Transcription
[Applause] Thank you very much. And people hear me okay at the back? Yeah. So, it's a real privilege to be here and to be following those two really fascinating talks. It's also slightly scary and intimidating to follow those two such fascinating tools. But I want to talk to you today a little bit about an afforded.
Maybe before I started, it would just be useful to know how many people here have read or studied Anna Freud's work? Okay, so yeah, maybe sort of about a quarter of the people in here or so. So, I'll just start by just saying a few words about Anna Freud. She was born in 1895, and as many of you know, she was the sixth and youngest daughter of Sigmund and Martha Freud. She was the only one of the Freud family who followed her father into the field of psychoanalysis, sort of connecting a bit to what Liz was talking about earlier.
Like many women of her generation and of her culture, she finished her formal education at fifteen. So, although she was ferocious ly well self educated, I think she was always very conscious of the fact that she had no formal university education either in psychology or in psychiatry. And I think probably, I don't think she ever was a member of the British Psychological Society because she wasn't a psychologist, and I think would have been really excited but also possibly somewhat surprised that this conference today was including her in celebrating her work as part of women in psychology.
A couple of years before Anna Freud died – she died in 1982 here in London – a couple of years before that, there was a poll in the U.S. of all of the child psychiatrists in the U.S., and they were asked, in fact, they voted Anna Freud as the most influential figure in child psychiatry in the 20th century. And that's quite an extraordinary fact, and I think sort of it's rather uneasily with the fact that I think today probably Anna Freud is somewhat of a forgotten figure. So, for example, most of her work is now long out of print, and I think as was reflected in the audience here today, many people working in the field of psychology probably haven't read or studied and Freud's work.
So, I suppose what I wanted to do in this talk was reflect a little bit on why that might be, but also talk about some of the ways in which I think Anna Freud has been remembered. I'm going to start by talking about three ways that I think Anna Freud's work has been remembered, and then go on and talk about some of the ways in which I think it hasn't been, that perhaps her work could be reread and reread in a way that would make it relevant to us and speaking to our concerns today as psychologists.
So, let me begin with some of the ways that I think probably Anna Freud is read today. And probably those who do know Anna Freud are most likely to know her, as the plaque outside her home in Messier Gardens says, as one of the pioneers of child psychoanalysis. So, along with Melanie Klein and Hermione Hug-Hellmuth, she was one of the first people in the early 1920s to start thinking, "What would a psychoanalytic treatment of children look like?"
And the sort of the impetus for this really came from the fact that the work of Freud and psychoanalysis had suggested that many of the problems that adults were facing in terms of emotional well-being and mental health probably had their origins in childhood. So, there was a kind of natural logic that the next step should be, "Well, let's actually move in earlier. Let's see if we can make a difference in children's lives so that we can save them from a long life of suffering."
But I think it's easy to forget today just how conversional, in the way, how scandalous it was to suggest that children as young as 4 or 5 could be offered a psychological therapy. And although there's many things about the way Anna Freud originally tried to practice Psychonauts is with children which I think, you know, we would no longer follow today, I think there are some fundamental ideas that she had that are still very important for us today.
One of them is simply the idea that children's emotional and behavioral difficulties can be understood in psychological terms. Again, it's almost self-evident to us today, but that was an idea that was not self-evident when Anna Freud began this work. Secondly, and I think sort of following from that, that children's emotional difficulties could be helped through a relationship, through a relationship and a therapeutic relationship. Again, that was a revolutionary idea at the time that Anna Freud was beginning her work. And third, and I think again this is still very important for us today, that although talking is a central part of all psychotherapies for children, play is in a sense the natural language of childhood and the natural language through which children communicate their inner worlds. And I think that was something that Anna Freud tried to establish there, and that still is very important for us today.
