The Bi-Personal Field

Experiences in Child Analysis

Antonino Ferro

• Publisher: Routledge
• Year: 2003
• ISBN:
  9781134616664
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

First translation into English of work by Ferro - very distinguished Italian Analyst His work is very original, draws on Bion / The Barangers to develop his own conceptual system of clinical child analysis There are similarities between his work and popular US schools of analysis such as self-psychology, relational analysis, social cobnstruction and intersubjectivism

1
A review of the theoretical models

Many authors (Money-Kyrle 1968; Meltzer 1978; De Bianchedi 1991) have suggested simplifying adult psychoanalysis down to three fundamental models: the Freudian, the Kleinian, and a third model inspired by Wilfred Bion. In my view this tripartite division is equally valid for the analysis of children.

I am also of the belief that while other figures have made extremely important contributions to the advancement of this field, none has produced a truly unified model; rather, their work appears as a sort of Variation on a theme’. Some have undergone complex evolutionary transformations. Herbert Rosenfeld’s ideas and clinical approach changed considerably in his forty years of psychoanalytic practice. Meltzer started off from a strictly Kleinian stance but in recent years has adopted and given an original turn to some of the more radical elements in Bion.

Furthermore, I do not feel that there is anything particularly specific to the analysis of children (Ferro 1997) which would lead one to suppose that there are writers and problems specific to the analysis of adults and writers and problems specific to the analysis of children. In my view there is only one psychoanalysis, with varying clinical situations in which a ‘realization’¹ must be found, using different models, and perhaps with different objects. However, stressing the differences confirms how each analytic encounter is unique and unrepeatable.

I lay no claim to objectivity or thoroughness in the few points I shall make in characterizing these models. I shall simply explain what place they have for me, and how I have experienced them in my work.

But before embarking on a review of the various models of psychoanalysis, let me point out that, talking schematically, a tripartite subdivision emerges in any case, if we seek to characterize the different models in terms of how they account for the characters or the facts related in the session (Ferro 1991; Bezoari and Ferro 1992). A brief review of these approaches, which will be treated in greater detail in Chapter 5, may serve as an introduction to the issue.

According to one model of listening, the characters of the session are understood primarily as knots in a network of historical, factual relationships. Related facts, in this case, are occasions for the expression of feelings, conflict and emotional strategies, which are always connected with those characters. Alternatively, these facts, though considered present and real within the intrapsychic dynamics, may almost acquire an ‘autonomous’ existence. This, after all, is what we find in literary studies on character prior to the entrance on stage of Vladimir Propp.

In the second model (which is expounded most clearly by Klein and her followers) the characters are knots in a network of intrapsychic relationships. Related facts are ultimately a way to communicate the patient’s inner reality in disguise, a reality, however, which is seen as already ‘given’. It awaits an interpreter to clarify its functioning by discovering its root in the patient’s unconscious phantasies. For example, it is extremely fruitful to study Klein’s analysis of Richard and the way she perceives the characters that take shape in the session, or the way she interprets narrated facts, which are always traceable to the unconscious phantasies of the young patient.²

The third model—and we are now talking about Bion and the further development of his work—presents characters as knots in an interpersonal, or rather intergroup, narrative network, which emerge as ‘holograms’ of the current emotional interrelationship between analyst and patient. According to this view there are extremely primitive emotions, or better ‘moods’, at play in the session, which cannot yet be thought about. These moods are waiting for the analyst and the patient, using every possible means, to be in a position to receive them, to avoid being drowned by them, and to narrate them to each other.

The goal of the analytic couple (and of the ‘group’ that emerges from its work) is basically to communicate (generally, though not exclusively, through words) the emotions which pervade them. The characters are often ‘created’ then and there in the encounter and by the encounter of the two minds. The characters represent a way of sharing, narrating and transforming these primitive states of mind, helped by the psychoanalytical functions of the analyst’s mind.³ For example, in a famous passage in Bion (1962) in which ‘ice-cream’ (also frozen emotions) is transformed into the dramatic character ‘I scream’—a cry that inevitably reminds us of Munch—it is desperation that here emerges as narrative expression.

Let us now return to the three models we began with. Characteristic of the Freudian model is the central importance of reference to the past attributed to the patient’s communications. What the patient says is considered, with varying emphases, as having much to do with what he has actually experienced, whether in external reality or in psychic reality activated to some extent by external facts, as is the case of the well-known question of child seduction.

