Toward a Theory of Child-Centered Psychodynamic Family Treatment

The Anna Ornstein Reader

Anna Ornstein, Eva Rass, Eva Rass

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000078893
• Edition: 1
• Topic: Psicologia
• Subtopic: Psicoanalisi

Toward a Theory of Child-Centered Psychodynamic Family Treatment: The Anna Ornstein Reader offers a clear introduction to Anna Ornstein's ground-breaking work on psychoanalytic child orientated family therapy. Drawing on her writing from across her long career and including new material, the book sets out her important theoretical work on the mind, self, development, and parental influences, and the therapeutic consequences of these concepts.

Anna Ornstein's self-psychological work is unique and outstanding. First published in 1974, a time when attachment and affect regulation theory had just started, Ornstein's work has developed far-reaching ideas, therapeutic concepts, and practicable approaches for psychodynamic children and adolescence therapy, based on the concept of analytic self-psychology, which has anticipated very early results of later affect regulation and attachment research. This kind of treatment considers parental work not as only accompanying, but as central, representing the core of the treatment process. The parental maturation process is directly described, which should enable the parents to accompany their child empathically, and therefore attachment-security enhancing. This treatment concept integrates the later findings of neurobiologically-based attachment and affect regulation theory which emphasizes that intrapsychic and interpersonal experience are in a continuous and everlasting exchange. In this book, Eva Rass offers a better understanding of Ornstein's approach, an insight into her life and work, and an introduction into the concept of analytic self psychology, followed by a selection of Ornstein's significant publications, in which the central concern is clearly elaborated, to give the reader a thorough introduction and understanding of her work.

This book will be of great value and interest to professionals working with children and families in psychoanalytic settings, and to students training in child psychoanalysis, psychotherapy, and family therapy.

1 Introduction

Eva Rass

Due to her pioneering work, Anna Freud was the most influential person in the development of psychoanalytic psychotherapy with children. During her lifetime, and even after, she influenced the scientific theory as well as practical aspects of psychoanalysis. Her work ranged from establishing psychoanalytic techniques in the counseling process with children and adults to the psychoanalytic application in educational and other psychosocial areas where she achieved outstanding results through fundamentally expanding the psychoanalytic theory (especially in the field of child rearing). She ensured efficient dissemination to various professionals in other fields of social work (Stumm et al. 2005, p. 159). Her concept of a psychological development line opened up the field of assessment to new areas and possibilities for evaluating a healthy child development. Overall, Anna Freud did her work in the area of psychoanalytic research and teaching with great sovereignty – both by writings and speeches.

Approximately 50 years after Anna Freud’s classical work Introduction to the Techniques of Child Analysis (Freud, A. 1927), Anna Ornstein’s paper Making Contact with the Inner World of the Child: Toward a Theory of Psychoanalytic Psychotherapy with Children (1976) was published. This scientific essay is based on the psychoanalytic concept of self psychology introducing a paradigm shift in the field of psychoanalysis which also led to a crucial shift within the psychoanalytic child psychotherapy: the focal point of observations was not only the drive and associated outcomes but also defense mechanisms, as well as the unfolding of the self. A changed perspective on development led logically to change in the treatment model where, with creative courage, Anna Ornstein developed a concept of child psychotherapy based on analytic self psychology.

In the last 40 years Anna Ornstein and her husband have written many far reaching essays in the field of clinical theory based on analytic self psychology where they worked as co-authors and published papers individually. Joint publications on theoretical and practical approaches in adult treatment were collected in some volumes, however, there is no comprehensive collection of scientific writings and publications in child psychotherapy. With one exception (Ornstein, A./Ornstein, P. 1985) Anna Ornstein published her “children essays” individually. However, the collection in this booklet does not portray the full spectrum of Anna’s work. After reflecting with Anna on all her publications, we decided to integrate the most significant papers in this book. All writings were published between 1996 and 2012.

In order to understand the life and work of Anna Ornstein, the second chapter will portray an overview of her exceptional and unique way of life. A fundamental understanding and introduction into analytic self psychology by Heinz Kohut is needed as a base to proof and explain the theory and concept of child psychotherapy (Chapter 3).

