The New York Psychoanalytic Society and Institute — founded in 1911 by Dr. Abraham A. Brill — is the oldest psychoanalytic organisation in the United States.
Outline
The charter members were: Louis Edward Bisch, Brill, Horace Westlake Frink, Frederick James Farnell, William C. Garvin, August Hoch, Morris J. Karpas, George H. Kirby, Clarence P. Oberndorf, Bronislaw Onuf, Ernest Marsh Poate, Charles Ricksher, Jacob Rosenbloom, Edward W. Scripture and Samuel A. Tannenbaum.
The institute was a professional home to some of the leaders in psychoanalytic education and treatment, such as Margaret Mahler, Ernst Kris, Kurt R. Eissler, Heinz Hartmann, Abram Kardiner, Rudolph Loewenstein, Charles Brenner, Thaddeus Ames, Robert C. Bak, and Otto Kernberg.
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In psychology, introjection (also known as identification or internalisation) is the unconscious adoption of the thoughts or personality traits of others. It occurs as a normal part of development, such as a child taking on parental values and attitudes. It can also be a defence mechanism in situations that arouse anxiety. It has been associated with both normal and pathological development.
Theory
Introjection is a concept rooted in the psychoanalytic theories of unconscious motivations. Unconscious motivation refers to processes in the mind which occur automatically and bypass conscious examination and considerations.
Introjection is the learning process or in some cases a defence mechanism where a person unconsciously absorbs experiences and makes them part their psyche.
In Learning
In psychoanalysis, introjection (German: Introjektion) refers to an unconscious process wherein one takes components of another person’s identity, such as feelings, experiences and cognitive functioning, and transfers them inside themselves, making such experiences part of their new psychic structure. These components are obliterated from consciousness (splitting), perceived in someone else (projection), and then experienced and performed (i.e. introjected) by that other person. Cognate concepts are identification, incorporation and internalisation.
As a Defence Mechanism
It is considered a self-stabilising defence mechanism used when there is a lack of full psychological contact between a child and the adults providing that child’s psychological needs. In other words, it provides the illusion of maintaining relationship but at the expense of a loss of self. To use a simple example, a person who picks up traits from their friends is introjecting.
Another straightforward illustration could be a youngster who is being bullied at school. Unknowingly adopting the bully’s behaviour, the victim youngster may do so to stop being picked on in the future.
Projection has been described as an early phase of introjection.
Historic Precursors
Freud and Klein
In Freudian terms, introjection is the aspect of the ego’s system of relational mechanisms which handles checks and balances from a perspective external to what one normally considers ‘oneself’, infolding these inputs into the internal world of the self-definitions, where they can be weighed and balanced against one’s various senses of externality. For example:
“When a child envelops representational images of his absent parents into himself, simultaneously fusing them with his own personality.”
“Individuals with weak ego boundaries are more prone to use introjection as a defense mechanism.”
According to D.W. Winnicott, “projection and introjection mechanisms… let the other person be the manager sometimes, and to hand over omnipotence.”
According to Freud, the ego and the superego are constructed by introjecting external behavioural patterns into the subject’s own person. Specifically, he maintained that the critical agency or the super ego could be accounted for in terms of introjection and that the superego derives from the parents or other figures of authority. The derived behavioural patterns are not necessarily reproductions as they actually are but incorporated or introjected versions of them.
Torok and Ferenczi
However, the aforementioned description of introjection has been challenged by Maria Torok as she favours using the term as it is employed by Sándor Ferenczi in his essay “The Meaning of Introjection” (1912). In this context, introjection is an extension of autoerotic interests that broadens the ego by a lifting of repression so that it includes external objects in its make-up. Torok defends this meaning in her 1968 essay “The Illness of Mourning and the Fantasy of the Exquisite Corpse”, where she argues that Sigmund Freud and Melanie Klein confuse introjection with incorporation and that Ferenczi’s definition remains crucial to analysis. She emphasized that in failed mourning “the impotence of the process of introjection (gradual, slow, laborious, mediated, effective)” means that “incorporation is the only choice: fantasmatic, unmediated, instantaneous, magical, sometimes hallucinatory…’crypt’ effects (of incorporation)”.
Fritz and Laura Perls
In Gestalt therapy, the concept of “introjection” is not identical with the psychoanalytical concept. Central to Fritz and Laura Perls’ modifications was the concept of “dental or oral aggression”, when the infant develops teeth and is able to chew. They set “introjection” against “assimilation”. In Ego, Hunger and Aggression, Fritz and Laura Perls suggested that when the infant develops teeth, he or she has the capacity to chew, to break apart food, and assimilate it, in contrast to swallowing before; and by analogy to experience, to taste, accept, reject or assimilate. Laura Perls explains: “I think Freud said that development takes place through introjection, but if it remains introjection and goes no further, then it becomes a block; it becomes identification. Introjection is to a great extent unawares.”
Thus Fritz and Laura Perls made “assimilation”, as opposed to “introjection”, a focal theme in Gestalt therapy and in their work, and the prime means by which growth occurs in therapy. In contrast to the psychoanalytic stance, in which the “patient” introjects the (presumably more healthy) interpretations of the analyst, in Gestalt therapy the client must “taste” with awareness their experience, and either accept or reject it, but not introject or “swallow whole”. Hence, the emphasis is on avoiding interpretation, and instead encouraging discovery. This is the key point in the divergence of Gestalt therapy from traditional psychoanalysis: growth occurs through gradual assimilation of experience in a natural way, rather than by accepting the interpretations of the analyst.
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Transference (German: Übertragung) is a phenomenon within psychotherapy in which repetitions of old feelings, attitudes, desires, or fantasies that someone displaces are subconsciously projected onto a here-and-now person. Traditionally, it had solely concerned feelings from a primary relationship during childhood.
Brief History
Transference was first described by Sigmund Freud, the founder of psychoanalysis, who considered it an important part of psychoanalytic treatment. Transference of this kind can be considered inappropriate without proper clinical supervision.
Occurrence
It is common for people to transfer feelings about their parents to their partners or children (that is, cross-generational entanglements). Another example of transference would be a person mistrusting somebody who resembles an ex-spouse in manners, voice, or external appearance, or being overly compliant to someone who resembles a childhood friend.
In The Psychology of the Transference, Carl Jung states that within the transference dyad, both participants typically experience a variety of opposites, that in love and in psychological growth, the key to success is the ability to endure the tension of the opposites without abandoning the process, and that this tension allows one to grow and to transform.
Only in a personally or socially harmful context can transference be described as a pathological issue. A modern, social-cognitive perspective on transference explains how it can occur in everyday life. When people meet a new person who reminds them of someone else, they unconsciously infer that the new person has traits similar to the person previously known. This perspective has generated a wealth of research that illuminated how people tend to repeat relationship patterns from the past in the present.
Sigmund Freud held that transference plays a large role in male homosexuality. In The Ego and the Id, he claimed that eroticism between males can be an outcome of a “[psychically] non-economic” hostility, which is unconsciously subverted into love and sexual attraction.
Transference and Counter-Transference during Psychotherapy
Transference will appear in the full speech that occurs during free association, revealing the inverse of the subject’s past, within the here and now, and the analyst will hear which of the four discourses the subject’s desire has been metonymically shifted to, beyond the ego, leading to a dystonic form of resistance.
In a therapy context, transference refers to redirection of a patient’s feelings for a significant person to the therapist. Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing the therapist in a god-like or guru status. When Freud initially encountered transference in his therapy with patients, he thought he was encountering patient resistance, as he recognised the phenomenon when a patient refused to participate in a session of free association. But what he learned was that the analysis of the transference was actually the work that needed to be done: “the transference, which, whether affectionate or hostile, seemed in every case to constitute the greatest threat to the treatment, becomes its best tool”. The focus in psychodynamic psychotherapy is, in large part, the therapist and patient recognizing the transference relationship and exploring the relationship’s meaning. Since the transference between patient and therapist happens on an unconscious level, psychodynamic therapists who are largely concerned with a patient’s unconscious material use the transference to reveal unresolved conflicts patients have with childhood figures.
Countertransference is defined as redirection of a therapist’s feelings toward a patient, or more generally, as a therapist’s emotional entanglement with a patient. A therapist’s attunement to their own countertransference is nearly as critical as understanding the transference. Not only does this help therapists regulate their emotions in the therapeutic relationship, but it also gives therapists valuable insight into what patients are attempting to elicit from them. For example, a therapist who is sexually attracted to a patient must understand the countertransference aspect (if any) of the attraction, and look at how the patient might be eliciting this attraction. Once any countertransference aspect has been identified, the therapist can ask the patient what his or her feelings are toward the therapist, and can explore how those feelings relate to unconscious motivations, desires, or fears.
Another contrasting perspective on transference and countertransference is offered in classical Adlerian psychotherapy. Rather than using the patient’s transference strategically in therapy, the positive or negative transference is diplomatically pointed out and explained as an obstacle to cooperation and improvement. For the therapist, any signs of countertransference would suggest that his or her own personal training analysis needs to be continued to overcome these tendencies. Andrea Celenza noted in 2010 that “the use of the analyst’s countertransference remains a point of controversy”.
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Wilfred Ruprecht Bion DSO (08 September 1897 to 08 November 1979) was an influential English psychoanalyst, who became president of the British Psychoanalytical Society from 1962 to 1965.
Wilfred Bion in uniform in 1916.
