Abstract
A Child Analysis with Anna Freud, a collection of Anna Freud’s detailed case notes of her treatment of the young Peter Heller between 1929 and 1932, was first published in English in 1990. Not only does this work give us direct access to Anna Freud’s ways of thinking and working at a crucial period in the early history of child analysis; it is also one of the few records of an adult reflecting in depth on the experience of being in analysis as a child. Yet to date this work has received little attention in the psychoanalytic literature. In an attempt to redress this neglect, the Heller case study is placed in the context of Anna Freud’s emerging ideas about child analysis. In particular, its significance in the development of her psychoanalytic thinking is investigated in the light of her 1927 book, The Technique of Child Analysis.
In November 1972, Peter Heller, a professor of comparative literature at the State University of New York at Buffalo, received a letter from London. It was from Anna Freud, and included in the letter was a bundle of poems Heller had written as a young boy growing up in Vienna in the inter-war years. Anna Freud had collected these poems—and preserved them for over forty years—as part of her record of the analysis Heller had undertaken with her starting in 1929, when he was nine years old. In the letter Anna Freud explained that she had also kept all his drawings, short stories, and various jottings from the time, along with her complete notes on the course of the three-year analysis. She asked Heller if he wished her to leave him the notes upon her death or have them destroyed—as she had destroyed almost all her notes on her other child analytic cases.
In responding to the letter, Heller asked if she would send him the materials directly, rather than having them sent after her death. After a lengthy correspondence, a package containing the complete notes of the child analysis reached him in early 1974. Receiving these notes was to have a profound effect on the next twenty years of Heller’s life. On reading through them, he decided—initially against Anna Freud’s wishes, but ultimately with her consent—that he wanted to publish them as a book, alongside his own commentary on the analysis.
Heller’s experience was unique, not only because he had been in analysis with Anna Freud at a formative period in both his own life and in the professional life of Freud herself, but also because he had simultaneously been a pupil at the experimental “Matchbox School” (also known as the Hietzing School), which Freud and her colleagues had established in 1929 (see Heller 1992a; Midgley 2008). After his escape first to Britain and then to the U.S. following the Nazi rise to power, Heller continued to live a life intertwined with that of Anna Freud and her psychoanalytic circle—first marrying (and later divorcing) Tinky Burlingham, a fellow student at the Matchbox School and the daughter of Anna Freud’s companion, Dorothy Burlingham, and then undertaking a subsequent analysis, as a young man in the U.S., with Anna Freud’s colleague Ernst Kris. In his professional life as a professor of German and comparative literature, Heller continued to be influenced by psychoanalytic ideas (see, e.g., Heller 1978), while in his personal life he continued to struggle with some of the complex issues that were first identified in his child analytic treatment with Anna Freud all those years ago.
Heller’s book Eine Kinderanalyse bei Anna Freud was published in German in 1983, co-edited by Günther Bittner. A somewhat modified version of the book was subsequently published in English in 1990, titled A Child Analysis with Anna Freud. The work is of significance, not only because it is one of the only surviving documents that gives us direct access to Anna Freud’s ways of working at a crucial period in the early history of child analysis, but also because it is one of the few records of an adult reflecting in depth on the experience of being in analysis as a child. While the value of the work was acknowledged in reviews of the book at the time it was published in English (e.g., Ornstein 1994; Weiss 1992; Novick and Novick 1992), to the best of my knowledge there have been no substantial studies of the work undertaken since its publication, and certainly none that have attempted to examine what this work can teach us about the early history of child analysis. Perhaps this is because of the extremely complex and ambivalent picture that Heller himself paints of his child analysis and his wider experience of the world of psychoanalysis. Or maybe it is a reflection of the relative neglect that Anna Freud’s work has suffered since her death in 1982.
Either way, the silence surrounding this important historical work in the psychoanalytic literature is striking, even in recent studies of Anna Freud’s contribution to child analysis (e.g., Edgcumbe 2000; Holder 2005; Young-Bruehl 2008). This despite the fact that Anna Freud herself commented that the notes on this case “were more extensive than any I made about any of my other cases of child analysis” (quoted in Heller 1990, inside flap), and that the surviving case notes are uniquely accompanied not only by a full record of the drawings and poems the young patient made, but also his later recollections of the treatment—both in the book and in a subsequent article (Heller 1992a). And though this account, as Heller himself acknowledges, may be distorted or motivated by unconscious motives, “only patients may tell reliably what analysis really ‘feels like’” (p. 54).
Here I will attempt to redress the neglect of this work in the history of child analysis by placing the Heller case study in the context of Anna Freud’s emerging ideas about child analysis, and investigating its significance in the development of her psychoanalytic thinking. I will also briefly explore Heller’s own reflections on the case and consider what significance these have for our understanding of the early history of child analysis.
Background and Brief Overview of the Child Analysis of Peter Heller (1929–1932)
Peter Heller was referred to Anna Freud at the beginning of 1929, at a time when child analysis itself was still in its infancy. Freud, having trained initially as a teacher, only began working analytically with children in 1923, building on the pioneering work of Hug-Hellmuth and others (Giessmann and Giessmann 1998; Young-Bruehl 2008). Yet in this short period of time she had already become established as a major figure in the field of child analysis, leader of the “Vienna School” of child analysis and author of the controversial book, The Technique of Child Analysis (1927).In that book, based on a series of lectures she had given the previous year, Anna Freud used her clinical experience of analyzing ten latency-age children to set out the basic principles by which she believed a child analysis could take place. In particular, she stressed the fact that child analysts needed to take into account the fundamental difference between adults and children, namely, that the “adult is—at least to a considerable degree—a mature and independent being, while the child is immature and dependent” (A. Freud 1927, p. 5). As we will see, this had a number of major implications for how she approached psychoanalytic work with children.