It is possible to investigate facts which in any case maintain a high level of historical truth. Facts can be reconstructed and revealed behind the opaque veil of repression. Various defence mechanisms work to obstruct the analyst’s attempts at disclosure, and he is forced to remove them in order to arrive at a truth that must be revealed. Psychoanalysis becomes a sort of archaeology, though a ‘living archaeology’, to use Green’s expression (1973).⁴

According to this model it is possible to know the patient, to examine his functioning and character independently. It is a model which, as the Barangers point out (1969), despite its elaboration as relation and dialogue, requires most of the concepts which make up its theoretical edifice to be formulated, as Freud thought, in monopersonal terms.

But let us get back to the model. Freud had brilliant insights: the method of free association instead of hypnosis and suggestion; the discovery of the intense bond created between patient and analyst; the transference, understood as a repetition of what cannot be remembered about early childhood; and the use of the interpretation as a way of making conscious what has been repressed, thus permitting the extension of the boundaries of consciousness.

It is well known that Freud continually revised his theoretical framework, adding new elements without ever completely eliminating the old ones. Certain concepts, however, remain central to his thought, such as ‘trauma’, ‘instinct’, ‘infantile sexuality’, and development in ‘phases’ (oral, anal, phallic, genital), each of which is accompanied by particular aspects of the functioning of the mind and personality.

Another remarkable theory concerns dreams. It is thanks to Traumdeutung and to Freud’s rejection of more neurophysiological models that it is possible to explain the mind through the mind. Freud identifies specific ways in which the dream takes shape (the hallucinatory realization of wishes, condensation, censorship, displacement, symbolization, the day’s residues) and the factors involved in the subsequent interpretation, which require the dreamer to help decode the dream. All this makes it possible to discover the latent meaning behind the overt text of the dream. This dream text must then be broken down into its component parts, so that it is possible for the patient freely to associate with each of its subunits, and the text must be connected to the patient’s current life and childhood experiences.

One of the key concepts in Freud’s thought is that of repression.⁵ In 1906 Freud wrote that through repression something mental was pushed out of reach while at the same time being retained. It is as though events had to be dug up, as in Pompeii, even though the work of excavation must first cross the territory of the emotional present of the therapy. This passage, in turn, makes buried facts the ‘living materials of the narrative’ (Petrella 1988). In any case the idea is maintained that there is a historical nucleus of truth belonging to the patient and knowable. This in itself is considered to be a healing factor.

The mental apparatus is now necessarily described as having a first topography (conscious, preconscious and unconscious) and a second topography (id, ego and super-ego).

Of course, the above outline is little more than a sketch. Indeed, it would be interesting to investigate the implications of this model for symbolism, defences, interpretation, transference, countertransference, and so on, but this is not the place to do so.

We cannot leave Freud, however, without quoting one of his clinical cases, which was for him (and for anyone dealing with child analysis) of crucial importance. I am, of course, referring to Little Hans (1909). This case was extremely significant for Freud, since it gave him the opportunity to check in real life all the theories about development, infantile sexuality, the Oedipus complex, and so on, that had been based on the analysis of adults and could now be studied statu nascenti. The case is important for us because it provides the first model of child analysis. It gives us access to the paraverbal language of a child (comparable to free association), such as drawing, dreams and phantasies, which lays the foundations for a technique of child analysis.

As the reader will recall, we are dealing with a phobia about horses which Hans suddenly developed. Hans is not analysed directly but rather through his father, who does with Freud what today would be called supervision. Freud finds in Hans confirmation of the existence of infantile neurosis. He identifies as traumatic events the anxiety of castration (the mother’s threats that the doctor would cut off his genitals if he kept on touching them), the birth of his sister Hanna (or rather, how he was lied to on that occasion, in open contradiction to what he himself perceived), the difficulties connected with evacuation and, finally, the imprecise description of the differences between the sexes.

Aberastury (1981) emphasizes that this list must be extended to include the trauma of the tonsillectomy, which she finds gave rise to the particular phobia about the colour of the ‘white’ horse, linked with the doctor’s smock, like the fear that his fingers would be bitten (‘the fingers of the doctor that operated on him’; the ‘fingers of masturbation’). She also asserts that if sex had been adequately explained it might have prevented Hans’s phobia. This is because the anxieties of castration were confirmed by the tonsillectomy, which showed that actual bodily mutilation was possible. Gradually, Freud showed the connections between the phobia, the Oedipal process, the reality of sexual instincts, the castration complex, and so on. Hans ingeniously proposes to keep his mother for himself, while offering his grandmother to his father in exchange, hoping that in this way everyone would be satisfied. As Hans’s conflicts and fears become clear and manifest, the phobia finally disappears.

