The Online Journal of the American Association for Psychoanalysis in Clinical Social Work
Anna Freud Interview with Milton Senn, M.D.
Editor’s Note: This interview with Anna Freud was conducted by Milton Senn, M.D. on October 13, 1977 as part of an oral history project he conducted that is archived at the National Library of Medicine in Bethesda, Maryland (“American Child Guidance Clinic and Child Psychiatry Movement Interview Collection, 1975-1978”). Dr. Senn, a psychoanalytically-trained pediatrician, had been Chairman of the Department of Pediatrics at Yale and the Director of Yale’s renowned Child Study Center from 1948 to 1966. A visionary, Senn authored a seminal 1948 article “ The Psychotherapeutic Role of the Pediatrician” in the journal Pediatrics.
Introductory Note by Dr. Senn:
: Dr. Freud was interviewed in her study, which is on the third floor of her beautiful home. It is a large room with exposures to the gardens in front and in the rear, and a sunny exposure to the side. The room contains her couch for sleeping, her analytic couch, a larger terrarium, a desk, bookshelves and bookcases lined with books, and plants. It is a most comfortable room.
Dr. Freud was dressed in a black pinafore with a burgundy colored blouse and wore black beads. She was more frail than I had seen her some years ago.
She began our conversation today, which is not recorded, in talking about her age and my age and her sister’s age. It appears that her sister is about to reach the age of 90, is of excellent mind but frail in body. Dr. Freud does not wish to live that long; she is in her mid-80s and considers herself healthy but tires and gets short of breath on slight exertion. [Miss Freud was actually 81 at the time of this interview. She died, October 9 th, 1982, at the age of 86. WSM]
She spoke about her mother who had died at the age of 90 and had emigrated to London at the age of 75 after she and her husband, Sigmund, and the children were driven out of Vienna by the Nazis. This had been an extremely stressful period for the Freuds, as Sigmund Freud was ill. Mrs. Freud was then in excellent health. Dr. Sigmund Freud lived and was to die in this house, where I am interviewing Miss Freud, from1938 to 1939.
Subsequently, when the war and the blitz struck London, Mrs. Freud was sad, but completely unafraid, according to her daughter. Mrs. Freud frequently went to the windows to watch the flares at night and the bombs explode. Anna Freud had to draw her mother back from the windows, lest she be injured.
Anna Freud told me today that she was the only one of Sigmund Freud’s children to become an analyst; that he was more desirous that his sons become other than physicians because he wanted them to have their independent lives. He was very happy, however, that Anna Freud became a child analyst.
Miss Freud’s problems today stem mostly, as she says in the interview, from a lack of money for her Hampstead clinics. Some of the American foundations have stopped giving their money to her clinic and with costs having gone up in Britain, she finds it difficult to meet the expenses. She works on no salary. She hopes that word can be gotten to her American friends that she is still active and healthy despite her age and that she believes that it is necessary for her clinic to continue to work in therapy with children and to train individuals. Many of these trainees are Americans who go to certain centers, particularly Cleveland, where they become child therapists. Speaking about money raising, Miss Freud said that she did not like that part of work, that part of her life, and she was very hurt when she was turned down after she had appealed to someone for funds. For that reason, she frequently used intermediaries to seek out funds and if a donor was then disinterested he could tell the intermediary and the news would ultimately come to her. She was rather upset when someone told her directly that she could not be given funds for her work.
INTERVIEW WITH DR. ANNA FREUD
In her home, in Hampstead, London
INTERVIEWER: Dr. Milton J. E. Senn.
Dr. Anna Freud is the distinguished daughter of Sigmund Freud and is being interviewed about the relationship between American child psychiatry and psychoanalysis and British child guidance work.
SENN: Dr. Freud, I appreciate very much your seeing me today and I understand that this is the first interview you have ever given anyone; it is a great honor. Would you tell us what you think have been influences from the American side on British childcare, particularly of the emotionally disturbed child, or the influence from the American side on British child guidance work, child psychiatry or child analysis?