Early Life and Military Service
Bion was born in Mathura, North-Western Provinces, India, and educated at Bishop’s Stortford College in England. After the outbreak of the First World War, he served in the Tank Corps as a tank commander in France, and was awarded both the Distinguished Service Order (DSO) (on 18 February 1918, for his actions at the Battle of Cambrai), and the Croix de Chevalier of the Légion d’honneur. He first entered the war zone on 26 June 1917, and was promoted to temporary lieutenant on 10 June 1918, and to acting captain on 22 March 1918, when he took command of a tank section, he retained the rank when he became second-in-command of a tank company on 19 October 1918, and relinquished it on 07 January 1919. He was demobilised on 01 September 1921, and was granted the rank of captain. The full citation for his DSO reads:
Awarded the Distinguished Service Order.
[…]
T./2nd Lt, Wilfred Ruprecht Bion, Tank Corps.
For conspicuous gallantry, and devotion to duty. When in command of his tank in an attack he engaged a large number of enemy machine guns in strong positions, thus assisting the infantry to advance. When his tank was put out of action by a direct hit he occupied a section of trench with his men and machine guns and opened fire on the enemy. He moved about in the open, giving directions to other tanks when they arrived, and at one period fired a Lewis gun with great effect from the top of his tank. He also got a captured machine gun into action against the enemy, and when reinforcements arrived he took command of a company of infantry whose commander was killed. He showed magnificent courage and initiative in a most difficult situation.
“Bion’s daughter, Parthenope…raises the question of just how (and how far) her father was shaped as an analyst by his wartime experiences…under[p]inning Bion’s later concern with the coexistence of regressed or primitive proto-mental states alongside more sophisticated one”.
Education and Early Career
After World War I, Bion studied history at The Queen’s College, Oxford, earning a Bachelor of Arts degree in 1922, before studying medicine at University College London.
Initially attracted to London by the “strange new subject called psychoanalysis”, he met and was impressed by Wilfred Trotter, an outstanding brain surgeon who published the famous Instincts of the Herd in Peace and War in 1916, based on the horrors of the First World War. This was to prove an important influence on Bion’s interest in group behaviour. Having qualified in medicine by means of the Conjoint Diploma (MRCS England, LRCP London) in 1930 Bion spent seven years in psychotherapeutic training at the Tavistock Clinic, an experience he regarded, in retrospect, as having had some limitations. It did, however, bring him into fruitful contact with Samuel Beckett. He wanted to train in Psychoanalysis and in 1938 he began a training analysis with John Rickman, but this was brought to an end by the advent of the Second World War.
Bion was recommissioned in the Royal Army Medical Corps as a lieutenant on 01 April 1940, and worked in a number of military hospitals including Northfield Military Hospital (Hollymoor Hospital, Birmingham) where he initiated the first Northfield Experiment. These ideas on the psychoanalysis of groups were then taken up and developed by others such as S.H. Foulkes, Rickman, Bridger, Main and Patrick De Mare. The entire group at Tavistock had in fact been taken into the army, and were working on new methods of treatment for psychiatric casualties (those suffering post-traumatic stress, or “shell shock” as it was then known.) Out of this his pioneering work in group dynamics, associated with the “Tavistock group”, Bion’s papers describing his work of the 1940s were compiled much later and appeared together in 1961 in his influential book, Experiences in Groups and other papers. It was less a guide for the therapy of individuals within or by the group, than an exploration of the processes set off by the complex experience of being in a group. The book quickly became a touchstone work for applications of group theory in a wide variety of fields.
In 1945, during the Second World War, Bion’s wife Betty Jardine gave birth to a daughter, but Betty died a few days afterwards. His daughter, Parthenope, became a psychoanalyst in Italy, and often lectured and wrote about her father’s work. Parthenope died, together with her 18-year-old daughter Patrizia, in a car crash in Italy in July 1998.
Later Career
Returning to the Tavistock Clinic Bion chaired the Planning Committee that reorganised the Tavistock into the new Tavistock Institute of Human Relations, alongside a new Tavistock Clinic which was part of the newly launched National Health Service. As his interest in psychoanalysis increased, he underwent training analysis, between 1946 and 1952, with Melanie Klein. He met his second wife, Francesca, at the Tavistock in 1951. He joined a research group of Klein’s students (including Hanna Segal and Herbert Rosenfeld), who were developing Klein’s theory of the paranoid-schizoid and the depressive positions, for use in the analysis of patients with psychotic disorders. He produced a series of highly original and influential papers (collected as “Second Thoughts”, 1967) on the analysis of schizophrenia, and the specifically cognitive, perceptual, and identity problems of such patients. To this he added a valuable final section called Commentary, showing how some of his views on clinical and theoretical matters had changed.
Bion’s theories, which were always based in the phenomena of the analytic encounter, revealed both correspondences and expansions of core ideas from both Sigmund Freud and Melanie Klein. At one point, he attempted to understand thoughts and thinking from an ‘algebraic’, ‘geometric’ and ‘mathematised’ point of view, believing there to be too little precision in the existing vocabulary, a process culminating in “The Grid”. Later he abandoned the complex, abstract applications of mathematics, and the Grid, and developed a more intuitive approach, epitomised in Attention and Interpretation (1970).
In 1968, Bion moved to Los Angeles, California, where he remained until 1977. During those years he mentored a number of psychoanalysts interested in Kleinian approaches, including James Gooch (psychoanalyst) and other founding members of the Psychoanalytic Centre of California. Shortly before his death, he returned to Oxfordshire.
Reception and Stature
Bion left a reputation which has grown steadily both in Britain and internationally. Some commentators consider that his writings are often gnomic and irritating, but never fail to stimulate. He defies categorisation as a follower of Klein or of Freud. While Bion is most well known outside of the psychoanalytic community for his work on group dynamics, the psychoanalytic conversation that explores his work is mainly concerned with his theory of thinking, and his model of the development of a capacity for thought.
Wilfred Bion was a potent and original contributor to psychoanalysis. He was one of the first to analyse patients in psychotic states using an unmodified analytic technique; he extended existing theories of projective processes and developed new conceptual tools. The degree of collaboration between Hanna Segal, Wilfred Bion and Herbert Rosenfeld in their work with psychotic patients during the late 1950s, and their discussions with Melanie Klein at the time, means that it is not always possible to distinguish their exact individual contributions to the developing theory of splitting, projective identification, unconscious phantasy and the use of countertransference. As Donald Meltzer (1979, 1981), Denis Carpy (1989, p.287), and Michael Feldman (2009, pp.33, 42) have pointed out, these three pioneering analysts not only sustained Klein’s clinical and theoretical approach, but through an extension of the concept of projective identification and countertransference they deepened and expanded it. In Bion’s clinical work and supervision the goal remains insightful understanding of psychic reality through a disciplined experiencing of the transference–countertransference, in a way that promotes the growth of the whole personality.
‘Bion’s ideas are highly unique’, so that he ‘remained larger than life to almost all who encountered him’. He has been considered by Neville Symington as possibly “the greatest psychoanalytic thinker…after Freud“.
Bion’s work has left a strong impression on a number of contemporary psychoanalytic thinkers, including Antonino Ferro, Thomas Ogden, or Elias Mallet da Rocha Barros.
There is some historical evidence to suggest that the idea of containment may have been suggested to Bion in the mid-1930s, by an encounter with C.G. Jung: Bion attended Jung’s 1935 lectures at the Tavistock Clinic, in which Bion was an active participant (asking three questions of Jung about a range of aspects of Jung’s thinking). The experience was described by James Grotstein, Bion’s biographer and “one of Bion’s most influential pupils”, as having had a “dramatic impact” on Bion.
Group Experiments
Bion performed a lot of group experiments when he was put in charge of the training wing of a military hospital. Besides observing the basic assumptions recurring in these groups, he also has observed some very interesting phenomena to which he believed may well apply to society.
Among his interesting findings was that in a group, the standards of social intercourse lack intellectual content and critical judgement. This observation agrees with Gustave Le Bon’s findings about groups to which he mentioned in his book The Crowd.
Another interesting observation was that whatever a group member says or does in a group illuminates that member’s view of the group and is an illumination of that member’s personality. This phenomenon is what psychologists call Projection.
If the contributions of the group and its members can be made anonymously then the foundations for a system of denial and evasion is established. This phenomenon is better known as Deindividuation.
And perhaps one of the most important findings in his experiments was that whenever a group is formed, it always seeks a leader to follow. The group then searches for someone who has questionable attributes with his or her mental health. Initially, the group will search for someone who is paranoid schizophrenic or someone who is malignant hysteric. If the group is unable to find someone with those attributes, the group looks for someone with delinquent trends and a psychopathic personality. Otherwise, the group would just settle on the verbally facile high-grade defective.
Group Dynamics – The “Basic Assumptions”
Wilfred Bion’s observations about the role of group processes in group dynamics are set out in Experiences in Groups and Other Papers, written in the 1940s but compiled and published in 1961, where he refers to recurrent emotional states of groups as ‘basic assumptions’. Bion argues that in every group, two groups are actually present: the work group, and the basic assumption group. The work group is that aspect of group functioning which has to do with the primary task of the group—what the group has formed to accomplish; will “keep the group anchored to a sophisticated and rational level of behaviour”. The basic assumption group describes the tacit underlying assumptions on which the behaviour of the group is based. Bion specifically identified three basic assumptions: dependency, fight-flight, and pairing. When a group adopts any one of these basic assumptions, it interferes with the task the group is attempting to accomplish. Bion believed that interpretation by the therapist of this aspect of group dynamics would, whilst being resisted, also result in potential insight regarding effective, co-operative group work.
