Psycho-Analytic Insight and Relationships

A Kleinian Approach

Isca Salzberger-Wittenberg

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781134962365
• Edition: 1
• Topic: Psychologie
• Subtopic: Psychische Gesundheit in der Psychologie

Melanie Klein has been one of the most important contributors to our thinking about human development and human personality. In this classic text, Isca Salzberger-Wittenberg demonstates through theoretical exposition and the use of case material the ways in which Melanie Klein's main concepts and theories illuminate the practice of social casework. These theories are often complex and controversial, but this concise and lucid account continues to enable social workers and others in helping professions to judge the relevance of the Kleinian approach for themselves.

II

Conflict, Anxieties and Defences

1

Persecutory Anxieties and Defences Against them in the Adult, Child and Infant

A Frightened Client

Mrs B., a thirty-four-year-old married woman with two children of school age, was referred to the Local Authority Mental Welfare Officer by her doctor following her brief stay in a Mental Hospital.

The worker found a slight, anxious-looking woman who keeps her flat very clean and neat, tastefully furnished in rather muted colours. The client says that her main trouble is that she is afraid to go out in the street. She had tried to be sensible about it but she couldn’t get herself out of the house. As soon as she tries, she panics, and has an attack of dizziness and nausea. She will not allow daily papers in the house for fear that they contain accounts of war and murder. Her children play mainly outside because she cannot bear their noisiness and demands. She dislikes her father-in-law’s visits, complains that he is rowdy, and she would much prefer to be ‘left in peace’. When her husband is out, she is terrified of what will befall him and gets into a panic when he comes home late. She praises him for his patience with her and his placid nature (the worker got the impression of a colourless, immature young man lacking in masculinity).

Mrs B. tells the caseworker that she used to be headstrong and had a dreadful temper as a child and young woman. This led to frequent quarrels in the early years of her marriage ‘but now my husband is always right’. Occasionally, she feels like ‘exploding’. Then she retreats to her bedroom and tries to control the impulse to ‘bash the place to bits’. She had difficulty in conceiving and did so only after some years. In the first few weeks of the baby’s life she was sure he would die. She was unable to breast-feed. Lately she has suffered from excessive bleeding during menstruation. She feels all her troubles are sent by God to punish her.

This brief account gives us a picture of a woman whose everyday life is dominated by acute anxieties. Her attempt to control them by shutting herself in, and shutting the feared world out, in the hope of achieving peace is only partially successful. She is still left with her worry about her husband’s safety and a feeling that her need to restrict her own life and that of her family makes her a bad wife and mother.

What we have learnt about Mrs B.’s phantasies so far is that the inside of her house is a place of relative peace and quiet, while the outside, the street, the world about which the newspapers bring reports, is a place of destruction and horror. The sharp juxtaposition of ‘safe inside house’ and ‘dangerous outside world’ is matched by her inner world which is either one of docility or one in which she smashes everything. So here we have concepts of security and danger, good and bad, passivity and aggression, right and wrong which have an either or, black-or-white quality about them with no shadings in between.

We might ask how did Mrs B. come to think of herself and the outside world in these terms? How has she in the course of her development come to conceive of safe places and dangerous spaces? What do house and street represent to her in phantasy? Why is anger felt to be completely destructive? What is the nature of the ‘peace’ she is seeking? Why does she conceive of something so punishing that it threatens her marriage, her creativity, her very existence?

Before attempting some answers, we will look briefly at what Mrs B. was able to tell the caseworker in the course of months of weekly visits, about her past. Mrs B. is the youngest of seven children. Her father died when she was six weeks old and she was subsequently cared for in the maternal aunt’s home until her mother remarried. She was with her mother and step-father from the age of three until she was evacuated during the war at the age of seven. At first she was very unhappy, but later settled down and liked her foster-mother, though she remembers her as an anxious person. She did not wish to return home after the end of hostilities, and at her repeated request was allowed to stay on with the foster-parents for another two years, though her brothers and sisters went home. When she was eleven, step-father died. Two years after she had returned home the client’s mother again remarried. Mrs B. remembers being so furious that she went to stay with her older sister who was then already married with two children. Four years later the sister’s husband died. The client married at nineteen and as we know had difficulties in conceiving and feeding her baby. One-and-a-half years ago her mother-in-law collapsed in Mrs B.’s arms and subsequently died. Since then the client’s symptoms have intensified.

We might say: given such experiences, little wonder that this woman is always expecting disaster! The client reported that a doctor told her that her troubles were due to all these deaths in the family, but what he said, had done nothing to alleviate her problems. Such an explanation is inadequate because it does not link the outer events to the person’s inner experience in terms of phantasy. It became meaningful to her only when she was shown that she had attributed these deaths to herself and that they had been understood by her as a confirmation that her temper tantrums and jealousy were extremely dangerous, i.e. murderous. The client described herself as a headstrong, often bad-tempered child, and we know from her present-day feelings that ‘temper’ means something like destroying everything around her. It is significant that she has this feeling in the bedroom which must be associated with marriage and sexual relationships. Although we know little about her early life, she remembers being furious at her mother’s third marriage, wanting to keep her to herself and feeling that the man was stealing mother from her. The extent of her anger with her mother is shown by her moving away from home, just as earlier she had insisted on staying with the foster-parents even when the war was over. She also recalled how angry she had been that her mother frequently left her at an earlier age in charge of older sisters while she went out to the pub. So we are presented with a division: a good ‘housemother’ that the girl can possess—represented now by the good feelings while she is in the house—and the bad ‘street-mother’ associated with men, going out, leaving the girl, drinking—represented now by the street and its dangers.

