’s unconscious. Work since Klein’s day has amply demonstrated that vivid bodily-based phantasies often become conscious in the analysis of adults, especially readily in the case of psychotic and borderline patients. No one who has read Klein’s accounts of her work with children or the clinical reports of her more talented students and colleagues can fail to be impressed by their clinical imagination and their grasp of unconscious phantasy. (There are several examples in the present collection.) In less skilled hands, however, this approach loses its freshness and becomes routinised. Some of her more youthful and enthusiastic followers made and still sometimes make interpretations in terms of verbal and behavioural content seen in a rigidly symbolic form which now seems likely to be detrimental to the recognition of alive moments of emotional contact. Such interpretations are based not on the analyst’s receptiveness to the patient but on the analyst’s wish to fi nd in the patient’s material evidence for the analyst’s already formed conceptions. ‘Memory’ and ‘desire’, in Bion’s terms, replace hypothesis and receptivity (1967b). This prejudiced attitude can of course operate with any set of analytic concepts. A number of analysts, perhaps especially Donald Meltzer, fi nd it appropriate to interpret unconscious phantasy directly in part-object bodily language, but the general tendency nowadays is to talk to the patient, especially the non-psychotic patient, less in terms of anatomical structures (breast, penis) and more in terms of psychological functions (seeing, hearing, thinking, evacuating etc.). Together with the increasing emphasis on function, concentration on the patient’s immediate experience in the transference often leads to discovery of deeper layers of meaning, some of which may be seen to be based on infantile bodily experience. Talking about unconscious phantasy in bodily and part-object terms too soon is likely to Downloaded by [New York University] at 03:54 14 August 2016 lead to analyst and patient talking about the patient as if he were a third person (Joseph 1989; Riesenberg-Malcolm 1981). But there is a danger also that if the analyst concentrates too exclusively on the immediate present, the here and now, he will lose sight of the infantile levels of experience and phantasy that the immediate expression in the here and now is based on, that the baby will get thrown out with the bath water so to speak. Both levels of expression need to be listened for together and linked with experience. And, indeed, several colleagues have said that they think the concepts of the inner world and unconscious phantasy are getting so attenuated that much of the clinical richness of Melanie Klein’s approach is in danger of being lost. (iii) Transference, counter-transference and projective identifi cation. Trans- ference is now regarded as based on projective identifi cation, using that term in the 80 Kleinian thought widest sense as I have suggested above. According to Segal, Klein frequently used the concept of projective identifi cation in her own work, but phrased her interpretations about it as statements about the patient’s wishes, perceptions and defences. Her emphasis was primarily on the patient’s material, not on the analyst’s feelings, which, she thought, were only aroused in a way that interfered with his analytic work if he was not functioning properly. Her view is illustrated in the now classic story about a young analyst who told her he felt confused and therefore interpreted to his patient that the patient had projected confusion into him, to which Klein replied, ‘No, dear, you are confused’ (Segal 1982). This example, however, is a case of a wrong or inadequate use of the idea of projective identifi cation; the analyst was not seeing his own problem and was blaming his own defi ciencies on the patient. Bion, however, made use of exactly the same process but based on an accurate grasp of the way his patients were attempting to arouse in him feelings that they could not tolerate in themselves but which they unconsciously wished to express, and which could be understood by the analyst as communication. Bion, Rosenfeld, and now many other colleagues are explicitly prepared to use their own feelings as a source of information about the patient. Klein was uneasy not only about possible misuse of the concept of projective identifi cation but also about the closely related issue of widening the concept of counter-transference, as described by Heimann (1950), to mean use of the analyst’s feelings as a source of information about the patient. She was very much aware of a tendency, especially in inexperienced analysts attempting to use their feelings constructively, to become over-preoccupied with monitoring their own feelings as their primary clue to what was going on in the session, to the detriment of their direct contact with their patient’s material. Nearly all Kleinian analysts, however, now use the concept of counter-transference in the wider sense, that is, as a state of mind at least partly induced in the analyst as a result of verbal and non-verbal action by the patient, thus giving effect to the patient’s phantasy of projective identifi cation (see Spillius 1988, vol. 2: 11–13). As Money-Kyrle says: ‘The analyst experiences the affect as being his own response to something. The effort involved is in differentiating the patient’s contribution from his own’ (1956: 342; see also Sandler 1976b: 46). Bion uses the literal word ‘counter-transference’ in the restricted sense to mean the analyst’s unconscious pathological feelings, his ‘transference’ towards the patient, which indicates a need for more analysis for the analyst. This is of course confusing, since Bion constantly uses the idea of counter-transference in the widened sense; it is only when he uses the actual term that he means counter- transference in the more restricted pathology-in-the-analyst sense. In practice, however, the two types of counter-transference are not invariably separable, since Downloaded by [New York University] at 03:54 14 August 2016 arousing pathology-in-the-analyst is often the means by which the patient effects his projective identifi cation. It has become increasingly apparent that far more is involved in transference and counter-transference than explicit verbal communication, that there is a constant non-verbal interaction, sometimes gross, sometimes very subtle, in which the patient acts on the analyst’s mind. Many analysts have discussed the importance of what the patient does in contrast to the content of what he says, but Betty Joseph has particularly emphasised this contrast as a starting point for her understanding of the way patients very early in their lives and in the analytic situation adapt to their objects and attempt to control them through projective identifi cation (Joseph 1989). The patient is constantly but unconsciously ‘nudging’ the analyst to behave in accordance with his unconscious phantasies and expectations, a more Kleinian thought 81 colloquial term for what Sandler describes as ‘actualisation’ (1976a; 1976b; Sandler and Sandler 1978). Joseph’s approach builds on and extends the usual psychoanalytic view that the patient relives and repeats in the transference his infantile experiences, his particular patterns of anxiety and defence, the confl icts between different parts of his personality. Her method particularly stresses the repetition of infantile defences, the attempt to draw the analyst into behaviour that will evade painful emotional experiences by attempting to maintain or restore a life-long system of psychic equilibrium. Her method of work has aroused the interest of many analysts. All agree with the importance of emotional contact, but many feel that one can make more comprehensive, holistic interpretations and more immediate links with the patient’s history without losing emotional contact in the immediate analytic situation. Some feel the method to be too limiting and restrictive, but no one doubts that Joseph has developed a new and very important emphasis in Kleinian technique. (iv) Reconstruction and the here and now. Finally, in recent years there has been much discussion among Kleinian analysts of the way past experience emerges in the analytic situation, especially concerning whether and when the patient’s account of the historical past should be explicitly linked with interpretations of the transference/counter-transference situation in the session. There is a considerable range of views which do not fall into neatly demarcated sets. Reconstruction, remembering and repeating have always been considered important ever since Freud fi rst drew attention to them, but I think the renewed interest in the topic of the past in the present has come about at least partly because of the emphasis of Joseph and her colleagues on acting-in, that is, on ‘repeating’ as the central process that analysts should address themselves to. The hope is that through thoroughgoing analysis of ‘repeating’, ‘remembering’ will occur, not only in the form of remembering forgotten historical events but in the sense of making conscious anxieties, defences and internal object relationships that are being kept unconscious in the present. According to one view this is all that is necessary. If explicit links are to be made with actual events of the past, which can in any case usually be known only through the fi lter of the patient’s projections, the patient will make these links for himself. Reconstruction by the analyst in the form of making explicit links with the historical past is both unnecessary and misleading, for making such links is likely to distract the patient from the emotional impact of the session, and it is in the session itself that the relevant aspects of the past are most immediately experienced. Many analysts, however, think that explicit linking with the historical past is a crucial part of the psychoanalytic process which enriches the meaningfulness of the psychoanalytic experience and gives the patient a sense of the continuity of his Downloaded by [New York University] at 03:54 14 August 2016 experience (Brenman 1980). There is some disagreement over when and how explicit linking with the past should be done. There is one set of analysts who think that although the fi rst objective should be to clarify and make conscious the past in the present through analysis of the patient’s ‘repeating’, his acting-in, one can then make links with the patient’s current view of his historical past (Joseph 1989; Riesenberg-Malcolm 1986). Common to these authors is a view that talk about the past is more distant than experience in the immediacy of the here and now of the transference/counter-transference situation, but all agree that it can be extremely useful provided it is not used defensively. Segal, however, does not agree that interpretations about the past are necessarily more intellectual and distant than interpretations about the immediate analyst–patient interaction. In this she is joined by Rosenfeld, who thinks that 82 Kleinian thought useful reconstructive interpretations and observations can be brought in whenever they seem relevant and are indeed thought of as an essential component in the analysis of transference (Rosenfeld 1987). But in some of his later work Rosenfeld goes further. In the case of traumatised patients he thinks that interpretations in the immediate transference/counter-transference situation are likely to be positively harmful because the patient experiences them as the analyst repeating the behaviour of a self-centred primary object, always demanding to be the centre of the patient’s attention and concern (Rosenfeld 1986). He thinks the analyst should concentrate, at least initially, on a sympathetic elucidation of the traumatic events of the past in all their ramifi cations. Critics of Rosenfeld’s view think that the problem of repeating the behaviour of a self-centred parent can be dealt with by interpretation rather than by behaving differently from the parent, and are further concerned that concentrating mainly on elucidation of past traumas may lead to splitting between an idealised analyst and denigrated primary objects, and to a belief by the analyst that he can know what the external reality of the historical past actually was. Thus after many years of very little explicit discussion of technical issues, it now seems likely that these and similar exchanges will lead to more explicit statements of a growing range of views.

III. Personal thoughts on clinical material and the hypothetical infant In the lectures Klein gave in England in 1925, which eventually became Part 1 of The Psycho-Analysis of Children (1932), she reports detailed clinical material, and such theory as she uses and develops is restricted to the ideas she needs in order to make sense of her particular clinical observations. In Part 2 of The Psycho-Analysis of Children, originally given as lectures in 1927, and in many of the more theoretical of her early papers, Klein writes not about actual clinical material with children but about a hypothetical infant. She extrapolates backwards, assuming that infants think in much the same way as the children she analysed and assuming too that there is psychic continuity from infancy to early childhood to latency to puberty, adolescence and adulthood. When discussing infants she does not bring much supporting evidence from infant observation (but see 1952c), and indeed it is often diffi cult to know how and why she arrives at her system of dating. In the development of her theory of the paranoid-schizoid and depressive positions this process of speculative theorising about developments in infancy is carried further. As described above, however, the positions are now increasingly thought of as states of mind, with decreased emphasis on their place in a conjectural sequence of infantile development. The positions cannot be ‘proved’ by infant observation or Downloaded by [New York University] at 03:54 14 August 2016 experiment since they are concerned with modes of thought and feeling, and it is even more diffi cult to gain direct access to infantile thinking and feeling than to the conscious and unconscious thoughts and feelings of older children and adults. In constructing a hypothetical infant, Klein is not alone. Freud, Abraham, Winnicott, Mahler, indeed virtually all analysts, are very free in constructing hypothetical accounts of the mental development of infants. I believe that these accounts are mainly derived from what happens in clinical work with patients, adult and child, supplemented by some rather unsystematic observation of infants and by general reasoning and ideas of what is plausible. In other words, the theories are derived from one set of data but expounded as if they were based on a different set. It is as if the analyst had asked himself: ‘What reconstructed thoughts and feelings of infants would be consistent with what I observe clinically and with my thoughts Kleinian thought 83 about it?’ Ideas about what is plausible are likely to be strongly infl uenced by whatever theory of psychology is current at the time. In connection with the rival theories of the Controversial Discussions, Riccardo Steiner (1991) presents a most interesting account of the various scientists and authors who infl uenced the Viennese into believing that very young infants could not phantasise and think and, in contrast, the thinkers and scientists who infl uenced Susan Isaacs in the opposite direction. Coming from another discipline which had already moved from a belief in hypothetical phases to the view that theories should be designed to make sense of specifi c ethnographic facts, I found it surprising that psychoanalysts of all schools of thought phrased so much of their theory in terms of hypothetical conjectures about infant development when it seemed obvious that these assertions and conjectures could not be directly investigated with infants. This preoccupation with infantile thought was particularly striking in the Controversial Discussions in which much of the scientifi c part of the controversy consisted of arguments over highly speculative constructions of infantile experience. I fi nd Isaacs’ paper plausible partly because she presented considerable observational evidence and made good use of the idea of genetic continuity, and partly, of course, because I am very familiar with her point of view. But the real usefulness of Melanie Klein’s concept of phantasy emerges not from its conjectured role in infantile thought but in the meaningfulness and enrichment it gives to clinical work with patients. The relation of concepts to actual clinical data, however, was not the principal focus of the Controversial Discussions. I am not at all against making conjectural hypotheses – psychoanalysis would be immeasurably poorer if Freud, Abraham, Klein and others had not had the courage and imagination to do so. And it is hardly surprising that the hypotheses should have taken the form of speculations about infant thought. But trouble starts when such speculations are treated as fact. In the Controversial Discussions each side tended to act as if what Freud said must be a ‘correct’ theory and then to shift from regarding it as a correct theory into regarding it as fact. Since Freud said many things and each side hunted for statements that supported their own point of view, it is hardly surprising that they did not come to any agreement, or even to a better understanding of each other. Such emotional attachment to conjectural theories puts one in danger of clinging to a theory that is not as useful as it should be because one thinks it is literally ‘true’. Freud describes the appropriately tentative attitude one should adopt towards one’s hypotheses in the fi rst paragraph of ‘Instincts and their vicissitudes’ in 1915. Indeed it was one of the great strengths of both Freud and Klein that they were prepared to drop one set of speculative hypotheses in favour of another that fi tted clinical material better or that made more sense of existing observations and theory. This sort of development has been continued by Klein’s colleagues, though Downloaded by [New York University] at 03:54 14 August 2016 on a smaller scale, and with more attention to clinical work and less to phrasing theory in terms of speculative reconstructions of infancy. Meanwhile in recent years there has been a vast increase in studies of infancy both by psychoanalytic baby observation and by the observations and experiments of developmental psychologists. And it is worth noting that experimental research on very young infants has substantiated some of Klein’s more ‘cognitive’ conjectures, especially her assumption that very young infants are able to make rudimentary distinctions between self and object. Daniel Stern puts it as follows:

Infants begin to experience a sense of an emergent self from birth. They are predesigned to be aware of self-organising processes. They never experience a period of total self/other undifferentiation. There is no confusion between self 84 Kleinian thought and other in the beginning or at any point during infancy. They are also predesigned to be selectively responsive to external social events and never experience an autistic-like phase. (Stern 1985: 10)

I fi nd it interesting that Kleinian analysts have not drawn particular attention to this bit of confi rmation; presumably this is because their interest has shifted away so much from the hypothetical phases of infancy. In my view the experiments and observations of developmental psychologists are best at testing cognitive discriminations and sequences of behavioural interaction. They are not, or not yet, so good at telling us about infants’ thinking and feeling and other such matters of especial relevance to psychoanalytic theory. Most of the concepts of developmental psychologists are not formulated in a way that would discover such matters, and perhaps such formulation is not possible. I surmise that it is for this reason that many psychoanalysts are only peripherally interested in the experiments of developmental psychologists. Andre Green, for example, thinks that infant observations and experiments do not tell the psychoanalyst what he needs to know, and that in any case the observer is likely to see only what his preformed theory encourages him to see (Green 1990). My own view is that psychoanalytic theory should at least be consistent with the fi ndings of developmental psychology, although it cannot be reduced to them. And, recipro- cally, I think that developmental research would be enriched by making more use of psychoanalytic concepts of development, however conjectural. It seems to me that two new trends of psychoanalytic thinking have been developing recently. Both depart from the highly conjectural theories of infantile development and phases current at the time of the Controversial Discussions. One trend is closely associated with (though not limited by) empirical developmental psychology; an example is the observational and therapeutic study by George Moran and his colleagues at the Anna Freud Centre of the development of the individual’s theory of mind (Fonagy 1991). A second trend is the development of a theory of mental models, and this is the trend of much recent Kleinian thinking. Following the initiative of Bion, interest in the precise dating of the paranoid- schizoid and depressive positions in infancy has ceased to be a preoccupation. It is implicit in most papers that the author is thinking of the positions as mental models, if viewed from the analyst’s perspective, or as states of mind if viewed from the point of view of the patient’s experience. Change of emphasis from the infant-development aspect to the states-of-mind aspect is much more pronounced in some analysts than others. Analysts who have a particular talent for seeing the expression of infantile experience in the analytic Downloaded by [New York University] at 03:54 14 August 2016 relationship are more likely to think within the infant-development framework and to use reconstructive interpretations. Analysts who stay more explicitly in the here- and-now are more likely to use the positions as current and fl uctuating states of mind. But overall, compared to the thinking and clinical practice of thirty or forty years ago, it seems to me that the general trend for both the reconstructive and the here-and-now analysts is towards a greater use of the positions as models.

IV. An overview Klein’s early work, then, was a great period of empirical clinical discovery and formulation which included fi ndings at variance with some of Freud’s views and fi ndings. Then came her later period of theory-building with its delineation of the Kleinian thought 85 paranoid-schizoid and depressive positions, a new understanding of anxiety, and new ideas about the importance of envy and gratitude in primary experiences of object relations. Finally I have described some central developments in Kleinian thought in recent years: studies of psychosis; theories of thinking and experiencing; projective identifi cation and counter-transference together with developments in technique; and developments in the conception of the paranoid-schizoid and depressive positions and use of these conceptions as models. Looking at the Kleinian development overall, two features stand out. First, in theoretical orientation it is both an object-relations and a drive-structure theory. Second, the clinical attitude: it is an approach that has special regard for psychic reality and for the individual’s need to ‘know’ in Bion’s sense and sometimes to evade ‘knowing’. There are now many variations of interest and orientation in Kleinian thinking, but all seem to me to have in common an interest in exploring the roots of current object relations in the internal world and in the remembered past experience of the individual, and all are involved in studying the expression of archaic object relations in modifi ed forms in the relationship of analyst and patient. Many times I have asked myself why have I got involved in such an exacting discipline, with so much anxiety and so little certainty, so much need for openness to things one does not understand, so much temptation to cling to what one knows. But every now and then comes that sense of discovery I felt more than forty years ago on reading Klein’s early clinical papers.

References ABRAHAM, K. (1924). ‘A short study of the development of the libido viewed in the light of mental disorders’. In Selected Papers on Psychoanalysis. London: Hogarth Press (1927: 418–501). ANZIEU, D. (1989). The Skin Ego. New Haven: Yale University Press. BICK, E. (1968). ‘The experience of the skin in early object relations’. International Journal of Psychoanalysis, 49: 484–486. —— (1986). ‘Further considerations on the function of the skin in early object relations: Findings from infant observation integrated into child and adult analysis’. British Journal of Psychotherapy, 2: 292–299. BION, W.R. (1955). ‘Language and the schizophrenic’. In New Directions in Psycho- Analysis, eds M. Klein, P. Heimann and R. Money Kyrle. London: Tavistock Publications, pp. 220–239. —— (1962a). ‘A theory of thinking’. In Second Thoughts. London: Heinemann (1967: 110–119). —— (1962b). Learning from Experience. London: Heinemann. Downloaded by [New York University] at 03:54 14 August 2016 —— (1963). Elements of Psycho-Analysis. London: Heinemann. —— (1965). Transformations. London: Heinemann. —— (1967a). Second Thoughts. London: Heinemann. —— (1967b). ‘Notes on memory and desire’. The Psycho-Analysis Forum, 2: 272–273; 279–280. Also in Melanie Klein Today, vol. 2, Mainly Practice, ed. E. Bott Spillius. London: Routledge (1988: 17–21). BOWLBY, J. (1944). ‘Forty-four juvenile thieves’. International Journal of Psychoanalysis, 25: 19–52, 107–127. —— (1951). Maternal Care and Mental Health. Geneva: World Health Organisation. BRENMAN, E. (1980). ‘The value of reconstruction in adult psychoanalysis’. International Journal of Psychoanalysis, 61: 53–60. BRITTON, R. (1989). ‘The missing link: Parental sexuality in the Oedipus complex’. In The Oedipus Complex Today, ed. J. Steiner. London: Karnac Books (1989: 83–102). 86 Kleinian thought

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Downloaded by [New York University] at 03:54 14 August 2016 —— (1929). ‘Infantile anxiety situations refl ected in a work of art and in the creative impulse’. Writings, vol. 1, pp. 210–218. —— (1930). ‘The importance of symbol-formation in the development of the ego’. Writings, vol. 1, pp. 219–232. —— (1932). The Psycho-Analysis of Children, Writings, vol. 2. —— (1935). ‘A contribution to the psychogenesis of manic-depressive states’. Writings, vol. 1, pp. 236–289. —— (1940). ‘Mourning and its relation to manic-depressive states’. Writings, vol. 1, pp. 344–369. —— (1945). ‘The Oedipus complex in the light of early anxieties’. Writings, vol. 1, pp. 370–419 —— (1946). ‘Notes on some schizoid mechanisms’. Writings, vol. 3, Envy and Gratitude and Other Works, pp. 1–24. —— (1948). ‘On the theory of anxiety and guilt’. Writings, vol. 3, pp. 25–42. —— (1952a). ‘The origins of transference’. Writings, vol. 3, pp. 48–56. Kleinian thought 87

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Downloaded by [New York University] at 03:54 14 August 2016 Press (1986: 306–321). —— (1986). ‘Interpretation: The past in the present’. In Melanie Klein Today, vol. 2, ed. E. Bott Spillius (1988): 73–89. RIVIERE, J. (1936). ‘A contribution to the analysis of the negative therapeutic reaction’. In The Inner World and Joan Riviere: Collected Papers, ed. A. Hughes. London: Karnac Books (1991): 134–153. RODMAN, F.R. (Ed.) (1987). The Spontaneous Gesture: Selected Letters of D.W. Winnicott. London: Harvard University Press. ROSENFELD, H. (1950). ‘Notes on the psychopathology of confusional states in chronic schizophrenia’. International Journal of Psychoanalysis, 31: 132–137. —— (1965). Psychotic States. London: Hogarth Press. —— (1971). ‘Contribution to the psychopathology of psychotic states: The importance of projective identifi cation in the ego structure and object relations of the psychotic patient’. In Melanie Klein Today, vol. 1, ed. E. Bott Spillius (1988: 117–137). 88 Kleinian thought

—— (1986). ‘Transference-countertransference distortions and other problems in the analysis of traumatised patients’. Unpublished talk given to the Kleinian analysts of the British Psycho-Analytical Society, 30 April 1986. —— (1987). Impasse and Interpretation. London: Routledge. SANDLER, J. (1976a). ‘Dreams, unconscious fantasies and “identity of perception”’. International Review of Psychoanalysis, 3: 33–42. —— (1976b). ‘Countertransference and role responsiveness’. International Review of Psychoanalysis, 3: 43–47. —— (1987). ‘The concept of projective identifi cation’. In Projection, Identifi cation, Projective Identifi cation, ed. J. Sandler. Madison, CT: International University Press: 13–26. SANDLER, J. and SANDLER, A.M. (1978). ‘On the development of object relationships and affects’. International Journal of Psychoanalysis, 59: 285–296. SEGAL, H. (1952). ‘A psycho-analytical approach to aesthetics’. International Journal of Psychoanalysis, 33: 196–207. Also in The Work of Hanna Segal, New York: Jason Aronson (1981: 185–206). —— (1957). ‘Notes on symbol formation’. International Journal of Psychoanalysis, 38: 391–397. Also in The Work of Hanna Segal (1981): 40–65, and in Melanie Klein Today, ed. E. Bott Spillius (1988: 160–177). —— (1964). ‘Phantasy and other processes.’ In The Work of Hanna Segal. New York: Jason Aronson (1981: 41–47). —— (1967). ‘Melanie Klein’s technique’. In Psychoanalytic Techniques, ed. B.B. Wolman. New York: Basic Books. Also in The Work of Hanna Segal: 3–24. —— (1974). An Introduction to the Work of Melanie Klein. London: Hogarth Press. —— (1982). ‘Mrs Klein as I knew her’. Unpublished paper read at the Tavistock Clinic. —— (1991). Dream, Phantasy and Art. London: Routledge. SOHN, L. (1985). ‘Narcissistic organisation, projective identifi cation, and the formation of the identifi cate’. International Journal of Psychoanalysis, 66: 201–213. SPILLIUS, E. Bott (Ed.) (1988). Melanie Klein Today, vol. 1, Mainly Theory and vol. 2 Mainly Practice. London: Routledge. —— (1989). ‘On Kleinian Language’. Free Associations 18: 90–110. —— (1992). ‘Clinical experiences of projective identifi cation’. In Clinical Lectures on Klein and Bion, ed. R. Anderson: 59–73. STEINER, J. (1982). ‘Perverse relationships between parts of the self: A clinical illustration’. International Journal of Psychoanalysis, 63: 241–251. —— (1987). ‘The interplay between pathological organisations and the paranoid-schizoid and depressive positions’. International Journal of Psychoanalysis, 68: 69–80. Also in Melanie Klein Today vol. 1, ed. E. Bott Spillius: 324–342. —— (1992). ‘The equilibrium between the paranoid-schizoid and the depressive positions’. In Clinical Lectures on Klein and Bion, ed. R. Anderson: 46–58. STEINER, R. (1991). ‘Some scattered notes on Die Zeitgeist (spirit of the age) and Die Ortgeist (spirit of the place) and their relevance in the cultural background of the Controversial Discussions 1941–1944’. Unpublished lecture given to Conference on the

Downloaded by [New York University] at 03:54 14 August 2016 Freud–Klein Controversies, March 1991. STERN, D. (1985). The Interpersonal World of the Human Infant: A View from Psychoanalysis and Developmental Psychology. New York: Basic Books. TUSTIN, F. (1972). Autism and Childhood Psychosis. London: Hogarth. —— (1981). Autistic States in Children. London: Routledge. —— (1990). The Protective Shell in Children and Adults. London: Karnac Books. WINNICOTT, D.W. (1945). ‘Primitive emotional development’. In Through Paediatrics to Psycho-Analysis. London: Hogarth Press (1975): 145–156. —— (1950–1955). ‘Aggression in relation to emotional development’. In Through Paediatrics to Psycho-Analysis. London: Hogarth Press (1975): 204–218. —— (1952). ‘Psychoses and child care’. In Through Paediatrics to Psycho-Analysis. London: Hogarth Press (1975): 219–228. —— (1956). ‘Primary maternal preoccupation’. In Through Paediatrics to Psycho-Analysis. London: Hogarth Press (1975): 300–305. Kleinian thought 89

—— (1960). The theory of the parent–infant relationship. In The Maturational Processes and the Facilitating Environment. London: Hogarth Press (1965: 37–55). YORKE, C. (1971). ‘Some suggestions for a critique of Kleinian psychology’. Psycho- Analytic Study of the Child, 26: 129–155. Downloaded by [New York University] at 03:54 14 August 2016 CHAPTER 6

ON FORMULATING CLINICAL FACT TO A PATIENT

A slightly different version of this article was originally published in International Journal of Psycho-Analysis (1994), 75: 1121–1132.

The original version of this paper began with a question about the order in which thought processes should start in the analyst’s mind in order that he or she might form a meaningful understanding of the patient. The approved sequence at the time was that one should start by discussing a ‘perceived clinical fact’, followed by conceptualisation of the clinical fact, followed in turn by formulation to the patient, and fi nally by validation or non-validation. This sequence was not always followed, and indeed in the case of Mrs Lewis, the analytic patient with whom I was working, we were not convinced by the need to follow a prescribed order and we concluded that there were several methods of arriving at valuable forms of clinical facts, and we did not think that any of them should necessarily be privileged. After considerable further clinical practice my view remains much the same. I tend to think that seeing how analysts and patients discover useful analytic experiences is more likely to come about through being prepared to let things happen than by following a formally prescribed system. The patient I will discuss, Mrs Lewis, came to England from a commonwealth country and began work as a writer, critic and journalist. She married an Englishman and they decided to live in England. After some time she sought analysis because of diffi culties at work. The period of her analysis that I will discuss began about two years after she had started work. Her work was not the central problem – she found my holiday breaks arbitrary and diffi cult to endure, and I will devote much of this paper to our work on the events that took place in three of them, which I will call Break A, Break B and Break C.

Sessions before holiday Break A Downloaded by [New York University] at 03:54 14 August 2016 There is a background fact of considerable importance to the sessions before Break A. Not long before these sessions, some years ago, I had moved house and consulting room. A prominent feature of the new consulting room was that two of its walls were fi tted with handmade mahogany cupboards and bookcases, which were directly in the patient’s line of vision as he or she lay on the couch. Most patients made some sort of comment about these bookcases. Mrs Lewis did not. Is this a clinical fact? I think not. It may have been, for Mrs Lewis did comment on other aspects of the new consulting room, but it was diffi cult to know whether there was any particular signifi cance in her ignoring the bookcases. In any case she had other things on her mind at the time which seemed much more important. On formulating clinical fact to a patient 91 At this period of her analysis Mrs Lewis maintained a friendly, even-tempered stance towards me, even before breaks. When other patients were complaining in some form or other about my self-centredness and arbitrariness in having a break and had phantasies about what I might be doing, Mrs Lewis mostly ignored approaching breaks or talked about them in a perfunctory, dutiful way as if she thought I expected it. When I tried to point this out she listened politely, but did not react much one way or the other. I felt I was making bookish interpretations – at least, that is, until the sessions I shall now describe. It was a week before a long summer break. On Monday she said she no longer felt as depressed as she had been feeling, though she didn’t know why. On Tuesday she talked about an episode of what she called ‘echolalia’. She had telephoned a particular woman critic and asked to speak to her husband, an editor with whom she works. The wife had said, ‘Can you hang on a minute?’, and Mrs Lewis found herself also saying, ‘Can you hang on a minute?’ to the wife. She explained that the husband, once he came to the telephone, had agreed to continue working with her on a particular project, but said that she would have to wait. She then told me about a dream she had had the night before the present session. In the dream: The editor was being very friendly and attractive, virtually sexually seductive. But his wife was there in the dream. She can’t remember exactly what happened. I said her feelings for the editor were similar to her feelings for me. She felt we both tantalised her, apparently offering her something – seduction, sessions – and then made her wait. The editor’s wife was there in the dream. I thought Mrs Lewis felt I was leaving her during the holiday to be with someone else, my own editor, whoever that might be. She agreed with this easily and went back to talk about the echolalia. I said that in the echolalia she had become the wife/critic. ‘Can you hang on a minute?’, she had said, meaning that she herself was the one in control and was not the one who was having to do the waiting and the hanging on. In the echolalia the wife/critic had been got rid of, so there remained only herself and the editor. She agreed with this, again rather easily, and described two recent instances in which she had actually made people wait for her. There was a pause. Then she said it was a good thing that she had found a really nice cleaning woman. I said the good cleaning woman was perhaps a substitute for her bad analyst, who wasn’t going to be cleaning her up during the holiday. There was a pause. Then she said she had decided to redecorate her loo (‘loo’ is an everyday, slightly euphemistic word for lavatory or toilet in British English). She described in considerable detail how she thought she would buy a mahogany loo seat. I said: ‘The loo here does not have a mahogany seat. But there is one room here Downloaded by [New York University] at 03:54 14 August 2016 in which there is a lot of mahogany.’ ‘Oh’, she said, ‘You mean here, in this room.’ She looked carefully around the room. ‘Yes’, she said, ‘This room is full of mahogany.’ I said: ‘When you stress that your loo seat is to be made of mahogany, it’s as if you are shifting the mahogany from the consulting room into the loo.’ ‘Oh’, she said. (I felt as if I was spelling things out to an interested but rather bewildered child. Was she really so unaware of what she was saying, I wondered to myself, or had I confronted her too brusquely? It was one of the few occasions up to this time that I was aware of the ‘obliviousness’ that she said other people sometimes complained of.) ‘And so’, I went on, ‘you are putting the consulting room into the loo, fl ushing me and your analysis away. I’m the much valued cleaner, but when it’s the last 92 On formulating clinical fact to a patient week of our sessions, I’m fl ushed away. It’s not a case of my leaving you, it’s a case of your fl ushing me away.’ There was a very long pause. I felt that at last, perhaps, she had some conscious inkling of the feelings that were getting stirred up by my arbitrarily dismissing her at the time of the holiday. Then she said: ‘I wish my mother had been more like you.’ I was silent for a bit, somewhat disconcerted. It sounded like a non-sequitur, but clearly was not. Was this, I wondered, a way of getting rid of possible bad feeling between us? Not quite, I thought. What I actually said was: ‘I think that at the moment I recognised that you were really being quite attacking and told you so, you felt relieved.’ She murmured agreement. I went on to say that if I could see her attack and yet continue to be reasonably well-disposed towards her, it must mean that it wasn’t so dreadful after all. ‘Yes’, she said, ‘that’s right.’ After a pause I said it was time to stop. In the next two sessions of the week, Wednesday and Thursday, she went around this material again, adding that at such times she got a feeling that she desperately wanted something and was going to have it, come what may. No waiting. ‘I want it NOW,’ she said, imitating her small son. When I thought about Tuesday’s session later, the material at fi rst seemed so obvious that I could not imagine seeing it in any other way. Then I began to wonder. Perhaps she had been right about the importance of the echolalia, which had made her into the wife/critic so that she did not have to wait and in addition she then had the editor/husband to herself. In similar fashion, she had changed something she sees, namely, a relationship between mahogany bookcase and books, into something she sits on, mahogany loo-seat. A three-person situation had been changed into a two-person situation. If I was the mahogany, she was sitting on me. This emerged more clearly in the last session, on Friday. To summarise Friday’s session very briefl y: she told me that she felt sad and fl at about her sessions ending, and then told me about two diffi cult colleagues. While telling me about the colleagues, her feet in their sandals left their customary position on the little carpet I always put at the end of the couch, and began walking all over the couch cover itself, ending up with her feet fl at on the couch cover and her knees slanting to one side. I pointed this out. She said, with much embarrassment, that she felt she had got into a sort of foetal position, and that being on the couch was like sitting on my lap. After considerable to-ing and fro-ing about this, including an association about her son jumping up and down on her bed, I said I thought she found it very diffi cult to put together two views of herself: herself as an innocent baby sitting on my lap, a baby whose feet could do whatever they liked, and herself as a more grown-up person, who, evidently without her Downloaded by [New York University] at 03:54 14 August 2016 being aware of it, could take advantage of her supposed innocence to do something quite aggressive and spoiling to me and to the partner she felt I would be with in the summer. I felt that in this week of sessions she was beginning to have some idea of the ancient feelings of attachment, jealousy and hatred that can get stirred up by analytic breaks. She was beginning to be aware of separation and separateness, both mine and hers, though she was fi ghting against it. I had mainly interpreted her denigration and her jealous attack, perhaps partly because I might have been more irritated about the loo-seat and the couch cover than I realised at the time. In retrospect, her possessiveness, expressed through the echolalia and her sitting on me, was equally important. I think she was evading awareness of jealousy and exclusion as much as she could by a phantasy of becoming me through a form of projective On formulating clinical fact to a patient 93 identifi cation, or, even if she did not actually become me, she was getting rid of rivals by sitting on my lap.

The Monday session of the week before holiday Break B This break came a few months after Break A. Mrs Lewis was becoming increasingly aware of being upset in sessions before breaks, though she still found it diffi cult to realise that she got angry or aggressive about them rather than just upset, and she still reported instances of being unaware of what people thought about her. Some sessions before Break B helped to make things a bit clearer. She was becoming aware that her attempts at what she now called ‘wiping people out’ had painful psychic consequences for herself as well as for the targets of the wiping out, and she made a concerted effort to understand what was happening. She began the Monday session of the last week before the break by telling me more details about a very diffi cult work situation with her immediate editorial boss, a Mrs K. Then she returned to describe a feeling she had had the preceding Friday that was just awful, though it had not lasted long. I said she had felt quite ‘wiped out’ (her words) on Friday, and that what had set it off was Mrs K’s threatening to make far-reaching changes in the arrangements at work; that made her feel utterly helpless and put her into despair. She said, yes, that was right. I went on to say that I thought it linked with the analytic holiday; I change the arrangements here from sessions to no-sessions, and she feels wiped out. She said that when Mrs K threatens to change the arrangements she feels that she is trying to make her ineffectual, like her father. Does she feel like that because she wiped her father out? (We had been talking about her relationship with her father in earlier sessions; I wondered who was making whom ineffectual now, but decided not to tackle it at that moment.) I said that sounded right, but went on to say that she also gave the impression that her feelings about her mother might also be involved in this situation. It was as if Mrs K had virtually become a stand-in for her mother. She (Mrs Lewis) is terrifi ed of offending her, just as she used to be afraid of offending her mother. But when she has offended Mrs K, she clings to her, just as she used to cling to her mother’s legs. And that, apparently, irritates Mrs K even more, just as it used to irritate her mother. She was silent, then agreed quite suddenly and with real interest in her voice, as if she had never thought of the similarity in her relationships with these two women. She was then silent for quite a long time, evidently thinking. Then she asked, ‘How does it connect with the holiday? And with how I try to manage Mrs K?’ I said she had often described the way she felt her mother wiped her out, was Downloaded by [New York University] at 03:54 14 August 2016 preoccupied or worried about something and did not have time to attend to her. She began to feel this about me as well, especially before a holiday when I turned away from her and didn’t attend to her. She felt it about Mrs K, too. I said I thought she tried to manage this experience by becoming like her mother and like me. She wipes me out, as she wipes out Mrs K. She said: ‘That really is exactly what I do to Mrs K. I treat her as if she hardly exists.’ Then there was a very long silence. (Up to this point I had thought we were working on a more or less surface level, as if accumulating evidence. Then, through her initiative, things deepened.) She said: ‘When I’m away from Will [her husband], most of the time he is present somehow or other in my mind. I don’t mean I think about him all the time, but he is just there. I feel all right then. But every now and then I just feel he isn’t 94 On formulating clinical fact to a patient there, and I get in a panic. I fi nd it diffi cult to describe. It’s as if I myself don’t exist. Something is going on that just wipes me out. It doesn’t correspond at all to what he is really like or to what you’re like either – it happens with you too. I know you continue to exist and that I’ll be coming back to analysis, but I don’t believe it. I go through something awful and I don’t know how to describe it. Everything hangs by a thread. Once I’m in this mood I can’t get out of it. It’s self-perpetuating. The only thing that stops it is when I actually see him or see you. Or when I see Mrs K and she’s not as bad as I expect.’ She went over this two or three times, as if feeling she could not describe it properly or that I would not understand it. I said, fi nally: ‘So you have to see and to cling to this actual external me, or Will, or Mrs K to disprove this terrible thing that you’ve got inside your mind. You can’t bear the thought of my leaving you for fear I’ll turn into this awful, terrifying person who “un-makes” you – (I could not think of a better word) – this awful presence who takes your self away, who puts you into terror.’ ‘That’s right,’ she said, and her voice was full of relief. ‘Being un-made’, she said, ‘means that I don’t have that active presence of you or Will inside me at all.’ She paused. ‘There’s something more. Can’t you do a bit more, can’t you push it on a bit?’ ‘Well’, I said, ‘I think you want me actually to do something now, in the session, so that you won’t have the awful me inside you, the one who un-makes you.’ She laughed slightly. ‘You mean it’s happening now? I suppose it is. I think you’re right, it’s what I do to Mrs K.’ (This time I thought that she’d moved to Mrs K to get away from what she thought was happening between her and me. Now, in a small way, she was enacting it, not just describing it.) ‘It’s not only Mrs K,’ I said. ‘It’s happening now. You’re trying to avoid my wiping you out by wiping me out fi rst. You’re doing it by moving away to Mrs K. You do it by taking the signifi cance out of my leaving, by making yourself unaware of it. But that’s what makes it happen. Unawareness is the real attack. That’s what you think I do to you when I leave, and that’s what you do to me – you switch me off. But then you get a kind of no-me, a minus-me in your mind, a wiped out/wiping out me that unmakes you from inside.’ ‘Hmm,’ she said. But it was time to stop. I think that my frames of reference, or my way of using them, had not given me a ready-made set of expectations that made it easy for me to conceptualise the link between Mrs Lewis’ ‘obliviousness’ and ‘wiping out’ of other people with her denial of loss, but in this session she had explained her experience more graphically and then began to act it out in the session. I felt slightly wiped out, and could use this experience, combined with her description, to conceptualise what was happening. On this occasion the conceptualisation and the formulation came more or less simultaneously. She remembered this session for some time, referring to it Downloaded by [New York University] at 03:54 14 August 2016 as ‘the one about wiping out’. It was a small but meaningful step in our mutual understanding of loss, separateness and the effect of her defences against both.

