“An Unconventional Psychoanalytic Education”

 

Joel Kanter, MSW, LCSW– C

This article is re-printed here with the kind permission of the author. It appeared first in the American Association for Psychoanalysis in Clinical Social Work’s  Spring, 2017, Newsletter at  www.aapcsw.org

Joel Kanter who is based at Silver Spring Maryland USA can be contacted about this article by email. His address is joel.kanter@gmail.com

 

Fraiberg’s earliest experiences in social work involved public assistance and “child placement”: the latter included finding homes for refugee children from Nazi Europe.She credited these experiences with teaching her the basics of interviewing and listening. But as she continued her graduate social work education at Wayne State University, she had the good fortune to encounter three refugee analysts from Vienna who taught in the social work program: Richard and Editha Sterba and Fritz Redl.

Fritz Redl, the most central of these three analysts during Fraiberg’s years of graduate education at Wayne State, received his PhD in philosophy and psychology from the University of Vienna, but did not practice as a psychologist. He taught in a progressive high school; one experience in that role involved taking students on camping trips to facilitate bonding between students and faculty. Soon, he began analytic training with adults and children and was analyzed by Editha Sterba and Jeanne Lampl – de Groot. His adult control case was supervised by Heinz Hartmann and his child training involved Anna Freud, August Aichorn and Marianne Kris (Gottesfeld and Pharis, 1977). Redl came to the United States in 1936 on a two year appointment to study adolescent issues, but he remained after Hitler annexed Austria in 1938. Redl was appointed to teach group work at the Wayne State School for Social Work in 1941 and remained until his appointment in 1953 to become Director of the children’s psychiatric unit at the National Institute of Health. Redl’s early experiences with the social milieu of his students remained as a cornerstone of his analytic perspective. In his view, group work was just an extension of his psychoanalytic identity:

The emergence of child analysis,, for what it claimed to do must have sounded simply crazy and revolting to the first generation of adult analysts. In fact, I have no doubt that, if anybody but Freud’s own daughter had taken such a radical,, revolutionary step, the mere cheek of using the name “analysis” would have been rejected – and no holds barred. For how could one, at a time when the question whether the prone position of the patient makes the difference between analysis or other forms of therapy was still a focal one, allow anything as crazy as what child analysts did to be called by the same name? To wit: no couch, no free association, no positional ritual; no guarantee that the therapist’s aloof attitude can be maintained for more than a few minutes at a time; no guilt about association with family members, or about turning up in the natural habitat of the child patient at times; no contempt of the “ego”” as being merely a “superficial”” part of the personality; no attempt to withhold value judgments entirely, no hesitation at interfering, at times, in the patient’s life – space arrangements; no guarantee against physical contact during the time which therapist and patient spend together in their “pressurized treatment cabin”; and worse – not even a transference neurosis!
How could things like that be called “analysis’? (Redl,, 1963)”.

Fraiberg internalized Redl’s expansive view of psychoanalysis; her identity as a psychoanalyst was never inconsistent with her identity as a social worker, regardless of the parameters involved in any specific intervention. Like Redl, she comfortably moved beyond conventional analytic parameters — ultimately emphasizing the importance of “kitchen table therapy” — while still maintaining her core analytic identity.

As described in Part One of this series, Fraiberg collaborated with Redl in his early group work initiatives at both the Jewish Children’s Bureau and the Fresh Air Camp. In 1946 , she presented her second professional paper “Studies in Group Symptom Formation” at the American Orthopsychiatric Association (Fraiberg,, 1947). In this paper,, Fraiberg applied her emerging analytic understanding to two group situations with children. In one, she discussed a rape fantasy which becomes widespread in a group home for adolescent girls; in the other, she discussed a racial conflict which emerges between boys at the Fresh Air Camp during the summer of the 1943 Detroit race riots. In both situations, Fraiberg addresses the intrapsychic,, interpersonal and environmental dimensions of these group experiences. Years later, in her infant mental health initiatives, she remains attentive to the impact of the “person – in – environment” perspective that is central to social work practice.

While Fraiberg continued her work with children in groups (Fraiberg 1959; Shapiro, 2009)) after receiving her MSW, she also pursued what she described as a “quite unorthodox” psychoanalytic training with the Sterbas. She began a personal analysis with Editha Sterba and continued a series of seminars on psychoanalytic theory with Richard Sterba and on child therapy with Editha Sterba.

The seminars focused intensely on important texts. One studied Freud’s Interpretation of Dreams for two years, including a single year devoted to Chapter Seven alone. One year focused only on the “Little Hans” case and one other reading. Ego and the Mechanisms of Defense. These seminars involved a “close reading of the text” where “each class member took turns reading aloud in what someone once described as a ‘cheder’ ” (Fraiberg1963). Fraiberg described these seminars as “a remarkably good training ” although she acknowledged that an analytic “curriculum needs to be broader..” Nonetheless, Fraiberg argued that there were “advantages…… of this kind of close analysis of psychoanalytic texts and the opportunity to ask questions, clarify obscure points, to discuss and to argue” (FFraiberg,, 1963)).

