New Directions in Psycho-Analysis

The significance of infant conflict in the pattern of adult behaviour

Paula Heimann, Melanie Klein, R. E. Money-Kyrle, Melanie Klein Trust, Paula Heimann, Melanie Klein, R. E. Money-Kyrle, Melanie Klein Trust

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781136441325
• Edition: 1
• Topic: Medizin
• Subtopic: Gesundheitsversorgung

Tavistock Press was established as a co-operative venture between the Tavistock Institute and Routledge & Kegan Paul (RKP) in the 1950s to produce a series of major contributions across the social sciences.
This volume is part of a 2001 reissue of a selection of those important works which have since gone out of print, or are difficult to locate. Published by Routledge, 112 volumes in total are being brought together under the name The International Behavioural and Social Sciences Library: Classics from the Tavistock Press.
Reproduced here in facsimile, this volume was originally published in 1955 and is available individually. The collection is also available in a number of themed mini-sets of between 5 and 13 volumes, or as a complete collection.

Part One
Papers in Clinical Psycho-Analysis

1
The Psycho-Analytic Play Technique: Its History and Significance¹

MELANIE KLEIN

IN offering a paper mainly concerned with play technique as an introduction to this book, I have been prompted by the consideration that my work both with children and adults, and my contributions to psycho-analytic theory as a whole derive ultimately from the play technique evolved with young children. I do not mean by this that my later work was a direct application of the play technique; but the insight I gained into early development, into unconscious processes, and into the nature of the interpretations by which the unconscious can be approached, has been of far-reaching influence on the work I have done with older children and adults.

I shall, therefore, briefly outline the steps by which my work developed out of the psycho-analytic play technique, but I shall not attempt to give a complete summary of my findings. In 1919, when I started my first case, some psycho-analytic work with children had already been done, particularly by Dr. Hug-Hellmuth.² However, she did not undertake the psycho-analysis of children under six and, although she used drawings and occasionally play as material, she did not develop this into a specific technique.

At the time I began to work it was an established principle that interpretations should be given very sparingly. With few exceptions psycho-analysts had not explored the deeper layers of the unconscious—in children such exploration being considered potentially dangerous. This cautious outlook was reflected in the fact that then, and for years to come, psycho-analysis was held to be suitable only for children from the latency period onwards.³

My first patient was a five-year-old boy. I referred to him under the name "Fritz" in my earliest published paper.¹ To begin with I thought it would be sufficient to influence the mother's attitude. I suggested that she should encourage the child to discuss freely with her the many unspoken questions which were obviously at the back of his mind and were impeding his intellectual development. This had a good effect, but his neurotic difficulties were not sufficiently alleviated and it was soon decided that I should psycho-analyse him. In doing so, I deviated from some of the rules so far established, for I interpreted what I thought to be most urgent in the material the child presented to me and found my interest focusing on his anxieties and the defences against them. This new approach soon confronted me with serious problems. The anxieties I encountered when analysing this first case were very acute, and although I was strengthened in the belief that I was working on the right lines by observing the alleviation of anxiety again and again produced by my interpretations, I was at times perturbed by the intensity of the fresh anxieties which were being brought into the open. On one such occasion I sought advice from Dr. Karl Abraham. He replied that since my interpretations up to then had often produced relief and the analysis was obviously progressing, he saw no ground for changing the method of approach. I felt encouraged by his support and, as it happened, in the next few days the child's anxiety, which had come to a head, greatly diminished, leading to further improvement. The conviction gained in this analysis strongly influenced the whole course of my analytic work.

The treatment was carried out in the child's home with his own toys. This analysis was the beginning of the psycho-analytic play technique, because from the start the child expressed his phantasies and anxieties mainly in play, and I consistently interpreted its meaning to him, with the result that additional material came up in his play. That is to say, I already used with this patient, in essence, the method of interpretation which became characteristic of my technique. This approach corresponds to a fundamental principle of psycho-analysis—free association. In interpreting not only the child's words but also his activities with his toys, I applied this basic principle to the mind of the child, whose play and varied activities— in fact his whole behaviour—are means of expressing what the adult expresses predominantly by words. I was also guided throughout by two other tenets of psycho-analysis established by Freud, which I have from the beginning regarded as fundamental: that the exploration of the unconscious is the main task of psycho-analytic procedure, and that the analysis of the transference is the means of achieving this aim.

