More than Klein’s Rebel Daughter
In current histories of psychoanalysis, Melitta Schmideberg still lives under the shadow of her mother, Melanie Klein. If Schmideberg’s name is mentioned at all, it is in the context of the Controversial Discussions that took place at the British Psychoanalytical Society in the early 1940s. Instead of focusing on Schmideberg’s relationship with Klein, I wish to contribute to a different historical account of Klein’s rebellious daughter: that of a socially engaged, passionate, original analyst who devoted her life to working with marginalised people and who helped to found two successful institutes for the psychological treatment of offenders, one in the UK and another in the USA.
The A.P.T.O.
The Association for the Psychiatric Treatment of Offenders (the A.P.T.O.) was founded by Schmideberg and her colleague Jack Sokol in New York in 1950. They imagined a ‘small, closely knit group with volunteer doctors treating offender patients in their own private offices.’ Soon, a volunteer clinical team of fifteen psychiatrists, five psychologists and ten workers in related fields was established. At the second meeting, Sokol and Schmideberg expanded the call to social workers and correctional staff. Finally, a forum for ‘enlightened laymen’ was founded, which served to educate the wider public, as well as to win support for the organisation.
‘Group Therapy in Reverse’
Patients were seen free of charge and the frequency of sessions ranged from one to three sessions a week. However, it was quickly established that neither individual nor group analysis provided sufficient support for patients referred to the A.P.T.O. Consequently, Schmideberg and her colleagues invented a method which they called ‘group therapy in reverse’. If the offender is to be helped, they need a team of people working with them therapeutically as well as assisting them in their daily life until they are in a position to build such a network of supportive relationships themselves. In her 1968 article on techniques of offender therapy in Britain and the USA, Schmideberg explicitly formulated this view and related it to the social nature of education and family life: ‘There should be steady co-ordination and co-operation between those interested. In a child’s life, in addition to the parents, there are grandparents, neighbours, uncles, aunts, and other children. This is the basis of social life.’ Rather than a single therapist providing help to a group of people in need, the aim was to ‘utilize the impact of as many therapeutically oriented persons as possible’ to help a single individual. Patients were analysed, but also assisted in finding jobs, a place to live, advised about practical problems, relationships etc.
Time, Money, Space and Transference
In outlining the differences between her patients and the middle-class, neurotic patients who were (and still are) more readily associated with psychoanalysis, she outlined three key points. The first was that patients come to therapy regularly and by appointment. Being unable to adapt themselves to the norms of social life, most of Schmideberg’s patients would regularly miss appointments and this was taken as a matter of course. Rather than strictly keeping to the time-frame, sessions were prolonged or shortened if this was possible for the therapist and the patient felt there was a need for it. Additional sessions were offered in crisis situations.
Secondly, all patients were treated free of charge. The organisations Schmideberg worked for (the Berlin Policlinic, the I.S.T.D. and the A.P.T.O.) all understood themselves to be institutions that provided a public service and thus the funding came from the state, from charitable sources or from private individuals, but not from the patient’s own pocket. The premise was that money should not become a hinderance to treatment, a reason to stop therapy or to punish the less affluent patient. As Schmideberg put it, ‘I believe that with most patients a deep analysis is possible only if they are sure that the analyst treats them not merely for their fees and would not stop if the patient could not afford them any longer.’ Asking for money would only reinforce the social exploitation, associated in complex ways with interpersonal exploitation, in which the patient found themselves, whilst placing the analyst on the side of the exploiting forces.
A number of analysts in the inter-war and post-World-War-II period, especially those who worked with anti-social or ‘maladjusted’ children and adults, emphasized the difficulty of establishing a positive transference and a trusting relationship. In order to achieve this, many were willing to bend the rules of traditional psychoanalysis. Schmideberg’s methods were a part of this trend. She was willing to lend the patient books and to accept small presents without analysing the action. She went to see a patient’s lecture, visited another analysand in hospital. She exchanged recipes with the mother of a child patient, was willing to help in reality matters, to offer occasional advice, went to see a patient and his wife when they had a baby, often prolonged sessions or offered an extra session if the patient was struggling. She did not require patients to lie on the couch, did not reproach them if they did not keep to the rule of free association or avoided talking about something. In therapy, she behaved fairly spontaneously and did not attempt to hide personal matters of little importance.
A further important aspect concerned the spatial framework of the sessions. While the ideal spatial setting varied for each patient, Schmideberg warned against a quiet or impersonal consulting room as ‘a bare clinical setting makes the frightened patient still more uneasy.’ Instead, she tried to emulate a relaxed and homely atmosphere. She ‘had her cat around’, showed her books and paintings to those patients that were interested, got up to pop into the kitchen during sessions, did needlework while she talked, avoided staring at the patient and did not take notes during sessions.
Credit: Wellcome Library, London. Wellcome Images
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Reassurance
While Klein claimed that ‘techniques based on reassurance are seldom successful’ and are there to assuage the analyst’s needs, rather than the patient’s, Schmideberg had a different view. She argued that until the analyst had managed to establish for themselves the position of the good object, the whole interpretative process was of little avail. In patients whose belief in and introjection of good objects was weak or non-existent, analysis could not be conducted under frustration as very little frustration could be withstood. As Schmideberg explained, ‘I believe that under unfavourable conditions even correct interpretations will have unfavourable effects. A very inhibited boy was told by his mother that he avoided work to make her upset. This correct interpretation only increased his anxiety and his inhibition.’ The analyst’s active assistance, as well as their reassurance and non-retaliation, would enable the patient to gain trust and let the interpretations affect them on a deeper level.
Class and the Care System
Schmideberg’s questioning of hierarchies within the analytic relationship was directly related to her questioning of social hierarchies, particularly when it comes to the issue of class. In the aftermath of the 1946 Curtis Report on the welfare of children in care in England and Wales, she wrote Children in Need (1948) – a now largely forgotten but seminal work suggesting psychosocial interventions to improve deprived children’s chances of growing up into happy individuals. Edward Glover stressed the key place class played in Schmideberg’s work as a psychoanalyst.
In the past, too many books have been written by psychologists, or for that matter psychoanalysts, whose practice has been confined to the middle and leisured classes and whose vision has, in consequence, been contracted. Being concerned mainly with […] the hidden causes of maladjustment, they tend to neglect social factors which must be taken into account if any large-scale measures of prevention are to be brought into fruition.
Too great a focus on the patient’s internal world, rather than the connection between the internal and the external, was not only a point of contention between Schmideberg and her mother, but between Schmideberg and analysts who worked predominantly with middle-class patients. For Schmideberg, there was no way of approaching her patients’ psyche without taking into account the wider social context of their lives, as well as those of their families.
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