In dependency, the essential aim of the group is to attain security through, and have its members protected by, one individual. The basic assumption in this group culture seems to be that an external object exists whose function it is to provide security for the immature individual. The group members behave passively, and act as though the leader, by contrast, is omnipotent and omniscient. For example, the leader may pose a question only to be greeted with docile silence, as though he or she had not spoken at all. The leader may be idealised into a kind of god who can take care of his or her children, and some especially ambitious leaders may be susceptible to this role. Resentment at being dependent may eventually lead the group members to “take down” the leader, and then search for a new leader to repeat the process.
In the basic assumption of fight-flight, the group behaves as though it has met to preserve itself at all costs, and that this can only be done by running away from someone or fighting someone or something. In fight, the group may be characterized by aggressiveness and hostility; in flight, the group may chit-chat, tell stories, arrive late or any other activities that serve to avoid addressing the task at hand. The leader for this sort of group is one who can mobilize the group for attack, or lead it in flight.
The final basic assumption group, pairing, exists on the assumption that the group has met for the purpose of reproduction—the basic assumption that two people can be met together for only one purpose, and that a sexual one’. Two people, regardless the sex of either, carry out the work of the group through their continued interaction. The remaining group members listen eagerly and attentively with a sense of relief and hopeful anticipation.
Bion considered that “the three basic-assumption groups seem each in turn to be aggregates of individuals sharing out between them the characteristics of one character in the Oedipal situation”. Behind the Oedipal level, however, Bion postulated the existence of still more primitive, part-object phantasies; and “the more disturbed the group, the more easily discernible are these primitive phantasies and mechanisms”. Such phantasies would prove the main focus of Bion’s interest after his second analysis.
Bion on Thinking
“During the 1950s and 1960s, Bion transformed Melanie Klein’s theories of infantile phantasy…into an epistemological “theory of thinking” of his own.” Bion used as his starting point the phenomenology of the analytic hour, highlighting the two principles of “the emergence of truth and mental growth. The mind grows through exposure to truth.” The foundation for both mental development and truth are, for Bion, emotional experience.
The evolution of emotional experience into the capacity for thought, and the potential derailment of this process, are the primary phenomena described in Bion’s model. Through his hypothesized alpha and beta elements, Bion provides a language to help one think about what is occurring during the analytic hour. These tools are intended for use outside the hour in the clinician’s reflective process. To attempt to apply his models during the analytic session violates the basic principle whereby “Bion had advocated starting every session ‘without memory, desire or understanding’—his antidote to those intrusive influences that otherwise threaten to distort the analytic process.”
Alpha Elements, Beta Elements, and Alpha Function
Bion created a theory of thinking based on changing beta elements (unmetabolized psyche/soma/affective experience) into alpha elements (thoughts that can be thought by the thinker). Beta elements were seen as cognate to the underpinnings of the “basic assumptions” identified in his work with groups: “the fundamental anxieties that underlie the basic assumption group resistances were originally thought of as proto-mental phenomena…forerunners of Bion’s later concept of beta-elements.” They were equally conceptual developments from his work on projective identification—from the “minutely split ‘particles'” Bion saw as expelled in pathological projective identification by the psychotic, who would then go on to “lodge them in the angry, so-called bizarre objects by which he feels persecuted and controlled”. For “these raw bits of experience he called beta-elements…to be actively handled and made use of by the mind they must, through what Bion calls alpha-functions, become alpha-elements”.
β elements, α elements and α function are elements that Bion (1963) hypothesizes. He does not consider β-elements, α- elements, nor α function to actually exist. The terms are instead tools for thinking about what is being observed. They are elements whose qualities remain unsaturated, meaning we cannot know the full extent or scope of their meaning, so they are intended as tools for thought rather than real things to be accepted at face value (1962, p.3).
Bion took for granted that the infant requires a mind to help it tolerate and organize experience. For Bion, thoughts exist prior to the development of an apparatus for thinking. The apparatus for thinking, the capacity to have thoughts “has to be called into existence to cope with thoughts” (1967, p.111). Thoughts exist prior to their realization. Thinking, the capacity to think the thoughts which already exist, develops through another mind providing α-function (1962, p.83) – through the “container” role of maternal reverie.
To learn from experience alpha-function must operate on the awareness of the emotional experience; alpha–elements are produced from the impressions of the experience; these are thus made storable and available for dream thoughts and for unconscious waking thinking… If there are only beta-elements, which cannot be made unconscious, there can be no repression, suppression, or learning. (Bion, 1962, p.8).
α-function works upon undigested facts, impressions, and sensations, that cannot be mentalized—beta-elements. α-function digests β-elements, making them available for thought (1962, pp.6–7).
Beta-elements are not amenable to use in dream thoughts but are suited for use in projective identification. They are influential in producing acting out. These are objects that can be evacuated or used for a kind of thinking that depends on manipulation of what are felt to be things in themselves as if to substitute such manipulations for words or ideas… Alpha-function transforms sense impressions into alpha-elements which resemble, and may in fact be identical with, the visual images with which we are familiar in dreams, namely, the elements that Freud regards as yielding their latent content when the analyst has interpreted them. Failure of alpha-function means the patient cannot dream and therefore cannot sleep. As alpha-function makes the sense impressions of the emotional experience available for conscious and dream—thought the patient who cannot dream cannot go to sleep and cannot wake up. (1962, pp.6–7).
Bizarre Object
Bizarre objects, according to Bion, are impressions of external objects which, by way of projective identification, form a “screen” that’s imbued with characteristics of the subject’s own personality; they form part of his interpretation of object relations theory. Bion saw psychotic attacks on the normal linking between objects as producing a fractured world, where the patient felt themselves surrounded by hostile bizarre objects—the by-products of the broken linkages. Such objects, with their superego components, blur the boundary of internal and external, and impose a kind of externalised moralism on their victims. They can also contain ego-functions that have been evacuated from the self as part of the defence against thinking, sensing, and coming to terms with reality: thus a man may feel watched by his telephone, or that the music player being listened to is in fact listening to him in turn.
Later Developments
Hanna Segal considered bizarre objects more difficult to re-internalise than either good or bad objects due to their splintered state: grouped together in a mass or psychic gang, their threatening properties may contribute to agoraphobia.
Knowledge, Love and Hate
Successful application of alpha-function leads to “the capacity to tolerate the actual frustration involved in learning (“K”) that [Bion] calls ‘learning from experience'”. The opposite of knowledge “K” was what Bion termed “−K”: “the process that strips, denudes, and devalues persons, experiences, and ideas.”
Both K and −K interact for Bion with Love and Hate, as links within the analytic relationship. “The complexities of the emotional link, whether Love or Hate or Knowledge [L, H, and K – the Bionic relational triad]” produce ever-changing “atmospheric” effects in the analytic situation. The patient’s focus may wish to be “on Love and Hate (L and H) rather than the knowledge (K) that is properly at stake in psychoanalytic inquiry.”
For Bion, “knowledge is not a thing we have, but a link between ourselves and what we know … K is being willing to know but not insisting on knowledge.” By contrast, -K is “not just ignorance but the active avoidance of knowledge, or even the wish to destroy the capacity for it” – and “enacts what ‘Attacks on Linking’ identifies as hatred of emotion, hatred of reality, hatred of life itself.”
Looking for the source of such hate (H), Bion notes in Learning from Experience that, “Inevitably one wonders at various points in the investigation why such a phenomenon as that represented by −K should exist. … I shall consider one factor only – Envy. By this term I mean the phenomenon described by Melanie Klein in Envy and Gratitude” (1962, p.96).
Reversible Perspective and −K
“Reversible Perspective” was a term coined by Bion to illuminate “a peculiar and deadly form of analytic impasse which defends against psychic pain”. It represents the clash of “two independently experienced views or phenomena whose meanings are incompatible”. In Bion’s own words, “Reversible perspective is evidence of pain; the patient reverses perspective so as to make a dynamic situation static.”
As summarised by Etchegoyen, “Reversible perspective is an extreme case of rigidity of thought. … As Bion says, what is most characteristic in such cases is the manifest accord and the latent discord.” In clinical contexts, what may happen is that the analyst’s “interpretation is accepted, but the premises have been rejected … the actual specificity, the substance of the interpretation”. Reversible perspective is an aspect of “the potential destruction and deformation of knowledge” – one of the attacks on linking of −K.
O: The Ineffable
As his thought continued to develop, Bion came to use Negative Capability and the suspension of Memory and Desire in his work as an analyst, in order to investigate psychic reality – which he regarded as essentially ‘non-sensuous’ (1970). Following his 1965 book Transformations he had an increasing interest in what he termed the domain of “O” – the unknowable, or ultimate Truth. “In aesthetics, Bion has been described as a neo-Kantian for whom reality, or the thing-in-itself (O), cannot be known, only be “be-ed” (1965). What can be known is said by Bion to be in the realm of K, impinging through its sensory channels. If the observer can desist from “irritably reaching for fact and reason”, and suspend the normal operation of the faculties of memory and apperception, what Bion called transformations in knowledge can permit an ‘evolution’ where transformations in K touch on transformations in Being (O). Bion believed such moments to feel both ominous and turbulent, threatening a loss of anchorage in everyday ‘narrative’ security.