FREUD: I can only answer it in a very personal way because I am not actively concerned with the child guidance move¬ment here, only with child analysis. But from what I understand from my people in the clinic, the training, especially of the psychiatric social workers and the influence on the building up of the child guidance clinics has come from the American child guidance movement. As far as I understand it, the idea is that no child should be judged by an individual but by a team and that the team should be able to look at the child from all aspects, physically, mentally, socially, which also means en¬vironmentally and psychologically. I think this is probably a great step forward compared with the past, but like all develop¬ments, it has also become rather rigid. The specialization in child guidance work, as in all children’s work, is not always to the child’s advantage since it also means that the various specialists keep strictly to their own area. My own feeling is that it would be ideal if each specialist knew not only his own area, but also all the others. I have often talked against specialization in children’s work. For example there is the fact that pediatricians – with very few exceptions – know very little about mental development while psychoanalysts know not enough about a child’s physical development. Knowledge is needed from both sides. There are only very few places like Yale, where the professors’ firm grounding in both areas is taken for granted.
I remember the wartime arrangements here for children when hospital nurses were put in charge of children’s homes who never in their life had had dealings with a healthy child; they only knew children who had to be in bed and be looked after. But I have also watched teachers in school who have no idea about a child in illness. In the end, it is only the mothers who are expected to deal with illness and health, mental needs, emotional needs, physical needs, all at the same time; if they are untrained, they have to do it according to their feelings. So the team is only excellent if information is shared and ex¬changed between them.
SENN: How about now in Britain, has there been any real possibility of a coming together of these specialists, and integration? I know you have worked with groups of pediatricians, but what about that – has there been any attempt to really conceptualize in a broad way about the child, the physical, emotional…
FREUD: Not in a broad way yet; there are only pioneering be¬ginnings, as in my own group of pediatricians, or Dr. Winnicott’s group of pediatricians; as in the person of Bianca Gordon who works with hospital personnel.
SENN: Who is Bianca Gordon?
FREUD: She is a psychoanalyst who works in children’s’ hospitals as a consultant in the children’s ward and she has these seminars for inter¬disciplinary hospital personnel.
SENN: What is her aim in working in the hospital with the patients? What does she hope to do for them?
FREUD: In the hospital she has, together with the pediatrician, a special consultation group; for instance, mothers of newborn and their difficulties, crying infants and their diffi¬culties, dying children and the difficulties of the parents…crises situations, really.
SENN: Is there anything else that you see coming from across the water from America that might have influenced things here? What is there from the field of child development in America that has had any influence on British psychoanalysis?
FREUD: You know there is no such thing as British psycho¬analysis. There is in Britain my kind of child-analysis and there is the Melanie Klein kind; they are quite widely apart. What my co-workers and I do is connected with what happens in America in child analysis, so are my Clinic’s efforts. I can hardly tell you now what of it is British and what is American; we exchange. For instance, two thirds of the people we have trained for child analysis and child therapy in my clinic work now in America; two thirds of the students that we accept for further training come from America. You can call it a common effort between people here and people in America.
SENN: How do you and the Americans exchange your ideas? I know, years ago, I had a very important meeting with you and some of your group in Walberswick; I presume that the Americans, like the Kris’s (Ernst and Marianne) and Al Solnit and others, meet with you to discuss and exchange ideas, but will you tell us more about that?
FREUD: Yes. First of all we exchange ideas through the Psycho¬analytic Study of the Child, the Annual. There, the publications are partly from American colleagues, partly from British colleagues and, like interracial relationships, we don’t really ask, “Are you British, are you American?,” we belong to the same association, to the same profession and we publish together. The same is true for the meetings of the Association of Child Psychoanalysts. There are probably as many people from Britain and the Continent as there are from America. It is a joint effort, and it is difficult to say who influences whom. I think what we do in my clinic here and what I have written over the years had quite a bit of influence in America as well as the people who went over; on the other hand, what Ernst Kris did, and some other people in America, did have a great influence here – it is interaction rather than influence.
SENN: How many American students do you now have on an average a year?
FREUD: Our maximum is eight students, and out of these eight there will probably be six Americans¬.
SENN: What do they do when they leave here?
FREUD: They work in various places in America. Quite a number work in Cleveland – I think there are probably six or eight of our people there if not more.