This training approach was reflective of early experiences of analytic training in Vienna, where young analysts were frequently analyzed,, supervised and educated by the small cadre of more experienced colleagues. When the Sterbas arrived in Detroit in 1939, there were only two or three other analysts in that city; none had the theoretical expertise of Richard Sterba nor Editha Sterba’s clinical training in child analysis..
Soon after her graduation from Wayne State, Fraiberg also began supervision on child analytic work with Editha Sterba. One of her cases was described in “A Critical Neurosis in a Two – and – a – Half Year Old Girl” which was first presented at the Detroit Psychoanalytic Institute in 1949 and later published in the Psychoanalytic Study of the Child (Fraiberg, 1952 ). This case report of over three years of child analytic work began first in the home in 1945 or 1946, but soon transitioned to a consulting room. he work presents the case in great detail with near verbatim descriptions of the analyst – child interactions and is rife with interpretations of genital fantasies, primal scenes and oedipal conflict.
During these postwar years, Fraiberg began working with an array of young children, ages 12 to 24 months, with sleep disturbances, culminating in her first publication in an analytic journal (Fraiberg,, 1950)). In contrast with the case described in the “Critical Neurosis”” paper (Fraiberg,1952)), this paper offered evocative descriptions of these children uncluttered by psychoanalytic theory:

‘]At twelve months Jimmy began to waken several times a night with terrifying screams. He clings to his mother as if he cannot bear to let her go. For hours he lies in her arms, tense and fearful. The beginning of his night waking coincides with the period in which his older sister begins vicious and savage attacks upon him. ….. Peter, at sixteen months, wakes several times a night with cries of terror. He is often sleepless for hours. The night waking came on soon after the mother returned from the hospital with a new baby (Fraiberg, 1950, p.. 286).

Fraiberg described these sleep disturbances as a response to an array of traumatic experiences:

in the case of fifteen – month – old Danny, the night waking followed an ordinary visit to the doctor’s office where he had protested violently against a throat examination and was restrained. He screams in his sleep before waking, “Let me down! Let me down!” as he had cried out on the examining table (Fraiberg, 1950, p. 286).

And Fraiberg’s literary voice emerges in this paper:

… the child of this age is confronted with a vast array of overwhelming forces. Many of these are unpredictable and beyond his comprehension. He stands up and a nameless force throws him down. He climbs on the chair and the temperamental piece of furniture spills him to the floor. He wants the lamp and the lamp wrestles with him, only to send him crashing to the floor a moment later. His brother kisses him tenderly; his brother delivers a healthy blow to the side of his head. Mama is pleased when he eats his carrots and displeased when he eats the contents of his potty. Some of these factors, while retaining their unpredictability, will yield to scientific investigation.. The second – year child begins to learn, for example, that departure is usually followed by return (Fraiberg, 1950, p. 287).

Alongside therapeutic work which appears less intensive than an actual analysis, Fraiberg is actively engaged with the mothers of these children, frequently offering them direct developmental guidance that can address their child’s anxieties that presages the work with high – risk infant – mother dyads near the end of her career.

In 1950, Anna Freud travelled to the United States for the first time;; a visit which perhaps elevated Fraiberg’s stature in the analytic community. Freud first spoke at the New York Psychoanalytic Society, then at Clark University and next at the first postwar conference on child analysis at the Austen Riggs Foundation in Stockbridge, Massachusetts. Her trip concluded at the Annual Meeting of the American Psychoanalytic Association in Detroit (Bulletin APsaA,1950a). On the first day of the conference, there was a special meeting of the Committee on the Psychoanalysis of Children and Adolescents which was only open to members of the American. Fraiberg, then 32 years old, was selected to present her paper “ Clinical Notes on the Nature of Transference in Child Analysis ” (Fraiberg, 1951); Anna Katan chaired the session and Marianne Kris and Editha Sterba were discussants. In this paper, she presented case material from two children and compared Anna Freud’s and Klein’s view of transference in child analyses; unsurprisingly, she supported Miss Freud’s perspective on this issue. The official report of the meeting stated that:

Miss Anna Freud corrected her original view that no transference neurosis takes place in child analysis. She stated that the earliest experiences and relationships of the oral phase which have already undergone repression and are separated from the original objects appear as transference phenomena in the analysis of children, similar to what we call transference neurosis in adult analysis. She approved of Mrs. Fraiberg’s concept of extension of the original relationships into the analytic relationship which leads to appearance of transference phenomena but not of a transference neurosis (Bulletin APsaA, 1950b).