Bion would speak of “an intense catastrophic emotional explosion O,” which could only be known through its aftereffects. Where before he had privileged the domain of knowledge (K), now he would speak as well of “resistance to the shift from transformations involving K (knowledge) to transformations involving O … resistance to the unknowable”. Hence his injunctions to the analyst to eschew memory and desire, to “bring to bear a diminution of the ‘light’ – a penetrating beam of darkness; a reciprocal of the searchlight. If any object existed, however faint, it would show up very clearly”. In stating this he was making connections to Freud, who in a letter to Lou Andreas Salome had referred to a mental counterpart of scotopic, “mole like vision”, used to gain impressions of the Unconscious. He was also making links with the apophatic method used by contemplative thinkers such as St John of the Cross, a writer quoted many times by Bion. Bion was well aware that our perception and our attention often blind us to what genuinely and strikingly is new in every moment.
Reverie
Bion’s concept of maternal “reverie” as the capacity to sense (and make sense of) what is going on inside the infant has been an important element in post-Kleinian thought: “Reverie is an act of faith in unconscious process … essential to alpha-function'” It is considered the equivalent of Stern’s attunement, or Winnicott’s maternal preoccupation.
In therapy, the analyst’s use of “reverie” is an important tool in his/her response to the patient’s material: “It is this capacity for playing with a patient’s images that Bion encouraged”.
Late Bion
“For the later Bion, the psychoanalytic encounter was itself a site of turbulence, ‘a mental space for further ideas which may yet be developed’.” In his unorthodox quest to maintain such “mental space”, Bion “spent the final years of his long and distinguished professional life [writing] a futuristic trilogy in which he is answerable to no one but himself, A Memoir of the Future.”
If we accept that “Bion introduced a new form of pedagogy in his writings…[via] the density and non-linearity of his prose”, it comes perhaps to a peak here in what he himself termed “a fictitious account of psychoanalysis including an artificially constructed dream … science fiction”. We may conclude at least that he achieved his stated goal therein: “To prevent someone who KNOWS from filling the empty space”.
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The term reparation was used by Melanie Klein (1921) (an Austrian-British author and psychoanalyst) to indicate a psychological process of making mental repairs to a damaged internal world. In object relations theory, it represents a key part of the movement from the paranoid-schizoid position to the depressive position — the pain of the latter helping to fuel the urge to reparation.
Melanie Klein
Melanie Klein considered the ability to recognise our destructive impulses towards those we love and to make reparation for the damage we have caused them, to be an essential part of mental health. A key condition for that to take place is the recognition of one’s separateness from one’s parents, which makes possible the reparative attempt to restore their inner representations, however damaged they may be felt to be.
Acceptance of reality, inner and outer, forms a major part of the process and involves both abandoning fantasies of omnipotence and accepting the independent existence of one’s objects of attachment.
Where the damage done to the internal world is felt by a patient to be extreme, however, the task of reparation may seem too great, which is one of the obstacles facing the analytic attempt at cure.
Manic Reparation
Kleinian thought distinguishes between true reparation and manic reparation, the latter being driven by guilt rather than overcoming it. Manic reparation denies the pain and concern of feeling guilty by using magical methods of repair which maintain omnipotent control of the object in question, and refuse to allow it its separate existence. Thus manic reparation has to be endlessly repeated, since success would free the object from the manic person’s (contemptuous) power.
Donald Winnicott made his own distinctive contribution to the role of reparation in the “personalising” of the individual, the move from the ruthless use of the external object to a sense of concern. Winnicott focused on the way at a certain stage of development a feeling of guilt or concern begins to appear after the wholehearted instinctual experience of a feed. But once the reparative gesture—a smile, a gift—has been successfully acknowledged by the mother, Winnicott writes: “The breast (body, mother) is now mended and the day’s work is done. Tomorrow’s instincts can be awaited with limited fear”. The child’s contribution is a way of accepting the debt owed to the mother, for their survival and their participation in the work of reparation. If, on the other hand, the reparative gesture is not accepted, the infant is left with a feeling of depression or meaninglessness.
A similar dynamic may later appear between patient and analyst, with the making of progress being offered as a means of reparation.
Art
Kleinians considered that artistic creation was driven by the phantasy of repairing the loved object (mother).
Marion Milner in the Independent tradition also saw art as a way of both symbolizing and enacting inner reparation; but was criticised by Kleinians for giving too large a role to the omnipotent feelings of the artist in reparation.
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Donald Woods Winnicott (07 April 1896 to 25 January 1971) was an English paediatrician and psychoanalyst who was especially influential in the field of object relations theory and developmental psychology. He was a leading member of the British Independent Group of the British Psychoanalytical Society, President of the British Psychoanalytical Society twice (1956–1959 and 1965–1968), and a close associate of Marion Milner.
Winnicott is best known for his ideas on the true self and false self, the “good enough” parent, and borrowed from his second wife, Clare Winnicott, arguably his chief professional collaborator, the notion of the transitional object. He wrote several books, including Playing and Reality, and over 200 papers.
Early Life and Education
Winnicott was born on 07 April 1896 in Plymouth, Devon, to Sir John Frederick Winnicott and Elizabeth Martha, daughter of chemist and druggist William Woods, of Plymouth. Sir John Winnicott was a partner in the family firm, in business as hardware merchants and manufacturers, and was knighted in 1924 having served twice as mayor of Plymouth; he was also a magistrate and alderman. The Winnicott family were staunch, civic-minded Methodists.
The family was prosperous and ostensibly happy, but behind the veneer, Winnicott saw himself as oppressed by his mother, who tended toward depression, as well as by his two sisters and his nanny. He would eventually speak of ‘his own early childhood experience of trying to make “my living” by keeping his mother alive’. His father’s influence was that of an enterprising freethinker who encouraged his son’s creativity. Winnicott described himself as a disturbed adolescent, reacting against his own self-restraining “goodness” acquired from trying to assuage the dark moods of his mother. These seeds of self-awareness became the basis of his interest in working with troubled young people.
He first thought of studying medicine while at The Leys School, a boarding school in Cambridge, after fracturing his clavicle and recording in his diary that he wished he could treat himself. He began pre-clinical studies in biology, physiology and anatomy at Jesus College, Cambridge, in 1914 but, with the onset of World War I, his studies were interrupted when he was made a medical trainee at the temporary hospital in Cambridge. In 1917, he joined the Royal Navy as a medical officer on the destroyer HMS Lucifer.
Having graduated from Cambridge with a third-class degree, he began studies in clinical medicine at St Bartholomew’s Hospital Medical College in London. During this time, he learned from his mentor the art of listening carefully when taking medical histories from patients, a skill that he would later identify as foundational to his practice as a psychoanalyst.
Career
Winnicott completed his medical studies in 1920, and in 1923, the same year as his marriage to the artist Alice Buxton Winnicott (born Taylor). She was a potter and they married on 7 July 1923 in St Mary’s Church, Frensham. Alice had “severe psychological difficulties” and Winnicott arranged for her, and his own therapy, to address the difficulties this condition created. He obtained a post as physician at the Paddington Green Children’s Hospital in London, where he was to work as a paediatrician and child psychoanalyst for 40 years. In 1923 he began a ten-year psychoanalysis with James Strachey, and in 1927 he began training as an analytic candidate. Strachey discussed Winnicott’s case with his wife Alix Strachey, apparently reporting that Winnicott’s sex life was affected by his anxieties. Winnicott’s second analysis, beginning in 1936, was with Joan Riviere.
Winnicott rose to prominence as a psychoanalyst just as the followers of Anna Freud were in conflict with those of Melanie Klein for the right to be called Sigmund Freud’s “true intellectual heirs”. Out of the Controversial discussions during World War II, a compromise was reached with three more-or-less amicable groups within the psychoanalytic movement: the “Freudians”, the “Kleinians”, and the “Middle Group” of the British Psychoanalytical Society (the latter being called the “Independent Group”), to which Winnicott belonged, along with Ronald Fairbairn, Michael Balint, Masud Khan, John Bowlby, Marion Milner, and Margaret Little.
During the Second World War, Winnicott served as consultant paediatrician to the children’s evacuation programme. During the war, he met and worked with Clare Britton, a psychiatric social worker who became his colleague in treating children displaced from their homes by wartime evacuation. Winnicott was lecturing after the war and Janet Quigley and Isa Benzie of the BBC asked him to give over sixty talks on the radio between 1943 and 1966. His first series of talks in 1943 was titled “Happy Children.” As a result of the success of these talks, Quigley offered him total control over the content of his talks but this soon became more consultative as Quigley advised him on the correct pitch.[13]
After the war, he also saw patients in his private practice. Among contemporaries influenced by Winnicott was R.D. Laing, who wrote to Winnicott in 1958 acknowledging his help.
Winnicott divorced his first wife in 1949 and married Clare Britton (1906–1984) in 1951. A keen observer of children as a social worker and a psychoanalyst in her own right, she had an important influence on the development of his theories and likely acted as midwife to his prolific publications after they met.
Except for one book published in 1931 (Clinical Notes on Disorders of Childhood), all of Winnicott’s books were published after 1944, including The Ordinary Devoted Mother and Her Baby (1949), The Child and the Family (1957), Playing and Reality (1971), and Holding and Interpretation: Fragment of an Analysis (1986).