SENN: Western Reserve?
FREUD: Western Reserve, and also independent of it.
SENN: And they work as child analysts?
FREUD: They work as child analysts, also as consultants and as teachers in child psychiatry. Quite a number are now with Dr. Nagera in Ann Arbor. Dr. Nagera used to be in our clinic for many years; he is now head of a department in Ann Arbor where he collects people from us. A number work in California, formerly in the Reiss-Davis Clinic, while others work with Peter Neubauer in New York in the Child Development Center. Although they have some private practice, they work mostly in insti¬tutions.
SENN: What do they do in Britain, those that are from here?
FREUD: In Britain they go into the child guidance movement.
SENN: A s what? Therapists?
FREUD: As therapists.
SENN: Do you have trainees from other countries too?
FREUD: One or two from Germany.
SENN: What would they become? Child analysts in Germany?
FREUD: They have child analytic training, but they would probably be child therapists. We have had some students from Australia, from New Zealand, from South Africa, but mostly from America.
SENN: Have your trainees in child therapy that remained in Britain had any influence on what is done for children, say, in the courts?
FREUD: There are two people now who have great influence, and that is the Robertsons, Joyce and James. They had their beginnings in the Hampstead Nurseries. Also, the book where I am co-author with Goldstein and Solnit has had an in¬fluence, ”Beyond the Best Interests of the Child”.
¬SENN: Also in Britain, the child therapists, have they worked at all in education, in schools? That was your early interest.
FREUD: That was my early interest – there is not as much of it yet as I would like. My hope is that they should work as much with normal children as with problem children; the in¬fluence of child analysis on normal upbringing is important, in my own mind, as the cure of the problem child.
SENN: What are the difficulties in the field of education?
FREUD: Again, there are some enlightened pioneers but not yet a big movement. Have you ever heard of a Mr. Hill?
SENN: No. What is his full name?
FREUD: J. C. Hill. He is now an old man, older than you or I, but he was for very many years school inspector in London, and all on his own, without an analytic training he got deep into analysis and wrote a number of books applying psychoanalytic knowledge to teaching. He is an excellent teacher, the best teacher ever, and while he was in active service he had quite an influence on teaching.
SENN: Way back, was not the London School of Education, or Economics, interested in changing education, and where did Susan Isaacs come into this – the woman now dead – where did she come into this?
FREUD: I think she had quite an influence there. That was really before my time, before I came to England.
SENN: Was that the London School of Education?
FREUD: Yes, I think so.
SENN: Did she have any exposure to psychoanalysis?
FREUD: She was an analyst.
SENN: Trained where?
FREUD: Here, she was a Kleinian analyst.
SENN: I see.
FREUD: …and a very clever woman.
SENN: Now, has anything gone further apace in the London School?
FREUD: I would not think so.
SENN: You never had a relationship to them, to the London School?
SENN: How do you see trends in child analysis or child therapy? What is going on there?
FREUD: It is going in two directions: One direction is to improve the technique of child analysis more and more, so that it does not only reach the neurotic problem child but also the underdeveloped child, and the borderline child. The Association for Child Analysis is very much con¬cerned with the improvement of technique, which allows child analysis to widen its scope. I advocate next to it another trend, to use knowledge that we gain from child analysis to build up a detailed theory of normal development and then to apply this to the upbringing of children in general. And I am gradually trying to convince people that this is the principal task of the child analyst.
SENN: As I recall, this is not a new interest of yours?
FREUD: No, it is an old interest but it is not easy to gear a clinic to that interest.
SENN: Even your own clinic?
FREUD: Even my own clinic.
SENN: Because they are interested in pathology and want to work with pathology?
FREUD: And they want to get more and more effective as therapists.
SENN: And maybe one can measure something more readily when you work with deviant behavior than with normal?
SENN: You have come a long way in developing theories of normal development, haven’t you, your lines of development, profiles…?
FREUD: Yes, especially the developmental lines and the idea of development going in stages, each stage to be solved by the child, always seen as a conflict between various influences; there are adaptive ways of solving it just as there are pathological ways of solving it. To look at development from that point of view is what I am concerned with now.