Between 1920 and 1923 I gained further experience with other child cases, but a definite step in the development of play technique was the treatment of a child of two years and nine months whom I psycho-analysed in 1923. I have given some details of this child's case under the name "Rita" in my book, The Psycho-Analysis of Children.¹ Rita suffered from night terrors and animal phobias, was very ambivalent towards her mother, at the same time clinging to her to such an extent that she could hardly be left alone. She had a marked obsessional neurosis and was at times very depressed. Her play was inhibited and her inability to tolerate frustrations made her upbringing increasingly difficult. I was very doubtful about how to tackle this case since the analysis of so young a child was an entirely new experiment. The first session seemed to confirm my misgivings. Rita, when left alone with me in her nursery, at once showed signs of what I took to be a negative transference: she was anxious and silent and very soon asked to go out into the garden. I agreed and went with her—I may add, under the watchful eyes of her mother and aunt, who took this as a sign of failure. They were very surprised to see that Rita was quite friendly towards me when we returned to the nursery some ten to fifteen minutes later. The explanation of this change was that while we were outside I had been interpreting her negative transference (this again being against the usual practice). From a few things she said, and the fact that she was less frightened when we were in the open, I concluded that she was particularly afraid of something which I might do to her when she was alone with me in the room. I interpreted this and, referring to her nightterrors, I linked her suspicion of me as a hostile stranger with her fear that a bad woman would attack her when she was by herself at night. When, a few minutes after this interpretation, I suggested that we should return to the nursery, she readily agreed. As I mentioned, Rita's inhibition in playing was marked, and to begin with she did hardly anything but obsessionally dress and undress her doll. But soon I came to understand the anxieties underlying her obsessions, and interpreted them. This case strengthened my growing conviction that a precondition for the psycho-analysis of a child is to understand and to interpret the phantasies, feelings, anxieties, and experiences expressed by play or, if play activities are inhibited, the causes of the inhibition.

As with Fritz, I undertook this analysis in the child's home and with her own toys; but during this treatment, which lasted only a few months, I came to the conclusion that psycho-analysis should not be carried out in the child's home. For I found that, although she was in great need of help and her parents had decided that I should try psycho-analysis, her mother's attitude towards me was very ambivalent and the atmosphere was on the whole hostile to the treatment. More important still, I found that the transference situation— the backbone of the psycho-anaiytic procedure—can only be established and maintained if the patient is able to feel that the consulting-room or the play-room, indeed the whole analysis, is something separate from his ordinary home life. For only under such conditions can he overcome his resistances against experiencing and expressing thoughts, feelings, and desires, which are incompatible with convention, and in the case of children felt to be in contrast to much of what they have been taught.

I made further significant observations in the psycho-analysis of a girl of seven, also in 1923. Her neurotic difficulties were apparently not serious, but her parents had for some time been concerned about her intellectual development. Although quite intelligent she did not keep up with her age group, she disliked school, and sometimes played truant. Her relation to her mother, which had been affectionate and trusting, had changed since she had started school: she had become reserved and silent. I spent a few sessions with her without achieving much contact. It had become clear that she disliked school, and from what she diffidently said about it, as well as from other remarks, I had been able to make a few interpretations which produced some material. But my impression was that I should not get much further in that way. In a session in which I again found the child unresponsive and withdrawn I left her, saying that I would return in a moment. I went into my own children's nursery, collected a few toys, cars, little figures, a few bricks, and a train, put them into a box and returned to the patient. The child, who had not taken to drawing or other activities, was interested in the small toys and at once began to play. From this play I gathered that two of the toy figures represented herself and a little boy, a school-mate about whom I had heard before. It appeared that there was something secret about the behaviour of these two figures and that other toy people were resented as interfering or watching and were put aside. The activities of the two toys led to catastrophes, such as their falling down or colliding with cars. This was repeated with signs of mounting anxiety. At this point I interpreted, with reference to the details of her play, that some sexual activity seemed to have occurred between herself and her friend, and that this had made her very frightened of being found out and therefore distrustful of other people. I pointed out that while playing she had become anxious and seemed on the point of stopping her play. I reminded her that she disliked school, and that this might be connected with the fear that die teacher would find out about her relation with her schoolmate and punish her. Above all she was frightened and therefore distrustful of her mother, and now she might feel the same way about me. The effect of this interpretation on the child was striking: her anxiety and distrust first increased, but very soon gave way to obvious relief. Her facial expression changed, and although she neither admitted nor denied what I had interpreted, she subsequently showed her agreement by producing new material and by becoming much freer in her play and speech; also her attitude towards me became much more friendly and less suspicious. Of course the negative transference, alternating with the positive one, came up again and again; but, from this session onwards, the analysis progressed well. Concurrently there were favourable changes, as I was informed, in her relation to her family—in particular to her mother. Her dislike of school diminished and she became more interested in her lessons, but her inhibition in learning, which was rooted in deep anxieties, was only gradually resolved in the course of her treatment.

