Boundaries of reasoning in cases: The visual psychoanalysis of René Spitz

Abstract

This article argues that the foundational separation between psychoanalysis and experimental psychology was challenged in important ways by psychoanalytic infant researchers. Through a close examination of American psychoanalyst René Spitz (1887–1974), it extends John Forrester’s conception of reasoning in cases outside classic psychoanalytic practices. Specifically, the article interrogates the foundations of reasoning in cases—the individual, language, and the doctor–patient relationship—to show how these are reimagined in relation to the structures of American developmental psychology. The article argues that the staunch separation of experimental psychology and psychoanalysis, reiterated by philosophers and historians of psychology, is flimsy at best—and, conversely, that the maintenance of these boundaries enabled the production of a cinematic case study. Spitz created films that used little language and took place outside the consulting room with institutionalized infants. Yet key aspects of the psychoanalytic case, as put forth by John Forrester, were depicted visually. These visual displays of transference, failure, and interpersonal emotions highlight the foundations of what Forrester means by reasoning in cases. The article concludes that Spitz failed at creating classic psychoanalytic evidence, but in so doing stretched the epistemology of the case.

Keywords

American psychoanalysis attachment theory developmental psychology history of psychology scientific film

This article begins with John Forrester’s framework for the case: namely, that cases are defined against experimental and statistical reasoning, and that psychoanalysis, the exemplary discipline for thinking in cases, is defined by its aversion to its sister discipline, experimental psychology. Two questions emerge from the link between psychoanalysis and reasoning in cases. First, can the knowledge of psychoanalysis extend outside the bounds of the case? And second, does reasoning in cases depend on the clinic? This framework is considered through the examination of a psychoanalyst on the edge of these boundaries, at a time in the history of American psychoanalysis when disciplinary ambitions and sedimentations influenced the truth claims of psychoanalysis. This is the case of the psychoanalyst outside the consulting room.

Between 1930 and 1959, American psychoanalyst René Spitz, together with colleague Katherine Wolf, documented the intensity of suffering among infants in institutional settings.¹ Spitz famously depicted neglected infants in a 1947 film he titled Grief: A Peril in Infancy (Spitz and Wolf, 1947). This film showed young children in varying states of disarray due to their environmental contexts, namely a prison and an orphanage. It was seen widely by researchers and medical personnel around the world, and continues to be referenced today. Figure 1 shows a still from this film. The infant’s distress is easily recognizable. The film requires very little context for the viewer to understand the situation of the infants depicted. As a result, the film has remained outside the dominant psychoanalytic canon. They are merely pointed to as tangible evidence for the importance of human contact in the first years of life.² Though Spitz did not treat the infants in the film, he claimed that this research was visual evidence for psychoanalytic theories of development. This paper addresses how this filmic evidence, of subjects who could not speak, fits into an epistemological method defined by the doctor–patient relationship, language, and the individual.

Figure 1.

‘Close-Up Scream’: Still from Grief: A Peril in Infancy (1947).

This article argues that three aspects of Spitz’s research push the edge of the psychoanalytic case study and experimental psychology. First, as explored in the first section, Spitz traversed the lines between psychoanalysis and behavioural observation. Spitz made repeated appeals to the budding developmental psychology research community, while still asserting that his behavioural observations were psychoanalytic. This section asks how the individual is presented in such positioning. The second section details the role of the camera in Spitz’s psychoanalytic evidence. Spitz had repeated recourse to the objective ideals of film while producing highly constructed films. The third section of the article examines Spitz’s film Grief: A Peril in Infancy. This film serves as an example of how Spitz positioned the researcher within the camera frame. The film shows his reactions to the situation and exposes him as a fallible participant in the research. Ultimately, this article argues that Spitz positioned his films as exemplars that could be shown to demonstrate psychoanalytic theories of development, as well as data to be respected by the behavioural psychology community. In this way, he brought psychoanalytic modes of discovery—namely transference, free association, and writing—into tension with behavioural and experimental methods. This article brings this tension to the fore in order to highlight the unique form of discovery represented by reasoning in cases.