Sessions during the week after Break C Break C came soon after Break B, and the sessions I have described above were still very much in Mrs Lewis’ mind. Break C came at a diffi cult time for her – ‘not a good time for you to be having one of your breaks’, as she put it. I did not record the sessions before Break C, but became very much aware of the ones after it. For some time I had noticed a particular pattern in Mrs Lewis’ behaviour in the fi rst week after breaks. She fell prey to feelings of contradiction and chaos. She would telephone people to tell them she had no time to telephone On formulating clinical fact to a patient 95 them; she double-booked appointments; she scheduled a meeting and forgot to go to it; while racing to answer the telephone she tripped over a chair and sprained her ankle. Should these be described as clinical facts? According to my defi nition of clinical fact, probably not. They were indications of the state of Mrs Lewis’ internal world, which she expressed not only in the actions themselves but also in describing them to me, arousing my concern and curiosity. She conveyed in her sessions that she felt very agitated about the way she was feeling and acting and was almost desperate that I should do something to make it better. These aspects of the relation between us I regard as clinical facts. It gradually emerged that this fi rst week after breaks expressed much of what she had felt during the break, usually without her being very much aware of it. I had said this to her on numerous occasions, and it seemed right, but not right enough. Something was missing. On the fi rst day back after Break C Mrs Lewis was, as usual after breaks, quite agitated. Everything seemed to be going wrong. In particular, she was desperately worried about money. She hadn’t done the sums exactly, but she was sure she couldn’t afford to go on with the analysis. Then suddenly she said to herself, ‘No! Stop this!’, and went on to say that she knew it was because of her upset about my holiday, adding that there was a real problem about money, but that didn’t mean she had to get in such a state over it. ‘What I can’t understand is why I get in such a panic,’ she said. But it was the end of the session. In the next session the panic continued. Several things had upset her at work and she felt she had behaved badly and stupidly, and things between herself and her husband and child were strained as well. I found it diffi cult to get a sense of what was happening between us. I made a few desultory descriptions of the atmosphere of the session, and she agreed, but continued in an increasingly anxious and chaotic vein. This response was not a validation or a contradiction of my remarks, but rather a confi rmation that I could not conceptualise what was going on. In so far as I could understand it at all, I thought she felt rather battered and confused, and so did I. It was a bit like the helpless feeling that a mother gets when all her efforts to understand her baby are unavailing; but who was mother and who was baby was not clear to me. I had a feeling that my inability to think was in part being evoked by my patient, but I could not understand what phantasy of projective identifi cation was involved. In the next session, as I mused about my inability to understand the transference/countertransference situation, there drifted into my mind one of what I called to myself her ‘personal stories’. These were stories of things that had happened to her in her childhood; she often thought of them when refl ecting on herself and her life. Some of them she remembered, some she had been told. This Downloaded by [New York University] at 03:54 14 August 2016 one she had been told by her mother. It concerned the fi rst week of her life; my personal name for it was ‘the fi rst-week story’. Her mother had tried to breast- feed her, but apparently did not have enough milk and so had given up after one week, and had put her on to the bottle. Mrs Lewis deeply wished that her mother had kept on trying to breast-feed her. She had several attitudes to her mother over this failure in breast-feeding. On some occasions when she had told me the fi rst- week story she had sounded sad for herself. On other occasions she seemed to feel sad for her mother, as though her mother could not believe that she (the mother) really had something good to offer. On other occasions Mrs Lewis sounded resentful and angry. On an earlier occasion in her analysis I had drawn Mrs Lewis’ attention to the parallel between the fi rst week of her life and the fi rst week after breaks, but had 96 On formulating clinical fact to a patient felt it was too much of a mechanical formula and that neither she nor I could do much with it. As I pondered on the fi rst-week story this time, I remembered that, characteristically, Mrs Lewis had never put together her contradictory feelings of anger and sadness about her mother’s failure to feed her. I had a dim feeling that this lack of putting together opposing feelings had something to do with the chaos she was in at the moment, and perhaps also with the feeling of incomprehensibility that I was having. Without quite knowing what I was doing, that is, without any proper conceptualisation to guide the way, I started thinking out loud. Even though she had not mentioned her fi rst-week story this time, I reminded her that she always had a tough time during the fi rst week after breaks and that she felt she’d had a tough time in the fi rst week of her life as well. I said, as I had said before, that we had no way of knowing what had really happened at the time, no way of knowing what she had felt or what her mother had felt. (I knew that this story had become a signifi cant part of her internal world, but exactly how the internal version was related to the historical events of the fi rst week of her life I thought I could not know, although I did not say all of this to my patient.) I said I thought that perhaps she imagined that her mother had not been able to stand the pain and sense of loss over not being able to feed her baby, and that she had dealt with it by convincing herself that bottle was as good as breast – ‘all for the best’ – that the pain and loss of the breast-feeding had to be minimised, even wiped out. (I knew that my patient thought such ‘sensible’ attitudes were typical of her mother from later periods when she could actually remember how her mother had behaved, and I knew too that she also expected such ‘sensible’ no-nonsense attitudes from me.) As I said all this about her mother’s possible denial of loss, I began to feel things coming together in my mind: perhaps Mrs Lewis thought that I, too, felt there was no loss, that bottle was as good as breast. ‘You mean’, she replied slowly, ‘that there is a difference between saying it doesn’t matter, bottle is the same as breast, and saying that it is too bad, breast is best, but as I can’t have breast, bottle it will have to be.’ ‘Yes,’ I said. (I was amazed that she had not only grasped what I was groping towards, but had found so clear a language to express it. There was no panic or confusion in this formulation.) She was silent for quite a long time. I said: ‘I think you do that too, but even more to the point, you worry that I do it. When I have a break, you think that my actual behaviour, whatever I may say in words, says that no-sessions are just as good as sessions, bottle is the same as breast. There is no loss, and that’s a lie.’ ‘Ha,’ she said, and her voice was full of relief. ‘I think the panic is going.’ She was silent for quite a long time, and then she said: ‘It must link up with the way everything gets so awful, but I don’t quite get it. I know that I attack you and Downloaded by [New York University] at 03:54 14 August 2016 the analysis.’ I said: ‘You have come to know that your analysis matters to you, and it’s a serious thing when I take it away. No-sessions are not the same as sessions. Without your quite realising it, I think you have thought that I was implicitly lying to myself and to you about this, the way you’ve lied to yourself and the way you thought your mother may have. That’s what’s always been missing in your idea about the fi rst week of your life, your implicit belief that your mother denied that the loss of the breast-feeding mattered. You expect me to think this too, and it makes you frantic without your knowing why. You attack me, your analysis, and yourself. Especially yourself. It’s as if you’re saying, “Look what you’ve done to me!” without even knowing that that’s what you’re saying.’ She was silent, but not agitated, I thought. On formulating clinical fact to a patient 97 This was all reasonable enough, I thought, but something was missing. Then I had another thought, and this time thought to myself, ‘Ha! I’ve got it’, though to be more accurate, it felt as if the thought had got me. What I said was: ‘Actually this time you know that I chose to leave you. I didn’t have to, I chose to. But I think you also know that I’m aware that my leaving is hard on you. The fact that I leave doesn’t mean that I’m claiming that it’s good for you. I think you know that two contradictory things are true at the same time: that I chose to leave, and that I know it’s not good for you.’ She said, ‘I never thought of it that way.’ I thought of Freud’s paper ‘Negation’ (1925, p. 239), where he says that some such form of words is often the fi rst reaction to an effort to uncover the unconscious. I thought that this set of interpretations was too long and didactic, contrary to what I had been taught and believe about clinical procedure, the precedence of the here-and-now, the role of reconstruction, the harmfulness of intellectualisation – and yet I had a sense that I had got hold of something that mattered to both of us. I concluded that it must obviously be the case that there can be more than one way of arriving at valuable formulations to the patient. In the remaining sessions of the week she continued on the same theme, expanding it and adding her own ways of expressing it. She thought it helped to understand why she often felt uncertain about whether she had anything really good to offer her child, her husband, her readers, for what she offers might contain some deadly denial at its core. Or she might have to claim that she and only she was right, because if she listened to the denied opposition she would collapse in confusion – hence her occasional obliviousness. She began to feel she might cope better with the inevitable contradictions and confl icts of everyday life, and that she might be more able to sort out priorities. She said it had been a revelation that she could see the loss of the thing she had wanted without having to deny the goodness of what she does have. ‘The important thing’, she said, ‘was when you said that you chose to leave, yet you knew what it meant to me. You didn’t pretend that it was good for me. You left because you wanted to, but you knew what it meant. Actually you’ve never claimed it was for my own good, but I think I thought that way. I suppose you’ve said this before, but I’ve never got it. It just makes a difference that you know it’s a real pig when you leave, even when I make out that it’s all right. Whereas if you pretend that it’s all for my own good, it’s like those Truby King babies being starved for their own good – that’s when things go wrong.’ Gradually, between the two of us (and it was hard even at the time to know exactly who contributed what), it became possible to link this material with the fact that she so frequently cannot hold on to two opposite ideas or feelings at the same time without becoming confused and chaotic. If she opts for one, she has to deny the Downloaded by [New York University] at 03:54 14 August 2016 other; if she recognises both, one or other is damaged, or she gets in a panic – such as her phoning people up to tell them she has no time to telephone them (phone/ don’t phone), or her rushing to the telephone and tripping over a chair (answer/ don’t answer), or double-booking appointments (see two/see neither). In the course of listening to this material I remembered, among other examples, the earlier session when she had said, ‘I wish my mother had been more like you’, and realised that the particular thing that had impressed her was that I could have two contradictory feelings at the same time without being confused or in a panic. I could see how denigratory she was, and I think she thought I must have been at least a bit angry myself, but she also felt that I was reasonably well-disposed towards her. On that occasion, too, in other words, the coexistence of apparent opposites was a crucial theme. 98 On formulating clinical fact to a patient Discussion The clinical facts I have tried to describe concern the behaviour of a patient around breaks in her analysis. At fi rst she blandly denied any upset or anger about these breaks. Then just before what I have designated as Break A came a spell of what I thought were fairly obvious attacks on me, though she was not aware of these attacks until I pointed them out. On this occasion I conceptualised the clinical situation fi rst and then formulated it gradually to the patient; I had followed the expected interpretive order, and I believed too that her ensuing response validated my formulation, which I still think it partly did. But I had not realised at the time that there were other or additional conceptualisations that might have led to more inclusive formulations. Nor had I fully realised how important was her diffi culty in tolerating opposites. On the matter of ‘publication’ to other analysts, I imagine that the material from Break A about the mahogany loo-seat and the feet on the couch cover will be familiar, though other analysts might not have formulated interpretations to the patient in the way I did, and, as I have said, on refl ection I saw elements that I was not aware of at the time. The material of Break B was not so immediately obvious to me as the material of Break A. My patient, however, gave a detailed description of becoming aware of something very frightening happening inside herself in which she lost touch with me as a good fi gure and felt destroyed from inside. The way I formulated it was that when I was going to leave her, she felt that I was going to wipe her out of my mind. She tried to protect herself by doing the same thing to me, and she did it by making herself unaware of the meaningfulness of my leaving. She wiped me out; but then she got a wiped out/wiping out me inside her. I described it as a no-me, a minus-me, that ‘un-made’ her from within. On this occasion conceptualisation and formulation came about almost simultaneously. Most of her responses in this session were positive validations, though not so fi rmly stated as in the sessions of Break A. Some took the form of thoughtful silences, others as urgings to go further; one was an attempt at distraction, which was a bit of enactment of the wiping-out process that I was trying to describe. It was in fact my feeling in response to this enactment that helped me to reach the formulation I have described. I think it likely that the material of this session will be less familiar and less convincing to other analysts than the earlier sessions of Break A about the mahogany loo-seat and the feet on the couch, for, though I was hardly aware of it in the session, the way I conceptualised and interpreted the material of Break B to my patient was very dependent on my use of Klein’s and Bion’s theory of internal Downloaded by [New York University] at 03:54 14 August 2016 objects, which is not universally known or shared by other analysts (see Klein 1935, 1940, 1946, 1952a, but especially 1952b; Bion 1962a, especially pp. 111–13, and 1962b, especially p. 34 and also pp. 83–5). After Break C, by a somewhat unorthodox route, and at fi rst groping about without knowing what I was doing, I arrived at an interpretation of her acute feeling of chaos, confusion, and contradictory actions after breaks. She thought not only that I wiped her out at breaks, but also that I was denying that there was any loss in the break. She believed I was deceiving myself and her into believing that no-sessions were the same as sessions, just as she thought her mother might have maintained to herself in the past that bottle (no-breast) was as good as or even the same as breast. She found the idea of this false equation illuminating and went on to develop many ramifi cations of it in her own way. Later, among other refl ections, On formulating clinical fact to a patient 99 she went back to the ideas of the ‘good me’ and the ‘minus-me’ of Break B, saying that real understanding required acceptance of the presence of both. In using her ‘fi rst-week story’ after Break C I did not mean to convey to my patient, to myself, or to other analysts that I was attributing causal signifi cance to my reconstructive conjectures. They were a means to an end, an imaginary construction that I found myself following, although I did not fully realise it at the time, in order to understand what my patient unconsciously felt about me in the here-and-now of the analytic situation. Once I had made the imaginary reconstruction, I could fl esh out the transference details. I do not believe, however, that my thinking of the fi rst-week story at this time was fortuitous. I suspect that I was having an unconscious analytic intuition that told me that at that moment the fi rst- week story was living again in my patient’s experience, and that something in it was very disturbing to her. I do not know whether her mother actually or persistently deceived herself and her child in the way I have described. It would not be inconsistent with Mrs Lewis’ descriptions of her mother, though she did not particularly stress self-deception and denial in her characterisations of her mother, and she certainly did not seize on this part of my exploration to dwell on her mother’s behaviour. What was clear, though it took me a long time to see the pervasiveness of it, was that Mrs Lewis easily deceived and confused herself and that she had a very particular diffi culty in tolerating the contrariness of opposites. She had an unconscious belief that I was a hypocrite, which radically contradicted her conscious belief that I was honest and straightforward. Almost any pair of opposites touched on this basic incompatibility in some form or other. One or other of the opposites had to be denied or she was overcome by panic and confusion. Exactly what her mother’s behaviour and feelings had been I do not of course know, but Mrs Lewis’ internal mother was unconsciously hypocritical, and much of Mrs Lewis’ defensive system was built around this theme. After subsequent breaks she seemed to be less preoccupied by it. She had not forgotten it, but it had somewhat faded. There is an apparent contrast between the sessions of Break A, when Mrs Lewis was relieved because I had two opposing attitudes – slight anger on the one hand, but acceptance on the other – and her panic and confusion in Break C. I think the difference is that in the session of Break A, the opposites were conscious and verbalised. In the sessions of Break C, her suppositions about my opposing attitudes were unconscious, and a very important aspect of her supposition was that I too did not know about my denial. Part of my diffi culty in understanding her panic and confusion was that her unconscious assumptions about my feelings over leaving her were so different not only from her conscious beliefs, but also from my own. Using the language I had adopted earlier in the session just before Break B, Downloaded by [New York University] at 03:54 14 August 2016 one could say that she had introjected a bad analyst, who ‘un-made’ her from within, and the particular mode of the un-making was that she was seized by incompatible beliefs and impelled to act them out. My making conscious her belief that I unconsciously deceived myself and her was, she said, a revelation. But a more convincing form of validation was her proceeding to use this idea further in understanding other situations in which she was involved. Most of the conceptualisations and interpretations that I have described in this chapter were limited to the immediate session. When it came to the sessions after Break C, however, it seemed to me that I and my patient had arrived at a more inclusive set of conceptualisations than the ones that developed over Breaks A and B. The central idea after Break C came suddenly; it was comparable to Bion’s ‘sudden precipitating intuition’, the ‘selected fact’ (Bion 1967, p. 127, and 1962b, pp. 72–3 100 On formulating clinical fact to a patient and pp. 86–7). But it led to what I have come to call a ‘working model’, a set of interlocking conceptualisations that integrates and helps to understand a considerable number of clinical facts. As with all conceptualisations and working models, however, I have had to remind myself that it is not a good idea to hold on to inte- grative conceptions too fi rmly, for then one may be blind to new clinical facts, and, equally, one may become unwilling to see new conceptualisations because they do not fi t the working model. My patient, too, was quick to point out when I was making what she called ‘heady remarks’ about opposites and incompatibilities. Normally, as I have described at the beginning of this chapter, the process of formulating interpretations goes from observing clinical facts to conceptualisation to interpretation to validation or non-validation by the production of more clinical facts. But sometimes, as in the sessions I have described after Break C, the process does not follow this order. I had assembled a number of clinical facts from the immediate situation and from awareness of my patient’s general pattern of behaviour and feeling after breaks, but I did not get them to form any sort of gestalt until I began to muse out loud about her fi rst-week story. Formulation preceded conceptualisation. Only after my imaginary reconstruction could I get back to the here-and-now of the session, and only then could I fi nd a language that she found fully meaningful. Finally, from this exercise in examining how I arrived at formulations I conclude that there can be more than one way in which the analyst may reach understanding and arrive at meaningful formulations to the patient. Similarly, there are factors in the analytic setting, in the state of the analysis, and in the patient’s own character that infl uence how insight is achieved.

References BION, W. R. (1962a). A theory of thinking. In Second Thoughts. London: Heinemann (1967), pp. 110–19. BION, W. R. (1962b). Learning from Experience. London: Heinemann. BION, W. R. (1967). Second Thoughts. London: Heinemann. FREUD, S. (1925). Negation, S.E. Vol. 19, London: Hogarth Press, pp. 233–36. KLEIN, M. (1935). A contribution to the psychogenesis of manic-depressive states. In The Writings of Melanie Klein, Vol. 1, Love, Guilt and Reparation and Other Works. London: Hogarth Press (1975), pp. 262–89. KLEIN, M. (1940). Mourning and its relation to manic-depressive states. In The Writings of

Downloaded by [New York University] at 03:54 14 August 2016 Melanie Klein, Vol. 1, Love, Guilt and Reparation and Other Works. London: Hogarth Press (1975), pp. 344–69 KLEIN, M. (1946). Notes on some schizoid mechanisms. In The Writings of Melanie Klein, Vol. 3, Envy and Gratitude and Other Works. London: Hogarth Press (1975), pp. 1–24. KLEIN, M. (1952a). Some theoretical conclusions regarding the emotional life of the infant. In The Writings of Melanie Klein, Vol. 3, Envy and Gratitude and Other Works. London: Hogarth Press (1975), pp. 61–93. KLEIN, M. (1952b). On observing the behaviour of young infants. In The Writings of Melanie Klein, Vol. 3, Envy and Gratitude and Other Works. London: Hogarth Press (1975), pp. 94–121. CHAPTER 7

DEVELOPMENTS IN KLEINIAN TECHNIQUE

This paper was ﬁ rst published in Encounters with Melanie Klein: Selected Papers of Elizabeth Spillius, eds P. Roth and R. Rusbridger (2007), London: Routledge. The paper was included in a German version of Spillius’ papers, and a slightly different version was to be published in Greece.

In this paper I describe some of what I regard as the central themes in the development and current practice of Kleinian technique in England. It is important to remember that Melanie Klein’s work began with the analysis of children. Looking back now to her earliest work, she seems to have had a touch- ingly naïve faith in Freud’s method. When she began analysing children (in addition to her own child, ‘Fritz’) she tried to get them to lie down on the couch and to free- associate, and it was some time before she realised that this method was not really appropriate (Frank 2000). Eventually she went to get an armful of her own children’s toys for one of her younger patients to use and so embarked on the famous ‘play technique’ (Klein 1955). But in spite of the play technique Klein stuck as closely as possible to Freud’s method: sessions fi ve times a week, rigorous maintenance of the setting, emphasis on transference as the central focus of analyst–patient interaction, and emphasis on interpretation as the main agent of therapeutic change. There is something especially vivid about Klein’s way of working, a sense of immediacy and immense bodily concreteness about the children’s phantasies that she deduced. Looking back now, some of this early work seems striking but hardly surprising, though at the time it must have been quite shocking. For example, here is Klein’s description of Peter, aged three years and nine months, in his fi rst and second session.

At the very beginning of his fi rst session Peter took the toy carriages and cars and put them fi rst one behind the other and then side by side, and alternated this arrangement several times. In between he took two horse-drawn carriages and bumped one into another, so that the horses’ feet knocked together, and he said:

Downloaded by [New York University] at 03:54 14 August 2016 ‘I’ve got a new little brother called Fritz.’ I asked him what the carriages were doing. He answered: ‘That’s not nice,’ and stopped bumping them together at once, but started again quite soon. Then he knocked two toy horses together in the same way. Upon which I said: ‘Look here, the horses are two people bumping together.’ At fi rst he said: ‘No, that’s not nice,’ but then, ‘Yes, that’s two people bumping together,’ and added: ‘The horses have bumped together too, and now they’re going to sleep’’ Then he covered them up with bricks and said: ‘Now they’re quite dead; I’ve buried them.’ In his second session he at once arranged the cars and carts in the same two ways as before – in a long fi le and side by side; and at the same time he once again knocked two carriages together, and then two engines – just as in the fi rst session. He next put two swings side by side and, showing me the inner and longish part that hung down and swung, said: ‘Look 102 Developments in Kleinian technique how it dangles and bumps.’ I then proceeded to interpret. Pointing to the ‘dangling’ swings, the engines, the carriages and the horses, I said that in each case they were two people – Daddy and Mummy – bumping their ‘thingummies’ (his word for genitals) together. He objected, saying: ‘no, that isn’t nice’, but went on knocking the carts together, and said: ‘That’s how they bumped their thingummies together.’ Immediately afterwards he spoke about his little brother again. (Klein 1932: 17)

There is another feature that was typical of Klein’s early work and that has continued to be a leitmotif in Kleinian analysis: the negative transference (see especially Klein 1955 and Frank 2000). Where Anna Freud and her Viennese colleagues at fi rst thought the analyst should cultivate the positive transference with children (A. Freud 1927), Klein thought the analyst would get the analytic situation more effectively established by interpreting the child’s negative as well as positive feelings both about the analyst and the analytic situation and, more generally, about what was going on in his inner world. Klein did not do this in order to convince the child – and later the adult – of his own badness, but because she thought negative feelings were the greatest source of anxiety and needed to be fully known in order to be lived with, possibly modifi ed, or used as constructively as possible by both child and analyst. Klein thought that unconscious phantasy was always based on bodily functions and she phrased her interpretations to children in vivid bodily language. This indeed was one of the criticisms levelled at her during the Controversial Discussions of the British Society (King and Steiner 1991), namely, that she was assuming that infants and small children were having phantasies and thoughts of which they would not have been capable. Anna Freud is especially pungent about the absurdity of so-called ‘deep’ interpretations. ‘It has always puzzled me,’ she says, ‘how it was possible in Kleinian technique to interpret deeply repressed cannibalistic phantasies in the beginning of analysis without meeting absolute disbelief in the patient or without strengthening his resistance’ (King and Steiner 1991: 425). But in spite of criticisms, Klein always retained her emphasis on unconscious phantasy and the usefulness of interpreting it, although in her work with adults, as described for example in Envy and Gratitude, she phrased interpretations in a language less specifi cally ‘bodily’, though never losing its directness. This change in linguistic phrasing continued among her followers after her death. Where Klein would have talked about ‘breast’ and ‘penis’, we are now more likely to talk about functions: taking in, swallowing, listening, thinking, evacuating. It all sounds more reasonable, less shocking. But there is a danger in this approach too, a danger that Klein’s concepts of unconscious phantasy and the inner world will become so much watered down that some of the clinical richness and imaginativeness of her approach may be lost. Downloaded by [New York University] at 03:54 14 August 2016 In addition to changes of the content of interpretations, there are three respects in which Klein and her various colleagues have developed and changed Freud’s technical approach. First there is Strachey’s idea of the mutative interpretation (Strachey 1934). Second is Klein’s idea of transference as a ‘total situation’ (Klein 1952). Third is the idea of the role of projective identifi cation and countertransference in the analytic relationship, leading to what I will describe as ‘transference/ countertransference as enactment’.

Strachey and the ‘mutative interpretation’ As is well known, it was Strachey’s idea that the patient projects his archaic superego on to the analyst and that the analyst, by behaving differently from the Developments in Kleinian technique 103 patient’s expectation, might be able to show the patient, in a series of small steps, that he was not acting like the patient’s archaic superego, and the patient might be able to take in these new aspects of what Strachey calls the ‘auxiliary superego’ (Strachey 1934). The point that Strachey makes, and certainly the point that Klein emphasises, is that it is transference interpretations that are most likely to be mutative. But what exactly did Klein mean by ‘transference interpretation’?

Klein’s idea of transference as the ‘total situation’ Freud defi nes transference as the revival and expression in the analysis of experiences with early primary objects. He describes this revival as being felt ‘not as belonging to the past but as applying to the person of the physician at the present moment’ (Freud 1905: 116). Klein extends this idea, saying that what is transferred into the analytic relationship is not so much the actual relationship that existed with a particular person in the past, but rather the place of that person in the patient’s inner world, which is an amalgam of actual experience and unconscious phantasy, constantly processed by projection, perception, re-introjection and re-projection, so that the mother of the inner world, for example, may be rather different from the actual mother of the past. This is the way Klein puts it in her paper, ‘The origins of transference’:

I hold that transference originates in the same processes which in the earliest stages determine object-relations. Therefore we have to go back again and again in analysis to the fl uctuations between objects, loved and hated, external and internal, which dominate early infancy. (Klein 1952: 53)

It is my experience that in unravelling the details of the transference it is essential to think in terms of total situations transferred from the past into the present, as well as of emotions, defences, and object-relations. For many years – and this is up to a point still true today – transference was understood in terms of direct references to the analyst in the patient’s material. My conception of transference as rooted in the earliest stages of development and in deep layers of the unconscious is much wider and entails a technique by which from the whole material presented the unconscious elements of the transference are deduced. For instance, reports of patients about their everyday life, relations, and activities not only give an insight into the functioning of the ego, but also reveal – if we explore their unconscious content – the defences against the anxieties stirred up in the transference situation. For the patient is Downloaded by [New York University] at 03:54 14 August 2016 bound to deal with confl icts and anxieties re-experienced towards the analyst by the same methods he used in the past. (Klein 1952: 55)

Klein also began to think that transference was even more central than Freud had thought, although it is also clear that in her own clinical work she made many extra-transference interpretations. She makes clear, especially in unpublished lectures in the Klein archive, that she does not think any transference interpretation is complete if it only refers to the ‘here-and-now’ of the session; she thinks the analyst should link the present up to the phantasies and if possible to the realities of the remembered past (Melanie Klein Archive, C59). This approach led her to a less explanatory sort of analysis and to richer and more varied clinical work. So, 104 Developments in Kleinian technique where Freud had at fi rst made didactic explanations to his patients and then began to stress the role of transference and to use it as evidence for his deductions and reconstructions, Klein carried this trend further, focussing even more than Freud on the analyst/patient relationship, which left the way open for many modern analysts to take this trend even further.

The role of projective identiﬁ cation and countertransference in the analytic relationship1 Klein developed the idea of projective identifi cation in 1946 in the course of describing the paranoid-schizoid position (Klein 1946), a way of thinking and feeling she thought was characteristic of early infancy but which she also thought might be continued by many individuals into childhood and adulthood. In the paranoid-schizoid position good and bad experiences are omnipotently kept split apart as much as possible, the good being idealised and the bad demonised. In phantasy good and bad feelings are projected into external objects so that they too are seen as split. The individual thus lives in a world in which he and some of his objects are felt to be very good, sometimes unrealistically good, whereas others are felt to be very bad, and whole objects, that is, objects recognised to be both good and bad, are not yet perceived as such. Klein thinks that in this constellation of anxieties and typical object relationships, omnipotent projection, introjection, splitting, idealisation and denial are the major processes and defences. She describes projective identifi cation as a process in which the individual splits off aspects of himself, projects them in phantasy into an external object, and then reacts to the object as if it were the self or the part of the self that has been projected into it. This can happen with both good and bad aspects of the self, though except in the case of a few recent exceptions (Sodre 2004; Roth 2001) it has been the bad aspects that have mainly been talked about in the literature. Klein’s colleagues and students gradually began to use her idea of projective identifi cation and found that it greatly enriched their understanding of object relations in general and of the analytic relationship in particular. So much is this the case that projective identifi cation has become perhaps Klein’s most popular concept, having been adopted or at least written about by many other schools of thought. It is important to stress that Klein thought of projective identifi cation as the patient’s phantasy. In cases of projection by a patient into the analyst, Klein thought that the analyst should not be emotionally affected by the projection. If the analyst were affected, Klein thought it was because the analyst was not working properly. But Bion, in particular, began to show how a patient’s projection might affect the analyst emotionally and how, if the analyst understood what was Downloaded by [New York University] at 03:54 14 August 2016 happening correctly, he could use his own emotional responses as a source of information about the patient. In ‘Language and the schizophrenic’ (Bion 1955), for example, Bion gives a striking illustration of a session with a psychotic patient in which, although the patient at fi rst seemed calm, Bion felt a growing fear that the patient would attack him. Bion interpreted that the patient was pushing into Bion’s insides the patient’s fear that he would attack Bion. The tension in the room then lessened, but the patient clenched his fi sts. Bion then interpreted that the patient had taken his fear of murdering Bion back into himself, and was now afraid that he might actually make a murderous attack on Bion. In my opinion this new conception is the main difference between Klein’s theory and technique and that of contemporary Kleinians. Such use by the analyst of his own emotional responses makes for vivid analysis but is of course susceptible to Developments in Kleinian technique 105 error and misuse. The dangers are that the analyst will be overwhelmed by the patient’s projection and will become unable to think, that he will refuse to take in the projected emotion, or that he will get caught up in some form of acting out with the patient such as mutual idealisation or a sado-masochistic encounter. The basic diffi culty for the analyst, as Money-Kyrle describes it, ‘is in differentiating the patient’s contribution from his own’ (Money-Kyrle 1956). Klein herself thought that too much departure from the idea of projective identifi cation as the patient’s phantasy would lead the analyst to blame patients for the analyst’s defi ciencies and mistakes (Segal, personal communication). For the same reason Klein also did not like Paula Heimann’s idea of widening the notion of countertransference to include all the analyst’s emotional responses to the patient and using them as a source of information about the patient (Heimann 1950). And, indeed, although I think the use of the ideas of projective identifi cation and countertransference have greatly enriched our understanding of the analytic relationship, we also need to be aware of the dangers of getting preoccupied with monitoring our own feelings to the detriment of direct contact with the patient’s material. But projective identifi cation and countertransference have won the day. Taken together, they have greatly infl uenced our view of the analyst–patient relationship and have led us to look increasingly to understand the actions of the patient, his unconscious pressures – sometimes gross, sometimes very subtle – to get the analyst to feel certain feelings, think certain thoughts, act in certain ways. All this has become as important, sometimes more important, than the actual verbal content of sessions. This emphasis has been particularly central in the work of Betty Joseph (1989), who describes in a series of technical papers how patients constantly ‘nudge’ their analyst to behave in accordance with the patient’s unconscious phantasies and expectations. This is Joseph’s way of describing what Joseph Sandler calls ‘actualisation’ (Sandler 1976a and 1976b). At fi rst Joseph spoke of this process as the patient ‘acting out’ in the session, then as his ‘acting-in’; more recently this process has been described as transference/countertransference ‘enactment’. Like Klein, Joseph speaks of the ‘total situation’, but makes a subtle change in emphasis. Where Klein thought of the total situation as all the complex experiences and phantasies of the past that are likely to be transferred into the present, Joseph focusses more on the totality of their expression in the current analyst–patient relationship, saying, for example:

What he [the patient] brings in can best be gauged by our focusing our attention on what is going on within the relationship, how he is using the analyst, alongside and beyond what he is saying. Much of our understanding of the transference comes through our understanding of how our patients act on us Downloaded by [New York University] at 03:54 14 August 2016 to feel things for many varied reasons; how they try to draw us into their defensive systems; how they unconsciously act out with us in the transference, trying to get us to act out with them; how they convey aspects of their inner world built up from infancy – elaborated in childhood and adulthood, experiences often beyond the use of words, which we can often only capture through the feelings aroused in us, through our countertransference, used in the broad sense of the word. (Joseph 1985: 157)

Joseph tends to focus on the immediate analyst–patient relationship fi rst before linking it with the patient’s view of his past (Joseph 1985), but this is a topic on which there is considerable variation from analyst to analyst (Spillius 1988, vol. 2: 15–16). 106 Developments in Kleinian technique In spite of the increasing emphasis on understanding the analyst–patient relationship, it is important to stress that such understanding is viewed as a means to another end, the end being that of the patient coming to understand himself better. Understanding the analyst–patient relationship is not regarded as an end in itself.

Stereotypes, variation, my own view Kleinian technique is sometimes seen as rigid, with too much stress on transference interpretation, too little appreciation of the therapeutic effect of extra-transference interpretation, too much focus on what Rickman (1951) described as the ‘here- and-now’ of the session, and too much emphasis on destructiveness and too little on the ‘environment’ (see especially Blum 1983; Couch 1995; Gill 1982; Greenson 1974; Stewart 1992; Winnicott 1956). Of course being a Kleinian analyst I do not agree with the general sort of stereotyping that this characterisation suggests, though individual instances must occur of one sort or another. My own view is that more attention tends to be paid nowadays by both Kleinians and many other analytic schools (see Cooper 1987) to transference as enactment than was the case twenty or thirty years ago, but there is much variation in the way Kleinian analysts have combined the three ideas of the mutative interpretation, transference as a total situation, and transference/countertransference as enactment. There is variation both from analyst to analyst and from work with one patient to work with another (Britton 1998). Klein herself made many extra-transference interpretations, as her work with Richard shows (Klein 1960) and she had a remarkable clinical gift for sensing and describing unconscious phantasies. As I have said, she was more cautious than many of her colleagues about making full clinical use of the concepts of projective identifi - cation and countertransference. Bion, as I have described, led the way in developing the idea of enactment and use of countertransference in understanding the analytic relationship and hence the patient. Betty Joseph continued and developed his approach; she focussed primarily on the immediate analyst–patient situation (Joseph 1985, 1989). Segal’s way of working was perhaps closest to Klein’s though she used the idea of transference as enactment more than Klein did (Segal 1989). Rosenfeld did not focus as strictly on the analyst–patient relationship as many of his colleagues; he believed that the important thing was to take up whatever was urgent in the material, wherever it was located (see especially Rosenfeld 1987). He thought that insistent transference interpretations were unwise with traumatised patients and that one should pay close attention to the patient’s perceptions of the analyst, especially of the analyst’s failings (Rosenfeld 1986 and 1987). He was critical of what he called the ‘Me Too’ school of interpretation in which every- Downloaded by [New York University] at 03:54 14 August 2016 thing the patient says is translated into a statement about the analyst. Thus there is considerable variation among Kleinian analysts and it has continued in the younger generation. (See especially Brenman Pick 1985; Britton 1989; Feldman 1997; Riesenberg-Malcolm 1994; O’Shaughnessy 1992; Roth 2001; Sodre 2004; Steiner 1984 and 1993, Chapter 11.) In my own work I fi nd that thoughts about both the patient’s immediate and longstanding relationship with me are always in my mind, though not always in the foreground of it. This attitude is similar to the French distinction between analysis in the transference and analysis of the transference (Laplanche 1999: 216). I think too that whatever one’s view of transference may be – and I think it important to know that whether one likes it or not one is bound to have a theoretical view – it should be suffi ciently formulated and accepted by oneself to be Developments in Kleinian technique 107 allowed to be in the back of one’s mind. If the analyst becomes too preoccupied with it either consciously or unconsciously he is likely to foist it on his patient. Freud (1912b), Bion (1967) and Sandler (1976b) all warn against having too set an idea of what one should see. I would re-phrase this somewhat: I think it is when one is preoccupied or troubled about what one should see that one’s receptiveness is most likely to be disturbed. Further, psychoanalytic work involves both uncer- tainty and clinical responsibility, a diffi cult combination which can foster both anxiety to conform and determination to be original, neither of which is a good basis for impartial curiosity. I fi nd it important when working to have a free- fl oating expectancy about the complexities of the patient’s inner world and the way he may use the opportunities presented by the session to express them. I frequently fi nd myself musing about the patient’s remembered history even when I am interpreting something in the immediate relationship; and conversely I often fi nd that I am keeping in mind the current atmosphere and relationship in the session when I am verbally addressing something in the past. It is my belief that the analyst should work from a double perspective. His readiness to focus on the interaction of transference and countertransference involves a form of what anthropologists, who I believe invented the term, call ‘participant observation’, that is, an emotional involvement and interaction with the patient which is, however, combined with study of that involvement from an outside perspective. One hopes, as James McLaughlin felicitously put it, to achieve binocular vision, not double vision (McLaughlin 1993).

