Psychoanalysis and Psychotherapy

FREE ASSOCIATIONS No: 46..

ETHICAL DILEMMAS OF THE PSYCHO-ANALYTICAL BIOGRAPHER:

THE CASE OF DONALD WINNICOTT.

by Brett Kahr.

Within the last fifteen years, devotees of the history of psycho-analysis will have had the opportunity to enjoy a veritable bevy of newly published biographical studies, detailing the lives of our celebrated Freudian ancestors. These books have included a variety of titles about Sigmund Freud himself, notably the hefty tome by Peter Gay (1988), as well as the worthy study of Freud's mid-life crisis by Peter Newton (1995), among others (cf. Roith, 1987; Donn, 1988; Gay, 1990; Schultz, 1990; Appignanesi and Forrester, 1992; Freud, 1992; Rosenzweig, 1992; Lohser and Newton, 1996; Margolis, 1996).

Additional biographies might be mentioned, especially Edward Hoffman's (1994) survey of the life of the much neglected pioneer Alfred Adler; Martin Stanton's (1990) guide to the career of Sándor Ferenczi; E. James Lieberman's (1985) definitive book on Otto Rank; John Kerr's (1993) study of Sabina Spielrein; Paul Roazen's (1985) affectionate tribute to his dear friend and mentor Helene Deutsch; Elisabeth Young-Bruehl's (1988) detailed examination of the career of Anna Freud; Phyllis Grosskurth's (1986a) commendable and controversial attempt to grapple with Melanie Klein; as many as two thorough treatments of Karen Horney, by Susan Quinn (1987) and by Bernard Paris (1994); a biography of Dorothy Tiffany Burlingham, written by her grandson, Michael John Burlingham (1989); Lawrence Friedman's (1990) well-documented analysis of Karl Menninger and his family; John Sutherland's (1989) appreciation of Ronald Fairbairn; Élisabeth Roudinesco's (1993, 1997) informed coverage of the life and work of the notorious Jacques Lacan; Judy Cooper's (1993) stimulating account of the infamous Masud Khan; Paul Roazen's (1993) study of Freud's children; Adrian Laing's (1994) biography of his father, Ronald Laing (cf. Mullan, 1995; Burston, 1996; Clay, 1996; Kotowicz, 1997); two portraits of Bruno Bettelheim, by Nina Sutton (1995) and by Richard Pollak (1997); Jeremy Hazell's (1996) work on Harry Guntrip; George MacLean and Ulrich Rappen’s (1991) biography of Hermine Hug-Hellmuth; Suzan van Dijken’s (1998) survey of the early life of John Bowlby; a number of studies on Carl Gustav Jung (e.g. Smith, 1996; Noll, 1997; Shamdasani, 1998); Michel Grignon’s (1998) edited festschrift for Clifford Scott; as well as some shorter publications such as Jeremy Holmes's (1993) work on John Bowlby; Sheila Spensley's (1995) useful assessment of the contributions of Frances Tustin; and James Astor's (1995) intellectual biography of Michael Fordham (cf. Evans, 1996; Siegel, 1996; Symington and Symington, 1996).

One could of course extend this laundry list greatly by including briefer article-length studies of recent years such as those by Martin Stanton (1988, 1992) on Wilhelm Stekel and Otto Gross; Athol Hughes (1991) on Joan Riviere; Michael Sinason (1995) on William Gillespie; and Naome Rader Dragstedt (1998) on Marion Milner. And the survey could be expanded even further by including autobiographies of important figures who have now since died such as Martin Grotjahn (1987), Margaret Mahler (1988), Wilhelm Reich (1988), Esther Menaker (1989), Michael Fordham (1993), and Clifford Scott (1993, 1998). The autobiography of Freud's early disciple, Sándor Rádo (1995), has recently appeared in print, under the joint editorship of Paul Roazen and Bluma Swerdloff, and so have the memoirs of another Viennese refugee, Fritz Wittels (1995), under the editorship of Edward Timms. Several volumes of selected letters have appeared as well, namely those by Donald Winnicott (1987), those by Anna Freud (1992) to Eva Rosenfeld, and those by Heinz Kohut (1994), as well as Sigmund Freud's letters to Eduard Silberstein (Freud and Silberstein, 1990), to Ernest Jones (Freud and Jones, 1993), and to Sándor Ferenczi (Freud and Ferenczi, 1993, 1996).