The Technique of Child Analysis immediately made a considerable impact on the psychoanalytic community, and was the subject of a vigorous critique by Melanie Klein and her colleagues at the “London Symposium” on child analysis in 1927. Apart from her Four Lectures on Psychoanalysis for Teachers and Parents, published in 1930, Anna Freud was not to publish any other major work until 1936, when The Ego and the Mechanisms of Defence first appeared. It was during this period, between the publication of the two major works from her time in Vienna, that Peter Heller began his intensive (five sessions a week) analysis with Anna Freud. The notes she made on this treatment, although they are not detailed process recordings, represent one of the few records of her clinical development during this crucial period.
Heller’s sessions took place in Anna Freud’s consulting rooms at Berggasse 19, the Freud townhouse, in a room at the end of a dark passage, with her large desk and a couch covered with a carpet “and brown cloth antimacassars at head and foot” (Heller 1990, p. xxii). In the reminiscences published alongside the case notes of his treatment, Heller remembers Anna Freud as “a young woman, rather pretty and delicate, dark-eyed, with that pure and penetrating gaze which she retained even in old age’ (p. xxii). Heller recalls how, while he was waiting for a session, the ill and elderly Sigmund Freud would sometimes pass by, bent-over and frail, yet with a cheerful air. Heller remembers how Freud would sometimes pat him on the shoulder, saying “So groß, so groß” (“how you’ve grown”), which the young boy felt showed “the typical stupidity of a grown-up” (p. xxii), while at the same time it touched on the very anxiety that so occupied him—that of being a “big man,” a great man.
Looking back more than fifty years, Heller describes himself at the time of starting his analysis as a “stocky strong little boy with black curly hair, slovenly and spoilt, pugnacious and anxious; who sometimes acted and thought of himself as a poor, piggish soul, and sometimes as an ‘immortal’” (p. xxi). Living in a beautiful villa in an affluent district of Vienna, the young boy grew up in a liberal, enlightened environment in which sexual freedom and psychoanalysis were natural parts of the atmosphere. Peter’s father was educated, cultured, and well-off—equally familiar with the work of Marx and Freud, radical politics and radical self-examination (pp. xxxiii–xxxiv). Heller describes his mother as “a dashing, elegant young woman (fesch, as one would say in Vienna) with dark hair, large expressive, dark eyes, and a slightly oversized nose about which she was unhappy. . . . She had intense intellectual and artistic interests . . . and tended to be radically open and, occasionally, embarrassingly exhibitionistic in her reporting of intimate details” (p. xxxix). Although her later life was deeply unhappy (she would ultimately commit suicide, as her own mother had done), at the time of his referral Heller’s mother (whom he referred to as “Mem,” “Menga,” or “Memka”) seemed glamorous and daring to her little boy.
Peter’s parents had fallen in love when they were both quite young, but the relationship deteriorated in the years after Peter’s birth, as both took other lovers. They separated when he was four years old, though they kept up a semblance of a marriage for several years after this, despite his mother’s long absences. Unusually for that time, part of the separation agreement was that Peter would live with his father, while his mother moved back and forth between Vienna and Berlin (where her lover lived), appearing and disappearing from Peter’s early life with regular irregularity.
Peter’s young life was deeply caught up with the world of Viennese psychoanalysis. As well as attending the Matchbox School, where his principal teachers were Peter Blos and Erik Erikson (both of whom went on to become leading psychoanalysts), Peter’s governess was Thesi Bergmann, who went on to train as a psychoanalyst in Vienna before working first with Anna Freud in the Hampstead War Nurseries and then immigrating to Cleveland, where she became an eminent therapist and instructor. It must be kept in mind that Heller’s analytic treatment was therefore but one aspect of a broader “psychoanalytic upbringing,” his therapy sessions combining with his broader education at the Matchbox School, not to mention his subsequent personal relationship with the Burlingham family, of which Anna Freud was effectively a part (Heller 1992b; Young-Bruehl 2008).
It was in this context that Heller was referred by his father (who was in analysis himself at the time with Ludwig Jekels) for psychoanalytic treatment with Anna Freud. It seems that Peter’s attendance at the Matchbox School coincided with his analytic treatment, so that he was able to build his sessions into the daily routine of the school. The primary reason for Peter’s referral was pavor nocturnus (night terrors). In her preliminary notes on the case, Anna Freud wrote that the boy
described [his attacks] as follows: He wakes up at night from his sleep, stands in his bed with eyes wide open as if he saw something, and usually cries out, ‘Please, please, please don’t.’ During the day too he is afraid when he goes through the dark hallway; and of death; and that he might be reborn into this world as a weak child. Otherwise he is very cheerful and trusting [p. 3].
In his retrospective notes, Heller himself describes the anxiety dream that left him screaming, if not most nights, then “often enough.” In it, he is “walking on the edge of white gravel, along the rondelle, the circular path round the big oval pond of the upper Belvedere Gardens, humming and whistling. A big blue-black machine with handles and shafts comes towards me. I cannot get out of its way. It seizes me, draws and presses me with its iron rods into its shafts and grinds me up so that I cannot stop screaming until, at last, voices from afar penetrate like drops, through a black, resounding thicket, calling my name, first softly, then louder” (p. 281).
Anna Freud’s analysis of Heller lasted just over three years in total. The first fifteen-month period of treatment is described in some detail, and is divided in the notes into nine “phases,” each summarized briefly in her records and given a title. In April 1930 the analysis came to an end, but five months later it was resumed, apparently after Peter’s mother suffered some sort of psychological breakdown that summer. Anna Freud reports that her young patient suffered a relapse in his symptoms—the night terrors returned and his urge to see (and be seen by) men in the public toilets resurfaced—which led him to resume his analysis, which continued (though with rather less detailed notes by Anna Freud) for at least another eighteen months. The analysis broke off during the Easter holidays of 1932, for reasons not entirely clear. The Matchbox School was being disbanded around this time, and Peter was soon sent to a much more traditional public secondary school. It may be, then, that the analysis came to an end along with Peter’s attendance at the Matchbox School. Anna Freud’s notes also suggest that Peter’s parents’ support of his treatment had significantly reduced by this point, which may have made continuance of the analysis difficult. Or it may be that Anna Freud felt that the treatment had gone as far as it could go. Whatever the exact reason, at this point the child analysis comes, somewhat abruptly, to an end.