My own way of working and some of its variations To illustrate, I will describe sessions with two patients.

Linda, aged three years and six months This session took place when Kleinian analysts were beginning to shift away from interpretations involving anatomical part-object language and more towards focus on mental functions and the immediate transference/countertransference situation. I was very much aware of Linda’s current situation outside the analysis, and it was my sudden realisation that she seemed to be living this out in the session that led to the particular interpretation of the primal scene that I made. After saying some words normally when she was about a year and a half, Linda had stopped speaking. At that time her parents were still living in a one-room fl at while waiting to be re-housed. Another child was born when Linda was two and a quarter years old and since that time she had refused to say a word. She was also Downloaded by [New York University] at 03:54 14 August 2016 said by her mother to be stubborn and disobedient. When I fi rst met her I saw a small, sturdy, determined little girl who seemed to be silently saying, ‘I’m not having any nonsense from you!’ She was courageous as well as defi ant; she came with me to the consulting room on the very fi rst day without asking her mother to come with her even though she looked quite frightened. As the sessions went on she soon began playing with the toys I had provided and much of her play involved making things. When I said I thought she was making a baby the way her mother and father had, she looked at me rather contemptuously as if to say, ‘Why would you need to say something so obvious?’ It was clear that her understanding was intact in spite of her not talking. The incident I will discuss occurred after the fi rst long break in Linda’s analysis. Linda came along readily to the playroom and the minute I had shut the door she 108 Developments in Kleinian technique grabbed hold of the bottom edges of my coverall and gave a sharp jerk, which sent several buttons fl ying around the room. She looked intently at my abdomen. After a pause for thought, I said she thought that when I’d left her for such a long time I had been with my husband making a baby, and she was looking to fi nd it. She turned away and with great vigour got out several plastic cups and fi lled them with water. Then she put some bits of paper and Plasticine in one, put another on top of it to make a lid, and gave it good shake. I said she was trying to show me that she could make a baby too, and furthermore she could do it all by herself. She gave me a withering look, but she took the top cup off and peered inside. Then she threw the whole thing on the fl oor in my direction. I said she was furious – it was only water and paper and Plasticine. It was just pooh and pee, no baby. While I was saying this she quickly pushed a little table beside a bookcase, climbed on top of the table and then on top of the bookcase where she marched up and down. I said she wanted me to think she didn’t care if she couldn’t make a baby. She was getting very excited and wanted to show me that she was bigger and more important than I was even if she couldn’t make a baby. She hummed the tune of ‘I’m the king of the castle and you’re the dirty rascal’. Unwisely I turned my head away for a moment and in that moment she leaped on my back and the two of us crashed noisily down together on to the fl oor. After I had made sure that neither of us was hurt, I said she was being the daddy and leaping on my back the way she thought her Daddy did to her Mummy when they were together in bed and made babies – and I added that she wanted to bash up both me and the baby she thought I might have been making. She looked a bit sobered. Then she nodded. Shortly afterwards she began to speak, fi rst at home and then in her sessions. But her talking to me was not quite open or clear. That would have given me too much credit. Instead she sang all the verses of ‘Ten green bottles hanging on the wall’, with a specially penetrating look at me when she got to the bit about ‘if one green bottle should accidentally fall…’, and on she went happily till all the bottles had fallen. We had a tacit agreement, which I eventually tried to put into words, that although I had helped to make things better, I was not to rub it in. And I thought too that Linda agreed with her parents that analysis was all very well but it was soon time to stop. When Linda acted out her idea of the primal scene I thought it was not a simple transference on to me of feelings about her mother or her father. It was that, but more too. It was an enactment of the aggressive, damaging sort of intercourse she felt that her parents were having and that she wanted me to have; she was attacking both me as mother but also the baby inside me. I do not of course

Downloaded by [New York University] at 03:54 14 August 2016 know whether her parents’ intercourse was as violent as Linda thought; whatever its nature, I assume that her perception of it was infl uenced by her own impulses. Although I did not interpret it fully at the time, I think Linda was expressing something else in addition to her sadistic view of intercourse. She had given me quite a shock, and I think that in so doing she was giving me a graphic demon- stration of how violent and persecuting she felt her parents’ intercourse was and how frightened and resentful she felt at constantly having to witness it – she was always provoked, always excluded, but never excluded enough to feel even partially free of it. I suppose one could say that her elective mutism was her way of saying that she felt that what she was going through was unspeakable. She was trying to evoke in me her own feelings of shock and outrage – an example of the communicative potential of projective identifi cation, of transference viewed as enactment. Developments in Kleinian technique 109 Finally, an example from an adult, MRS X In this session we both became absorbed in analysing a particularly expressive dream, perhaps too much absorbed, I thought later, so that I missed some of the importance of the dream as an enactment in the session. It was the penultimate session of Mrs X’s long analysis and, although I do not want to give all the details of the session, it touched on many issues of her infancy, the diffi cult years of her adolescence and adulthood and of her current situation, including the analysis itself and its end. In the course of the session Mrs X reported a dream. She was in New Zealand. She was travelling through the interior. She knew that she was a foreigner there and she was allowed to travel through the country but wasn’t allowed to settle there. As she drove along she wondered what would happen if the car broke down. She was in a wood and there were people there who seemed to be blue. They looked almost as if they were the trunks of trees but they were actually people. They were the native people. She knew that there was some idea that she ought not to disturb them, that they were very primitive but they had their own lives and their own way of doing things, their strange customs, which shouldn’t be disturbed. Then she saw one of them lying down in the road and she thought to herself, ‘I must be careful. I mustn’t kill that one.’ That was the end of the dream. Although I did not say so directly to my patient, I found this dream very moving. In a compressed and visual form it conveyed her conception of the experience of analysis, including its imminent ending, but beyond that the dream seemed to link this situation with earlier, sensual, pre-verbal experiences, probably originating in infancy, perhaps concerned with observing and being observed. I thought that Mrs X did not literally remember these experiences, but unconsciously felt them to be alive in the present as feelings in her inner world – the kind of experience that Klein describes as ‘memories in feeling’ (Klein 1957). I asked why she thought it was New Zealand and she said she’d no idea. I said I thought ‘New Zealand’ meant ‘new-seeing-land’, and she laughed. (She had occasionally described analysis as a new way of seeing things.) ‘It was a strange dream,’ she went on to say, ‘and I think it’s about the world inside my mind, inside mine and perhaps yours too, the strange world I have been in here. Just the way it actually is, I’m allowed to visit but I can’t stay permanently.’ I agreed and went on to say that this strange land with its primitive people was an attempt to describe her feeling not only about her analysis and about me, but about the way, as she’d said, she felt about the ‘interior’, the inside of my mind. These were the thoughts and people inside me that gave me my particular character and individuality and that made it possible for me to give her something that was Downloaded by [New York University] at 03:54 14 August 2016 different from what she could give herself. It was as if I had a sort of intercourse with these strange beings, an intercourse whose outcome was valuable to her, but which at the same time made her feel angry, even murderous. (I was thinking at this moment in the session, perhaps too explicitly, about the strange wood as an internal version of the primal scene with herself as observer which Britton [1989] describes as ‘triangular space’.) ‘You mean because there was that one I had to be careful not to kill. I suppose what you’re saying is that I wouldn’t have had to think about not killing him if I hadn’t wanted to. It’s jealousy again.’ ‘And yet you make it clear’, I said, ‘how much you’ve valued being in that strange world even if it does make you so jealous. And you’ve said too that it’s a picture of the inside of your own mind as well as mine.’ 110 Developments in Kleinian technique She reminded me that she had very mixed feelings about the objects in my room. (These are various bits and pieces from my anthropological past.) I said her description of this primitive land where people had their own dignity and their own customs had some connection with her knowledge that I was an anthropologist and that she knew I had lived and worked in so-called ‘primitive’ societies. I thought the atmosphere of the dream conveyed much of what she felt about her analysis: she felt not only that she was visiting my room and my mind, but also that I was a temporary visitor/anthropologist to her mind, observing the world of her past and her present as it lived inside her now. The blue of the bodies, it emerged, came from the feeling of the consulting room with its blue rug. And perhaps the people were like trees because of the Tree of Life pattern of the blue rug. She said she thought the unconscious mind was extraordinary. As the session drew to a close she talked of leaving, loss and fear of a possible breakdown – a reference to her diffi cult past and perhaps future, and to the detail in the dream about what would happen if her car broke down. She also expressed gratitude for my having given her ‘gifts’, especially the gift of greater tolerance of her mother’s unhappiness and its effect on herself. And she expressed a wish that there would be some sort of gift she could give me. Perhaps the gift was the dream itself, I said, and I went on to describe the complex atmosphere of the session: the pervasive feeling of sadness and hope; the wish and fear that I would be unrealistically encouraging; her pride and misgiving about having to manage all this on her own. Later I thought about another less idealising aspect of the dream which would have added depth to the understanding of it. The predominant theme in the content of the dream was that she was visiting me and my world rather than my visiting hers. Perhaps this expressed a feeling that she was now the anthropologist/analyst – a way of coping with the ending by taking over my role and my identity. But the session was also suffused with feelings of loss about ending which were having a powerful effect on both of us. If I were doing it again I would stress even more the presence of both feelings, the loss but also the taking over of my role, and I would recognise more explicitly the pressure we both felt to idealise the work and for mutual harmony in the face of the defi ciencies in the analysis and the inevitable uncertainties about ending. This would have given a more complete view of the total situation.

In conclusion I have tried to convey something of the Kleinian approach to technique, namely, the combination of the ideas of the mutative interpretation, transference as a total situation, and interpretation of the effect of projective identifi cation and countertrans-

Downloaded by [New York University] at 03:54 14 August 2016 ference on the analyst–patient relationship. Inevitably every analyst uses these ideas in his own way, according to his own character and experience, and according to differences in his patients. I have tried to describe my way, including two of its variations.

Note 1 The role of projective identifi cation and countertransference is further discussed in Chapter 3, ‘Clinical experiences of projective identifi cation’.

References BION, W.R. (1955) ‘Language and the schizophrenic’, in M. Klein, P. Heimann and R. Money- Kyrle (eds) New Directions in Psycho-Analysis, London: Tavistock Publications: 220–239. Developments in Kleinian technique 111

BION, W.R. (1967) ‘Notes on memory and desire’, The Psychoanalytic Forum, 2: 272–273; 279–280. Also in SPILLIUS, E. BOTT (ed.) Melanie Klein Today, vol. 2, Mainly Practice, London: Routledge: 17–21. BLUM, H.P. (1983) ‘The position and value of extratransference interpretation’, Journal of the American Psychoanalytical Association, 34: 309–328. BRENMAN PICK, I. (1985) ‘Working through in the counter-transference’, International Journal of Psycho-Analysis, 66: 157–166. A slightly revised version is also published in SPILLIUS, E. BOTT (ed.) Melanie Klein Today, vol. 2, Mainly Practice, London: Routledge: 34–47. BRITTON. R. (1989) ‘The missing link: parental sexuality in the Oedipus complex’, in The Oedipus Complex Today, ed. John Steiner, London: Karnac: 83–101. BRITTON, R. (1998) Contribution to panel discussion, ‘The Controversial Discussions Fifty Years Later’, Fall Meeting of the American Psychoanalytical Association, New York. COOPER, A. (1987) ‘Changes in psychoanalytic ideas: Transference interpretation’, Journal of the American Psychoanalytic Association, 53: 77–98. COUCH, A. (1995) ‘Anna Freud’s psychoanalytic technique: A defence of classical analysis’, International Journal of Psycho-Analysis, 76: 153–171. FELDMAN, M. (1997) ‘Projective identifi cation: The analyst’s involvement’, International Journal of Psycho-Analysis, 78: 227–241. FRANK, C. (2000) Melanie Kleins erste Kinderanalysen: Die Entdeckung des Kindes als Objekt sui generis von Heilen und Forschen. Stuttgart: Frommann-Holzboog. FREUD, A. (1927) ‘Four lectures on child analysis’, The Writings of Anna Freud, 1: 3–69. New York: International Universities Press (1974). FREUD, S. (1905) Fragment of an Analysis of a Case of Hysteria. Standard Edition, 7: 3–122. FREUD, S. (1912b) ‘Recommendations to physicians practising psychoanalysis’, Standard Edition, 12: 109–120. GILL, M. (1982) Analysis of Transference: vol. 1, Theory and Technique. Psychological Issues, Monograph 53. New York: International Universities Press. GREENSON, R. (1974) ‘Transference: Freud or Klein’, International Journal of Psycho- Analysis, 55: 37–48. HEIMANN, P. (1950) ‘On countertransference’, International Journal of Psychoanalysis, 31: 81–84. JOSEPH, B. (1985) ‘Transference: The total situation’, International Journal of Psycho- Analysis, 66: 447–454. Also in JOSEPH, B. (1989) Psychic Equilibrium and Psychic Change, London: Routledge: 75–87, and in SPILLIUS, E. BOTT (ed.) (1988) Melanie Klein Today, vol. 2, Mainly Practice, London: Routledge: 48–60. JOSEPH, B. (1989) Psychic Equilibrium and Psychic Change, London: Routledge. KING, P. AND STEINER, R. (eds) (1991) The Freud-Klein Controversies, 1941–1945, London: Routledge. KLEIN, M. (1932) The Psycho-Analysis of Children, vol. 2 of The Writings of Melanie Klein, London: Hogarth Press and the Institute of Psycho-Analysis (1975). KLEIN, M. (1946) ‘Notes on some schizoid mechanisms’, Envy and Gratitude and Other Works, vol. 3 of The Writings of Melanie Klein, London: Hogarth Press and the Institute

Downloaded by [New York University] at 03:54 14 August 2016 of Psycho-Analysis: 1–24. KLEIN, M. (1952) ‘The origins of transference’, Envy and Gratitude and Other Works, vol. 3 of The Writings of Melanie Klein, London: Hogarth Press and the Institute of Psycho- Analysis (1975): 45–56. KLEIN, M. (1955) ‘The psycho-analytic play technique: Its history and signifi cance’, Envy and Gratitude and Other Works, vol. 3 of The Writings of Melanie Klein, London: Hogarth Press and the Institute of Psycho-Analysis (1975): 122–140. KLEIN, M. (1957) Envy and Gratitude and Other Works, vol. 3 of The Writings of Melanie Klein, London: Hogarth Press and the Institute of Psycho-Analysis. KLEIN, M. (1960) The Narrative of a Child Analysis, vol. 4 of The Writings of Melanie Klein, London: Hogarth Press and the Institute of Psycho-Analysis. LAPLANCHE, J. (1999) Essays on Otherness, London: Routledge. McLAUGHLIN, J.T. (1993) ‘Work with patients: The impetus for self analysis’, Psychoanalytic Inquiry, 13: 365–389. 112 Developments in Kleinian technique

MELANIE KLEIN ARCHIVE. Wellcome Institute for the History of Medicine, London. Lecture on Child Analysis, C59. MONEY-KYRLE, R. (1956) ‘Normal counter-transference and some of its deviations’, The International Journal of Psycho-Analysis, 37: 360–366. Reprinted in The Collected Papers of Roger Money-Kyrle (1978), ed. Donald Meltzer with the assistance of Edna O’Shaughnessy, Strathtay, Perthshire: Clunie Press. O’SHAUGHNESSY, E. (1992) ‘Enclaves and excursions’, International Journal of Psycho- Analysis, 73: 603–611. RICKMAN, J. (1951) ‘Refl ections on the function and organization of a psycho-analytical society’, International Journal of Psycho-Analysis, 32: 218–237. RIESENBERG-MALCOLM, R. (1994) ‘Conceptualisation of clinical facts in the analytic process’, International Journal of Psycho-Analysis, 75: 1031–1040. ROSENFELD, H. (1986) ‘Transference-countertransference distortions and other problems in the analysis of traumatized patients’, unpublished talk given to the Kleinian analysts of the British Psycho-Analytical Society. ROSENFELD, H. (1987) Impasse and Interpretation, London: Routledge. ROTH, P. (2001) ‘The paranoid-schizoid position’, in C. Bronstein (ed.) Kleinian Theory: A Contemporary Perspective, London: Whurr Publishers: 32–46. SANDLER, J. (1976a) ‘Dreams, unconscious fantasies and identity of perception’, International Review of Psycho-Analysis, 3: 33–42. SANDLER, J. (1976b) ‘Countertransference and role responsiveness’, International Review of Psycho-Analysis, 3: 43–47. SEGAL, H. (1989) Interview with Hanna Segal. In HUNTER, V. (1994) Psychoanalysts Talk, New York: Guilford Press: 41–80. SODRE, I. (2004) ‘Who’s who? Pathological forms of identifi cation’, in E. Hargreaves and A. Varchevker (eds) In Pursuit of Psychic Change: The Betty Joseph Workshop, London: Routledge. SPILLIUS, E. BOTT ( Ed.) (1988) Melanie Klein Today, vol. 2, Mainly Practice, London: Routledge. STEINER, J. (1984) ‘Some refl ections on the analysis of transference: A Kleinian view’, Psychoanalytic Inquiry, 4: 443–463. STEINER, J. (1993) ‘Problems of psychoanalytic technique: patient-centred and analyst- centred interpretation’, Chapter 11 of Psychic Retreats, London: Routledge. Also in Psychoanalytic Inquiry (1994), 14: 406–422.

Downloaded by [New York University] at 03:54 14 August 2016 STEWART, H. (1992) Psychic Experience and Problems of Technique, London: Routledge. STRACHEY, J. (1934) ‘The nature of the therapeutic action of psychoanalysis’, International Journal of Psycho-Analysis, 15: 127–159. WINNICOTT, D.W. (1956) Letter of 3 February 1956 to Joan Riviere, in Rodman, F. R. (ed.) The Spontaneous Gesture: Selected Letters of D.W. Winnicott, Cambridge, MA: Harvard University Press. CHAPTER 8

FREUD AND KLEIN ON THE CONCEPT OF PHANTASY1

This paper was ﬁ rst published in International Journal of Psycho-Analysis (2001), 82: 361–373. It was also published in Encounters with Melanie Klein: Selected Papers of Elizabeth Spillius, eds P. Roth and R. Rusbridger (2007), London: Routledge.

One of Freud’s earliest discoveries was that in the unconscious, memories and phantasies are not distinguished – hence his abandonment of his earliest theory of neurosis, the ‘seduction’ or ‘affect trauma’ theory. From that time onwards phantasies have been of central interest. In this paper I discuss the ideas of Freud and Klein on this interesting and complex concept. Throughout the discussion of Freud’s and Klein’s ideas about phantasy I refer briefl y to the Controversial Discus- sions of the British Psychoanalytical Society in the 1940s, in which the concept of phantasy played a central role (King and Steiner, 1991). I then describe certain more recent but minor changes in the Kleinian use of the concept. The paper concludes with brief conjectures about the use of the concept in other current schools of psychoanalysis. Considering its importance, it is perhaps surprising that Freud did not devote even a paper to the concept of phantasy, let alone a book. His ideas on it are scattered about in the fi rst twenty years of his psychoanalytic writings. His most explicit theoretical statements about it are to be found in his paper ‘Formulations on the two principles of mental functioning’ in 1911 and in Lecture 23 of the Intro- ductory Lectures in Psycho-Analysis (1916). In her work with children Klein gradually developed a rather different view from that of Freud. Klein’s view was explicitly stated by Susan Isaacs in ‘The nature and function of phantasy’ (1952) and was the central theoretical issue of the Controversial Discussions in the British Psycho-Analytical Society in 1943 (King and Steiner, 1991). The various views on phantasy voiced at the Discussions are clearly described and discussed by Anne Hayman (1989). One of the diffi culties in expounding the differences between Freud’s and Klein’s

Downloaded by [New York University] at 03:54 14 August 2016 views on phantasy is that Freud uses the term rather differently in different places. In ‘Formulations on the two principles of mental functioning’, which is where he comes closest to making a formal defi nition, he speaks of phantasy as a wish- fulfi lling activity that can arise when an instinctual wish is frustrated. Phantasies derive ultimately from unconscious impulses, the basic instincts of sex and aggression. I shall call that Freud’s central usage. (It is well expounded by Sandler and Nagera, 1963.) In understanding Freud’s central usage it is important to remember that his idea of phantasy, like his work on dreams, is closely bound up with the development of his topographical model of the mind (Freud, 1900, Chapter 7, 1915a, b; Sandler et al., 1997). In the topographical model of the mind, conceptualised as the system unconscious, the system preconscious, and the system conscious, there is a double 114 Freud and Klein on the concept of phantasy focus, fi rst on the attributes of consciousness and unconsciousness, and second on primary and secondary process. The ‘secondary process’ Freud defi ned as the rational thinking of ordinary logic; the ‘primary process’ he thought of as a much more peculiar system of logic, characteristic of the system unconscious, in which opposites are equated, there is no sense of time, no negation, no confl ict. Although Freud thought that some unconscious phantasies might be ‘unconscious all along’, he thought that most phantasies originated as conscious or preconscious daydreams and might subsequently be repressed. As he puts it in ‘Hysterical phantasies and their relation to bisexuality’, the unconscious phantasies of hysterics ‘have either been unconscious all along and have been formed in the unconscious; or – as is more often the case – they were once conscious phantasies, day-dreams, and have since been purposely forgotten and have become unconscious through “repression”’ (Freud 1908, p. 160). In Freud’s view the basic motive force for phantasy formation is an unconscious wish that is blocked from fulfi lment, and the phantasy is a disguised expression and partial fulfi lment of this unconscious wish. If phantasies are formed in the system conscious or if they are allowed into it – that is, if they are daydreams – they are known not to be true. If they are formed in the system preconscious or if they are repressed into it, they will be descriptively unconscious but formed according to the everyday logic of the secondary process. If phantasies are further repressed into the system unconscious, they become subject to the peculiar logic of the primary process and from their position in the system unconscious they may become indistinguishable from memories and may also fi nd their way into dreams, symptoms, symptomatic acts, further preconscious and conscious phantasies, and other drive derivatives. Freud’s ‘central usage’, with its emphasis on phantasies being formed according to the logical thinking of the secondary process, is the usage that was adopted by Anna Freud and the other Viennese analysts during the Controversial Discussions, and by several British analysts, notably Marjorie Brierley and to some extent by Ella Freeman Sharpe and Sylvia Payne (King and Steiner, 1991). This is the usage that has been adopted by ego-psychologists (Beres, 1962; Arlow, 1969a, 1969b, 1995; Inderbitzin and Levy, 1990), by the Contemporary Freudian group of analysts in Britain (especially Sandler, 1986; Sandler and Sandler, 1986, 1994, 1995) and also by many Independent analysts. In Freud’s view, although there are phantasies in the system unconscious, the basic unit of the system unconscious is not phantasy but the unconscious instinctual wish. Dream-formation and phantasy-formation are parallel processes; one might speak of ‘phantasy work’ as comparable to the ‘dream work’; both involve transformation of primary unconscious content into a disguised form. For Klein, on the Downloaded by [New York University] at 03:54 14 August 2016 contrary, unconscious phantasies are the primary unconscious content, and dreams are a transformation of it. For Freud, the prime mover, so to speak, is the unconscious wish; dreams and phantasies are both disguised derivatives of it. For Klein the prime mover is unconscious phantasy. I think that Freud and Klein emphasised contrasting aspects of the everyday usage of the word phantasy. The word conveys contrasting implications both in English and I believe also in German. It has a connotation of the imagination and creativity that underlie all thought and feeling, but it also has a connotation of make-believe, a daydream, something that is untrue by the standards of material reality (see Rycroft, 1968, p. 118; Laplanche and Pontalis 1973; R. Steiner, 1988; Britton, 1995). Freud’s central usage emphasises the fi ctitious, wish-fulfi lling aspect of the everyday usage, whereas Klein’s usage tends to focus on the imaginative aspect. Freud and Klein on the concept of phantasy 115 But this relatively clear-cut contrast between Freud and Klein is complicated by the fact that Freud’s ‘central usage’ is not by any means his only usage. Further, he moves easily from one implied defi nition to another without being fi nicky about his formulations. In some of his early work he seems at times almost to equate unconscious phantasy with unconscious wish (1900, p. 574); at others he speaks of phantasies largely as conscious or preconscious day-dreams (1900, pp. 491–8). In his clinical work he deduces phantasies of quite surprising content, phantasies of which the patient has presumably been unaware. He assumes, for example, that the Wolf Man when he was one and a half years old had a phantasy of being inside his mother’s womb so as to intercept his father’s penis (1918, pp. 101–3). It is not clear whether Freud thought the Wolf Man was consciously aware of this phantasy at the time and repressed it later, or whether it never became conscious at all. Freud deduces similarly striking phantasies in the case of Dora (1905), though he does not discuss their precise topographical status. Some of Dora’s phantasies were presumably conscious, such as her phantasy of revenge on her father. Some were probably at least descriptively unconscious, such as her phantasy of fellatio, of the female genital (the ‘nymphs’ in the ‘thick wood’; that is, the labia minora in the pubic hair), her phantasy of defl oration, of bearing Herr K’s child, and her homosexual love for Frau K. It seems likely that Freud always tacitly assumed that at least some phantasies may originate directly in the system unconscious without being originally preconscious or conscious derivatives of unconscious wishes. Indeed in 1916 he speaks of primal phantasies, which he thinks are inherited; these are the phantasies of the primal scene, of castration, of seduction by an adult. He does not mean, he makes clear, that parental intercourse is never seen, that threats of castration do not occur, or that seduction does not happen in reality. But he thinks that these phantasies will occur even if external reality does not support them because they were once, to quote him, ‘real occurrences in the primeval times of the human family, and that children in their phantasies are simply fi lling in the gaps in individual truth with prehistoric truth’ (1916, p. 371). Most of Freud’s followers have not adopted this view, presumably because they think it too Lamarckian. But with some alter- ation I think it is not far away from Klein’s notion of inherent knowledge of bodily organs, birth and intercourse (1927, pp. 175–6), or from Bion’s idea of ‘preconceptions’ waiting to combine with experience to form conceptions (1962a, b). In French psychoanalysis these primal phantasies are considered to be of fundamental signifi cance both in theory and in clinical work (Roussillon, 1998). In summary, Freud is not punctilious in his defi nition of phantasy. He uses the term in several senses and, as Laplanche and Pontalis point out, he is more concerned with the transformation of one sort of phantasy into another than with Downloaded by [New York University] at 03:54 14 August 2016 any static defi nition (Laplanche and Pontalis, 1973, pp. 314–19). What I have called his ‘central usage’, however, is one that has been adopted by most of his immediate followers. What, then, is Klein’s view of unconscious phantasy? And why did it arouse so much controversy? Basically, Klein focusses on the ‘unconscious all along’ aspect of phantasy. She regards phantasy as a basic mental activity present in rudimentary form from birth onwards and essential for mental growth, though it can also be used defensively. Klein developed this view of phantasy through her work with children, especially through discovering that children accompanied all their activities by a constant stream of phantasy even when they were not being frustrated by external reality. One of many examples is Fritz and the letters of the alphabet: 116 Freud and Klein on the concept of phantasy For in his phantasies the lines in his exercise book were roads, the book itself was the whole world and the letters rode into it on motor bicycles, i.e. on the pen. Again, the pen was a boat and the exercise book a lake … In general he regarded the small letters as the children of the capital letters. The capital S he looked upon as the emperor of the long German s’s; it had two hooks at the end of it to distinguish it from the empress, the terminals, which had only one hook. (1923, p. 100)

Klein developed her idea of phantasy gradually from 1919 onwards, stressing particularly: the damaging effect of inhibition of phantasy in the development of the child; the ubiquity of phantasies about the mother’s body and its contents; the variety of phantasies about the primal scene and the Oedipus complex; the intensity of both aggressive and loving phantasies; the combination of several phantasies to form what she called the depressive position (Klein, 1935, 1940) – the paranoid- schizoid position was to come later, in 1946 – the development of phantasies of internal objects and, of course, the expression of all these phantasies in the play of children and the thinking and behaviour of adults. Essentially, I think that Klein viewed unconscious phantasy as synonymous with unconscious thought and feeling, and that she may have used the term phantasy rather than thought because the thoughts of her child patients were more imaginative and less rational than ordinary adult thought is supposed to be. Further, Klein thought that it was possible to deduce the phantasies of infants from her analyses of small children, assuming that she was discovering the infant in the child much as Freud had discovered the child in the adult (Britton, 1995). So important was the concept of phantasy in Klein’s thinking that the British Society made it the central scientifi c topic of the Controversial Discussions of the 1940s (King and Steiner, 1991), the aim of the discussions being to see whether Klein’s ideas were to be regarded as heresy or development. It was Susan Isaacs, however, who gave the defi nitive paper, ‘The nature and function of phantasy’, fi rst given in the Discussions, then published in revised form in 1948 and 1952. In this paper Isaacs stressed the link between Klein’s concept of phantasy and Freud’s concept of drive. She defi ned phantasy as ‘the primary content of unconscious mental processes’, ‘the mental corollary, the psychic representative, of instinct’ (1952). Phantasies are the equivalent of what Freud meant by the ‘instinctual representative’ or the ‘psychic representative of an instinctual drive’. Isaacs, like Klein, particularly emphasises the idea that everyone has a continual stream of unconscious phantasy, and, further, that abnormality or normality rests not on the presence or absence of unconscious phantasy but on how it is expressed,

Downloaded by [New York University] at 03:54 14 August 2016 modifi ed and related to external reality. She distinguishes between conscious and unconscious phantasy and suggests the ph spelling to distinguish the latter.2 Isaacs’ and Klein’s defi nition of phantasy is thus much wider than Freud’s central usage. In the Kleinian view, unconscious phantasy is the mainspring, the original and essential content of the unconscious mind. It includes very early forms of infantile thought, but it also includes other forms that emerge later on in development through change in the original phantasies. Also, as described by Freud, some unconscious phantasies may start off as conscious daydreams or theories that are later repressed. But, unlike many of Freud’s successors, Klein does not think that repression of once conscious daydreams is the only or even the main source of unconscious phantasies. Freud’s central usage, the wish-fulfi lling defi nition of phantasy, is a specifi c and more limited form, a particular type of phantasy within Klein’s more inclusive defi nition. In the Controversial Discussions Klein and Isaacs Freud and Klein on the concept of phantasy 117 did not stress this relation between their all-inclusive defi nition and the wish- fulfi lling defi nition of phantasy as a particular type within it. Certainly the argument in the Discussions was made more diffi cult by the fact that each faction was using the same word for a different concept; much of the time the two factions talked past each other. Sometimes the Viennese seemed to assume that Klein’s defi nition of phantasy was the same as their own, so that they could not understand how Klein could possibly say that phantasies occurred in very early infantile life, since this would have meant that very small infants were capable of secondary-process thinking. At other times Glover and Anna Freud specifi cally criticised Klein for broadening the concept of phantasy so much that it included everything and hence had become meaningless (King and Steiner, 1991, pp. 399, 423–4). Ronald Britton (1998) has suggested that Isaacs probably did not fully clarify the difference in defi nitions because she did not want to emphasise Klein’s difference from Freud, for Klein and her colleagues were worried that Glover might succeed in banishing them from the Society on the grounds that they differed from Freud and were therefore not ‘legitimate’. Freud is not very specifi c in making conjectures about the nature of early infantile thought. Klein called such thought phantasy and assumed that it was closely linked to bodily experience. She assumes that phantasising starts very early, in some primitive form ‘from the beginning’, as she was fond of saying. She did not bother much about Freud’s distinction between the system unconscious and the system preconscious, between primary- and secondary-process thinking. Klein and Isaacs assumed that phantasies could be formed according to primary-process thinking – indeed, that primary- and secondary-process thinking were very much intertwined. Isaacs assumes that the earliest phantasies are experienced mainly as visceral sensations and urges, the other senses of touch, smell, sound, taste and sight being added later and gradually. Such unconscious phantasies can perhaps be regarded as similar to the ‘thing presentations’ that Freud describes in ‘The unconscious’ (1915b). Isaacs makes much use of the principle of genetic continuity to link these very early phantasies with the more structured verbal phantasies of the older child and the adult. She assumes that what is experienced is a sensation and an impulse, together with a feeling of something happening that is involved with the sensation and may have an effect on it; looked at from the perspective of an outside observer, the ‘something’ is some aspect of external reality. From the perspective of the infant, things are assumed to be inside him. Hinshelwood describes it as follows:

An unconscious phantasy is a belief in the activity of concretely felt ‘internal’ objects. This is a diffi cult concept to grasp. A somatic sensation tugs along with it a mental experience that is interpreted as a relationship with an object Downloaded by [New York University] at 03:54 14 August 2016 that wishes to cause that sensation, and is loved or hated by the subject according to whether the object is well-meaning or has evil intentions (i.e. a pleasant or unpleasant sensation). Thus an unpleasant sensation is mentally represented as a relationship with a ‘bad’ object that intends to hurt and damage the subject … Conversely, when he is fed, the infant’s experience is of an object, which we can identify as mother, or her milk, but which the infant identifi es as an object in his tummy benevolently motivated to cause pleasant sensations there. (1989, pp. 34–5)

Through introjection and projection a complex phantasy world of self and internal objects is slowly built up, some of it conscious, but reaching to the unconscious 118 Freud and Klein on the concept of phantasy depths. This notion of internal objects and the internal world was and has continued to be central in Kleinian thought. This internal world is imaginary by the standards of material reality, but possesses what Freud calls ‘psychic’ reality – that is, to the individual concerned it feels real at some level, conscious or unconscious, and it is also real in the sense that it affects his behaviour. It is noteworthy too that in the unconscious aspects of the internal world Klein and Isaacs think of phantasies as combining both ideas and feeling – another difference from Freud, who spoke of the system unconscious as the realm of ideas and memory traces and was never entirely resolved about the status of unconscious feelings. Early phantasies are omnipotent: ‘I want it, I’ve got it’. ‘I don’t want it, it’s gone!’ They are stated by Isaacs to have many attributes Freud thought to be characteristic of the primary process – no co-ordination of impulses, no sense of time, no contradiction, no negation. But Klein also thought of unconscious impulses and phantasies being in confl ict with each other in the unconscious; unconscious confl ict between love and hate, between a good self and a bad self, between a good parent and a bad parent were conceptions she found appropriate and useful, though in Freud’s topographical conceptualisation, wishes (and wishful phantasies) in the system unconscious are in confl ict not directly with each other but indirectly through their contact with the regulating ego. Klein’s discoveries about the phantasies of small children led her to be very aware of their intense bodily concreteness, their concern with birth, death, the primal scene, babies, faeces, urine, murderous hatred and equally violent love. Her descriptions of phantasies are as graphic and surprising as those of Freud. For example:

One day while Ruth was once again devoting her attention exclusively to her sister, she drew a picture of a tumbler with some small round balls inside and a kind of lid on top. I asked her what the lid was for, but she would not answer me. On her sister repeating the question, she said it was ‘to prevent the balls from rolling out’. Before this, she had gone through her sister’s bag and then shut it tightly ‘so that nothing should fall out of it’. She had done the same with the purse inside the bag so as to keep the coins safely shut up … I now made a venture and told Ruth that the balls in the tumbler, the coins in the purse and the contents of the bag all meant children in her Mummy’s inside, and that she wanted to keep them safely shut up so as not to have any more brothers and sisters. The effect of my interpretation was astonishing. For the fi rst time Ruth turned her attention to me and began to play in a different, less constrained way. (Klein, 1932, pp. 26–7) Downloaded by [New York University] at 03:54 14 August 2016 Or again:

As I was putting a wet sponge beside one of them [a doll] as she had done, she burst out crying again and screamed. ‘No, she mustn’t have the big sponge, that’s not for children, that’s for grown ups!’ I may remark that in her two previous sessions she had brought up a lot of material concerning her envy of her mother. I now interpreted this material in connection with her protest against the big sponge, which represented her father’s penis. I showed her in every detail how she envied and hated her mother because the latter had incorporated her father’s penis during coitus, and how she wanted to steal his penis and the children out of her mother’s inside and kill her mother. I explained to her that this was why she was frightened and believed that she had killed her mother or Freud and Klein on the concept of phantasy 119 would be deserted by her … Gradually she sat up and watched the course of the play with growing interest and even began to take an active part in it herself … [When] the nurse came … she was surprised to fi nd her happy and cheerful and to see her say goodbye to me in a friendly and even affectionate way. (Klein, 1932, p. 28)

Nowadays, like our classical colleagues, many Kleinian analysts have become more cautious about interpreting phantasies so boldly and so concretely (see Spillius, 1988, pp. 8–9, 1994). In spite of this change, I think that emphasis on the unconscious and on adult forms of living out infantile experiences and phantasies has remained characteristic of Kleinian analysis. Like Klein herself, her present-day followers take it for granted that in thinking, in dreaming, in creativity, in all experiencing there is a constant and often uncomfortable mixture of logic and illogic. Further, unconscious phantasy is the mainspring of both creativity and destructiveness. It gives meaning to the external world and richness to the internal world. Klein and Isaacs assume that the expression of unconscious phantasy in words comes very much later than their original sensory formulation. Indeed, in current Kleinian thought it is assumed that some unconscious phantasies about infantile experience are never formally articulated in words, though words may be the means unconsciously used to communicate them by evoking them in an external person. To give an example: in the course of a preliminary consultation an articulate young woman suddenly said, ‘Hollow inside’, and then continued with what she had been saying. At a suitable pause I asked, ‘Did you say “Hollow inside”?’ She asked what I meant, adding that she had no memory of having said anything about ‘hollow inside’. I felt rather disorientated. Once her sessions began she talked intelligently and apparently meaningfully about her history and her current life, but I felt detached and unable to fi nd any real meaning or emotional connection with what she was saying. Eventually it occurred to me that now I was experiencing the ‘hollow inside’ that she had so accurately and so disconcertingly put into words. Gradually this split-off experience became the focus of our sessions. Klein and Isaacs assume that phantasies affect the perception of external reality, but, equally, that external reality affects phantasies, that there is a continual interplay between them. This assumption – namely, that actual external events are interpreted and understood, experienced in other words, in terms of pre-existing phantasies, and that phantasies may be modifi ed to take experience of events into account is a basic premise in Kleinian thought. It comes, for example, into the Kleinian idea that the infant gradually develops the more realistic thinking of the depressive position (Klein, 1935, 1940; Segal, 1964) alongside and partially replacing the omnipotent thinking of the paranoid-schizoid position (Klein, 1946), Downloaded by [New York University] at 03:54 14 August 2016 although each infant and each adult will have their own characteristic realisation of the two forms of thought in the particular content of their phantasies. The fi rst part of Klein’s idea about the interaction of phantasies and external events, namely, her idea that external events are interpreted and understood in terms of pre-existing phantasies, caused considerable argument during the Contro- versial Discussions and subsequently as well, for many analysts disputed Klein’s assertion that an infant or child could have, say, attacking and destructive phantasies without having been destructively attacked. In the Kleinian view such phantasies of attack may conceivably be a realisation of a hereditary disposition, though they may also arise from earlier experiences of bodily sensations of discomfort, as described above in the quotation from Hinshelwood. External reality thus often operates not only as a stimulus or cause of phantasies but as a confi rmation or 120 Freud and Klein on the concept of phantasy disproof of them. One does not have to see a breast being cut to pieces to have a phantasy of it, but for one’s mother’s breast to ooze blood and pus is likely to be felt as an alarming confi rmation of a phantasy of attack, or a disturbing disproof of a phantasy of a loving and well-cared for breast able to stand up to attack. The argument about which are primary, pre-existing phantasies and which are external events is an expression of a more general, and in my opinion unproductive, psychoanalytic argument about the relative priority of heredity and environment – unproductive because the relevant psychoanalytic evidence for deciding the issue in particular cases, especially direct evidence about the past, is usually not available. Klein and Isaacs assume that phantasies are not used solely to express unconscious impulses and wishes. Mechanisms of defence too are expressed through phantasy. Projection, introjection, splitting, idealisation, denial, repression are abstract terms that describe general psychic processes, but a given individual’s use of them is expressed through a particular phantasy. Phantasies expressing particular impulses and defences do not operate in isolation. Gradually some of them may build up into a complex system that involves the individual’s own unique way of being, of relating to the world, of maintaining his balance. The concept of phantasy is thus central to the idea of the organisation of the personality as a whole. This is the main sense of the term ‘unconscious fantasy’ favoured by Arlow (1969a, b, 1995), by Shane and Shane as global fantasies (1990) and by Inderbitzin and Levy (1990). Kleinian usage includes such central or ‘global’ phantasies but does not confi ne the general term to such particular sorts of phantasy.

