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Clinical
Lectures on Klein and Bion Review by Howard B. Levine.(1993)
Clinical Lectures on Klein and Bion. In nine short chapters, six devoted primarily to Klein and three to Bion, the contributors—Patricia Daniel, Irma Brenman Pick, Ronald Britton, John Steiner, Elizabeth Bott Spillius, Michael Feldman, Edna O'Shaughnessy, and Ruth Riesenberg Malcolm—have crafted a "sampler" that touches upon many of the most interesting and, for the American-trained analyst, perplexing aspects of contemporary Kleinian thinking. Central issues in Kleinian theory are addressed in the book. One involves the fundamental importance and meaning of "unconscious phantasy," a bridge concept between the biology of drive and the psychology of its representation in the mind that is fundamental to the Kleinian conceptualisation of character and of transference. Also presented are clinically illustrated explications of the "depressive and paranoid-schizoid positions." Especially emphasised are the fluid and dynamic relationship that is seen to exist between them in the clinical hour and the intimate connection that is seen to exist between the depressive position and the Oedipus complex. Another issue addressed is "projective identification" and its relation to thinking, knowing, and being known, which are viewed as fundamental motivational forces in human relations. When their development goes awry, we are told, conflicts arise that can lead to schizoid withdrawal or to frank psychosis. This book does not attempt to be either systematic or comprehensive in its presentation of the ideas of Klein and Bion. Instead, its major strength resides in its ability to engage the reader's interest across a wide range of topics. While these interests will vary with the specific predilections of each reader, I suspect that most will find the discussions and the many clinical illustrations of the concept, "projective identification," to be of particular value. Especially worthy of commendation is the chapter by Spillius, "Clinical Experiences of Projective Identification," which offers a succinct description of how the term was originally used by Klein, was then elaborated on by Bion and Joseph, and is now used clinically by many contemporary Kleinians. Spillius states that Klein "did not think that the patient literally put things into the analyst's mind or body" and felt "that if the analyst was influenced by what the patient was doing to him it was evidence of something that the analyst was not coping with" (p. 61). Thus, Klein emphasised that it was the patient's fantasy that the analyst was being influenced. The subsequent contributions of Bion delineated normal from pathological forms of projective identification. The work of Joseph emphasised the subtle, often unconscious pressures brought to bear by patients upon their analysts in order to get them to behave in ways that conformed to the patients' unconscious fantasies. Spillius's case vignettes reflect her belief that all three models of projective identification are apt to be simultaneously operative in any analytic session: "The analyst is always affected to some degree by his patient's projection; there is always some 'nudging' by the patient to push the analyst into action; and inevitably there is usually some acting out by the analyst, however slight" (p. 64). In a related chapter, "Splitting and Projective Identification," Feldman describes case material that amplifies Spillius's discussion. It offers the reader a very lucid illustration of how Kleinian analysts think about the projective identification of potentially useful functions of the mind, such as the capacity to think, recognize, etc. That is, if, under the influence of the unconscious fantasy, these ego capacities have been evacuated into the object, the patient might stop using them to work in the analysis in his or her own behalf. The Feldman chapter also serves as a transition to the three Bion chapters, which contain important references to Bion's theories of knowledge, thought, and mental functioning and their relationship to psychosis. For example, O'Shaughnessy ("Psychosis: Not Thinking in a Bizarre World") describes how Bion's view of psychosis, which not only refers to fragmentation of the personality, but also to "expulsion of the means by which the ego knows reality; … the fragmentation and expulsion of the senses, consciousness, and thinking" (p. 90), was derived from Freud's death instinct, which Klein understood as an intrinsic current of hatred for the stringencies and restrictions of reality. (In this sense, the latter seems close to Chasseguet-Smirgel's formulations of mental functioning at the level of the archaic Oedipus complex.) Britton ("Keeping Things in Mind") discusses Bion's views of psychosis in relation to the theory of container and contained. To the extent that the containing function includes the provision of "sanctuary"—a feeling of being held or protected—and "meaning"—the provision of a sense