Winnicott died on 25 January 1971, following the last of a series of heart attacks and was cremated in London. Clare Winnicott oversaw the posthumous publication of several of his works.
Concept of Holding
Winnicott’s paediatric work with children and their mothers led to the development of his influential concept concerning the “holding environment”. Winnicott claimed that “the foundations of health are laid down by the ordinary mother in her ordinary loving care of her own baby”, central to which was the mother’s attentive holding of her child.
Winnicott considered that the “mother’s technique of holding, of bathing, of feeding, everything she did for the baby, added up to the child’s first idea of the mother”, as well as fostering the ability to experience the body as the place wherein one securely lives. Extrapolating the concept of holding from mother to family and the outside world, Winnicott saw as key to healthy development “the continuation of reliable holding in terms of the ever-widening circle of family and school and social life”.
Winnicott was influential in viewing the work of the psychotherapist as offering a substitute holding environment based on the mother/infant bond. Winnicott wrote: “A correct and well-timed interpretation in an analytic treatment gives a sense of being held physically that is more real…than if a real holding or nursing had taken place. Understanding goes deeper”.
His theoretical writings emphasised empathy, imagination, and, in the words of philosopher Martha Nussbaum, who has been a proponent of his work, “the highly particular transactions that constitute love between two imperfect people.”
Anti-Social Tendency
Connected to the concept of holding is what Winnicott called the anti-social tendency, something which he argued “may be found in a normal individual, or in one that is neurotic or psychotic”. The delinquent child, Winnicott thought, was looking for a sense of secure holding lacking in their family of origin from society at large. He considered antisocial behaviour as a cry for help, fuelled by a sense of loss of integrity, when the familial holding environment was inadequate or ruptured.
Play and the Sense of Being Real
One of the elements that Winnicott considered could be lost in childhood was what he called the sense of being – for him, a primary element, of which a sense of doing is only a derivative. The capacity for being – the ability to feel genuinely alive inside, which Winnicott saw as essential to the maintenance of a true self – was fostered in his view by the practice of childhood play.
In contrast to the emphasis in orthodox psychoanalysis upon generating insight into unconscious processes, Winnicott considered that playing was the key to emotional and psychological well-being. It is likely that he first came upon this notion from his collaboration in wartime with the psychiatric social worker, Clare Britton, (later a psychoanalyst and his second wife) who in 1945 published an article on the importance of play for children. By “playing”, he meant not only the ways that children of all ages play, but also the way adults “play” through making art, or engaging in sports, hobbies, humour, meaningful conversation, et cetera. At any age, he saw play as crucial to the development of authentic selfhood, because when people play they feel real, spontaneous and alive, and keenly interested in what they’re doing. He thought that insight in psychoanalysis was helpful when it came to the patient as a playful experience of creative, genuine discovery; dangerous when patients were pressured to comply with their analyst’s authoritative interpretations, thus potentially merely reinforcing a patient’s false self. Winnicott believed that it was only in playing that people are entirely their true selves, so it followed that for psychoanalysis to be effective, it needed to serve as a mode of playing.
Two of the techniques whereby Winnicott used play in his work with children were the squiggle game and the spatula game. The first involved Winnicott drawing a shape for the child to play with and extend (or vice versa) – a practice extended by his followers into that of using partial interpretations as a ‘squiggle’ for a patient to make use of.
The second, more famous instance involved Winnicott placing a spatula (tongue depressor) within the child’s reach for him to play with. Winnicott considered that “if he is just an ordinary baby he will notice the attractive object…and he will reach for it….[then] in the course of a little while he will discover what he wants to do with it”. From the child’s initial hesitation in making use of the spatula, Winnicott derived his idea of the necessary ‘period of hesitation’ in childhood (or analysis), which makes possible a true connection to the toy, interpretation or object presented for transference.
Many of Winnicott’s writings show his efforts to understand what helps people to be able to play, and on the other hand what blocks some people from playing. Babies can be playful when they’re cared for by people who respond to them warmly and playfully, like a mother who smiles and says, “Peek-a-boo!” when she sees her baby playfully peeking out from behind his hands. If the mother never responded playfully, sooner or later the baby would stop trying to elicit play from her. Indeed, Winnicott came to consider that “Playing takes place in the potential space between the baby and the mother-figure….[T]he initiation of playing is associated with the life experience of the baby who has come to trust the mother figure”. “Potential space” was Winnicott’s term for a sense of an inviting and safe interpersonal field in which one can be spontaneously playful while at the same time connected to others (again a concept that has been extrapolated to the practice of analysis).
Playing can also be seen in the use of a transitional object, Winnicott’s term for an object, such as a teddy bear, that has a quality for a small child of being both real and made-up at the same time. Winnicott pointed out that no one demands that a toddler explain whether his Binky is a “real bear” or a creation of the child’s own imagination, and went on to argue that it’s very important that the child is allowed to experience the Binky as being in an undefined, “transitional” status between the child’s imagination and the real world outside the child. For Winnicott, one of the most important and precarious stages of development was in the first three years of life, when an infant grows into a child with an increasingly separate sense of self in relation to a larger world of other people. In health, the child learns to bring his or her spontaneous, real self into play with others; in a false self disorder, the child has found it unsafe or impossible to do so, and instead feels compelled to hide the true self from other people, and pretend to be whatever they want instead. Playing with a transitional object can be an important early bridge between self and other, which helps a child develop the capacity to be genuine in relationships, and creative.
Playing for Winnicott ultimately extended all the way up from earliest childhood experience to what he called “the abstractions of politics and economics and philosophy and culture…this ‘third area’, that of cultural experience which is a derivative of play”.
True self and False Self
Winnicott wrote that “a word like self…knows more than we do.”. He meant that, while philosophical and psychoanalytic ideas about the self could be very complex and arcane, with a great deal of specialised jargon, there was a pragmatic usefulness to the ordinary word “self” with its range of traditional meanings. For example, where other psychoanalysts used the Freudian terminology of ego and id to describe different functions of a person’s psychology, Winnicott at times used “self” to refer to both. For Winnicott, the self is a very important part of mental and emotional well-being which plays a vital role in creativity. He thought that people were born without a clearly developed self and had to “search” for an authentic sense of self as they grew. “For Winnicott, the sense of feeling real, feeling in touch with others and with one’s own body and its processes was essential for living a life.”
True Self
“Only the true self can be creative and only the true self can feel real.” For Winnicott, the True Self is a sense of being alive and real in one’s mind and body, having feelings that are spontaneous and unforced. This experience of aliveness is what allows people to be genuinely close to others, and to be creative.
Winnicott thought that the “True Self” begins to develop in infancy, in the relationship between the baby and its primary caregiver (Winnicott typically refers to this person as “the mother”). One of the ways the mother helps the baby develop an authentic self is by responding in a welcoming and reassuring way to the baby’s spontaneous feelings, expressions, and initiatives. In this way the baby develops a confidence that nothing bad happens when she expresses what she feels, so her feelings don’t seem dangerous or problematic to her, and she doesn’t have to put undue attention into controlling or avoiding them. She also gains a sense that she is real, that she exists and her feelings and actions have meaning.
Winnicott thought that one of the developmental hurdles for an infant to get past is the risk of being traumatised by having to be too aware too soon of how small and helpless she really is. A baby who is too aware of real-world dangers will be too anxious to learn optimally. A good-enough parent is well enough attuned and responsive to protect the baby with an illusion of omnipotence, or being all-powerful. For example, a well-cared-for baby usually doesn’t feel hungry for very long before being fed. Winnicott thought the parents’ quick response of feeding the baby gives the baby a sense that whenever she’s hungry, food appears as if by magic, as if the baby herself makes food appear just by being hungry. To feel this powerful, Winnicott thought, allowed a baby to feel confident, calm and curious, and able to learn without having to invest a lot of energy into defences.
False Self
In Winnicott’s writing, the “False Self” is a defence, a kind of mask of behaviour that complies with others’ expectations. Winnicott thought that in health, a False Self was what allowed one to present a “polite and mannered attitude” in public.
But he saw more serious emotional problems in patients who seemed unable to feel spontaneous, alive or real to themselves anywhere, in any part of their lives, yet managed to put on a successful “show of being real”. Such patients suffered inwardly from a sense of being empty, dead or “phoney”.
Winnicott thought that this more extreme kind of False Self began to develop in infancy, as a defence against an environment that felt unsafe or overwhelming because of a lack of reasonably attuned caregiving. He thought that parents did not need to be perfectly attuned, but just “ordinarily devoted” or “good enough” to protect the baby from often experiencing overwhelming extremes of discomfort and distress, emotional or physical. But babies who lack this kind of external protection, Winnicott thought, had to do their best with their own crude defences.
One of the main defences Winnicott thought a baby could resort to was what he called “compliance”, or behaviour motivated by a desire to please others rather than spontaneously express one’s own feelings and ideas. For example, if a baby’s caregiver was severely depressed, the baby would anxiously sense a lack of responsiveness, would not be able to enjoy an illusion of omnipotence, and might instead focus his energies and attentions on finding ways to get a positive response from the distracted and unhappy caregiver by being a “good baby”. The “False Self” is a defence of constantly seeking to anticipate others’ demands and complying with them, as a way of protecting the “True Self” from a world that is felt to be unsafe.