SENN: Are you constantly working at these lines of development, challenging them or modifying them?
FREUD: …or learning more about them, yes. Dr. Yorke, in the clinic, who is my co-director, is a great help on that.
SENN: Coming back to the preventive, a long time ago – you wouldn’t remember this – I sat in your backyard at Walberswick and looked out at the sea and said to you then, “Miss Freud, was your father ever interested in prevention?” and you said, “Absolutely,” and then you and I talked about your own interest. Well now then, my interest too was in prevention way back, but we also had our problems. You have said more than once about the misinterpretation of Freudian theory by child rearers, child educators – how would you like to see these lines of development, this new knowledge about child develop¬ment applied in child rearing? How do you see that as coming about?
FREUD: You know what-I think: the better we understand the child, the better we handle it; there is no doubt about that. We learn in analysis about drive development, ego development and superego development, about the external in¬fluences. Somehow we have always had the idea that these trends ought to stay on prescribed lines and fit in with each other. But if we look more closely, we become very aware of disharmonies. What happens if one line of development goes very fast and the other very slow, and the handling of the child from the environment is not at all in line with that? I think we could have an eye for the disharmonies and act accordingly. We have at the moment in our Nursery school a child who is very unevenly developed. He is enormous. He came to us when he was not yet three, but could have been five according to his body development. At the same time he behaved like a toddler. His body had grown but he had no pleasure in motility. One would think that such a big, strong child would like to run, to climb, to walk, and to do everything – no. We have a tiny boy who does all these things, which this big boy doesn’t. He sucks and drools, but he can also reason like a seven-year old. So there is an absolute disharmony between all the parts of his personality; and I have a feeling that if one gets an eye for harmonious and disharmonious development, that one would learn a lot about applying that knowledge.
¬SENN: So you are studying that boy and his family here?
SENN: Do you perceive that one-day, with that knowledge, that one could have classes with parents, or conferences with parents about their children and help them inter¬vene?
FREUD: Yes. After all, we have spread – you too – spread over the years quite a lot of knowledge – sometimes good knowledge, sometimes-premature knowledge – to the parents and this has to continue. When we talk later about the Field Foun¬dation, I shall say more how much I would like to develop the clinic further towards applied work.
SENN: Do you want to say a little bit more about that here now, your vision about application?
FREUD: You know, what one can do in that field is almost limitless. Unluckily, it all depends on money nowadays; it didn’t in the past. The whole of child analysis in Vienna was developed without a grant and without money ¬people just worked. But it can’t be done any more, people can’t live, life has become more expensive, more difficult for the young; no one can work nowadays who is not paid.
SENN: Do you have any classes for parents in the clinic?
FREUD: Connected with the Nursery school they have evenings for parents to discuss problems. ¬SENN: In childcare, child rearing?
FREUD: In child rearing. Since we have underprivileged child¬ren, we don’t have intellectual parents, we have very simple parents, which makes it very interesting. We also have a toddler group, which means children between one and two, where the parents are involved.
SENN: In these parents’ groups, is the leader a child therapist?
FREUD: No, the leader is our Nursery school teacher.
SENN: Is she alone or do therapists come in on occasion to talk to the group?
FREUD: At the moment she develops her relationship with the parents but the whole Nursery school has one of the qualified child analysts as a consultant. – I started as a teacher, I taught primary school for five years. I would have liked to work in the schools of the city but that was not possible at that time.
SENN: That was in Vienna?
FREUD: That was in Vienna, of course – I was 19 at the time, that was the lowest age of a teacher – but they did not employ Jewish people in the city; they thought it would not be good for their children. So I worked in a private school for five years teaching chi1dren between the ages of 7 to 10; I learned an enormous amount in those years. Those were, of course, normal children and one learned how to keep discipline in the class, how to interest them, how to attach them to oneself and to the subject. I enjoyed it very much.
SENN: What did you come from? Was it a normal school, as we call it in the States? What kind of a school did you come from?
FREUD: I did five years in a primary school of the city and then six years in what was called a Lycee, i.e. a girls’ school, probably equivalent up to college entrance.