The fate of the concept of phantasy after the Controversial Discussions It is hardly surprising that in the Controversial Discussions of the 1940s Anna Freud, Glover and their associates were not convinced by Isaacs’ arguments, nor she by theirs. As I have said, they meant such different things by the same term, phantasy, that they were talking past each other. Since 1943 the differences of defi nition and usage have continued, though most of the heat has gone out of this particular debate.

Later Kleinian developments Kleinians’ changes in their defi nition and use of the concept of phantasy have been minimal. Considering that Kleinians regard unconscious phantasy as such an important concept, it is perhaps surprising that little has been written about it since Isaacs’ original paper (but see Segal, 1964, 1994; Joseph, 1981; Hinshelwood, Downloaded by [New York University] at 03:54 14 August 2016 1989; Britton, 1995). I think so little has been written because the concept is now taken for granted. Many of the developments in Kleinian thought have used the concept of phantasy without changing Klein’s view of it. Much of the work on the development of thinking, for example, uses the idea of changes in the content and functions of phantasy in the movement from the paranoid-schizoid to the depressive position, as I have briefl y described above. Bion takes the concept of phantasy for granted in describing the model of the container and the contained and its role in the development of thinking (1962b). Similarly, much of the work on psychic equilibrium and on pathological organisations uses the concept of phantasy, especially in the course of describing the relevant clinical material (Riviere, 1936; Rosenfeld, 1971; Segal, 1972; O’Shaughnessy, 1981; Joseph, 1982; J. Steiner, 1993). Phantasy comes into everything. Freud and Klein on the concept of phantasy 121 Although Klein’s successors have thus made little fundamental change in her concept of phantasy, they have in my view made three minor changes: more emphasis on the role of phantasy in the development of logical thought; a change in the language used to describe unconscious phantasies to the patient; and more emphasis on the enactment of phantasies by the patient in the analytic situation. First, phantasies are now viewed by Kleinians as crucially important in the development of logical thought since they may be used as hypotheses to be confi rmed or disproved by experiences of external reality, an idea implicit in Klein’s thought but explicitly added to the Kleinian conception of phantasy by Hanna Segal (1964, 1994). The testing of phantasies against reality does not mean that earlier more omnipotent phantasies are necessarily abandoned; they remain but are added to by more sophisticated versions in keeping with experiences of external reality. Also, often the more sophisticated versions are used to deny the continuing psychic reality of the cruder and perhaps earlier phantasies (Segal, 1994; Britton, 1995). Second, as I have briefl y mentioned above, many Kleinians have become more cautious about using part-object anatomical language in describing to certain patients the content of unconscious phantasies (Spillius, 1988, 1994). Third, in describing clinical material there has been a tendency to devote attention not only to the symbolic content of phantasies but also, and increasingly, to the way they are lived out in the session. This has been a notable trend in the highly infl uential work of Betty Joseph (1989). I shall now give an example of the enactment of an unconscious phantasy.3 My patient, Mrs B, aged 50, had had several separations in early and middle childhood. She remembered them, especially the later ones, as painful and distressing but accepted them as an inevitable part of her family’s way of life. Consciously she felt considerable respect and admiration for her parents. Analytic breaks were not easy for her, but my attempts to link them with her childhood separations had not seemed particularly meaningful to her. Another feature that had emerged slowly in her analysis was a cruel streak that seemed quite alien and split off from her general character. For two or three weeks before a particular analytic break, which Mrs B planned to extend by going away for an additional few days herself, she became fed up, critical of herself, her analysis and particularly of me. Gradually I became fi lled with more self-doubt than usual about my ability as an analyst. In the particular session I shall describe, Mrs B came about ten minutes late and was silent for a long time. Eventually, on the basis of the quality of the silence, I said she gave the impression of feeling very negative and angry. Again there was a long silence. At the end she launched into a description of a lot of inconveniences and minor grievances, mainly at work. She said it was a peculiar twist that analysis Downloaded by [New York University] at 03:54 14 August 2016 stirs things up in such a way that all these minor complaints turn into an attack here. I said she wanted me to regard them as minor complaints but … ‘No’, she said, ‘only to know the difference between major and minor.’ (There was utter contempt in her voice.) There was a short silence, then she said, ‘I don’t know whether it’s you or me, but in the past ten days it seems to me you just totally and utterly keep missing the point.’ (Her tone was exceedingly scathing.) ‘Yesterday you apparently didn’t notice it was so painful for me to admit that I fi nd analysis and everything you do so terribly uninteresting. I can’t stand it.’ I waited a bit, then started to speak, but she broke in, ‘Don’t talk!’ (almost screaming). ‘You’re just going to repeat what I said, or you’re going to alter it. You don’t take things in, you don’t listen to what I say, or you listen and you just want to hear it the way you want it to be and you distort it.’ 122 Freud and Klein on the concept of phantasy I was fi nding it hard to think, and I knew that my own self-doubt was getting even more powerfully stirred up by her accusations. But I managed one small thought, which was that she must be feeling inadequate too, and that my leaving had a lot to do with it. Then came a second thought, that she hates herself for being cruel even though she gets excited by it. I said she couldn’t bear for me to know how painfully attacking she was, how much she wanted to hurt me, how cruel she felt; but she also couldn’t stand it if I didn’t know, didn’t react. It meant she was unimportant. ‘Can’t you realise’, she screamed, ‘that I am totally and utterly uninterested in you! I don’t care! I only care about myself. Take your pain to your analyst. Well, it’s not my fault if you haven’t got one.’ What I said, after quite a long pause, was that I thought she felt I treated her cruelly, with complete scorn and indifference, as if she was boring and utterly uninteresting, and that was why I was leaving her. She felt that the only way she could really get this through to me was to make me suffer in the same way. There was another long silence. Then she said, ‘None of this alters my being tired and having too many things to do.’ (She sounded like a slightly mollifi ed but still petulant child.) ‘I suppose’, she went on, ‘I am in a childish rage with you. I never could attack my parents, so I have to make up for it now.’ This, although probably true, led to something of a detour, and the session ended more or less amicably but with many loose ends. In later sessions it became clearer that Mrs B had an unconscious phantasy in which she thought her parents had cruelly left her in those childhood separations because she was stupid and unlovable. In the session I have described she lived this out: I was the stupid child and she the cruel parent. I believe that she had sensed my self-doubt and that unconsciously she exploited this to get me to play her role as the stupid child in a cruel scene of abandonment. Once this unconscious phantasy and its enactment had been clarifi ed, Mrs B felt a much deeper and more forgiving understanding of this aspect of herself and of her parents. A fi nal word about the Kleinian view of unconscious phantasy. It is clear that in the Kleinian view, unconscious phantasy is really synonymous with the content of the unconscious mind. That was one of the objections that Glover, Anna Freud and others made to Klein’s usage: all mental functions were encapsulated into this one concept. Of course it is clear that all analysts, regardless of school of thought and regardless of their defi nition of the concept of phantasy, use the idea of unconscious thoughts and feelings. In Kleinian analysis such thoughts and feelings are called unconscious phantasy; in classical analysis they are called drive derivatives, and the term phantasy is used only for one particular form of drive derivative. But the conception of unconscious thoughts and feelings occurs in all schools of analysis. Perhaps the importance Downloaded by [New York University] at 03:54 14 August 2016 of the Kleinian notion of unconscious phantasy, overall, is that it has tended to keep the attention of Kleinian analysts even more focussed on unconscious anxieties and defences than is the case in other schools of psychoanalytic thought.

Later Independent views on phantasy The concept of phantasy has not been central in the thinking of psychoanalysts of the Independent group, but Harold Stewart thinks that Independent analysts have made an important contribution to it by stressing the particular importance of actual external experiences in contributing to patients’ phantasies (Stewart, 1992, also personal communication). This is in keeping with the general Independent stress on the importance of actual external events in shaping the internal world. Freud and Klein on the concept of phantasy 123 Later contemporary Freudian views Contemporary Freudians, as described above, use Freud’s central defi nition of phantasy. Joseph Sandler has been especially interested in the defi nition and use of the concept of phantasy (Sandler, 1986; Sandler and Nagera, 1963). He and his wife, Anne-Marie Sandler, have constructed a model of the mind involving what they call the past unconscious and the present unconscious (Sandler, 1983; Sandler and Sandler, 1984, 1986, 1987, and particularly 1994, 1995), which corresponds roughly to Freud’s System Ucs. and System Pcs. of the topographical model, in which the concept of unconscious phantasy is most at home.

Phantasy in continental and especially French psychoanalysis The idea of unconscious phantasy is particularly important in French psychoanalysis, especially the phantasies of the primal scene, seduction, castration and also the Oedipus complex. This emphasis on unconscious phantasy has not occurred because of British or Kleinian infl uence but because of interest in Freud, especially perhaps the earlier Freud of the topographical model.

Phantasy in American psychoanalysis It is my impression, though there are many exceptions to this (especially Jacob Arlow), that less attention is paid to manifestations of unconscious phantasy or of the unconscious in general in American psychoanalysis than in British and continental analysis. The American Psychoanalytical Association held a panel on unconscious phantasy (Inderbitzin and Shapiro, 1989), with papers by Shapiro (1990), Trosman, (1990) Abend (1990), Shane and Shane (1990), Dowling (1990) and Inderbitzin and Levy (1990). This was the fi rst panel on the topic for many years and in it Shapiro (1990) specifi cally remarked that the concept of phantasy had been neglected. I think that such neglect is perhaps encouraged by the structural model of id/ego/superego, which focusses attention on confl ict between these three conceptualised agencies of the mind and on the defences and adaptations of the ego. The two distinctions of conscious/unconscious and primary/secondary process, which cut across each other and which are so important in Freud’s characterising of different types of phantasy, also cut across the id/ego/superego classifi cation, which does not provide a natural ‘home’ for unconscious phantasy. Of course the concept of unconscious phantasy is clinically useful, essential even, and talented clinicians have found ways of focussing attention on it even though the structural model tends to discourage focus on the Downloaded by [New York University] at 03:54 14 August 2016 dynamic unconscious. Although yet again there are exceptions (e.g. Shane and Shane, 1990) it seems to me that decreasing focus on unconscious phantasy is even more apparent among self-psychologists, intersubjectivists and relational analysts than among other sorts of American psychoanalyst. Presumably this decreased emphasis on the unconscious of the analysand occurs because it is felt that the interpersonal perspective on both the analytic relationship and the analysand’s personal history offers a more cogent understanding of personality, normal as well as pathological, than do the concepts of unconscious phantasy and, more generally, of confl ict between conscious and unconscious. I do not see any logical reason why the interpersonal focus should necessarily tend to exclude the unconscious, but empirically it does seem to be so. 124 Freud and Klein on the concept of phantasy Summary In summary, I think Freud’s idea is that the prime mover of psychic life is the unconscious wish, not phantasy. The ‘work’ of making phantasies and the ‘work’ of making dreams are parallel processes in which forbidden unconscious wishes achieve disguised expression and partial fulfi lment. For Freud himself, especially in his central usage, and even more for his immediate followers, phantasies are conceived as imagined fulfi lments of frustrated wishes. Whether they originate in the system conscious or the system preconscious, they are an activity of the ego and are formed according to the principles of the secondary process. That is not the whole story, however, because phantasies may get repressed into the system unconscious, where they become associated with the instinctual wishes, become subject to the laws of the primary process, and may fi nd their way into dreams and many other derivatives. For Freud and for French psychoanalysts particularly, there are the primal phantasies, ‘unconscious all along’, of the primal scene, castration and seduction, also capable of being directly incorporated into dreams and expressed through other derivatives. For Klein phantasy is an even more central concept than for Freud and it has continued to be used by her successors with only minor changes. In Klein’s thinking unconscious phantasies play the part that Freud assigned to the unconscious wish. They underlie dreams rather than being parallel to them – a much more inclusive defi nition of phantasy than Freud’s. The earliest and most deeply unconscious phantasies are bodily, and only gradually, with maturation and developing experience through introjection and projection do some of them come to take a verbal form. Freud’s central usage, the wish-fulfi lling defi nition of phantasy, is a particular type of phantasy within Klein’s more inclusive defi nition. And, as in Freud’s formulation, conscious phantasies may be repressed, but in Klein’s formulation this is not the only or even the main source of unconscious phantasies. In Klein’s usage, unconscious phantasies underlie not only dreams but all thought and activity, both creative and destructive, including the expression of internal object relations in the analytic situation. Finally, it is my tentative suggestion that conceptual and clinical focus on the concept of phantasy, especially unconscious phantasy, as in Britain and France, tends to involve a heightened awareness of the unconscious – hardly surprising, since unconscious phantasy is such a fundamental aspect of the unconscious. I have suggested that, although there are many individual variations, the structural model and the self-psychology, relational and intersubjectivist models tend to discourage focus on the dynamic unconscious.

Downloaded by [New York University] at 03:54 14 August 2016 Acknowledgements: I am grateful to several colleagues for discussion and help in writing this paper, especially Dr H. Segal, Dr R. Steiner, and Dr R. Britton.

Notes 1 This is the fi rst of several articles to appear on the topic of phantasy, following on from the articles on counter-transference, in the Journal’s Education Section (edited by Robert Michels with the assistance of Clàudio Eizirik, Alain Gibeault and Richard Rusbridger). Each set of articles is designed to set out the main issues embraced by a basic concept and at the same time to illustrate how the concept is viewed and understood from the perspective of each of several different psychoanalytic cultures (Michels, 1997, 78: 1067–9). This article is a modifi ed version of a chapter being published by Whurr in Kleinian Theory: A Contemporary Perspective, edited by Catalina Bronstein. Freud and Klein on the concept of phantasy 125

2 Nowadays most British analysts use the ph spelling for all phantasies, I believe because it is sometimes diffi cult to be sure whether phantasies are conscious or unconscious. 3 See Spillius, this volume, Chapter 3, for a more detailed description of this clinical material.

References Abend, S. M. (1990). Unconscious fantasies, structural theory, and compromise formation. J. Amer. Psychoanal. Assn. 38: 61–73. Arlow, J. (1969a). Fantasy, memory and reality testing. Psychoanal. Q., 38: 28–51. Arlow, J. (1969b). Unconscious fantasy and disturbances of conscious experience. Psychoanal. Q., 38: 1–27. Arlow, J. (1995). Unconscious fantasy. In Psychoanalysis: The Major Concepts, eds B. E. Moore and B. D. Fine. New Haven, CT: Yale University Press, pp. 155–62. Beres, D. (1962). The unconscious fantasy. Psychoanal. Q., 31: 309–28. Bion, W. R. (1962a). The psychoanalytic study of thinking: II. A theory of thinking. Int. J. Psycho-Anal., 43: 306–10. Bion, W. R. (1962b). Learning from Experience. London: Heinemann. Britton, R. (1995). Reality and unreality in phantasy and fi ction. In On Freud’s ‘Creative Writers Day-Dreaming’, eds E. S. Person, P. Fonagy and S. A. Figueira. New Haven, CT: Yale University Press. Britton, R. (1998). Contribution to panel discussion on ‘The Controversial Discussions: Fifty Years Later’. Fall 1998 Meeting of the American Psychoanalytic Association. Dowling, S. (1990). Fantasy formation: a child analysis perspective. J. Amer. Psychoanal. Assn. 38: 93–111. Freud, S. (1900). The Interpretation of Dreams. S.E. 4–5. Freud, S. (1905). Fragment of an Analysis of a Case of Hysteria. S.E. 7. Freud, S. (1908). Hysterical Phantasies and their Relation to Bisexuality. S.E. 9. Freud, S. (1911). Formulations on the Two Principles of Mental Functioning. S.E. 12. Freud, S. (1915a). Repression. S.E. 14. Freud, S. (1915b). The Unconscious. S.E. 14. Freud, S. (1916). Introductory Lectures on Psycho-Analysis. S.E. 16. Freud, S. (1918). From the History of an Infantile Neurosis. S.E. 17. Hayman, A. (1989). What do we mean by ‘phantasy’? Int. J. Psycho-Anal., 70: 105–14. Hinshelwood, R. D. (1989). A Dictionary of Kleinian Thought. London: Free Association. Inderbitzin, L. B. and Shapiro, T. (1989). Unconscious fantasy. (Panel report). J. Amer. Psychoanal. Assn. 37: 823–5. Inderbitzin, L. B. and Levy, S. T. (1990). Unconscious fantasy: a reconsideration of the concept. J. Amer. Psychoanal. Assn. 38: 113–30. Isaacs, S. (1952). The nature and function of phantasy. In The Freud/Klein Controversies, 1941–1945. London: Routledge, eds P. King and R. Steiner, 1991, pp. 264–321 (fi rst edition). Revised edition: Int. J. Psycho-Anal.: 29: 73–97 (1948). Also in Developments in Psycho-Analysis, eds M. Klein, P. Heimann, S. Isaacs and J. Riviere. London: Hogarth,

Downloaded by [New York University] at 03:54 14 August 2016 pp. 67–121. Joseph, B. (1981). Defence mechanisms and phantasy in the psychoanalytical process. In Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, eds M. Feldman and E. Bott Spillius. London: Tavistock/Routledge, 1989, pp. 116–26. Joseph, B. (1982). Addiction to near-death. Int. J. Psycho-Anal., 63: 449–56. Also in Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, eds M. Feldman and E. B. Spillius. London: Routledge, 1989. Joseph, B. (1989). Psychic Equilibrium and Psychic Change. London: Routledge. King, P. and Steiner, R. (eds) (1991). The Freud/Klein Controversies, 1941–1945. London: Routledge. Klein, M. (1923). Early analysis. In The Writings of Melanie Klein, Vol. 1, Love, Guilt and Reparation. London: Hogarth, 1975, pp. 77–105. Klein, M. (1927). Criminal tendencies in normal children. In The Writings of Melanie Klein, Vol. 1, Love, Guilt and Reparation. London: Hogarth, 1975, pp. 170–85. 126 Freud and Klein on the concept of phantasy

Klein, M. (1932). The Writings of Melanie Klein, Vol. 2, The Psycho-Analysis of Children. London: Hogarth, 1975. Klein, M. (1935). A contribution to the psychogenesis of manic-depressive states. In The Writings of Melanie Klein, Vol. 1, Love, Guilt and Reparation. London: Hogarth, 1975, pp. 262–89. Klein, M. (1940). Mourning and its relation to manic-depressive states. In The Writings of Melanie Klein, Vol. 1, Love, Guilt and Reparation. London: Hogarth, 1975, pp. 344–69. Klein, M. (1946). Notes on some schizoid mechanisms. In The Writings of Melanie Klein, Vol. 3, Envy and Gratitude and Other Works. London: Hogarth, 1975, pp. 1–24. Laplanche, J. and Pontalis, J.-B. (1973). Phantasy. In The Language of Psychoanalysis. London: Hogarth, pp. 314–19. O’Shaughnessy, E. (1981). A clinical study of a defensive organization. Int. J. Psycho-Anal., 62: 359–69. Riviere, J. (1936). A contribution to the analysis of the negative therapeutic reaction. Int. J. Psycho-Anal., 17: 304–20. Also in The Inner World and Joan Riviere, ed. A. Hughes. London: Karnac, 1991. Rosenfeld, H. (1971). A clinical approach to the psychoanalytic theory of the life and death instincts: an investigation into the aggressive aspects of narcissism. Int. J. Psycho-Anal., 52: 169–78. Roussillon, R. (1998). Historical reference, après-coup and the primal scene. In Standing Conference on Psychoanalytical Intracultural and Intercultural Dialogue. Paris: International Psychoanalytical Association, pp. 1–31. Rycroft, C. (1968). Phantasy. In A Critical Dictionary of Psychoanalysis. London: Nelson. Sandler, J. (1983). The ‘second censorship’, the ‘three box model’, and some technical implications. Int. J. Psycho-Anal., 64: 413–26. Sandler, J. (1986). Reality and the stabilizing function of unconscious phantasy. Bulln Anna Freud Centre, 9: 177–94. Sandler, J. and Nagera, H. (1963). Aspects of the metapsychology of fantasy. Psychoanal. St. Child, 18: 159–94. Sandler, J. and Sandler, A.-M. (1984). The past unconscious, the present unconscious, and interpretation of the transference. Psychoanal. Inq., 4: 367–99. Sandler, J. and Sandler, A.-M. (1986). The gyroscopic function of unconscious fantasy. In Towards a Comprehensive Model for Schizophrenic Disorders, ed. D. Feinsilver. New York: Analytic Press, pp. 109–23. Sandler, J. and Sandler, A.-M. (1987). The past unconscious, the present unconscious and the vicissitudes of guilt. Int. J. Psycho-Anal., 68: 331–41. Sandler, J. and Sandler, A.-M. (1994). Phantasy and its transformations: a contemporary Freudian view. Int. J. Psycho-Anal., 75: 387–94. Sandler, J. and Sandler, A.-M. (1995). Unconscious phantasy, identifi cation, and projection in the creative writer. In On Freud’s ‘Creative Writers and Daydreaming’, eds E. S. Person, P. Fonagy and S. A. Figueira. New Haven, CT: Yale University Press. Sandler, J., Holder, A., Dare, C. and Dreher, A. U. (1997). Freud’s Models of the Mind: An

Downloaded by [New York University] at 03:54 14 August 2016 Introduction. London: Karnac. Segal, H. (1964). Phantasy and other processes. In The Work of Hanna Segal. New York: Aronson, 1981, pp. 41–7. Segal, H. (1972). A delusional system as a defence against the re-emergence of a catastrophic situation. Int. J. Psycho-Anal., 53: 393–401. Segal, H. (1994). Phantasy and reality. Int. J. Psycho-Anal., 75: 395–401. Also in Psychoanalysis, Literature and War, ed. J. Steiner. London: Routledge, 1997, pp. 27–40. Shane, M. and Shane, E. (1990). Unconscious fantasy: developmental and self-psychological considerations. J. Amer. Psychoanal. Assn. 38: 75–92. Shapiro, T. (1990). Unconscious fantasy: Introduction. J. Amer. Psychoanal. Assn. 38: 39–46. Spillius, E. Bott (ed.) (1988). Melanie Klein Today. Vol. 1, Mainly Theory; Vol. 2, Mainly Practice. London: Routledge. Spillius, E. Bott (ed.) (1994). Developments in Kleinian thought: Overview and personal view. Contemporary Kleinian psychoanalysis. Psychoanal. Inq., 14: 324–64. Freud and Klein on the concept of phantasy 127

Steiner, J. (1993). Psychic Retreats. London: Routledge. Steiner, R. (1988). Paths to Xanadu … Some notes on the development of dream displacement and condensation in Sigmund Freud’s Interpretation of Dreams. Int. Rev. Psycho-Anal., 15: 415–54. Stewart, H. (1992). The process of therapy and theory of technique. Unpublished paper presented at a Colloquium in London on Self-Psychological and British Independent Technique in Psycho-Analysis. Trosman, H. (1990). Transformations of unconscious fantasy in art. J. Amer. Psychoanal. Assn. 38: 47–59. Downloaded by [New York University] at 03:54 14 August 2016 CHAPTER 9

PSYCHOANALYSIS AND PSYCHOTHERAPY Learning to understand oneself in contrast to being understood by another

This is from an unpublished article (2003).

Although I have supervised a considerable number of psychoanalysts and psycho- therapists, I have never been much impressed by attempts to distinguish between them or to assert that one or the other is best for some particular complaint. However, I have slowly come to think that there are differences between the two activities of psychoanalysis and psychotherapy. Basically in psychoanalysis the analyst tries to help the patient to understand himself. In psychotherapy the therapist usually tries to give the patient understandings which the therapist already possesses, but which are usually new to the patient. Both these activities may occur in an analysis and in a psychotherapy, but overall I think the two types of therapy differ in the activity that each involves. There are many contradictory views of psychoanalysis and psychotherapy but on one point most authors agree: psychoanalysis involves more frequent sessions. In this paper I want to describe some of the effects of frequency on the therapeutic process, for it is my impression that the differences I have described in the preceding paragraph, that is, the difference between helping the patient to understand himself, and giving the patient the therapist’s understandings, is at least partly a function of the frequency of sessions. I believe that the greater frequency of sessions in psychoanalysis allows the analytic process itself to ‘carry’ the analysis, whereas in psychotherapy the lesser frequency of sessions puts the psychotherapist under pressure to give the patient a formulation that will carry the work from one session to the next. I do not mean to assert that moments of clear formulation and understanding are lacking in psychoanalysis, though I think that pressure to carry the patient is less likely to

Downloaded by [New York University] at 03:54 14 August 2016 play a role in such formulations than is the case in psychotherapy. I do not claim that frequency is the sole differentiation characteristic of psychoanalysis and psychotherapy, only that it is an important factor. Other factors are clearly relevant. If the problem brought by the patient is specifi c, and if the overall duration of the treatment is to be limited, these factors also push the therapist towards giving clear and explanatory formulations. There are other less tangible factors such as the skill and clinical ideology of the practitioner that affect both psychoanalysis and psychotherapy. In the descriptive account that follows I have tried to control such intangible factors to some extent by comparing two practitioners, both of whom, in my opinion, are clinically gifted and in a similar way in that both are primarily clinicians rather than theoreticians at least at the present state of their development. I shall call them Mr Brown and Mrs Green. Psychoanalysis and psychotherapy 129 Mr Brown – Psychoanalysis Mr Brown is treating a woman of working-class origin who is in her early thirties. All through her childhood she felt unloved and misunderstood by her family. Several later experiences, particularly with men, confi rmed her sense of danger and discouragement. She had been in analysis for six months at the time I began to work with Mr Brown. He was seeing his patient fi ve times a week in the usual psychoanalytic fashion. Before telling me about the session he was going to discuss, Mr Brown said he didn’t have any idea of what was going on. Last week he had a bit of a grip on things but this week he was at sea. I said that was because he was doing a psychoanalysis. It was partly because it was near the beginning of the work, but I added that feeling at sea wasn’t at all unusual in analysis even later on. It was part of the process of discovery. Monday’s session. She came late, and told a complicated story about collecting or not collecting a presentation for one of her clients. This led to her being reprimanded by her employer. She did not give details and the story was diffi cult to understand. She also said she was doing a writing course and got her fi rst assignment back with the feedback that it was ‘patronising and school ma-mish’. She said the tutor did not understand her humour, her tone. Mr Brown said that she seemed to believe that she should keep things to herself. He said she felt she could not trust anyone to keep a right perspective on what she was saying, and that he was aware how hard it is for her to give him details. She laughed in recognition and said she does tell herself not to share her thoughts. I said I thought she was surprised, pleasantly surprised, that he knew this about her. His patient went on to say that she gave her manager notice. (She has an alternative employer.) She saw one client she would not see again because of giving in her notice, and this person expressed regret and wanted to hug and kiss her. She felt somewhat put off by this outward show of affection. ‘I thought she would sweep me off my feet,’ his patient concluded. She went on to talk about a friend who had said that Mr Brown was very well informed and knew so much and so did his patient. The patient was irritated by this because it was a recipe for disappointment because the friend will realise that neither the patient nor Mr Brown can know everything. Mr Brown said that what seemed to be a compliment had turned into a criticism. He said that she was telling him about someone who had diffi culty in accepting something from someone, like her client felt about the pension, and perhaps her own inability to make a decision about collecting the pension was because of her identifi cation with this woman. Downloaded by [New York University] at 03:54 14 August 2016 A little later he said there seemed to be something in this session about things being better – last week they had sorted out one change of time – but that this session seemed to be followed by ‘tripping up’; her coming late for today’s session. He said she might be worried that great expectations would be placed on her that neither he nor she could live up to and she seemed to be conveying a warning: ‘Do not expect too much from me’, which erodes her sense of her own qualities. His patient became very quiet and he found it diffi cult to gauge her response. She seemed rather tearful, wiping her eyes, but he was not sure whether his remarks had moved her because she felt understood or because she felt hurt. She went on to tell him about another woman client who had hardened skin around her feet and as a result cannot walk. This client does not want to go into a 130 Psychoanalysis and psychotherapy home, she wants to be independent. He said that perhaps she felt that she had developed a hardened skin around her feelings, wanting to be seen to be independent, yet also very much wanting better contact but that he and perhaps she too were frightened of how that might sweep her off her feet and disrupt her equilibrium. That was the end of the session. I said he had recognised what she felt and that, especially in the last two interpretations, he had expressed it very well, using her own idiom to express his understanding. I added that he could be a little more direct. For example, he had been vague about who was going to have the great expectations of her, and it was clear that it was his expectations that she feared. Tuesday. In this session she was listless and said she felt mediocre and it was this reaction to the meaningful session of Monday that had made Mr Brown feel that he didn’t know what was happening. I said I thought it was mainly a negative therapeutic reaction, but also, she was living out exactly the thing that he had said on Monday – he would have expectations of her and she would feel ‘I can’t!’ Wednesday. All change. She spoke about her brother’s abuse of her when she was a child. Even more than the abuse, what she resents is that her mother did not do anything about it, and made her vulnerable to the abuse in the fi rst place by being ill and overburdened herself. She wasn’t robust. After a diffi cult discussion Mr Brown said that she felt doubtful if he was robust enough, so that she felt angry at being with someone who needed to be looked after just when she felt she needed so much attention. She became quiet and thoughtful and towards the end of the session she remembered having asked him in an earlier session if he thought she was irrational. In the supervision I asked about the atmosphere in the session, linked it to Monday and Tuesday and said I thought that she was developing an erotic transference and that they were both fi nding it rather diffi cult to cope with. Later, when discussing the sequence of these sessions, I told him I thought the analysis was moving – that I knew he felt he was barely following her, but he was following her, fi nding out what the world felt like to her, learning about her internal world, making links that were leading her to think about herself in a new way. That was enough to be getting on with.

Mrs Green – Psychotherapy Mrs Green trained as a psychotherapist and has had many years of analysis. In the last six years she has established a psychotherapeutic practice in a foetal medicine unit. Most of her clients are women or couples who have had some sort of painful Downloaded by [New York University] at 03:54 14 August 2016 experience of an abnormal pregnancy leading to miscarriage, foeticide or an abnormal birth. She has established a particular psychotherapeutic procedure: women or couples who want psychological help are offered once-weekly consulta- tions for six weeks followed by three follow-up sessions at six weekly intervals. Any woman who has a subsequent pregnancy after the original sessions is offered more treatment if she wants it. After hearing a few of her cases I said I was amazed at how undefended her patients were, how willing to talk about the distress they were experiencing and how ready to accept her interpretations of it. I said it was partly a tribute to her work with them, and partly occasioned by the acuteness of the trauma they were experiencing. She agreed, but said that it also depended on the time limit she had imposed on the duration of treatment. Psychoanalysis and psychotherapy 131 Mrs Wilkinson, one of Mrs Green’s patients in the throes of deciding whether or not to undergo a termination of a seriously damaged 21-week-old foetus Mrs Green already knew the patient and her history because she had had a diffi cult earlier twin pregnancy in which one twin had died in utero although the other twin, Andrew, had survived. He was now one year old. In the current pregnancy the following year, several abnormalities were discovered at the 20-week scan. In her fi rst session after the 20-week scan Mrs Wilkinson began to cry as soon as she sat down. She said it was a sheer nightmare. Eventually, she said, ‘Gerry (her husband) is clear, he is very upset about it but he thinks the only option open to us is a termination. I do not think I can go through a termination and if I do, I don’t see how I can survive what the termination would involve.’ She cried inconsolably. Mrs Green thought to herself that she would survive, as they all do, but at what price. She caught herself thinking what was ahead of her in her work with the patient, and she wished that she wasn’t her patient, not because she was diffi cult or off-putting but because her whole story was so painful and disturbing, and now this. Mrs Green felt she had no space left in her mind and heart for these new misfortunes. But she was aware that what she herself felt refl ected what her patient felt inside herself, and this made what lay ahead more bearable. In the supervision I said that I too found this woman’s suffering almost unbearable and I agreed that Mrs Green’s feelings probably expressed those of her patient. Put in theoretical terms, her patient was communicating her feelings by projection and appropriate evocative behaviour, and Mrs Green was taking in this behaviour and refl ecting on it. Mrs Green had then said to her patient that it did not surprise her that her husband was clear about what to do. The patient looked puzzled, and Mrs Green explained that it was her impression that Gerry was inclined to make sense of diffi cult and painful events in terms of what he could rationally comprehend, which currently corresponded to the medical facts about their baby. Her patient nodded vigorously and they continued with an exchange about how quickly her husband had been able to grasp the medical facts and possibilities about the death of John, the twin who died. A little later she said, ‘What really bugs me is that we are both scientists, we both attach importance to the facts. I can do that as well as he can’ – at this she smiled – ‘I can put my feelings to one side and say to myself that the best option is to have a termination, but at the same time I cannot.’ Mrs Green said, ‘Well perhaps what we need to do here is to try to understand what is the meaning for you of what you think you are expected to do and you cannot do.’ Her patient cried and cried and looked appealingly at Mrs Green. Mrs Green continued: Downloaded by [New York University] at 03:54 14 August 2016 ‘You look at me in an appealing way as though I, if anyone, should be in a position to understand why you could not go through this termination.’ The patient nodded and Mrs Green continued: ‘I know where you were before all this happened – struggling to face what you have already lost, feeling so alone with the living dead inside you. I also suspect that in your mind the baby in your body now, just like John also (the twin who died), is identifi ed with the unwanted/abandoned child you once were.’ The patient nods slowly. Mrs Green said: ‘I suspect that having a termination would turn you in your mind into the mother you always feared you might turn out to be – the uncaring abandoning mother who once carried you in her womb.’ The patient nodded. (The patient had been given up for adoption by her biological mother at birth.) In our supervisory discussion I said that I thought this was a turning point in the session, that Mrs Green had gone beyond empathising with her distressed patient 132 Psychoanalysis and psychotherapy and had been able to help her understand why the thought of termination was so particularly dreadful for her. However, although this understanding had been helpful in earlier sessions the previous year, in the current session it did not bring much immediate relief or insight. Perhaps, I thought later, Mrs Green might have brought it in a bit too soon. The patient agreed with Mrs Green’s interpretation and said that this time round she would really be getting rid of her baby, unlike the case with John who had died inside her womb. She described in vivid and gruesome detail exactly what she would have to agree to if she signed the consent form for the foeticide and the ensuing birth of the dead foetus. She wondered how women could go through this. Mrs Green said they did it with much the same sort of struggle and feelings as her patient was having. A little later Mrs Green wondered about the difference in the way Mrs Wilkinson pictured John and this baby, which Mrs Wilkinson then said she had thought about a lot, including many bad dreams. (This time I was a bit doubtful about Mrs Green’s intervention but decided to ignore it as our supervision time was getting near the end.) Mrs Wilkinson moved on then to talk about how she could only think of this baby as newly born, when its disability would not matter. Mrs Green said that having been Andrew’s mother (Andrew is their living, one-year-old child) and discovered that she was able to be a loving mother, especially after all her fears of being like her own mother, meant that she could not think about her current situation without being aware that she was a mother who felt close and wanted to care for and nurture her baby. Her patient vigorously agreed. In the supervision I said Mrs Green was now recognising something very important, which was that her patient had discovered that she was a good and caring mother and this very advance in her life was part of what was making the thought of termination so excruciating. Her husband, the patient explained, was very concerned about the effect a damaged baby would have on Andrew, and she thought he was attributing his own feelings to Andrew. But she was doing that too, she said. And she knew that if she were to have a termination, it would not be for her husband’s sake, or her son’s sake, but for her own. She said there was something else. She was a Catholic, not a very strict Catholic, but she had always sworn that having an abortion was something she would never do. Mrs Green said that it seemed as if in her view having an abortion of a healthy foetus and having a late termination due to serious medical complications were one and the same thing, to which her patient again agreed. She talked a bit about her shame in facing people who would know she had had a termination, and Mrs Green said her shame was not so much in facing other people but in facing the part Downloaded by [New York University] at 03:54 14 August 2016 of herself who was against terminating this pregnancy. Her patient agreed. Mrs Green said it was time to stop, but in view of the circumstances she could see her again on Monday, and the patient said yes, she wanted this. On Monday morning Mrs Wilkinson came to have the foeticide and came to see Mrs Green immediately afterwards. It was another harrowing session, with the patient calmer but in terrible mental pain, as was her therapist. But through it all the patient was sustained by Mrs Green’s effort to recognise her feelings. And in the session the patient herself put into words her own version of the interpretations that her therapist had made in the preceding and other earlier sessions. In the next supervision I asked Mrs Green what had been her aim in these sessions. She said it was that whatever her patient decided to do, she should know as much as she could bear to know about what it really meant to her. I said I Psychoanalysis and psychotherapy 133 thought it was very important that she had not only been willing to go through the anguish with her patient but that she had also worked very hard to help her to understand all the emotional factors infl uencing her decision. We went on to discuss the effect of the pressure of circumstances on the defi nition of the therapeutic task and on the willingness of the patient to struggle to fi nd the truth of her situation. Mrs Green said that she thought the length of the therapy was also a factor – that if the duration of the therapy was not limited, the patient’s attitude was often different, more defended, but perhaps also the therapy might be more far-reaching in the long run. She was also aware of focussing more on the transference when the therapy was open-ended. And since that time I have heard many examples of Mrs Green’s work with other patients who have come to realise that they wanted to understand more about themselves than the obstetric crisis that was the occasion for starting the therapy. But, compared to psychoanalysis, there has always been considerable pressure to reach a ‘holding’ formulation to carry the patient from one session to the next. Downloaded by [New York University] at 03:54 14 August 2016 CHAPTER 10

ON BECOMING A BRITISH PSYCHOANALYST This paper was written in 2002–2003 for an issue of Psychoanalytic Inquiry edited by Elizabeth Wolf, and with an overview by Michael Parsons.