We might also add the studies about Freud's patients, such as Patrick Mahony's (1986) text on Ernst Lanzer [Rat Man], as well as his more recent study of Ida Bauer [Dora] (Mahony, 1996); Hannah Decker's (1991) book on Ida Bauer; and Zvi Lothane's (1992) thesis on Daniel Paul Schreber (cf. Roazen, 1995). Additional titles might include the study of two of Carl Jung's patients, namely Forrest Robinson's (1992) biography of Henry Murray, and Claire Douglas's (1993) work on Christiana Morgan. This collection of titles does not purport to be comprehensive, and no doubt, a wealth of scholarly biographies will continue to materialise. In the very near future, we can anticipate Lawrence Friedman's book on Erik Homburger Erikson; Joel Kanter's sketch of Clare Winnicott; and ultimately, Sonu Shamdasani's magnum opus on Carl Gustav Jung, not to mention the complete text of the correspondence between Sigmund Freud and Karl Abraham, and the final volume of Freud's letters with Sándor Ferenczi.

My own contribution to this increasingly unwieldly literature will be a set of books on the life and work of Donald Winnicott. An edited book of essays on Winnicott, which will include personal reminiscences of the great child analyst, as well as a transcript of Paul Roazen's hitherto unpublished interview with Winnicott, conducted more than thirty years ago, in 1965, will be published by Karnac Books of London in the latter part of 1998. This will be followed by an introductory guide to Winnicott's life and work which will be published by Karnac Books in 1999. I have also completed a short, biographical portrait of Winnicott (Kahr, 1996); and by the end of the century, I will hope to have completed a full biography of Winnicott, of the size of Professor Phyllis Grosskurth's work on Melanie Klein. The larger biography will be based on a detailed scrutiny of Winnicott's extensive body of writings, both published and unpublished, penned between 1919 and 1971; and this primary data will be supplemented by a study of hundreds and hundreds of unpublished letters housed in the Donald W. Winnicott Papers at the New York Academy of Medicine, in New York City. I have also utilised other archival holdings in Great Britain, and in Switzerland; and I have conducted approximately seven hundred interviews with some of Winnicott's surviving relatives, patients, friends, colleagues, associates, supervisees, students, admirers, and detractors, in order to form as comprehensive a portrait as possible of the man whom I regard as the undisputed cartographer of infancy.

The formal research for the biography began in the last months of 1990, but fortunately, I have had the opportunity to conduct more informal interviews with such figures as Dr. John Bowlby and Dr. Margaret Little, both now deceased, since 1985. Needless to say, I have spent a great deal of my time ruminating about Winnicott in the last ten years, and as the project has begun to adopt a more coherent shape, as a full-scale work, I find that I have become increasingly concerned, as well as disturbed, about the implications of writing a psycho-analytically orientated biography of a fairly recently departed figure in the international psycho-analytical community.

Of the many biographers or editors responsible for the works cited above, I have estimated that some thirty-five authors have received training in one of the clinical disciplines, and have devoted a substantial part of their lives to professional psychotherapeutic work; two of these individuals have undergone clinical training, Professor Peter Gay and Mr. John Kerr, but do not practise; and the remaining thirty-two authors have not qualified as mental health practitioners, but rather, have worked as academics, as writers, or as independent scholars. We can indeed count ourselves fortunate that the history of our field continues to be written both by practising clinicans, and by scholars from non-clinical fields as well. Those biographies authored by psycho-analysts and other psychotherapists benefit from the fact that substantive professional issues will no doubt be addressed with aplomb; furthermore, the clinically trained authors often possess unique first-hand knowledge of their subjects through personal contact in the analytical institutions; and furthermore, because clinicians have virtually no spare time, they tend to write their books over decades, thus affording an extensive period of cogitation, and for the sophisticated development of insight. By contrast, the works of psycho-analytical biography undertaken by university-based scholars possess an entirely different set of merits. Perhaps most vitally, academics need not chain themselves to consulting rooms for approximately forty-two weeks of the year, or more; and therefore, they can travel with greater freedom to consult archival collections all over the world, devoid of any anxieties about abandoning patients. Academic historians also tend to have a more critical appreciation of source materials; and as a general rule, they read more foreign languages than the clinicans do, and they tend to be less phobic about the increasingly computerised complexities of modern libraries. In an ideal world, the best biographies would be written as collaborative efforts, or under the single authorship of those who can claim expertise in both clinical psycho-analysis and in history.

Clearly, both groups of writers can boast of the advantageous aspects of their particular backgrounds, as well as bemoan their deficits. As a clinician with a longstanding interest in historiography, I have attempted to utilise the best methodological strategies from both clinical psycho-analysis and from professional biography to construct as accurate, comprehrensive, and readable a biography of Donald Winnicott as I can muster, ever aware that this work must be done in stolen moments, in between sessions with patients, over a very long period of time.