II

I have described how the use of the toys I kept especially for the child patient in the box in which I first brought them proved essential for her analysis. This experience, as well as others, helped me to decide which toys are most suitable for the psycho-analytic play technique.¹ I found it essential to have small toys because their number and variety enable the child to express a wide range of phantasies and experiences. It is important for this purpose that these toys should be non-mechanical and that the human figures, varying only in colour and size, should not indicate any particular occupation. Their very simplicity enables the child to use them in many different situations, according to the material coming up in his play. The fact that he can thus present simultaneously a variety of experiences and phantasied or actual situations also makes it possible for us to arrive at a more coherent picture of the workings of his mind.

In keeping with the simplicity of the toys, the equipment of the play-room is also simple. It does not contain anything except what is needed for the psycho-analysis.¹ Each child's playthings are kept locked in one particular drawer, and he therefore knows that his toys and his play with them, which is the equivalent of the adult's associations, are only known to the analyst and to himself. The box in which I first introduced the toys to the little girl mentioned above turned out to be the prototype of the individual drawer, which is part of the private and intimate relation between analyst and patient, characteristic of the psycho-analytic transference situation.

I do not suggest that the psycho-analytic play technique depends entirely on my particular selection of play-material. In any case, children often spontaneously bring their own things and the play with them enters as a matter of course into the analytic work. But I believe that the toys provided by the analyst should on the whole be of the type I have described, that is to say, simple, small, and non-mechanical.

Toys, however, are not the only requisites for a play analysis. Many of the child's activities are at times carried out round the washhand basin, which is equipped with one or two small bowls, tumblers, and spoons. Often he draws, writes, paints, cuts out, repairs toys, and so on. At times he plays games in which he allots roles to the analyst and himself such as playing shop, doctor and patient, school, mother and child. In such games the child frequently takes the part of the adult, thereby not only expressing his wish to reverse the roles, but also demonstrating how he feels that his parents or other people in authority behave towards him—or should behave. Sometimes he gives vent to his aggressiveness and resentment by being, in the role of parent, sadistic towards the child, represented by the analyst. The principle of interpretation remains the same whether the phantasies are presented by toys or by dramatization. For, whatever material is used, it is essential that the analytic principles underlying the technique should be applied.¹

Aggressiveness is expressed in various ways in the child's play, either directly or indirectly. Often a toy is broken or, when the child is more aggressive, attacks are made with knife or scissors on the table or on pieces of wood; water or paint is splashed about and the room generally becomes a battlefield. It is essential to enable the child to bring out his aggressiveness; but what counts most is to understand why at this particular moment in the transference situation destructive impulses come up and to observe their consequences in the child's mind. Feelings of guilt may very soon follow after the child has broken, for instance, a little figure. Such guilt refers not only to the actual damage done but to what the toy stands for in the child's unconscious, e.g. a little brother or sister, or a parent; the interpretation has therefore to deal with these deeper levels as well. Sometimes we can gather from the child's behaviour towards the analyst that not only guilt but also persecutory anxiety has been the sequel to his destructive impulses and that he is afraid of retaliation.

I have usually been able to convey to the child that I would not tolerate physical attacks on myself. This attitude not only protects the psycho-analyst but is of importance for the analysis as well. For such assaults, if not kept within bounds, are apt to stir up excessive guilt and persecutory anxiety in the child and therefore add to the difficulties of the treatment. I have sometimes been asked by what method I prevented physical attacks, and I think the answer is that I was very careful not to inhibit the child's aggressive phantasies; in fact he was given opportunity to act them out in other ways, including verbal attacks on myself. The more I was able to interpret in time the motives of the child's aggressiveness the more the situation could be kept under control. But with some psychotic children it has occasionally been difficult to protect myself against their aggressiveness.

III

I have found that the child's attitude towards a toy he has damaged is very revealing. He often puts aside such a toy, representing for instance a sibling or a parent, and ignores it for a time. This indicates dislike of the damaged object, due to the persecutory fear that the attacked person (represented by the toy) has become retaliatory and dangerous. The sense of persecution may be so strong that it covers up feelings of guilt and depression which are also aroused by the damage done. Or guilt and depression may be so strong that they lead to a reinforcing of persecutory feelings. However, one day the child may search in bis drawer for the damaged toy. This suggests that by then we have been able to analyse some important defences, thus diminishing persecutory feelings and making it possible for the sense of guilt and the urge to make reparation to be experienced. When this happens we can also notice that a change in the child's relation to the particular sibling for whom the toy stood, or...