The individual in behavioural research

The play between generalized and specific knowledge animates Forrester’s genealogy of the case study. Forrester sets up the case in contradistinction to the rise of statistical reasoning in the 19th century. While statistical reasoning eliminates the specificity of individuals by creating knowledge around a number of individuals, cases are ‘nailed down to the level of the individual’ (Forrester, 2017: 49). The case allows those fields that employ this reasoning style—law, medicine, social work, psychoanalysis—to ‘treat their objects as persons’ (ibid.). Knowledge is produced, then, by taking cases as examplars or working models. The disciplinary community ties the cases together. Perhaps even more importantly, this ‘nailing down’ requires that the clinical physician, courtroom lawyer, and psychoanalyst resist losing the specificity of the case to abstraction and theory. Rather than pointing toward generalized theories, reasoning in cases remains grounded in the empirical.

This foundational element of reasoning in cases is clarified by the divergence of psychoanalysis from the statistical mode of experimental psychology (Forrester, 2017: 4). The psychoanalytic case study takes an individual as its object, and maintains this specificity even as it acts as an exemplar for a more generalized claim. The statistical method of experimental psychology, in contrast, loses the specificity of its object by developing a method around the indefinite variability of a number of individuals. Forrester is not alone in framing psychoanalytic reasoning against other scientific practices, especially experimental psychology. Many historians and philosophers of science see psychoanalysis as an emblematic counterpoint to proper scientific reasoning (Popper, 1986; Stengers, 1997). Indeed, Freud’s departure from the Salpêtrière and divergence from Charcot’s methods is an origin story of sorts in the history of the field (Cartwright, 2008; Gilman, 1985; Hale, 1995). Freud introduced the ‘talking cure’ as a contrast to Charcot’s images and live demonstrations that displaced pathology from the body and propelled it into the mind. This revolution from theories of bodily disturbance to theories of mental disturbance involved a shift from the visual toward the linguistic. As Forrester shows in his genealogy of the case study, writing enables its epistemological singularity. Writing and knowledge of the particular seem to go hand in hand. Visual evidence, then, is a switch point in the history and philosophy of psychoanalysis.³

These positions, however, are complicated by the role that empirical data on young children plays in psychoanalytic theories. That is, the separation between behavioural observation and reasoning in cases is perpetually navigated and reimagined by practitioners. As Jacy Young argues in this issue, 19th-century psychologists who relied on statistical reasoning (via, for instance, the questionnaire) actually used and drew on an amalgamation of reasoning styles, including especially individual cases (Young, 2020). I add that perhaps the case could be brought into conversation with what appears to be the generalizable method of behavioural observation and experimentation.⁴ Specifically, infants and young children were a testing ground for epistemological invention for the first generation of analysts following Freud.⁵ Observation and even experimental protocols were key tools psychoanalysts employed to gain new ground in theories of infant development. Through the 1940s, Melanie Klein and Anna Freud conducted a field-altering debate that brought the mental life of children to the fore (King and Steiner, 1992). The place of fantasy was a central issue in these discussions. Anna Freud, who remained a leading figure in the psychoanalytic community after her father’s death, advocated for some reference to empirical events within the developing mind. Her work with war-displaced babies and young children at the Hampstead War Nursery expanded the purview of psychoanalytic evidence from the consulting room to more sustained and systematic studies, especially with infants and children (Freud, 1953; Likierman, 1995; Midgley, 2007). During and after World War II, British and American psychoanalysts influenced social and political conversations about the welfare of children. They did so by drawing from methods and data outside the strict boundaries of the analytic couch. Infant research, then, was both marginal in relation to traditional psychoanalytic practice, and a way to gain relevancy in the war-altered world. While the emergence of infant research during this period has been well documented, the ways the case study influenced observational evidence have not been adequately explored.