of inner meaning or coherence—Bion's work appears related to that of Winnicott (the "holding environment"), to whom Britton refers, and to Kohut (the "selfobject"), to whom he does not. In addition, these chapters make clear the extent to which Bion understood the paranoid-schizoid position of psychotic patients as being different from that of non-psychotic patients. They also demonstrate the extent to which Bion took actual experience into account as an influence upon development: e.g., Bion thought that the decisive factor in the development of overt psychosis is usually an intrinsic, constitutional factor. There is far more of interest and value than can be mentioned and discussed in a limited space. Suffice it to say, this is a very worthwhile book that should prove useful to anyone interested in understanding Kleinian practice and theory. This book should also be of interest to American analysts who seek to understand the foundations—and parallel evolution—of concepts and issues which are currently being discussed under the rubric of a purported new "relational" paradigm for psychoanalysis. These include the clinical implications of object relations theory, the potentially positive use of the countertransference, the significance of enactments, and the interactive aspect of the psychoanalytic relationship. The books in this series can be ordered from Karnac Books Ltd
Review by David Taylor (1993) Clinical Lectures on Klein and Bion. Psychoanal. Q., 62:651-653 (PAQ) (1994) Clinical Lectures on Klein and Bion. Int. J. psychoAnal., 75:627-632 (IJP) The publication of lectures originally intended for a wider audience of some kind, be it the general public or specialists from related disciplines, scientific or cultural, has a distinguished history in psychoanalysis. Freud gave his 'Five Lectures on psychoanalysis' on successive weekday evenings in the Autumn of 1909 at Clark University, Worcester, Massachusetts. On that, his first, visit to the USA, Freud met James Jackson Putnam, the neurologist, and William James, the psychologist and philosopher. In An Autobiographical Study Freud wrote: In Europe I felt as though I were despised; but over there I found myself received by the foremost men as an equal. As I stepped on to the platform at Worcester to deliver my Five Lectures on psychoanalysis it seemed like the realisation of some incredible day-dream: psychoanalysis was no longer a product of a delusion, it had become a valuable part of reality (Freud, 1925, p. 52). As far as publication of these lectures went, Freud (1910) wrote them out from memory two months later! The function of these lectures was to mark public recognition for Freud and for the body of knowledge he had created, as well as to disseminate psychoanalytic ideas in the new world. For speaker and audience, public lectures have pronounced elements of occasion and rite. However, as we see from Freud's comments, the public acceptance of knowledge can be a way of modifying anxieties we can all have about the truth and usefulness of new discoveries. The subsequent publication of lectures is an attempt to consolidate a coming of age, or rite of passage, to mark the social acceptance of knowledge, or is sometimes part of a struggle to achieve acceptance. Another example was Melanie Klein's visit to London in 1925 to give six lectures on child analysis. This was a turning point in her own life as well as largely determining the way in which psychoanalysis developed in Britain. The lectures given to those 53 members, associates and guests of the British Society who attended the meeting at the house of Karin and Adrian Stephen fired a preexisting interest in child analysis. These lectures were highly original scientific papers intended for specialists, but from very early on their content began to reach workers in other fields, most notably, the progressive-education movement, others involved in child development, as well as literary and artistic figures. Some of the material in the lectures was repeated in a course of more open public lectures given by Klein in the autumn of 1927. These were entitled 'Adult Psychology in the Light of Child Analysis', and were advertised as being for 'the advanced student of psychoanalysis'. Klein had moved permanently to London in 1926. Her lectures were published in 1932 as the first part of The psychoanalysis of Children. Subsequently, Klein wrote three papers for a wider, non-psychoanalytic audience, and in the 1930s she gave two public lectures similar to the lectures in this book. In February 1935, she gave a paper entitled 'Weaning' as part of a series of six lectures, whose overall title was 'Can Up-bringing be Planned?' In 1936 she gave another public lecture, 'Love and Reparation', this time as one of a series of three, Riviere and Payne being the other speakers, under the overall title of 'The Emotional Life of Civilised Men and Women'. The original notices for these events still exist in the archives of the British psychoAnalytical Society. Finally, in 1959 