Anna
Anna
Anna
This series of introductory, critical texts looks at the work and thought of key contributors
to the development of psychodynamic psychotherapy. Each book shows how the
theories examined affect clinical practice, and includes biographical material as well
as a comprehensive bibliography of the contributor’s work.
The field of psychodynamic psychotherapy is today more fertile but also more
diverse than ever before. Competing schools have been set up, rival theories and
clinical ideas circulate. These different and sometimes competing strains are held
together by a canon of fundamental concepts, guiding assumptions and principles of
practice.
This canon has a history, and the way we now understand and use the ideas that
frame our thinking and practice is palpably marked by how they came down to us, by
the temperament and experiences of their authors, the particular puzzles they wanted
to solve and the contexts in which they worked. These are the makers of modern
psychotherapy. Yet despite their influence, the work and life some of these eminent
figures is not well known. Others are more familiar, but their particular contribution is
open to reassessment. In studying these figures and their work, this series will articulate
those ideas and ways of thinking that practitioners and thinkers within the
psychodynamic tradition continue to find persuasive.
Laurence Spurling
A view of development,
disturbance and therapeutic
techniques
Rose Edgcumbe
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any
form or by any electronic, mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.
Acknowledgements viii
3 Observation 21
Glossary 209
Chronology 213
Bibliography 214
Index 229
Acknowledgements
I am indebted to Laurence Spurling who asked me to write this book and was
helpful and encouraging as I worked on it. Over the years I have discussed Anna
Freud’s ideas and work with many colleagues in the Anna Freud Centre (previously
The Hampstead Clinic); they are too numerous to list, though some are mentioned
in this book; I am grateful to all of you with whom I have enjoyed fruitful discussion.
I am especially indebted to Clifford Yorke and Hansi Kennedy who thought over
past history with me while I was writing the book, and to Anne Hurry who read a
draft and made clarifying suggestions. For the conclusions I have come to, however,
nobody is to blame except myself.
I would like to thank the following: Mark Paterson and Associates on behalf of
The Estate of Anna Freud for permission to reproduce extracts from Infants Without
Families by Anna Freud, Reports on the Hampstead War Nurseries by Anna Freud
and Normality and Pathology in Childhood by Anna Freud, Copyright © 1965,
1973 Anna Freud; Extracts from The Writings of Anna Freud, Vols 1, 4, 5, 7 & 8,
Psychoanalytic Study of the Child, Vol. 21, and The Analysis of Defence by Sandler
and Freud reproduced by permission of Mark Paterson and Associates on behalf of
The Estate of Anna Freud (UK and Commonwealth) and International Universities
Press (US); the Institute of Psycho-Analysis and the Hogarth Press for permission
to quote from Instincts and Vicissitudes (1915) from the Standard Edition of the
Complete Psychological Works of Sigmund Freud, translated and edited by James
Strachey, Sigmund Freud © Copyrights, the Institute of Psycho-Analysis and the
Hogarth Press (UK and Commonwealth) and Mark Paterson and Associates (US);
Routledge for permission to reproduce quotes from Journal of Child Psychotherapy
[see http://www.tandf.co.uk ], volume 21, ‘Memories of a “qualified student”’ by
Erna Furman; Yale University Press (New Haven and London) for permission to
use an extract from The Psychoanalytic Study of the Child, volume 39: 1984. Peter
Neubauer, ‘Anna Freud’s Concept of Developmental Lines’, p.15; Sheil Land
Associates Ltd for material from Anna Freud by E. Young Bruehl (© Elizabeth
Young Bruehl 1988), London, Macmillan.
Chapter 1
Introduction
Three questions about
Anna Freud’s work
Anna Freud’s work is a mine of information and insight for anyone interested
in understanding the vagaries of human development. It is of special value to
all who have care of children, whether as parents or professionals. Anna
Freud combined a powerful intellect and questioning mind with a keen capacity
for observation.