The fact that I devote a bit of time each day to Donald Winnicott, sandwiched in the pauses amid clinical encounters, has meant that whenever I think about Donald Winnicott and his life, I invariably find myself thinking about my own patients and my own clinical practice at the same time. Since I have begun to work with forensic patients in more recent years, I often call to mind the image of Winnicott working in a psychiatric hostel in Oxfordshire during World War II with deprived, delinquent children. The continuous picture of Winnicott unearthing the infantile psychic injuries of his highly aggressive patients has helped me immeasurably in the often frustrating task of working with paedophile offenders.

So, I think about my own patients, and I ponder about Winnicott's patients, and how he worked with them. But since I have now met a handful of Winnicott's surviving analysands, I also feel that I must consider carefully how a biography of their late analyst will affect them. In spite of the growth of psycho-analytical historiography in recent years, I cannot recall a single instance in which an author stopped to write about the possible effect of revealing intimate, personal information on the analysands of the particular biographical subject. Perhaps such a concern will be of interest only to psychotherapists and psycho-analysts, but perhaps it should become a concern of all those who aspire to write the history of psycho-analysis.

In December of 1983, I had the good fortune to have lunch with a brilliant and charming Kleinian psycho-analyst who spent a good deal of time extolling the virtues of Professor Phyllis Grosskurth, whose biography of Melanie Klein had not yet appeared. On 28th June of 1986, I had supper with Grosskurth herself, shortly after the publication of her outstanding, though much criticised, and much maligned, biography. She seemed desolate, and shocked, that the eminent Kleinian informant who had once praised her, had now dropped her flat, ostensibly for revealing that Mrs. Klein's son, Hans Klein, may have had homosexual tendencies, and that he may even have committed suicide. Grosskurth (1986b) seemed quite surprised that some of Melanie Klein's former analysands might have felt resentful that a biographer with scant connection to the psycho-analytical world had forced them to confront some ugly insight into the mothering abilities of their late analyst.

Similarly, one of Wilfred Bion's surviving patients told me that he had become livid when Bion's widow, Francesca Bion, published the two volumes of Bion's (1982, 1985) autobiography which described his childhood history and his private life in great detail. The analysand told me that he did not want to read the books, and yet, at the same time, he also felt compelled to do so. Even after all these years, he still regarded the publication of Bion's autobiographies as an intrusion into his own analysis.

My research on Winnicott has confirmed to me his greatness, and his unparalleled ability to communicate with disturbed children. But in the course of having studied Winnicott in considerable depth, the less salubrious side of his character structure has of course begun to emerge, and I find myself pausing and hesitating before sharing this information with the general reading public, ever mindful that many people who cherish an idealised image of Donald Winnicott still remain alive today.

During the course of an interview with one of Winnicott's many cousins, I learned that Winnicott's aunt by marriage could trace her lineage to a certain soldier who had committed a terrible series of military blunders during the English Civil War, more than three hundred years ago. The cousin instructed me that I must not include the precise details of this one piece of information in my biography in case it might embarrass the family. I regard this vignette as but one of many comparable instances in which the biographer must tread with extremely great delicacy. Such a piece of data could be readily excluded from the biography in deference to the wishes of Winnicott's cousin, with very little sacrifice. But what about the more crucial areas of Winnicott's vulnerability.

I now have extensive information about Winnicott's sexual impotency, his infertility, his unconsummated marriage of twenty-five years to Alice Buxton Taylor Winnicott, the history of Alice Winnicott's psychiatric illness, as well as confirmation of quite a number of patients who committed suicide during the course of analysis with Winnicott. I have also ascertained quite a good deal of information about some of the irregularities of Winnicott’s clinical practices, and about his many technical experiments with highly regressed and psychotic patients (cf. Kahr, 1999a, 1999b). For instance, one of Winnicott’s associates told me a story that on a certain occasion, Winnicott felt very sleepy in the middle of a psycho-analytical session, and he asked his patient to trade places, so that Winnicott ended up lying on the couch, and the patient had to sit in Winnicott’s chair. Apparently, Winnicott had explained that he needed to lie down, but that he would still be able to listen effectively to his patient from this recumbent position! Any portrait of Winnicott that withheld such aspects of his life would be both corrupt and incomplete; and yet, a book which communicated such data might be felt to be offensive or hurtful to those who knew healthier areas of Winnicott's life, and who wish to remember him that way.