Anna’s work is characterized by her extraordinary courage to think critically in her own way, investigating concepts from recognized analytic child therapists that were seen as untouchable. In this context (Chapter 7) she rethought the case study of “Little Hans” based on a self psychological perspective leaving her with completely different results than S. Freud did during his lifetime. These results are so outstanding because the case study of “Little Hans” represents a fundamental building block for the Freudian concept.

Chapters 4, 8, and 9 will outline various main foci of theoretical and practical approaches by giving insight into A. Ornstein’s concept of child centered family treatment. There will be focus on specific problems during the process of maturation classified by case studies. Tirelessly she sheds light on the developing child within its dynamic family bonding network, integrating Winnicott’s concept that emphasizes parents’ support to eliminate obstacles from appearing that adversely affect the developmental process of the child. The parental work in treatment is therefore not an accompanying process but rather a central procedure as the parents are the crucial mediators who have to continue the development of the child, even after therapy has ended. The co-authored essay with Paul Ornstein entitled: “Parenting as a Function of the Adult Self: A Psychoanalytic Developmental Perspective” describes the parental maturation process with the aim of enhancing the caretaker’s perception of the child’s experience and needs to provide conditions in everyday life important for growth in a sensitive, empathetic, and secure environment (Chapter 5).

Chapter 10 describes the fate of the “Children of Theresienstadt” who survived traumatizing life situations without any attachment to parents but with an existential attachment to each other. After being rescued, these children were brought to England where they lived in an orphanage with caregivers being supervised by Anna Freud. The adult lives of these children were based on emotional responsibility that opens up perspectives in attachment experiences between children. Love Despite Hate is the title of the book describing the unique fates of these children (Moskowitz 1983).

Chapter 6 discusses the fate of two young adolescences, Anne and Vivienne. The main focus will be on the environment of both girls and the importance of idealized adults who should support a healthy upbringing especially with view of major deficits in the early development of the self. Both girls left unusual writings of their unique experiences. In Vivienne’s case, Anna Ornstein worked out the causing factors of suicide and analyzed through “telescopic” psychological work the early deficits in the development of the self which were not successfully “reorganized” during early adolescence.

Due to analytic self psychology perspective on babies – not as a drove bundle that solely discharges its tensions, seeking bliss in a joyful nirvana – infants are realized as actively striving for mutual reciprocity and engagement with the environment. Therefore, self psychology could easily integrate findings from infant observation studies and attachment, and affect regulation research into its concept. Long before infant/toddler-parent treatment was conceptualized, Anna Ornstein developed the child centered family treatment using the central attachment based principals of empathy, regulation, and secure attachment.

In this respect, the first writing from 1976 is still scientifically up to date and acknowledged. Through regulation, responsiveness, and empathy parents can develop the much needed attachment security and it is therefore necessary to take the primary caregivers as co-therapists. The therapist functions as a mediator helping the parents to approach and to experience the psychological misery of the child with the goal of initiating change and therapeutic progress. In order to achieve real structural changes this process represents the main focus of therapy.

The essays collected in this book encompass early childhood up until early adolescence: the children from Theresienstadt; case studies of school aged children; the fates of two female teenagers; and the 15 year old Tommy who had fallen into great despair. He had lost his father and was not able to find a comfortable place in his family. Based on theoretical observations, both the positive development of the self and its failing can be well comprehended. The self psychological concept of human development leaves no doubt that child therapy can only be performed in the interplay between therapist, child, and parents – stressing the importance of parents within the child’s treatment.

References

Freud, A. (1927): Einführung in die Technik der Kinderanalyse. Leipzig/Wien (Internationaler psychoanalytischer Verlag).

Moskowitz, S. (1983): Love Despite Hate, Child Survivors of the Holocaust and Their Adult Lives. New York (Schocken Books).

Ornstein, A. (1976): Making Contact with the Inner World of the Child. Toward a Theory of Psychoanalytic Psychotherapy with Children. Comprehensive Psychiatry 17, New York (Grune and Stratton).

