Book Review: Reading Anna Freud, Nick Midgley. Karnac, 2013. (Part of the New Library of Psychoanalysis ‘Teaching…’ series)
Nathan Szajnberg, MD, Managing Editor
Clarity, pragmatism, systematic dedication to children and even humility are words we apply to Anna Freud. Elizabeth Young-Bruehl, who died last year, wrote a magisterial biography of Ms. Freud; Robert Coles, a more personal account. Now comes Midgley’s contribution, something that goes beyond an annotated bibliography, but a book that, like Ms. Freud, is crisp, clear and well-organized. Little flash, much substance.
While this is an overall chronological accounting of her work, each chapter has major works over Anna Freud’s lifetime that contribute to the chapter’s topic. For instance, on child analysis, Midgley lists not only her 1927 “Theory of Child Analysis,” but also later contributions such as her 1936 paper in which she revises some of her earlier ideas, such as shortening the preparatory period, or recognizing Klein’s contributions to “play” as a form of free association, even as Anna Freud cautions that play can have a retrogressive effect.
Ms. Freud’s major influences in thinking about children and adolescents included Aichhorn (the master who fostered a coterie of adolescent experts, including Peter Blos, Erikson and others), Montessori and Bernfeld. In turn, Ms. Freud taught Blos, Erikson (she also was his analyst), Spitz, and the Robertsons, among many others.
Rather than listing all the chapters of this book, I cite some key topics.
Ego and the Mechanisms of Defense was Anna Freud’s masterpiece (and eightieth birthday gift to her father, perhaps complementing his gift in the year of her birth, the “Studies in Hysteria.” Ms. Freud rejiggers our thinking on analytic technique, suggesting that we focus on the defenses against anxiety and the impulses that generate anxiety, rather than focusing on the impulses directly. Impulses are found in us all; the defenses we construct (while limited in number) are those that we create, build, over our life experiences; that is, our defensive profile is more idiosyncratic. She recounts thirteen defenses: repression, reaction formation, regression, undoing, isolation, introjection, identification, projection turning against the self, reversal, sublimation, identification with the aggressor and altruism. The latter two defenses are her contributions. Identification with the aggressor serves to dramatize and forestall punishment from the aggressor; altruism appears more fully in adolescence, but can be seen in healthy preschool children. This systematic approach to defenses spawned clinical research such as Vallaint’s and Cramer’s work. Bettelheim found her ideas about identification with the aggressor helped explain his and others’ behaviors in concentration camp. Ms. Freud’s book complemented Hartmann’s ideas about autonomous ego functioning and the adaptive aspects of defensive maneuvers; these became guiding texts for American psychoanalysis for several decades.
Anna Freud’s developmental lines were a logical step following the defense book. She hoped to articulate how defenses evolve. Her prototype model for developmental lines was the line towards emotional self-reliance and adult object relations. While she believed that early childhood was the era for the foundations of infantile neurosis, she found that adolescence (that psychological counterpart to physiological puberty) was the era when we learn how much is reactivated or retained.
The book describes Ms. Freud’s focus and dedication to child well-being once in London. She wrote on her work with the orphans from Nazi-run Theresienstadt, describing their close peer relations, almost feral behavior and the slow process of beginning to trust adults. She both studied and helped understand children’s reactions to the V-bombing of London and how much the children responded to their mothers’ reactions.
The Hampstead Index was her effort to systematize clinical observation across clinicians, a task we still are needing to master today. This approach proved too unwieldy for most.
Midgley notes her work with adults, with children in hospital and those entangled in adults’ legal messes, such as divorce. For analysis, she articulated the fundamentals: free association, resistance as both obstacle and essential opportunity, and intrapsychic conflict. She fully believed and showed that putting things into words resulted in ego growth and self-observation. Increasingly, she considered “diagnosis” to be a matter of assessing the capacity for development.
In sum, Midgley has done Anna Freud right and given us a book of clarity and substance.