Mad, Bad, and Sad: A History of Women and the Mind Doctors

by Lisa Appignanesi

  Lacan describes how the utterly banal electricity failure triggered a passage à l’acte–the moment in which the ‘obscure’, the hidden depths, suddenly take on material form and are transmuted into violent action. While paying homage to Dr Logre’s interpretation, Lacan disagreed. His own diagnosis was delusional paranoia: the sisters, particularly Christine, suffered from a mental delirium around the themes of grandeur and persecution which can breed aggressive, often murderous reactions. Underlying this are social tensions: a conflict between what the self, which incorporates an ideal, wants and what society demands. For Lacan, delirium itself is a camouflage–rather than any straightforward expression–of aggressive instincts which can find no compromise with the individual’s understanding of social demands and ideals. Murder serves as a punishment for inner, unconscious desires.

  The crime of the Papin sisters, he shows, contains a symbolic meaning in the very atrocity of its details. ‘Pull out her eyes,’ shouts Christine, as if this were merely the everyday expression of hatred it is–and then literally does so, making the symbolic actual, taking language to its logical conclusion, castrating her employers, tearing away their power–the power of the gaze–and taking it into herself. This power is sexed male, as is Christine’s relationship to her sister whose ‘husband’ she has once been. It is clear to Lacan that the sisters’ delirious ideas, their délire à deux, predated the murder. There was a slow build-up of delusionary ideas. Their tenuous hold on the reality of their crime is part of its continuation.

  Aimée, with her ambivalent hatred of her sister, had struck out at a displaced version of her ego ideal which she both loved and hated. The Papin sisters, with their Siamese twinning, didn’t turn against each other but acted as one in two parts. By turning against their mother/daughter mistresses, castrating them, pulling out their eyes, they enacted their own murderous punishment for the sins of their homosexual desires. They were also engaged in a symbolic language of rebellion against, and hence castration of, the masters. In this last we all share.

  Such cases, Lacan wants to say, are susceptible to analysis. The unconscious motivation of the Papin sisters, their delirium with its underlying disturbance of love and social rage, is readable. He doesn’t, however, call for the sisters’ pardon or release. They are guilty of a crime–whether or not we are all potentially guilty of it as well.

  10

  MOTHER AND CHILD

  Freud’s psychoanalysis had its origins in the idea that psychic disorders were prompted by conflicts related to sexuality. A simple description might have it that civilized sexual morality, with all its strains and hypocrisies, its punishment of childhood masturbation, its enforced ignorance, acted through parents, nannies and schools upon the curious, growing child with her instinctual desires and polymorphous perversity. Gradually internalized through a process fraught with inevitable Oedipal difficulties and, for the boy, the fear of castration, repression ensued. Psychic troubles of varying degrees alongside a panoply of symptoms emerged. The very same process also produced all the goods of civilization. Psychoanalysis could treat underlying problems by giving the adult a space in which to remember, re-enact, and work through blockages that the drama of family life had created. Symptoms–always the markers of deeper psychic problems in this narrative of the self–would then be relieved, transformed, reworked. The individual would be released into the ability to work and to love, with only an ordinary everyday unhappiness to bear.

  In the consulting room, Freud’s child was always a creature of memory, evoked through free association, hidden in the interstices of dreams or behind screens, misremembered, pushed and pulled, teased and seduced by adult desires and her own forgettings, all the while re-enacting a family romance in relation to the analyst. This child was both buried within and instrumental to the adult’s analytic agenda. It stood at doorways peering into the parental bedchamber, was struck by a glance from a shopkeeper, experienced sexual stirrings and fantasies, loved and hated its parents of the same and opposite sex, raged at the infidelities of its parents and the resulting competing intruders, was punished for masturbation, feared castration, developed fantasies, anxieties and phobias. Above all, this child was ever-curious and conducted sexual research into the origins of life. The Freudian child is an energetic, sensual being, an adventurer and a seeker after truth. No innocent in terms of sensuous pleasures, he nonetheless has everything to learn about the world.