Now, if there's a second way in which people perhaps do still read Anna Freud's work today, it's as the person who in a sense popularized this idea of the mechanisms of defense. And in fact, this book, "The Ego in the Mechanisms of Defense," which was first published in 1936, is the only work van of Freud's which has remained in print ever since then and is still in print today. And many of the ideas from this book have kind of entered the popular language. So, when we talk about ideas like "identification with aggressor," this is a concept that comes from Anna Freud 1936 work.
But I think what was sometimes lost with this book was that actually it was quite a revolutionary shift in the focus of psychoanalysis itself. So, for Freud, Freud had seen the mess for he often used for himself as a psychoanalyst was as an archaeologist. That he saw that what psychoanalysis was about was digging down into the deaths and discovering something deep in the unconscious, which he felt up to that point psychology had really paid very little attention to. And I think in this book Anna Freud was suggesting that actually psychoanalysis could expand the domain that it was interested in. So, Freud was digging down to the depth, but Anna Freud in this book was asking, "But what is it? What are those layers that have led these things to be buried? How have those layers been accumulated so that those deep unconscious things have become lost?" In other words, "What if we, what do we do in our minds, in our psychology, to protect ourselves against pain and against fear and indeed against our own desires?" So, I think this is the contribution that she made in this book.
The third way that I think Anna Freud's work is perhaps still read today is Anna Freud as, in a sense, the guardian of a classical Freudian psychoanalysis. And there's no doubt that Anna Freud herself, in a sense, very much this was the narrative that she also told about herself, that she put herself forward as the person who was there to preserve and to protect the classical theory of psychoanalysis. And I think in the 1960s and 1970s, as there was a real turn against psychoanalysis, this is part of the reason why Anna Freud's work began to be discredited. So, with the Freud Wars and in a way the rejection of a classical psychoanalytic model, I think Anna Freud's ideas were thrown out with that as soon as part of this very old-fashioned classical psychoanalytic theory which didn't really speak to us anymore.
But what I wanted to sort of talk about for the last part of the rest of this talk is that I think there were other ways of reading Anna Freud work which perhaps shed a different light on her legacy and ideas that I think are still very relevant to us as psychologists today.
So, the first thing, which in a way suits rather surprisingly with this idea of Anna Freud as a rather traditional psychoanalytic conservative, was that she was a rad or activist. Anna Freud came to adulthood in the early 1920s in Vienna. This was following the First World War and the collapse of the austro-hungarian Empire. And with the collapse of that Empire, in a way, a real challenging of the authoritarian and the patriarchal sort of system that that Empire had stood for. And Vienna, where Anna Freud was living, was not by accident known as "Red Vienna." After Moscow, it was probably the most radical left-wing city in Europe.
And Anna Freud, with her peers, really was interested in changing society. That there was, in a way, two ideologies which were seen as contributing to making a better world: Marxism on one side in terms of political revolution, and psychoanalysis on the other in terms of psychological revolution and personal revolution. So, Anna Freud, although I talked to her about her in the 1920s developing analytic treatment for children, and she spent plenty of time in the consulting room paying very careful attention to the inner life of a particular child in front of her, she was equally committed to engaging in society.
So, she worked, she set up our support groups for children who'd been made orphans in the First World War. She campaigned with the social care and social welfare teams to try and help them think about the psychological needs of children. She also worked with her colleague Auguste Aichhorn on engaging what they called in one book "wayward youth." We would probably now say "hard to reach adolescence" or maybe the "difficult families" or "challenging families." But she tried to find ways to work with the most disenfranchised and, in a way, the victims of that society.
I said to Donna Freud left school at 15. She went on to train as a teacher, as a nursery school teacher. And Anna Freud was equally committed to thinking about the education of children. She felt if we're going to build a better society in a different kind of childhood, then education has a fundamental role to play in that. And there's many ways in which she tried to do this, but one of them that I thought I just mentioned briefly it was actually in Vienna in the late 1920s. She helped set up her own school, the "Hietzing School," the "Matchbox School." And the question that she, in a sense, posed herself and the staff who worked with her was, "What would a school look like where our aim is not to make children learn but to inspire in them a love of learning?" "What would a school look like?" She didn't know the answer to that. She just said, "Let's get together and see if we can find some answers to that question."