Obviously the girl’s anger did not kill off men and women in reality, though we have to assume that it did so in her phantasy. It is the omnipotence of thought and phantasy that leads to the fear and conviction that people have in fact been killed by anger. Actual deaths are taken as a confirmation that phantasy and mental phenomena are omnipotent. To the child, or the child inside the adult, it means: ‘I need only think it, and it happens; my anger is so dangerous, the other one will die’. This feeling of being dangerous must have been strengthened in Mrs B.’s case by her being sent away from home twice, as if this was to say: Mother can only remarry, and a family survive, when you are not there. Indeed if we are to credit the client’s story that the grandmother and stepfather’s deaths occurred during her periodic visits to the parental home, this would lend substance to her phantasy.

We can see in Mrs B. that such fears can lead to a severe control of aggression. She must always be docile and quiet and so must those around her. Her feeling that all aggression ends in disaster has led her to try and rid herself of it.

The more the destructive feelings are pushed out the more the outside (and others) come to be felt as a place filled with them. Not that there is any awareness that such projection has taken place—it is an unconscious phantasy ‘action’ of which only the result comes into consciousness: the world is bad and the house is good and peaceful. In this way the division between ‘good inside house-mother’ and ‘bad outside-mother and men’ has become strongly reinforced. Her own angry feelings with men are put into this outside world which is then felt to be killing to men. This explains her panic when her husband is late and her conviction that he must have been struck down.

The process is not completely successful and never can be: the internal war continues, feelings of exploding with anger and the fear of being sought out by a punishing killing God-father. But again we need to take note of the fact that Mrs B. is quite unaware why she feels herself to merit God’s wrath. While she is out of touch with the source of her fear and guilt, namely her aggressiveness, there can be no change; for her very denial of aggressiveness—due to her fear of its omnipotent power —does not make it possible to bring it into the orbit of loving feelings which might modify and control it. There seems to be no concept in Mrs B. of a father who can act as a firm but kind policeman keeping her aggression under control. All the fathers Mrs B. knew died, and so must have appeared insufficiently strong to protect themselves and mother against destruction. The only powerful father is felt to be an extremely revengeful, punishing God.

The greatest help the caseworker can render this woman is to be aware of the client’s reactions to herself; particularly when holidays or other occasions give rise to anger towards the worker and her husband, and to help her to verbalize, acknowledge and accept aggressive feelings. Any playing down of the client’s hated feelings, in conflict with loving ones, would be taken as the worker’s fear of them (like the husband who denies them) and so would serve to strengthen the client’s conviction of their omnipotent power; conversely, their acceptance and the survival of the worker’s marriage might lessen the belief in their omnipotence and so bring relief.

A Case of School Phobia

The above case strongly resembles a type of school phobia. While Mrs B. is afraid of open spaces, my patient Peter, aged fourteen, was afraid of entering buses and school and felt sick and dizzy when asked to do so. By the time I saw him he had stopped attending school altogether-Despite good intelligence, his school achievements had been poor. He was said to have kept apart from and been afraid of other boys. The parents were worried that he would not be able to get a job, as he could not go far away from home. Peter himself showed no urge to work. He demanded that mother be in the house, and serve his meals on time—he had never eaten school or restaurant meals—and he suggested that she had married the wrong man. When she went out, he wanted her to account for her every movement, to tell him whom she had spoken to and who kept her away so long. He watched carefully over the amount of food and affection that was given to his father and younger brother and compared it unfavourably to what he got. He sulked when visitors called, and if they had tea, complained that there would not be enough milk left for him.

His feelings of greed and ownership were evident from the beginning of treatment. The non-directive therapy session felt to him ‘like walking into a strange house, helping yourself to the food in the larder and switching on the television’. He demanded more and more time, and more talking on my part, which was linked to his wish for more mental food experienced as mother’s milk by a baby part of himself. He always came half-an-hour early and was watching out for me. In this way he was also helping himself to more than he was offered, looking into my life and my activities.

On one such occasion when he was sitting in the waiting-room long before he was due, he saw me talking to a male colleague and to another boy. When he came into my room he thought it was stuffy, musty-smelling, smoky like a bus and he did not think he could stay there. Then he got a stomach pain, rushed out and had an attack of diarrhoea. This sequence shows that when I did not fulfil his demand to be owned by him, enslaved as a larder-mother to provide for him alone, I became in his eyes filled with bad stuff; he turned away from me, not only externally but by turning me into sick food and getting rid of me via his anus.