My aim in this book is to describe Anna Freud’s innovative and still
relevant work in the observation, upbringing and care of children, as well as in
child psychoanalysis. I especially want to stress the interaction between her
clinical observation and her interest in developing the structural theory of her
father. She was an adult analyst who maintained a large practice in addition to
her other work throughout her life; and she played an important role in
psychoanalytic training for work with adults first in Vienna and then in
London. But her earliest papers concerned her work with children, and she
was one of the first people to explore the possibilities of psychoanalysing
children. It was from children that she gained many of the insights which she
incorporated into her contributions to psychoanalytic theory. Her major
influence on the theory and technique of clinical work with adults also derives
from the understanding of human development which grew out of her immense
experience with children. Yet the extent of her influence is not always
recognised; and in trying to understand this, I wish to consider three questions.
Question 1 : Why did she not accept ‘developmental help’ – her own innovative
approach to deficiency disorders – as a legitimate part of psychoanalytic
technique?
2 Anna Freud
Question 2 : Why is she still thought of as a drive theorist only, in spite of her
excellent theory of object relations?
In the debate about what motivates human behaviour, Anna Freud continues
to be labelled as a ‘drive theorist’, although it is evident that she also placed
great emphasis on object relations as sources of motivation for development.
Her work on development contains a very clear and detailed theory of the
development of object relations. It is to be found in her ‘developmental
lines’; and in many papers her formulations about the development of ego and
superego, of impulse control, of thinking, and of the management of emotions,
all stress the central importance of the child’s relationships, as does her
theory of technique. If forced to choose she would no doubt have opted to be
counted among those who take drives rather than object relations as the
primary motivating force in human behaviour. But she would, I believe, have
seen no reason to make such a choice, given that both are important.
I do not claim to have complete answers to these two questions, which are
not merely of historical interest, although part of the answer may be historical,
and links with the third question.
Introduction 3
Her work is not commonly recognised in Britain, and is more widely accepted
among analysts in the USA as well as Europe. Yet Anna Freud’s work is as relevant
today as it ever was, since it offers avenues of approach to understanding and
managing the children whose difficult behaviour can create havoc in schools, who
become violent, murderous, delinquent or promiscuous, vandalise schools and the
areas where they live, or turn to substance abuse. It also offers understanding and
ways of treating those who create trouble not for others but for themselves,
through crippling anxieties, failure in their schoolwork, inability to cope with
social relationships and situations, or incapacity for work. Both groups of children
may suffer difficulties in their sexual partnerships and in parenting in later life,
because of their anxieties, inadequacies or immaturities, and her work offers ways
of helping such individuals as parents, too.
I believe we can go some way towards answering my three questions by
examining Anna Freud’s relationship with her father’s work, and her way of handling
controversies within the British Psychoanalytic Society. To put it in a vastly
oversimplified way: Anna Freud’s loyalty to Sigmund Freud’s drive and structural
theories, in which instinctual drives are seen as the motivating force for all human
behaviour, meant that when writing or speaking theoretically she formulated all her
ideas about relationships in terms of drive theory and ego functioning. She believed
that those who propounded new theories of object relations were in danger of
abandoning drive theory, which she regarded as the bedrock of psychoanalysis.
Her own object relationships theory was essentially an attachment theory, similar
to Bowlby’s in many ways. She recognised this, but also clarified the differences in
a discussion of Bowlby’s work (Freud, A. 1969a). Her stress is not merely on the
importance of the child’s external attachments but on the effect of these real
external relationships on the child’s inner world of self–object relations. She was
among those in the analytic community who for many years regarded Bowlby’s
work with suspicion, feeling that he had abandoned psychoanalysis. Time has
softened such extreme positions, and Bowlby’s work is now better valued in the
psychoanalytic community.
I do not think it was simply fear of appearing to side with those who abandoned
drive theory which motivated her. Rather, she genuinely thought that the
4 Anna Freud
Biographical note
This book is not a biography of Anna Freud; it is a book about her work, especially
as a child analyst, especially in Britain, and especially those aspects of it which are
most innovative. It is my personal attempt to evaluate her work, which spans six
decades, and to understand and try to reconcile some of the contradictory elements
in it. I became her student at the Hampstead Clinic in 1959, and a member of her
staff in 1963, so I know the major part of her work only from reading and being
taught by those already familiar with it. But I was more directly involved in the last
two decades of her work as it developed. It has been an illuminating and sometimes
surprising experience to re-evaluate work I thought I knew well.