Anna Freud gave a lengthy presentation on the case of Peter Heller at the Psychoanalytic Association in Budapest, probably in 1930 (Heller 1992b, p. 88), the record of which is unfortunately now lost; but except for a brief mention of the case in The Ego and the Mechanisms of Defence (1936), Anna Freud never published an account of the analysis. However, there would have been a number of reasons why she would have welcomed the opportunity to investigate a case of pavor nocturnus at this point in her development as a child analyst. Not only were night terrors an extremely common symptom among children, but they brought to the fore the question of children’s anxieties and how they could best be understood. Melanie Klein had recently made references to pavor nocturnus in “The Psychological Principles of Infant Analysis” (1927a), where she argued that the night terrors suffered by “Rita” during her second year of life could be understood in relation to the primitive oedipal situation and destructive phantasies related to the mother (p. 29).
In this context, the analysis of Peter was an opportunity for Anna Freud to investigate at close hand the significance of night terrors and to see how her own understanding related to that of Melanie Klein, especially in the light of her own emerging interest in the role of the ego and the mechanisms of defense. It was also an opportunity to further explore her ideas about the appropriate technique for child analysis, and implicitly throughout her notes on this case one can see how the ideas that she set out in her 1927 lectures were played out in practice over the course of an intensive psychoanalytic treatment.
In discussing the analysis of Peter Heller, I will therefore organize the material in relation to the four topics that Anna Freud addressed in The Technique of Child Analysis: the preparation for child analysis; the methods of child analysis; the role of transference in the analysis of children; and the relationship between child analysis and the upbringing of children. In her subsequent career, Anna Freud never published a detailed case study of her work to compare with Klein’s Narrative of a Child Analysis or Winnicott’s The Squiggle. This situation has left many commentators unclear as to exactly how Anna Freud’s ideas about the technique of child analysis would manifest themselves across the course of an entire treatment. In addition to illustrating her approach, I will also suggest that the problematic ending of young Peter’s analysis may have had a significant impact on Anna Freud’s thinking about child analysis, and had an important influence on subsequent developments in the field.
Much rested, then, on this treatment—both for little Peter and for Anna Freud—and for the development of child psychoanalysis.
Revisiting Anna Freud’s Approach to the Technique of Child Analysis
Early Stages of Treatment: The Preparation for Child Analysis
In the first chapter of The Technique of Child Analysis, Anna Freud had argued that since children rarely refer themselves for treatment, and in many cases it is those around them who are more concerned than the children themselves, a “preparatory period” was necessary to help make the child “analyzable.” She saw this period as an opportunity to help the child gain confidence in the analyst, becoming an ally while simultaneously helping the young person gain a degree of insight into his or her disturbance.
Anna Freud’s views on the preparatory period had been strongly criticized by Klein and her colleagues during the Symposium on Child Analysis held in London in 1927. In relation to her ideas about the initial stages of treatment, Joan Riviere (1927), for example, argued that the conscious wish for a cure is not a significant part of either child or adult analysis, while Klein (1927b) argued that “it is a grave error to ensure for ourselves a positive transference from the patient by employing such measures as Anna Freud describes. . . . It would appear obvious that after this ‘breaking-in’ she will never wholly succeed in establishing a true analytic situation” (p. 343).
The notes on the treatment of Peter Heller give us the first opportunity to see how Anna Freud responded to this powerful critique of her ideas about the opening stages of a child analysis. Although the notes are not detailed accounts of each session, what is clear is that Anna Freud wastes no time in beginning the analytic work. By the second week of treatment young Peter is already lying on the couch, recounting his dreams and being invited to associate to them, with Anna Freud sitting behind him, in direct imitation of the analytic setting for adults. From her summary of the first two months of treatment, we can see that Anna Freud has already made a fairly complete formulation of Peter’s neurosis—interpreting both his symptoms and his major preoccupations (with literature, great writers, his parents) in oedipal terms. In her notes she summarizes what she has learned from this first phase in a condensed way:
relationship to parents as an outcome of normal oedipal relations, curiosity displaced onto books, jealousy on plans for the future, fear of father on fear of death [p. 5].
It is in Heller’s reminiscences that we get a clearer sense of the way in which Anna Freud began the analysis by trying to build some kind of positive relationship with her young patient, while at the same time moving quickly to the core of her analytic interest. Looking back, he describes how Anna Freud “impressed [him] right away as a beautiful and interesting grown-up, commanding respect” (p. 288). He remembers how they sat at a small table during their first meeting and played tiddlywinks together, but that from the start there was another agenda to the meetings:
At first, I recall, it was all rather pleasant: She was not one of those silly grown-ups, but natural in her ways, and one felt almost free in her presence without being encouraged or provoked to be naughty. But I also remember the disappointment, the irritation, the humiliation which I thought I felt for her and me when she began to aim at a subject that seemed quite improper and embarrassing to me. ‘How,’ she asked, ‘can you tell the difference between boys and girls?’ [p. 288].
Heller goes on to describe how Anna Freud began to use the tiddlywink counters to portray the sexual anatomy of boys and girls, and made links between this and the “sex games” that Peter had played with his young cousin Madi for some time before being discovered by his nurse when he was four years old. As Heller himself notes, in bringing in the topic of sexuality and sexual difference in this rather direct way, Anna Freud “aimed, straight as an arrow, at [his] sore point with her question, to perplex [him] deeply, and perhaps to startle [him] out of a hypocritical pretence of modesty” (p. 289).