SENN: Then you went from that…?
FREUD: I stopped there, with the matric at 16 and then had two or three years just private teaching where I learned Latin and things I had not learned in school. At the same time I did my examination as a teacher and then taught for five years. And then, after five years I stopped and went into analysis.
SENN: Did your father want you to be a teacher?
FREUD: No, but he would not have prevented me. He did not want me to be a doctor.
SENN: He wanted you to be an analyst?
FREUD: Yes. I wanted to be an analyst and he agreed.
SENN: When did you first get that desire, to be an analyst?
FREUD: Probably in those years of teaching. Yes, early.
SENN: And you saw already then the potential value?
FREUD: Yes, to understand children.
SENN: Now, at that time, I have forgotten the name of the man who was very involved with the juvenile delinquents …
FREUD: Aichhorn – oh, I worked with Aichhorn.
SENN: Tell us about that.
FREUD: Aichhorn was a wonderful person. He was a real Viennese, also came from the teaching profession originally, was very interested then in delinquents and after World War I he was commissioned by the City of Vienna to collect the waifs and strays, left in Poland and Austria when the Russians re¬treated. They were youngsters without parents running wild ¬and he did a marvelous job with them. Then he contacted us analysts and I became great friends with him, visited his in¬stitutions, worked with him and also helped a little with the writing of his book. I learned a great deal from him.
SENN: Was he a psychoanalyst?
FREUD: Yes, he became a psychoanalyst. He did not start out as a psychoanalyst, but he became a psychoanalyst.
SENN: Did he practice as a psychoanalyst?
FREUD: Yes, in his later years, not in the years when he worked with the delinquents, but in his later years he practiced. He was a wonderful man.
SENN: What do you think was the reason for his success with those kinds of children?
FREUD: He said because he had a delinquent phase in his ado¬lescence himself and understood them so well. He had an enormous influence on them, just man to man. And I remember when I visited him in one of his institutions, the way they re¬lated to him. He took me around and showed me the buildings; we came to one of the buildings that was locked and there was one of these boys who said: “You stay here, I’ll run to the main building, I’ll bring the key, I’ll bring it to you and you can go in. Just wait here for me.” I said, ”What a charming boy.” He said, ”Yes, he is here because he is (do you know any German?) ein Messerstecher (cutthroat).” He had an influence on these boys, you could see, they ate out of his hands.
SENN: Did any of your brothers or sister become analysts?
SENN: None, you are the only one?
FREUD: I am the only one, yes.
SENN: Did your father like that or did he hope for more ¬
FREUD: No, I think he was very glad that the sons took in¬dependent professions. He did not think it was good for a son to follow the father. These were the post war years when Vienna had gone social-democratic and there was the so-called school reform in Vienna, a move from old-fashioned methods to progressive ones. There were two very enlightened inspectors, and they asked me and Mrs. Burlingham to give a seminar for the city to nursery school teachers. That was really the beginning of the outside reaching, and we conducted it so that the teachers brought up their practical difficulties with the child while we tried to show them what was the difficulty, how the child reacted to the home surroundings, what was the best way of handling it. And then, Dr. Hoffer (whom you surely knew) afterwards started the Course for Pedagogues, and some of the teachers that we had worked with then came into the course.
SENN: Dr. Hoffer was an analyst at the time?
FREUD: Yes; also, I was asked during that same time in the post war years to give a series of four lectures for the day care centre people which are my “Introductions to Psychoanalysis”. These two links with the City of Vienna were very promising ones.
SENN: Now, your book Introductions to Psychoanalysis, it is still being printed, isn’t it? That was really a bible for schoolteachers and…
FREUD: Yes, it was meant for that. The lectures were as I had given them.
SENN: What about the next World War, when you were in Britain and dealt with the children of Britain? What about those days, what did you learn?
FREUD: There was something in between. Mrs. Burlingham and I and Dr. Stross, became very curious about the second year of life. We thought the transition from babyhood to two years was especially interesting. Edith Jackson provided the money for building up a small day nursery for twenty children between one and two.
SENN: In Vienna?
