Clinical Lectures on Klein and Bion

Robin Anderson

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781134913466
• Topic: Psicología
• Subtopic: Salud mental en psicología

Clinical Lectures on Klein and Bion outlines the basic ideas in their thinking and shows in detail how these ideas can be used to tackle a clinical problem. The contributors correct some common misconceptions about Kleinian analysis, while demonstrating the continuity of their everyday work with seminal ideas of Klein and Bion.

Originally given as a series of lectures intended to acquaint the general public with recent developments in psychoanalytic thinking and practice, the papers in this book cover the most fundamental ideas put forward by Klein and Bion; child analysis, Klein's use of the concepts of unconscious phantasy, projective identification, the paranoid-schizoid and depressive positions, Bion's study of psychotic thinking, his ideas of the relation between container and contained, and the usefulness of the ideas of reversible perspective in understanding 'as if' personalities.

In particular, this book provides an eminently readable and authoritative introduction to some of the most original and controversial concepts ever put forward in psychoanalysis.

1 Child analysis and the concept of unconscious phantasy

Patricia Daniel

DOI: 10.4324/9780203167779-1

Introduction

In this chapter I shall focus on the first phase of Melanie Klein’s work, roughly between 1919 and 1934, when she was working within the theoretical framework of Freud and Abraham and before she made her own theoretical formulations. During this period there were two major developments: the working out of her play technique for child analysis, a clinical development, and a broadening of Freud’s concept of unconscious phantasy, a theoretical development. These two developments were closely linked, as so often happens in psychoanalysis.

Melanie Klein’s contributions to psychoanalysis are rooted in her work with children. From the beginning she was convinced that full Freudian analysis of young children was possible and, as Hanna Segal (1979) describes it, Klein’s stroke of genius was to realize that play is the child’s natural means of dramatizing his phantasies and working through his conflicts. I shall describe her play technique and try to show how it gave her access to the liveliness of the projective and introjective phantasies operating in the mind of the very young child. Freud and Abraham had started to conceptualize the introjects; that is, the parts and aspects of persons taken into and active within the mind as unconscious phantasies. Her play technique, like a new tool, made it possible for her to build on their work and to show the importance for psychic development of the nature of these introjects. Her understanding of the operation of unconscious phantasies in young children’s minds opened up the liveliness and richness of the internal world of objects. These discoveries eventually led her and her co-workers to deepen and widen the concept of unconscious phantasy and to formulate ideas about how the infant’s psychic world is gradually built up from birth onwards. I shall include illustrations of the operation of infantile phantasies as they emerge in the analysis of children and adults.

Discovery of the psychoanalytic play technique

Apart from ‘Little Hans’ whose analysis was carried out by his father under Freud’s (1909) direction, it is generally thought that Dr Hildi Hug-Hellmuth was the first to attempt psychoanalytical work with children. She also taught and must have influenced Anna Freud, who came to child analysis with a background in teaching. At that time both Hug-Hellmuth and Anna Freud worked only with children of latency age between six and twelve whose verbal associations were limited and sporadic, and at first they tried to deal with this difficulty by playing with the child and seeing it in its family circle so as to get to know its everyday life and relationships. These early pioneers of child analysis sometimes analysed their own children as well as those of friends and colleagues, probably not yet fully realizing the power of the transference in a child.

An important step in the development of Klein’s play technique came with the analysis of her youngest patient Rita, aged two years and nine months. Rita had night terrors, was inhibited in her play, and suffered from excessive guilt and anxiety. Since analysis of so young a child was a new venture, Klein (1955) approached the task with some trepidation, and her misgivings seemed to be confirmed in the first session when she was left alone with Rita in her nursery. Rita was silent and anxious, and asked to go out into the garden. So out they went, Rita seeming less frightened when they were in the open. While in the garden Klein interpreted Rita’s negative transference to her, telling Rita that she was afraid of what Klein might do to her and linked it to her night terrors. After these interpretations Rita’s fear lessened and she was able to return to the nursery and play. It was during this analysis that Klein concluded that the transference situation could only be properly established and maintained if the child feels that the room, the toys, and the whole analysis are separate from his ordinary home life. So she provided her next patient, another little girl, with a box of small toys to be used only by her during analytical sessions.

By 1923 her principles of child analysis and her technique were worked out.