she published Our Adult World and its Roots in Infancy (Klein, 1959) Klein's approach in these public lectures differs somewhat from the style adopted by the authors of this volume; later in this review a comparison of the significance of this, with particular reference to Klein's paper on 'Weaning', may provide some idea of how the climate for these lectures has changed over the years. Clinical Lectures on Klein and Bion is a book made up of nine papers originally given as talks on three separate public lecture days in 1988 and 1989, with three lectures on each day. All but three of the lectures were written specifically for their intended occasion, two of the days being devoted to the ideas of Melanie Klein, while the subject of the third was the work of Bion. The writers, who come from the British psychoAnalytical Society, are Anderson (the editor), Brenman Pick, Britton, Daniel, Feldman, Riesenberg-Malcolm, O'Shaughnessy, Spillius and Steiner, and belong to that second generation which followed in the footsteps of Bion, Rosenfeld, Segal and Joseph—the main representatives of the first generation having come after Klein and her immediate co-workers. In the first paper, Daniel describes how Klein's development of the play technique permitted the formulation of the notion of unconscious phantasy and vice-versa. As well as examples drawn from Klein's writings, Daniel describes her own work with a girl of 6. From Daniel's work, one gets the impression of a serious, commonsense view which carries quiet authority. We are given a chance to look at the problems of verification of interpretation in child analysis. How do we come to our interpretations? How do we draw our conclusions, and on what basis? Primitive phantasy and early object relations are also the subject of Brenman Pick's paper. One of Klein's most important contributions was the way she extended the correlation of mental operations with infantile phantasies about bodily activities. In the past, as was evident in the 'Controversial Discussions', this was misunderstood as Klein's concreteness of thought, or as an inability to separate metapsychology from infantile phantasy. Yet, as Petot (1990) has recently shown, in her early work, Klein believed in an epistemophilic instinct. One of her first concerns was with the effects of sexual knowledge, curiosity and enlightenment upon the child's wider attitude to knowledge of the world. As we shall see, one of the most important developments of Klein's work took her insight into the nature of knowledge and thinking to develop sophisticated ideas about psychological functions such as symbolisation and learning from experience. Brenman Pick foreshadows this connection when she describes how a retarded 7-year-old boy watched an electric light, making it swing, cowering, watching it, first frightened, then ecstatic. Following interpretation that the light seemed to be 'all the world to him', the boy wanted a drink of water and also wanted Brenman Pick to swing the light with her head, placing his own head against the light, too. She interprets that the boy now seemed to be wanting something from her head; perhaps, she comments, food for thought comes from the analyst's head or mind and this is what he thirsts for. It is one thing to talk about something, to define, for example, a concept such as envy or projection, and quite another to bring the idea alive by showing it in operation. Definitions, while helpful, can also be restrictive. There should be no gateposts on the road to truth. So Brenman Pick, in some complex clinical material, tries to illustrate, rather than define, a whole series of factors in some material from a patient's session; these include the effect of recent events to show the importance of the current situation, the nature of various anxieties, the impact of trauma and the presence of envious rivalry with mother. The result is a convincingly many-layered view of the personality, appropriately complicated and recognisable, illustrating several ideas important in Klein's thinking. The next paper, by Britton, 'The oedipal situation and the depressive position', moves on to the middle period of Klein's work, and is one of several in the book which contain a new idea. Klein had described the early Oedipus complex as being precipitated by an experience of loss in the form of weaning. Later she emphasised the simultaneity of the Oedipus complex with the depressive position. Britton's ideas concern this linkage. He writes: 'We resolve the Oedipus complex by working through the depressive position and the depressive position by working through the Oedipus complex' (p. 35). While this notion is implicit in Klein's theory, Britton's ideas clarify the interaction whereby, in the depressive position, the infant's greater capacity to recognise reality leads to knowledge of the parental couple. The infant knows he doesn't have exclusive possession of his objects. This loss leads to further working through of the anxieties characteristic of the depressive