Sometimes it still surprises me that I have become a psychoanalyst because I was quite happy in anthropology. It seemed to happen almost by accident, although actually I now think that there is a structural affi nity between the two fi elds so that it was a change of content but not a change in my basic way of thinking. There have been several high points in my journey from anthropology to psychoanalysis: my fi rst reading of Klein; my fi rst understanding of psychoanalysis – the feeling of ‘This is it – the approach for me!’; starting the clinical part of the training; supervision with Rosenfeld; supervision with Bion; Betty Joseph’s seminar; and then, gradually, intense interchanges with Kleinian colleagues and the realisation that we were building a new and coherent body of ideas based on Klein’s work, and that I was contributing to this ‘post-Kleinian analysis’. All this went on, of course, in the context of a ‘three-Group’ society with constant awareness of other theories, other attitudes, and involvement in many activities – teaching, committees, editorial work – that involved all three Groups of the British Psycho- analytical Society: Kleinian, Independent – sometimes called the ‘Middle Group’ – and Contemporary Freudian.

The beginning Having studied psychology at the University of Toronto and anthropology at the University of Chicago, I came to the London School of Economics in 1949 as a junior lecturer in anthropology. On the advice of an American sociologist I went to see what was going on at the Tavistock Institute of Human Relations. I arrived at a good time, for I was imme-

Downloaded by [New York University] at 03:54 14 August 2016 diately offered a job as anthropological fi eldworker in an exploratory study of ordinary London families. This meant leaving the London School of Economics where I had been an Assistant Lecturer though I kept in touch with my anthropological colleagues for a considerable number of years. I knew almost nothing about psychoanalysis. I had tried to read Freud when I was sixteen but found his attitudes towards women so off-putting that I did not read very far. I had heard that most people in the Tavi were ‘Kleinian’ or ‘Middle Group’ in outlook and so, in the long and delightful summer of 1951 I read The Psycho-Analysis of Children and Contributions to Psycho-Analysis by Melanie Klein. These books were a revelation – especially because the things she encountered in small children stirred distant memories of my having thought similar things when I was a child. I had something of the same sense of discovery that I had had On becoming a British psychoanalyst 135 years earlier when I read Emile Durkheim and decided then and there that I was going to be an anthropologist. I read some Winnicott too, made a start on Freud, and read most of the sociological writings of the people I would be working with. My future colleagues had told me about Bion. I was rather put off by their adulation of him and in any case I did not believe that a non-anthropologist could say anything useful about groups. But I read his papers in the journal Human Rela- tions, which were later put together in the book Experiences in Groups (Bion, 1961) and I thought that here was a truly original mind. The next seven years were an exciting time, mostly devoted to study of the research families and their social environments, work which I eventually published as Family and Social Network. But I was experiencing and learning about psychoanalysis too at the Institute of Psychoanalysis. I started analysis for personal reasons in 1952 and helped my Tavistock colleagues with some of their other research work in which they were using psychoanalytic ideas. Isabel Menzies, a Kleinian analyst and social scientist, supervised my interviews with the research families. By 1957 I had begun an anthropological study of a mental hospital and was realising that the idea of the unconscious components of social roles would be extremely useful.

The training After some gentle persuasion by my Tavi colleagues I applied to do the psychoanalytic training in 1956 and was interviewed by Hedwig Hoffer and Roger Money- Kyrle.1 Mrs. Hoffer struck me as both pleasant and astute. She seemed to size me up in a way that was penetrating but also kindly and fair. Dr. Money-Kyrle lived in a beautiful, dusty disorganised house in Regent’s Park – just my idea of a tolerant, thoughtful, upper-class intellectual in his natural habitat. When I got back to the Tavistock Institute my colleagues asked how the interview had gone and I said we had mostly talked about anthropology and that I’d explained to him that we no longer thought of his sort of anthropology as real anthropology. ‘Oh no! Whatever did you do that for?’ they said. But, presumably thanks to the kindness and amusement of both interviewers, I was accepted in spite of my anthropological arrogance. There were three Groups in the British society: a small group of Kleinians, which was the Group I wanted to belong to; a large group known as the ‘Middle Group’ of the Independents, and a small group of ‘Contemporary Freudians’, which Anna Freud belonged to. I found the training rather disappointing, especially at fi rst. It seemed to me – to us, I should say, for the other students were not happy with the training either – that there were not very many gifted seminar leaders. Or perhaps it was because Downloaded by [New York University] at 03:54 14 August 2016 there was not a very good tradition of teaching psychoanalysis, especially theory. I found it very odd that no one seemed perturbed by the fact that much of what we were taught as if it were established fact was actually highly conjectural; all psychoanalytic theory seemed to be described not in terms of what patients did in sessions, which was what psychoanalysts had direct experience of, but in terms of imaginative constructions about infantile thinking that could not be studied directly, and, since infants do not talk, perhaps could never be known even if infant behaviour was observed. It would not have been so bad if these theories had been described as if they were models, but it sounded as if analysts thought of them as fact. In spite of this sort of discontent about the teaching of theory, we had no complaints about the supervisory system or the clinical seminars, as I found out later. I think this divided attitude towards the teaching of theory and of clinical 136 On becoming a British psychoanalyst psychoanalysis is still true today, nearly 50 years later, although perhaps the discrepancy is not quite so marked. Most of our seminar leaders seemed to expect us to accept what they said on faith and not to ask questions or to argue. This was very different from the atmosphere in social anthropology where nothing was sacred, everyone was developing new ideas and a student’s ideas might be listened to as seriously as those of a professor. Our psychoanalytic seminar leaders seemed not to know or to care about schools of thought different from their own. We were not given much of an idea about continental or American psychoanalysis and no one tried to clarify the differences between the three British Groups. I did not think about it at the time, but implicitly the attitude seemed to be that to know about another fi eld or another point of view would be contaminating. What none of us realised at the time was that our senior colleagues were probably still suffering from the aftermath of the Controversial Discussions, which we did not know about. I was surprised too about the ignorance of our teachers (and many students too) about the social sciences. Even distinguished psychoanalysts said surprisingly unin- formed things about so-called ‘primitive’ peoples and their supposedly primitive thinking. And no one, of course, knew about my work as an anthropologist. Nor did I know much, at fi rst, about the background of the other students. Perhaps the fact that we students were all in analysis had something to do with the deadened atmosphere of the training. It’s a sobering thought to know that your behaviour may become analytic food for thought on several other couches besides your own. I tried to ignore this and was told by an older but kindly fellow-student that I talked too much and was giving the impression of being very competitive, which would count against me. I was surprised because I thought of myself, rightly, as the least experienced and worst informed of our year. I was especially in awe of the many students who were psychiatrists. For most of the time they sat in silence looking wise and sometimes they fell asleep. When I knew them better I realised they were working very long hours, carrying heavy loads of responsibility and that they found the new learning even stranger than I did. One of them said I was lucky not to be a psychiatrist because I didn’t have so much to unlearn. Another said he had no time to hear about different points of view. He just wanted to have a ‘crib’ about the accepted point of view so that he could learn it off by heart. I was shocked. He said I was an academic and rather naïve so it was different for me. Perhaps we were one of the last year-groups that cared about ‘the Groups’. The six contemporary Freudian students rather shunned the six Kleinians and later told us that frankly they thought Melanie Klein was mad. We thought they were old- fashioned. I can’t remember what we thought of the six ‘Middle-Groupers’ (now called ‘Independents’) or what they thought of us. In 1956 I was rather glad that Downloaded by [New York University] at 03:54 14 August 2016 the Klein Group was by far the smallest in the Society. I thought that Kleinian theory was really interesting and felt pleased to be in what I regarded as a group of eccentrics in which I could think what I liked. In spite of accepting Group differences, we made many friendships across Group lines when we were students, and I think this is still the case. By the 1970s when I started to teach, students’ attitudes about Groups appeared to have changed. It was no longer acceptable to ‘believe’ in Group differences or Group ideology the way we had in 1956. The accepted view according to 1970s Group culture was that Groups only mattered to qualifi ed analysts, especially to Training Analysts. Willi Hoffer was an exception to my criticisms of our teachers. A Freudian not a Kleinian, he was not particularly good at organising his Freud lectures but he certainly encouraged us to ask questions and really tried to answer them. He went On becoming a British psychoanalyst 137 further. When I complained that I really did not grasp the difference between the ego and the self he invited me to have tea with himself and his wife and together they tried to enlighten me. I was very touched. Hanna Segal was exceptional in a different way – very clear, very defi nite, and she gave excellent clinical examples. These were the lectures that in 1964 were published as An Introduction to the Work of Melanie Klein. I found it hard to see why many of my colleagues found Klein’s work and Segal’s exposition of it hard to follow. Although there seemed to be nothing we could do about it, we all thought it was a pity that neither Anna Freud nor Melanie Klein was teaching either fi rst- or second-year students. Once we were allowed to attend Scientifi c Meetings we saw them there occasionally. Anna Freud came only rarely but Melanie Klein was usually there sitting up at the front along with a group of rather formidable women: Hanna Segal, Paula Heimann, Betty Joseph and Esther Bick. Joan Riviere was seldom there. I do not remember where Bion, Jaques and Rosenfeld sat. Students sat at the back, as they still do, with Associates and Members in the middle. I don’t remember where the leading members of the Independent Group sat. If I had been a more conscientious anthropologist I would have made a seating plan. I already thought that it was inevitable that the Wednesday Scientifi c Meeting was a tribal ritual as well as a place of scientifi c communication. It was the same in academia, at least when people presented formal papers. By the autumn of 1957 several of our year, the elite, had already started seeing patients. They became completely absorbed in supervision and clinical seminars and were less and less bothered about theory and the organisation of courses. I was withdrawing too, but for different reasons: marriage, the publication of Family and Social Network and planning a fi eld trip with my husband to the Kingdom of Tonga in the Southwest Pacifi c. I remember a last Scientifi c Meeting on 15 January 1958 at which Paula Heimann announced that she had left the Klein Group and Betty Joseph, her ex-patient, announced that she was staying. We all wondered what had been going on but did not ask. We knew our place. I was away in Tonga for two and a half years, another formative experience but that is another story. When we got back in the autumn of 1960 Melanie Klein had just died. I had not known her personally, but realised of course that this was a major event for senior Kleinians and for the Society too. In my absence Family and Social Network had become quite well-known in academic circles and I was under considerable pressure to continue work in that fi eld but decided for various reasons that I had better fi nish the training. Although I was very grateful indeed for my years at the Tavi and liked the work, I did not want to continue working in the fi eld of family research, and I thought that network Downloaded by [New York University] at 03:54 14 August 2016 research would probably take a new sort of form that I would not enjoy. I was also trying to think out something about anthropology and psychoanalysis but I still did not know exactly what it was. At this time I was lucky: I was offered a fellowship by the Ford Foundation that would pay for the remaining cost of my training. I think this must have been because of Family and Social Network. The selection process consisted of an interview with Anna Freud, whom I remember as extremely intelligent and a little remote. I was rather intimidated by the Egyptian statuettes. As part of the fellowship I was supposed to write something that would integrate the thinking of psychoanalysis and the social sciences. I thought that was far too large an aim for my way of thinking and I said I would try to write about the mental hospital, which I eventually did, though not until many years later, in 1976. 138 On becoming a British psychoanalyst Before resuming the training I was re-interviewed by Hedwig Hoffer – another pleasant and searching exchange – and then put in the current second year, which this time was almost entirely composed of Independents: ten Independents, one Contemporary Freudian and me. As a group we were even more withdrawn and sedate than the year I had been in before. My fellow students wanted to get through the training and get back to their psychiatric practices. Only four, counting myself, went on to do a considerable amount of analytic work and I think I was the only one who became a training analyst although I thought several of the others were more clinically gifted than I was. Shortly after joining my new second year a fellow student told me I was no longer a Kleinian and that I had become a member of the Middle Group (the ‘Inde- pendent Group’). I was astonished and asked why. He said it was because my analyst’s analyst, Paula Heimann, had changed to the Middle Group and so that meant I had changed too. I said that what Group I belonged to was my affair not my grandmother’s. It left me with an even more jaundiced view of groups. Of course I badgered my analyst (Lois Munro) to tell me what she thought of all this but I got only interpretations in reply. Only very late on in my analysis did she say, ‘I have always been a Kleinian’, which was what I thought she would say. Before I had left for Tonga in 1958 I had asked Paula Heimann to supervise my fi rst training patient when I got permission to start, and I certainly did not want to change my mind because she had left the Klein Group. I was terrifi ed of starting clinical work. Unlike most of the members of my year and unlike most of today’s candidates, I had never seen a patient. I had done a lot of research interviewing and observation but felt that was quite different. I found that the idea that I might help a patient to change was preposterous. For a start I did not know how, and in any case I was deeply imbued with the anthropological attitude that one’s task is to understand, not to change. It was many years before I realised that this attitude might be a help rather than a defi ciency, and that it had in fact been advocated by Freud (Freud, 1912). On the day I was to see my fi rst patient I walked along New Cavendish Street wishing that a large hole would open up in the street and that I would disappear into it. One of my fellow students practically pushed me upstairs where I was to see my prospective patient. Somehow or other I got through the preliminary interview, having noticed eventually that my patient was even more terrifi ed than I was. We arranged to start and after waiting a decent interval for him to leave I rushed down the stairs two at a time and into the Library to tell my colleague I had survived, and what was more, I thought I had made an interpretation. He asked what I had said. I told him and he said, ‘Elizabeth, really, that was all wrong!’ Supervision had begun. Downloaded by [New York University] at 03:54 14 August 2016 Once the clinical part of the training had started I felt much more engaged. It no longer bothered me that the theory was not very well taught and that the minds of teachers and students seemed so closed to other points of view. The world of clinical understanding was full of wonders. Every now and again someone had a clinical insight that was so ‘right’ that it was profoundly moving. Whether it was aesthetic, therapeutic, scientifi c or moral understanding did not seem to matter, it was just there. It was similar in feeling to the sense of discovery I knew from anthropology. Even Group differences became less important, which was a relief. I had a fi rm conviction that I had no fl air for clinical work, but under the infl uence of supervision and clinical seminars I came to feel that this was a self-centred attitude and that the whole notion of clinical understanding was so important that it was worth pursuing even if one wasn’t especially gifted at it. ‘Try to forget about On becoming a British psychoanalyst 139 yourself’, I told myself, ‘and just concentrate on the patient and the work.’ Saying it was one thing, doing it was more diffi cult. I enjoyed supervision with Paula Heimann, who was patient with both me and my patient and did not make me feel too badly over my ineptitude and inexpe- rience. She helped me to see that I could not force understanding. ‘But why is he homosexual?’ I asked, and she replied, ‘Only he can tell us that, in the fullness of time.’ Flashes of insight were not especially frequent in this supervision but it was supportive and kindly. Herbert Rosenfeld was my second supervisor. Again, I do not remember many details of what he said except for the feeling that he had a profound understanding of my patient and of the psychoanalytic situation. I remember the constant feeling that I was listening to a master clinician. He was also a little bit formal as a supervisor, which made it possible for me to ask him for analysis several years later. I think the general atmosphere of the Society in the early 1960s was rather different from the way it is now. In particular, each Group was felt to have several leaders in theory and clinical work and no one of these leaders was much more well-known or more highly regarded than the others. In the Klein Group there were Segal, Rosenfeld and Bion, each creative in a different way, each writing about psychotics. Betty Joseph, Elliott Jaques, Leslie Sohn and Donald Meltzer were becoming well-known too. In the Independent Group the main names were Winnicott and Balint. Both were well-known to us, Winnicott for his fl ashes of brilliance in lectures and seminars but also for his occasional lapses into what seemed like utter boredom and exhaustion. I found Winnicott’s thinking diffi cult: allusive, suggestive, ambiguous, rather seductive. I preferred more straightforward thinking that I could get to grips with without feeling that I was missing something or reducing imagination to platitude. Throughout the 1960s we heard several of Winnicott’s well- known papers without thinking at the time that they were more striking than those of our other well-known analysts. Balint was something of an enfant terrible even in his old age. In seminars it seemed to us that he was especially charming to the women and rather aggressive towards the men, which was quite appealing if one was a woman until one realised what was going on. In the early 1960s we students thought Winnicott and Balint were equally important. It would have astonished us to know that in thirty years’ time Winnicott would have become the central theorist of the Independent Group and would be very well-known in France and in the United States, whereas Balint, except to a small number of Independents and Hungarian analysts, would be remembered only for his work with groups of general practitioners. In the 1960s Masud Khan was also an important fi gure in the Independent Downloaded by [New York University] at 03:54 14 August 2016 Group. In seminars he was by turns terrifyingly authoritarian, seductive, very clever. The later revelations of Wynne Godley (Godley, 2001) cannot have been a surprise though they made all of us, even those who were students at the time, feel appalled at what we and our Society had allowed to go on unchecked. Finally, Pearl King and William Gillespie were well-known to students too, though perhaps not so much for ideas as for their organisational activities both in the Society and internationally. In the Contemporary Freudian Group there was the single most important fi gure of Anna Freud, well-known at the Hampstead Centre and internationally, especially in the United States, but mysteriously absent from the British Society. Walter Joffe and Joseph Sandler were becoming well-known for their writing and teaching, and Ilse Hellman was greatly valued by us students for her clinical 140 On becoming a British psychoanalyst teaching. Willi Hoffer and his wife Hedwig were particularly important to me, as I have described above. In my last year in the training I persuaded a group of students that we ought to do something about the absence of Anna Freud from the curriculum, and so we requested that she do a clinical seminar so that we could hear her point of view. She did not exactly do a clinical seminar, but she arranged for us to attend two evenings at the Hampstead Clinic in which a senior trainee (or perhaps he was already an analyst) would present clinical material. My memory is that it was a rather strange event. Many students attended, mostly sitting in the hall on chairs with some of us sitting on the stairs. The senior student presented, but only the patient’s history, not material from sessions. I think we asked a few questions but not many because there wasn’t enough time and in addition questions did not seem welcome. Miss Freud spoke very little. When we left I and the other students who had asked for the evening were accosted by the remaining students and asked ‘What on earth did you put us through that for?’ I can’t remember the second evening. Perhaps it did not take place. That was the end of my ecumenical efforts as a student. In the early 1960s things were a bit less formally arranged in the training organisation than they are now. In my last year I became pregnant with our second child and it was diffi cult to know which would come fi rst, the baby or the qualifi cation. Some considerable time before the baby was due I met the Institute caretaker on the stairs of Mansfi eld House and he said, ‘They are discussing you tonight.’ I asked who was discussing me, and he said it was the Training Committee. He seemed to be saying it was about my qualifying. I said that was impossible because I had not fi nished the time requirements. He would not say any more. I left thinking that if he was right, it must be because of the baby. Then I thought no, it was that Dr. Rosenfeld wanting to get rid of me so that he could take on another supervisee. Needless to say I got nothing out of my analyst though I had the feeling she was not pleased with our caretaker. And I heard nothing more about early qualifi cation. I fi nished at the proper time, fortunately just before our second baby arrived. And so ended the formal training and my supervision with Dr. Rosenfeld, as I had predicted, and a little later, my supervision with Paula Heimann. My fi rst analysis was concluded too, as we had arranged. Dr. Munro was very generous. With some uneasiness I said that in some years’ time perhaps I would want a second analysis. She agreed and gently discussed who might be good for me. Then we said goodbye. It was Easter 1964.

On becoming a Member and a training analyst The rest of the 1960s are a bit of a blur because I was more involved with children Downloaded by [New York University] at 03:54 14 August 2016 and my personal affairs than with psychoanalysis and I had very few patients. In any case it takes a long time to feel that one is really an analyst and to get fully involved in clinical work, teaching and writing. I had a year’s supervision with Bion in 1965 which was deeply important to me. I expected him to be as obscure as I had at fi rst found some of his writings to be, but found that everything he said was straightforward and seemingly obvious, except that it hadn’t been obvious until he had thought of it. He was not at all judgemental, and he had a way of communicating, largely by example I think, that whatever gifts one had as an analyst, it was one’s duty to use them as best one could for one’s patients and for psychoanalysis. Later I had several years’ supervision with Donald Meltzer – another very interesting but very different sort of mind. I was sorry when, as he put it, he had On becoming a British psychoanalyst 141 ‘differences of opinion with senior colleagues’. I stayed on for more supervision until sometime later. I went to a very interesting seminar on infant observation conducted by Esther Bick, who had an unusual gift for understanding babies, their mothers, and the relation between them. She was very sure about her conclusions and did not like questions, which she interpreted as attacks, but her rather dictatorial attitude was worth putting up with because of her remarkable imagination and insight. I also went to several postgraduate clinical seminars, by Meltzer, Segal, Sohn and one that was a mixed group of Freudian and Jungian analysts which I had been asked to because of my work in the mental hospital. And, of course, there was Betty Joseph’s seminar. I began to see children for analysis, not because I wanted to be a child analyst but because I thought it would help me in work with adults. Meltzer supervised the fi rst case, Hanna Segal the second. She was judgemental, and rightly so, but in a way I did not fi nd persecuting because she criticised what I did but not what I was. I had considerable supervision with Leslie Sohn too. He had an uncanny knack of understanding the anorexic girl I was trying to treat, though I found it diffi cult to follow what he said. I felt as if I was a sort of conduit between Sohn and my strange girl. And fi nally came a period in Betty Joseph’s seminar in which she was developing her technique of immediate emotional contact with the patient and understanding of enactment by patient and analyst. I found this work most impressive. By this time I had given up any idea of continuing in anthropology. Slowly I wrote up the hospital study and some of the Tongan material, but any other sort of involvement was no longer practicable. However much I still felt like an anthropologist, I could not work in the fi eld, keep up with the literature or seek a University appointment. I had begun my second analysis in the early 1970s with Dr. Rosenfeld, had moved house and seriously began to practise psychoanalysis. I began writing and teaching as soon as my children had grown up a bit and I had built up a practice, which was easier then than now. I have always enjoyed writing, or, more accurately, I enjoy having done the writing. The actual process is too diffi cult to be enjoyable in itself. Much of my writing in psychoanalysis has happened because of some obligation I had to fulfi l. The fi rst obligation/opportunity came in 1967 when I was asked to give a public lecture for the Society using ideas from psychoanalysis and anthropology. This turned into an analysis of the kava ceremony of the Kingdom of Tonga (Bott, 1968) in which I was much helped by several colleagues, particularly Pearl King. The next obligation was something of an ordeal: the Membership paper. It was the only way to become a Member in 1974 and several colleagues urged me to get on with it. I wrote it with some help from Betty Joseph as an adviser, but the Downloaded by [New York University] at 03:54 14 August 2016 amount of help was strictly limited by the Membership regulations. One of my colleagues of my own analytic generation and Group helped me with it too. I was very anxious when I had to give it to a large panel – it was nearly as bad as my fi rst interview with a patient. One had to sit at the head of a large table in the Board Room on a throne-like chair that had a satin cover. I kept slipping forward, convinced that I would slowly slide under the table. I was very grateful to Geoffrey Thompson (Ind), the Chair of the panel, who asked quietly before the panel began, ‘Are you feeling nervous? Don’t be too apprehensive. Many less worthy applicants have sat in that chair.’ Once I got going I saw that people looked interested and the questions were not hard to answer. Only one was a bit negative – from a Kleinian. Ten years later I remembered this when a Kleinian candidate said to me, ‘You Kleinian training analysts don’t know what you do to us! First you treat 142 On becoming a British psychoanalyst Independent and Contemporary Freudian students with kid gloves, then you clobber us Klein students for not being good enough. And on top of that we get clobbered by Independent and Contemporary Freudian seminar leaders because we are Kleinian!’ I have often wondered if her view was generally shared by other Kleinian candidates. Unfortunately I was not in a position to assure her that I had once been treated very kindly by a leading Independent. I applied to become a training analyst the next year, 1975, which was a much easier procedure: a small panel of three people, and all one had to present was a bit of the patient’s history and two or three sessions. It was quite a searching discussion, but nothing like as intimidating as the Membership panel. It felt like an anti-climax, this fi nal achievement of psychoanalytic status. I felt myself still to be a beginner.

The next thirty years: acquiring the analytic attitude In a sense becoming a training analyst was a beginning. It was the start of an emotional and intellectual inner journey which was extremely important to me but which I have tended to play down at the same time. I thought of myself as ‘just visiting’ psychoanalysis as I had just visited the research families and the Kingdom of Tonga. This attitude has certain advantages. It has that peculiar combination of involvement and detachment that is typical of anthropology. It meant that I approached my patients with a wish to discover and to understand rather than to cure. It stopped me from being too judgemental when I encountered patients and colleagues with attitudes very different from my own. But it inhibits imagination and leads to an apparent self-deprecation which stops one from a realistic recognition of one’s potentialities. It is like my conviction that I could not do clinical work, which I eventually had to recognise as, at least in part, a disguised form of self-importance. Although it is fundamentally an inner journey, it has involved much external activity as its medium: work with patients, supervising, teaching, intense discussion with colleagues, writing, work in the Society, being Editor of Books, exploring the Melanie Klein Archive, concern about ‘the Groups’. Of these, work with patients is of course the most important, but the development of my thinking has been infl uenced by all the others as well. Supervising students, analysts and psychothera- pists has been almost as important as clinical work, though in a different way. It led me to understand the great variety of talents and diffi culties that analysts and therapists bring to the work, and something about how to help them. And it has vastly increased the number of patients I know something about, although the knowledge is of course more intellectual than the experience of one’s own patients. Downloaded by [New York University] at 03:54 14 August 2016 Teaching Teaching has been particularly important because it led to thinking and writing about ideas. It began with a Freud Reading Seminar which involved intensive reading and discussion of The Interpretation of Dreams (1900) and Freud’s case histories, which was I think one of the most enjoyable courses I have taught. The candidates seemed to enjoy it too. In the process I discovered Joseph Sandler’s (CF) papers on Freud’s models of the mind. These were eventually published as a book (Sandler et al., 1997). Discussing these papers with Joe led to friendship with him and his wife Anne-Marie (also CF). I then taught courses on elementary and advanced Kleinian analysis which were very important to me because I realised that I could describe Klein’s thought in a On becoming a British psychoanalyst 143 way that students were able to hear and to understand. It also led to my fi rst efforts in formulating what later came to be called ‘post-Kleinian thought’. I also taught infant observation for several years and helped to establish it as an important part of the British training. Perhaps surprisingly, this experience did not lead me in the direction of developmental psychology and attachment theory as the answer to the inevitable uncertainties about intellectual and emotional development in psychoanalytic theory. I fi nd those fi elds interesting, but have stayed convinced that the analytic session is the best place to study the unconscious mind. Infant observation, however, proved to be useful in other ways. It helped candidates learn how to observe in detail without becoming either a friend or an expert. It also turned out to be a very good predictor of candidates’ success or failure in the later, clinical part of the training. Much more recently I have taught a course on the development of technique in the British Society, starting with Freud and then, with the help of several colleagues, going on to outline and illustrate technique in each of the three Groups – a course which I believe the candidates too have found interesting in spite of the amount of reading involved. It has contributed to my understanding of both Kleinian technique and of technique in other points of view. All along I have also taught clinical seminars, another useful opportunity for understanding and for meeting more patients, so to speak. As time went on, I made increasingly frequent visits to Europe, Latin America and the United States, sometimes to give papers, but also to conduct clinical seminars and supervisions. This gave me a much broader view of variations in outlook and technique, and, once again, a wider view of types of patient. Though I can no longer travel, my curiosity and interest remain strong.

Committees Just before I became a training analyst I joined the Curriculum Committee, one of the six or seven training committees of the British Society’s extremely complex way of dividing up the educational task. As an anthropologist I had studied several social organisations, but this was the fi rst time I had been closely involved in trying to re-design the way an organisation worked. Pearl King (Ind) had started the process by introducing choice into the curriculum. The next Chair of the committee, Norman Cohen (Ind), and I as his Hon. Secretary spent several years reorganising the design of the curriculum so as to ensure that candidates would get a good basic training, especially in Freud, and would then be able to choose what other courses to take. We assumed that if the other courses were well taught candidates would choose them. I found this work very satisfying. It led to consid- Downloaded by [New York University] at 03:54 14 August 2016 erable improvement in the basic structure of the curriculum and I think it is still followed, though of course with changes of content year by year. It meant that the sharp divide between theoretical and clinical teaching was not quite so deep as it was when I was a student. I owe a great deal to Norman Cohen. Insofar as I know anything about committees I learned it from him. He was also scrupulously fair in matters to do with Groups. I have worked on several other committees in the Society – Student progress, Membership, the Education Committee, the Publications Committee, Board and Council – but Curriculum was by far the most satisfying. It was a surprise, because I share the usual rather superior attitude of psychoanalysts towards administrative work. It was also a considerable departure for the ‘I’m just visiting’ person that I was and still sometimes am.2 144 On becoming a British psychoanalyst So-called research While I was involved with the Curriculum Committee I scrutinised candidates’ records to carry out several small investigations. This sort of minor research did not involve the methods I had used in anthropology and did not require the same effort of thinking, but I found it a useful corrective to the usual tendency for analysts to make categorical generalisations based on sketchy information usually derived from the three or four candidates the analyst happens to have in analysis and supervision. One fi nding was that infant observation is a good predictor of how a candidate will get along in the clinical training, as I have described above. Another was that, at least for candidates accepted for training between July 1969 and June 1980, one- quarter of the candidates withdrew from the training or were rejected in the course of it. This fi nding contradicts the usual belief among British analysts that once a student is accepted by the Admissions Committee he or she is sure to qualify. Yet another fi nding was that male doctors polarise themselves. On the one hand a disproportionate number of male doctors became training analysts, but on the other hand nearly half of the candidates who had diffi culty in the training were male doctors. Again, both aspects of this fi nding came as rather a surprise, but the second aspect suggested that the time and money that had been spent in trying to recruit doctors, especially male doctors, had not been well spent. I found it interesting that female doctors, unlike male doctors, were not polarised into ‘excellent’ and ‘just all right’ or ‘inadequate’; female doctors who became analysts showed a wide range of ability. In this respect they were like the ‘non-medical analysts’, both male and female. Perhaps the most disturbing fi nding was that Kleinian students only very rarely choose supervisors in the other two Groups, though Independent and Contem- porary Freudian candidates frequently did so. Choice was not random, however; Contemporary Freudian candidates almost always choose Independent supervisors if they choose outside their own Group. I think this matter of choice of supervisor must have been known for years but that no one quite wanted to know they knew it. Gradually it has become the focus of ill-feeling and discord, especially in the case of quite a few Independent analysts and some Contemporary Freudians too. This sort of simple-minded tabulation takes a lot of time but I think it is important to do it especially when there are strong beliefs that some traditional practice is or is not essential for the training.

On editing the book Melanie Klein Today Downloaded by [New York University] at 03:54 14 August 2016 Putting together this book of post-Kleinian papers (Spillius, ed., 1988) really began with the courses I had given on elementary and advanced Klein, which had involved careful reading of Klein’s own work and that of her colleagues. Having to teach it showed me where my thinking was clear and where it was not. Then in 1982, Klein’s centenary year, I was asked to give a paper to the Society on developments in Kleinian thought. It was nearly a disaster. At fi rst all went well. In order to get both an inside and an outside view of Kleinian thought, I spent a lot of time asking people in all three Groups what they thought were the central ideas of Kleinian analysis. I also made a brief study of historical changes in Kleinian technique by reading through all the Kleinian Membership papers stored in the Institute Library. That was all fi ne, but then I spent almost all the time I had set aside for writing the paper in a very different activity: I kept reading Bion and arguing with a friend On becoming a British psychoanalyst 145 about the meaning of ‘O’ and ‘the thing in itself’ (Bion, 1965). I had only a day left to draft the actual paper, and Betty Joseph pronounced it ‘muddled’. Then at the last minute I saw how to do it – by topics instead of by people – and it began to make sense. I fi nished it an hour or so before giving it. The actual lecture was well attended and seemed to go well except that Dr. Rosenfeld went to sleep! But what was I doing, I asked myself later, spending all my writing time worrying about ‘O’? Perhaps, I thought, I didn’t like making a position statement. ‘I’m just visiting’ was staging a little rebellion. That paper (Spillius, 1983) became the basis for the introductions to the various topics covered in Melanie Klein Today. Before making the fi nal selection of papers I talked once more to several colleagues, mainly Kleinians but friends in the other Groups too. I also set aside three weeks of a holiday to reread Bion from ‘The imaginary twin’ (1950) through to Attention and Interpretation (1970) – still without being very clear about ‘O’ and quite a lot else besides, but nevertheless I was very much impressed. By this time I was developing a pattern of work that consisted of reading on the one hand and intensive discussion with colleagues on the other. We discussed not only our own ideas but also the synthesis I was developing about the general development of Kleinian thinking as a whole. Without realising it at the time this was a strand in the development of what came to be called ‘post-Kleinian analysis’. And because of the intense discussions with colleagues, I felt more certain that what I was talking about and writing was real and clinically relevant. I was pursuing ‘O’ even if I hadn’t quite realised what it was.

Post-Kleinian analysis I realised that Klein had left us a very important legacy: a general theory which was not watertight or rigid, but which allowed her colleagues to work on particular ideas within it without interfering with the whole – actually with enrichment to the whole. She herself had encouraged this process when Rosenfeld, Segal and Bion began using her ideas in the study of psychosis. Bion concentrated on psychosis and thinking, Segal on psychosis, aesthetics and thinking, Rosenfeld on psychosis, narcissism and borderline states, Joseph on technique, Meltzer on internal object relations. This sort of development within her general theory had also been going on, for example, in the case of the topic I discussed in Volume 1 of Melanie Klein Today under the heading of ‘Pathological Organisations’ – John Steiner’s term. Quite a number of colleagues had been working on this topic – Rey, Meltzer, Rosenfeld, Brenman Pick, Sohn, O’Shaughnessy, Malcolm, Joseph and John Steiner – without Downloaded by [New York University] at 03:54 14 August 2016 quite realising that they were talking about very similar things. My linking them under John Steiner’s name of ‘pathological organisations’ drew attention to their similarities. I also tried to draw out two main strands of thinking in the idea as described in all their papers: the idea of a bad self perversely dominating the personality, and the idea of a structured pattern of impulses, anxieties and defences which roots the personality somewhere between the paranoid-schizoid and depressive positions. John Steiner took the concept of pathological organisations still further in his book Psychic Retreats (1993) and his ideas have been widely adopted and used. Some years after the publication of Melanie Klein Today in 1988 I wrote another paper on the development of Kleinian thought (Spillius, 1994) in which I covered much the same ground as in the various introductions of Melanie Klein Today. In 146 On becoming a British psychoanalyst some ways I prefer this paper to the introductions in the book because it allowed me to expand on the development of Klein’s own thought and to describe more clearly the continuities between her thought and the developments of it by her colleagues. As before, I discussed this paper beforehand with several colleagues. Much discussion of Kleinian ideas takes place in various post-graduate clinical seminars, especially Betty Joseph’s workshop but also seminars by Segal, O’Shaughnessy, Sohn, Brenman Pick and Malcolm. But much discussion also goes on between individual colleagues, especially in the form of reading early drafts of one another’s papers. Out of this sort of interchange I was able to develop the particular form of my ideas on envy, projective identifi cation, unconscious phantasy; Britton’s on the Oedipus complex, belief, the truth-seeking and truth- evading aspects of unconscious phantasy, the selected fact (Britton, 1998); O’Shaughnessy’s views on technique and the superego (O’Shaughnessy, 1992 and 1999); Riesenberg-Malcolm on the bearing of mental pain (Riesenberg-Malcolm, 1999); and the many ideas of the participants in Betty Joseph’s workshop (Varchevker and Hargreaves, 2004). And there are many other examples of Kleinian friends working together on ideas. In spite of the fact that the name ‘post-Kleinian analysis’ has stuck, I have never liked it because it implies that there is more difference in it from Klein’s own work than there really is. The decline in the use of part-object language is sometimes thought to be a major transformation, but in my view it is not a very important change; greater use of her idea of projective identifi cation and the linking of it with countertransference is indeed an important change, but the other aspects of post- Kleinian analysis are developments rather than major changes. The overall framework of Kleinian thought tolerates more internal variation than is sometimes realised. Many of my colleagues do not agree with my ideas about envy, for example. Britton does not fi nd the term ‘death instinct’ useful in spite of the fact that the term is considered one of the hallmarks of Kleinian analysis. There is also variation from one Kleinian analyst to another in how much clinical emphasis to place on inherent destructiveness. But in spite of these internal variations there is no doubt that both the body of theory as a whole and the group of people who use it have considerable coherence and a sense of common identity. Further, the Group has slowly grown in the last fi fty years from 24 in 1951 to 155 members in 1985, until it is now nearly as large as the Independent Group which has always been the largest. But these numbers are really very small – a reminder that the British Society as a whole is small – 442 worldwide, only 354 in the United Kingdom, plus 45 students. Its renown, past and present, is based not on its size but on the contributions of particular individuals. Downloaded by [New York University] at 03:54 14 August 2016

My own writing By the 1980s I had started writing about my own psychoanalytic ideas as well as trying to formulate the trends of post-Kleinian analysis. Such papers usually arose from interaction between clinical work and the ideas I was reading about and teaching, and were enriched by discussions with colleagues, as I have described. The paper that has meant most to me is one on envy (Spillius, 1993) which I had thought about off and on for years. Klein’s last book Envy and Gratitude (1957) has been an especially important contribution to her theory and all her colleagues and students have been profoundly infl uenced by it. In my clinical work I had come to think that a certain amount of envy is present in everyone, which I began to On becoming a British psychoanalyst 147 think of as ‘ordinary’ envy, a basic and probably inevitable reaction to having to accept the otherness of the other. I sometimes thought of it as ‘allergy to otherness’, and was delighted to fi nd that Britton was thinking about much the same sort of thing, which he describes as ‘psychic atopia’ (Britton, 1998, p. 58). Recognising the otherness of the other is ridden with confl ict: otherness is the source not only of envy but also of the greatest delight – vive la difference – and, as Klein says, it is the arena of gratitude as well as envy. I stopped thinking of envy as totally regrettable, or, rather, I thought of it as regrettable and painful but also to some degree unavoidable and valuable. However, it was clear from my practice that some patients were utterly preoccupied by envy, eaten up by it. Unlike the sufferers of ordinary envy, they felt very little guilt about it, for they believed that it was the other person’s fault that they had to feel such envy. They lived in what might be called a culture of blame – constantly looking for the culprits who were responsible for their envy, their unhappiness, their failure to thrive. This I thought of as ‘grievance’ or ‘impenitent envy’. The difference between ordinary envy and grievance is partly a matter of degree but I also came to think of it as a difference in kind. It would be tempting to look at patients’ remembered history as an explanation of their envy, but that seemed to me a fruitless approach for there is no way of establishing the ‘facts’ of a patient’s past experience from any other point of view than the patient’s experience of them, which is part of the pattern of envy rather than an explanation of it. The facts that are special to psychoanalysis are the behaviours and feelings in the session, the patient’s and the analyst’s, and the relation between them. And here the salient fact that emerged in the case of grievance patients was that in spite of their many complaints, they did not want to lose their grievances. The deepest impression one is left with is that without grievances the patient is nothing, he loses his specialness, his reasons for existing as himself. And loosening the grip of such a belief system is a slow and diffi cult process. To help me conceptualise the process, I developed a model of ways of giving and receiving that I have found helpful in understanding the factors that alleviate and exacerbate experiences of envy. Looking back, I realise that the issues I have thought about in this paper touch on the themes of nearly all the other papers I had written before and have written since: perversion, modes of projective identifi cation, unconscious collusion in analysis, developments in Kleinian thought, especially in technique, formulation of clinical facts, unconscious phantasy, the negative therapeutic reaction, the unconscious aspects of social roles, the role of ceremony in creating, stating and allevi- ating social tensions, and, fi nally, even in comparisons of psychoanalysis and psychotherapy. The common theme, I think, is that whatever the immediate issue I am working on, I fi nd myself tacitly exploring how people deal with the otherness Downloaded by [New York University] at 03:54 14 August 2016 of the other. And in the process of this constant exploration I have found myself increasingly freed from the dominance of ‘just visiting’.