On the extreme edge of this research was John Bowlby. Bowlby began his career as a psychoanalyst in the late 1940s, but became famous for his empirical research that purported to demonstrate the biological inevitability and importance of mother–infant bonding. In many ways, Spitz and Bowlby mirrored one another through their theories of development and their focus on early caregiving relationships.⁶ Both were psychoanalysts interested in observational and comparative methods. Both were focused especially on evolutionary explanations for development. However, in 1960, Spitz joined two other senior members of the psychoanalytic community, Anna Freud and Max Schur, in a public and critical response to Bowlby’s research (Spitz, 1960). These public critiques permanently marginalized attachment theory in the psychoanalytic milieu (Cartwright, 2004; Van der Horst, 2011; Vicedo, 2013). All three took issue with Bowlby’s use of psychoanalytic language, but more importantly, they each argued that his evidence for mourning in infancy was both insufficient and not psychoanalytic. Bowlby used direct behavioural evidence to extrapolate a broader psychoanalytic idea: grief and mourning in infancy. There was a one-to-one link between his observations and psychoanalytic theory, which thereby short-circuited the case history. He moved from general observation to a universal theory. Generalizability was the aim of his work. As Forrester (2017: 4) argues, the unique knowledge of the case in the 20th century offered ‘a new form for the specific and unique facts that make that person’s life, their life’. The psychoanalytic method, the case study, made the individual scientific and public. The critiques of Bowlby by Anna Freud, Schur, and Spitz all sensed this incommensurability between psychoanalytic knowledge and Bowlby’s conclusions, though none, especially Spitz, sought to dispense with behavioural observation altogether. Of the three critics, Spitz was most aligned with Bowlby’s observational method. He too observed infant distress in response to caregiver loss, and he also appealed to the authority of experimentation and systematic observation. Unlike Bowlby, who grew to see his training in psychoanalysis as fundamentally contradictory to his empirical research, Spitz created psychoanalytic empirical research. Spitz’s psychoanalytic behavioural evidence retained key aspects of the case study outside the strict linguistic framework: the importance of the doctor–patient relationship, the case’s ability to expose the unconscious in both reader and author, and its use as a pedagogical exemplar. Spitz bridged the gaps identified by Forrester and upheld by the history of psychoanalysis and American experimental psychology.

These boundaries were not traversed lightly. To the analytic community, Spitz argued for the necessity of systematic infant observation. He showed that psychoanalysis relied on the role of early life experiences, yet it had failed to test the validity of adult reconstructions (Spitz, 1965).⁷ In this way, Spitz argued against the single-patient case study in favour of repeatable and perhaps even comparative experimental protocols. Many psychoanalysts were hostile to this line of research, and saw experimental psychology as incapable of adding to the study of unconscious psychological processes.⁸ These debates centred on the relation between manifest (or externally observable) behaviour and psychoanalytic dynamics. The undeniable despair that infants displayed when separated from their mothers consolidated this issue. Sigmund Freud discussed the role of manifest infant behaviour in his discussion of separation anxiety. For Freud, separation anxiety resulted from intolerable aggression toward the lost object. Separation anxiety was a distinct dynamic from what Freud described as the ‘expression of [the infant’s] face and its reaction of crying [that] indicate that it is feeling pain as well’ (Freud, 1977[1926]: 169). That is, the expression of pain was an addition to the psychoanalytic definition of separation anxiety. Freud concluded that the manifest pain, though empirically valid, did not in itself demonstrate the psychopathology of separation anxiety. Freud was making a theoretical point here, but, more interestingly for the purpose of this paper, he was laying out which method of knowledge production was valid for psychoanalysis. Direct observation did not prove psychoanalytic theory. Spitz undermined this dogma by bringing externally observable infant reactions into his psychoanalytic theories of development.

In parallel to these appeals to the psychoanalytic community, Spitz and Wolf made appeals to mainstream psychology. By the early 20th century, experimental psychology in the US had become a discipline with established funding bodies, departments, and labs dedicated to the scientific study of human behaviour. Increasingly, academic psychology achieved legitimacy by creating its own set of scientific boundaries. John B. Watson’s experiments on conditioning were the epitome of this period (Watson and Rayner, 1920). His research marked the extreme of what would come to dominate American developmental psychology: the quantification and analysis of a single observable behaviour.⁹ Though Piaget-influenced American developmental research did not add to the theory of behaviourism, it subscribed to similar methods by confining the hypothesis and observation to single, testable, and repeatable physical actions.