Even after many rereadings, this case continues to be surprising and fascinating, especially when it shows us Freud at work, with extraordinary delicacy, in the only direct encounter he describes with his young patient.

The father, who is often described by Freud as excessive and even intrusive, appears to be over-realistic. He frequently invades the boy with questions and queries to the point where once, in the course of one of these interrogations, in response to the umpteenth question on what he is thinking about, Hans answers: ‘raspberry syrup and a gun for shooting people dead with’, as if to say: ‘About a bit of sweetness, and about shooting at anybody who torments me like that.’

It would be too easy for us today to criticize the interpretations and explanations given to the child, easy not to grasp how Hans himself felt ‘like a crumpled giraffe’ because of the often unsolicited clarifications. But we must not forget that we are in the year 1908, at the dawn of psychoanalysis, and that it is already quite amazing that meaning and attention were given to the words, phantasies and dreams of a 5-year-old child.

It is also true that in the case described there is a forced attempt to find in Hans’s words confirmation of what was being sought. But, after all, this was a unique opportunity to confirm the theoretical foundations of the new science. ‘Does the Professor talk to God, as he can tell all that beforehand?’, Hans asks his father in amazement after a meeting with Freud, who had explained certain aspects of the Oedipus complex to him.

Meltzer (1978), of course, says that today it would be unthinkable, without running grave risks, either to explore a child’s mental life so directly or to stimulate his unconscious phantasies. Moreover, he stresses the difference between reconstructive work, on the one hand, that is work aimed at confirming the hypothesis of infantile neurosis, which was carried out with Hans and, on the other, what Klein did with her young patients, which was from the very beginning evolutionary, as it focused on the development of the child.

It goes without saying that there have been an almost infinite number of elaborations of this Freudian text. Many have sought new truths and points of view, occasionally bordering on ‘deconstructionism’, which recognizes all possible interpretations. Freud’s greatness lies not only in his monumental theoretical and clinical work, but also in the fact that he left us a method for work and research (Tagliacozzo 1990) that can be used to understand mental phenomena, and this is true also for child analysis.

After Freud, the attempt to analyse children was continued by Hug Hellmuth (1921), who did not, however, leave us a systematic statement of her working procedure using play. Then we get to Sophie Morgenstern, who worked at the Heuyer clinic in France. Morgenstern left us a book on child psychoanalysis (1937) which shows that she placed priority on drawings. Drawings, in fact, had become necessary for the treatment of a 10-year-old

boy who was affected by mutism but drew a lot. The successful therapy encouraged her to continue in the same direction. Rambert (1938), in Switzerland, introduced marionettes representing typical characters (the mother, the aunt, the father, the doctor, etc.) and used them to animate stories.

Anna Freud (1946) and Melanie Klein (1932) were the first to publish methodological books presenting systematic techniques for the analysis of children. For Anna Freud a preparatory period must precede the analysis. She lays stress on the use of dreams, daytime phantasies and drawings, while limiting that of play. We shall see how Melanie Klein’s introduction of play in the analytic situation marked a revolutionary turning point in child analysis.

Before discussing this second model, I would like to mention a few of Anna Freud’s attitudes and theoretical positions which, as we will see, are notably different from those of Klein, although they have subsequently undergone considerable reworking and modification (Aberastury 1981).

Anna Freud held that children do not have the capacity for transference, since they have not yet dissolved their primary external ties. Consequently, there can be no second version, if the first has not yet been exhausted. Children, in her view, need a preparatory period before they will accept therapy. They must have a positive environment, and negative situations that arise must be faced and resolved with non-analytic means. A constant pedagogical commitment is required of the analyst, since children have an immature super-ego. Free associations could not be replaced by play, or better, free play corresponds to free associations, whereas play in the consulting room is comparable to resistance against the continual interruptions and changes which the child faces.

Later Anna Freud was to give up the preparatory phase and placed the child directly in the analytic situation, but she remained firm on many other aspects of her theory. It is not my intention here to go into Anna Freud’s many dynamic contributions, among which I should mention her insights into the defence mechanisms of the ego, that remain fundamental for the whole of psychoanalysis.

It is with Melanie Klein that we encounter a true revolution and the full, exhaustive formulation o...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Acknowledgements
• Introduction
• 1. A Review of the Theoretical Models
• 2. Drawings
• 3. Play
• 4. Dreams
• 5. The Dialogue: Characters and Narratives
• 6. The Child and the Family Group
• 7. A Geography of the Theoretical Model In Use
• 8. The Analyst’s Mind At Work: Problems, Risks, Needs
• Notes
• Bibliography