The picture we get from Anna Freud’s notes and Heller’s reminiscences suggests that Freud clearly worked hard to establish a “therapeutic alliance” with young Peter, but she also began the interpretive work of psychoanalysis from the very first sessions. In these early sessions, she focused on interpreting some of the resistances that young Peter showed to the emergence of unconscious wishes, without directly interpreting his sexual or aggressive impulses. Her aim, it appears, was not simply to build a trusting relationship with this young boy, but also to identify a central psychodynamic formulation, which would become the focus of the subsequent analytic work, and in particular to establish a focus on the defensive strategies Peter was using to manage his conflicts.
It was not until 1946, however, that Anna Freud publicly acknowledged this shift in her technique, when in her preface to the English translation of The Technique of Child Analysis she spoke of “ways and means to uncover and penetrate the first resistances in the analysis of children, whereby the introductory phase of the treatment is shortened and, in some instances, rendered unnecessary” (p. xii). She credits the work of Berta Bornstein (1945) for this change in technique, by which a focus on the child’s resistances and typical means of defending against anxiety were seen to replace the need for a preparatory phase. What is clear from the notes on the treatment of Peter Heller, however, is that Anna Freud had already begun making this change in her analytic technique as early as 1929.
Playing, Dreaming, and Interpretation: The Methods of Child Analysis
Although Anna Freud had emphasized the important differences between the analysis of the adult and the child in her 1927 lectures, what is perhaps most striking when one looks at how she approached the work with the nine-year-old Peter is how closely it is modeled on the techniques of adult analysis—offering him the couch rather than a box of toys, emphasizing speech (free association and dream interpretation) rather than play as the primary means of communication. Although young Peter was given materials with which to draw (as the large number of pictures included in the book testify), this analysis is conducted primarily through words. As well as Peter’s speaking about his life and thoughts, the notes often refer to his bringing in stories he had written at home (some of which are presented in the book) and reading them aloud in session, alongside poems that he had discovered and wanted to share with his analyst.
Anna Freud’s lectures in The Technique of Child Analysis had made it clear that she was cautious about the priority given by Klein and her “London School” colleagues to using play as the primary medium of working with children. This is reflected in her work with Peter, where it appears that other than drawing supplies she did not provide play materials. But her reasons for not emphasizing the use of play were complex, and her view in the 1927 lectures, that children’s play should not be seen as equivalent to the free association of adults, has been frequently misunderstood. Contrary to what is often supposed, Anna Freud agreed with Klein that play probably gives more direct access to the child’s unconscious fantasy life than the adult’s free association ever can; her concern was precisely that, as she put it in 1936, this would be therapeutically retrogressive:
The dreams and day-dreams of children, the activity of their phantasy in play, their drawings and so forth reveal their id-tendencies in a more undisguised and accessible form than is usual in adults. . . . But when we dispense with the fundamental rule of analysis, the conflict over its observance also disappears, and it is from that conflict that we derive our knowledge of the ego-resistances when we are analysing adults. . . . There is therefore a risk that child-analysis may yield a wealth of information about the id but a meagre knowledge of the infantile ego [pp. 40–41].
Anna Freud’s concern, then, was that a focus on the unconscious phantasies that emerge through play would too easily bypass the child’s immature ego. From her perspective, the child analyst should be equally interested in the repressed instinctual drives (which play reveals very clearly) and the unconscious working of the ego (which, she believed, play mostly bypasses). Without such a dual focus, she argued, there was a danger of returning to the “pre-psychoanalytic” days when Sigmund Freud had used hypnosis to assist his patients to quickly access repressed memories, but without helping them integrate such memories into their whole personality.
We can see in the treatment of Peter that Anna Freud is always trying to hold a position at an equal distance from the id, the ego, and the demands of the outside world. While a great deal of her analytic focus is placed on uncovering the repressed impulses (especially those derived from the oedipus complex), she is equally interested in the way in which Peter is trying to deal with those impulses, using defense mechanisms such as “restriction of the ego” or “regression to anality.” Alongside this, we can see her paying attention to the very real demands of the external environment, especially the unpredictable and oversexualized world in which Peter was being brought up, his confusion about his parents’ divorce, and the very direct effect this was having on his internal world.
Although the relative lack of play materials is a key difference between Anna Freud’s way of working with Peter and more contemporary approaches, what is perhaps most striking for contemporary child analysts is the extent to which she interprets Peter’s dreams—and the degree to which he both brings in dream material and provides associations to the manifest content. For many analysts working with children today, dream interpretation—despite its central place in the history and theory of psychoanalysis—is no longer a major component of the treatment of latency-age children (Lempen and Midgley 2006). Yet in her 1927 lectures Anna Freud had argued that when it comes to dream interpretation, “we can apply unchanged to children what we have learned from our work with adults” (p. 24). The case of Peter appears to support this statement, as her notes refer to a vast number of reported dreams and a string of associations in relation to them. In February 1930, for example, Anna Freud records the “dream of the lame uncle”:
He is at the Rosenfelds, then goes up to his grandmother’s house. On the doorplate, which should read, for example, Dr. Heller, it says: The lame uncle. He gets terribly afraid, runs away.—Then he is in the garden with Thesi, and says: The lame aunt. She says: Why do you always say the lame aunt; it does say: The lame uncle [p. 81].
Anna Freud then records the associations that Peter provides to the dream, including various associations with feet, hygiene, and the anxiety about one’s eyes getting stuck in a certain position if you squint. On this basis she interprets his fear of masturbation, of harming himself or losing his “foot” because he did something unhygienic. In relation to the associations to the eye, she interprets that “he fantasizes intercourse between f[ather] and m[other], squints at them [to look], has an erection while doing it, his penis could remain stiff, fall off” (p. 81).