position, leading, in turn, to further awareness of parental sexuality, and further accentuations of oedipal rivalry. Britton has a remarkable capacity to convey the emotional content of different states with evocative turns of phrase. The pre-depressive world is Eden. For some patients, the recognition of parental intercourse is destructive of everything good about mother and hence the world'. In these circumstances, the primal scene is 'a catastrophe leading to a fallen world. It is the eating of the fruit of the tree of knowledge which brings the fall: the advent of shame and sex and the avenging angel' (p. 42). In, 'The equilibrium between the paranoid schizoid and the depressive position', Steiner lucidly draws a number of clarifying distinctions, for example, between normal splitting and pathological fragmentation, and describes the states of fear, chaos and confusion experienced by patients when fragmentation is employed to deal with severe anxieties. He clarifies two stages of the depressive position: the first, in which the loss of the object is denied; and the second, in which it is experienced. In the early stages of loss that there is often identification and 'Because of the identification with the object, the mourner believes that if the object dies he must die with it, and, conversely, if he is to survive then the reality of the loss of the object has to be denied' (p. 54). A critical point in the depressive position is described when, 'The earlier trend which aims at possessing the object and denying reality has to be reversed if the depressive position is to be worked through' (p. 53). This means that the mourner must expose himself to the reality of the fact that he is unable to protect his objects from his own sadism that arises as a consequence of separation and loss. So, the painful paradox is that the mourner must kill what he loves in order, ultimately, to be able to restore it at a symbolic level within the ego. All this was understood by Klein, but Steiner's formulations are part of a working out of implications and consequences. For example, he connects mourning and the loss of the object with psychic growth and change through the return of projected, split-off parts of the ego to the self and its consequent enrichment. Of all Klein's ideas, projective identification is perhaps the one which has been most widely applied by analysts from other traditions. Spillius, in a typically scholarly review, describes how Klein's initial concept of projective identification as an omnipotent phantasy of the patient, influencing only the patient's representation of the object, was developed through Bion's later concept, which included the infant communicating to the mother and the mother's processing these communicated emotions through reverie. Joseph has extended this work further by applying it to the clinical situation, detailing how the analyst is influenced or 'nudged' by the patient, inclining the analyst to take one position or another, often subtly re-enacting previous object relations. Feldman's paper, 'Splitting and projective identification', is a companion to that of Spillius, as it covers some of the same ground but with a greater clinical emphasis, giving a picture of one man's Kleinian analysis. Feldman's carefully observed work carries increasing authority as he details the unobtrusive manifestations of certain envious, attacking aspects of a patient who had also suffered from an undeniably explosive and traumatising mother. The help and support experienced by the patient as she was able to integrate these aspects of her character are the more impressive because they are evident in the material and in Feldman's technique, rather than announced in testimonial fashion. Most of the papers primarily devoted to Klein's ideas make some mention of Bion's contributions to the subsequent development of Kleinian thinking. On several occasions the issues of learning, knowledge and thinking surface along with Bion's ideas about normal and pathological forms of projective identification and his working out of the nature of psychotic mechanisms—the mind's omnipotent action upon the mind—where mental contents and ego functions are obliterated and/or projected. These are the contents of the last three papers of the book, namely, 'Psychosis: not thinking in a bizarre world' (O'Shaughnessy), 'Keeping things in mind' (Britton), and 'As if: the phenomenon of not learning' (Riesenberg-Malcolm). Anderson, whose helpful introduction provides brief biographies of Klein and Bion, describes how Bion was a provocative, fascinating thinker, whose writings could sometimes be unnecessarily abstruse and abstract. However, these drawbacks are insignificant compared with his power and originality. Bion had a facility for describing clinical situations that we can recognise but have never been able to formulate. A small example is provided by Brenman Pick, when she quotes him as remarking that the first thing a patient does when he finds an object which provides the support