And just interestingly, the two young teachers who she appointed to run this school were two unknown young men who were hanging around Vienna at the time. One of whom was called Peter Blos, and the other was Erik Erikson. And as you may know, both of those went on to make really major contributions, particularly to the psychology of adolescents. And I think actually a lot of what they learnt came from their experience working with Anna Freud in this school, particularly in a school where they were helping children in that transition, in a sense, from middle childhood through to adolescence.
In 1938, as you may know, the Freud family were forced to escape from Vienna and come and live in London. And within a year of being here, Sigmund Freud had died, and the Second World War had broken out. And I think it's really typical of Anna Freud, who we must remember was herself a refugee and an exile here in London, that within a couple of years of being here, she was already setting up a project to think, "How can we help the children who have been most affected by the war?"
So, she set up what in 1941 came to be known as the Hampstead War Nurseries. And what this was was a nursery and later a residential nursery for children who, for example, had been affected by the bombings of East London, the Blitz, or whose parents were away fighting in the war, or whose mothers were in the munitions factories and weren't able to care for them. And again, Anna Freud said this was making, trying to make a practical difference to the lives of these children. But she asked herself a question about this. So again, the question was, "What would fara peuta care looked like if it wasn't just organized around the needs of the staff?"
So, in a sense, most therapeutic care was either paying attention to the physical well-being of children, the hygiene and the nutrition, or what is convenient for the staff running residential care. And she said, "What would a residential home look like if it was organized around the physical and emotional and psychological needs of the children living in that residential home?"
So, I could give you a whole talk about this, but to give just one example, most residential care I gave very limited opportunities for parents or other family members to have contact with the children, similarly in for children in hospitals. And one of the reasons for that was that when parents did visit or family visited, it was very disruptive. That it would upset children, they'd get very excited, but then they'd get upset when the families left. So, the normal approach was not to encourage visits or have very set visiting hours.
Anna Freud in her colleagues took a completely different approach. First of all, they said, "We'll have entirely open visiting hours." So, if a parent was working in a munitions factory and could come, their shift finishes, and they could come, they were allowed to visit at any time. She tried to be creative about, for example, giving mother's employment as a staff in the nursery to maintain contact. She organized these, these when they had the residential nursery out in Essex, she organized buses and cars to bring family members from London at the weekend, and they organized picnics in the garden of the residential home in order to sort of maintain contact. And she and her staff also wrote regular as sometimes weekly letters to fire who away at the war, giving them updates about their child's development and progress in the nursery. And one of the ideas about this was, "How could she maintain the idea of the child in the father's mind when they might have gone in some cases years without seeing those children?"
Now, I think Liz was mentioning earlier sometimes the choice between whether one's one has a caring role or an understanding role. And I think one of the things that was unique about Anna Freud was that she tried to maintain both. So, the Hampstead War Nurseries clearly had an a caring function, but she also saw it as having a research function. And this was at a time when many psychoanalysts were frankly pretty opposed to empirical research. But Anna Freud said, "Actually, this nursery, it's like a natural experiment. It's a chance for us to really understand something about how children develop in the context of a war and in the context of being separated from their parents and living in residential care."
So, I've got this photo up here. This was, we were going through the cupboard in the Anna Freud Center a few years ago, and we discovered this this box. I don't know if you can see it there, and it's a box of index cards. And what Anna Freud did in Hampstead ward nurseries was introduced a system of systematic observation. So, all of the staff in the nursery, not just the nurses, but also the gardeners or the cooks or anyone who had contact with children, they were encouraged during the day, "If you noticed something about a child, just write it down on this index card and we'll store it." And then they would meet one evening a week, and they would bring their observations and they would share the observations and think, "What does it tell us about this particular child, but also a particular issue that may be common to the children?"