For those who wish to read about Anna Freud’s life there is a good biography by
Introduction 5
Elisabeth Young-Bruehl (1988). For those who want more information about her
work in Vienna there is a detailed study by Uwe Henrik Peters (1985). Peter Heller
(1990) gives an account of his experience as one of her child patients in Vienna. For
those interested in the relationship of her work to that of her father, there is
Raymond Dyer’s (1983) book. For those wishing to place her pioneering work
with children in the historical context of the development of child analysis, there is
now an English-language translation of a history by two French analysts, Claudine
and Pierre Geissman (1998). There is a short introduction to her work by Clifford
Yorke (1997) published only in French. A useful study guide to a selection of some
of her main papers, with editorial introductions which help to guide the reader
through each paper, has recently been produced by Ekins and Freeman (1998).
Here, I give only enough detail to place Anna Freud in her professional and
cultural context. Born in Vienna in 1895, the youngest of Martha and Sigmund
Freud’s six children, she was the only one to become a psychoanalyst. In clinical
discussions she would occasionally joke about the ambitiousness of youngest
children. Her first training and work was as a teacher, and she soon became involved
in attempts to improve the lives of socially and economically deprived children,
especially in the aftermath of the First World War. She began psychoanalytic work
in the early 1920s. As well as working with adults she joined the very small band
of those developing ways of working with children. Her father’s illness with cancer
precipitated her into taking unexpected administrative responsibilities in the Vienna
Psychoanalytic Institute. Her first book on child analysis was published in German
in 1927, but was fiercely attacked by Klein and other British analysts (Peters
1985, pp. 94–100), and rejected for publication in Britain by the International
Psycho-analytical Library, where Melanie Klein’s influence was great enough to
suppress rival theories at that time. Klein, together with other Berlin analysts, had
been invited to come to England in the 1920s and had been integrated into the
British Society.
The rise of the Nazis made life increasingly difficult for the Viennese analysts.
The Freud family fled to England in 1938 following the Nazi anschluss into Vienna.
Ernest Jones, President of the British Psychoanalytic Society, was instrumental in
assisting the escape of the Freuds and other Viennese analysts, who were welcomed
into the British Society. When, subsequently, theoretical and clinical disagreements
arose between the groups of analysts led by Anna Freud and Melanie Klein, they
6 Anna Freud
led to the ‘Controversial Discussions’ (King and Steiner 1991), a series of meetings
in which views were expounded and discussed. But differences were not resolved,
and led to the creation of different streams of training to reflect the differing views.
Because Anna Freud was grateful to the British Society for helping her family and
others to escape and find homes and work in this country, she felt it would have
been improper to respond to such kindness with further overt quarrelling (Freud,
A. 1979a). So although she remained an important member of the British Society,
to some extent she withdrew from it, preferring to become less prominent. She
continued to live and work in London until her death in 1982.
Anna Freud was also extremely aware of the dangers of ‘wild analysis’: the
application of imperfectly understood theory by insufficiently trained people
who might misunderstand or misuse classical technique, thereby doing their patients
more harm than good. She believed, further, that any departure from classical
technique must be based on a careful assessment of the clinical state of the patient,
and used only after scrutiny of existing techniques had revealed a gap which needed
to be filled by a modified or new technique. She was also aware that throughout the
history of psychoanalysis there had been those who found it difficult to accept the
full depth of psychoanalytic understanding of unconscious conflict, and were
therefore eager to find more superficial ways of understanding and treating emotional
disturbances, especially in children. I believe that all these considerations went into
her rationale for her careful distinction between the interpretative techniques of
psychoanalysis and the more educative techniques of developmental help. The
latter seemed to come perilously close to the ‘corrective emotional experience’
proposed by Alexander (1948) and disapproved of by mainstream psychoanalysts.
In the chapters which follow I will begin by discussing Anna Freud’s first major
contribution to psychoanalytic theory, her book on defences, which was for years
the definitive text on defences, and remains a standard text even today (Freud, A.