needed to understand—which he has previously not had—is to 'tell' the object what it was like not to have it. Bion was influenced by many in his development of Klein's thought. Anderson mentions how important was Bion's early upbringing in India and how he drew on classical Indian writings in his later work, for example, The Bhagavad-Gita. The English romantic tradition of Keats and Coleridge as well as Bion's own idiosyncratic reading of German idealist philosophy, especially Kant, provided him with some central concepts and idioms and were used to transform Klein's findings into a psychoanalytic epistemology. Dreams, myths, concepts, thoughts, symbols, mathematical ideas and scientific theories—were all seen, from the psychoanalytic point of view, as transformations, one of another, and dealing with certain basic emotional problems. Bion's originality is brought out very clearly in O'Shaughnessy's paper which is, in my view, a minor classic. Her purpose is to give some idea of Bion's contribution to the theory of psychosis. This she achieves with concise descriptions of Freud's ideas about psychosis, then Klein's, then Bion's, supported by clinical examples which are singularly apt and moving. Bion's view that psychotic functioning derives from, 'a highly adverse inborn disposition, and … its interaction with an adverse environment', is supported and explicated by a description of the psychotic personality's subjective experience of life as, 'a preponderance of destructive impulses, a never-decided conflict between life and death instincts, anxiety at a horrific level, a dread of imminent annihilation and a total intolerance of frustration' (p. 91). This succinct but terrifying list is later summarised further: In psychotic states there is an overall divergence from the normal due both to what the mind has lost—the power of thinking, the capacity for awareness, sense organs for perceptions, mental depth and contrast—and to what the mind has become—fragmented, its elements concrete and without variety, its sense organs become apertures, its chief functions splitting and evacuating bad fragments, an abnormal projective process which has made the world bizarre (p. 101). Some sessions from the analysis of a 5-year-old boy convey the need for the analyst to take in projected feelings and modify them, rather than to work at a verbal, more neurotic, level. At one point, when he feared falling apart, the little boy says helplessly, in a lady's anxious voice, 'Oh, my nerves, my nerves'. For me, this carried echoes of one of Klein's patients, Rita (Klein, 1932), who, when sobbing uncontrollably, was asked, '"Why are you crying?". 'Because I am sad". "Why are you sad?". "Because I am crying"'! Bion's theory of the mother as the container and modifier of the infant's projective identifications is one of the ideas which underpins our adopting of a clinical stance in which, as analysts, we try to remain open to the patient's emotional communications. Britton's second paper in this book is devoted to this idea, which he considers 'a piece of major metapsychology and … a notable contribution to psychoanalysis … a new rationale for the efficacy of psychoanalysis … the transformation of experience through the process of containment' (p. 104). One implication of the theory is that if the process goes wrong the child, and later the adult, may be unable to think symbolically. One of Britton's patients is described as experiencing a world that she knew at some level was mental and emotional, but which she couldn't experience as such, instead tipping into hallucinations, action, hypochondriasis or psychosomatic illness. This patient longed for the sanctuary of her sessions when she hoped to find some relief from this ill-defined, but terrible torment. Once within her sanctuary, she would ask, 'What does it mean? What does it mean?' Our understanding of Klein's epistemophilic instinct has been much enriched by Bion's ideas. The search for meaning among patients and analysts makes more sense when we are able to understand some of the consolations offered by meaning. But there is an obverse to epistemophilia; the analyst and patient often fail to be simultaneous in their search for understanding. Britton describes how when an object remains closed to projections, 'curiosity encounters a hostile object … an object that neither wishes to know, or be known'. This is in the territory of Bion's description of the psychotic patient's internal object as a psychic structure which denudes and strips away meaning rather than adding to it. Taken together, O'Shaughnessy and Britton's explication of these difficult notions convey a lot of what Bion was trying to get at when he described these meaning-stripping functions as a 'vagina-like breast'. Britton correctly argues that Bion, with his notion of container/contained, provided a theory for the efficacy and nature of psychoanalysis. However, his development of a theory of thinking, the observation of the psychotic's internal objects denuding