And out of that came two books which have long been out of print, both written with Dorothea Burlingham, who again, in the context of our earlier presentations, I think we might describe as the lifelong partner and both professionally ampere me of Anna Freud. So, the first of these books was "Young Children in Wartime," and the question they were asking that book was, "What is the impact of living in a war on children?" I think this is one that we would probably say sadly is just as relevant today as it was then. And the second book, "Infants Without Families," which is asking, "What is the impact on the child's development when they are separated from their parents and living, you know, in a residential setting?"
And again, I just give you one example which I think shows how in many ways Anna Freud was also a precursor of attachment theory. So, going back to these these the contacts with the family, one of the things they noticed when when they in their observation cards was how distressed children could be when their parents came to visit but then had to leave at the end of the visit. Likewise, if they're expecting a parent to visit and they didn't turn up, that could cause great distress. Or if other children were having visitors and they were not having visitors, that would create intense rivalry and anger between the children. And they thought long and hard about about what this meant for the children. And they reached this conclusion, which I still think is such an important and profound conclusion. They wrote in that in 1945 paper, "When choosing between the two evils of broken and interrupted attachments and an existence of emotional Berenice, the latter is the more harmful solution. In reality, it's not the absence of irrational emotional attachments which helps a child to grow up normally, but the painful and often disturbing process of learning how to deal with such emotions."
Okay, so when the Second World War ended and the Hampstead War Nurseries was disbanded, Anna Freud thought, "Where to go from here?" And in 1947, with many of the colleagues who had worked with her in the Hampstead War Nurseries, she decided to set up a clinic but also a training institute, which was called the Hampstead Clinic. And after Anna Freud death, it was renamed the Anna Freud Center and is still here in Maysville Gardens 70 years later.
And in setting the this dis clinic up, one of the things that they were faced with was many children being referred often who had experienced extreme neglect or in in many cases maltreatment to abuse. And they and they struggled with this question, "How do we meaningfully assess these children's problems? How do we meaningfully make some kind of diagnosis of their difficulties?"
Now, unlike the anti-psychiatry movement, for example, which really rejected the whole idea of diagnosis, Anna Freud was very passionate about the value of assessment and diagnosis. She thought that without proper assessment and diagnosis, we can't really understand something about where these difficulties may fit within the child's development, what the likely prognosis is, what kind of treatment recommendations, if any, we should be making. But at the same time, she was really frustrated and critical of the dominant psychiatric model of diagnosis, which she felt really told us very little about children's emotional needs.
And again, I'm only going to give one example of that. One of the areas where she really was critical which that she felt the whole psychiatric system was profoundly adult her morphic. In other words, that it had taken a set of descriptive diagnostic categories based on adult presentations and simply shrunk them down and applied them to children as if as if those adult categories could be equally meaningful to children. And what she felt was lost by that was not only the psychological mechanisms underneath it, but also the developmental process within which these difficulties were occurring.
So, this led in a way to Anna Freud being one of the founders of what we would now think of as the field of developmental psychopathology. In fact, in 1967, Anna Freud was one of the first people in print to use this term, "developmental psychopathology." And as Rose Edgecombe, who is one of Anna Freud colleagues, has written, this idea of needing to understand disturbance against the background of normal development was probably the clearest mark of the Anna Freudian tradition. And Anna Freud wrote about it most fully in what's probably other most well-known book, "Normality and Pathology in Childhood."
Obviously, in as far as the clinic was thinking about assessment and diagnosis, it was also thinking about treatment. And I think one of the ways in which an affords work is misread is that actually surprisingly she wrote very little clinically about her treatment of children after the 1920s. So, I think it's led to a perception that the way that Anna Freud described her approach to child psychotherapy from the 1920s was the way in which he carried on thinking about it until the end of her life.