Winnicott thought that the “False Self” developed through a process of introjection (a concept developed early on by Freud) or internalising one’s experience of others. Instead of basing his personality on his own unforced feelings, thoughts, and initiatives, the person with a “False Self” disorder would essentially be imitating and internalising other people’s behaviour – a mode in which he could outwardly come to seem “just like” his mother, father, brother, nurse, or whoever had dominated his world, but inwardly he would feel bored, empty, dead, or “phoney”. Winnicott saw this as an unconscious process: not only others but also the person himself would mistake his False Self for his real personality. But even with the appearance of success, and of social gains, he would feel unreal and lack the sense of really being alive or happy.
The division of the True and False self roughly develops from Freud’s (1923) notion of the Superego which compels the Ego to modify and inhibit libidinal Id impulses, possibly leading to excessive repression but certainly altering the way the environment is perceived and responded to. However it is not a close equation as the Id, Ego and Superego are complex and dynamic inter-related systems that do not fit well into such a dichotomy. The theory more closely resembles Carl Rogers’ simplified notions of the Real and Ideal self. According to Winnicott, in every person the extent of division between True and False Self can be placed on a continuum between the healthy and the pathological. The True Self, which in health gives the person a sense of being alive, real, and creative, will always be in part or in whole hidden; the False Self is a compliant adaptation to the environment, but in health it does not dominate the person’s internal life or block him from feeling spontaneous feelings, even if he chooses not to express them. The healthy False Self feels that it is still being true to the True Self. It can be compliant to expectations but without feeling that it has betrayed its “True Self”.
Winnicott on Carl Jung
Winnicott’s assessment of the other great pioneer of psychoanalysis, Carl Jung, appeared when he published an extensive review of Jung’s partially autobiographical work, Memories, Dreams, Reflections. In it Winnicott focuses on the first three chapters of the work that:
every psychoanalyst must read’ and in particular the first chapter, ‘First Years’. (Winnicott).
He discusses Jung’s evident early experiences of psychotic illness from around the age of four, from within his own theoretical framework. He goes on to comment on the relationship between Freud and Jung. He also discusses the Jungian ‘unconscious’ and Jung’s concept of the ‘self’.
Criticism and Influence
Winnicott’s theoretical elusiveness has been linked to his efforts to modify Kleinian views. Yet whereas from a Kleinian standpoint, his repudiation of the concepts of envy and the death drive were a resistant retreat from the harsh realities she had found in infant life, he has also been accused of being too close to Klein, of sharing in her regressive shift of focus away from the Oedipus complex to the pre-oedipal.
The psychoanalyst, Jan Abram, a former director of the Squiggle Foundation, intended to promote Winnicott’s work, who therefore may be said to be partisan, has proposed a coherent interpretation for the omission of Winnicott’s theories from many mainstream psychoanalytic trainings. His view of the environment and use of accessible everyday language, addressing the parent community, as opposed to just the Kleinian psychoanalytic community, may account in part for the distancing and making him somewhat “niche”.
Winnicott has also been accused of identifying himself in his theoretical stance with an idealised mother, in the tradition of mother (Madonna) and child. Related is his downplaying of the importance of the erotic in his work, as well as the Wordsworthian Romanticism of his cult of childhood play (exaggerated still further in some of his followers).
His theories of the true/false self may have been over-influenced by his own childhood experience of caring for a depressed mother, which resulted in the development of a prematurely mature self which he was only subsequently able to undo.
Nevertheless, Winnicott remains one of the few twentieth-century analysts who, in stature, breadth, minuteness of observations, and theoretical fertility can legitimately be compared to Sigmund Freud.
He has been a major influence for the American psychoanalyst Thomas Ogden, and the Italian psychoanalysts Giuseppe Civitarese and Antonino Ferro, all of which have cited Winnicott’s interest in play as being central to their work. He has also strongly influenced the work of Adam Phillips.
Along with Jacques Derrida, Winnicott is a fundamental resource for philosopher Bernard Stiegler’s What Makes Life Worth Living: On Pharmacology (2010).
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Edward Bibring (1894–1959) was an Austrian American psychoanalyst. He studied philosophy and history at the University of Czernowitz until the First World War.
After his military service he went to study medicine at the University of Vienna, and later was accepted for training by the Vienna Psychoanalytic Society, in which he became an associate member from 1925, and then a full member in 1927. He was closely associated with Sigmund Freud. He was an co-editor of the Internationale Zeitschrift für Psychoanalyse for a brief period. In 1921 he married his fellow analyst Grete L. Bibring, and in 1941 the pair emigrated to the US.
Writings
His publishing’s focused on scientific contributions to the theory of psychoanalytic therapy, the study of depression, and the history of psychoanalysis.
Bibring’s early writings included studies of the instincts, and of the repetition compulsion. He also wrote a pair of articles on paranoia in schizophrenia, including a case study of a woman who believed herself to be persecuted by someone called “Behind”, a figure onto whom she had projected aspects of her own rear.
Ernest Jones reported with approval Bibring’s measured disagreement with Freud’s concept of the death drive:
“Instincts of life and death are not psychologically perceptible as such; they are biological instincts whose existence is required by hypothesis alone…[&] ought only to be adduced in a theoretical context and not in discussion of a clinical or empirical nature”.
While struggling with writer’s block in the States, Bibring did publish a 1954 article on the role of abreaction in what he called “emotional reliving” – a theme later developed by Vamik Volkan in his re-grief therapy.
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Edmund Bergler (20 July 1899 to 06 February 1962) was an Austrian-born American psychoanalyst whose books covered such topics as childhood development, mid-life crises, loveless marriages, gambling, self-defeating behaviours, and homosexuality. He has been described as the most important psychoanalytic theorist of homosexuality in the 1950s.
Biography
Edmund Bergler was born in Kolomyia, in today’s Ukraine, in 1899 into a Jewish family. Bergler fled Nazi Austria in 1937–1938 and settled in New York City, where he worked as a psychoanalyst. Bergler wrote 25 psychology books along with 273 articles that were published in leading professional journals. He also had unfinished manuscripts of dozens of more titles in the possession of the Edmund and Marianne Bergler Psychiatric Foundation. He has been referred to as “one of the few original minds among the followers of Freud“. Delos Smith, science editor of United Press International, said Bergler was “among the most prolific Freudian theoreticians after Freud himself”.
Work
Summarising his work, Bergler said that people were heavily defended against realization of the darkest aspects of human nature, meaning the individual’s emotional addiction to unresolved negative emotions. He wrote in 1958, “I can only reiterate my opinion that the superego is the real master of the personality, that psychic masochism constitutes the most dangerous countermeasure of the unconscious ego against the superego’s tyranny, that psychic masochism is ‘the life-blood of neurosis’ and is in fact the basic neurosis. I still subscribe to my dictum, ‘Man’s inhumanity to man is equaled only by man’s inhumanity to himself.'”
Sexuality
Bergler was the most important psychoanalytic theorist of homosexuality in the 1950s. According to Kenneth Lewes, a gay psychiatrist, “…Bergler frequently distanced himself from the central, psychoanalytical tradition, while at the same time claiming a position of importance within it. He thought of himself as a revolutionary who would transform the movement.” Near the end of his life, Bergler became an embarrassment to many other analysts: “His views at conferences and symposia were reported without remark, or they were softened and their offensive edge blunted.” However, it is unknown where did Lewes got this information, because there is no published autobiography of Bergler.
Bergler was highly critical of sex researcher Alfred C. Kinsey, and rejected the Kinsey scale, deeming it to be based on flawed assumptions. In an article published in the peer-reviewed medical journal Psychiatric Quarterly, Bergler criticized Alfred C. Kinsey: “Statistically speaking, Kinsey avoids with 100 percent completeness even the smallest concession to the existence of the dynamic unconscious. According to the “taxonomic approach,” to which Kinsey adheres, the “human animal,” as Kinsey calls homo sapiens, seems not yet to have developed the unconscious part of his personality…” “Derogatory remarks about Freudian psychoanalysis are mainly based on ignorance or resistance, or both. When this pair of characteristics occurs in biased laymen, one explains it away as typical resistance to acceptance of unconscious facts. The reason for this attitude in biased scientists is, of course, identical, though less defensible.” Bergler also states that: “Psychoanalytically, we know today that a complicated inner defence is involved. Homosexuals approve of their perversion because such acceptance of it – corresponding to a defence mechanism – enables them to hide unconsciously their deepest conflict, oral-masochistic regression. Since the homosexual who has not been treated has no inkling of the real state of affairs, he clings “proudly” to his defence mechanism. Only in cases in which a portion of inner guilt is not satiated by the real difficulties (hiding, social ostracism, extortion) which every homosexual experiences does the problem of changing come up.”
He is noted for his insistence on the universality of unconscious masochism. He is remembered for his theories about both homosexuality and writer’s block – a term he coined in 1947. Bergler, who did more work on the subject than any other psychoanalyst, argued that all gamblers gamble because of “psychic masochism”.
Legacy
Novelist Louis Auchincloss named his book The Injustice Collectors (1950) after Bergler’s description of the unconscious masochist of that type.
Bergler’s Homosexuality: Disease or Way of Life? (1956) was cited in Irving Bieber et al.’s Homosexuality: A Psychoanalytic Study of Male Homosexuals (1962). Bieber et al. mention Bergler briefly, noting that like Melanie Klein, he regarded the oral phase as the most determining factor in the development of homosexuality.
