Academic journal article The Psychoanalytical Study of the Child

"There Has Never Been Anything like a Classical Child Analysis": Clinical Discussions with Anna Freud, 1970-1971

Academic journal article The Psychoanalytical Study of the Child

"There Has Never Been Anything like a Classical Child Analysis": Clinical Discussions with Anna Freud, 1970-1971

Article excerpt

This paper reports on a series of clinical discussions with Anna Freud, faculty and trainees at the Hampstead Clinic in 1970-1971. Anna Freud's comments are published here for the first time. The meetings concerned the nature and use of relationships in work with children who do not have a well-defined neurosis. If parochial borders are erased among the domains of upbringing, education, and psychoanalysis, potential therapeutic fertility and strength can increase. The clinical material in the paper makes it possible to explore the old and new aspects of the treatment relationship, such as the transferential, the externalization of the self-representational, the developmental, and so forth. This is a personal account of a formative experience during training.

Introduction

IN 1970, AS A FOURTH-YEAR STUDENT IN FULL-TIME TRAINING AT the Hampstead Clinic, then in my mid-twenties, I longed to hear Anna Freud talk about specific clinical interactions with particular children, what she would have done or said, and why. I wished to add to the three wonderful years of listening closely to Miss Freud's extraordinary case discussions and summaries, and I wanted to learn more about work with children whose difficulties strained certain ideas of what was technically possible or useful in child analysis. Miss Freud accepted an invitation to attend new meetings for interested staff members and students.

Between October 1970 and July 1971, there were seventeen meetings. Five clinical cases were discussed, two to four times each. Two meetings focused on reconstruction. Discussions centered on clinical material and the presenting analyst's questions, which followed a brief developmental and family history and a word about treatment context. With Anna Freud's agreement, the meetings were transcribed from recorded cassette tapes; I was thus able to prepare introductions for each meeting and link issues and questions as we proceeded. My presentation here draws exclusively from more than 320 pages of introductory remarks and discussion transcripts, unless otherwise noted. Anna Freud's comments comprise about 70 pages of the text. The meetings were called "Treatment of 'Atypical' Children," and this was a purely descriptive use of the word atypical', no reference is meant to the way other analysts may have used the word. For the sake of clarity, sometimes I have taken the liberty to quote Anna Freud from several meetings when she spoke about the same point. At this time, the complete record of these meetings is at the Anna Freud Centre in London; the volume is entitled Clinical Discussions with Anna Freud, 1970-1971.

In the meetings, I wished to provide a forum for the discussion of clinical details outside the precious and necessarily protected privacy of supervision. Open discourse had seemed elusive at this level of clinical specificity. I hoped we could relegate our particular theoretical orientations and formulations to the background and instead, follow the particulars of what happens. I felt that discussion of children whose difficulties were not entirely neurotic would offer the chance, in fact, to talk about almost any child in the clinic and give permission to raise questions that might seem too rudimentary in other contexts. I saw that we would learn of the thoughts we wished we had had and the better quality of work that might have been attained (by someone else perhaps) in simply hearing and responding to the child's feelings. We went ahead, knowing we would risk feeling unwise; and feeling unwise is very hard, especially when working with children.

In this paper, I will try to give a glimpse into Anna Freud's clinical thinking about the treatment relationship in work with children without a well-defined neurosis. Central questions with each patient-therapist couple included: What was the general nature of the treatment relationship? How do we understand its myriad aspects? Which ones might be explored and beneficially used? …

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