The New Library of Psychoanalysis In 1988 I was appointed Editor of Books for ten years. The main task was the editing of books for the New Library of Psychoanalysis, a venture started by David Tuckett (Ind) to succeed the earlier International Library of Psycho-Analysis. It was a great deal of work but on the whole very pleasurable. I was much helped, especially in the beginning, by Christopher Bollas. This work allowed me to make a considerable gift to the Society – the editorial time needed to send twenty-eight books to the publisher – and it was something I really liked doing. It was a natural 148 On becoming a British psychoanalyst undertaking for a person who just visits. I tried to encourage serious psychoanalytic writing of all schools of thought both from the British Society and from the continent and further afi eld, and if authors wanted it I tried to help them realise the ideas that they had not quite formulated. All I really insisted on was that each book should be clear and that it should hold together as a book even if it had started as a series of disparate papers, which is what most psychoanalytic books are composed of. It also meant, of course, that I became more familiar with points of view I had not known about in such detail, many of which I found very interesting.

The Klein Archive and other plans The Klein Archive was set up in January 1984 at the Wellcome Library for the History and Understanding of Medicine. It is a treasure, containing Klein’s volu- minous notes, drafts of many of her papers and written-out lectures on child analysis and on technique. One day I hope to publish something based on her technique lectures, for they show clearly how she worked and it is rather different from the way we work today. The lectures and notes also give one a clear impression of the sort of person she was – not at all the severe antagonistic sort of analyst she is often thought to have been. Sorting out her lectures will be a formidable task, however, for they are undated and rather mixed up, with frequent borrowings from the child analysis lectures and vice versa. I am saving up this treasure to work on when other projects are not quite so time-consuming as they are now, the other projects, besides analysing, supervising and teaching here and abroad, being the editor of a book with Edna O’Shaughnessy on the spread of the concept of projective identifi cation, and chairing a small team working on a new edition of Hinshelwood’s Dictionary of Kleinian Thought (1989/1991), which he has asked the Melanie Klein Trust to be responsible for. (By 2012 both these books had been published by Routledge.) I would also like eventually to write about the development of technique in the British Society, based on the course on technique I have been teaching for several years. I have found that this course has crystallised my feeling about psychoanalysis in a way that I had not been able to articulate clearly until a former student did it for me. What I had conveyed in the course, he said, was that it was possible to have fi rm views about one’s own technique while at the same time being curious and receptive about the technique of other analytic schools of thought. As he said this I realised that his statement was equally true of the anthropological attitude towards other societies, another indication of concordance in the basic approach of the two disciplines of anthropology and psychoanalysis in spite of the differences in their content. Downloaded by [New York University] at 03:54 14 August 2016

On looking at the Society with an anthropologist’s eye I should know better than even to try to look at the Society as an anthropologist because one of the fi rst things one learns in anthropology is that one cannot really study a group that one is deeply part of. So whatever these refl ections are, they cannot be proper anthropology. As is well-known, now is not an easy time for psychoanalysis generally, and it is not an easy time for the British Society either. Perhaps the basic problem is a change in the Society’s environment, namely, the growth of other therapies and medical treatments for mental disorders, treatments that are thought to be easier, cheaper and less time-consuming than psychoanalysis though of less epistemological On becoming a British psychoanalyst 149 interest. But epistemological interest is not of much concern to governments or society as a whole. In Britain, as elsewhere, there is some decline both in the number of applicants for psychoanalytic training and the number of patients who want intensive psychoanalysis, and as yet there has been no agreement on how to tackle either issue. British psychoanalysis has also shared in a general trend for psychoanalysts to become older, female and non-medical. Recently the Society has become less closed. Several initiatives have been developed that have increased contact with other disciplines and with the general public. But this has not done much as yet to alter the decline in prospective analytic patients or in applicants for training. Paradoxically, intellectual interest in psychoanalysis has been increasing at a time when clinical interest is declining – and it is clinical psychoanalysis that is the particular forte of the British Society. There is some pressure in the British Society for a reduction of the current requirement of fi ve-times-a-week analysis for candidates and for candidates’ training patients, although this suggestion has not yet gained widespread support. I would resist such a change because it is my belief that the most creative innova- tions in psychoanalysis have come from the practice of intensive psychoanalysis, not primarily from psychotherapy or from research in other though related fi elds. Psychoanalytic societies worldwide have always been prone to contentiousness and a tendency to split into separate societies. I think this occurs because of the presence of two factors that are intrinsic in the nature of the work. Psychoanalysts carry clinical responsibility for their patients, and yet there is no very adequate way of showing that one psychoanalytic theory is more adequate than another either for achieving better understanding or for achieving ‘cures’. Clinical responsibility and diffi culty in evaluation make an awkward combination. Medical practitioners, by contrast, carry clinical responsibility, but the evaluation of their treatment methods is usually easier. Anthropology is like psychoanalysis in that there is no way of showing convincingly that one theory is better than another, but anthropologists do not carry clinical responsibility for the societies they study. What tends to happen among psychoanalysts is that they seek out like-minded colleagues to share their beliefs and anxieties, and they get rid of their uncertainties and inadequacies into others of whom they disapprove and with whom they tend to quarrel. Every now and again an issue fl ares up and the existing but not very clearly defi ned sub-groups within a psychoanalytic society are likely to split. In the British Society such a fl are-up happened in the 1940s over whether Melanie Klein’s approach was legitimate analysis or not, but the British Society managed not to split. Instead it developed the three-Group system, its most distinctive internal feature. It remains a puzzle to both continental and American analysts, who some- Downloaded by [New York University] at 03:54 14 August 2016 times regard it as a great achievement of pluralistic psychoanalysis, sometimes as just a peculiar anomaly of the British. Certainly the function and character of the Group system have changed since its beginnings in the 1940s, when I think fi ssion was avoided not only because of the negotiating skills of Sylvia Payne and others but also because most people realised that the Society was too small to split. Later on when the Society was larger it could have split, but by that time we had apparently got used to the system and did not particularly want to split. The ‘gentleman’s agreement’ for rotation of offi ces was made workable by a system of behind-the-scene negotiations: ‘We are thinking of nominating so-and-so to be President or Chair of Such and Such, would that be acceptable to your Group?’ Or, ‘I think it’s about time we did it, but no one of our lot wants to or is suitable, could one of yours fi ll in?’ And so forth. Even at a lower 150 On becoming a British psychoanalyst level various accommodations had to be used to achieve Group balance on important committees. For example, when it was time for Norman Cohen to retire as Chair of Curriculum he could not immediately do so because that would have upset the Group balance on the Education Committee on which, as Chair of Curriculum, he had to sit. He told me to run the Curriculum Committee, to ask his advice when necessary and to tell him what to report to Education. He then told me what Education had said. This arrangement suited him and me and both committees, but strictly speaking it was slightly irregular. This sort of Group adjustment and manoeuvring was going on at a time when demand for psychoanalysis was still increasing and no Group felt particularly inferior or superior to the others, and no one disapproved too strongly of the fact that an informal elite of senior training analysts of all Groups was making the accommodations and decisions. It was not always as easy as I have made it sound, of course. Occasionally diffi cult issues arose that required everyone to put the interests of the whole Society above Group interests. Once the demand for analysis and the number of applications for training began to decrease, competition between the Groups appeared to increase, and ill-feeling between Groups became stronger. At the same time the Klein Group was increasing in size and Kleinian theory was becoming better known nationally and internationally, and ill-feeling increased still more, particularly, I believe, between Kleinians and Independents whereas in the beginning the tension had been strongest between Kleinians and Contemporary Freudians. Such ill-feeling no longer centres on theories as much as it used to in the 1940s and 50s, perhaps because there has been a certain amount of convergence in theory and technique but also because there has been considerable internal diversifi cation on matters of theory in the Independent and Contemporary Freudian Groups. Ill- feeling now centres particularly on issues of Group balance and succession of offi ce, and in this type of issue there have been new alliances within and across Groups, often with considerable acrimony. But the older issue of Kleinian candidates choosing only Kleinian supervisors rumbles along too. This pattern of choice has been going on for a long time, nearly fi fty years, but no one resented it when the Klein Group was very small. Now it is often regarded as clear evidence of Kleinian arrogance. From time to time Kleinians and indeed all candidates are publicly reminded that they are free to choose whatever supervisor they wish. Encouragement by an individual Kleinian supervisor to consider a supervisor from another Group is usually met with polite refusal by the Kleinian candidate. Such exhortations have little effect. Whatever the personal opinions of individual candidates, I think that the weight of a practice that has gone on for nearly fi fty years is a decisive factor. Forcing candidates of all Downloaded by [New York University] at 03:54 14 August 2016 Groups to have one supervisor in another Group is a solution that is sometimes thought about, but I think that many analysts, and not only Kleinians, would regret diminishing choice in this way. In 2005, however, there has been a change of policy. The Society has agreed to abandon the gentlemen’s agreement according to which an attempt was made to secure a balance of Group membership when appointing analysts to particular positions. Analysts will now be proposed for offi cial positions without Group membership being taken into account. It is too soon, however, to know how this will work out in practice. I think this change has come about partly because it seems fruitless to worry about internal divisions when psychoanalysis as a whole is increasingly under threat, and partly because it has become increasingly diffi cult to stick to the gentleman’s agreement because of changes in Group size. On becoming a British psychoanalyst 151 Finally Where has my intellectual and emotional journey got to? I think to a place that feels less personally fraught than it used to, even though the Society itself has been having a more diffi cult time than it was having when my journey began. I felt less fraught because I came increasingly to like clinical work even when it troubled me that I could not understand my patients as well as I would like to. And I also have very much enjoyed supervising, teaching, travelling, writing. I am grateful both to psychoanalysis and to the British Society for the opportunities and enrichment they have given me.

Notes 1 Hedwig Hoffer belonged to what was then called the ‘B Group’. She would now be called ‘Contemporary Freudian’ (CF). Roger Money-Kyrle was Kleinian (K). Because the three Groups were important in my experience of the Society, I will identify people’s Groups as I proceed. 2 In my personal idiom the phrase originated many years ago when an artist friend looked around her tiny, chaotic Paris fl at occupied by her husband, her young baby, her pregnant self and an immense amount of clutter. ‘I’m not living in this,’ she said, ‘I’m just visiting.’

References Bion, W. R. (1950), The imaginary twin. In Second Thoughts. London: Heinemann, 1967, pp. 3–22. —— (1961), Experiences in Groups. London: Tavistock. —— (1965), Transformations. London: Heinemann. —— (1970), Attention and Interpretation. London: Tavistock. Bott, E. (1957, 2nd edition 1971), Family and Social Network. London: Tavistock. —— (1968), Psychoanalysis and ceremony. In The Psychoanalytic Approach, ed. J. Sutherland. Published for the Institute of Psychoanalysis by Baillière, Tindall and Cassell Ltd. pp. 52–77. Also published in Spillius, E. Bott, Melanie Klein Today, Vol. 2, Mainly Practice. London: Routledge (1988), pp. 259–283. Britton, R. (1998), Belief and Imagination. London: Routledge. Freud, S. (1900), The Interpretation of Dreams. S. E. 4 and 5. London: Hogarth Press and the Institute of Psycho-Analysis. —— (1912), Recommendations to physicians practising psycho-analysis. S. E. 12, pp. 109–120. London: Hogarth Press and the Institute of Psychoanalysis (1958). Godley, W. (2001), Saving Masud Khan. London Review of Books, 22 February 2001. Hinshelwood, R. (1989, 2nd edition 1991), A Dictionary of Kleinian Thought. London: Free Association Books. Downloaded by [New York University] at 03:54 14 August 2016 Klein, M. (1932), The Psycho-Analysis of Children. London: Hogarth Press and the Institute of Psycho-Analysis. —— (1948), Contributions to Psycho-Analysis. London: Hogarth Press and the Institute of Psycho-Analysis. —— (1957), Envy and Gratitude. In Envy and Gratitude and other Works, 1946—1963, vol. 3 of The Writings of Melanie Klein. London: Hogarth Press and the Institute of Psycho-Analysis (1975), pp. 176–235. O’Shaughnessy, E. (1992), Enclaves and Excursions. International Journal of Psycho-Analysis, 73: 603–611. —— (1999), Relating to the superego. International Journal of Psycho-Analysis, 80: 861–870. Riesenberg-Malcolm, R. (1999), On Bearing Unbearable States of Mind. London: Routledge. Sandler, J., Holder, A., Dare, C. and Dreher, A. U. (1997), Freud’s Models of the Mind. London: Karnac Books. 152 On becoming a British psychoanalyst

Segal, H. (1964, 2nd edition 1973), An Introduction to the Work of Melanie Klein. London: Heinemann; Second edition: London: Karnac. Spillius, E. Bott, (1976), Hospital and society. British Journal of Medical Psychology, 49: 97–140. Revised as Asylum and Society in The Social Engagement of Social Science, Vol. 1, The Socio-Psychological Perspective, eds E. Trist and H. Murray. Philadelphia: University of Pennsylvania Press (1990). —— (1983), Some developments from the work of Melanie Klein. International Journal of Psycho-Analysis, 64: 321–332. —— (ed.) (1988), Melanie Klein Today. Vol. 1, Mainly Theory; Vol. 2, Mainly Practice. London: Routledge. —— (1993), Varieties of envious experience. International Journal of Psycho-Analysis, 74: 1199–1212. —— (1994), Developments in Kleinian thought: Overview and personal view. Psychoanalytic Inquiry (Special issue: Contemporary Kleinian Psychoanalysis), 14(3): 324–364. Steiner, J. (1993), Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Borderline Patients. London: Routledge. Varchevker, E. and Hargreaves, A. (2004), In Pursuit of Psychic Change: The Betty Joseph Workshop. London: Routledge. Downloaded by [New York University] at 03:54 14 August 2016 CHAPTER 11

RECOGNITION OF SEPARATENESS AND OTHERNESS 1

Part of the material of the original version of this paper was included in a Fest- schrift for André Green (2002), Penser les Limites. Écrits en l’honneur d’André Green. Sous la Direction de César Botella. Éditeur Delachaux et Niestlé, Paris, Genève. A slightly different version was also published in Encounters with Melanie Klein: Selected Papers of Elizabeth Spillius, eds P. Roth and R. Rusbridger (2007), London: Routledge, and has been further revised for the present book. Freud for the most part assumed that young infants were not very much aware of their environment. For some time many American analysts took this assumption further. Margaret Mahler (Mahler et al., 1975), for example, thought that infants were born in a state of ‘autism’ in which they had no awareness of their environment, a state which soon developed into a state of ‘symbiosis’ in which the infant was assumed to be in a state of fusion or merger with his primary caregiver, a state from which the infant gradually evolved into a state of awareness of his separateness. These assumptions were eventually challenged by developmental researchers who showed that even new-born infants were aware of external objects and presumably could distinguish external objects from themselves. Slowly ideas about separateness gradually evolved into study and concepts about separateness in relation to attachment. Without knowing about American psychology, Klein assumed that infants were aware of objects at birth, so that her assumptions were closer to the fi ndings of Stern (1985) and others than to Mahler’s ideas about autism and symbiosis. Klein went further, however, because she assumed that infants have a rudimentary constitutional knowledge of self, objects and of the primal scene. But Klein also assumed that the infant’s perception of objects was at fi rst considerably distorted by his own mental operations, especially by his projection of both bad and good feelings into his objects, so that he lived in a split world of good and bad part- objects and good and bad parts of the self. As is well-known, Klein called this constellation the ‘paranoid-schizoid position’ (Klein, 1946). In it the separateness of objects is recognised, but distorted by projections. In the ensuing ‘depressive position’ (Klein, 1935, 1940), good and bad feelings are more integrated and

Downloaded by [New York University] at 03:54 14 August 2016 perceptions, including perceptions of separateness and attachment, became more realistic. Klein did not talk very much about recognition of the separateness of the self as an aspect of the depressive position, although it is clear that recognition of the otherness of the object is a central aspect of the depressive position, which implies recognition of the separateness of the self as well. In the depressive position, Klein says, it becomes possible for the ego to have ‘a full and stable identifi cation with another object, in the sense of looking at it and understanding it as it really is’. Continuing experiences of fl uctuation between the paranoid-schizoid and depressive positions involve further development of awareness of the separateness of oneself, one’s objects and of their relationships. In this chapter I will describe instances of separation and reunion which illustrate aspects of awareness of separation and attachment in a baby, a three-year-old 154 Recognition of separateness and otherness child and in an adult returning to analysis after a brief separation. I will then describe in more detail the analysis of three episodes of separation/reunion in the analysis of a woman which show the development of greater understanding of their psychic ramifi cations in her internal world.

Katie: separation/reunion in an eight-week-old baby Katie was the fi rst child of a young and rather insecure mother. I was observing Katie and her mother for a seminar on infant observation supervised by Esther Bick (see Bick, 1964). By the age of eight weeks it seemed clear that Katie had a very clear responsiveness to her mother as the central fi gure in her life, rather different from her attitude towards her father, her grandmother, the health visitor and me. The night before the observation I shall describe, the mother had just for the fi rst time put Katie to sleep in her own room, at her husband’s insistence. The husband was older than the mother, gentle and supportive to his wife. On the night in question both Katie and her parents had slept well. Soon after I arrived the next morning for the weekly observation Katie woke and cried very hard for at least fi ve minutes. Her mother went on talking to me and let her cry. It was the fi rst time I had seen her mother do this. Eventually she fetched Katie, who looked blotchy and had tears in her eyes. Her mother tried to comfort her, Katie went on sobbing. Then she stopped crying and made a look her mother described as ‘her hungry look’. Katie gave an enchanting smile. But then nothing seemed to feel right to Katie. Her mother sat down with Katie on her lap. Katie looked around at her mother, at me, the window, the fi re. She looked unhappy and discontented. Her mother kept talking to me and paid no attention to Katie. Katie started twisting and kicking. Her mother offered the breast to Katie (still talking to me) but Katie would not turn her head towards it. Her mother said, ‘She isn’t really hungry’, went on talking, then asked me to hold Katie. I held her for a time, she smiled, then got restless. After asking her mother if it was all right if I put Katie down on a rug on the fl oor, her mother said, ‘She won’t like that’, and indeed the corners of Katie’s mouth turned down and she looked as if she was about to cry. She looked at her mother. I said that I’d put Katie in that position but it looked as if her mother was getting blamed for it. ‘I think she feels everything she feels is my doing,’ said her mother. Katie began to cry hard again. Her mother picked her up and slowly unbuttoned her blouse, still talking to me. Katie went on crying. ‘I think she is so annoyed she can’t take it yet,’ her mother said. Her mother waited, silent for a moment, then more talk to me. After a minute Katie took the nipple and sucked steadily for several minutes. The telephone rang, Katie jumped and gave a sudden cry. (I Downloaded by [New York University] at 03:54 14 August 2016 answered the telephone and took a message.) Katie let go of the breast and her mother sat her up. After a minute her mother put her back to the breast, Katie gave three sucks, let go, screamed. This time her mother did nothing in particular for a moment and then stopped talking completely. Katie turned her head away from her mother for several moments; her face seemed to relax, then she turned her head back and took hold of the nipple again. Throughout the sucking this time she looked at her mother’s face, the fi rst time I had noticed her doing this. Once she glanced at me. Towards the end of the feed she looked in at the breast and looked dozy. I had to leave. As I went Katie dropped the nipple, then turned back to it. What conjectures? First, the mother. Why did she let Katie cry like that when usually she went to her at the fi rst whimper? Esther Bick (Bick, 1964, 1968) who was supervising these observations, thought the mother was giving Katie what she Recognition of separateness and otherness 155 called ‘the double dose’. What she meant was that by putting her in her own room away from her parents the mother felt that she was depriving Katie and shutting her out. She thought Katie would feel badly, which made her feel guilty. So Katie became persecuting to her mother, reproachful and accusing, and had to be punished a second time by being allowed to cry, and a third time by her mother incessantly talking to me and paying very little attention at fi rst to Katie – though I think it possible that talking to me was caused not only by the mother’s need to shut out the persecuting Katie but also by her need to get my comfort and support. Esther Bick thought that Katie herself was having a phantasy of a bad mother and a bad breast. She had suffered not only the separation in the night but also the rejection of being allowed to wait and sob; then her mother kept talking to me, and Katie might have been hungry as well. Katie had to get her mother to accept the fact of Katie’s turning away before she could establish a good relationship with her mother and the breast once more. Once the mother did nothing for a few moments, which perhaps registered her awareness of Katie’s rejection of her, Katie turned to the breast and sucked reasonably steadily. My guess is that in turning away Katie was projecting her bad, painful feelings into her mother (or rather into her phantasy of her mother) and, by avoiding her mother was wiping her out. It was not until her external mother showed, by silently doing nothing in an attentive manner, that she accepted the bad feelings that Katie could once again develop a phantasy of a good breast and a good mother. Each interruption brought back the bad breast and the good breast had to be found again by another turning away. This observation made me aware of how much sense of loss Katie might be feeling, and of how much we as parents and adults take for granted such minor episodes of separation and reunion. Of course not all Katie’s experiences involved loss – on the whole she was a happy, well-cared for baby. Cumulatively a baby’s and small child’s so frequently encountered experiences of loss and gratifi cation soon build up a picture of attachment, temporary loss, reunion, and, I assume, an understanding of adults’ separateness, their power and the child’s relative but not total helplessness.

Linda: separation/reunion for a three-year-old child in analysis (Another episode in Linda’s analysis has been described in Chapter 7, this volume, ‘Developments in Kleinian technique’). Linda was brought to analysis because she would not talk. She had in fact talked a bit when she was one-and-a-half years old. Then she and her parents were temporarily housed in a one-room fl at while waiting to be re-housed. A brother was born when Linda was two and a quarter and since then Linda had not spoken. It seemed Downloaded by [New York University] at 03:54 14 August 2016 likely that Linda was upset not only by jealousy of her brother but also by repeated witnessing of parental intercourse, though it was not clear why her reaction took the form of not talking. Perhaps, I thought later, because her parents didn’t talk when they were having intercourse? After a bit of reluctance on the fi rst day Linda came to the playroom and played vigorously with the little toys while I tried to keep up with what she was doing as best I could. It seemed clear that she easily understood what I was saying, for after a supposedly ‘right’ interpretation she would look at me pityingly as if to say, ‘Why are you telling me something so obvious?’ Then came the fi rst weekend which Donald Meltzer, who was supervising Linda’s analysis, used to call ‘the wolf in the fold’. When I came to fetch her from the waiting-room on the following Monday she looked up from the little toy she had brought with her and gave me a look of deep 156 Recognition of separateness and otherness reproach. ‘How could you!’ it seemed to say. Big tears rolled down her face. Her mother told her to be a good girl and go with the lady to the play room. Linda wasn’t having it. She sat watching me accusingly and never stopped crying. Her mother said she could not understand it. She had been so eager to come that she had pulled her mother along the street, and now this. I said to Linda that she felt terrible because I had left her. She had got very angry with me and now felt I was all bad. Presumably, I thought to myself, she was separating the ‘good’ analyst she was hurrying to meet from the ‘bad’ one she encountered as soon as she arrived in the waiting room. Linda, so much older and tougher than Katie, had no trouble expressing her view about separations. She ‘knew’ that it was quite wrong of me to have left her for the weekend like that, and she knew how to make me realise what a wrong I had committed. She abandoned me in the same way I had abandoned her. She spent the whole session in the waiting room accusing me silently with angry tears. But Linda also had a powerful wish to be understood. In later sessions she skilfully showed me that it was the primal scene that was bothering her, and when I could put that into words she started to talk, fi rst at home, then gradually in the sessions.

An adult patient, Mrs Peters, returning from a holiday break This patient, Mrs Peters, had been in analysis for three years and was returning from a holiday break. She greeted me as usual with a slight smile as if to mark the fact that we were meeting after not seeing each other for longer than usual. Once she had lain down on the couch she said she had had a good time and described the holiday in some detail, and in a way that gave me the feeling she was full of beans, very much in command of herself, taking me for granted though not unpleasantly. Having described the holiday, she told me a dream: You were coming to give me a session at my country cottage, but it wasn’t a cottage, it was a magnifi cent house. The doorbell rang. I thought it would be you, but it wasn’t, it was my brother’s friends, great louts who were going to take our hospitality for granted. I said there wasn’t room and they weren’t to come in. They left. After they left one of my children said, ‘Don’t you realise they’re desperate for somewhere to stay?’ I said, ‘Quick, run after them and tell them they can stay in the attic.’ I wanted to give each of them £10 but doubted if I’d have enough money. Omitting her associations and the to-and-fro in the session, my eventual formulation was as follows: She had put me in the position she was in today. In reality she was coming to my house but in the dream I was coming to hers. I was in her position and she had become me, or rather her idea of me. I was living in a magnif- icent house, not the cottage-like house I actually live in. She had attributed her own Downloaded by [New York University] at 03:54 14 August 2016 greedy loutish feelings to her brother’s friends, but they were perhaps a substitute for me full of other patients and my own concerns and interests during the holiday. She, in her incarnation as me, would not let these greedy loutish feelings in. Did I not realise what every child would know, that she gets loutish and takes me for granted because I deprive her? She had not actually felt badly during the holiday, it emerged, but was feeling uncertain of her mood now, and not at all sure that she wanted to come back to analysis. It slowly emerged that she thought, without being explicitly aware of it, that I should pay her for the sessions I took away from her in the holiday just as she would have had to pay me for sessions she booked but did not use. (£10 was her fee at the time.) In all three of these accounts involving separation each individual objected to the separation in some fashion, although it was expressed and perhaps also felt not Recognition of separateness and otherness 157 as much during the actual separation as during the reunion. Katie slept quietly at night but the next day she was restless and discontented and did not easily take the breast. Linda was all right during the weekend (her parents told me this later on) but found a way to express her complaint when she returned to me on Monday. Mrs Peters was fi ne during the break but told me a dream when she came back, in which she reversed our roles. Provided the individual or patient is not too disturbed and not in a crisis, I think that this sort of reaction to separations is typical. The actual separation is not experienced as particularly diffi cult in itself, and usually the fi rst session back in analysis is a sort of ‘hello’ session. The diffi culties are more likely to come in the second session, or sometimes in the second week. It is then that there are likely to be complaints, or an assertion that the patient is now so well that really it is time to stop the analysis, or some similar declaration. In this respect adults are likely to be more controlled than children. Katie and Linda, for example, had not as yet fully built up their defensive systems. Perhaps the reaction of these individuals to separations were envious, but I think that if this were indeed so, it was the sort of ‘ordinary’ envy that I have described above in Chapter 4, ‘Varieties of envious experience’. I thought that Katie was indeed unhappy about sleeping alone, but not so much that she could not turn to the breast after some protest. Linda, I thought, was actually starting to feel quite relieved to be having analysis but did not want me or anyone else to make a point of it. And the adult patient, Mrs Peters, quickly understood her reversal of roles and the element of attack in it. In different ways all were reacting to separation and otherness. All felt somewhat attacked by the separation, or felt that loss was being imposed on them whether they wanted it or not. All made some sort of attack in return, more disguised and defended against in the case of the adult.

Mrs Lewis: three separation/reunion episodes in analysis I want now to examine three episodes of separation/reunion in the analysis of a patient where it was possible to examine what was going on consciously and unconsciously in more detail. Mrs Lewis was 37 years old at the time of the three holiday breaks in her analysis I will describe. I will give the sessions in considerable detail.