  Though for much of the 1890s as a specialist in children’s nervous diseases, Freud, rather like Winnicott later, saw thousands of children, he never treated any but one analytically, his own children apart. That was Little Hans whose predicament, complete with his phobia of horses, was brought to Freud by parental report. Hans’s father was a member of Freud’s early psychoanalytic Wednesday group and Freud only once saw the little boy, whose sexual researches fuelled parts of two papers as well as a case history. Daughter Anna provided an occasional case: Anna’s greed for ‘stwawbewwies’ features in her father’s dream book and her own rescue fantasies in his paper ‘A Child is Being Beaten’. Freud’s grandson Ernst, son of his favourite daughter Sophie, appears as the child in Beyond the Pleasure Principle, where he manages his mother’s coming and going, absence and presence, by making a game of it: repeating it and controlling the emotions through play.

  Women were the first psychoanalytic practitioners to deal directly with the living child. Psychoanalysis had opened its doors to them, if not without a little dissension amidst the original members of Freud’s circle. But Freud prevailed and women came into the new profession in proportionately significant numbers. In Germany by the early thirties, women analysts made up about 40 per cent of the profession, whereas they constituted only 6.5 per cent of doctors. The British Psychoanalytic Society in the thirties was also 40 per cent female, and women were numerous in the ranks of the Tavistock Centre.

  Even if the early women analysts, such as Helene Deutsch, were all too eager to get away from the ‘tyranny of the mother’ or, as in Anna Freud’s case, treated the maternal home-maker with an edge of contempt tinged with discomfort, they showed a marked interest in recreating women as mothers. They focused on women in relation to their biological destiny–menstruation, pregnancy, menopause. Or they zeroed in on the child as if, despite their professionalism, they were playing out their own mothers’ concerns. Given the constrictions on women’s work, this was in part a social imperative: children were their permitted domain. But the exceptions–like the flamboyantly independent Princess Marie Bonaparte who wrote about adult female sexuality, or the feminist Karen Horney who worried about the pathologization of the feminine, about marriage and the monogamous ideal–only highlight the regularity with which most of the early women analysts, feminist in their social concerns or not, concentrated in writing as well as in practice on children or motherhood. Many, like Helene Deutsch, saw in the mother the consummation of the feminine trajectory, or, like Melanie Klein, theorized her as an adjunct to the child. Many were or became mothers and their own experience fed into their work.

  The earliest impetus of the child analysts was to enlighten children about the sexual secrets which damaged them by the very fact of secrecy. Hermine Hug-Hellmuth, one of the first female members of the Vienna Society, was lauded by Freud for her researches into the sexual life of the growing child, and for her intelligent application of psychoanalysis to the ‘prophylactic upbringing of healthy children’. The Young Girl’s Diary, which she claimed to have edited rather than written, caused a scandal on its appearance in 1919 because of its honesty about a middle-class girl’s fantasies and sexual curiosity.

  In her first article in the International Journal of PsychoAnalysis Melanie Klein writes:

  We can spare the child unnecessary repression by freeing–and first and foremost in ourselves–the whole wide sphere of sexuality from the dense veils of secrecy, falsehood and danger spun by a hypocritical civilisation upon an affective and uninformed foundation. We shall let the chil
d acquire as much sexual information as the growth of its desire for knowledge requires, thus depriving sexuality at once of its mystery and of a great part of its danger. This ensures that wishes, thoughts and feelings shall not–as happened to us–be partly repressed and partly, in so far as repression fails, endured under a burden of false shame and nervous suffering. In averting this repression, this burden of superfluous suffering, moreover, we are laying the foundations for health, mental balance and the favourable development of character.