Following this trend, Spitz and Wolf honed their observational methods and behavioural evaluations.¹⁰ They presented their findings in tables and charts in order to show (and argue) methodological rigour. They too focused on outwardly observable infant behaviours using standard observational techniques, most notably film.¹¹ Their first major publication was called ‘The Smiling Response: A Contribution to the Ontogenesis of Social Relations’ (Spitz and Wolf, 1946) and was accompanied by a film, titled The Smiling Response (1946). The decision to concentrate on a single observable facial reaction—smiling—was effective for creating disciplinary legitimacy. The pair followed the trend in experimental psychology toward focusing on single observable behaviours as they introduced their psychoanalytic framework.

Spitz and Wolf opened their ‘Smiling Response’ article by differentiating their method from those used in previous infant research. Other contemporary researchers, they argued, treated ‘the infant as a machine to be observed only in stimulus-response terms. This resulted in an atomization of the infant’s whole personality into a multitude of small sectors’ (Spitz and Wolf, 1946: 65). In contrast to this disjointed understanding of infant behaviour, they viewed the smiling response within a system of factors, including environment, caregiver, and developmental maturity. The smile, in Spitz and Wolf’s argument, was both a biological reflex, like grasping or flinching, and an expression of the importance of developmental context. This change in emphasis, from behavioural achievement to emotional interaction, positioned Spitz squarely within psychoanalysis. In more psychoanalytic terms, Spitz and Wolf studied the development of the smile as an expression of object relations. It remains to be seen how this new quasi-experimental, quasi-analytic knowledge was created.

The film, The Smiling Response, cut together decontextualized test subjects completing various interactive tasks. It showed a number of infants interacting with Spitz moving dolls, Spitz bringing his face toward the infants with exaggerated smile gestures both in profile and straight on, and Spitz wearing a mask. The film was later adapted for a popular audience. In this later film, used as a pedagogical tool, intertitles between scenes explained the psychoanalytic conclusion viewers were to draw. Spitz argued that the earliest smile was more than imitative behaviour; it ‘must take place by means of some sort of rudimentary identification’ (Spitz and Wolf, 1946: 67). The smile was a manifestation of the internal experience of the primary relationship. Though the film and accompanying article led with repeatable and seemingly generalized observation, there was an element of psychoanalytic reasoning that brought the disciplinary tensions into relief. Spitz himself was a constant in almost all scenes in the film. That is, the film showed an individual, Spitz, interacting with infants. Spitz did not merely draw psychoanalytic conclusions from observable data; he brought a psychoanalytic sensibility to his behavioural research. The viewer was able to trace Spitz’s personal and individual way of interacting with the infants.

Spitz, in placing himself within the film, disrupted the standardization of his work. This, I argue, was intentionally done to bring psychoanalysis together with the experiments on a behavioural marker. As Wolf wrote in a grant application,

We borrowed our observation technique partly from behaviorism [but] we took the viewpoint for supplementing these research procedures from another psychological school, from psychoanalysis. Up to date, psychoanalysis is the only psychological school which tries to describe the human individual as a whole interacting with its environment, determined by its past.¹²

Spitz and Wolf did not shy away from the tensions between behavioural observation and psychoanalysis. In the film, Spitz was shown interacting as a way to draw out the importance of environmental context. The boundary between the specific and the general was skirted by Spitz, who claimed the generality of his research while showing highly personalized images of himself with a series of infants.

Film as pedagogy

Spitz disseminated his films widely as pedagogical tools. They were shown in hospitals and medical schools and, interestingly, played in a few popular outlets, most notably at Cinema 16, an avant-garde film house in New York City run by Amos Vogel. Spitz’s dual roles as educational film-maker and behavioural researcher raise an important point concerning the visual evidence under consideration in this paper. One could argue that the films act as examplars and are therefore a kind of case. This is complicated, however, by Spitz’s recourse to the experimental. At the same time as he was stressing their pedagogical value, in other words, he argued for the films as research objects. In this section, I show how Spitz used the veil of legitimacy lent by the camera, as well as the pedagogical (non-experimental) tone of the films, to circle between his critics.