meaning, the hatred of knowledge, curiosity and intolerance of pain and frustration, together have contributed to a psychoanalytic theory of the vicissitudes of learning from experience. Riesenberg-Malcolm's paper addresses a group of patients displaying the phenomenon of as-if personality, in which there are pronounced problems with emotional learning, and instead there is a pseudo-adaptation both to external reality and to the analysis itself. She describes under the heading of Bion's description of reversible perspective a whole variety of ways in which the patient in an as-if state evades the significance of interpretations thus maintaining an emotional status quo. She quotes Bion, 'The interpretation is accepted but the premises have been rejected!' Some patients achieve this by, for example, relating interpretations always to past situations. These she describes as, 'once upon a time'. Riesenberg-Malcolm's paper is a psychoanalytic paper proper, addressing weighty and robust issues. She concludes, The as-if patients experience the awareness of their internal world as a menace to their sanity. They feel that they have (and had historically) only one of two ways of coping with the situation. Either they disintegrate completely, or they remain 'as if'. The experience of not learning and being in analysis offers these patients a modus vivendi (p. 125). Bion considered that the ego's capacity to know aspects of reality was dependent upon several ego functions, including perceptual functions corresponding to the sense organs. Several of the writers here make reference to the ego's perceptual apparatus—the ears, eyes, mouth, touch—of the mind. That these are not simply metaphors is clear from the clinical examples given. For instance, one of the patients described in Riesenberg-Malcolm's paper developed, at a time of potential insight and change, visual difficulties which were ambiguously on the borderline between physical fact and hypochondriacal anxiety. The way in which psychoanalytic ideas are communicated presents a number of interesting problems, even when the audience is a psychoanalytic one; when the audience is non-specialist, the task is probably still more difficult. In this book, each writer has adopted the strategy of showing—predominantly through their current clinical work—how Klein's and Bion's clinical and theoretical contributions are now used. So, we are presented with a palimpsest; the ideas as they originally arose in their historical context are described, but the accretions, developments and workings out of clinical technique and theoretical enquiry as these reveal themselves in each author's account are the principal focus. Within this general framework each author has his or her own style, but there is throughout an emphasis upon the power of detailed sessional material to convey analytic ideas. This is a book about psychoanalysis rather than its applications to other areas. This approach is very different from that adopted by Klein herself in her public lectures to a wider audience. For example in her 1935 lecture, 'Weaning', she spoke mainly about the baby, not about the patient, child or adult. The first part of the paper brings in the analytic concept of the unconscious followed by a more detailed account of unconscious phantasy. She talks about the infant's powerful feelings of love and hate, about good and bad objects, restoration wishes, projection and introjection and the symbolic significance of urine and faeces. There is only one short passage of clinical material and her language is almost entirely free of technical terms. The method is commonsensical and everyday. The paper in this volume which has the most similar content is that of Daniel. Like Klein, Daniel introduces the concept of unconscious phantasy, but, interestingly, she does so in a more detailed way, which resembles the Klein of The psychoanalysis of Children rather than her public-lecture style. Daniel uses a lot of detailed clinical material; part-object interpretations of unconscious phantasy are not ducked. It is an intriguing question as to how much this difference has arisen from the greater analytic sophistication of today's public audience. The second half of Klein's paper is about the emotional significance of nursery issues, such as weaning, breast and bottle-feeding, thumbsucking, masturbation, toilet training, whether or not the child should sleep in the parents' bedroom and general features of the mother–infant relationship. It seems likely that Klein's audience was comprised of either mothers (and fathers) or of workers in the newly-formed child-development clinics. One of the several remarkable things in this paper is Klein's emphasis upon the importance of the external object and the way the mother behaves. She is repeatedly described as having a crucial role in, for example, softening the loss of the breast at weaning. Klein writes: We must remember that at the critical time of weaning the child, as it were, loses his good object, that is he loses what