0.4 Neo-freudian perspectives on personality  (Page 8/28)

The play technique worked out by Mrs. Melanie Klein is certainly valuable for observing the child. Instead of taking the time and trouble to pursue it into its domestic environment we establish at one stroke the whole of its known world in the analyst’s room, and let it move about in it under the analyst’s eye but at first without his interference…

Mrs. Klein however…assumes the same status for these play-actions of the child as for the free associations of the adult patient…if the child’s play is not dominated by the same purposive attitude as the adult’s free association, there is no justification for treating it as having the same significance. (pgs. 28-29; A. Freud, 1946)

Anna Freud’s steadfast belief that children do not have the intellectual or psychological capacity for free association, in part because they simply can’t relax and lie still for an hour on the psychoanalyst’s couch, also raises questions for the use of the second most common psychoanalytic technique, dream analysis. Dream analysis depends on the patient’s ability to freely associate about the manifest content of the dream. With children, it is necessary for the psychoanalyst to connect the manifest content with the latent content, and this process will always be somewhat suspect (A. Freud, 1946). These problems lead into another controversy, the age at which psychoanalysis can occur. Whereas Klein and her colleagues believed that psychoanalysis could occur at any age, since babies are involved in play as part of their earliest activities, Anna Freud believed that some amount of speech was necessary to form an adequate therapeutic relationship with a child (so the earliest reasonable age for psychoanalysis would be around two to three years of age; A. Freud, 1946).

In her conclusion to The Psycho-Analytical Treatment of Children , Anna Freud re-emphasizes the role that the developmental processes play as a child (and their id, ego, and superego) grows. As such, a child analyst needs to be “as intimately familiar with the normal sequence of child development as he is familiar with the neurotic or psychotic disturbances of it” (A. Freud, 1946). She specifically mentions academic psychology and the tests being created by psychologists for the measurement of personality as useful in this regard. She also mentions one test as being especially useful in examining libido development and its disturbances: the Rorschach test. Still, she acknowledges that our understanding of the developmental processes of the libido and of the ego is “very incomplete.” Yet she cautions psychoanalytic investigators “not to confine examinations to short-cuts of any kind…” (A. Freud, 1946). Clearly her concern for children, and for a professional approach to psychoanalytic research and practice, were foremost in her mind.

So what does current research tell us about the effectiveness of psychoanalysis on children? As is often the case, the results are not clear. Although a number of studies have shown that children benefit from psychoanalysis, the degree of that benefit has been disappointing (see Jarvis, 2004). When children of different age groups were studied, the results showed that psychoanalysis was more effective for younger children than it was for adolescents, something that Anna Freud would probably not have predicted. An important problem in many of the studies providing positive results, however, is that the results are based on reports by the therapists. Such reports are highly subjective and open to bias (Jarvis, 2004). Also, as we might expect, the effectiveness of psychoanalysis is dependent on the experience and skill of the analyst. Typically, analysts who have experience teaching and supervising psychoanalysis, as well as those who are prepared to try a variety of psychoanalytic techniques, achieve significantly better outcomes with their patients (Kernberg, 2004). So we must consider the question of the effectiveness of child psychoanalysis as one that remains unanswered.