The notes make it clear that interpretation and the gaining of insight is a central aspect of her approach: the aim of Peter’s treatment was ultimately to make all his repressed, unconscious material accessible to consciousness: “I tell him as a rule: Every anxiety can be transformed back into a thought” (p. 135). The interpretations she offers during this first period of the analysis are classically Freudian in their emphasis on oedipal desire for the mother, hostility to the father, and the anxiety caused by the fear/threat of punishment. The interpretations are also classically Freudian in the emphasis on the bisexual nature of the oedipal conflict, with the young Peter responding to the oedipal anxiety by, on the one hand, a regression to anal erotism and, on the other, the adoption of a passive/homosexual position in relation to the feared father-figure. This formulation of the child’s internal dynamics is at the core of Anna Freud’s treatment of Peter, and runs through all the interpretations made during the first year of treatment.
The Role of Transference in the Analysis of Children
The third chapter of The Technique of Child Analysis had specifically examined the role of transference in child analysis, arguing that analytic work with children could not follow the model of adult psychoanalysis in how it considered this topic. Anna Freud suggested that the child’s continuing dependence on his “real objects” (the parents) meant that a full transference neurosis was not possible. From her perspective, the child could not be expected to make “new editions” of early object relations, when the parents were still a significant part of the child’s everyday reality. Although the child will display all kinds of positive and negative impulses toward the analyst, she believed that this should not be considered a “transference neurosis” as it would be viewed in the case of a relatively independent adult patient.
This view of the role of transference in child analysis was one of the most controversial aspects of her 1927 work, and the one that was criticized most by Klein and others at the London symposium. Klein (1927b) argued that even very young children were able to develop a full transference neurosis and that failing to interpret the negative transference from the very earliest sessions of treatment meant that the child’s deepest anxieties would be neglected. Klein believed that this led to an increased risk of a split transference between the therapist and the parents, with the former receiving the positive feelings, and the latter the negative. Anna Freud, however, had taken a different view. As she had put it in her 1927 lectures,
We know that with an adult we can work for prolonged periods of time with a negative transference, which we turn to account through consistent interpretation and reference to its origins. But with a child negative impulses towards the analyst—however revealing they may be in many respects—are essentially disturbing and should be dealt with analytically as soon as possible [p. 41].
What is immediately clear from reading her notes on Peter Heller’s analysis is that Anna Freud did pay special attention to any transference manifestations that appeared in her young patient’s material, but that she never attended to these to the neglect of his “actual” object relations. Instead she moved between them—analyzing transference manifestations as and when they appeared (rather than seeing all material as related to the transference)—but also speaking about Peter’s real relationship with his mother and father, and trying to influence the way in which these real relationships continued to impact on his internal world. The analytic aim, all along, was articulated not in terms of the working through of the transference, but rather in terms of psychodynamics: to undo the defenses and allow the unconscious impulses to emerge into consciousness, where they could be dealt with in more “adaptive” ways. In the first few months of treatment it appears from her notes that Anna Freud allowed the positive relationship with Peter to become established, without these feelings being overly interpreted. This is not to say that hostile feelings were not “allowed.” There are sessions early in treatment, for example, in which she reports that Peter is “very critical of me . . . finds a picture of me ugly etc.” (p. 29), and she clearly understands this in transference terms. But it is not until six months into treatment that she appears to make a direct transference interpretation. This comes during a session in which Peter has been angry after another sudden disappearance of his mother. At this point Anna Freud interprets “that he takes his anger against his mother out on me” (p. 35). Peter’s response is to pick up a knife to sharpen a pencil, saying suddenly: “‘I’ll stab you’—as a joke, but unexpected in its surprising speed” (p. 35). The theme of an attack on the eyes is taken up again the following week, when Anna Freud notes that Peter’s mother has come back to visit again:
Mother here; empty, resistance, reads aloud book titles from Christmas catalogues for hours. Finally, on Friday, he admits to an anxiety about his eyes: he had to draw figures with protruding eyes. Is afraid somebody could pierce his pupils with a needle. I ask if he wanted to see something forbidden. Thinks once, his mother, when he found her door locked when he came to her [p. 35].
During the first six months of the analysis the material above is fairly typical. Anna Freud makes a link between Peter’s feelings toward his mother and his behavior toward her in the session, seeing this as a “transference” and recognizing both positive and negative aspects to it. But the interpretation of this is aimed at bringing an unconscious wish (and the defense against it) into consciousness. Once that has been achieved, the work continues, without further reference to the transference implications.
As the analysis continues, however, Anna Freud gives increasing attention to the way in which Peter’s conflicts are manifested in the transference. In her notes for February and March 1930, having already done a lot of work on making the unconscious dynamics conscious to Peter, she describes what she calls “the high point of transference”:
Again very excited and angry, scolds me, tells me not to speak, calls me disgusting, I should not smile. Suddenly shouts at me: Where did you get this necklace? I do not want you to get such presents. Like a jealous husband, You should not have a private life. Then jealousy of the Burlinghams, whom I like privately, him only professionally. How it would be if I were suddenly to kiss him [pp. 95, 97].
Here we can see very clearly the “erotic transference” in the sense in which Freud (1915) first described it, where the whole of the ambivalence belonging to the primary objects has been transferred onto the person of the analyst. For Anna Freud, as for her father, this can be seen as a type of resistance—thereby providing an opportunity to analyze how the ego struggles with unacceptable thoughts and wishes as they reemerge from repression. Although Anna Freud interprets the erotic transference, it is clearly in the context of an “educational” position, helping Peter differentiate his fantasies from his actual situation. She explains to Peter that whereas these feelings are “natural,” fulfillment of them “cannot happen yet, later, with a woman, yes” (p. 99). She records that this intervention brings “great relief” to Peter, and although the possibility of termination raises new transference anxieties about her wish to abandon him (p. 109), she appears to believe that the working through of his oedipal anxieties has been largely successful.
The Second Period of Treatment: Child Analysis and the Upbringing of Children
If the treatment of Peter Heller had ended in May 1930, after the first fifteen months of treatment, as it seems was originally intended, the notes suggest that there had been a reasonably satisfactory ending to the analysis. The oedipal hostility to the father, which Anna Freud believed underlay the night terrors, had been interpreted and the symptom was much improved; the negative oedipal solution, by which the young child attempted a “homosexual” response to his fear of castration, had been made conscious and the feelings worked through in the transference. As the older Peter Heller comments, in response to the notes written around this period of what seemed to be the termination of his treatment, “if matters had stopped there, perhaps something like a happy end would have been achieved” (p. 336).