The ﬁ rst break These sessions occurred about two years after Mrs Lewis’ analysis had begun. She had come to England from a Commonwealth country to do a higher degree in Downloaded by [New York University] at 03:54 14 August 2016 English after which she had started slowly and with many ups and downs, to work as a writer, critic and journalist. In the midst of this process of getting started in a career she had married in this country and decided to stay. She came to analysis primarily because of diffi culties in her career and her relationships, particularly at work. People complained, she said, that in spite of her gifts and intelligence her thinking and writing were at times confused; it appeared also that she could make herself oblivious to things she did not want to know, to the point where she sometimes became controlling, even attacking, without realising it. She got very upset when she realised she had behaved badly. There is a background fact of considerable importance to the sessions before the fi rst break I shall describe. Not long before these sessions I had moved house and consulting room. A prominent feature of the new consulting room was that two of 158 Recognition of separateness and otherness its walls were fi tted with handmade mahogany cupboards and bookcases, which were directly in the patient’s line of vision as she lay on the couch. Most patients made some sort of comment about these bookcases. Mrs Lewis did not. It was diffi cult to know whether there was any particular signifi cance in her ignoring the bookcases. In any case she had other things on her mind. At this period of her analysis Mrs Lewis maintained a friendly, even-tempered stance towards me, including the sessions before breaks. When other patients were sometimes likely to complain about my self-centredness and arbitrariness in having a break and had phantasies about what I might be doing, Mrs Lewis mostly ignored approaching breaks or talked about them in a perfunctory, dutiful way as if she thought I expected it. When I tried to point this out she listened politely, but did not react much one way or the other. I felt I was making bookish interpretations. It was a week before a long summer break. On Monday Mrs Lewis said she no longer felt as depressed as she had been feeling, though she didn’t know why. On Tuesday she talked about an episode of what she called ‘echolalia’. She had tel ephoned a particular woman critic and asked to speak to her husband, an editor with whom she works. The wife had said, ‘Can you hang on a minute?’ and Mrs Lewis found herself also saying, ‘Can you hang on a minute?’ to the wife. She explained that the husband, once he came to the telephone, had agreed to con tinue working with her on a particular project, but said that she would have to wait. She then told me about a dream she had had the night before the present session. In the dream the editor was being very friendly and attractive, virtually sexually seductive. But his wife was there in the dream. Mrs Lewis couldn’t remember exactly what happened. I said her feelings for the editor were similar to her feelings for me. She felt we both tantalised her, apparently offering her something – sessions, a project of working together – and then made her wait. And the editor’s wife was there in the dream. I thought Mrs Lewis felt I was leaving her during the holiday to be with someone else, my own editor, whoever that might be. She agreed with this easily and went back to talk about the echolalia. I said that in the echolalia she had become the wife. ‘Can you hang on a minute?’, she had said to the wife, meaning that she herself was the one in control and was not the one who was having to do the waiting and the hanging on. In the echolalia the wife had been got rid of, so there remained only Mrs Lewis herself and the man, the editor. She agreed with this, again rather easily, and described two recent instances in which she had actually made people wait for her. There was a pause. Then she said it was a good thing that she had found a really nice cleaning woman. Downloaded by [New York University] at 03:54 14 August 2016 After a slight pause because of the apparent non-sequitur I said the good cleaning woman was perhaps a substitute for her bad analyst, who wasn’t going to be cleaning up during the holiday. There was a pause. Then she said she had decided to redecorate her loo (‘loo’ is an every day, slightly euphemistic word for lavatory or toilet in British English). She described in considerable detail how she thought she would buy a mahogany loo seat. I said, ‘The loo here does not have a ma hogany seat. But there is one room here in which there is a lot of mahogany.’ ‘Oh’, she said, ‘you mean here, in this room.’ She looked carefully around the room. ‘Yes’, she said, ‘this room is full of mahogany.’ I said, ‘When you stress that your loo seat is to be made of mahogany, it’s as if you are shifting the mahogany from the consulting room into the loo.’ Recognition of separateness and otherness 159 ‘Oh’, she said. (I felt as if I was spelling things out to an interested but rather bewil dered child. Was she really so unaware of what she was saying, I wondered to myself, or had I confronted her too brusquely? It was one of the few occasions up to this time that I was aware of the ‘obliviousness’ that she said other people sometimes complained of.) ‘And so’, I went on, ‘you are putting the consulting room into the loo, fl ushing me and your analysis away. I’m the much valued cleaner, but when it’s the last week of our sessions, I’m fl ushed away. It’s not a case of my leaving you, it’s a case of your fl ushing me away.’ There was a very long pause. I felt that at last, perhaps, she had some conscious inkling of the feelings that were getting stirred up by my arbitrarily dismissing her at the time of the holiday. Then she said: ‘I wish my mother had been more like you’. I was silent for a bit, somewhat disconcerted. It sounded like a non-sequitur, but clearly was not. Was this, I wondered, a way of getting rid of possible bad feeling between us? Not quite, I thought. What I actually said was: ‘I think that at the moment I recognised that you were really being quite attacking and told you so, you felt relieved.’ She murmured agreement. I went on to say that if I could see her attack and yet continue to be reasonably well-disposed towards her, it must mean that it wasn’t so dreadful after all. ‘Yes’, she said, ‘that’s right.’ After a pause I said it was time to stop. In the next two sessions of the week, Wednesday and Thursday, she went around this material again, adding that at such times she got a feeling that she desperately wanted something and was going to have it, come what may. No waiting. ‘I want it NOW,’ she said, imitating her small son. On Friday she told me that she felt sad and fl at about her sessions ending, and then told me about two diffi cult colleagues. While telling me about the colleagues, her feet in their sandals – not absolutely clean – left their customary position on the little carpet at the end of the couch, and began walking all over the couch cover itself, ending up with her feet fl at on the couch cover and her knees slanting to one side. I pointed this out. She said, with much embarrassment, that she felt she had got into a sort of foetal position, and that being on the couch was like sitting on my lap. After considerable to-ing and fro-ing about this, including an association about her son jumping up and down on her bed, I said I thought she found it very diffi cult to put together two views of herself: herself as an innocent baby sitting on my lap, a baby whose feet could do whatever they liked, and herself as a more grown-up person, who, evidently without her being aware of it, could walk all over me, could take advantage of her supposed innocence to do something quite aggressive and spoiling to me and to the partner she felt I would Downloaded by [New York University] at 03:54 14 August 2016 be with in the summer. I felt that in this week of sessions she was beginning to have some awareness of the ancient feelings of attachment, jealousy and hatred that can get stirred up by separations, by enforced recognition of separateness. She was beginning to be aware of separation and separateness, both mine and hers, though she was fi ghting against it. I had mainly interpreted her denigration and her jealous attack, perhaps partly because I might have been more irritated about the loo seat and the couch cover than I realised at the time. In retrospect, her possessiveness, expressed through her echolalia and her sitting on me, was equally important. I think she was evading awareness of jealousy and exclusion as much as she could by a phantasy of becoming me through a form of projective identifi cation, or, even if she did not actually become me, she was getting rid of rivals by sitting on my lap. 160 Recognition of separateness and otherness The second break It was Monday, the fi rst session of the week before the second break, which was going to occur a few months after the break I have described above. Mrs Lewis was becoming increasingly aware of being a bit upset in sessions before weekends and breaks, but it was diffi cult for her to realise that she got rather angry and aggressive rather than just upset. She still reported instances of people telling her things about herself that she hadn’t been aware of. She was becoming somewhat more aware in herself of what she called ‘wiping people out’, which had painful consequences for herself as well as for the targets of the wiping out. She began Monday’s session by telling me more details about a very diffi cult work situation with her immediate boss, a Mrs K. Then she returned to describe a feeling she had had the preceding Friday that was just awful, though it had not lasted long. She had felt quite ‘wiped out’ (her words) on Friday, and that what had set it off was Mrs K’s threatening to make far-reaching changes in the arrangements at work. That had made my patient feel utterly helpless and in despair. I said I thought those feelings were also linked with the coming analytic holiday. I change the arrangement from sessions to no-sessions and she feels wiped out. She said that when Mrs K threatens to change the arrangements she feels that she is trying to make Mrs Lewis ineffectual. Does she (Mrs Lewis) feel like that because she wiped her father out? (We had been talking about her relationship with her father in earlier sessions; I wondered to myself who was making whom ineffectual now, but decided not to tackle the role of her father and the father aspect of me at that moment, for I knew that her feelings towards her father were much easier for her to deal with than her feelings for her mother. Some time later, when I was thinking about these sessions again, I felt that this jump Mrs Lewis made to thinking about her father was very important, for it slowly became clear as the years of analysis continued that she turned to her father in her mind when the particular diffi culties she had with her mother were getting stirred up. But I did not fully see this at the time of the session I am describing.) What I actually said in the session was that what Mrs Lewis had said sounded right, but I went on to say that she gave the impression that her feelings about her mother might also be in volved in this situation. It was as if Mrs K had virtually become a stand-in for her mother. She (Mrs Lewis) is terrifi ed of offending her, just as she used to be afraid of offending her mother. But when she has offended Mrs K, she clings to her, just as she used to cling to her mother. And that, apparently, irri tates Mrs K even more, just as it used to irritate her mother. She was silent, then agreed quite suddenly and with real interest in her voice, as if she had never thought of the similarity in her relationships with these two women. Downloaded by [New York University] at 03:54 14 August 2016 She was then silent for quite a long time, evidently thinking. Then she asked, ‘How does it connect with the holiday? And with how I try to manage Mrs K?’ I said she had often described the way she felt her mother wiped her out, was preoccupied or worried about something and did not have time to attend to her. She began to feel this about me as well, especially before a holiday when she felt I turned away from her and didn’t attend to her. She felt it about Mrs K, too. I said I thought she tried to manage this experience by becoming like her mother and like me. She wipes me out, as she wipes out Mrs K. She said: ‘That really is exactly what I do to Mrs K. I treat her as if she hardly exists.’ Then there was a very long silence. Up to this point I had thought we were working on a more or less surface level, as if accumulating evidence. Then, through her initiative, things deepened. Recognition of separateness and otherness 161 She said: ‘When I’m away from Will (her husband), most of the time he is present somehow or other in my mind. I don’t mean I think about him all the time, but he is just there. I feel all right then. But every now and then I just feel he isn’t there, and I get in a panic. I fi nd it diffi cult to describe. It’s as if I myself don’t exist. Something is going on that just wipes me out. It doesn’t correspond at all to what he is really like or to what you’re like either – it happens with you too. I know you continue to exist and that I’ll be coming back to analysis, but I don’t believe it. I go through something awful and I don’t know how to describe it. Everything hangs by a thread. Once I’m in this mood I can’t get out of it. It’s self- perpetuating. The only thing that stops it is when I actually see him or see you. Or when I see Mrs K and she’s not as bad as I expect.’ She went over this two or three times, as if feeling she could not describe it properly or that I would not understand it. I said, fi nally: ‘So you have to see and to cling to this actual external me, or Will, or Mrs K to disprove this terrible thing that you’ve got inside your mind. You can’t bear the thought of my leaving you for fear I’ll turn into this awful, terrifying person who “un-makes” you – (I could not think of a better word) – this awful presence who takes your self away, who puts you into terror.’ ‘That’s right,’ she said, and her voice was full of relief. ‘Being un-made’, she said, ‘means that I don’t have that active presence of you or Will inside me at all.’ She paused. ‘There’s something more. Can’t you do a bit more, can’t you push it on a bit?’ I said, ‘I think you want me actually to do something now, in the session, so that you won’t have the awful me inside you, the one who un-makes you.’ She laughed slightly. ‘You mean it’s happening now? I suppose it is. I think you’re right, it’s what I do to Mrs K.’ (This time I thought that she’d moved to Mrs K to get away from what she thought was happening between her and me. Now, in a small way, she was enacting it, not just describing it.) ‘It’s not only Mrs K,’ I said. ‘It’s happening now. You’re trying to avoid my wiping you out by wiping me out fi rst. You’re doing it by moving away to Mrs K. You do it by taking the signifi cance out of my leaving, by making yourself unaware of it. But that’s what makes it happen. Unawareness is the real attack. That’s what you think I do to you when I leave, and that’s what you do to me – you switch me off. But then you get a kind of no-me, a minus-me in your mind, a wiped out/ wiping out me that unmakes you from inside.’ ‘Hmm’, she said. But it was time to stop. In this set of sessions I think Mrs Lewis was allowing herself to be more aware of what separations could do to her. If she really cared about her object and felt her object cared about her, it was possible that the break would be all right. But if there Downloaded by [New York University] at 03:54 14 August 2016 was discord she was in danger. I think she responded to this feeling of danger by wiping the offending object out of her mind, out of her awareness. But then the particular form of retaliation that she imagined would come from the wiped-out bad object was that it would invade her with wiping-out, and she would be reduced to a wiped-out state in which she would feel serious panic and distress. When I thought about it later I realised that something else was evident in these sessions around the two breaks I have described. Unlike most patients, Mrs Lewis’ disturbance about the separation was expressed more acutely before the break, not primarily after it. Although I did not take note of this at the time, I think now that her disturbance in anticipation of the break probably happened because she was already sensing more tension and strain between us than either of us had consciously noticed. 162 Recognition of separateness and otherness Sessions of the week after the third break This break came soon after the second one I have just described, and those sessions were still very much in Mrs Lewis’ mind. There were also additional reasons that made this a diffi cult time for her – ‘not a good time for you to be having another one of your breaks’, as she put it. For some time I had noticed a par ticular pattern in Mrs Lewis’ behaviour in the fi rst week after breaks. She fell prey to feelings of contradiction and chaos. She would telephone people to tell them she had no time to telephone them; she double- booked appoint ments; she scheduled a meeting and forgot to go to it; while racing to answer the telephone she tripped over a chair and sprained her ankle. I think these actions were indications of the state of Mrs Lewis’ internal world, which she expressed not only in the actions themselves but also in the way she described them to me, arousing my concern and curiosity. She conveyed in her sessions that she felt very agitated about the way she was feeling and acting and was almost desperate that I should do something to make it better. It gradually emerged that this fi rst week after breaks expressed much of what she had felt during the break, usually without her being very much aware of it. I had said this to her on numerous occasions, and it seemed right, but something was missing. On the fi rst day back after the third break Mrs Lewis described what the break had been like – more or less all right. On the second day back she was quite agitated. Everything seemed to be going wrong. In particular, she was desperately worried about money. She hadn’t done the sums exactly, but she was sure she couldn’t afford to go on with the analysis. Then suddenly she said to herself, ‘No! Stop this!’, and went on to say that she knew it was because of her upset about my holiday, adding that there was a real problem about money, but that didn’t mean she had to get in such a state over it. ‘What I can’t understand is why I get in such a panic,’ she said. But it was the end of the session. In the next session the panic continued. Several things had upset her at work and she felt she had behaved badly and stupidly, and things between herself and her husband and child were strained as well. I found it diffi cult to get a sense of what was happening between us. I made a few desultory descriptions of the atmosphere of the session, and she agreed, but continued in an increasingly anxious and chaotic vein. This response was not a validation or a contradiction of my remarks, but rather a confi rmation that I could not con ceptualise what was going on. In so far as I could understand it at all, I thought she felt rather battered and confused, and so did I. I had a feeling that my inability to think was in part being evoked by my patient, but I could not understand what particular phantasy of projective identifi cation was involved. Downloaded by [New York University] at 03:54 14 August 2016 In the next session, as I mused about my inability to understand the transference/counter-transference situation, there drifted into my mind one of what I called to myself her ‘personal stories’. These were stories of things that had happened in her childhood; she often thought of them when refl ecting on her self and her life. Some of them she remembered, some she had been told. This one she had been told by her mother. It concerned the fi rst week of her life; my personal name for it was ‘the fi rst-week story’. Her mother had tried to breast-feed her, but apparently did not have enough milk and so had given up after one week, and had put her on to the bottle. Mrs Lewis deeply wished that her mother had kept on trying to breast-feed her. She had several attitudes to her mother over this failure in breast-feeding. On some occasions when she had told me the fi rst-week story she had sounded sad for herself. On other occasions she seemed to feel sad for her Recognition of separateness and otherness 163 mother, as though her mother might well have felt she had nothing good to offer. On other occasions Mrs Lewis sounded resentful and angry with her mother for having failed her. On an earlier occasion in her analysis I had drawn Mrs Lewis’ attention to the parallel between the fi rst week of her life and the fi rst week after breaks, but had felt it was too much of a mechanical formula and that neither she nor I could do much with it. As I pondered on the fi rst-week story this time, I remembered that, characteristically, Mrs Lewis had never put together her contradictory feelings of anger and sadness about her mother’s failure to feed her. I had a dim feeling that this lack of putting together opposing feelings had something to do with the chaos she was in at the moment, and perhaps also with the feeling of incomprehensibility that I was having. Without quite knowing what I was doing I started thinking out loud. Even though she had not mentioned her fi rst-week story this time, I reminded her that she often had a tough time during the fi rst week after breaks and that she felt she’d had a tough time in the fi rst week of her life as well. I said, as I had said before, that we had no way of knowing what had really happened at the time, no way of knowing what she had felt or what her mother had felt. (I knew that this story had become a signifi cant part of her internal world, but exactly how the internal version was related to the historical events of the fi rst week of her life I thought I could not know, although I did not say all of this to my patient.) I said I thought that perhaps she imagined that her mother had not been able to stand the pain and sense of loss over not being able to feed her baby, and that perhaps she had dealt with it by convincing herself that bottle was as good as breast – ‘alI for the best’ – that the pain and loss of the breast-feeding had to be minimised, even wiped out. (I knew that my patient thought such ‘sensible’ attitudes were typical of her mother from later periods in her life when she could actually remember how her mother had behaved, and I knew too that she also expected such ‘sensible’ no-nonsense attitudes from me. As I said all this about her mother’s possible denial of loss, I began to feel things coming together in my mind: perhaps Mrs Lewis thought that I, too, felt there was no loss, that bottle was as good as breast.) ‘You mean’, she replied slowly, ‘that there is a difference between saying it doesn’t matter, bottle is the same as breast, and saying that it is too bad, breast is best, but as I can’t have breast, bottle it will have to be.’ ‘Yes,’ I said. (I was struck that she had not only grasped what I had tried to express, but had described it much more clearly than I had. There was no panic or confusion in this formulation.) She was silent for quite a long time. I said: ‘I think you do that too, but even more to the point, you worry that I do it. When I have a break, you think that my actual behaviour, whatever I may say in words, says that no-sessions are just as Downloaded by [New York University] at 03:54 14 August 2016 good as sessions, bottle is the same as breast. There is no loss, and that’s a lie.’ ‘Ha’, she said, and her voice was full of relief, ‘I think the panic is going.’ She was silent for quite a long time, and then she said: ‘It must link up with the way everything gets so awful, but I don’t quite get it. I know that I attack you and the analysis.’ I said: ‘You have come to know that your analysis matters to you, and it’s a serious thing when I take it away. No-sessions are not the same as sessions. Without your quite realising it, I think you have thought that I was im plicitly lying to myself and to you about this, the way you’ve lied to yourself and the way you thought your mother may have lied to herself too. That’s what’s always been missing in your idea about the fi rst week of your life, your implicit belief that your mother denied that the loss of the breast-feeding mattered. You expect me to think this too, and it makes you frantic without your knowing why. You attack me, your analysis, 164 Recognition of separateness and otherness and yourself. Especially yourself. It’s as if you’re saying, “Look what you’ve done to me!” without even knowing that that’s what you’re saying.’ She was silent, but not agitated, I thought. This was all reasonable enough, I thought, but something was missing. Then I had another thought, and this time thought to myself ‘Ha! I’ve got it’, though to be more accurate, it felt as if the thought had got me. What I said was: ‘Actually this time you know that I chose to leave you. I didn’t have to, I chose to. But I think you also know that I’m aware that my leaving is hard on you. The fact that I leave doesn’t mean that I’m claiming that it’s good for you. I think you know that two contradictory things are true at the same time: that I chose to leave, and that I know it’s not good for you.’ She said, ‘I never thought of it that way.’ (I thought of Freud’s paper ‘Negation’ (1925) in which he says that some such form of words is often the fi rst reaction to an effort to uncover the unconscious.) I thought that this set of interpretations was too long and didactic, contrary to what I had been taught and believe about clinical procedure, the precedence of the here-and-now, the role of reconstruction, the harmfulness of intellectualisation – and yet I had a sense that I had got hold of something that mattered to both of us. In the remaining sessions of the week she continued on the same theme, expanding it and adding her own ways of expressing it. She thought it helped to understand why she often felt uncertain about whether she had anything really good to offer her child, her husband, her readers, for what she offers might contain some deadly denial at its core. Or she might have to claim that she and only she was right, because if she listened to the contradiction, the denied opposing thought, she would collapse in confusion – hence her occasional obliviousness. She began to feel she might cope better with the inevitable contradictions and confl icts of everyday life, and that she might be more able to sort out priorities. She said it had been a revelation that she could see the loss of the thing she had wanted without having to deny the goodness of what she did have. ‘The important thing’, she said, ‘was when you said that you chose to leave, yet you knew what it meant to me. You didn’t pretend that it was good for me. You left because you wanted to, but you knew what it meant. Actually you’ve never claimed it was for my own good, but I think I thought that way. I suppose you’ve said this before, but I’ve never got it. It just makes a difference that you know it’s a real pig when you leave, even when I make out that it’s all right. Whereas if you pretend that it’s all for my own good, it’s like those Truby King babies being starved for their own good – that’s when things go wrong.’ Gradually, between the two of us (and it was hard even at the time to know exactly who contributed what), it became possible to link this material with the Downloaded by [New York University] at 03:54 14 August 2016 fact that she so frequently cannot hold on to two opposite ideas or feelings at the same time without becoming confused and chaotic. If she opts for one, she has to deny the other. If she recognises both, she gets confused, or she gets in a panic and acts out the contradiction – such as her telephoning people up to tell them she has no time to telephone them (phone/don’t phone), or her rushing to the telephone and tripping over a chair (answer/don’t answer), or double-booking appointments (see two/see neither). In the course of listening to this material I remembered, among other examples, the earlier session when she had said, ‘I wish my mother had been more like you’, and realised now that the particular thing that had probably impressed her was that I could have two contradictory feelings at the same time without being confused or in a panic. I could see how denigrating she was being, and I think she Recognition of separateness and otherness 165 thought I must have been at least a bit angry myself, but she also felt that I was reasonably well-disposed towards her. On that occasion, too, in other words, the coexistence of apparent opposites was a crucial theme. In these sessions after the third break I think that it had become clear that Mrs Lewis had a particular diffi culty in accepting incompatibilities and contradictions both within herself and between herself and her objects. Not all differences between herself and her object caused her diffi culties, however. It was a relief to her, for example, that I could tolerate contradictory attitudes within myself and between her and myself, whereas the differences between herself and Mrs K were deeply disturbing to her. And there were occasions when similarities between herself and her objects caused her diffi culties too, as in the case of her relationship with her mother, for it seems likely that Mrs Lewis’ mother might also have had a similar sort of trouble with contradictions and incompatibilities as Mrs Lewis herself. Neither Mrs Lewis nor I developed a fi rm idea of how Mrs Lewis’ trouble over contradictions had developed. She was too intelligent and too fair-minded to blame her mother, and although the idea occurred to me that perhaps she had identifi ed with her mother, I do not believe that this sort of hypothetical reconstruction can be demonstrated in analysis. It is perhaps useful to think with, but not to be convinced of.

In conclusion All of the individuals I have described recognised at least to some extent that their objects were separate from themselves, although all of them had different sorts of abilities and problems in recognising fully the nature of the differences and similarities between their objects and themselves and all made some sort of aggressive statement about separations. Katie, the eight-week-old baby was near the beginning of a long process of recognising that she and her mother were separate, and that her mother could do things that Katie did not like. But she was also aware that she could express her discontent in a way that her object might pay attention to. Much appeared to have happened in eight weeks. Linda, three years old, used not talking to send a powerful message to her parents. ‘Something is wrong with me! And it’s your fault!’ Whether she was saying precisely this I of course do not know, but that is the message that I think her parents heard. I think that Linda recognised her parents’ separateness from her, that she thought they were doing something highly dangerous and exciting with each other at night, that they excluded her from it and subjected her to it at the same time, and that she hated it. In the fi rst week of her analysis she had showed considerable enthusiasm about getting into her sessions, and then came the fi rst Downloaded by [New York University] at 03:54 14 August 2016 weekend. If I excluded her like that, she would exclude me. She wasn’t going to have yet another person shutting her out and making her feel helpless. Mrs Peters, the fi rst adult patient I described, had no trouble in recognising her separateness from other people, but did not at fi rst realise that she minded separations. It was comparatively easy for her, however, to recognise her defence of reversing our roles, fi rst in the explicit content of her dream, and then in her general approach to separations not only with me but also with other people who were close to her. Mrs Lewis recognised her objects’ and her own separateness, but had diffi culty in accepting some of the differences and similarities between her objects and herself. Gradually her analysis showed both her and me that she had diffi culties in tolerating contradictions both within herself and between herself and her objects, and that this diffi culty was the basis of her trouble over separations from her analyst 166 Recognition of separateness and otherness and over certain diffi culties involving similarities to her objects and differences from them. My colleague and friend Ronald Britton thinks that individuals vary in degree of what he calls ‘psychic atopia’, that is, allergy to otherness, allergy to difference between oneself and one’s object. As he puts it:

So is there something in the temperament of some individuals that predisposes them to this particular development or response to trauma? Is there anything in the endowment of the individual that might encourage the individual to believe that an independently existing object will destructively misunderstand him or her? Is there an innate factor in the infant that increases the risk of a failure of maternal containment, and, if so, what might it be? I believe there is, and I have come to think of it as a kind of psychic atopia. A hypersensitivity to psychic difference, an allergy to the products of other minds. … In analysis this sensitivity applies not only to minute variations in the analyst but also to approxi- mations in understanding. Where this sensitivity is considerable what is required in the way of understanding is perfect understanding. Less than perfect understanding might therefore be perceived as misunderstanding. … I fi nd Bion’s equation of –K with envy less helpful than regarding –K as a variable factor that joins together with other factors to produce envy. This may seem to some like splitting hairs, but I have a suggestion as to what –K might be, namely that which underlies what I have called psychic atopia – an antipathy to knowing anything that is different. I believe this variable in the individual constitution, the psychic counterpart to the tolerance and intolerance of the somatic immune system, may contribute to diffi culties in infantile containment. (Britton, 1998, pp 57–58. The reference to Bion is to Bion, 1962)

I fi nd Britton’s idea of allergy to otherness, ‘psychic atopia’, both compelling and at the same time not quite satisfying. In my view the allergy depends on the content of the otherness. Although he is right that most people are tacitly on the lookout for otherness and often do not like it, some forms of otherness are deeply desirable – sexual difference, for example. And milder forms of otherness can be valued too. Mrs Lewis, for example, welcomed in me certain differences from her own way of being, especially difference from her diffi culty over contradictions. And certain forms of similarity to others were very diffi cult for her, especially if the similarity had to do with intolerance of contradictions. What I think analysis aims to create is an atmosphere of exploration where the nature of otherness, similarities and contradictions can be explored and known, seen more realistically, more as things one can take responsibility for and not so Downloaded by [New York University] at 03:54 14 August 2016 much as sources of panic, blame and persecutory guilt. Such exploration, painful as it may sometimes be, is likely to foster curiosity and an awareness that other people are separate from oneself but have minds fundamentally similar to one’s own, even though they may have thoughts and feelings that are different from one’s own.

Note 1 The observational and clinical material of the fi rst three individuals described in this paper has been included in a paper by the author in a Festschrift for André Green (2002), Penser les Limites. Écrits en l’honneur d’André Green. Sous la Direction de César Botella. Éditeur Delachaux et Niestlé, Paris, Genève. The material of the fourth person has been included in a paper called ‘On formulating clinical fact to a patient’, International Journal of Psycho-Analysis, 1994, 75: 1121–1132. Recognition of separateness and otherness 167 References Bick, E. (1964) Notes on infant observation in psychoanalytic training, International Journal of Psychoanalysis, 45: 558–66. Bick, E. (1968) The experience of the skin in early object relations, International Journal of Psychoanalysis, 49: 484–86. Bion, W. (1962) Learning from Experience, Maresfi eld Reprints, London: Karnac Books (1984). Britton, R. (1998) Belief and Imagination, London: Routledge. Freud, S. (1925) Negation, S.E., vol. 19, London: Hogarth Press, pp. 233–36. Klein, M. (1935) A contribution to the psychogenesis of manic-depressive states, Writings, vol. 1, pp. 236–89, London: Hogarth Press. Klein, M. (1940) Mourning and its relation to manic-depressive states, Writings, vol. 1, pp. 370–419, London: Hogarth Press. Klein, M. (1946) Notes on some schizoid mechanisms, International Journal of Psychoanalysis, 27: 99–110. Mahler, M., Pine, F. and Bergman, A. (1975) The Psychological Birth of the Human Infant, London: Karnac Books. Stern, D. (1985) The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology, New York: Basic Books. Downloaded by [New York University] at 03:54 14 August 2016 CHAPTER 12

MELITTA AND HER MOTHER

This was originally published in The Psychoanalytic Quarterly (2009), vol. 78, issue 4, pp. 1147–1166. This version includes minor changes made in 2011, mainly concerning Klein’s letters, or drafts of letters to Ernest Jones, probably written in 1941. This material is based on research by Pearl King and Riccardo Steiner reported in The Freud–Klein Controversies 1941–45, 1991.

I wonder what American readers thought about Melitta Schmideberg’s paper ‘After the analysis…’ when it was fi rst published in the Psychoanalytic Quarterly in 1938. Perhaps they saw it as a judicious description of the somewhat unrealistic expectations of analysts and patients about the benefi ts of psychoanalysis. English readers, especially psychoanalytic readers, would have seen it very differently. Watching the wrangles in their formerly peaceful psychoanalytic society, they would have recognised it as a very much toned-down version of a savage attack on Melanie Klein by her daughter Melitta. In a letter to James Strachey, Joan Riviere, a close colleague of Klein, describes her own reaction to Melitta’s fi rst presentation of ‘After the analysis – some phantasies of patients’ to the British Society in February 1937: ‘Melitta read a really shocking paper on Wednesday personally attacking Mrs Klein and her followers and simply saying we were all bad analysts – indescribable’ (Grosskurth,1986, p. 229, citing ‘Strachey Letters’, British Library). In her paper Melitta describes the way patients have unrealistic ideas about analysis, but the implication is that some analysts encourage idealisation of analysis. ‘In his over-valuation of analysis the patient often repeats his attitude to religion,’ Melitta says. ‘These ideas are sometimes increased through the attitude of the analyst when for example the analyst displays an over-estimation of analytic ceremonial or is inclined to regard it as the only true therapy’ (Schmideberg, 1938, p. 128). It is her view that:

the analysis of the preconscious is more important than the singling out of certain newly discovered fantasies or mechanisms; that the knowledge and

Downloaded by [New York University] at 03:54 14 August 2016 interpretation of the unconscious is only one element in the therapeutic process. The human relationship to the analyst which remains unaffected by any increase in our knowledge is certainly no less an important factor. (Schmideberg, 1938, p. 133)

In the following passage she attacks Klein’s new idea of the depressive position (Klein, 1935).

It is known for example that a number of patients pass through a phase of depression. Some analysts think that while such a phase is unavoidable in certain cases, that in others it is due to imperfect technique. Other analysts think that no analysis is satisfactory or ‘deep-going’ enough if the patient has Melitta and her mother 169 omitted to pass through a phase of depression and will not hesitate to express an opinion to that effect. The idea that he must necessarily pass through a phase of depression may stimulate the patient’s anxiety, punishment fantasies and masochistic impulses; it may also play into his religious views concerning the repentance and atonement which must precede salvation (cure). (Schmideberg, 1938, p. 135)

The background The arrival in Britain ﬁ rst of Klein and soon after that of her daughter, and then other continental analysts As is well-known, Klein initially came to London in 1925 to give lectures on child analysis, and she was then invited by Ernest Jones and the British Society to come to settle permanently. The years from 1926 to 1933 or so were calm and productive in the British Society, and Klein’s ideas were thought about and used or not used with considerable interest but little antagonism or over-idealisation. Many of the senior British analysts at that time had been analysed by Abraham, Ferenczi or Freud; some were medical, some came from other professions. Interest in child analysis was developing, and this was a main factor in Ernest Jones’ inviting Klein to come to England. In May 1929 Klein was recognised in England as a training analyst and in October of the same year she joined the Training Committee, a post she held for many years. In the introduction to The Freud–Klein Controversies, 1941–45 (King and Steiner, 1991) Pearl King outlines the background of the British Society and the rapid transformation of it that occurred when Austrian and German analysts joined it because of the political rise of the Nazis in Germany, the invasion of Austria by Germany and the imminent likelihood of Britain declaring war against Germany. The arrival of the Viennese analysts in England in 1938 led not only to what have come to be called the ‘Controversial Discussions’ on psychoanalytic ideas, but also to new developments in the structure of the British Psycho-Analytical Society and its relation to other British institutions. Klein and her close associates played a major role in the discussion of ideas. Melitta played a minor and somewhat obstreperous role in the changes in the structural arrangements. Melitta was born in Vienna in 1904 and brought up at fi rst in Vienna, then in Budapest and fi nally in Berlin where she studied medicine and psychoanalysis. She married Walter Schmideberg, an Austrian aristocrat, psychoanalyst and friend of Freud, in 1924 and she graduated in medicine in 1927. In Berlin she was analysed by Karen Horney. There is some disagreement about when the Schmidebergs came Downloaded by [New York University] at 03:54 14 August 2016 to London. According to Pearl King (King and Steiner, 1991, p. xx) both Schmidebergs moved to London in 1932. According to Grosskurth (1986), Melitta came fi rst, in 1928, and stayed with her mother while Walter was still in Germany trying to get a visa; he arrived in 1932. In England Melitta practised analysis, especially child analysis, and she regularly attended meetings of the British Society. At some point she was analysed by Ella Sharpe. She wrote many papers, one of which, ‘The play-analysis of a three-year-old girl’ (1934), won the Clinical Essay Prize of the British Society in 1933. It is worth noting that at this time, 1933, Melitta’s ideas were close to those of Klein, and Klein’s book The Psycho-Analysis of Children (1932) is listed among the references of Melitta’s prize-winning paper. (So are two papers by Edward Glover, ‘On the aetiology of drug addiction’ (1932a) and ‘A psycho-analytic approach to the classifi cation of mental disorders’ (1932b).) 170 Melitta and her mother Melitta eventually became a training analyst, but I have not been able to discover the date. Relations between Klein and the Schmidebergs appear to have been cordial for a time, although Grosskurth quotes an undated letter from Melitta to her mother in which Melitta states her desire for Klein to show more recognition of Melitta’s need for autonomy (Grosskurth, 1986, p. 199, citing ‘Eric Clyne Collection’). At some point – the exact date seems to be uncertain, but probably in 1933 or 1934 – Melitta began to have analysis with Edward Glover, an eminent British analyst who was also politically very powerful. He was Scientifi c Secretary of the British Society, Chairman of the Training Committee, Director of the London Clinic of Psycho-Analysis and Deputy to the President, Ernest Jones. He was expected to become President when Jones retired. Both he and Jones had held their positions for many years and there were no rules governing tenure of offi ce. Glover’s attitude towards Klein and her work had initially been very positive, as shown in his laudatory review of her 1932 book The Psycho-Analysis of Children (Glover, 1933), but this attitude soon changed. Glover himself dates his antagonism to Klein as beginning in October 1934 (Glover, 1945). He particularly disapproved of her 1935 paper on the depressive position although he did not really say why at the time. The year 1934 was a time of great tragedy for Klein: the death of her son Hans in a climbing or walking accident in April led to a long period of mourning – for the rest of her life, her son Eric thought. Melitta immediately said it was suicide, and made a comment on suicide in November 1934 to the British Society in which she said:

Anxiety and guilt are not the only emotions responsible for suicide. To mention only one other factor, excessive feelings of disgust brought about, for example, by deep disappointments in persons loved or by the breakdown of idealiza- tions prove frequently an incentive towards suicide. (Schmideberg, 1936, p. 2)

Perhaps the tragedy of Hans’ death and Melitta’s hatred contributed to the creativity that led to Klein’s groundbreaking paper of 1935 on the depressive position, a paper which is now generally regarded as the defi nitive beginning of her new psychoanalytic theory. This was also the view of Klein herself. Riccardo Steiner has made the important discovery that ‘considerable correspondence … exists in various archives … between Melanie Klein and her colleagues and the leading members of the British Society, such as Ernest Jones, Sylvia Payne, Barbara Low, Marjorie Brierley, Edward Glover and Anna Freud’ (King and Steiner, 1991, p. 227). Many Downloaded by [New York University] at 03:54 14 August 2016 of these letters concern the diffi culties of Klein’s position in the British Society, but at least one describes the great creative experience which led to her new discovery.

My greatest experience in this was Beyond the Pleasure Principle and The Ego and the Id and what an experience it was. In a smaller way I saw in my own work repeatedly a new light appear and things altered by it. Particularly was this so when I began to understand it in connection with aggression, reparation and the part it plays in the structure of personality and in human life. From there heads a straight road to the insight into depression which so much occupied my mind ever since … I began to understand the origins and contents of depression and of the immense range of human feelings, of the strength of love and hate, sorrow and hope and with it the realization of a very rich inner Melitta and her mother 171 world … But it is an overwhelmingly diffi cult task to describe this knowledge to others who cannot see it. I think these fi ndings could not have been unworthy to have been made even by Freud and he would have had the greatness, the strength, the powers to present them to the world. I don’t want you to misunderstand me. I am not afraid of fi ghting against anybody, but I really don’t like fi ghting. What I wish to do is to let quietly others participate in something I know to be true, important, and helpful, to let them share in it and to teach them if they are willing to learn. I have actually much changed in this respect. I am not any more keen to convince others and to debate. The loss of my son, the grief about my daughter have much contributed to this change … The fact that my daughter is one of my main opponents has a bearing on this wish not to fi ght … That the former friendly and inspiring cooperation of the group as a whole [meaning the British Society] has changed into the contrary is not only disconcerting, it has taught me much about the diffi culties of conveying this work to others so that they may hold on and use it. (Riccardo Steiner, in King and Steiner, 1991, pp. 231–232)

This passage helps us to understand not only Klein’s feeling about her work but also something of her feeling about Melitta and her own refusal to make any response to Melitta’s attacks. In a letter to her supporters after the Second Extraor- dinary Business Meeting of the British Society on 11 March 1942, an occasion when Melitta made a spectacular attack on her mother, Klein wrote to say:

From one thing I feel very strongly we must refrain, even though it is quite unfair to ourselves – and that is to make any aspersions or accusations which cannot be at once supported by irrefutable facts, not as they appear to us, but as they appear to the others. That is to say, we seem to have to restrict ourselves to refuting their accusations. And there is even one very obvious fact which I feel quite sure should not be mentioned, nor even hinted at by any of us, and that is Melitta’s illness. I think it must not even be hinted at by any of us either privately or as an argument in the coming discussions. I am convinced, however true it may be, it will be held against us if it is mentioned. (Grosskurth, 1986, p. 297)

Eva Rosenfeld, one of the immigrant Viennese, describes the disconcerting experience of watching the interaction between Melitta and her mother at the British Society.

At the meetings I could only see something quite terrible and very un-English happening, and that was a daughter hitting her mother with words and this Downloaded by [New York University] at 03:54 14 August 2016 mother being very composed, quite quiet, never defending herself, but having such power in that society, being so powerful that it really didn’t matter what Melitta said. We knew only that we would be the victims of this quarrel and we were and the society was, and there was no doubt about it. (Grosskurth, 1986, pp. 242–243)

Melitta and Klein in the British Society’s Eight Extraordinary Business Meetings (25 February 1942 to 8 March 1944) and the ten Discussions of Scientiﬁ c Controversies (27 January 1943 to 3 May 1944) Pearl King has described in detail the complex structure of the British Society in the 1930s and early 1940s, together with the fact that there was considerable discontent 172 Melitta and her mother over the fact that senior offi cers like Ernest Jones and Edward Glover held many positions simultaneously and had held offi ce for many years; there was also criticism of the way Jones and Glover had handled the public relations of the Society (King and Steiner, 1991, pp. 9–36). In addition, there was awareness that the newly arrived analysts from Austria and Germany held different psychoanalytic views from those of the British analysts, particularly different from the views of Klein and her adherents. These various discontents emerged in three discussions in November and December of 1941 in a paper called ‘The psychoanalytic society and the public’ by an English analyst, Barbara Low. Four members, Barbara Low, Melitta Schmideberg, and Adrian and Karin Stephen then demanded that the Council of the British Society should call an Extraordinary Business Meeting to discuss the state of affairs in the Society. The fi rst Extraordinary Business Meeting took place on 25 February 1942, and there were seven more, ending with the eighth such meeting on 8 March 1944. The Fifth Extraordinary Business Meeting on 10 June 1942 was particularly memorable. It came to be known as the ‘Armistice Meeting’, because this was the meeting in which Marjorie Brierley, a senior British analyst, presented her ‘Armistice Resolution’ which led to the design and holding of the ten Discus- sions of Scientifi c Controversies from January 1943 to May 1944. These are the discussions that have come to be called, for short, the ‘Controversial Discussions’. Melitta thus played an active role in calling for the holding of the Extraordinary Business Meetings; she was particularly vocal in the second of these meetings which was held on 11 March 1942. She was much less active in the later (1943) Discussions concerning Scientifi c Controversies, attending only once and sending two written contributions.

