Selected Papers

Psychoanalysis and Group Analysis

S.H. Foulkes

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429918841
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The collection of the author's papers, which includes some unpublished material and some published in English for the first time, comprises not only the later Group-Analytic writings but also those from the first part of his career as a psychoanalyst. Among the latter, the paper "On Introjections" is of particular interest and importance.

PART ONE

Biographical

CHAPTER ONE

S. H. Foulkes: a brief memoir

Elizabeth Foulkes

Having spent 25 years in a close working relationship with S. H. Foulkes, including the last 16 years of his life as his wife, this is bound to be a personal account. My late husband enjoyed thinking aloud about many things, not least about the stimulations he found in his daily work with patients and in teaching and in sharing his ideas. Much of what follows is based on our conversations over the years.

It happens that I knew Foulkes’ parents and siblings (we were distant cousins), and I can therefore describe his background from my own impressions, both direct and indirect. We were and remained in contact from 1936 on, when I myself arrived in London to learn the antiquarian book trade.

During the war we met occasionally when he was a Major in the Royal Army Medical Corps at Northfield near Birmingham. At the time I was in the ATS (the women’s army), posted to a temporary home for pregnant army girls outside Worcester, where amongst other duties I was entrusted with conducting discussion groups with the girls. I remember asking Foulkes how I could tactfully stop the girls in my groups from endlessly repeating their life story, having once, with difficulty, succeeded in getting them to talk freely. (I cannot recall the exact answer—something like, ‘let the group help you’…).

S. H. Foulkes was married three times. The first marriage, to Erna Stavenhagen, ended in divorce in 1937. All his three children were of this marriage. Tom was born in 1924, Lisa (now Mrs Ward) in 1927 and Vera (now Mrs Mayer) in 1931. There are six grandchildren. He married, secondly, Kilmeny (Kim) Graham, who died in New York in 1959. His third wife was the present writer, Elizabeth Marx.

Before I begin, something needs to be said about the names by which my late husband was known. As a child he was called Siegmund. As an adult, in Frankfurt and in Vienna, he was known as Dr Heinz Fuchs. Having become a naturalized British citizen in 1938, he changed his surname, phonetically, to Foulkes, preceded for professional purposes by his initials, S. H. To family and friends he was Michael, but he never used this professionally: he grew up in an era when colleagues usually addressed each other simply by surname. Since his death, however, he has sometimes been referred to as ‘Michael Foulkes’, even in writing. This causes confusion, and I have avoided using this name in a professional context. I shall mainly refer to him as SH, the form he himself liked.

Siegmund Heinrich FUCHS was born in 1898 in Karlsruhe, then the capital of the Grand Duchy of Baden, the youngest son of a comfortably-off Jewish family. His father, Gustav Fuchs, was the third of 15 children (13 of whom were male) and an active partner in the family firm of timber merchants and importers who had settled in Karlsruhe in 1870. His mother, Sarah (Claire) Durlacher, was born into a family of wine merchants; she was a great beauty as a young woman. Although it was common in Jewish families to arrange marriages, it seems that this was a love match; Sarah brought no dowry with her as her father had died young.

Gustav Fuchs was a small, robust, jolly man. He rode regularly in the nearby woods; he had a great love of music, sang in a choir and was particularly fond of opera. His special liking for Wagner is reflected in the names of his children: the eldest was called Richard, and the others were named after Wagnerian characters—Senta, Gottfried and Walther. They, were eleven, ten, nine and seven years older, respectively, than Siegmund.

SH felt that he had been deeply influenced by this family background in his choice of career and development. He was fascinated by the differences between his brothers. Richard was artistic, very musical—spending hours at the piano—and he was usually top of his class. He chose architecture as his profession. The next brother, Gottfried, developed in contrast to Richard, excelling at sport rather than in academic fields. Before the 1914-1918 War he was captain and centre forward of the Karlsruhe Football Club, which won the German championship twice, and thus he was something of a local hero. In a match against Russia in the 1912 Olympic Games he personally scored ten goals—a feat unlikely to be repeated in a major international competition. Lastly, Walther had been the youngest for seven years when SH, clearly unplanned, displaced him. In many ways these two brothers were close, but the relationship was not always an easy one.

SH was an attractive child and well liked by the many uncles who came to the house when visiting his grandmother, Fanny Fuchs, who during 20 years of widowhood had an apartment in the house Gustav Fuchs later bought and moved into with his family. Grandmother Fanny, the matriarch, was a strong influence on this young grandson living upstairs.