The majority of films created by Spitz and Wolf between 1930 and 1945 were marked by visible moments of helplessness, crying, and loneliness. This intense despair was shown primarily through focused and close-up shots of the faces of babies. The pair generated over 60,000 feet of 16 mm footage for their major research project, The Psychoanalytic Project on Problems of Infancy. This project recorded over 366 children for the purpose of ‘presenting the total unselected behavior of children’.¹³ These children were studied in American homes, a children’s nursery in a women’s prison outside New York City, and what the researchers called a ‘foundling home’ in Mexico. Through examples of experiments, mothers feeding their infants, infants playing with one another, and birthing scenes, the films all pointed to the necessity of early emotional interaction. Spitz referenced these numbers often, indicating a generalized epistemology. The films, however, were more specific. The same shots and the same subjects were cut together in numerous combinations to form more than 25 films. Some films had comparative narratives, while some merely documented an infant playing. The footage of institutional care was screened widely as didactic films for medical personnel and social workers in the US and Europe. The films became part of a movement that changed institutional practices and prompted further inquiry into the early emotional experiences of infants.¹⁴ The didactic aspect of the films fit into the rise of the pedagogic use of cases in medical schools. Yet they played the additional role of linking Spitz to the psychology research community. The infants depicted, then, stood as exemplars while being named as research subjects.

Filming infants was not unique to Spitz during this time. In fact, it was a galvanizing tool for the nascent field of developmental psychology. Psychological research was faced with the challenge of systemizing data on humans. Many developmental psychologists of this era saw film as an instrumental way around the problems associated with independent observation.¹⁵ As Watson remarked, ‘Without instrumentation…many of the phenomena of conduct cannot be brought under adequate scientific control’ (Watson, 1916, quoted in Curtis, 2011: 424). The earliest psychological films include Watson’s demonstration of fear conditioning of the infant Albert B. in the film Little Albert (Watson, 1923), Mary Fisher Langmuir’s study of a preschool child (Langmuir, 1942), Kurt Lewin’s use of documentary film with children to develop his field theory (Frowein et al., 1931), and J. G. Lynn’s footage of the stimulation of involuntary facial expressions (Lynn, 1940). Film in itself seemed to provide scientific control.

Film theorists mark World War II as a key period that shifted the way film documentation was viewed. Following an increase in newsreels and mental health films during World War II, film began to be portrayed as a more straightforwardly mechanical record of the external world.¹⁶ It could capture and contain the passage of time more accurately than the paintbrush or photographic camera (Winter, 2006: 114). For instance, the leading American developmental lab during and immediately following the war, the Yale Child Study Center, created a film lab that attempted to eliminate all contact between researcher and subject. Led by Arnold Gesell, this group of researchers used standardized tests to observe the maturation of cognitive and physical processes such as puzzle solving, grasping, sitting up, following directions, jumping, and so on (Gesell and Ilg, 1943; Thelen and Adolph, 1992). They gathered hundreds of hours of film footage from their custom-built film lab. This glass room, which the researchers referred to as the Observation Room, was designed to hide the observer from the subjects (mostly toddlers and their mothers). This Observation Room was imagined to create a natural environment within the laboratory setting, where researchers did not colour the behaviours of the children that came into the lab. The researchers used this dome to simulate the home environment while minimizing the added variables of cameras and doctors. As Scott Curtis convincingly argues in a 2011 article on the Gesell lab, film documentation provided researchers with a way to make developmental behaviours ‘as tangible as tissue’ (Curtis, 2011: 441). These researchers imagined that their observations were untainted by researcher intervention. The notion that filmic evidence was neutral and tangible placed observational methods within the experimental fields. Film was a method of data collection.

This kind of view-from-nowhere observational technique bolstered Spitz’s project.¹⁷ Spitz made frequent appeals to this aspect of film. In a grant application describing the films, Spitz noted that the purpose of film was

screen analysis (pictures taken at 24 frames per second are slowed down to 8 frames per second, a threefold magnification of the observed movements being thus achieved). The situations filmed were aimed at presenting the total unselected behavior of children.¹⁸

Here, Spitz claimed that filming was for the purpose of data collection, as in the case of the Gesell lab. The films as pedagogical and even cinematic objects are subverted in this instance.