he loves most. Anything which makes the loss of an external good object less painful and diminishes the fear of being punished will help the child to preserve the belief in his good object within. At the same time it will prepare the way for the child to keep up a happy relation to his real mother and to establish pleasurable relations with people other than his parents (Klein, 1936, p. 296). The general tenor of the paper is a powerful antidote to the view of Klein as persecuting, severe and neglectful of the importance of the actual relationship between mother and baby. At several points she gives quite practical advice. Since a number of the authors in this book make extensive use of metaphor, examples and quotations from literature, and since Klein herself recommends 'a sip of dill-water or sugar-water in between times', it is possibly justifiable to mention Shakespeare's description of weaning in Romeo and Juliet. Juliet's mother is designing to marry her adolescent 14 year old to the socially appropriate Paris. The nurse reflects upon Juliet's age and muses about her weaning when Juliet was 3 and she, her wet nurse, 'laid wormwood to my dug', and 'When it did taste the wormwood on the nipple/Of my dug and felt it bitter, pretty fool, /To see it tetchy and fall out wi'th' dug!' Although weaning at 3 years makes the timing a bit different, Shakespeare's dramatic insight does anticipate Klein's connection of weaning and the Oedipus complex. The nurse continues her wry teasing of the mother and recalls that the day before the wormwood Juliet had fallen and bumped her head. The nurse's husband, 'God be with his soul, /A was a merry man!- took up the child./'Yea', quoth he, 'dost thou fall upon thy face?/Thou wilt fall backward when thou hast more wit, /Wilt thou not, Jule?' And, by my halidom, /The pretty wretch left crying and said 'Ay'. The nurse then slyly taunts Juliet's mother by twice recalling these events with the refrain, 'Wilt thou not Jule?' quoth he, /And pretty fool it stinted and said 'Ay' (Romeo and Juliet, Act 1, Scene 3). Illustrations which employ the skills of the artist, the poet, or the novelist can evoke some essence of the idea in question. These figurative or literary representations repay especial study as this is one way of increasing our understanding of the phenomenon depicted. There is a nice example of this in the Melanie Klein archives. In one of the boxes, marked 'press cuttings on matters of interest', there is a small cartoon cut out from the Punch magazine of 26 July 1939. It shows a bare-chested British sailor having a medical examination. The doctor's stethoscope is positioned over his heart, where the sailor has a large tattoo of a mermaid. She, too, lies beneath the stethoscope. The caption reads, 'How is she today doctor?' Here, the concept of internal objects and the understanding of the cartoonist enhance each other to produce a little masterpiece, which no amount of learned explication can replace. This depiction is as useful for the analyst familiar with the idea of internal objects as much as for those who have never heard of it. The same can be written of this book, where each author has taken very seriously the task of conveying some difficult psychoanalytic ideas. There is little, in any of the papers, of routine exposition or tired précis of well-known standard texts; original ways of formulating the central ideas of Klein and Bion have been found. The audience, and now the reader, are treated with great respect. As Hanna Segal points out in her excellent Foreword to the book, they were not talked down to or condescended to. The aspects of Klein's and Bion's work presented have been carefully chosen as representative, so that although a comprehensive summary of their ideas has been eschewed we still end up with a pretty good idea of the range, depth and importance of the contributions they made to psychoanalysis. As several of these authors have made their own significant contributions to the development of psychoanalysis, the result is a powerful book which appeals on a number of levels. Although this book has several equals, I know of no better introduction to the modern use of Klein's and Bion's contributions. I wonder whether in future editions the editor would consider including one, or all, of Klein's own public lectures? REFERENCES FREUD, S. 1910 Five Lectures on psychoanalysis. S.E. 11 FREUD, S. 1925 An Autobiographical Study. S.E. 20 KLEIN, M. 1932 The psychoanalysis of Children London: Hogarth Press, 1975 KLEIN, M. 1936 Weaning In Love, Guilt and Reparation and Other Works 1921-1945 London: Hogarth Press, 1975 pp. 290-305 KLEIN, M. 1959 Our adult world and its roots in infancy In Envy and Gratitude and Other Works 1946-1963 London: Hogarth Press, 1975 pp. 247-263 PETOT, J. M. 1990 Melanie Klein: Volume 1, First Discoveries and First System. 1919-1932 trans. C. Trollope. Madison, CT: Int. Univ. Press. Copyright
© 2001 British Psychoanalytical Society &
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