The house where SH was born (destroyed in the Second World War) was a handsome late-eighteenth-century building in the local pinkish sandstone. It had a wide entrance for coaches and horses, and its large stable yard and garden were SH’s playground. Often by himself, he would sit for long periods and think quite deeply. He recalled how, puzzling about just what it was that he really knew, he had concluded that it was the very act of thinking, long before he came across Descartes’ famous dictum, cogito ergo sum.

His father preferred the more progressive curriculum of a new ‘Gymnasium’, which offered English instead of the more traditional Greek; eventually, SH had some regrets about his lack of Greek. Being one of the youngest in his class, he passed his Abitur while still too young to join the army—his three brothers were already serving in the field—and he took a brief course in architecture at the local Polytechnic.

Sport was important in the family; after school, the habit was to play football with friends on the Engldnderplatz [the ‘Englishmen’s ground’] at the edge of the woods. For a short while SH also played in the team of the Karlsruhe Club, but his preferred sport was tennis; he was junior champion of Baden one year and also won the junior doubles with a cousin. Having embarked on his medical studies after his war service, he continued to play in tournaments and later played for the City of Frankfurt. His preferred use of initials to that of a full first name was inspired by the usage in sport.

In 1917, at the age of 18, he joined the telephone and telegraph section of the German army and served in France throughout the rest of the war. While contemplating what he wanted to do should he survive the war, he was attracted to the idea of working in the theatre, as a director. After being discharged from the army in 1919 he was told by the family that he could go to a university, but that he must choose a profession that would allow him to earn a living.

SH was still undecided about which subject to choose—medicine, or possibly philosophy and psychology. A maternal uncle was a doctor at a small town nearby and was admired for being one of the very first owners of a motorcar in the neighbourhood. SH’s sister was married to an ear, nose and throat specialist. On the train to Heidelberg, the nearest and almost automatic choice, he met an old schoolfriend, also on the way to begin his studies, who had decided for medicine. SH decided to do the same.

During his two years of pre-clinical studies at Heidelberg, he read Jaspers, Gruhle and other writers on psychopathology. Gruhle, writing about obsessional ideas and compulsions, stated that no one knew whence they came and added a footnote, ‘except Sigmund Freud, about his opinions see …’ Recalling that his eldest brother had talked about Freud, Foulkes was now stimulated to find out just what it was that Sigmund Freud knew, and he read the New Introductory Lectures on Psychoanalysis. Deeply impressed, he went on to read the Studies in Hysteria, The Interpretation of Dreams and all other writings by Freud that were then published. He has written (Foulkes, 1968c, p. 117): This was in 1919, and ever since, Freud and his work have been the greatest influence in my professional life, and remain so at the present time. From then on I knew exactly what it was that I wanted to be, namely a psychoanalyst.’

His first clinical term, spent at Munich, gave him his initial contact with psychiatry, when he attended lectures by Kraepelin. ‘I was duly impressed by his clear, precise presentation, but I also knew that this was not the psychiatry I anticipated spending my life on’ (ibid.). The accident of a love affair influenced his decision to continue his studies in Frankfurt. He remained in Frankfurt, where he qualified and obtained his doctorate in 1923—indeed, Frankfurt was his base until he emigrated to England in 1933.

During his student years, his principal teachers were Gustav von Bergmann and Karl Kleist. Von Bergmann is known for the central position he gave to what is now known as psychosomatic medicine. In SHF’s final medical examination, he was presented with a severe case of diabetes. The patient asked him whether he thought the condition might have been brought on by a great disappointment. Receiving a positive reply, the patient then spent much time telling her story, so that there was no time left for Foulkes to examine her urine for sugar. In spite of this, von Bergmann—the examiner—passed him.

Karl Kleist was known for his organic orientation and his emphasis on minute localization in the brain. Foulkes nevertheless felt that his clinical lectures gave him a good grounding in basic psychiatry, and he also profited from Kleist’s course on psychopathology, though it was quite un-Freudian. Clinical visits provided his first contact with psychoses. He recalled (ibid., p. 118) the deep impression these ‘cases’ made on him—how he could not help but look upon them as persons, even though he was only required to differentiate between a catatonic and a simple schizophrenia or between that and a postencephalitic disturbance.

A year’s clinical hospital work was spent at the Charite II in Berlin. The attitude there was that having taken a patient’s history if one did not know what he suffered from, one would never find out. This suited Foulkes’ own way of thinking. He mentions as characteristic of his whole medical career that all he came into contact with ‘turned into psychopathology’.