Nonetheless, Spitz had many detractors in the developmental psychology community. Many were sceptical of the validity of his scientific evidence. Researchers argued that Spitz’s data was not reproducible, because he had not disclosed the locations of the institutions and had failed to detail the training and background of the research staff. One critic concluded that ‘the results of Spitz’s studies cannot be accepted as scientific evidence’ (Pinneau, 1955: 435). Despite these critiques, the films continue to be referenced today for their empirical demonstration of the effects of emotional neglect. The images are taken to point to a single decipherable conclusion: Infants deprived of human stimulation fail to develop. They seem intrinsically conclusive. Paradoxically, the films and resulting studies were both self-evident and bad science. To combat his critics, Spitz had recourse to the pedagogical purpose of the films. In contrast to his impulse to gain experimental authority from the camera, in other instances Spitz highlighted the constructed nature of the films. In response to a review board, for instance, he wrote,

Evidently the review board was unaware of the fact that this film is only a very popular illustration of an elaborate piece of research published by me in the ‘Genetic Psychology Monographs (1946, 34).…’ As you will see if you read the text, more or less all the objections raised, such as the questions about the sample, the frequency of the smile, the full details of the stimulus and the careful exclusion of misleading stimuli ….¹⁹

When pressed on the experimental legitimacy of his work, Spitz argued that the films were merely case studies.

Spitz allowed the films to play a dual professional role. To the behavioural researchers who claimed his work did not have experimental validity, he argued that they had misread the films, and that they were meant merely for demonstrative purposes. To the analytic community, he claimed that the films were taken from large samples with standardized methods of observation, including magnification and slow-motion analysis. In both instances, Spitz used divergent ideas of film to make the case for the epistemological legitimacy of his work. His recourse to film in part demonstrates his failure as a psychoanalytic thinker and behavioural researcher. This failure, however, does much to illuminate the specific boundaries of the case methodology.

Visualizing the doctor–patient relationship

Rhetorically, the camera allowed Spitz to mirror his experimental psychology contemporaries. He made reference to the camera to increase the verifiability and level of control. The actual footage, however, went far beyond behavioural observation. The films interpolated the viewer through explanations on-screen and scenes of Spitz engaging directly with the camera. By extending the frame beyond the behaviours of the infant, Spitz traversed the line between psychoanalytic interpretation and observational evidence. In a speech at Vassar College in 1948, Spitz described the benefits of film. He claimed that

on the film we can observe ourselves and our reaction behavioristically, not introspectively. Observed emotions are difficult to render, to verbalize or to communicate, particularly emotions of the first year. In a film they can be shown. The object of the psychoanalytic approach are emotions. Therefore we use behavioristic methods applied from a psychoanalytic viewpoint.²⁰

Spitz made repeated reference to the way the camera enabled standardized and objective observation of behaviour. It appears, however, that unlike his contemporaries, Spitz did little to utilize the camera as an experimental tool. Instead, the camera provided Spitz with the possibility of showing his own behaviours in relation to those of the infants, and submitting them for reflection and analysis. Spitz was a constant participant in all of the published films. The mechanical tool of the camera appeared to heighten the objectivity of the research while depicting relational scenes between researcher and object. Spitz saw the camera as a shield from the fallibility of internal reflection. Furthermore, the camera became a tool for interaction. Part of Spitz’s visual evidence of emotional interaction was created through the infant’s knowledge of and involvement with the camera. Rather than hiding the camera from view so as not to disrupt the behaviour of the infant, Spitz and Wolf allowed the viewfinder to become part of the relationship they developed with the infant. The camera was placed within the visible stimulus range of the infants, and Spitz and Wolf were the primary cinematographers.²¹ The infants in the films could be seen interacting directly with the camera and the invisible researcher behind it.

