The beginnings of child analysis

“My work with both children and adults, and my contributions to psycho-analytic theory as a whole, derive ultimately from the play technique evolved with young children.”

Melanie Klein

The background to Klein’s child analysis

Sigmund Freud shocked many, both within and outside of his field, by talking to patients about their unconscious sexual phantasies, aggressive impulses and deepest inner conflicts. Building on Freud’s foundations, Melanie Klein went on to shape the course of psychoanalytic history by showing that such interventions could be just as powerful and effective in clinical work with children. One of her major contributions was to illuminate the earliest phases of psychic life, through exploring the emotional world of babies and young children.

Freud’s ‘Little Hans’

Colourful painting by a child patient of Melanie Klein
Painting by one of Melanie Klein’s child patients

In 1909 Freud described the emotional development of a five-year-old boy, ‘Little Hans’, who had developed a phobia about horses. Under Freud’s supervision, Hans’s father gradually understands this phobia as a communication of the little boy’s unconscious anxieties, revealed through his words and his play. After he carefully describes to his son the root of these anxieties, Hans experiences great relief and his phobia is resolved.

Freud believed this vignette illustrated his theory that children struggle with unconscious sexual conflicts and anxieties which can lead to symptoms similar to those found in adult neuroses – and that this can happen even within an ordinary, loving family. Although Freud did not work directly with Hans, this piece of work provided Klein and others with a prototype for psychoanalytic work with children.

Freud, like many others at that time, was sceptical about taking very young children into analysis, feeling that they could not be expected to open up to anyone other than their own parents. Melanie Klein did not waver in her belief that child patients would benefit just as much as adults from having their unconscious conflicts and anxieties understood and interpreted. In fact she felt they would be more able to get in touch with infantile states of mind, being closer to the raw experiences of infancy. Within 10 years of the publication of Little Hans she was taking on very young children as analytic patients.

Klein’s child patients

Pencil drawing by a one of Klein's early child patients
Drawing by one of Klein’s early child patients

Klein, like Freud, grounded all her theoretical discoveries in her clinical work. Her first child patients came to see her at her home in Berlin in 1919. Many of these children were severely disturbed. ‘Erna’, six, suffered with obsessional anxiety, sleeplessness and paranoia; Rita, at three years old, was aggressive, impossible to manage, and plagued by obsessional rituals. Others presented with severe night terrors, soiling and enuresis, inhibitions in learning, and sometimes overt psychotic features. Accounts of these analyses were published in The Psychoanalysis of Children.

Klein understood that young children communicate their inner dramas not by lying on a couch and talking, but through their drawings and – most of all – through their play. She discovered that ‘It is when the child plays with the small toys that we can see the expression of opposing emotions most distinctly’. She set out a low table on which she laid out ‘little wooden men and women, carts, carriages, motor-cars, trains, animals, bricks and houses, as well as paper, scissors and pencils.’

Photograph of wooden toys of the type Klein used with her child patients, including cars, animals and people
Wooden toys from the 1920s like those used by Klein with her child patients

Klein would sit alongside the child, watching them draw or play, with an attitude of ‘reserved interest’. She joined in with the imaginative play, taking on the roles assigned to her, and talked with the child about their worries. Sometimes she focused on real-life concerns, but above all she attempted to get at the heart of what she saw as the deepest level of unconscious anxiety causing their suffering. Her approach was direct and sometimes blunt, but always showed integrity and a deep compassion for the sufferings of her small patients. Read more about Klein’s technique.

Child psychotherapists today will recognise many of the symptoms of Klein’s early patients, although many of them will now have received a mental health diagnosis (attention deficit hyperactivity disorder, obsessional compuslive disorder, Aspergers, and so on). Many therapists today use the same basic technique pioneered by Klein, although clinicians rarely speak to children in the graphic language that Klein used. Read Margaret Rustin’s paper exploring how contemporary approaches to clinical practice compare to Klein’s original approach.

Controversies

Klein’s child analysis was warmly welcomed in some quarters. Karl Abraham, a profoundly influential figure for Klein, announced that, ‘[T]he future of Psycho-Analysis lies in Play Analysis’. But others among her colleagues were more sceptical. Anna Freud – who was pioneering her own model of child psychotherapy during the early 1920s – strongly disagreed with Klein that young children could cope with interpretations of their own aggressive impulses; neither did she believe that they formed a ‘transference’ relationship with their analyst. She saw the analyst as more of an educator, using psychoanalytic theory to build a benign therapeutic alliance with the child. It was her view that, ‘[I]t is in their positive relation to the analyst that truly valuable work will always be done’.

Copy of a typed and hand-annotated manuscript page - the first page of a draft critique of Anna Freud's approach to child analysis by Klein (c.1927)
First page of a draft critique of Anna Freud’s approach to child analysis by Klein, with handwritten notes and corrections (c.1927)

These early differences over theory and technique in child analysis led to a split in the psychoanalytic community, and to the setting up of different schools of thought and different trainings. To some extent the same discussions and differences of emphasis in clinical work with children continue to permeate the different schools of child psychotherapy, although there are also many shared beliefs and practices.

Against this backdrop of both praise and controversy, Klein pushed on with her clinical work with children, all the time revising and developing her theories of early emotional development. The most vivid account of her method of child analysis is available to us in her account of an analysis of a 10-year-old boy which took place during the Second World War. Published a year after Klein’s death, in 1961, Narrative of a Child Analysis was to change the course of psychoanalysis and become a touchstone for the future development of psychoanalytic work with children.

Read more about Klein’s clinical work with a child patient