Undoubtedly, even though her training involved only five years of unconventional preparation, her maturity as a child analyst was already evident.Yet, the Detroit psychoanalytic community was clearly uncomfortable with lay analysts in private practice. By the early 1950’s, there were approximately 20 psychoanalysts in Detroit registered with the American Psychoanalytic Association; 12 had been analyzed by Richard Sterba and 2 by Editha Sterba. There was considerable unhappiness with Richard Sterba’s leadership of the Institute and the American appointed a committee to travel to Detroit to carefully investigate.. The committee found an institute torn by dissention and angry with Dr. Sterba’s reluctance to select other training analysts; even 8 of his 12 analysands openly disapproved of his leadership. One section of the committee report was titled “The One – Man Institute” (Report of the Subcommittee, 1953).
Another section of the American’s report was titled “The Training of Layman” and read as follows:

Dr. and Mrs. Sterba have freely expressed their opinion that medical training is not a necessary prerequisite for the practice of psychoanalysis. They have even depreciated the role of medicine in its relation to psychoanalysis…….. It is also known that a number of lay people have had both analyses and seminars with Dr. and Mrs. Sterba.. (They) told the subcommittee that they have trained only those laymen who would work adjunctively in educational or remedial activities. In contradiction to this statement, there is much evidence that a number of these layman did undergo “training”” and that some of these people are now practicing psychoanalysts with both children and adults (Report of the Subcommittee,1953).

Similarly, the Detroit Psychoanalytic Society established its own committee on lay analysis which reported that the Sterbas had been conducting their own seminars in psychoanalysis outside the formal structure of the Detroit Institute. The committee was even more concerned that several of these lay analysts were openly in private practice in violation of Michigan state law and that the Institute’s collusion with this practice put the whole organization in legal jeopardy. This report stated that these lay analysts in private practice had been invited to
all non – business meetings of the Society and also that “most members of our Society have referred patients to these lay people”. All training of lay persons was abruptly discontinued as was a seminar taught by Fraiberg herself (Committee on Lay Analysis,, 1953).

In December 1953,, the Board of the American Psychoanalytic Association accepted the recommendation of its investigating committee and the Detroit Institute was no longer allowed to train candidates. Several months later, in an internal “coup”, a majority of the Detroit Society voted to affiliate with the Wayne County Medical Society. As a result, any Society member who was not also a member of the local Medical Society was effectively expelled; this pointedly included both Editha Sterba and Fritz Redl.
Yet, Fraiberg’s analytic talents continued to be recognized by the American Psychoanalytic Association. She was appointed a “special instructor” at the New Orleans Institute in 1959, presented at the Baltimore Institute’s conference in 1960; soon after Baltimore requested a waiver to allow her to supervise trainees in child analysis:

The Committee described an exhaustive review of Mrs.. Fraiberg’s record, curriculum vitae, publications, and qualifications. They had interviewed her, and attended a case seminar which she conducted. Its report details the reasons for the unanimous recommendation of the
Committee that the waiver be granted,, and the Board acted in accord with its recommendation  (BBulletin APsaA,1962).
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Finally, in 1971, Fraiberg accepted, along with a dozen other lay analysts, an invitation for membership in the American Psychoanalytic Association (BBulletin APsaA, 1972).
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References:

Bulletin American Psychoanalytic Association (1950a), Anna Freud in America. 6C(3)):1 – 3

Bulletin American Psychoanalytic Association (1950b), Annual Meeting:
Report of the Meeting of the Committee for the Psychoanalysis of Children and Adolescents, 6D(4): 67 – 71

Bulletin American Psychoanalytic Association (1962), Fall Meetings — December 1961, 18:423.

Bulletin American Psychoanalytic Association (1972), 28: 419.

Fraiberg, S . (1947): Studies in Group Symptom Formation, Am J Orthopsychiatry, 17 (22), 278 – 289..

Fraiberg, S . (1950)) On the Sleep Disturbances of Early Childhood, Psychoanalytic Study of the Child, 5: 285 -309.

Fraiberg, S . (1951), Clinical Notes on the Nature of Transference in Child Analysis. Psychoanalytic Study of the Child,, 6: 286 – 306

Fraiberg, S . (1952). A Critical Neurosis in a Two – and – a – Half Year Old Girl. Psychoanalytic Study of the Child,, 7: 173 – 215..

Fraiberg, S. (1959)). An Appraisal of Group Methods in Casework Agencies. In Group Methods in the Practice of Casework. Tulane University School of Social Work.

Fraiberg, S. (1963)). Personal correspondence with Ilse Judas.. February 20, 1963.

Gottesfeld, M. & Pharis, M. (1977). Profiles in Social Work. Human Services Press, New York..

Redl, Fritz (1963). Psychoanalysis and Group Therapy: A Developmental Point of View.. Am J Orthopsychiatry, 33: 135 – 147.

Report of the Subcommittee on the Detroit Psychoanalytic Insitute, American Psychoanalytic Association, 1953.

Report of the Committee on Lay Analysis, Detroit Psychoanalytic Society, 1953.

Shapiro, V. (2009). Reflections on the work of professor Selma Fraiberg: a pioneer in the field of social work and infant mental health. Clinical Social Work Journal. 37: 245 – 255

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