This shows how he clings to his mother in a possessive way in order to avoid not only frustration but his hatred of a frustrating mother and the resulting attacks which turn her into a horrid and terrifying one. It makes it clear that the bus meant to him a mother who has men inside (the conductor and driver-father figures), and child passengers, while the school, as we came to see it, represented a mother full of rival children as well as master-fathers. In phantasy he attacks them, pushing into them his smells and wet! As a consequence, he experiences the inside of bus and school (which is felt by the baby part of him as a mother’s body) to be a dirty, dangerous place full of counter-attacking children and men.

Infantile Roots of Persecutory Anxieties

The infantile nature of the fears which we see in the two cases indicates that they derive from an earlier stage of development. In children, a variety of phobias are indeed common and can usually be overcome with patience and tolerance. It is only when they persist, are extreme or seriously interfere with the child’s life, that outside help may be necessary. In Analysis of a Phobia in a Five-Year-Old Boy (1909), Freud has given us a brilliant and delightful account of his first child case. Little Hans’s phobic fears stemmed from his rivalry with his father for the love and possession of his mother and showed how sexual anxieties were transformed into a phobia of horses. Freud saw this as a symptom arising out of the Oedipal conflict, a conflict which he regarded as a part of normal emotional development in a five-year-old child. He saw also that he had been correct in claiming that elements of earlier development continue to exist in the depth of the mind and can be discovered in an adult’s analysis.

Melanie Klein (1928) found fear of rivals and consequent anxieties to be equally common in still younger children. Furthermore, she saw the Oedipal genital desires of the boy and girl to have their forerunners in the baby’s wish to own the feeding mother. We can see evidence of this earlier concept of father as a rival for mother’s food in the fourteen-year-old Peter who watched carefully and resentfully over every morsel, particularly milk, given to father, brother and visitors. In Peter’s case, the degree to which the possessiveness is still attached to the actual food and the extent to which it dominates over his more mature self, is extreme, but in small children such behaviour is common. Klein concluded that such feelings stemmed from early infancy; that whenever the infant is not being fed, he phantasies that mother is giving her breast to a rival: to father, brother or even herself.

Such ‘baby-feelings’ in relation to a person who is felt to be able to provide physical or mental food, security and love continue to exist to some extent throughout life; they are particularly active in any emotionally dependent relationship and particularly pressing in times of stress and crisis. The client may thus have strong feelings about the caseworker. Whenever she is not attending to him he is likely to experience her as putting her husband, children and other clients before him or withholding treatment for her own benefit. To the extent that such feelings are operative, he perceives the caseworker-—as the infant the mother—in terms of his own needs; we might say: in a self-centred way.

Focusing attention on the motivation underlying behaviour, Klein found that this attitude of: ‘I need you, I must have you all the time’, is based not only on greed and possessiveness, but is a way of keeping at bay terrible anxieties such as ‘1 am so frightened when you, the good and helpful one, go away’: ‘I cannot survive without your presence’: ‘I’ll die’.

It would be rare for a child or adult to put this directly into words. A child might cling or scream in desperation and the intense cry of the baby conveys the message of Tm dying’, ‘I’m in danger’ so forcefully, it compels us to rush to his aid. With adolescents and adults, we may have to be more perceptive to understand their cries for help; it may be delinquent or criminal behaviour, done so openly that it shows an unconscious wish to be found out; it may be accident-proneness; or just a feeling that is conveyed which makes us worried and concerned about the safety of our client. In every case we have to decide how far this is based on the client’s anxiety and to what extent it is used to manipulate and control us.

As Klein has shown (1963), it is not simply a fear of being left alone but left with something: with terror. The content of the terror may be manifold: the fear of exposure to one’s self-hatred and suicidal impulses; of hatred of the other person and fear of retaliation; of robbers and plotters; of witches and ghosts; of utter physical or mental helplessness; fear of the unknown, which is always felt to be potentially dangerous. While the content varies from one person to the other, the common factor is the fear of death or harm that might befall one in the absence of the good and helpful other person.

Klein distinguished between these fears centred round the safety of the sell: persecutory or paranoid anxieties and what she called depressive anxieties: fears centred round the safety of others (1934 and 1946).

Klein related these fears of a bad ‘presence’ in the absence of the good mother to the projection of hate, and following from this, an expectation of a hating, death-or harm-inflicting outside force. We saw in the case of Mrs B. how her attempt to rid herself of aggression led to her pushing it out and so constantly increasing her fear of a bad external world. We saw in Peter, how this jealousy of rivals and his phantasied attacks on them, turned me in his mind into both an external dangerous person and internally into a frightening object. The fear of this bad frightening ‘other’ in turn increased his greed for the presence of the good mother to act as a barrier against hatred and the experience of a ‘bad’ one.

These feelings may sound so irrational as to appear mad. Why, we could argue, did Peter, who after all could see and hear me and who had previously experienced me as helpful, not tell himself that I was the same person as the one he now found so frightening? Indeed, by interpreting to him and recognizing that a baby part of him felt terrified and was temporarily ruling over the more adult part of him that knew me as a helping therapist, I enabled him to return to my room. In making this distinct...