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III. The Schizophrenia Papers

Donald Meltzer Harris Meltzer Trust ePub

It is perhaps difficult for people unaquainted with the use of the concepts of splitting and projective identification, as well as for those who have become perhaps a little blasé about them, to realize the electrifying impact of Mrs Klein’s 1946 paper, ‘Notes on Some Schizoid Mechanisms’, upon the analysts who were working closely with her. With the notable exception of Bion’s later work it could be said that the history of the next thirty years of research could be written in terms of the phenomenology and implications of these two seminal concepts.

Thus in approaching the papers written by Bion in the years 1953 to 1958 one immediately is struck by this aspect of the content in its application to the phenomena of the psychotic, and especially the schizophrenic patient. The 1950s were in a sense the heyday of psycho-analytical interest in the psychoses and the literature swells with contributions to their meta-psychology and reports of successful treatment by psychological methods. In the latter category, especially the work done in America at that time by people like Frieda Fromm Reichmann, John Rosen, Milton Wexler; or in France by Mme Sechehaye, turned largely upon the modification of the psycho-analytical method to the treatment of these disorders. While this was intended to be an adaptation in the technical sense, by which means the analytical method had been made suitable to the treatment of children by Mrs Klein and Miss Freud, for instance, a great deal of methodological confusion reigned. It was not perhaps realized that, at least as far as Melanie Klein’s adaptation of the method was concerned, the intention had been to alter nothing in the method, but to facilitate the means of communication available to the patient. This was not so true of Miss Freud’s early work, largely on the basis of an assumption that the child would not be able to form a transference in die same sense as the adult patient. That assumption was based in turn upon a view of the transference that stressed its ‘transfer’ from the past under the sway of the repetition compulsion rather than viewing it as an externalization of internal object relations under the pressure of the immediate operation of impulse and anxiety.

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6 - Beliefs and Evaluations

Roger Money-Kyrle Harris Meltzer Trust ePub

Language, having been evolved for practical affairs, can be notoriously misleading in psychology. To say that we walk implies no more than that our bodies move. To say that we think, because of its grammatical similarity, suggests some entity which does the thinking. (And in unconscious phantasy, there are figures which do so.) But as Hume disturbingly observed, the most careful introspection fails altogether to detect an actual mental entity separate from the mental activities the grammatical ego is said to indulge in. Strictly speaking, we do not contain the ego of our grammar (or the more complex population of unconscious phantasy); but we – that is, our mental selves – consist of mental activity and nothing more. So to say that we think is equivalent to saying that thought is one of the mental activities of which we are composed.

A mind – that is, a given totality of mental action – has three distinguishable aspects: the cognitive, which includes perception as well as thought, the affective, and the conative. The main function of the cognitive aspect is the construction of a world-model – a process which we tried to follow in Part I. Only a small part of it is, as it were, present in a mind at any given time. The rest (not counting what is permanently unconscious) is available as and when required. It consists of pictures, including verbal pictures, of everything that the individual concerned would expect to experience in other times and places and in other people’s shoes. It is, therefore, dualistic: it refers both to those percept-objects which belong, as we say, to the external world and to the perceptions, thoughts, feelings and desires which belong to, or rather constitute, his own and other people’s minds. It represents the sum of his ‘beliefs’ about both these aspects of what we call reality.

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VI. The Residual Autistic Condition and its Effect upon Learning - Piflic

John Bremner Harris Meltzer Trust ePub

SHIRLEY HOXTER

The main concern of this chapter will be to study some factors which appear to have impeded or enhanced one particular boy’s capacity for growth. Christopher, usually known as ‘Piffie’, commenced psychotherapy with me at the age of three and a quarter years. He attended four times weekly for the most part, until he was eight and a quarter, when treatment was terminated. Two and a half years later his therapy was recommenced and, from eleven until fourteen (his age at the time of writing) he has attended once weekly.

The periods of psychotherapy to be discussed mainly concern the residual effects of an autistic state. Piffie was probably beginning to emerge from this state before he commenced psychotherapy and he shed its more blatant manifestations within the first year of therapy. Nevertheless traces of former autistic features may still be discerned and they continue to have a constricting effect upon his development.

Christopher is the youngest of three children. At the time of his birth, by Caesarian section, his mother was very anxious, having from her previous experiences reason to fear that he might die. In fact he was a healthy, but a very passive baby, sleeping a great deal and never grasping the nipple or bottle teat sufficiently strongly to suck properly. Milk had to be practically poured into him.

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17: The child psychotherapist and the patient’s family

Esther Bick Harris Meltzer Trust ePub

(1968)

Practical matters of setting and communication are first considered, then attention is paid to underlying unconscious communications between family and therapist, clarifying the role of therapy as something that supports rather than interfering with the child’s relationship with his parents. The process of transferring anxieties and working in the transference is described by means of two clinical cases (a ten-year-old boy and a sixteen-year-old girl), followed by one example of consultation with parents and child in which the therapist’s role is specifcally “to help the parents use the unrivalled experience they have of their own child.”

Those of us who work with children are more dependent on the co-operation of the patient’s family than is the adult therapist as a rule. If the patient is a young child it is usually the mother, sometimes the father, who has to bring the child to treatment; the older child or adolescent still needs parental backing and encouragement at times to continue during difcult periods.

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18: The family circle

Esther Bick Harris Meltzer Trust ePub

(1967)

A series of four articles written for New Society in conjunction with Mary Douglas, Reader in Social Anthropology at University College, London, who wrote complementary articles from an anthropological perspective. The series is headed: “In this special four-week series, a psychologist and an anthropologist look at the ‘outer circle’ of family relationships which are too often left unexplored: brother/sister; grandparent/grandchild; in-laws; aunts, uncles and cousins.” It bears witness to Martha Harris’ emphasis on understanding the wider social and developmental context of personality growth, as borne out by the personality development seminars which she instituted for child psychotherapy trainees.1 During this period she was also preparing a series of small books for parents on children’s personality development (the first Tavistock Clinic series), published in 1969. There are a number of autobiographical illustrations in these books and articles. Martha Harris was involved with all the books in the Tavistock series and wrote Your Eleven Year Old, Your Twelve to Thirteen Year Old and Your Fourteen to Sixteen Year Old (1969; these were republished in 2007 as Your Teenager). Other editors in the series were Christopher Dare, Dilys Daws, Elsie Osborne, Edna O’Shaughnessy, and Dina Rosenbluth.

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