FREUD: In Vienna. That was a wonderful venture and we learned enormously there.
SENN: Do you remember Julia?
FREUD: She worked there with us; Edith Jackson provided the money; Dr. Stross was the doctor, we had a very good nurse and nursery school teacher; we did all sorts of experiments with sleeping and eating, all most interesting. We only had it for a year and a half – and then the Nazis came-¬ it was a Jewish venture and they closed it immediately. We had 20 cribs and when we came to London, the 20 cribs, by chance, came too with our luggage. When the war started here, we said we must do something with those 20 cribs and so, with the help of somebody here, and then the American Foster Plan for War Children, we started the War Nursery.
SENN: How fortuitous that the 20 cribs came with you…
FREUD: We had, for five years, 80 children between ages 10 days to age about 8 years, day and night, as residential… There was one house here in Netherhall Gardens for 50 babies; another house where we had a nursery school for the older children; one house in the Country. As the bombing got worse and worse here, gradually all the children were sent to the country. So we had 80 resident children, about 20 mothers…
SENN: How did those children influence your conceptions of child development?
FREUD: I learned very much there because we had the children day and night – quite different from a spot observation.
SENN: And under all kinds of circumstances – illness and health …
FREUD: Illness and health, separation – the whole book about it has been published now. (The book is Infants without Families; Reports on the Hampstead ¬Nurseries, 1939 to 1945, which is in the series, The Writings of Anna Freud, Vol. 3, International Universities Press, New York, Copyright 1973.)
FREUD: The Foster Parent Plan for those children had financed those three houses very generously but we had to de¬liver a monthly report. Since the next money only came, when our report had arrived, we were very punctual with our re¬ports. There were many nights when one could not sleep anyway because of the bombing, so these reports were written in those nights; it was the best way to use the time. We collected many examples of child development; of reaction to separation; of the ways the children either satisfied them¬ selves or made new attachments; how they treated the new attach¬ments.
FREUD: …that leads from there to the present Clinic. It was not easy, in these very difficult war conditions, to keep personnel because there were no holidays, no free times – no one in war times had holidays – but we were very well staffed, mostly with refugee girls and conscientious – -¬objectors. James Robertson was a conscientious objector who was our handyman and social worker. To keep the staff happy under these conditions, we started a training scheme so that whatever they had to work on, at the same time served their training.
SENN: And they would get credit for it, one day, maybe?
FREUD: Yes. And it is these same people who were then our first students in the Hampstead Clinic. Do you know Hansi Kennedy?
FREUD: She came to the nurseries as a refugee girl; she is now one of the directors of the Hampstead Clinic. Many of our trainees there studied afterwards and then took a training in child analysis.
SENN: Was there anything else you would like to say about trends or how you see things going?
FREUD: I believe very much in nursery school education, but only in nursery school education if the nursery is small, can give individual attention, is daily, and has proper premises. I have often thought that the solution for the American young in the cities would be an enormous number of nursery schools, with no nursery school having more than 15 or 20 children, and no nursery school having a different child population morning and afternoon, and no nursery school teachers so overworked that they cannot give individual atten¬tion; nor premises used for more than one group of children. I have heard people say often, “What a waste, in the after¬noon, or in the evening the premises, are empty,” and to that I used to answer, “What a waste that no one sleeps in our beds in the daytime, they just stay empty.” We like it that way and the children like their nursery school to be their own. I feel if one were really generous with nursery schools but even beyond the Head Start program – it would solve many of the school problems.
SENN: Do you want to say something about the nature of the teachers, what they should be like?
FREUD: They should be very well trained.
SENN: In what?
FREUD: In nursery school technique and in analytic child psychology, i.e. in the kind of knowledge of children that can be applied. Nearly all the children we have in our nursery school were sent to us as children at risk. They would have been enormous school problems or school failures if they had not been there. But it is only possible with in¬ individual attention; not with big groups.
SENN: What about mixing the sexes in terms of teachers, men and women?
FREUD: Yes, why not. There are not very many men who want to be nursery school teachers but some do- it does not matter which sense.
SENN: What do you do about the parents? Do you ever involve them in participating as sort of assistant teachers?