Melanie Klein held that the child’s play expresses its preoccupations, conflicts and phantasies, and her technique consisted in analysing the play exactly as one analyses dreams and free associations, interpreting phantasies, conflicts and defences. The child’s drawings and his associations to them are often particularly instructive.

(Segal 1979: 42)

The room, the toys, and the analyst provide the setting for the play technique. Klein favoured very small toys, as they are easy for little children to handle. Nowadays when we see very disturbed children in analysis small toys are also safer when hurled about. As far as possible they should be nondescript so as not to suggest games. The choice of toys is important because the child’s free play functions like free association in the analysis of adults. They usually include bricks, a few animal and human figures in two sizes for use as adult and child figures, a few small cars and trucks, a few small balls and containers; also paper, pencils, and crayons, glue, scissors, string, and plasticine. If running water is not available, then a jug of water and a bowl are provided. The purpose of these materials is to provide the child with maximum scope for his imaginative play. The room has a table, at least two chairs, and a couch. The furniture is arranged so that the child is free to express aggression without danger to himself or undue damage to his surroundings. Each child has his or her sessions at fixed times, fifty minutes five times a week.

There is an interesting illustration of Klein’s technique which is more fully described in Volume 2 of The Writings of Melanie Klein, Chapter 2, entitled ‘The technique of early analysis’ (1932: 17). Peter, aged three years and nine months, was timid, difficult to manage, unable to tolerate frustrations and inhibited in his play. He had a younger brother. His analysis was intended to be a prophylactic measure. At the start of the first session Peter puts the toy carriages and cars first one behind the other, then side by side and then alternates this arrangement. In between whiles two horse-drawn carriages are made to bump into each other so the horses’ feet are knocked together, and Peter says, ‘I’ve got a new little brother called Fritz.’ Klein does not enquire about the little brother, the external reality; she pursues the internal reality, for she asks ‘What are the carriages doing?’ He replies, ‘That’s not nice,’ stops their bumping but soon resumes it. Then he knocks two toy horses together in the same way. Klein makes her first interpretation; she says, ‘Look here, the horses are two people bumping together.’ Peter says, ‘No, that’s not nice,’ but then he says, ‘Yes, that’s two people bumping together and now they are going to sleep.’ He covers them with bricks, and says, ‘Now they’re quite dead; I’ve buried them.’ In the second session he repeats this sequence with cars, carts, carriages, and two engines. Then new material emerges. He puts two swings side by side, shows Klein the inner long part that hangs down and swings and says to her, ‘Look how it dangles and bumps.’ Then comes her interpretation. She points to the dangling swings, the engines, carriages, and horses, and says that they are each two people, ‘Daddy and Mummy bumping their thingummies.’ Her practice was to find out beforehand from the parents the child’s own words for genitals, faeces, urine, and bodily functions. First Peter objects, ‘No, that isn’t nice,’ but he continues knocking the carts together, and soon after he says, ‘That’s how they bumped their thingummies together.’ Then he speaks about his little brother again. In the rest of the second session Peter’s play develops to reveal more details of his phantasy of his parents’ intercourse, his own wish to join in, and he and his brother masturbating together. As Klein follows him and interprets, so Peter shows her more.

Through her analytic work with young children, some seriously ill, Klein became convinced that the child forms a transference and that his play is symbolic of unconscious phantasy and equivalent to free association in adults. Therefore she thought that the sole function of the analyst is to interpret the unconscious phantasies and conflicts as fully as possible from all that the child patient does and says, as in adult analysis. These remain the principles underlying the Kleinian approach to child analysis today, and many of these have become more or less generally accepted in British psychoanalytic child analysis. But in the 1920s these were revolutionary ideas and aroused controversy in the psychoanalytic societies. Technical differences were linked to differences in theoretical approach. Anna Freud (1927) and her followers held that a child could not develop a transference neurosis while still emotionally dependent on its parents; they also thought the child’s ego and superego were too immature to establish a full analytic process, so the analyst should adopt, they suggested, a supportive role to guide the ego and strengthen the superego. At this time Anna Freud also thought valuable work with children was done only in a positive transference and the negative transference should be avoided.