Melitta and the Extraordinary Business Meetings of 1942 The fi rst Extraordinary Business Meeting was a general discussion to decide on aims and procedures, and the fact that there were a great many resolutions to be discussed and voted upon. In the Second Extraordinary Business Meeting on 11 March 1942 both Melitta and Glover made important speeches. Melitta accused ‘the Kleinian clique’ of blackballing analysts they did not approve of. She described how, when an analyst called Nina Searl gave lectures for candidates, Kleinian training analysts and full members attended these lectures in order to attack Miss Searl concertedly in the subsequent discussion in front of candidates (King and Steiner, 1991, p. 93). She herself had been subjected to attack. She gave the names of other analysts who had been attacked, and others who did not attend the Society or did not speak because they would be attacked. She continued: Downloaded by [New York University] at 03:54 14 August 2016

When Drs Bowlby and Middlemore brought original contributions they were unfairly attacked. In the last ten years I heard Dr A. Stephen take part in scientifi c discussions only two to three times, Mrs A. Strachey not once. Mr Strachey has been patronized or attacked in indirect ways, disparaging remarks were systematically spread about Dr Brierley and Miss Sharpe; serious attempts were made to wreck Dr Glover’s reputation … By the way, Mrs Klein regretted that the Viennese did not take more part in the activities of the Society; I think Miss Freud will be able to explain why! To sum up: it is suffi cient to say that every Member who was not 120 per cent Kleinian has been attacked systematically, directly or indirectly. (King and Steiner, 1991, p. 94) Melitta and her mother 173 She went on to say:

No society can exist without a reasonable measure of tolerance. Analysts who believe themselves to be tolerant are in practice less so than any group of people I know, with the possible exception of the Nazis. Some persons have the gift to bring out the best in others. Certain Members seem to have the gift to bring out the worst. (King and Steiner, 1991, p. 95)

She continued by giving two examples, and then asked ‘Now why do the Kleinians go to such lengths to hold or procure analysands? Because they hope to turn analysands into converts’ (King and Steiner, 1991, p. 96). Towards the end she concluded:

The Kleinians shelter behind ambiguity and vagueness … They lack the most elementary scientifi c discipline. In a manner somewhat reminiscent of Dr Goebbels they try to impress us by repeating time after time the same slogans, by putting forward exaggerated claims and dogmatic statements, by accusing their opponents and intimidating the hesitants, by a constant play on emotions of every sort, instead of presenting and substantiating their theories according to scientifi c standards. (King and Steiner, 1991, p. 98)

Ernest Jones, who was chairing this meeting, had not seriously taken issue with Melitta before, but on this occasion he said, when she fi nally stopped, ‘Dr Schmideberg has really admirably illustrated the diffi culty of discussing these matters without personal attacks. The problem is now how to turn it into more profi table work’ (King and Steiner, 1991, p. 99). Glover also made a speech at this Second Extraordinary Business Meeting, stating at some length that in his view the central issue was to discover whether there was a group in the Society whose aim was to use the machinery of the Society to increase its own infl uence, to secure infl uence through committees, and to develop a private organisation outside the Society for the purpose of infl uencing the Society (King and Steiner, 1991, pp. 101–103). Klein was relieved that Jones had tackled Melitta, though regretful that he had not done the same to Glover. It was after this Second Extraordinary Business Meeting that she wrote to her supporters saying that they should not attack Melitta or mention her ‘illness’. It is hard to imagine what any mother would feel after being subjected to this sort of attack by her daughter. Even the explanation of Downloaded by [New York University] at 03:54 14 August 2016 illness could hardly diminish the sense of suffering and catastrophe about oneself as a mother. I have not as yet found any notes in the Melanie Klein Archive that touch on this particular experience of March and April 1942, but the earlier draft or letter to Jones quoted by Riccardo Steiner and described above helps to convey some of Klein’s feeling that the seriousness and insight of ideas can give one an understanding that helps to bear such experiences. At the Third Extraordinary Business Meeting held on 15 April 1942 Dr Sylvia Payne, the Honorary Secretary of the Society, made a clear statement aimed at Melitta. ‘At the last meeting’, she said, ‘accusations of what in law would be called malpractice were made against Mrs Klein and her immediate supporters. Names of members were used freely without their consent. The charges were grave and in my opinion such charges cannot be made without the liability of libel actions being 174 Melitta and her mother incurred’ (King and Steiner, 1991, p. 109). Payne went on to describe the procedures that would need to be followed by those who wished to make such charges. After this explanation Melitta’s accusations diminished, or were more judiciously stated. She did not bring formal charges. Also at the Third Extraordinary Business Meeting Riviere gave a long refutation of the statements against Mrs Klein brought by Glover, Melitta and Walter Schmideberg. Later, during the Fourth Extraordinary Business Meeting on 13 May 1942, Jones said:

In the meeting before last you will remember that Dr Glover and Dr Schmideberg read papers discussing the question of the activities of what they call a clique in the Society. In the course of that Dr Schmideberg made the very remarkable statement that the majority of Members felt themselves ill- treated by that clique. At the opening of the next meeting three Members came to me and said that they wished to bring forward evidence to rebut this thing – which they did … This seemed to be our next move: how would the Society prepare to meet a situation in which a great number of Members is accused of browbeating or badly treating others and other Members say that this is quite untrue. (King and Steiner, 1991, pp 133–134)

There was a prolonged discussion of this matter, complicated by a long (and inac- curate) description by Glover of how the Kleinians were dominating the Society through their numbers and their concentration in London – an assertion eventually disproved by accurate fi gures circulated by Sylvia Payne (King and Steiner, 1991, pp. 193–194.). Later, on 23 July 1942 Klein circulated her own rebuttal of Glover’s accusations. At the Fifth Extraordinary Business Meeting on 10 June 1942 Brierley presented her ‘Armistice Resolution’, unanimously accepted, according to which all members agreed that the Society should pass a self-denying ordinance in respect of all charges and counter-charges, and that all members should refrain from personal attack or innuendo in discussion, although strongly affi rming the right of all members to complete freedom of speech within the limits of common courtesy. There was also a vote in favour of appointing a committee to investigate the question of tenure of offi ce and the holding of multiple offi cial positions. At the Annual Meeting on 29 July 1942, it was decided to allot one meeting per month to the discussion of scientifi c differences in the Society. A committee consisting of Dr Glover, Dr Brierley and Mr James Strachey was appointed to organise what came formally to be called the ‘Discussions of Scientifi c Controversies’, Downloaded by [New York University] at 03:54 14 August 2016 which, under the shorter name of the ‘Controversial Discussions’ have become well-known, even though the discussions of ideas, the ‘scientifi c controversies’, were only part of the discussions as a whole. The particular topic chosen for presentation and discussion was ‘The role of introjection and projection of objects in the early years of development’ and Dr Susan Isaacs was asked to give the fi rst paper. And so Isaacs came to write her famous paper, ‘The nature and function of phantasy’, which she discussed with Klein and other colleagues, but which she presented with her own special clarity to the Society as a whole, and which she discussed and defended politely and effectively. The ‘Controversial Discussions’ became well worth listening to, and the backbiting and insults diminished. Klein, I surmise, must have become somewhat less worried that Glover was going to be able to get rid of her, her colleagues and their ideas. Melitta and her mother 175 Melitta played very little part in the Scientifi c Discussions. She made two written contributions and came to only one of the Discussions. However, one of her contributions is interesting, and somewhat less vituperative towards her mother than usual. It makes one regret that Melitta’s feelings about her mother prevented her from using her capacity to formulate ideas and to link them to observations in a way that might have developed her mother’s ideas – and Melitta’s own ideas – further. In the Third Discussion of Scientifi c Controversies on 17 February 1943, Melitta said, ‘We have, in my opinion, no way of ascertaining what a small infant feels or thinks’, and she lists the sorts of material from which deductions may be drawn: behaviouristic observations, how infants react to changes of environment etc., observations of psychotics, defectives and other regressive conditions, deductions from general analytical theory of development, conclusions from the analysis of adults and older children (King and Steiner, 1991, p. 393). She lists various observations she herself made of children and the immediate conclusions she drew from them. She says that Mrs Isaacs wishes to show that babies under twelve months of age have phantasies, which Melitta believes no one will disagree with. But, she goes on to say, ‘Mrs Klein assumes that they have very specifi c phantasies, and her idea of what these phantasies are has been derived not from observation of babies but from the analysis of adults and older children. If Mrs Klein wants to convince us, she should give us the analytical material from which she draws her conclusions, and the method step by step by means of which she has arrived at the conclusion’ (King and Steiner, 1991, p. 394). She continues: ‘To be told “we found in analysis” or “the material proved” is no argument … Children have no direct memories of infancy’, she went on, and ‘the “constructions” made by analysts must be very carefully checked … But it is important to stress that these are only speculations which are diffi cult both to prove and to disprove. Needless to say it is not possible to observe the unconscious phantasies of babies directly. It is possible to observe their expression of emotions, their actions, etc., but again we must distinguish strictly between such observations and the speculations derived from them’ (King and Steiner, 1991, p. 395). Poor Melitta – she had little hope of understanding where her mother’s ideas came from – a fl ash of intuition, a sudden awareness of love and hate at the same time, a realisation in 1955 of a new understanding of something she had observed in Erna in 1926 (Frank, 2009). But what if Klein’s imagination had been combined with Melitta’s logic and careful observation: how much more systematic her work would have been, how convincing her arguments, how systematic her presentation of evidence. But there could never have been a way that Melanie’s Downloaded by [New York University] at 03:54 14 August 2016 thinking and Melitta’s thinking could have come even close to mutual understanding, certainly not to mutual admiration.

And what of Glover? Glover appeared to admire Klein’s work up until her depression position paper, which she gave orally in 1934 and 1935 and published in 1935. She had written many papers in the 1920s, but this one was clearly different: it was a statement of a new theory of mental development. Glover never explicitly recognised this except by his dislike of the paper. Melitta disliked it too, as she stated in her paper ‘After the analysis…’. It is thanks to Susan Isaacs, Strachey, Grosskurth, Pearl King and Riccardo Steiner that we know how much Melitta and Glover hated the paper, 176 Melitta and her mother Klein herself and the other Kleinians. It is diffi cult to avoid the idea that both Melitta and Glover were smitten by envy – here was this preposterous woman, Melanie Klein, having an idea of her own when they had not – although I am sure that the envious feeling did not appear to them in that form. All they knew was that the idea was wrong and that Klein was their enemy. Glover seemed to think that he had a mission to save the British Society and British psychoanalysis from Klein. It is hard to know why he saw her as such a threat, and, indeed, his seeing her as a threat seemed to give her and her colleagues a power that they would not otherwise have had – although they certainly were not aware of this at the time. It seemed clear at the beginning that Glover’s position was utterly secure, that he would succeed Jones and would have the same sort of long-term tenure and multiple offi ce-holding that Jones had had. But Glover behaved badly during the Extraordinary Business Meetings, making statements about Klein’s supposed power that were demonstrably not true. Melitta’s unbalanced behaviour cannot have helped his cause. Then he chaired the Discussions of the Scientifi c Controversies during which Isaacs’ paper on phantasy was presented and discussed at length, and Pearl King says that she was ‘informed by some Members who were present at these meetings that Glover did much to alienate himself from the more moderate Members of the Society by his partisan chairing of these meetings’ (King and Steiner, 1991, p. 224). Glover tried to secure Anna Freud as a political ally, but she behaved very correctly, in spite of her disap- proval of Klein’s ideas. But perhaps the most revealing exposure of Glover’s inept political behaviour occurred in connection with the discussion at the Annual Meeting of the Society on 21 July 1943 concerning the possible appointment of a medical committee and a child welfare committee (King and Steiner, 1991, pp. 476– 500). Dr W. H. Gillespie and Dr John Bowlby gave an almost impassioned presentation of the failure of the British Society to grasp the fact that society generally, and the structure of medicine and provisions for children in particular, were going to change, were in fact already changing. Bowlby said:

We fi nd ourselves in a rapidly changing world and yet, as a Society, we have done nothing, I repeat nothing, to meet these changes, to infl uence them or to adapt to them. That is not the reaction of a living organism but of a moribund one. If our Society died of inertia it would only have met the fate it has invited. But there is no reason for this ignorance and inertia and incoodination to continue. (King and Steiner, 1991, pp. 489–490) Downloaded by [New York University] at 03:54 14 August 2016 The resolution of Gillespie and Bowlby that the Society should establish a medical committee was unanimously accepted, and a secret ballot was taken according to which the following members were elected to serve on the Medical Committee: Dr Bowlby, Dr Gillespie, Dr Payne, Dr Winnicott, Dr Adrian Stephen, Dr Glover and Dr Rickman. In a note referring later to this election, King and Steiner say:

At the AGM in 1943, in the election of members for the Medical Committee, Sylvia Payne received the most votes and Glover the least (according to an informant). This meant that if he had to stand against her in an election for the President of the Society, she would probably be elected. (King and Steiner, 1991, p. 869; this was supposed to be a secret vote, and one cannot help wondering who the mysterious ‘informant’ was!) Melitta and her mother 177 In a letter to Sylvia Payne on 24 January 1944 which was read to members at the Sixth Extraordinary Business Meeting on 2 February 1944, Glover said, ‘following the Annual Meeting of 1943 I decided to resign my offi ce and membership, and was induced to postpone the decision only on urgent representations from certain members of the Society’. In fact he resigned in January 1944. During this Sixth Extraordinary Business Meeting on 2 February 1944, Melitta repeatedly asked the members to discuss the signifi cance for the Society of Glover’s resignation from the Society and Miss Freud’s resignation from the Training Committee, but nobody seemed to hear her. They were taken up with the fact that Glover had attacked the use of selection tests by Army psychiatrists (four of whom belonged to the Society) in a popular periodical. Eventually, at the Seventh Extraordinary Business Meeting on 23 February 1944, a resolution was passed to ask Dr Glover to issue a statement to the ‘Medical Press’ stating that his views on Army psychiatrists and selection were personal and did not represent the views of the British Psycho-Analytical Society as a whole. The Eighth Extraordinary Business Meeting on 8 March 1944 was devoted to discussion of the Final Report of the Training Committee, including Dr Glover’s comments on the fi rst draft. On voting, the (Preliminary) Report was carried. Dr Balint suggested that the Training Committee should consider a new system of training, which was seconded by Miss Low and carried. A proposal by Dr Balint to limit tenure of offi ce to two years was seconded and carried unanimously, to be put on the Agenda for the Annual Meeting. Lastly, Dr Payne read Dr Glover’s letter replying to the Committee’s letter about Army psychiatrists and selection. He refused to comply with the Society’s suggestion saying that it was clear already that his views were his personal opinion. He said, among other things, ‘In my opinion the only reason the Society has for being apprehensive about the future is that it is now in effect committed to the Klein deviation from Freudian psychoanalysis.’ And he concluded his letter by saying:

As an independent Freudian I am under no obligation whatsoever to a Society from which I have resigned because I no longer regard it as a Freudian Society. My goodwill would in fact be a measure of my esteem for those colleagues who now constitute the Freudian minority of it. (King and Steiner, 1991, p. 894)

It looks as if Glover’s attitude was that if he could not be President, he did not want to belong to the British Society at all. Dr Payne said it was diffi cult to make any particular suggestion, but she thought it important not to continue any confl icts more than could be helped. Dr Downloaded by [New York University] at 03:54 14 August 2016 Bowlby said that the fact of Dr Glover’s resignation was known, the damage would be healed, and he thought it would be a waste of time if they continued. Melitta said members should not feel that such statements were made out of consideration for Dr Glover. She said that the resolution proposed by Drs Franklin and Carroll would still stand even if Dr Bowlby withdrew his. Dr Payne said that these resolutions could be put forward some other time and need not be connected with this situation. Melitta said they would still stand unless withdrawn, but Dr Payne said they were replaced by Dr Wilson’s resolution. She went on to ask, would Dr Bowlby’s proposal mean that Dr Glover should be notifi ed that… Dr Balint interrupted her to ask, ‘Does it mean that Dr Bowlby wants to drop his resolution?’ Dr Bowlby said ‘Yes’. Dr Balint said, ‘Then I want to support this’ and the meeting ended. 178 Melitta and her mother And so also ends any reference to Melitta in the following meetings. She went to New York in 1945, having apparently separated from her husband Walter Schmideberg, and, like Glover, she devoted herself to the study of delinquency. She returned to London in 1961 (after Klein’s death in 1960) and resigned from the British Society in 1962. She died in 1983. Today she is hardly remembered by the members of the British Society except by the few who are interested in the Society’s history. Dr Jones retired in 1944 and, as expected, Dr Payne was elected President. She made a very concerted and successful effort to persuade Anna Freud to return to the Society and to work out terms by which training in the Society could continue – by the devising of parallel courses, Course A organised as formerly, with teachers from all groups, and Course B, which would teach technique along the lines supported by Miss Freud and her colleagues. There was also for many years a ‘gentleman’s agreement’ that all important committees should contain representatives of all three ‘Groups’: the ‘B Group’ as Anna Freud and her colleagues came to be called, the Kleinians, and the ‘Independents’ or ‘Middle Group’. This agreement continued until 2005, when a general discussion was held which reached the conclusion that the terms of this agreement no longer needed to be followed so closely. And, as Pearl King says of Sylvia Payne: ‘It is largely due to her that there is only one psychoanalytical society in Britain today.’

References Frank, C. (2009) Melanie Klein in Berlin: Her First Psychoanalyses of Children. London: Routledge. Glover, E. (1932a) ‘A psycho-analytic approach to the classifi cation of mental disorders’, Journal of Mental Science, 78: 819–842. —— (1932b) ‘On the aetiology of drug addiction’, International Journal of Psycho-Analysis, 13: 298–328. —— (1933) ‘Review of The Psycho-Analysis of Children by M. Klein’, International Journal of Psycho-Analysis, 14: 119–129. —— (1945) ‘An examination of the Klein system of child psychology’, Psycho-Analytic Study of the Child, 1: 75–117. Grosskurth, P. (1986) Melanie Klein: Her World and Her Work. New York: Alfred A. Knopf. King, P. and Steiner, R. (Eds) (1991) The Freud–Klein Controversies 1941–45. London: Routledge. Downloaded by [New York University] at 03:54 14 August 2016 Klein, M. (1932) The Psycho-Analysis of Children. London: The Hogarth Press and the Institute of Psycho-Analysis. —— (1935) ‘A contribution to the psychogenesis of manic-depressive states’, International Journal of Psycho-Analysis, 16: 145–174. Also in The Writings of Melanie Klein, vol. 1, pp. 262–289. London: The Hogarth Press and the Institute of Psycho-Analysis. Schmideberg, M. (1934) ‘The play-analysis of a three-year-old girl’, International Journal of Psycho-Analysis, 15: 245–264. —— (1936) ‘A note on suicide’, International Journal of Psycho-Analysis, 17: 1–5. —— (1938) ‘After the analysis…’, The Psychoanalytic Quarterly, 7: 122–142. CHAPTER 13

TEN DRAWINGS BY ONE OF MELANIE KLEIN’S CHILD PATIENTS

Originally published in Albano, C., Allison, L. and Abel-Hirsch, N. (eds), Psychoa- nalysis: The Unconscious in Everyday Life, the online exhibition catalogue accompanying the Science Museum exhibition, 13 October 2010–15 April 2011. Available to download at http://www.psychoanalysis.org.uk/digital.htm. London: The Institute of Psychoanalysis and Artakt, pp. 61–67.

The ten drawings shown at the Science Museum’s exhibition The Unconscious in Everyday Life were the work of a ten-year-old boy, ‘Richard’, who was analysed by Melanie Klein in 1941. In several ways it was an unusual analysis, in that although the sessions took place at the usual frequency of fi ve times a week, the whole analysis lasted for only four months. Further, because of the war the analysis took place in a Girl Guides’ hut in a remote Scottish village near where Klein and Richard’s parents were temporarily staying. Klein describes Richard as a precocious and gifted child who had ‘an inherent capacity for love and kindness’. His particular diffi culty, which greatly worried his parents, was that he was so terrifi ed of other children that he had been unable to go to school for two years, and he was even frightened to go out in the street on his own. He was frequently ill, and, like his mother, was somewhat hypochondriacal. He was extremely worried about the war, and read the daily newspaper thoroughly every day. Although Klein recognised that Richard’s fears and loneliness made him diffi cult to live with, she implies that his mother’s disposition may have added to his diffi culties. She describes his father as a kind man who was fond of Richard but left his upbringing mainly to Richard’s mother. In addition to his parents, Richard had a brother, Paul, who was nine years his senior. The rest of the usual household consisted of Cook and Bessie, the maid. Usually only his mother or one of the servants stayed with Richard in the village, although Paul and his father also visited. Klein evidently always made detailed notes about her child patients, but she may have been able to follow this practice even more punctiliously than usual because she was seeing fewer patients than usual at the time of Richard’s analysis.

Downloaded by [New York University] at 03:54 14 August 2016 Many years after his analysis she organised these notes, with the addition of further notes based on her later ideas, into a book called Narrative of a Child Analysis which was fi rst published in 1961, a year after her death. Klein says that she was not able to discuss Richard’s early childhood in detail with his mother. She asked her what Richard’s names were for parts of the body and for bodily excretions, but his mother said that she did not know, because Richard did not talk about such things. Klein decided to use the terms that other children used – ‘big job’, ‘little job’ – but she also introduced adult terms – penis, genital, potent, sexual relations – which Richard did not know but quickly understood. He referred to his analysis as ‘the work’. Klein says she did not use technical terms in her interpretations to Richard, although for the sake of brevity she does use such terms very freely in her written account. Many readers have found her 180 Ten drawings by one of Melanie Klein’s child patients book about Richard diffi cult to read because of its unappealing technical language and its inevitable repetitiveness, although Donald Meltzer notes that Henry Reed said that the Narrative stood beside War and Peace on his bookshelf (Meltzer, 1978, Part II, p. 1). In the fi rst session Klein produced paper and pencils and various toys for Richard to use if he wished. (Later he brought his own set of toy ships.) In the fi rst session Klein suggested that Richard knew why he was coming to her – he had some worries that he wanted help with. Richard at once began to talk about his fear of the boys in the street, and the session was launched. Before long he went on to the war and how very bad Hitler was to other countries – including Austria (he knew Klein was Austrian, and also that Hitler was Austrian). He said that a bad tramp might attack Mummy but he would defend her. With a little help from Klein, he was able to imagine that even his good Daddy might turn into a Hitler- daddy and do something bad to Mummy at night. By the end of this fi rst session he was less anxious, said he had noticed the toys and pencils but he did not like toys. He wanted only to talk and to think. He said he was glad to come again the next day. And so the analysis started, and went on very quickly, perhaps at least in part because both Klein and Richard knew that they would have only a limited time together. It was some time before Richard began to draw. After session 12, Klein noticed that he was even more seriously anxious than usual and she felt that he needed some other form of expressing himself, and so she reintroduced pencils, crayons and a pad of writing paper, though not as yet the toys. Richard at once began to draw, mainly ships at fi rst. Both he and Klein interpreted the ships as people; sometimes the people were attacking each other, sometimes they were allies. I cannot discuss all the drawings displayed at the exhibition, but I will focus on three: Drawing 3, Drawing 9 and Drawing 36 (which is numbered Drawing 45 in Klein’s book on Richard). When Richard started Drawing 3, he said he wanted to draw ‘a lovely ship’. He said that the lower part of the drawing was ‘under water’ and ‘had nothing to do with the upper part’. Mrs K said that his making a lovely ship meant putting his parents right, adding that the smoke from the fi rst funnel represented his father’s genital, the smoke from the other funnel stood for Richard’s mother’s genital. Richard said that Mummy was thinner than Daddy, but he said he had never seen a woman’s genital. He felt less sure, though, that he might not have seen a little girl’s genital. Underwater there was a huge starfi sh (coloured red) which ‘liked the plant’ (the ‘plant’ being represented by the vertical black lines in the lower right- hand part of the drawing). On the lower left there was a black U-boat, and Richard said he did not know what it would do. Probably it would attack the ship. He said Downloaded by [New York University] at 03:54 14 August 2016 that the fi sh (yellow, in the middle of the drawing) was swimming quietly. He added, ‘This is Mummy, and the starfi sh is a baby.’ Mrs K interpreted that Richard was the hungry starfi sh who wanted to eat the plant, which stood for his mother’s breast, and when he could not have it, he became angry and jealous so he was also the U-boat which would ‘probably’ attack the ship. Klein said that Richard followed these interpretations with great interest and attention, and clearly felt relief. Klein does not explicitly say so, but it is striking that this ten-year-old child already had a feeling of the difference between thoughts that were conscious, ‘above the water’, and those that were ‘unconscious’, which ‘had nothing to do with the upper part’ (Klein, 1961, pp 58–59). Gradually it became clear, at least to Klein, that in his unconscious mind Richard had made ferocious attacks on his mother’s other babies, which he assumed she Ten drawings by one of Melanie Klein’s child patients 181 was full of. He believed, also unconsciously, that these other babies had somehow survived in spite of his attacks, and these were the other children that he was so afraid of meeting in the street and at school. Richard was reluctant to accept this interpretation, although it emerged in many different forms in the course of his analysis and gradually it appears to have made some sort of sense to him. Once he had started, Richard was keen on drawing. Drawing Number 9, reproduced at the exhibition, has become well known as the fi rst of his ‘empire’ drawings, as he called them. Mrs K thought the ‘empire’ meant his family, and Richard agreed. While looking at Drawing 9 Richard seemed to be far away in his thoughts. Mrs K asked him what he thought about it. Richard said it was a big starfi sh, but he had changed it into a nice design. (Several readers have agreed with him.) Mrs K reminded him that in the material of the session of the day before, the starfi sh had hurt Mummy’s inside; Richard had wanted to keep the family happy but had not been able to do so, and the discussion between Klein and Richard continued. In later sessions the colours of the ‘empire’ drawings became more standardised: red for Richard, light blue for Mummy, black for Daddy and purple for his brother Paul. The varying number of sections given to each colour was also signifi cant. (Some drawings have been omitted from her book, Klein says, because the names Richard wrote on them would have revealed people’s identities.) In the 2010 exhibition Drawing 36 (number 45 in Klein’s book) is one of the last empire drawings; it is a little more subdued than most of the others. After drawing it Richard dropped the red crayon, which he had said stood for himself, on the fl oor and said Mrs K should step on it. She said he felt so guilty about his attacks that he expected her to retaliate by crushing him. Richard asked if she knew the towns that had been bombed the previous night. Did she also know Munich, he asked, and was it beautiful? Mrs K said ‘yes’. Richard seemed very moved. At the end of the session, ‘He said in a sad voice, that so many steps towards victory were needed – hundreds and hundreds. It was like going up a hill made of glass, and you keep slipping back; we had slipped back at Crete’ (Klein, 1961, p. 262). Klein says in a footnote that she has no note of it, but she thinks she must have interpreted his last sad remark as referring to his analysis as a constant and unsuc- cessful fi ght against his destructiveness. This drawing occurred in session 53, a little more than half way through Rich- ard’s analysis. When Klein considered his analysis as a whole, she thought it had helped him considerably, even though it was very incomplete. Richard had known in advance that his analysis would be short, but, even so, the very last sessions are sad to read, even though both participants went on with ‘the work’ right to the end. Richard saw Klein occasionally after his analysis, but not for Downloaded by [New York University] at 03:54 14 August 2016 further analysis. Many years later Richard encountered Klein again, but this time through Phyllis Grosskurth who was writing a biography of Klein. He was somewhat bewildered by Grosskurth’s approach, especially since he had no idea that Klein had written a book about his analysis. Grosskurth questioned him about Klein, but his most eloquent answer came in the form of an action. Grosskurth writes:

When we met on a subsequent occasion, I brought along a copy of Narrative of a Child Analysis, which he had never seen before. He gazed at the photograph of Melanie Klein on the back cover. ‘Dear old Melanie’, he murmured. Then he suddenly put the photograph to his lips and kissed it affectionately. (Grosskurth, 1986, p. 275) 182 Ten drawings by one of Melanie Klein’s child patients References Grosskurth, P. (1986). Melanie Klein: Her World and Her Work. New York: Alfred A. Knopf. Klein, M. (1961). Narrative of a Child Analysis. London: The Hogarth Press and the Institute of Psycho-Analysis. Reprinted in 1975, second impression 1980. Meltzer, D. (1978). The Kleinian Development, Part II. Richard Week-by-Week. Perthshire: Clunie Press. Downloaded by [New York University] at 03:54 14 August 2016 INDEX

‘acquisitive’ projective identifi cation 35 case studies: Dora 115; Katie 154–5, 165; ‘actualization’ concept 36, 105 Linda 107–8, 155–6, 165; Mrs B. 121–2; administrative work 143 Mrs Lewis 90–100, 157–66; Mrs Peters aggression 68 156–7, 165; Mrs Wilkinson 131–3; Mrs ‘alpha function’ 74 X 109–10; Peter 101–2; Richard 179–82; American psychoanalysis 123 Wolf Man 115 analyst–patient relationship: analyst’s Catholic Church 56 preconceptions 79; analytic attitude 142; children: care of 15, 16; development of 66, breaks in analysis 90–100, 121–2, 82–4; drawings by child patient 179–82; 157–65; clinical fact formulation 90–100; phantasies 64, 117, 118; play technique 62; complexities of patient’s world 107; psychoanalysis 71, 101–2, 107–8, 155–6, counter-transference 79–81, 104–6; 165, 179–82; sadism 65; separation/ ‘participant observation’ 107; projective reunion 155–6, 165; social mixing 13; identifi cation 33–6, 69, 72–3, 79–81, superego 64, see also babies; infants 104–6; transference 77, 79–81, 102–10, class, social 3, 12, 13 see also psychoanalysis cleaning women 15 analytic attitude 142 clinical fact, formulation of 90–100 analytical breaks 90–100, 121–2, 157–65 clinical understanding 138 anthropology 136, 141 Cohen, Norman 143, 150 anxiety 65, 68, 69, 70 communities 22–3 Army psychiatrists 177 conjugal roles 3–24; attitudes towards husband and wife roles 11, 15–16; child babies: phantasies 175; separation/reunion care 16; division of labour 15, 18; friends 154–5, 165, see also infants 13–14, 20; intermediate segregation baby-sitters 14 16–19; joint relationships 3, 12–16; Balint, Michael 139 network connectedness 12–16, 20–2; Bick, Esther 141, 154–5 occupation types 7; segregated Bion, W.R.: container/contained model of relationships 3, 16–19; sexual thinking 74–5; counter-transference 80; relationships 11; social class 3; social originality of 135; projective identifi cation networks 12–16, 20–2 35, 36, 40, 72, 80, 104; thinking, models container/contained model of thinking 74–5

Downloaded by [New York University] at 03:54 14 August 2016 of 74–5; training supervision 140 continental psychoanalysis 123 Bowlby, John 176, 177 ‘Controversial Discussions’, British breaks in analysis 90–100, 121–2, 157–65 Psychoanalytical Society 83, 102, breast, as part-object 69 116–17, 171–8 Britain: Kleinian analysts 71–82; Klein’s counter-transference 79–81, 104–6 arrival in 169–71; projective Curriculum Committee, British identifi cation models 36 Psychoanalytical Society 143 British Psychoanalytical Society 47–8, 83, 102, 116–17, 136, 143, 148–50, 169, Davis, Allison 1 171–8 daydreams 114, 116 Britton, Ronald 50, 166 de-socialised families 19–20 184 Index

death instinct 45, 47, 49, 65, 68, 78, 146 collection methods 4–6; de-socialised delusional narcissism 27–9 families 19–20; division of labour 3, 5–6; depressive anxiety 70 families in process of moving 19; fi eld depressive position: catalyst of concept workers 5–6; home interviews 5; 170–1; envy 49, 57; infants 70; mourning individuation 23–4; occupation types 7; 71; negative therapeutic reaction 29, 30–1; social control 23, 24; transitional families Oedipus complex 71, 76; paranoid- 19–20; urban familial networks 22–4 schizoid position fl uctuation 75; plausibility Family and Social Network (Spillius) 137 of concept 67, 168–9; Schmideberg’s attack Feldman, Michael 51 on concept 168–9; separateness of self 153 femininity 66 destructiveness 49, 50, 51, 78–9 foetal medicine unit, psychotherapy case developmental psychology 84 131–3 dispersed social networks 4, 12–16 French psychoanalysis 123 division of labour: conjugal roles 15, 18; Freud, Anna 102, 137, 140, 178 families 3, 5–6; industrial societies 23 Freud, Sigmund: death instinct 68; drives doctors, as training analysts 144 concept 63; and Kleinian thought 62–3, domestic tasks, conjugal roles 11, 15 67; negative therapeutic reaction 25–7, Dora, case 115 31; penis envy 45; phantasy concept drawings by child patient 179–82 113–27; unconscious phantasies 114–15 dreams: as enactment of sessions 109–10; The Freud–Klein Controversies, 1941–45 and phantasy formation 114 (King & Steiner) 169 drives concept 63–4 friends 9, 13–14, 17–18, 20, 21 frustration, in infants 73, 74 echolalia 91, 92 editorial work 144–5, 147–8 Gillespie, W.H. 176 ego 67, 68 giving/receiving relationship 57–9 ego-dystonic envy 50, 51 Glover, Edward 170, 172, 173, 175–8 employment, London families study 7 Goffman, Erving 1, 2 enactment: dreams as 109–10; transference gossip 13 as 105, 106–10 gratitude 58 envy 45–61; attacks on object goodness 46; greed 45–6 case studies 52–9; conscious operation grievance 50, 51, 52, 147 50, 52; constitutional basis of 45, 47, 48; Grosskurth, Phyllis 181 defences against 52; defi nition 51; Group system, British Psychoanalytical dependence 51; depressive anxiety 70; Society 136, 149–50 deprivation/envy circle 58; destructiveness guilt 25, 26, 29–30, 31, 46 of 49, 50, 51; ego-dystonic envy 50, 51; giving/receiving relationship 57–9; Heimann, Paula 139 grievance 50, 51, 52, 147; guilt 46; Hinshelwood, R.D. 117 impenitent envy 50–9; infants 47, 49, 59; Hoffer, Hedwig 135 instinctiveness of 49; ‘molecular’ nature Hoffer, Willi 136–7 of 50; Mrs A case 52–4, 56–9; Mrs B case Holy Ghost, sins against 56–7 54–9; narcissism 51, 52; negative Hopper, Earl 48 therapeutic reaction 30, 31; ordinary housekeeping money 11 envy 50, 52–4, 56, 146–7; otherness and housework, conjugal roles 11, 15 Downloaded by [New York University] at 03:54 14 August 2016 147; pathological organisation 52; penis husbands see conjugal roles envy 45; unconscious operation 50 hypothetical infant 82–4 Envy and Gratitude (Klein) 45, 48, 50, 70 Envy and Jealousy Symposium, British id 67 Psychoanalytical Society 47–8, 52 impenitent envy 50–9 epistemophilic instinct 65–6 Independent analysts 122, 138, 139, 142 experiencing 73–5 individuation, families 23–4 external reality, and phantasies 119–20 industrial societies 23 ‘extractive introjection’ 35 infants: depressive position 68, 70; envy 47, Extraordinary Business Meetings, British 49, 59; frustration 73, 74; hypothetical Psychoanalytical Society 171–8 infant 82–4; object identity/perception 69, 153; paranoid-schizoid position 68, 69; families, London study 3–24; classifi cation phantasies 35, 117; separation/reunion of 6–7; communities 22–3; data 155–6, 165, see also babies; children Index 185

inner world concept 64, 118 Meltzer, Donald 79, 140–1 internal objects concept 64 Milton, John 51 Isaacs, Susan 83, 116–17, 119, 120, 174 Money-Kyrle, Roger 35, 40, 135 Moran, George 84 jealousy 45, 46 mother–daughter relationships 10, 14, 170–1 joint conjugal role-relationships: defi nition mourning 57, 71 3; friends 13–14, 20; kinship networks Mr A., case 36–8 14; mother–daughter relationships 14; Mr Brown, psychoanalysis example 129–30 recreation activities 14; social networks Mr C., case 41–2 4, 12–16; wives’ occupations 12 Mrs A., case 52–4, 56–9 Jones, Ernest 170, 172, 173, 174 Mrs B., case 38–41, 54–9, 121–2 Joseph, B. 36, 80–1, 105 Mrs Green, psychotherapy example 130–3 Mrs Lewis, case 90–100, 157–66 Katie, case 154–5, 165 Mrs Peters, case 156–7, 165 Khan, Masud 139 Mrs Wilkinson, case 131–3 King, Pearl 169 Mrs X., case 109–10 kinship networks 10, 14, 23 ‘mutative interpretation’ 102–3 Klein Archive 148 mutism 107–8, 155, 165 Klein Group 136, 137, 139, 141–2, 150 Klein, Melanie: arrival in Britain 169–71; narcissism 27–9, 31, 51, 52 British colleagues 71–82; relationship negative therapeutic reaction 25–32 with daughter 170–1 negative transference 102 Kleinian technique 77–82, 101–12 neighbours 9, 12, 17–18 Kleinian thought 62–89; counter-transference 79–81, 104–6; criticisms of 168–9; New Library of Psychoanalysis 147–8 depressive position 67, 70, 71, 75, 76, 153, object identity/perception, infants 69, 153 168–71; destructiveness 78–9; occupations, London families study 7 developments in 62–4; drives concept Oedipus complex 64, 71, 76 63–4; envy 45–50; epistemophilic instinct omnipotent projection 73 65–6; experiencing 73–5; and Freudian ordinary envy 50, 52–4, 56, 146–7 theory 67; inner world concept 64; internal O’Shaughnessy, E. 35 objects concept 64; language of otherness 147, 153–67 interpretation 79; Oedipus complex 64; paranoid-schizoid position 33, 34, 49, 57, Paradise Lost (Milton) 51 67–71, 75, 76–7, 104, 153; parental role in paranoid-schizoid position: defences 76–7; child development 66–7; phantasy concept depressive position fl uctuation 75; envy 64, 72, 83, 102, 113–27; phases concept 49, 57; projective identifi cation 33, 34; 66; positions concept 68; post-Kleinian theory development 67–71, 104 analysis 145–6; projective identifi cation parents, child development role 66–7 33–43, 69, 72–3, 79–81, 104–6; psychotic ‘participant observation’ 107 anxiety 65; reconstruction of past past experience reconstruction 81–2 experience 81–2; sadism 65; symbolism pathological organisation 75–7, 145 65–6, 73–5; thinking 73–5; transference patient–analyst relationship see analyst– 79–81, 103–4; variations 146 patient relationship Payne, Sylvia 173–4, 176, 177, 178 Downloaded by [New York University] at 03:54 14 August 2016 language of interpretation 79, 102 penis envy 45 Linda, case 107–8, 155–6, 165 perfectionism 38 logical thought, and phantasies 121 Peter, case 101–2 London families study see families, London phantasies: American psychoanalysis 123; study babies 175; children 64, 117, 118; London School of Economics (LSE) 2 contemporary Freudian views 123; dream Low, Barbara 172 formation 114; and external reality 119–20; French psychoanalysis 123; Mahler, Margaret 153 Freudian theory 113–27; Independent marriage, sexual relations 11, 16 analysts’ views 122; internal world 118; masochism 29 Kleinian successors’ views 120–2; Medical Committee, British Kleinian thought 64, 72, 77, 79, 83, 102, Psychoanalytical Society 176 113–27; logical thought development Melanie Klein Today (Spillius, ed.) 144–5 121; neglect of concept 123; primal 186 Index

phantasies 115; projective identifi cation self-destructiveness 78 34, 35, 36, 40; repression 114; system self-punishment 29 preconscious 114; US psychoanalysis 123 separateness/separations 153–67 phases concept 66 seven deadly sins 56 play technique 62 sexual relationships, conjugal roles 11, 16 positions concept 68 sins against the Holy Ghost 56–7 post-Kleinian analysis 145–6 social class 3, 12, 13 preconceptions, analyst’s 79 social control 23, 24 primal phantasies 115 social networks 3–24; dispersed networks 4, ‘primary process’ 114 14; friends 21; intermediate connectedness primitive societies 23 16–19, 22; joint conjugal role- projective identifi cation 33–44, 69, 72–3, relationships 4, 12–16; kinship networks 79–81; ‘acquisitive’ projective identifi cation 10; local standards 9; segregated conjugal 35; case studies 36–42; ‘extractive role-relationships 4, 8–11, 16–19, 20–2; introjection’ 35; Kleinian thought 104–6 transitional families 22 psychic atopia 50, 166 Sohn, Leslie 141 The Psycho-Analysis of Children (Klein) 65, Spillius, Elizabeth: administrative work 66, 82 143; becoming a psychoanalyst 134–52; psychoanalysis: analytic attitude 142; committee work 143; editorial work breaks in analysis 99–100, 121–2, 144–5, 147–8; psychoanalytical training 157–65; patient expectations 168; 134–42; research 144; teaching 142–3; psychotherapy comparison 128–33; writing 146–7 session frequency 128; training 134–42, states-of-mind 84 144, see also analyst–patient relationship Steiner, John 49, 145 psychosis, studies of 71–2 Steiner, Riccardo 83, 169, 170 psychotherapy 128–33 Stern, Daniel 83–4 psychotic anxiety 65 Strachey, J. 102–3 suicide 170 reality, and phantasies 119–20 superego 25, 64, 67, 102–3 reconstruction of past experience 81–2 symbolism 65–6, 73–5 recreation activities, conjugal roles 9, 14 system preconscious 114 relatives, entertaining of 9 system unconscious 67 remembering 81–2 reparation, child development 70 Tavistock Institute 2, 135 repeating 81–2 teaching 142–3 repression 114 therapeutic process 128–33 research 144 thinking 73–5 resentment 58 total situations, transference as 103–4 Richard, case 179–82 training, psychoanalysis 134–42, 144 Riviere, Joan 26, 48, 168 transference 102–10; counter-transference Rosenfeld, Herbert 27–8, 35, 81–2, 139 79–81, 104–6; as enactment 105, 106–10; negative transference 102; as sadism 65, 68 total situation 77, 103–4 Sandler, Joseph 41, 105, 142 transitional families 19, 22 schizoid position see paranoid-schizoid traumatised patients 82 Downloaded by [New York University] at 03:54 14 August 2016 position Schmideberg, Melitta 168–78 unconscious envy 50 Searl, Nina 172 The Unconscious in Everyday Life ‘secondary process’ 114 exhibition 179 Segal, Hanna 52, 73, 137 unconscious guilt 26, 29–30, 31 segregated conjugal role-relationships: unconscious phantasies 77, 79, 102, 114–24 attitudes towards husband and wife roles urban familial networks 22–4 11, 18–19; defi nition 3; domestic tasks US psychoanalysis 123 11; entertaining of friends/relatives 9; friends 17–18; housework 11; mother– Winnicott, Donald 139 daughter relationships 10; neighbours 9, wives see conjugal roles 17–18; recreation activities 9; social Wolf Man, case 115 networks 4, 8–11, 17–18 self-centredness 30 Zetzel, Elizabeth 48