Ornstein, A.; Ornstein, P. (1985): Parenting as a function of the adult self: A psychoanalytic developmental perspective. In: Anthony, J.; Pollock, G. (Ed.): Parental Influences in Health and Disease. Boston (Little Brown and Company).

Stumm, G.; Spritz, A.; Gumhalter, P.; Nemeskeri, N.; Voracek, M. (Ed.) (2005): Personenlexikon der Psychotherapie. Wien/New York (Springer).

2 Insights in the life and work of Anna Ornstein

Eva Rass

Anna Ornstein was born on 27 January 1927 in Szendro (Hungary). She lived in her hometown until 1944 when she and her family were deported to Auschwitz after Nazi Germany occupied her country. Together with her mother, Anna survived several concentration camps while her older brothers as well as her father died in Auschwitz. Before the war, her family had lived according to traditional Jewish rules and her parents were strongly influenced by intellectual streams which were not only based in Budapest, but also in Vienna, Prague, and other German speaking cities.

Both older brothers who did not survive the concentration camps had immense influence on Anna’s emotional development. A large part of her fighting nature evolved through her own motivation of keeping up with her brothers physically and mentally. Anna Ornstein described the Hungarian time as a contradiction; on the one hand everyday life was rather primitive but on the other hand she was raised in a family with intellectual ambition and dreams about a better future. As a Jewish girl she was not allowed to attend high school and it was not until the school year 1942/1943 that she was able to move into a Jewish high school in Debrecen.

The Debrecen school was a boys’ school that started accepting girls due to the country’s difficult political situation. Girls were only accepted if they could prove the completion of Latin, Algebra, and French courses as well as successfully pass an entrance exam. The continuous home schooling effort of Anna’s mother bore fruit and the young and highly motivated Anna was allowed to start her high school education. This life did not continue for long as after approximately two years the German troops invaded Hungary in March 1944.

Jews were not allowed to use public transportation and were herded up into a ghetto within a few weeks (Ornstein, A. 2007a, p. 80). At the beginning of June, just when American forces arrived in Normandy, Anna and her entire family were deported to Auschwitz. While teenage Anna was holding onto her mother, her father and his elderly mother were the first to exit the train which is the last memory Anna has of both of them. Again it was the foresight of Anna’s mother who recognized potentially fatal situations and acted appropriately to keep them both alive. The living conditions were horrendous and prisoners suffered from malnutrition, exhaustion, cold, and disease but both survived this excruciating time through the courage and bravery of Anna’s mother (p. 84).

Nevertheless, even the longest war has its ending and on 8 May 1945 the Russian troops arrived at the concentration camp in the Czech city of Parschnitz where mother and daughter worked in an ammunition factory. The “liberation” in itself was the opening of the gates and the survivors were basically sent on their own way. They had to figure out their own way back home and had to find food and shelter which was an extremely risky process in postwar Europe. Anna and her mother reached train tracks that surprisingly marked the railway track to Zagreb leading to Budapest.

The controller cleared a wagon for the Hungarian women and gave them food and water until they arrived in Budapest during the summer of 1945. Soon the two received the devastating news that they were the only survivors of their family of five. Again, it was the life wisdom of Anna’s mother who found work and employment. This new place of work was not only a way to make money and feed her daughter, but also exposed itself as a way of healing; Anna’s mother became the director of an orphanage where 40 children arrived after their parents never returned from the war and concentration camps. Anna Ornstein restarted her education right where she was forced to end it before being deported and registered herself in the Jewish high school in Budapest. Again, she was very fortunate and the principal of this high school was the former principal of the boys’ school in Debrecen that Anna attended. He was very happy to be reunited with his former student (pp. 86ff.).