He returned to Frankfurt for postgraduate studies in medicine—particularly in neurology. The two years he spent at the Frankfurt Neurological Institute with Kurt Goldstein were, apart from psychoanalysis, his most formative influence. He recalled the great stimulation he received there, which brought

a liberation from the limitations of received knowledge. It threw light on one’s unacknowledged, hidden prejudices and sharpened one’s perception of concealed theories disguised as Tacts’. [Fuchs, 1936, pp. 212–213]

Goldstein’s style of teaching, with improvised demonstrations and discussions, stimulating new ways of looking at problems, became a model for Foulkes’ own teaching (see chapter four, this volume). The holist approach learned from Goldstein was central to the development of SH’s thinking and is reflected in his emphasis on the whole being earlier and more elementary than its parts (Goldstein, 1934; Fuchs, 1936). The analogy of likening the individual person in his group to a nodal point in a network of neurons also stems from the time spent with Goldstein.

Of the greatest interest to me, however, was the insight, owed to K. Goldstein, that our methods determine what we find, that what we do is really a sort of self-confirmatory prophecy, in other words, what is basic are our assumptions, and our method includes these assumptions. [Foulkes, 1968c, p. 118]

Another influence during this period was SH’s contact with Gestalt psychology, and he attended lectures by Adhemar Gelb, who worked with Goldstein. The influence is clearly reflected in Foulkes’ view of the individual and the group as a figure/ground constellation.

The only subject on which Foulkes disagreed with Goldstein was the latter’s attitude to psychoanalysis; while estimating Freud highly as a person, Goldstein was critical of psychoanalysis and psychoanalysts (see chapter four, this volume).

While working at the Neurological Institute, Foulkes often accompanied a more orthodox neurologist, F, Kino, on his daily rounds, seeing neurological cases in all departments of the general hospital. He felt that this was a most valuable learning experience regarding the psychopathological relevance of many of the organic and functional diseases in the patients they examined. Indeed, he was struck when Kino’s attitude to one patient changed completely, once she was found to have a positive ‘Babinski’ and was diagnosed as a case of multiple sclerosis, having previously been considered ‘hysterical’. This gave SHF much food for thought concerning both doctors and patients (Foulkes, 1968c, p. 119).

Having long decided to have a psychoanalytic training, he discussed his plans with Karl Landauer, the only psychoanalyst in Frankfurt he had met. Landauer advised him to go to Vienna rather than to Berlin, adding that it would be useless to apply to Freud himself. SH later wished he had at least made an approach to Freud at the time.

He took his wife and two young children to Vienna in 1928 to start his training analysis. He had corresponded with Helene Deutsch, then Director of Training of the Vienna Society. When he went to see her, she offered him a vacancy herself, and she became his training analyst. More surprisingly, she also took his wife into analysis; SH thought this strange, but he accepted it as he felt Dr Deutsch must know what she was doing. Foulkes’ supervisors were Edward Hitschmann and Herman Nunberg.

At the same time he underwent a thorough psychiatric training at the University Clinic, directed first by von Wagner-Jauregg and later by Otto Potzl. He found Professor Potzl’s lectures particularly stimulating. ‘He was by far the most colourful teacher in psychiatry I have encountered … fully integrating his psychoanalytical orientation’ (Foulkes 1968c, p. 119). He was also much impressed by Paul Schilder’s seminars and his way of demonstrating elementary psychoanalytical mechanisms on carefully chosen psychotic patients who showed such mechanisms far more clearly than neurotics [ibid.].

Schilder also gave seminars at the Psychoanalytic Institute, which Foulkes attended. He remembered Otto Isakower as another participant, as well as Suzanne Zingg, a Swiss colleague who had worked with Bleuler in Zurich. He learned much from her about Bleuler’s approach, which he said he liked to use as a model for his own orientation in psychiatry.

This was a most intensive time for SHF. Though still only a candidate, he was invited to join a seminar for the younger generation of analysts, including Richard and Edith Sterba, Edward and Grete Bibring, Ernst and Marianne Kris, Willi Hoffer and Hedwig Schazel (later Mrs Hoffer), Otto Isakower, Erwin Stengel, Heinz Hartmann and Annie Reich. He remained on friendly terms with all these colleagues. Many hours were spent talking about psychoanalysis at the Cafe Herrenhof with Robert Walder, who became a life-long friend, the Kris’s and others; among recent publications which SH remembered being discussed at length was Freud’s Beyond the Pleasure Principle (1920g—Foulkes, 1968c, p. 120).

In the afternoons he would return to the Hospital and, having no official du...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• Preface Elizabeth Foulkes
• Foreword Malcolm Pines
• Part One Biographical
• Part Two Psychoanalytic papers
• Part Three Group-analytic papers
• References
• Index