The second period of Peter Heller’s analysis, however, complicates this picture. During the five-month gap in his treatment it is clear from her notes that Anna Freud believed that Peter had been “unfavourably changed” by his parents’ lifestyle and that she thought that the level of sexual overstimulation, coupled with his mother’s breakdown, had rearoused his oedipal anxieties to such a degree that “the only thing left for him [was] regression to the anal stage” (p. 221). This in turn created guilt and a belief in his own “badness,” which then appeared to confirm Peter’s belief that his mother had abandoned him because of his own “pig-ishness.” Peter’s relatively immature ego, one might say, had been unable to cope with the intensification of his wishes and anxieties caused by external events outside his control. Under these circumstances, Anna Freud clearly felt that it would be better for the analysis to continue, and so in October 1930 the sessions resumed.
From the beginning, Anna Freud had presented herself as an ally to Peter’s ego, both supporting it to allow the unconscious wishes and anxieties to emerge, and then trying to help it find more adaptive ways to manage them. To put it in different terms, she was acting as an “auxiliary ego,” helping him build up the kind of ego capacities that would make it possible for him to replace unconscious repression with “conscious condemnation.” In response to her encouraging Peter to demonstrate better self-control, we can observe him trying to internalize his analyst as a kind of ego ideal. For example, at one point when he finds his urge for exhibitionism manifesting itself again after a period in which it seemed to have subsided, he writes Anna Freud a letter in which he asks: “Could you tell me once more what the rule was about that?” (p. 124).
The idea that the child analyst should act as an ego ideal to her patients was one of the most controversial ideas put forward in The Technique of Child Analysis. In the final chapter of that book, Anna Freud set out her belief that in early childhood the superego is only partly developed, and the child is still dependent on his or her caregivers to maintain a sense of right and wrong. This view of early development had implications for technique, for whereas in adult analysis the interpretation of repressed wishes was expected to lead to their reemergence in conscious life, so that the ego could develop an increasing capacity to manage these impulses (“where id was, there ego shall be”), Anna Freud believed that children’s minds are not yet sufficiently developed to enable them to deal successfully with the “return of the repressed” on their own. She therefore argued that the child analyst had at times to play the role of the child’s ego ideal, helping him find ways to better manage the impulses released from repression by the process of analytic interpretation. She saw this as a dual role, “to analyse and to educate, that is to say, in the same breath he must allow and forbid, loosen and bind again” (p. 65).
In the 1927 symposium, Klein and her colleagues disputed this view. They argued for the fundamental identity of child and adult analysis, seeing the child analyst’s role as being to analyze the very early oedipal situation, as it developed during the first year of the child’s life in the infant’s relationship to the maternal breast, without recourse to any “educational” interventions. Rather than trying to build a positive relationship, in Klein’s view the child analyst should take up the child’s hostility and aggressive transference phantasies from the very start of treatment; and rather than helping the child control his or her impulses, the child analyst should interpret only the deepest and most primitive anxieties, thereby helping to modify an already formed, and often harsh, superego (Klein 1927b).
During the first period of Peter’s analytic treatment, one can find clear instances in which Anna Freud took a more pedagogical role. Early in the treatment, for example, she appears to encourage Peter to promise to avoid hanging around public toilets during the summer break, as he had reported to her he had been doing; and toward the end of the first period of treatment she actively encourages him to “take pride in health” rather than seek the “secondary gain” (people feeling sorry for him) that comes from illness (p. 105). As the planned termination approaches, and his fears of loss and abandonment reemerge, she tells him “not to scream at night in order to show how he still needs analysis”—something he promises not to do (p. 107).
In fact, as Heller acknowledges in his reminiscences, these attempts to encourage him to avoid his old, neurotic temptations largely had the opposite effect. “Promises given for the sake of someone else or in a moment of moral euphoria,” he writes, “. . . gave rise too easily to a sense of constraint or the compulsion and the wish to put one over on himself and the other” (p. 300). The limitations of this approach to the analysis became especially clear during the second period of young Peter’s analysis. In his reflections on the case material as a grown man, Heller wonders whether the relapse he suffered in the summer of 1930 was “an event of crucial importance . . . a breakthrough into deeper layers” (p. 344). Although Anna Freud did take up this new material analytically, both trying to reconstruct a primal scene experience that may have underlain the infantile neurosis (p. 195) and taking up the negative transference in relation to the abandoning mother (p. 197), her response to Peter’s relapse was also what Heller, in looking back, refers to as “palliative.” She worked with Peter’s parents to try to limit the degree to which he was exposed to the world of adult sexuality. encouraging his father to set up a separate apartment for his lover in order to “spare Peter the excitement”; supported a referral for Peter’s mother to an analyst in Berlin; and later went a step further (unsuccessfully) by trying to persuade Peter’s parents that he should be sent to a boarding school so he could be “sheltered from [his] parents’ conflicts and, above all, the ‘homosexual’ bond to [his father]” (p. 343). Although these interventions at the level of the environment may have been well-intentioned, and possibly of real value, it appears that Peter himself experienced them as an avoidance of grappling with the “deeper layers” of his disturbance.
Anna Freud’s interventions during this stage of the analysis highlight a genuine tension at the heart of therapeutic work with children. On the one hand she was sensitive to the very real, ongoing impact of the external world on Peter’s development, and took steps to limit the damage being inflicted. After all, there is little value in focusing exclusively on the child’s internal world when ongoing environmental trauma or failure is impinging on the child’s development. But Heller’s later reflections suggest the limitations he felt were introduced by his analyst’s taking a “palliative” role, and in retrospect he suggests that this led to the neglect of important dynamics.