The philosopher Gilles Deleuze cited Bergler’s The Basic Neurosis (1949) in his Masochism: Coldness and Cruelty (1967), writing that, “Bergler’s general thesis is entirely sound: the specific element of masochism is the oral mother, the ideal of coldness, solicitude and death, between the uterine mother and the Oedipal mother.”
Arnold M. Cooper, former professor of psychiatry at Cornell University Medical College and a past president of the American Psychoanalytic Association, said of Bergler’s work: “I have adapted my model for understanding masochism from the work of Bergler, who regarded masochism as the basic neurosis from which all other neurotic behaviors derive. As long ago as 1949 . . . he felt, and I agree, [that the mechanism of orality] is paradigmatic for the masochistic character.”
Freud critic Max Scharnberg has given Bergler’s writings as an example of what he sees as the transparent absurdity of much psychoanalytic work in his The Non-Authentic Nature of Freud’s Observations (1993), writing that few present-day psychoanalysts would defend Bergler. Scharnberg disapprovingly notes Bergler’s claim that all homosexuals “are subservient when confronted with a stronger person, merciless when in power, unscrupulous about trampling on a weaker person.”
Bergler’s theories, with their assumption that the preservation of infantile megalomania or infantile omnipotence is of prime importance in the reduction of anxiety, have been seen as anticipating Heinz Kohut’s self psychology.
Psychotherapist Mike Bundrant has based much of his work on Bergler’s early theory of psychic masochism, although Bundrant has distanced himself from Bergler’s views on homosexuality, claiming Bergler was victim to his own prejudice in this area, or simply mistaken. Bundrant discusses inner masochism in the form of “psychological attachments” that fit consistent patterns over time.
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Donald Meltzer (1922–2004) was a Kleinian psychoanalyst whose teaching made him influential in many countries.
He became known for making clinical headway with difficult childhood conditions such as autism, and also for his theoretical innovations and developments. His focus on the role of emotionality and aesthetics in promoting mental health has led to his being considered a key figure in the “post-Kleinian” movement associated with the psychoanalytic theory of thinking created by Wilfred Bion.
Life and Work
Meltzer was born in New York City and studied medicine at Yale University. He practised in St. Louis as a psychiatrist, before moving to England in 1954 to have analysis with Melanie Klein. He joined the “Kleinian group”, became a teaching analyst of the British Psychoanalytical Society (BPS) and took on British citizenship. In the early 1980s disagreements about the mode of training led him to withdraw from the BPS. Meltzer worked with both adults and children. Initially his work with children was supervised by Esther Bick, who was creating a new and influential mode of psychoanalytic training at the Tavistock Clinic based on mother-child observation and following the theories of Melanie Klein. As a result of the regular travels and teaching of Meltzer and Martha Harris, his third wife, who was head of the Child Psychotherapy Training Course at the Tavistock Clinic, this model of psychoanalytic psychotherapy training became established in the principal Italian cities, in France and Argentina.
Meltzer taught for many years at the Tavistock Clinic, and practised privately in Oxford until his death. Owing to having left the BPS, his ideas remained controversial. He supervised psychoanalytically-oriented professionals in atelier-style groups throughout Europe, Scandinavia and South America, and his visits also included New York and California. Since his death in 2004 his reputation has increasingly regained ground also in his adoptive country. Several international congresses have focussed on his work: in London (1998), Florence (2000), Buenos Aires (2005), Savona (2005), Barcelona (2005) and Stavanger, Norway (2007).
Imago Group
Meltzer was a member of the Kleinian Imago Group founded by the Kleinian aesthete Adrian Stokes for discussing applied psychoanalysis. The group included among others Richard Wollheim, Wilfred Bion, Roger Money-Kyrle, Marion Milner and Ernst Gombrich. With Stokes he wrote a dialogue “Concerning the social basis of art”. Meltzer’s aesthetic interests, combined with the mother-baby model of early learning processes, led to seeing psychoanalysis itself as an art form. His later works describe the relationship between analyst and analysand as an aesthetic process of symbol-making. This has had an influence on the philosophical view of the relation between art and psychoanalysis.
Overview
Some of Meltzer’s significant and widely used developments of Kleinian object relations theory are as follows:
The aesthetic conflict, the foundation for normal development, based on the internal mother-baby relationship, was formulated in Meltzer and Harris Williams (1988) The Apprehension of Beauty
Intrusive identification, a form of projective identification associated with life in the Claustrum (narcissistic pathology), first formulated in early seminal papers “The relation of anal masturbation to projective identification” and “The delusion of clarity of insight”, and expanded in The Claustrum (1992)
Pseudo-maturity, a common clinical manifestation of arrested development
Adhesive identification and dismantling in two-dimensional autistic states, formulated in a work documenting Meltzer’s experience with 5 colleagues in treating autistic children, Explorations in Autism (1975)
The preformed transference, first described in The Psychoanalytical Process (1967), referring to the patient’s initial preconceptions about a psychoanalytic relationship which have to be overcome before a genuine transference and countertransference can be established
A reappraisal of Melanie Klein’s discovery of the combined internal object, which stresses its beneficial nature as a basis for mental development, begun in Richard Week-by-Week, Part II of The Kleinian Development (1978).
The Claustrum
In his final work, The Claustrum: An Investigation of claustrophobic phenomena (1988), Donald Meltzer developed a theory of claustrophobia. Meltzer offers a Kleinian/Bionian appreciation of the phenomenon of claustrophobia, arguing that the claustrum emerges as a failure of integration in early childhood development. If there occurs massive projective identification, that the child cannot sustain, its understanding both of its own corporeality, and that of others is severely impacted. It is a result of maternal failure in the reverie and leads to an incorrect construction of the internal mother. Claustrophobia in that sense “means to be imprisoned in a state of mind without getting out”, it has do with being trapped in the projective identification of others.
As a Teacher
Meltzer was well known internationally as a teacher and supervisor. He favoured an atelier-style system for the teaching and selection of candidates for psychoanalytical training, adumbrated in his paper, “Towards an atelier system”.
His method was to ask supervisees to present sessions of unedited clinical material, rather than finished papers. Several of his groups and individual supervisees have documented their experiences:
Castella, R., Farre, L., Tabbia, C. (2003) Supervisions with Donald Meltzer. London: Karnac.
Emanuel, R. (2004) “A personal tribute to Donald Meltzer”, Bulletin of the Association of Child Psychotherapists 149, 11–14
Fisher, J. (2000) “Reading Donald Meltzer: identification and intercourse as modes of reading and relating”, Exploring the Work of Donald Meltzer ed. Cohen and Hahn. London: Karnac, 188–202
Hoxter, S. (2000) “Experiences of learning with Donald Meltzer”, Exploring the Work of Donald Meltzered. Cohen and Hahn. London: Karnac,12–26
Psychoanalytic Group of Barcelona (2000), “A Learning Experience”, Exploring the Work of Donald Meltzer ed. Cohen and Hahn. London: Karnac, 203–14
Psychoanalytic Group of Barcelona (2002) Psychoanalytic Work with Children and Adults. London: Karnac
Psychoanalytic Group of Barcelona (2007) De un Teller psicoanalitico, a partir de Donald Meltzer. Barcelona: Grafein (in Spanish)
Oelsner, M. and Oelsner, R. (2005) “About supervision: an interview with Donald Meltzer”, British Journal of Psychotherapy, 21 (3).
Racker Group of Venice (2004) Transfert, Adolescenza, Disturbi del Pensiero. Armando (in Italian)
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David Huntingford Malan (21 March 1922 to 14 October 2020) was a British psychoanalyticpsychotherapy practitioner and researcher recognised for his contribution to the development of psychotherapy.
He promoted scientific spirit of inquiry, openness, and simplicity within the field. He is also noted for his development of the Malan triangles, which became a rubric in which therapists can reflect upon what they are doing and where they are in relational space at any given moment.
Early Life
Malan was born in Ootacamund in the province of Tamil Nadu in India on 21 March 1922. His father was English, working in the Indian Civil service as Paymaster General of Madras State, and his mother Isabel (née Allen)was American. When Malan was seven years old his father died from pneumonia and Malan and his mother came to England. They moved into a house in Hartley Wintney which served as Malan’s home throughout his life. This early experience of grief was formative for his later work.
At preparatory boarding school Malan particularly enjoyed learning Latin and Greek, but as a scholar at Winchester he became interested in chemistry which he then studied, winning a scholarship to Balliol College, Oxford. He graduated in 1944 with a 1st class Honours degree in chemistry.
During the World War II, Malan was seconded to the Special Operations Executive (S.O.E), initially to develop devices for Resistance fighters, and later incendiary bombs for use in the Far East.
He was unable to partake in active service due to a foot injury. After the war he studied medicine at The London Hospital qualifying in 1952 and then trained in psychiatry at the Maudsley Hospital. Malan began his training in psychoanalysis whilst at Medical School. His initial analysis was with Michael Balint and then with Winnicott.
After a year at Courtaulds doing fundamental research, he knew he wanted to become a Psychotherapist.
Career
After qualifying from the London Hospital in 1952, he worked as a casualty officer, then as a psychiatrist at the Maudsley before transferring to the Tavistock Clinic in 1956. From 1956 to 1982, he remained at the Tavistock Clinic as a consultant psychiatrist, psychotherapist and psychoanalyst.