  This thrust was echoed in any number of social campaigns in Europe and America. Marie Stopes’s Married Love and Wise Parenthood, as well as her subsequent clinics, and Margaret Sanger’s work in America, are both part of a sexual education project that comes hand in hand with advice on birth control, so that the new child will be a wanted child and grow into the best possible environment. At its most politically idealistic, such educative campaigning formed part of a larger socialist enterprise: the creation of the new man and woman, who would leave behind the murderous aggression that world war had so tragically highlighted.

  Schools influenced by psychoanalytic thinking were founded in Vienna and Berlin, England, Russia and America. Delinquency moved from being a ‘moral’ problem to becoming a psychological one with roots in disturbed or broken families, or disciplinarian orphanages. New professions such as social work grew, and older ones–nursing, teaching, medicine, psychiatry itself–often took on a psychoanalytic gloss. This coexisted with changes in psychoanalytic practice and a proliferation of related and sometimes warring theories. While Freud in the postwar period moved beyond the pleasure principle to posit a death drive, explore the psychology of the group, or move back in historical time to find the roots of monotheism, others moved back to explore infancy before language, which had thus far been the only tool of analysis.

  This shift towards child and mother gradually dislodged sex as instinct from its central place in psychoanalytic thinking. Thwarted desire, sexuality and its attendant anxieties and fantasies moved aside as the key set of explanations for illness. Mothers displaced castrating fathers as the crucial authority dominating both childhood and the inner life: it was on the base of that earliest and fundamental relationship, not the paternal one, that all future relations, of love and power, of attachment and dependence, would be replayed.

  Undoubtedly a world war, followed within a single generation by another, fed into the process that made a healthy mother and child–the so-called nursing couple–a prime preoccupation for the mind doctors. They were part of a larger cultural impetus. The twenties brought a need to repopulate after the devastation both of war and of the 1918 flu pandemic, which had taken a terrifying fifty million lives worldwide. Women were urged back into the home from wartime work, and often went willingly. A backlash occurred against what many saw as rapacious feminist demands for an equality which included sexual equality. While all forms of sexuality and sexual orientation were on permanent display in its night-life, the Weimar Constitution forbade the public display of contraceptives and description of their use. The French rewarded mothers of five children with motherhood medals. In 1930 the Pope issued an encyclical that permitted marital sex only when the intention was to reproduce. Pro-natalism was widespread. Fascists monumentalized woman as mother. Although they didn’t share in their politics, women mind doctors hardly demurred from urging women to motherhood. Increasingly they emphasized the importance and complexities of his majesty, the child.

  Becoming a mother now took on an added ‘psychological’ interest, at once troubling and intelligible, a subject for professionals and social authorities, as well as for those older moral arbiters, the religions. All were now engaged, alongside mother and child, in determining conduct, measuring health and development, and attributing meanings to a function and relationship which was, after all, as old as humanity itself.

  Anna Freud (1895–1982) and Melanie Klein (1882–1960)

  Anna Freud and Melanie Klein were the two most influential early child analysts, not only through their writings, but through that form of diffusion which is the training analysis itself. In a sense, each took up different aspects of Freud’s capacious legacy and moved it in new directions. Rivals, they battled for the supremacy of their views and for the paternal mantle.

  Having trained as a teacher, undergone a partial analysis with her father and another with that most alluring of Freud’s early women followers, Lou Andreas-Salomé, the work of Freud’s youngest daughter always had a pedagogical and normative cast. She stressed the importance of working with parents and schools in order to shape the developing child into a well integrated adult. In 1927, with Dorothy Burlingham, she set up the experimental Hietzing School, and as early as 1936 pioneered nurseries for children under two. At the Jackson Nursery toddlers were observed and information gathered about their eating habits (Anna herself had suffered from an eating disorder), play, and general development. Anna shared the socialist hopes of Vienna’s therapeutically inclined radicals, such as Siegfried Bernfeld and August Aichhorn. The latter’s Wayward Youth set out to show a repressive, militaristic society that delinquents were not criminals but children whose inner development had gone awry. Psychoanalysis, for Anna, could help that development: its role was not only to focus on the unconscious psychic life, the repressed instinctual impulses and fantasies, but to strengthen the ego, so that the child could become a responsible adult.