On the other hand Klein had found the rich, imaginative world of unconscious phantasy, peopled with internal objects, which suffused the young child’s mind. These internal objects were distinct from the actual parental objects, although in interaction with and influenced by them. It was, for Klein, this world of inner phantasy objects which was alive and active, which determined the transference and which could then be modified by interpretation. In contrast to Anna Freud at that time, Klein found that the primitive superego was extremely harsh and cruel, but she also found that its strength could be reduced by interpretations, particularly of the underlying anxiety and guilt.

In her early papers on child analysis she gives a wealth of detailed description of children’s play and verbal associations and the simple direct way in which she couched her interpretations. What is so striking is the acuteness of her observations and her clinical insights which enabled her to grasp the meaning of the unconscious phantasies unfolding in the play and to trace the transference within them. Above all she was sensitive to the anxieties of her little patients and aimed to direct her interpretations to the point of maximum anxiety because she found that the resolution of anxiety brought progress in analysis and in the child’s development. She observed, listened to, and took seriously the anxieties of very little children, as Freud had done with adults suffering from mental illness. In the 1920s and 30s her discoveries opened up a whole new area in the understanding of children.

In child analysis the aim is to try to understand and interpret the dimension of unconscious phantasy, which Klein had discovered is always present in the ordinary play of a child. I want to give you a straightforward clinical example of very ordinary child material, where the little patient is not doing anything dramatic. She is playing in an ordinary sort of way. This is an obsessional girl of six who has been in analysis for a few years; she has one sibling, a sister fifteen months older than herself. In the second session after a summer holiday break she spends the first part sitting back rigidly in an armchair in a corner of the room. She remains silent and watchful, and occasionally her eyes flick rapidly round the room. Gradually her glances are directed more often to me, to the chest of drawers, and to her open drawer there. She gives no sign of hearing me when I talk to her about her being so scared of me and the room, though she wants to look around, how she feels she needs to control herself and me so that nothing frightening or unexpected can happen. Eventually she edges her way cautiously to her drawer where she rummages for a good ten minutes, apparently looking for all the loose bricks scattered amongst the jumble there. She places all the bricks on the table and two bags containing wooden figures and wooden animals. She checks their contents and then checks the bricks, returning to the drawer to hunt for more. She finds two tiny ones and puts some crumpled-up drawings she had done the previous term into the wastepaper basket. Next she groups all 24 bricks into their various shapes and colours and places them in their bag. She returns the other two bags to her drawer. She checks the time by her large watch and empties all the bricks onto the table; for a minute or two she seems very uncertain. Then she places four square bricks to form a square and later puts a thin blue stick brick inside the square; as I am uncertain as to what she has done I move nearer to see better, and she dismantles it. Next she builds a low wall of bricks, and on her side of the wall and attached to it is a flat square with a small coloured brick inside the square. On my side of the wall but separate from it she builds a pillar of bricks with coloured, rounded ones at its top. She surveys both structures and glances at me, expecting an interpretation. She has not spoken.

As she is obsessional, her initial defence against her anxiety in being with me again is to check and control both of us. The interpretation of her fear reduces the anxiety and then some detail of her unconscious phantasy gradually emerges in her behaviour and play. I think it is something like this. Her first anxiety is whether something has been taken from her, while she has been thrown out during the holiday like the crumpled drawings she put in the wastepaper basket. The next anxiety is what has been going on in the room and inside me, symbolized by the squares of bricks, in her absence. Is there a baby? Are there blue bricks in the square? She isn’t certain, as I am uncertain and moves nearer to look, but she suspects there are. I think the pillar outside the wall represents the penis which she suspects got inside and produced a baby, but which she now believes is somewhere outside. Klein was the first to realize the unconscious drama contained within such simple ordinary behaviour and play, and to appreciate the richness and power of these infantile phantasies in the minds of children and adults.