Indeed, the analyst–patient relationship is at the centre of psychoanalytic method and knowledge. What emerges in free association and from the unconscious of both parties is the core of the field. Forrester argues that this knowledge is intrinsically linked to reasoning in cases. The case history is ‘the privileged means for attempting to convey the unique psychoanalytic experience of both patient and analyst’ (Forrester, 2017: 65; emphasis in original). Forrester references the Dora case, the Wolf Man, and dreams as primary examples of instances where the case helps to reveal, sometimes unwittingly, the experience and unconscious of both Freud and his patient. Reading and writing cases results in unintentional revelations. Spitz did not write cases, but he centralized interaction in his behavioural evidence in unique ways. By placing himself within the film, I argue, Spitz exposed his own unintentional reactions.

In what follows, I read Spitz’s most widely screened film to show how a key element of the case study—that both the doctor and patient are revealed in its writing—is presented through film. Grief: A Peril in Infancy, released in 1947, presents stark images comparing the experiences of a group of infants in an orphanage in Mexico with the more emotionally adequate care of a New York prison nursery.²² The film is soundless and in black and white. Sections of written explanation appear between each new scene.²³ These words introduce the baby appearing in the subsequent scene, and provide brief background information on the subject’s care. In the prison nursery, the incarcerated mothers interact regularly with their babies, while in the foundling home, babies are given only basic care by nurses. The differences between the two groups, the film demonstrates, are lasting, visible, and stark. The babies in the prison nursery develop ‘normally’. They maintain easy relations with strangers and their mothers. They develop social groups as toddlers. In contrast, the orphans in the foundling home lose weight, become withdrawn, and stall in growth, muscle, and cognitive development. Many of them—the film states 37%—are dead by the age of two.

The first baby to appear on-screen a minute and a half into the film is a black seven-month-old infant called Jane. Chapter intertitles appear before Jane is presented. These describe Jane as having ‘outstandingly good relations with her mother’. She lives in the prison with her mother and is cared for by multiple nurses.²⁴ The film opens with Jane looking into the camera (Figure 2). The viewer becomes aware of Spitz’s presence before he appears on-screen as Jane turns her head and begins to crease her lips upward. Prior to beholding the face of the adult, the camera catches the white-coated arm of the researcher. This opening scene showing Jane happily gazing up at her surroundings is meant to demonstrate Jane’s healthy relationship with her mother. Jane’s mother does not appear in the film. Rather, the film uses Jane’s interactions with Spitz as evidence for the foundational role of the primary relationship. Importantly, the displacement of mother to researcher goes unexplained in the film. The researcher stands in for the mother for both Jane and the viewer.

Figure 2.

‘Jane and Spitz’: Still from Grief: A Peril in Infancy (1947).

Spitz’s behaviours on-screen are crucial to the psychoanalytic claims that he makes. As the film goes on, text explains that Jane’s mother has now been taken away for three months. This time, as Spitz approaches, Jane begins to cry. Tears well in her eyes, and she turns her head back and forth as the adult hand enters the frame to offer comfort to her (Figure 3). The strokes elicit increasingly violent cries and movements. Rather than end the shot or zoom into Jane’s wail, as with others, the camera stays on the whole scene as we watch Spitz brush Jane’s forehead to assuage the pain. Through this action, Spitz disrupts the standard experimental frame that would maintain the infant as the primary experimental object. He places himself within the frame, exposing his own reaction to the situation. This helps creates a visual narrative of the relationship established between the infant, the institutional setting, and the observing researcher.

Figure 3.

‘Jane Crying’: Still from Grief: A Peril in Infancy (1947).

In a 2004 article, Lisa Cartwright considers the place of visuality in the reform of institutional practices, with a focus on Spitz’s films. Spitz, as Cartwright argues, relies on visual cues of looking, touching, and grasping to establish meaningful interpretations of the plight of the infants in institutionalized care. The visible suffering of the infants pulls Spitz in to touch and respond in ways that disrupt both the classic analytic stance and proper scientific detachment. These disturbances of both psychoanalysis and objective observation are what make the films so effective for didactic purposes, and reveal the researcher as what Cartwright calls a moral spectator. They document not only the deterioration of the infants, but also the ‘intervention of the observer as moral agent in the process’ (Cartwright, 2004: 45). The films, for Cartwright, show the ways the observation of external suffering elicits a response in the observer, one that causes a split between witnessing at a distance and intervening.