When we turn to the notes written on the case from the end of 1930 onward, however, we can see that an important shift appears to have taken place between the first and second period of the analysis: from a focus primarily on oedipal dynamics in the first year of treatment to one in which, as Heller himself notes, the “central issue” of the traumatic separation from his mother “is taken up and worked through again and again” in the second period (p. 356). Early on in the second period we see Peter “playing incessantly with a fishing reel tied to a string, throwing the reel away from himself, then pulling it back with the string”—just as Sigmund Freud’s grandchild had done in the fort-da game so central to Beyond the Pleasure Principle (Freud 1920) and its reflections on traumatic separation. Anna Freud takes this up at several levels—interpreting it in terms of separation and aggression (“fishing is like murdering”), but also noting Peter’s own “spontaneous interpretation”:
he rolls the reel like his penis, masturbates very frequently now and in doing so wants to get everything to be “nice” and smooth (keep mother by having a genital like a man) [p. 133].
By the summer of 1931 the analytic focus is clearly on the powerful feelings evoked by Peter’s mother’s sudden appearances and disappearances, linked to her sexual relationships, which leave Peter feeling both excited and excluded. After one of his mother’s brief visits, Anna Freud reports a “transference to me with much loud anger, reproaches, culminating in the reproach that I am a nun (remark by Menga about my private life)” (p. 197). Anna Freud interprets as follows:
Menga [mother] should not have any man (nun) so that she wouldn’t leave. Anger about criticism of Menga turned towards me. Very turbulent and unmanageable, with much excitement, wants to stop analysis. . . . After Menga’s departure he turns his love to me, is disturbed by above-mentioned thought [that he has to pay women to love him] [pp. 197, 199].
The notes from this period of the analysis demonstrate the very complex processes of splitting, denigration, and idealization that are such a common part of child analytic work with children living in “uncontained” environments, where early development may have been seriously derailed. At the time of working with the young Peter Heller, Anna Freud may not have known quite how to work with such themes deriving from the earliest stages of personality development, while also trying to address real external impingements. (There was no idea of a separate “parent worker” at this time, as there might be today.) We see Anna Freud caught between trying to use her analytic understanding to prevent further difficulties arising (for example, she tells Peter’s mother that it would be better if she did not let not let her son touch her breasts), but this then backfires on the analytic work itself: Peter reports his mother screaming at him, “And a frigid woman of that sort dares to pass judgement on one who feels and is alive and open!” (p. 356)—the kind of experience that left the young child feeling in an impossible situation between these two women. Looking back, Heller writes of “memories of my incapacity to reconcile my feelings for [mother] with those I had for A.F.” (p. 363) and how this difficulty played itself out in later relationships he formed with women.
As we get toward the final months of treatment, there is a sense that the analysis is on fragile ground. At the beginning of 1932, Anna Freud suggests to Peter’s father that his son should go and live with Dorothy Burlingham—her close companion, who was also closely involved with the Matchbox School. When his father speaks to him about this, Peter rejects the idea, and although Anna Freud interprets that “he is afraid Menga would feel hurt if he went to the Burlinghams” (p. 225), it becomes clear that Peter feels caught in a loyalty conflict that the analytic work is not able to help him with. Within a couple of months, the analysis has ended, after a final note by Anna Freud on an interpretation of Peter’s bed-wetting as a sign of conflict about growing up. In his own notes, written almost fifty years later, Peter Heller adds:
And here, with the anticipation of virility, the treatment breaks off, or, at any rate, the notes come to an end. . . . Much as it went against my grain, I was now forced to cram systematically for tests and examinations [at a public secondary school he attended until he was eighteen]. . . . At that time, after Austria’s enthusiastic Anschluss, we Jews had to transfer to a Realgymnasium in Vienna’s former ghetto district where, although addressed by our Aryan teachers as ‘scum of the earth’, we were still permitted to graduate, which I managed to do in the late spring of 1938, just before my emigration to England as both a Jewish refugee and an ‘enemy alien’ [pp. 375–376].
Discussion
Although acknowledged as both a pioneer and a leader in the field of child analysis by the end of the 1920s, Anna Freud was still finding her way as a child analyst at this period in her life, reliant for her views on her experience of a relatively small number of cases, alongside the work of a few close colleagues taking forward their ideas about child analysis and the reform of education more generally (see Cohler 2008). The 1927 lectures had been an important statement of where her thinking had come on the basis of her early experience, but it was by no means her final word on the subject of the technique of child analysis. Her further clinical experience, as well as the reactions to it from both her colleagues and her critics, helped Anna Freud revise and refine her approach to child analysis, without ever abandoning the core principles she had set out in the 1927 lectures. In her later work, especially following her experience at the Hampstead War Nurseries, where she came to appreciate the impact of early separations on the young child’s development (Midgley 2007), she was able to conceive of these early difficulties in terms of “developmental deficits,” and later proposed a view of the analyst as a “developmental object” (A. Freud 1965). Such a view has come to have an important place in contemporary child analytic thinking (see, e.g., Hurry 1998; Midgley in press), but the insights came too late to have made a difference to Anna Freud’s treatment of the young Peter Heller.
Heller’s analysis is significant partly because it came fairly soon after the 1927 symposium on child analysis, where Klein and a number of other child analysts based in London had criticized Anna Freud’s approach, as set out in her 1927 lectures, for what they saw as her “betrayal” of the essence of psychoanalysis. From the notes on Peter Heller’s treatment we can see how Anna Freud responded to these criticisms—in some areas modifying her approach, and in others clarifying the way she worked and her reasons for doing so. From her notes we can see, for example, that she did not use play as the primary means of communication at this point, but relied more heavily on speech (including dreams) and, to a lesser extent, writing and drawing. The format of adult analysis (the couch, free association, the interpretation of dream material) was still the model for the treatment of a child, and it was only in the postwar years that she began to incorporate play materials more systematically into her treatment of children. But Peter Heller’s treatment also confirms her original belief that dream analysis can be a powerful tool, even in the analysis of quite young children, and that working with dreams allows the analyst to explore not only unconscious wishes but also the ego and what she was soon to call “mechanisms of defense.”