1936). This book signalled Anna Freud’s focus on Sigmund Freud’s structural
theory (Freud, S. 1923). Her interest in developing this theory, and in particular her
elaboration of the development and structuralisation of the ego can be traced
through all her subsequent work, reaching another high point in her diagnostic
Introduction 7
profile (Freud, A. 1962a), and leading into her work on the developmental lines,
which examined the myriad small strands of intertwining maturation and
development which contribute to the growth of the human personality.
I will then describe her early work as a teacher and director of nursery schools
and residential nurseries. The systematic observations made by all staff became the
basis for her first formulations about the developmental needs of children, including
the need for stable relationships with parents, and for her formulations on the way
in which the effects of relationships become built into the child’s psyche (Freud
and Burlingham 1944).
The clarity and power of theoretical conceptualisation and the careful, detailed
and open-minded observation of children are the two bases on which is founded all
Anna Freud’s subsequent work on the internal world of the child.
The early work influenced her ideas on how child analysis could be conducted,
one of the areas which led her into disagreements with the Kleinian school of
thought. One of the issues I particularly wish to examine is Anna Freud’s view of
the importance of the child’s experience with his parents, and the importance of
involving them in the child’s therapy. This view was based on her awareness of the
complex development of the child’s relationships and the myriad developments in
other areas of the child’s functioning which depend on the child’s relationships
with his parents. This was one of the areas of contrast with Klein’s theory and
practice of child analysis which Anna Freud felt to be insufficiently respectful of
the role of parents, concentrating as it did on the child’s internal world of fantasy
to the exclusion of external factors.
Subsequent chapters will describe how these early ideas were developed largely
through the research and study groups of the Hampstead Child Therapy Course
and Clinic, a charitable centre with the threefold aims of supporting psychoanalytic
training for child psychotherapists, psychoanalytic treatment for children and
adolescents, and research into childhood development and disorders. This institution
was founded following Anna Freud’s partial withdrawal from the British
Psychoanalytic Society, to meet the needs of workers in the war nurseries who
wished to continue the training they had begun there. This training has produced
therapists capable of working with children suffering from a wide range of emotional
disorders extending far beyond the neuroses for which child psychoanalysis was
originally deemed appropriate. Anna Freud encouraged her colleagues and students
8 Anna Freud
to devise techniques for working with children who could not respond to ‘classical’
psychoanalytic techniques, and needed ‘developmental help’ in order to progress.
For much of her lifetime she doubted that these techniques could be considered
truly analytic, seeing them, rather, as ‘educational’. Yet she did not think that
developmental help, as she envisioned it, could be provided by people without
analytic training.
Her developmental profile, a diagnostic tool for the thorough assessment of
childhood disturbances (Freud, A. 1962a, 1965a), emerged from the research work
of the Hampstead Clinic, as did the developmental lines, which describe the stages
a child passes through in a number of key areas of development, and which can be
used for assessing the child’s readiness for such life events as entry to school or
nursery school, separation from parents, or coping with hospitalisation.
Further chapters will cover the later developments in her theories and the
results of clinical research, and how these influenced her later views on technique.
I will also consider the many ways in which her thinking was applied to professions
other than psychoanalysis, since she never lost her more general interest in the
well-being of children, or her wish to improve the ways they were looked after by
all who had care of them.
After her death, The Hampstead Clinic was renamed the Anna Freud Centre.
Her work is continued there. Recent years have seen the drawing together of
research work by developmental psychologists and paediatricians with
psychoanalytic observations. Followers of Melanie Klein and Anna Freud have
been able to exchange ideas and work together. Bowlby’s work is used in a major
study on attachment in progress at the Centre. The wealth of clinical material
collected because of Anna Freud’s insistence on the importance of thorough recording
is the subject of a retrospective study using over eight hundred cases, studying the
efficacy of psychoanalytic treatment with different age groups and types of
disturbance. Further studies on the technique of child analysis give due weight to
what has eventually been renamed ‘developmental therapy’. This current work is
discussed in a final chapter which considers Anna Freud’s legacy to those who
work in many capacities with both normal and disturbed children.
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