And in fact, Anna Freud, again, she often as a leader of projects – I was thinking about the school again, with the Hampstead War Nurseries, and again with the clinic – she sets the collective a question which is, in fact, "Well, what would therapy need to look like if we're going to meet the needs of the kind of children who we're seeing today?" And again, so so many of these who experienced early trauma and maltreatment. And one of the things that she and her colleagues began to think about was that it wasn't enough to simply think about the therapist as a transference object. So, classically, the therapist was often thought in psychoanalytic terms as a transference object where the child would repeat early relationships in their relationship to the therapist. And Anna Freud said, "Yes, this is true, but the therapist is also what she came to call the developmental object." In other words, the therapist is also someone who is able to offer the child a new experience, and in particularly a new experience of being thought about as a person, a person in their own right, with their own mind and their own thoughts. For those of you who may be familiar with PETA Funaki and the ideas of mentalization based treatment, that what I've just described there may sound very, very like mentalization based treatment. And it's no coincidence that PETA Funaki was working at the Anna Freud Center in the 1980s and 90s when he was developing those ideas about an Beauty.
Okay, so again, to go back to where I started, Anna Freud was deeply involved with the psychs Therapy of children, but she always felt that there's going to be a very small number of children who are likely to be directly helped by therapy. So, she always believed that we needed to take what we could learn from that context and think, "How could it be used? How could it be applied to make a difference to children's lives more widely?"
So again, just to give you a flavor of what that meant in practice, in the 50s, 60s, and 70s, Anna Freud gave literally hundreds and hundreds of lectures to teachers, very often nursery school teachers. And she would take very practical questions and think, "How how had what they learned from psychoanalysis could it be used to help teachers in their practical setting?" So, she gave lectures on things like, "How do we know when a child is ready for school? What would be our way of assessing school readiness?" Or she gave lectures on, "And what should meal time in a in a school look like? How can we make a mealtime in school as important the developmental experience as well as a nutritional experience for children?" Very practical questions.
She also thought a lot about hospitals. She offered her a monthly consultation to the leading pediatricians in all of the teaching hospitals in London. And she wrote a book about children in hospital where she suggested that nurses really need needed a double training. She said nurses needed to be trained both in the physical health of children but also the mental health and the psychological health of children. So, in other words, she was making the case for for the parity of physical and mental health. And this is something it took another 40 years before the government decided to adopt this as a policy, and as we know, it's still far from being reality in practice out there.
And then the last example I wanted to give you, just cuz I thought this, I continued be amazed by this. When Anna Freud was about 75, she could have been taking her bus pass, you know, going to her country home in Ireland and reading her favorite Agatha Christie novels. But she got an invitation from the law department in Yale, and they said, "Would you like to come over to the States and be a visiting professor here and help us think about what psychoanalysis could contribute to thinking about children in family law?" And she took this offer up, and over the next five years, she'd made regular visits over to Yale, and it produced three books written with these two law professors, Joseph Goldstein and Albert's allness, where again they asked the question, "What would the Family Law system look like if it was designed around the needs and the developmental needs of a child rather than around the needs of the legal system?" Again, these books are almost unknown here in the UK, but but they were described as the most influential books on in the U.S. influencing the family law systems that they had a profound impact on thinking about in the sense what we might think of the best needs of the child.
So, in conclusion, I started by asking who Anna Freud was, and I wanted to end with a quotation that actually comes from Anna Freud niece, who I think, inspired by her aunt, went into a career as a social worker and ended up as a professor of social work in the United States. And she wrote this about Anna Freud after her death: "She wanted children to have lives that would not be oppressed and Exploited, restricted, impoverished or damaged by an uncaring adult world. It was her fur and hope that by spreading the wisdom of psychoanalytic insight, she could improve children's lives in their families, clinics, schools, hospitals, and courts. It was in this role of mother, educator, and advocate of children that she spoke most clearly in her own voice, and that we can celebrate her wholeheartedly."
[Applause]