This focus on the ego and resistances was also leading Anna Freud away from the idea of a preparatory period, as she had described it in her 1927 lectures. Although we can see her trying to engage and form a relationship with Peter early in treatment, the analytic and interpretive work also begins from the very start. In the early sessions she makes use of a version of “defense analysis” to interpret why Peter is avoiding certain topics, rather than trying to win him over using the techniques she had described in the 1927 lectures. As she gained more experience of child analysis, she became more and more convinced of the power of this way of working, so that by 1945 she was to write that her early view of the need for a preparatory period “must be modified in the light of modern developments” (A. Freud 1945, p. xi).
The notes of the treatment of Peter Heller also throw a somewhat different light on Anna Freud’s ideas about transference in child analysis. Klein (1927b) had criticized her for suggesting that transference cannot play the same role in the treatment of children as it does in the treatment of adults. We can see in the case of Peter Heller how Anna Freud did pay attention to a variety of transference manifestations, both positive and negative, without neglecting her fundamental belief that bypassing the defenses and interpreting the deepest layer of the unconscious too early was likely to increase the child’s negative transference and resistance, and that “the analyst should move from surface to depth, which also encourage[s] the development of a treatment alliance” (Miller 1996, p. 161). Nevertheless, her focus primarily on the positive and erotic aspects of the transference seems to have contributed to a split that occurred between young Peter’s relationship to his analyst and his feelings toward his parents.
Heller’s own memoirs of his life after leaving Vienna attest to the long-term implications of this “unanalyzed” part of his personality. In the book he describes the degree to which, as a child, he loved and revered Anna Freud, and how these feelings continued well into adult life, alongside a profound sense that he “did not think [he] was loved enough” (p. xxvii). Heller is left with a sense that his experience as a child had “an infantilizing and often debilitating influence” on his development, in contrast to the ostensible aim of psychoanalysis to promote the “liberation of man” (p. xxvii). He describes himself as suffering from a kind of “therapitis”: “a chronic state of disability in which a person has no autonomy and imagines that he cannot cope without the crutch of treatment” (Heller 1992a, p. 60).
Heller’s retrospective account also throws some light on the meaning to him of Anna Freud’s taking a “pedagogic” role at certain key moments in his analysis. We can see in the treatment of Peter that Anna Freud did not believe that this nine-year-old had the capacity to manage all of the impulses that could be lifted from repression on his own, and in various places she put herself forward in a more ego-supportive role, as someone who could help Peter find ways to better manage his impulses and anxieties.
By the end of the first period of treatment, it might have seemed as if this approach had succeeded. The young Peter was not only more conscious of the causes of his unconscious conflicts; he also appeared to have more capacity to manage those conflicts and find appropriate means of dealing with them on his own. However, the fact that this “cure” broke down so quickly after the first period of treatment ended, leading to a further eighteen-month period of analysis, may have helped Anna Freud realize the limitations of the approach she had taken, as well as the difficulties the child analyst faces when trying to play both an analytic and an educational role (as well as working with both the child and the parents). In writing about his experience as a child, Heller (1992a) recalls that “the pavor nocturnus, the screaming, and great anxiety subsided, but not the half-fantasized hang-ups such as the complex of exhibitionism-voyeurism or other variants connected with masturbation and self-torment, strangely tied up with guilt feelings” (p. 51). With alarming self-honesty, he acknowledges not only that he struggled with bisexual conflicts and a preoccupation with “confused, bewildering sexual fantasies” (Heller 1990, p. xxvi) that led him back into analysis with Ernst Kris in New York in 1946, but that he also went through the rest of his life with a sense of a weakened self, a “self-prevention of decisive action” alongside a sense of “unsettled megalomania” (Heller 1992a, p. 51) and a profound feeling that he had not achieved what he had hoped for with his life.
Of course one cannot say to what degree these later difficulties were a result of missing aspects of his child analysis. But it does seem likely that the unsatisfactory ending of Peter Heller’s analysis may have led Anna Freud to realize the limitations of trying to combine an educational with an analytic role. When she came to revisit her views about child analysis in 1945, she was to recall that her fears about reawakening repressed wishes in the child patient “were shared to a degree by some [adult] analysts who thought it quite possible that child-analysis might need some special form of educational guidance as its constant accompaniment and counterpart.” However, she continued:
But, as experience proved, this was not as often necessary as had been expected. It was demonstrated repeatedly that the ego and super-ego of a child which were consistent and severe enough to produce an infantile neurosis could also, with some help, be relied upon to deal with the sexual and aggressive instincts which emerged from repression after the neurosis had been analysed successfully [A. Freud 1945, p. 68].
The treatment of Peter Heller, then, can be seen as a case that contributed to a gradual evolution in Anna Freud’s approach to child analysis. That some of these developments came too late to help this particular boy is one of the tragedies of a newly emerging field of knowledge and practice. Peter Heller never underestimated the value that his encounter with Anna Freud had brought to his life, but his conclusion about its ultimate legacy is a sobering one. Writing about himself and his fellow patients who both attended the Matchbox School and had analyses with Anna Freud in those early, somewhat utopian days, he concludes:
We were the beneficiaries of a rudimentary method of treatment and were its guinea pigs. It is questionable how much gratitude one should expect of the guinea pig, as it limps away, especially since it is difficult to know whether the half-cured animal would have been better off or very much worse without the drastic intervention [1992a, p. 63].
Perhaps this kind of uncertainty lies at the heart of all endeavors to alleviate human suffering. It is to Anna Freud’s credit—and to that of her former patient, Peter Heller—that we have one record of how such an attempt was made. In making public this work, and in reflecting on it, we can better appreciate the gradual development of child analysis as it is practiced today.