The internal world

It has often been said that Freud discovered the repressed child in the adult and Klein discovered the repressed infant in the child. She saw how children and adults are dominated by their unconscious phantasied relation to parts of their parents, like breast or penis, introjected during the oral phase in infancy and already repressed in young children. These relations to parts and to whole people fill the child’s unconscious mind and have personal characteristics and personalities, for they can be seen as loving, appreciative, hating, greedy, or envious and so on. Klein thought that from the beginning of life the infant, in phantasy, introjects his mother’s breast and repeatedly splits its good and bad aspects with the aim of introjecting the good ones and projecting and annihilating the bad ones. In the Kleinian view it is of fundamental importance that the infant, and in analysis the patient, gradually internalizes a predominandy benign picture of his mother, or analyst, since this forms the basis for all loving, lasting reparative relationships in the future. This benign process can be seen at work in a little girl of two who was struggling with her first separation from her parents. She spent much of the morning of the third day clutching her teddy, staring out of the window, looking for her parents in the street beyond. She became more miserable and then felt physically sick, so she agreed, with some relief, to go to bed. As she wearily climbed the stairs pulling teddy after her she was heard consoling him_ ‘Poor Teddy, he’s so sick; poor, poor teddy.’ Her miserable self was projected into teddy but there was also a kindly, caring internal mother who was sympathetic and with whom the little girl identified.

Through her work with many young children Klein discovered the primitive Oedipal situation and the origins of the superego in a new world of the child’s complex phantasies and anxieties about his mother’s body. Phantasies include ones that mother’s body is full of good things, such as milk, food, magic faeces, babies, and father’s penis, which is imagined as incorporated by mother during intercourse, at first believed to be oral. In phantasy this body and its riches are desired, attacked, and robbed, and sometimes the destructive, envious attacks are motivated more by hatred than desire. There are also phantasies of repairing and restoring mother’s body. Klein thought that the basic persecutory anxieties in children and adults originated in the oral and anal phases of development and in this primitive relation to the mother’s body which was imagined as containing father’s penis. Later, when father is beginning to be seen more as a separate person, the baby’s phantasy creates what Klein called the combined parental figure. For she found her small patients produced play material which showed both parents in intercourse combined into one figure. While such a picture helps the baby to deny the pleasure it imagines its parents receive from each other, none the less the envy and jealousy are projected onto this combined figure. This is the basis of children’s nightmares of many-headed or many-legged monsters. The intensity of the baby’s anxieties in relation to. the mother’s body are similar in intensity to those found in adult psychotic patients. These anxieties are also the driving force in the displacement of interest from the mother’s body to the world around and push the baby toward developing an interest in the external world.

The concept of unconscious phantasy

Klein’s early work led on to a reformulation of the concept of unconscious phantasy. Her notion of unconscious phantasy comes from her view of symbol formation as the link between unconscious phantasy and reality. By symbolizing in words or play, the child expresses and modifies his phantasies through his experience of reality. All a child’s activities, and those of adults too, even those most geared to external reality, also express and contain their phantasies. External reality affects our phantasies, and our phantasies influence our perceptions of external reality. She and her co-workers focused their analytic work on locating and interpreting the content of unconscious phantasies and the unconscious functioning of the ego, and this led them to a wider view of phantasy. They came to the view that the primary contents of all mental processes are unconscious phantasies and that these phantasies form the basis of all unconscious and conscious thought processes (Isaacs 1952). Juliet Mitchell (1986) has this to say about Klein’s concept of phantasy:

phantasy emanates from within and imagines what is without, it offers an unconscious commentary on instinctual life and links feelings to objects and creates a new amalgam_ the world of imagination. Through its ability to phantasize, the baby tests out, primitively ‘thinks’ about its experiences of inside and outside. External reality can gradually affect and modify the crude hypothesis phantasy sets up. Phantasy is both the activity and its products.

(Mitchell 19...

Table of contents

• Cover Page
• Half Title Page
• Frontmatter1
• Frontmatter2
• Title Page
• Copyright Page
• Table of Contents
• List of contributors
• Foreword by Hanna Segal
• Acknowledgement
• Introduction—Robin Anderson
• 1 Child analysis and the concept of unconscious phantasy—Patricia Daniel
• 2 The emergence of early object relations in the psychoanalytic setting—Irma Brenman Pick
• 3 The Oedipus situation and the depressive position—Ronald Britton
• 4 The equilibrium between the paranoid-schizoid and the depressive positions—John Steiner
• 5 Clinical experiences of projective identification—Elizabeth Bott Spillius
• 6 Splitting and projective identification—Michael Feldman
• 7 Psychosis: not thinking in a bizarre world—Edna O’Shaughnessy
• 8 Keeping things in mind—Ronald Britton
• 9 As if: the phenomenon of not learning—Ruth Riesenberg Malcolm
• References
• Name index
• Subject index