In 1956, at the Tavistock Clinic, Balint asked him to join his Brief Psychotherapy research group investigating whether brief focal therapy was effective. Malan analysed the results which were highly encouraging. During his early years as a psychotherapist, he already advocated the accurate, reproducible clinical descriptions, as well as the prediction of desirable outcomes prior to the process of therapy or an “intention to treat”, which are then followed by unbiased evaluation post-treatment. This approach was met with suspicion during the 1950s within the analytic community, including Malan’s colleagues at the Tavistock Clinic.
In 1967 Malan developed the Brief Psychotherapy workshop which all trainees were required to attend for one year and treat a patient under his supervision. It attracted students internationally as well as nationally. The aim was to achieve effective therapeutic results in the shortest possible time and to research the factors that made this happen.
The therapy was actively interpretive, using the elements of the Two Triangles – the Triangle of Conflict and the Triangle of Person – as the basis for many of the interventions that the therapists made.
The outcome data exploded the Myth of Superficiality whereby critics claimed that Brief Psychotherapy could only be helpful with superficially ill patients, that the technique used should be superficial and that only superficial improvements can be achieved.
At this time Malan lectured nationally and internationally many times in the US, Canada, Norway, Switzerland, Italy and Greece, describing his active interpretive approach and his investigation of the factors that made Brief Psychotherapy most effective. He received the highest medical Merit award for this work.
In 1974, Davanloo showed his tapes of Intensive Short-Term Dynamic Psychotherapy to Malan who was convinced by the evidence that the technique used was extremely effective. They began a twelve-year collaboration, doing workshops and lectures together with Davanloo showing his tapes of therapy and Malan outlining the concepts and explaining the principles of the technique.
In 1979, Malan wrote Individual Psychotherapy and the Science of Psychodynamics pub. Butterworth-Heinnemann which outlines the principles of Dynamic Psychotherapy from the most elementary to the most profound, using true case histories to illustrate each concept. It has been translated into 8 languages and following a second edition in 1995 is still in print as a classic textbook for psychotherapists.
Private Life
He was married to Muriel (née Still) from 1959 to about 1982, with whom he had a son called Peter. He later married Jennifer (Jennie) Ann (née Stead). He enjoyed travelling in the countryside with his wife Jennie including in Scotland, New Zealand and India.
Retirement and Death
After his retirement, Malan continued to write and lecture extensively on Brief Psychotherapy and Intensive Short Term Dynamic Therapy (ISTDP), publishing his last book “Lives Transformed”, in 2006, which he co-authored with Patricia Coughlin. He also put on Conferences in Oxford in 2006 and 2008 to demonstrate the effectiveness of ISTDP as a method of Brief Psychotherapy. Following these conferences, core training courses developed, and therapists, who completed them and have become experienced, have continued to lecture and teach subsequent core trainings.
In 2005, Malan received a Career Achievement Award in recognition of his contribution to Psychotherapy from the International Experiential Dynamic Therapy Association, of which he was Emeritus President since its inception. He died in 2020.
Brief Psychotherapy
Although trained as an analyst, initially using analysis in therapy, and recognising the validity of analytic insights, Malan has always been concerned that analysis takes too long and too few patients can be treated.
His research and writing therefore focussed on finding the most effective treatment that can help more patients in the shortest possible time.
Balint’s Brief Therapy Research Group
In 1956, after becoming a psychotherapist at the Tavistock Clinic, Malan was invited by Balint to join his Brief Psychotherapy research group investigating whether brief focal therapy was effective. Patients were treated using a radical interpretive approach and the results were evaluated against specified criteria and, in general, they were extremely good. Malan analysed the results in his Oxford DM thesis and subsequently developed the ideas in A Study of Brief Psychotherapy: Tavistock publications 1963. Other publications analysing aspects of the results were The Frontier of Brief Psychotherapy and Toward the Validation of Dynamic Psychotherapy – both published by Plenum in 1976.
Brief Psychotherapy Workshop
Following his appointment as a Consultant in the Adult dept., Malan introduced a Brief Psychotherapy workshop which all trainees were required to attend. They presented cases where they had used the principles of Brief Psychotherapy under his supervision. The aim was to achieve effective therapeutic results in the fewest sessions and to research the factors that made this possible.
In the workshop the technique was actively interpretive. The work was initially focussed on the presenting problems but became more wide-ranging with responsive patients and demonstrated deep and lasting changes.
An account of twenty-four therapies completed by trainees as part of the Brief Psychotherapy Workshop is summarised in ‘Psychodynamics, Training and Outcome’ by Malan and Osimo, pub. Butterworth –Heinemann 1992. It is based not only on the sessions but on the follow-up of a series of patients, and shows that good therapeutic results can be achieved by trainees under supervision.
The Two Triangles
A key element of therapy is the linking of the Two Triangles – the Triangle of Conflict (Defence, Anxiety and Hidden Feeling) and the Triangle of Persons (Current, Transference/Present and Past). The Triangle of Conflict illustrates the relation between anxiety, defences and the underlying impulses or feelings. The Triangle of Persons shows the links between the relationship with the therapist, with current people in the patient’s life, and with people from their past.
Malan always acknowledges that each Triangle was independently devised by Ezriel (1952) and Menninger (1958) respectively, but he showed how, when put together, the relation between them for the patient at any given moment in therapy, can form a reliable basis for many of the interventions that the therapist makes. Ref: Individual Psychotherapy and the Science of Psychodynamics (p. 80)
As early as 1963 in his analysis of cases in Balint’s workshop, Malan had identified that good outcome correlated with a high frequency of interpretations making a link between the transference and childhood, but the full significance and usefulness of the concept of linking the Triangles came later.
The Myth of Superficiality
Research from the workshop exploded the ‘myth of superficiality’ whereby critics maintain that Brief Psychotherapy is a superficial treatment that can only be effective with superficially ill patients, bringing about superficial results. Malan maintains that the aim of every session is to ‘put the patient in touch with as much of their true feelings as they can bear and that the long-term outcome should demonstrate deep and lasting changes.’ The work does not have to be focal and limited to specific problems and should lead to therapeutic changes that are wide-ranging, deep-seated and permanent. This has been shown in many of Malan’s follow-up studies where Brief Therapy and Intensive Short-term Dynamic Psychotherapy have been used.
Collaboration with Habib Davanloo
In 1974 Davanloo presented videotapes of his therapeutic work using Intensive Short-term Dynamic Psychotherapy (ISTDP) at the Tavistock Clinic. The essence of ISTDP is to enable the patient to reach and experience their hitherto buried, and often unconscious feelings, which have been governing their emotional responses leading to deep-seated neurotic patterns of behaviour that in many cases have crippled their lives. He does this by challenging the defences that the patient has been using to avoid painful feelings of loss, grief, anger, hate and guilt about people who they loved and /or needed when children.
Although aspects of Davanloo’s challenging and sometimes abrasive technique were antipathetic to him, Malan recognised that the challenge was to the defences, not to the patient directly, and results were conclusive and convincing. The videotapes showed undeniable evidence that patients could be treated in a relatively few sessions (40 or fewer) and fully recover from a range of longstanding emotional and psychosomatic illnesses.
Malan and Davanloo collaborated for twelve years from 1974, doing many Conferences and Workshops worldwide. Davanloo showed his tapes of therapy while Malan outlined the rationale and objectives of the technique and explained the elements of the therapy. After his retirement, Malan wrote many books and articles about Davanloo’s concepts and technique.
Subsequent Developments using Intensive Short-Term Dynamic Psychotherapy.
It became apparent that the abrasive element when challenging the defences is not necessary, and the same results can be achieved by blocking them much more gently but persistently until they disintegrate. Malan recognised that as long as the patient reaches and experiences the buried, often previously unconscious painful feelings, they no longer have the power to govern their emotional responses. It is the avoidance of these feelings that underlies many neurotic and psychosomatic symptoms.
Malan has worked with many of Davanloo’s ex-trainees lecturing and writing extensively. In 2006 he co-authored with Patricia Coughlin ‘Lives Transformed – a Revolutionary Method of Dynamic Psychotherapy’ pub. Karnac.
In order to introduce Intensive Short-term Dynamic Psychotherapy to the UK, Malan organised two Conferences in Oxford in 2006 and 2008, where video-tapes of therapies were shown. Following these Core Training groups were established. Subsequent Conferences have been held demonstrating ISTDP and currently there are Core trainings in London and the North of England. Malan hopes ISTDP will become available as a treatment method on the NHS as it so effective, but it is difficult to learn and challenging to do.
Scientific Principles and Brief Psychotherapy
A hallmark of Malan’s work is his scientific approach to research in Psychotherapy. He is convinced that psychodynamic processes can and should be scientifically studied, and he rigorously insists on long-term follow-ups to see how effective therapy really has been and what factors contributed to this.
Outcome Studies
Malan believes that one of the most important tools for this ‘objective study of subjective matter’ is long-term follow-up interviews to obtain reliable psychodynamic outcome data. He considers that questionnaires are useless, and proper follow-up interviews are necessary based on the initial criteria the therapist sets for the complete resolution of the presenting problems. To this end he has carried out many such follow-ups and trained others to do so. These outcome studies are actually process and outcome studies as they analyse the process of change as well as the long-term results. He published papers throughout his career evaluating outcome data which showed that the results of Brief Psychotherapy are as good as, or better than, those found in long-term therapy.
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