Sigmund’s Daughter: Anna Freud and the Birth of Child Therapy
By Andrew Guthrie, Ph.D.
Like her father, Anna Freud was preoccupied with the special difficulties that psychoanalysis posed for the child analyst. She viewed analytic work with children as significantly different from the analysis of adults, and offered changes in technique that addressed these differences. At least one of the differences between children and adults worked in the analyst’s favour: that of the shorter distance between the child’s current level of functioning and the time and place where development went awry. “The child . . . need only retrace the steps a short distance in order to find the road which is normal and suited to its nature. It has not like the adult built up its whole life, chosen its calling, made friends, fallen in love, chosen its ideals, all on the basis of neurotic tendencies” (Freud, 1964, p. 60). With children, development is the analyst’s ally, enabling greater temporal closeness to the last open period of mental ground-laying (Herzog, 1996). Therefore, the interventions of the analyst promised to have more of an expeditious effect on the neurotic conflicts of the child.
Freud also claimed that child patients do not directly suffer from their conflicts, but instead are brought into treatment because of the suffering of the people surrounding the child who are exposed to the child’s symptoms and outbreaks of “naughtiness.” Children may not know that there is anything wrong, and therefore cannot wish for anything to change. Despite the potential for a faster result in work with children, child analysis “. . . lacks everything which seems indispensable in the case of the adult: insight into the malady, voluntary decision, and the will towards cure” (Freud, 1964, p. 6).
Freud also discovered that children refuse to free associate as adults do, as it is
“ . . . obviously contrary to a child’s nature to. . . expunge by an effort of its own will all criticism of emerging ideas, to exclude nothing from its communications and so to explore the surface of its consciousness” (Freud, p. 29). This was especially true in the interpretation of children’s dreams, an intervention Freud underscored in place of the interpretation of children’s play. She found that children told their dreams freely, but without the child’s free associations to the manifest dream to guide the analyst to understanding the latent meaning of the dream, the analyst was forced to supply links between the manifest dream content and the latent dream thoughts according to the analyst’s intimate knowledge of the child’s inner situation.Therefore, the classical method of analyzing adults was rendered useless, and the analyst was plunged into perplexity about what technique to use in its place. In the preface to her work, Normality and Pathology in Childhood (1965), Freud outlined this struggle and summarized the basic principles of adult analysis: “It is no easy matter . . . to fashion a technique which complies with the main demands of classical psychoanalysis – to interpret resistance and transference phenomena; to undo repressions and regressions and substitute sophisticated, adaptive measures for primitive, pathogenic mechanisms of defence; and generally to strengthen the ego functions and widen the area in the mind over which the ego can exert control . . . there is no absolute psychoanalytic technique for use with children, but rather a set of analytic principles which have to be adapted to specific cases” (in Solnit et al, 1993, p. 8).
In the first part of her professional career, Freud was a psychoanalyst and an educator who did not separate the two activities and the theoretical foundations on which they are both based. Similar to Hug-Hellmuth, Freud encouraged the analyst to offer educational support to the child, believing that analysis of children should not be pressed too far. Much of neurotic development was caused by parents giving too much or too little love, and psychoanalytic education was required that contacted the child’s conscious Ego, established a positive transference relationship, and observed, explored, understood, and explained to the child the analyst’s conceptualization of the child’s problems. Freud, “ . . . focused early and continually on the child’s developmental level and his position in the real world, particularly as these relate to how the child will be able to use the psychoanalytic situation” (Scharfman, p. 6).
For Freud, a child’s play is not equivalent to an adult’s free associations, and should not be interpreted as the analyst would interpret the verbal utterances of the adult. Freud considered certain play scenarios to be symbols for internal conflicts, but emphasized that “the task of the analyst is not to create, i.e. to invent, but to observe, explore, understand, and explain” (Geissman & Geissman, p. 87). The way a small boy played with his train might permit conclusions to be drawn about the concerns and conflicts that played a central role in his unconscious mind, such as parental intercourse, or the inside of the body, but Freud cautioned against viewing everything the children did as having symbolic meaning. “Like all interpretations of symbols . . . it has a tendency to become rigid, impersonal, and stereotyped without being open to corroboration from the child . . .” (Freud, 1964, p. 83). Just as the analyst is not justified in ascribing a symbolic significance to every one of the adult patient’s acts or ideas, nor should the analyst attribute unconscious meaning to every play scenario invented by the child.Direct interpretation of play is a trap the analyst may fall into, and this intervention only increases the child’s anxiety and resistance.
Some play, Freud maintained, was just conscious repetition of recent experience (Schaefer & O‘Connor, 1983). Freud used play to interest the child in analysis and the analyst and to foster the therapeutic alliance between the child and analyst. Play could lead to talking about the child’s dreams and daydreams, areas that interested Freud because they were accessible to the child’s conscious mind. For Freud, interpretation was useful only after the alliance was strong and an emotional relationship was well-founded, and even then, direct interpretation of a child’s play was not her common practice. Instead, she saw play as an instrument through which the child and the psychoanalyst communicated toward a common therapeutic goal (Sandler et al, 1980).
For Freud, interpretation, insight, and self-awareness were the major agents in therapeutic action. Therapeutic change does not occur because of a corrective, counteracting emotional experience, replacing the old relationship with a new one. Nor is change due to abreaction, or the discharged emotions related to previous repressed experience. Instead, changes that occur in a child during the process of analysis are due to the insight that is gleaned from becoming self-aware through observing oneself, a skill the child borrows from the analyst (Sandler et al, 1980). Child analysis does not conform to strict analytical principles, and may suffer from a reputation among classical, adult analysts as being a form of “wild” analysis, or impure practice. But Freud was adamant that child analysts must remain open to using whatever method seems appropriate for each specific child:“If an adult neurotic came to your consulting room to ask for treatment, and . . . proved as impulsive, as undeveloped intellectually and as deeply dependent on his environment as are my child patients, you would probably say, “Freudian analysis is a fine method, but it is not designed for such people.” And you would treat the patient by a mixed method, giving him as much pure analysis as he can stand and for the rest children’s analysis . . . In my opinion, there can be no detraction to the analytical method if one seeks to apply it with modification to others sorts of objects” (Freud, 1964, p. 61-62).
This startlingly modern sentiment is currently widely held not only in the treatment of children but also in psychoanalytic work with more disturbed adults.