Although many of Winnicott's former analysands have now reached ripe old ages and may well be deceased before I will have completed the biography, I now realise that we must consider not only the patients of Winnicott's, but, also, the patients of Winnicott's patients, as well. Quite a number of his analysands became Training Analysts at The Institute of Psycho-Analysis in London, or psychotherapy trainers in their own right, and at least four influential teachers have acknowledged this in public, or in print, namely, Enid Balint (1994), Harry Guntrip (1975), Masud Khan (1987), and Margaret Little (1985, 1990). A very large number of individuals received their own formation from these distinguished analysands of Winnicott's; therefore, one must consider not only Winnicott's analytical children, but also, his analytical grandchildren, who now constitute a very large percentage of contemporary practitioners of psycho-analysis and psycho-analytical psychotherapy.

I have a clear set of guidelines in my mind which I use in the writing of my historical work. Under no circumstances will I reveal any identifying biographical information about any of Winnicott's patients, however interesting or relevant it may be. I regard this as common courtesy as well as an allegiance to our professional codes of confidentiality. I will of course report information which has already appeared in the public record by patients who have written about their own treatment. But in view of my concerns, how much should I reveal about Winnicott and his family? No doubt I shall struggle with this vexing question throughout the construction of the biography and beyond, but whatever data I do impart, I plan to do so in a consistently psycho-analytical manner, explaining with compassion how the less attractive aspects of Winnicott's character emerged from infantile and childhood experiences, well beyond his control.

In a marvellous essay on the maligned therapist, published first in the Jahrbuch der Psychoanalyse, the formidable psycho-analyst and historian, Dr. Kurt Eissler (1991), has written bravely about how various insults and crass remarks hurled at him by Peter Gay (1988) and by Elisabeth Young-Bruehl (1988) have had a significant impact upon Eissler's own analytical patients. Eissler has cited numerous examples of the ways in which allegations by Professor Gay and Professor Young-Bruehl concerning Eissler's ostensibly totalitarian control of the Sigmund Freud Archives caused distress to several of Eissler's patients. Dr. Eissler also cited an instance in which Anna Freud suffered similarly. In his biography of Freud, published posthumously, Dr. Max Schur (1972, p. 499) reported on a conversation between Freud and his daughter from 1938. Schur wrote that after the Anschluss, Anna Freud had asked her father, ‘“Wouldn't it be better if we all killed ourselves?”’, whereupon Sigmund Freud replied, ‘“Why? Because they would like us to?”’ One can readily imagine that Anna Freud's patients might have squirmed substantially upon reading of Miss Freud's suicidal comment, irrespective of the extremity of the circumstances. A suicidal patient might have seriously questioned Miss Freud's capacity to contain such a treatment. Eissler (1993, p. 193) noted that, "it would have been sufficient to report that one of his children had asked the question, which would have spared Anna Freud the anguish she must have felt repeatedly when her patients reminded her of that tragic episode." This comment illustrates Eissler's sensitivity to those matters, a sensitivity far greater than that of Max Schur.

Dr. Eissler's article, extended further in his recent book on Three Instances of Injustice (Eissler, 1993), serves as a sobering reminder that the psycho-analytical biographies and histories that we write have an impact far beyond the reaches of the academy, and we must begin to devote very much more attention to the effect of our works on analytical patients and on their families. Previous attempts to theorise about psycho-analytically orientated biography have not always grappled with this issue in full (cf. Roazen, 1987). Historians who do not pontificate about clinical matters, and psychotherapists who do not reflect on these matters with enough depth, should think more prudently about these concerns, and would do well to cogitate upon these preliminary words of caution.

ACKNOWLEDGEMENTS.

I first presented this paper at the Second Annual Conference of the Universities Association for Psychoanalytic Studies in Sheffield, South Yorkshire, on 20th May, 1995. I want to extend my particular thanks to the members of the audience for their helpful comments, in particular, Professor Robert Young. I also want to express my gratitude to Dr. Sonu Shamdasani and to Mr. Richard Skuse for alerting my attention to the essay by Dr. Kurt Eissler.

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BIOGRAPHICAL NOTES ON THE AUTHOR.

Brett Kahr is Senior Lecturer in Psychotherapy in the School of Psychotherapy and Counselling at Regent's College in London, and Course Tutor in Mental Handicap in the Child and Family Department at the Tavistock Clinic in London. Additionally, he is a Tutor in the Department of Primary Care and Population Sciences at the Royal Free and University College London Medical School of the University of London, and an Honorary Psychologist at St. George’s Hospital.

He is the author of D.W. Winnicott: A Biographical Portrait (London: Karnac Books, 1996), which won the Gradiva Prize for biography and history from the National Association for the Advancement of Psychoanalysis.

Not to be quoted without permission.