From Klein Forward

By David E. Scharff, M.D.

Psychoanalysis is in a state of evolution. It is almost as though if we don’t keep up with the advances in neuroscience, attachment theory or latest research on the validation of psychotherapy, we can’t do our daily work. But at the same time that there is such an explosion of research, one of the most important findings is precisely the validation of our work, of the basic kind of work that analysts and analytic therapists have been carrying on for the last hundred years. I believe that this hearkens back to Fairbairn’s thesis that the foundation of analytic potential lies in the therapeutic relationship itself, because without that, none of the other things that promote change have any effect. We can include in those elements of therapy that support growth the genetic reconstruction of early developmental experience, transference interpretation, the use of countertransference as a “global positioning system,” the patient’s acceptance of her own projective identifications, the understanding of the co-construction of emotional experience in therapy, and the support therapy offers for deficits in early experience. All of these are important. They are all building blocks for change. Even the offering of support and advice, long relegated to the mere ranks of supportive psychotherapy, can offer something to patients attempting analytic work, given at the right times and in the right dose. But fundamental to the whole system is that the therapist offers herself as a person – even though she is a person in a role – who is dedicated in that role to the growth of her client or patient. She is in the growth and development business in a very personal way, even when she is being most professional.

Today I want to go back to another element of our roots, to the work of Melanie Klein, whose work was for many years disparaged in the United States, only to be widely embraced in the last 30 years. Jim Grotstein, Jay Greenberg and Steve Mitchell, Otto Kernberg, Roy Schaefer and many others brought these ideas across the Atlantic. Jill Scharff and I followed Henry Dicks of London in applying her ideas to couple and family therapy, combining her discovery of projective identification with Fairbairn’s idea of a psyche made up of multiple self-object units, and since then have written extensively about projective and introjective identification in all aspects of development, pathology and treatment.

Today, I want to re-evaluate her contribution in the modern context. First her emphasis on early development. Klein posited an infant and young child whose mind was formed in bodily terms, and especially in terms of sexual conflict. She envisioned a child focused at first on her mother’s breast as good or bad, and soon seeing her parents locked in intercourse of an oral sort, the mother capturing the father’s over-valued penis. It was the dramatically worded body language that drew much attention, but the controversial parts also included the early dating of triangular conflicts – the early oral Oedipus – to times within the first year. So what do we think now of these controversial elements?

I think she was undoubtedly right that the young child, within the first year, does have an experience of the parents as a couple, and begins to “think” of herself in relationship to them as a pair. But are things so sexual? Probably not. Is the thinking in terms of bodies? Probably. The infant is very much body-based, and modes of thinking do echo the signals coming from inside her own body, and from its handling by the parents. But I think that Klein was analyzing children who were almost three years old – young by the standards then of course, but old enough that these children had already been sexualized from hormonal and cognitive development. Then she read the material from these relatively advanced children backwards into their infancy, and made an error of inference. So is early thinking triangular? Yes. Is it intensely sexual? Probably not. But early thinking does influence sexual thinking as it blossoms in the third and fourth years, and the sexual versions the child creates do reflect triangular thinking, which is sexualized from that point on.

Klein posited two modes of thinking that organize life from the earliest months: the Paranoid/Schizoid and Depressive Positions. In the first, the paranoid/schizoid, life is divided into good and bad, black and white, as absolutes. There isn’t much grey, and the object world is handled by the tendency to guard things inside or project them in paranoid or projecting mode into the outside. Persecuting inner objects are felt to offer persecution from the outside because of the child’s use of projection. It was in writing about this mode that Klein first understood projective identification – the mode of thinking in which the child (and actually all of us) locate parts of our own psychic processes in another person with whom we have established intimate emotional relations. Klein originally thought this process allowed the child to off-load an excess of aggression, to make his own inner world less toxic, but we now see it as an all-purpose mechanism of unconscious communication, in which each of us seeks to unconsciously communicate our emotions, fears, wishes, fantasies and inner organizations of self and object to the other person by finding unconscious resonance with her mind.

To this we have added an equal emphasis on introjective identification: that the mother or spouse takes in the unconscious communication, identifies with it, subjects it to her own processing (all still unconsciously) and feeds it back in a continuous cycle of mutual projective and introjective identification. I said a moment ago that Henry Dicks understood this to be the basis of marital intimacy and formulated it as the forerunner of a general theory of interpersonal communication. So did Wilfred Bion, who took this another step forward to make the continuous cycle of projective and introjective identification the basis for the origin of the infant’s mind. Mind is, we can now see, the product of continuous unconscious communication (mainly about affects and their regulation) between child and parent. Conscious communication, we now understand due to the neuroscience writing of Alan Schore and others, comes much later.

So here’s where the neuroscience comes in. In the last 20 years, Gallese and others have described the presence in the motor cortex of the brain of “mirror neurons” that mimic an observed action right next to the motor neurons that we fire if we actually perform an action. Now, since all emotions involve some sort of motor discharge (muscles, hormones, the autonomic nervous system,) this gives the mirror neurons a central role in the communication of emotion. The purpose of these mirror neurons, to paraphrase Gallese, is to instantiate a shared manifold of subjectivity – that is, the other person’s emotional experience is installed deep within our own mind in a way comparable to the way our own emotional experience is represented there. In short, Klein’s “wild ideas” about the communication of emotion have been fully upheld by modern neuroscience – and can now be seen to be the fundamental basis of the growth of mind.

When Klein posited her second fundamental state of mind, the Depressive Position, she wrote that it was the basis for a more integrated view of the other person. It includes the capacity for concern for the other, the ability to feel that the mother who has mistreated you is also the one who loves you, and a potential for guilt. It is a more mature position, but not a better one. We all need both. In the paranoid/schizoid position (aren’t the terms terrible?) we can sort things, divide, parse things, see qualities that contrast. In the depressive position, we can integrate and join affect with that more integrated view, we can work on healing rifts. Later Thomas Ogden added another position, which he thinks (and I think) comes before the paranoid/schizoid. He calls it the autistic/contiguous position, maintaining the penchant for obscure terms. But what he means by this is crucial: that the infant, and all of us throughout life, worry about the cohesion of our self, and we manage this psychically by pulling away from our objects into ourselves at times (the autistic pole,) and at other times by leaning against the edges of other people (the contiguous pole) and that we all move back and forth along this continuum. I do believe that self cohesion is a life long worry, and that it is at least equally fundamental to the other positions of mind. Ogden makes the convincing argument that all three positions exist all the time – all three groups of mental concerns exist all the time, but that at any one moment, one of them may be dominant and seen to be the principal organizing mode of someone’s psyche. This complex formulation fits with the most modern ideas of the organization of mind as a set of complex functions widely distributed throughout the brain and the mind, with the highest and most abstract functions overseen by executive function in the prefrontal lobes. The writing of Herbert Rosenfeld on pathological positions, and the subsequent work of John Steiner on what he called psychic retreats, both give us language for the perversion of these modes of thinking that represent a short circuiting of the normal fluidity between the three developmental positions in mental states of severe pathology.

There is much more of our work that derives from Melanie Klein’s ideas, all formulated from the 1920s through the 1950s: Her work on envy and gratitude that came late in her life, and her invention of ways of working with the psychological life of young children that was among her first contributions. But I think we have covered enough for one posting.

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