After Anna’s return to high school, something unexpected and wonderful happened: Paul Ornstein whom Anna had known before the German occupation and the same Paul who fell in love with teenage Anna when they first met, had heard in Klausenburg that someone had seen Anna alive. He started his love-driven search for Anna and found her in Budapest. The reunion was overwhelming for both. Paul Ornstein had escaped from a Ukrainian work camp and was hiding in the basement of the Swiss embassy for the final few months of the war. Anna and Paul got married in March 1946 and escaped to west Europe with the help of a Jewish underground organization. They both arrived in Heidelberg where they started studying medicine (Ornstein, A. 2007a, pp. 88ff.).

During their studies at the Medical College in Heidelberg (1947–1951), Anna and Paul had barely any contact with German students. Instead they were members of a Jewish student association where they formed affectionate and family-like relationships with other war survivors. With lots of gratitude, Anna remembers an outstanding man named Hermann Maas – a Catholic dean – who had been sent to a concentration camp due to his membership of an anti-nationalistic underground organization. The experiences in postwar Germany were mixed: Anna and Paul encountered many Germans with different political convictions helping them to avoid taking on a prejudiced attitude or developing a generalization for all Germans (p. 89).

Anna Ornstein soon became a medical doctor and started her career as a medical specialist. At that time, there was the opportunity to immigrate into the United States and Anna and Paul decided to take this chance. It was during her first year of becoming a consulting physician that Anna noticed that she was more interested in the emotional difficulties of her young patients rather than their physical problems. At that time, there was the opportunity at the University of Cincinnati to specialize in the area of children and adolescent psychiatry which, however, meant that Anna had to start training in general psychiatry first (p. 91). In 1953, Anna and Paul’s first daughter was born and Anna succeeded in bringing her mother to America.

Michael Balint was one of the renowned psychoanalytic therapists who frequently visited the faculty of psychiatry in Cincinnati. The importance of early child development was a main focus at the time and additionally Balint introduced Anna and Paul to focal therapy that uses psychoanalytic principles during a short therapeutic time. Margaret Mead also visited the faculty frequently followed by Heinz Kohut who held lectures and discussion groups. Psychiatrists who wanted to become psychoanalysts had to fly for one hour to get to Chicago as there was no psychoanalytic institute in Cincinnati at that time.

First, Paul Ornstein completed the psychoanalytic training; Anna completed the training later because she had three children at this time; eleven year old Sharone, six year old Miriam, and four year old Rafael. The program in Chicago was a traditional psychoanalytic program working along traditional concepts with the main focus being on Freud’s work and the Ego Psychology (ibid. p. 92). In retrospect Anna appreciated the strict program as she was accompanied by outstanding supervisors. Both Anna and Paul remembered it as a streak of luck in their professional career that they came into contact with Heinz Kohut and his concept of psychoanalytic self psychology. Anna and Paul Ornstein were part of the privileged circle that frequently met with Kohut to discuss the ideas developed by him. The intense co-working led to an enriching friendship. The theory building of Heinz Kohut, i.e., the development of analytic self psychology, entailed major advantages compared to traditional psychoanalytic theories (p. 93).

The orientation toward self psychology was especially valuable for Anna’s work as a child psychotherapist as she was able to assess the relationship between the child’s inner world and its emotional development – with a healthy or pathological outcome. In addition, the books and writings by the outstanding child psychoanalyst Donald Winnicott had great influence on Anna’s therapeutic thinking.

Based on the fundamental meaning of the self-object concept for development, Anna published her first essay in 1976 i...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• 1 Introduction
• 2 Insights in the life and work of Anna Ornstein
• 3 Insight into the concept of Analytic Self Psychology
• 4 Making contact with the inner world of the child
• 5 Parenting as a function of the adult self: a psychoanalytic developmental perspective
• 6 Anne and Vivienne: the early adolescence of two young teenagers
• 7 Little Hans: his phobia and his Oedipus complex (“The Analysis of a Phobia in a Five-Year-Old Boy,” 1909)
• 8 Changing patterns in parenting: comments on the origin and consequences of unmodified grandiosity
• 9 Child-centered family treatment: conceptual framework and clinical implications
• 10 Early childhood traumata: adult reorganization
• 11 Closing remarks
• Permissions
• Index