FREUD: Not as assistant teachers, but free access.
SENN: Free access to visit and observe…?
FREUD: Free access to observe, to visit, and to discuss. I would not involve them as teachers, it is not good for their own children, who don’t like to share their parents with a lot of others. I know it is done now, but I have never seen the advantage.
SENN: In terms of child analysis, do you have here the pres¬sure that we have in the States for group therapy?
FREUD: There is the same pressure but we don’t answer to it in the Hampstead Clinic. There is absolutely the same pressure: group therapy, family therapy, community therapy – that has come over from America.
SENN: But you don’t practice that here?
FREUD: Not here, no.
SENN: Not at the clinic, you still have the one to one re¬lationship?
FREUD: The one to one – and no family interviews.
SENN: No family interviews.
FREUD: Have you ever had family interviews?
SENN: No. – How do- the parents come into the therapeutic milieu here?
FREUD: How do they come to us? Either through their general practitioner, or through the school, or through the health visitor.
SENN: And then once they arrive here, are there any pre-¬therapy meetings with the parents about details?
FREUD: The whole diagnostic process is rather a lengthy one with us.
SENN: Involving what?
FREUD: Involving probably several interviews with the parents, one to two interviews with the child, perhaps a school visit…
SENN: With the child alone?
FREUD: Alone…perhaps a school visit, or contact with the school, contact with their general practitioner.
SENN: And then after that, in the process of therapy, what is the relationship to the parent?
FREUD: The whole range, from seeing the parent only occasionally to simultaneous analysis. We always have a few cases where parent and child have analysis, partly for study purposes, partly for therapeutic purposes.
SENN: And what about the relationship with the community people, like the pediatrician who referred, is that an ongoing kind of …
FREUD: We give reports.
SENN: Give reports?
FREUD: We give reports, usually to the general practitioner because the children come not from the pediatrician. ¬That is different here.
SENN: They come mostly from general practitioners here?
SENN: Is there anything else you like to present about trends, changes that you see in the offing, good and bad?
FREUD: The bad changes I see in the offing is that people do not want therapy five times a week, but possibly four times, three times, twice or once. That dilutes it so that in the end it becomes a token therapy, a dangerous trend.
SENN: Anything else?
FREUD: In the child guidance clinics the trend goes towards family therapy as if one could do it.
SENN: Have you witnessed any bad effects from that?
FREUD: From family interviews – yes.
SENN: Like what?
FREUD: The child who very often has kept his disturbances quite private, especially from his siblings, is suddenly exposed and shamed over being invited to act out in front of an audience. I consider it an invasion of privacy, but that everybody does not share feeling.
SENN: Not shared by the people in the child guidance clinics, but people in your clinic agree.
FREUD: Yes, they agree and some have left because they didn’t agree.
SENN: Anything else that you see is good?
FREUD: Our cases are getting more and more difficult because of the family circumstances.
SENN: What kind of circumstances?
FREUD: Breaking up of families, one parent families, ill families, drug addiction in families, alcoholism in families, quarrels in families; of course the intact families may not need to come to us.
SENN: The nature of the child’s problem is different?
FREUD: We discussed an example in the Nursery School today. The child’s parents are divorced; the mother is herself in training to become a teacher so her times don’t coincide with the times the child is in the nursery. He has to go here and there until she can pick him up. The father lives in Austria in a commune. In the summer the mother takes the child to Austria, he has six weeks with his father, gets terribly attached to him—the father lives with another woman—the mother has to watch that and is terribly upset—he comes back and is not the same child, longing for his father; he will again see him in another year, probably for six weeks ¬it is like you gave him something, took it away, gave it to him, took it away.
SENN: The problem is being more severe then by the family situation being worse—how does that influence then what goes on in therapy? What does it demand of therapy?
FREUD: What it demands of therapy is to help the child to deal with bad situations in the best possible way and not, as usually happens, in the worst possible way.
SENN: Has it lengthened the course of therapy for these children?
FREUD: I suppose so. Is there anything else you would like to ask?
SENN: I think we should close because it is tiring, and I do appreciate this very much. I do thank you very much. ¬