This disruption, however, shows more than the undeniable seriousness of the institutional setting. Spitz’s involvement is key to the empirical psychoanalytic evidence. Spitz allows the researcher’s response to be part of the object of observation. Even in singular moments of infant facial expression, Spitz and Wolf affect the evidence. The baby looks directly into the camera, but behind the camera is Spitz or Wolf—both of whom the infant knows and responds to. Through the guise of the mechanical authority of the camera, Spitz pulls his own emotions and that of his audience into his research discoveries.

Conclusion

We now return to Spitz’s speech at Vassar College, where he made the case for filmic observation. He argued, ‘On the film we can observe ourselves and our reaction behavioristically, not introspectively’.²⁵ The camera allowed Spitz to have emotional reactions without explicitly invoking them as evidence. In Spitz’s claim to experimental legitimacy, he appeared to dispense with the epistemological style of psychoanalysis. At the same time, he failed at producing generalizable experimental evidence, because the data read like biased involvement of the researcher himself. This interaction is precisely what the psychoanalytic case study is meant to capture. Behind the mask of behavioural observation, Spitz invented ways to bring his own unconscious into the behavioural evidence. He did this not through language, as the classic psychoanalytic style of reasoning called for, but by revealing himself as participant in and director of his knowledge production.

Indeed, writing may be the central indispensable element that sets reasoning in cases apart from other modes of knowledge production in Forrester’s work. As Forrester argues, the unique knowledge of clinical writing ‘implies the repetition—or at very least the remobilization—of the original relations of transference and countertransference evident in the relation between patient and analyst’ (Forrester, 2017: 65). Clinical writing is not a direct representation of what happens in the consulting room; it is a remobilization of it. That is, in reading and writing cases, one furthers the transference and countertransference dynamic. The case of Spitz’s psychoanalytic observation pries the unique link between writing and transference apart. In many of the most indicative and evocative shots in Spitz’s films, the face of an infant expressing pain or pleasure engulfs the screen in a close-up. In one shot, a baby’s face—large and lonely—fills the screen (Figure 1). Though there is no sound, the movements evoke the feeling of a scream. These shots, which are wordless and without context, seem far away from the case study of classic psychoanalytic knowledge. Spitz himself fostered this separation, arguing that ‘screen analysis offers frequent detailed repeated observation’ (1951). Spitz claimed that the mechanical gaze of the camera enabled generalizable and standardized observations, rather than the specific story a case might tell. In contrast, the mechanical prosthetic of zooming in adds to the affectivity of the scene. It is an explicit choice made by the researcher to draw out an emotional reaction in the viewer. In much the same way as writing works, the close-up is an instance where the choice of the creator to focus on this and not that is revealed. Spitz’s films reveal their own construction.

Forrester explores the epistemology of the case in order to highlight not only the unique way of knowing that the case presents, but, importantly, the kinds of things that are revealed by this methodology—cases, and especially the process of writing cases, are the primary way to glimpse the unconscious. The case study reveals the uniqueness of an individual’s life. Spitz brought this promise of psychoanalysis into tension with observational styles, and churned it through the hierarchy of scientific reasoning. Ultimately, he failed to create data that was respected as science, or particularly legible to psychoanalysts. This failure on both fronts exposes the fault lines in the polarization between reasoning in cases and scientific psychology. As Adam Philips notes in his introduction to Thinking in Cases, Forrester is preoccupied with ‘transformational moments (and objects), or their failure’ (Phillips, 2017: xiii). In their failure, Spitz’s films approximate a case, in that they stand only for themselves. They are distinctly empirical. The films make general claims about infant development, but they are merged with the presence of the researcher himself. Forrester shows that the case study reveals more than an individual life; it reveals the unconscious of the writer as well. Spitz’s films convincingly approximate this form of reasoning because they hold on to this key element. Importantly, the case of Spitz demonstrates that this can be achieved outside the strict bounds of the case study.

Footnotes

Declaration of conflicting interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Rachel Weitzenkorn

Notes

References

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