From Obstacle to Ally: The Evolution of Psychoanalytic Practice

260 Pages·2004·3.25 MB·English

by  Judith M Hughes

From Obstacle to Ally
From Obstacle to Ally charts the history of psychoanalysis through a close look at
its clinical practice. In this study, Judith M. Hughes succeeds in bringing alive the
clinical struggles and theoretical contributions of the last century’s most influential
psychoanalysts, including Sándor Ferenczi, Anna Freud, Melanie Klein, Joan Riviere,
Wilfred Bion, Betty Joseph, and Heinz Kohut.
Taking a cue from Freud’s reflections on transference, Hughes traces a series of
encounters in which psychoanalysts managed to negotiate obstacles to treatment
and, on occasion, transform them into allies. Through an examination of the specific
obstacles posed by particular diagnostic categories, she shows, in convincing detail,
how grappling with such obstacles prompted advances in psychoanalytic practice.
As well as providing an excellent introduction to fundamental psychoanalytic
concepts, From Obstacle to Ally offers a highly original account of their evolution. It
is a book that will fascinate psychoanalysts and psychotherapists alike.
Judith M. Hughes is a professor of history at the University of California, San Diego
and is on the faculty of the San Diego Psychoanalytic Institute.
Also by Judith M. Hughes
To the Maginot Line: The Politics of French Military Preparation in the 1920s (1971)
Emotion and High Politics: Personal Relations at the Summit in Late Nineteenth-Century
Britain and Germany (1983)
Reshaping the Psychoanalytic Domain: The Work of Melanie Klein, W. R. D. Fairbairn,
and D. W. Winnicott (1989)
From Freud’s Consulting Room: The Unconscious in a Scientific Age (1994)
Freudian Analysts/Feminist Issues (1999)
From Obstacle to Ally
The evolution of psychoanalytic practice
Judith M. Hughes
First published 2004
by Brunner-Routledge
27 Church Road, Hove, East Sussex BN3 2FA
Simultaneously published in the USA and Canada
by Brunner-Routledge
270 Madison Avenue, New York NY 10016
This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”
Brunner-Routledge is an imprint of the Taylor & Francis Group
Copyright © 2004 Judith M. Hughes
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
This publication has been produced with paper manufactured to
strict environmental standards and with pulp derived from
sustainable forests.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British
Library.
Library of Congress Cataloging-in-Publication Data
Hughes, Judith M.
From obstacle to ally : the evolution of psychoanalytic practice /
Judith M. Hughes.– 1st ed.
p. cm.
Includes bibliographical references and index.
ISBN 1-58391-889-2 (hardcover)—ISBN 1-58391-890-6 (pbk.)
1. Psychoanalysis—Practice—History. 2. Psychoanalysis—
History. I. Title.
RC506.H846 2004
616.89′17′09–dc22 2004003623
ISBN 0-203-32294-0 Master e-book ISBN
ISBN 1-58391-889-2 (hbk)
ISBN 1-58391-890-6 (pbk)
For my patients

Contents
Acknowledgments ix
Abbreviations xi
Introduction 1
1 Hysteria: Transference 9
Freud, Ferenczi, and Elma 14
Ferenczi’s experiments in technique 24
Balint: Regressions, malignant and benign 35
2 Obsessional neurosis: Resistance 44
Freud and his “grand patient” 50
Anna Freud: The analysis of defense 56
Greenson: Forging a working alliance 62
3 Depression: Negative therapeutic reaction 72
Freud and his translator 79
Klein: The analysis of the superego 84
Riviere, Klein, and negative therapeutic reactions 92
4 Paranoia: Abnormal changes in the ego 107
Freud, Brunswick, and the Wolf Man 114
Bion: Learning from psychotics 122
Joseph: Countertransference and its uses 131
5 Narcissism: Megalomania 144
Kohut and narcissistic transferences 150
viii Contents
Kernberg and pathological narcissism 161
Rosenfeld and narcissistic object relations 169
Conclusion 178
Notes 183
Selected bibliography 211
Index 239
Acknowledgments
It gives me great pleasure to thank those who have helped me along the way—
including a number of the psychoanalysts who figure as protagonists in this
study. Years ago, in connection with an earlier project, I had the good fortune
to interview the late Herbert A. Rosenfeld. I have a vivid memory of him and
of our long conversation. In connection with this work I had similarly
extended talks with Betty Joseph, Otto F. Kernberg, and John Steiner. Their
openness and encouragement have been much appreciated.
At an early stage, before I was ready to put pen to paper, I tried out ideas
with two different groups: I gave a couple of most informal lectures to the
Psychoanalytic Interdisciplinary Seminar at the University of California,
San Diego; and I presented material that became the first chapter to the
University of California Interdisciplinary Consortium. Both groups urged
me to press on.
For steady support during and after my training at the San Diego Psycho-
analytic Institute, I have relied on Alvin Robbins, Allan D. Rosenblatt, Alan
Sugarman, and Robert L. Tyson. For intellectual companionship, I have
turned, again and again, to Roy D’Andrade, Donald L. Kripke, and Edward
Lee. Reva P. Greenburg and Melford E. Spiro have stood by me in the worst
of times.
In previous books I invariably expressed my deepest gratitude to my
husband, Stuart. He died as I was struggling with the second chapter of this
one. Until the very end, he wanted to know how I was progressing and
wanted to listen to my prose. His love and kindness have not been lost.