  Counter to Melanie Klein, whose focus lay on the infant’s earliest inner life and its rampant instinctual desires and aggression, Anna Freud emphasized that ‘From the beginning analysis, as a therapeutic method, was concerned with the ego and its aberrations: the investigation of the id and of its mode of operation was always only a means to an end. And the end was invariably the same: the correction of these abnormalities and the restoration of the ego to its integrity.’ Ego psychology, as well as the understanding of the ego’s defences–which she detailed in her 1936 book The Ego and the Mechanisms of Defence as repression, regression, reaction formation, isolation, undoing, introjection, identification, projection, turning against the self, reversal and sublimation–owe much to Anna Freud’s thinking, and although she, like Melanie Klein before her, settled in Britain, it was in the United States that her influence would be greatest.

  In 1933, the new Nazi government in Germany had effected a purification of the ‘Jewish’ science of psychoanalysis. On 10 May, some four months after it had taken power, Freud’s books were burned in Berlin. By the end of the month, sex counselling and birth control clinics were shut down. Eighty per cent of German psychoanalysts were Jewish, and emigration to the United States, Britain, France and Palestine began. Freud had felt he was too old to leave Vienna, but with the Nazi takeover of Austria in 1938 and ensuing threats to the family which Anna, his Antigone, fended off with great personal bravery, they moved to London. Freud died there on 23 September 1939, just as war was taking Europe over.

  As part of the war effort Anna, with her long-term partner Dorothy Burlingham, set up the Hampstead Nurseries for evacuated babies and children. Caring for displaced children also provided a rich field for gathering insights into the nature of the child’s life and family relations. Experience began increasingly to show that children were often less affected by the blitz, the war from the skies, than by their mothers’ anxiety, or by the separation itself. What emerges above all in the books based on the nurseries, Infants without Families (1944) and Young Children in WarTime (1942), is the crucial importance of the mother in the child’s emotional life: ‘A child in the infant stage of 1, 2, 3, 4 years of age will shake and tremble with the anxiety of his mother, and this anxiety will impart itself the more thoroughly to the child the younger he is. The primitive emotional tie between mother and baby, which in some respects still makes one being out of the two, is the basis for the development of this type of air raid anxiety in children.’

  Separation from the mother has a formative impact on the child. Taken away from its mothe
r, the youngest child will, out of need, adapt to a new carer. But for the three-to five-year-olds, separation can do severe damage to everything from toilet training to the acquisition of language. Killing a parent in fantasy, which, of course, is part of the ordinary Freudian child’s Oedipal desire, is tolerable when the parent is present and maintains the bond with the child. If the parents are absent, ‘the child is frightened…and suspects that their desertion may be another punishment or even the consequence of his own bad wishes. To overcome this guilt he overstresses all the love which he has ever felt for his parents. This turns the central pain of separation into an intense longing which is hard to bear.’

  The Hampstead Nurseries served the immediate needs of war work. But the observations garnered there also helped to shape postwar fostering, institutional and welfare policies. They crucially determined Anna Freud’s focus on the developing child, on learning disturbances, delinquency, eating disorders, and eventually family law. Her later work was instrumental in forging the concept of ‘the best interests of the child’ and in laying the foundations of children’s rights. Judgements in custody cases came to be shaped by a psychological view of the child as a highly sensitive and malleable creature. For the ‘sound development’ of the child, Anna Freud argued, stable bonds had to be formed. A child’s need was for ‘unbroken continuity of affectionate and stimulating relationships’ which could, of course, be provided by a caring, and not only by a biological, parent. From this it followed that protracted custody decisions, shuffling between foster parents or institutions, and joint custody, might not be in the child’s best interests. On the other hand, a social worker’s ‘rescue fantasies’ might be more detrimental to the child than continuity with parents the social worker didn’t altogether approve.