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Jelliffe, S.E. (1932). British Journal of Medical Psychology. Psychoanal. Rev., 19(3):345-354.
Psychoanalytic Electronic Publishing: British Journal of Medical Psychology

(1932). Psychoanalytic Review, 19(3):345-354

British Journal of Medical Psychology

Smith Ely Jelliffe, M.D.

(Vol. 8, No. 1)

1.   Ferenczi, Sandor. The Adaptation of the Family to the Child.

2.   Baynes, H. C. Freud versus Jung.

3.   Rickman, J. On Some of the Standpoints of Freud and Jung.

4.   Burrow, T. Biological Foundations and Mental Methods.

1.   Ferenczi, S. Family and Child.—The author speaks of this contribution as some free associations on children's education. The title, he says, is unusual, since the adaptation of the child to the family is usually emphasized, but here he would accent the reverse, i.e., try to understand the child. Physiology has much to learn from pathology and so psychoanalysis has taught us much about healthy requirements in the family constellation. Unhealthy parents often reap the whirlwind in their children. Psychoanalysis, he says, can tell more about dont's than do's at present in child education. The child is in need of study.

The adjustment of the family to the child cannot take place till the parents first of all understand themselves and thus get some grasp of the pathology of the mind. Up to now it has often been taken for granted that parents are endowed with a natural knowledge of how to bring up their children, though there is a German proverb which says the opposite: “It is easy to become a father but difficult to be one.” The first mistake that parents make is to forget their own childhood; even in normal people we find an astonishing lack of memory of the first five years of life, and in pathological cases the amnesia is even more extensive. These are years in which the child is really at the level of and the equal of adults—

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and yet they are forgotten! So the lack of understanding of their own past childhood proves to be the greatest hindrance to parents grasping the essential questions of education.

Ferenczi then tries to deal with the practical problems connected with the ways in which parents can adapt themselves to their children. Nature is very careless, she does not care for the individual, but human beings are different, they wish to save the lives of every one of their offspring and spare them unnecessary suffering. Let them, therefore, turn special attention to those phases of evolution in which the child has to deal with difficulties, and there are a great many of them. The first difficulty is birth itself. It was Freud himself who said that the symptoms of fear had something to do with the particular physiological changes which take place at the moment of the transition from within the mother's womb to the external world. One of his former pupils used this view of Freud's as a springboard from which to leap to a new theory, and, leaving psychoanalytical concepts behind him, tried to explain the neuroses and psychoses from this first great trauma; he called it “the Trauma of Birth.” Ferenczi himself was very much interested in this question, but the more he observed the more he realized that for none of the developments and changes which life brings was the individual so well prepared as for birth. Physiology and the intuition of the parents go to make this transition as smooth as possible. It would indeed be a trauma if there were not well-developed lungs and heart, whereas birth is a sort of triumph for the child and surely must exert as such an influence on its whole life. Consider the details: suffocation is impossible, for the lungs are there and begin to expand at the very moment after the umbilical cord is tied, and the left side of the heart, till then inert, takes up its rôle with vigor. In addition to these physiological aids the parents' intuition guides them to make the situation as agreeable as possible, the child is kept warm and protected from disturbing stimuli of light and sound as far as possible—indeed, they make the child forget what has happened, it can make believe that nothing has happened.

Sexuality does not begin with puberty but with “the bad habits” of children. These “bad habits” as they have been erroneously called are manifestations of autoerotism or the primitive manifestations of the sexual instinct in the child. Do not be afraid of these manifestations. The word masturbation frightens people immensely. If in consultation—and how often—the doctor's advice is asked about the autoerotic activities of children, he should tell the parents not to take it too seriously; parents have to be treated tactfully on this question because of their internal fears and their lack of comprehension. Curiously what the parents do not comprehend is precisely what the children understand and experience deeply, and what the children cannot fathom is as clear as daylight to the parents. Ferenczi says he will explain this riddle later

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on: it contains the whole secret of the puzzle in the relation between parent and child.

Ferenczi introduces an excellent diagram of the Id, Ego, Super-Ego situation.

Fig I.

Fig II.

Fig III.

Fig IV.

2.   Baynes, H. G. Freud versus Jung.—This is the opening paper of a debate between Baynes and Rickman on the positions of Freud and Jung. It seems to the reviewer to be an outline, well informed on Jung's position but not quite so up to date regarding the development of the Freudian conceptions. Baynes calls these a “sophisticated metaphysic which is foreign to the spirit of science.” Surely a very prejudiced statement which his argument, to us, fails to support.

It is impossible to abstract this polemical discussion. It must be read in the original. It indicates how complex the whole situation still is and is likely to be for some time. When Baynes, however, uses the arugment on page 31 (quoted below) it amuses us as “apple sauce” to use an Americanism.

“Philosophical deliberation is not as a rule an outstanding factor in the equipment of the extraverted scientific investigator, and, therefore, it was hardly to be wondered at that Freud should have taken over the mechanistic hypothesis from the scientific inheritance of the nineteenth century. Furthermore, the isolation which bias and prejudice forced upon him in the first decade of his research was most unfavorable for that coöperation with a deeply philosophical mind which he most needed. In spite of this isolation, however, the possibility for such a coöperation actually came across his path. For Jung has by nature a philosophical temperament, the shoot of a tree that for generations produced philosophers and physicians in regular succession. But the disparity of mind and basic standpoint proved to be too great and the possibility never ripened. Freud became increasingly isolated from every viewpoint and scientific labor other than his own, while Jung went on to lay the foundations of the new science in broad psychological conceptions, which were commensurate with the emerging culture of a new epoch.”

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3.   Rickman, J. Freud and Jung.—This comeback of Rickman's cannot be abstracted; few debates can be; but Rickman makes out a good feet on the ground case as the reviewer reads it.

4.   Burrow, T. Biological Foundations and Mental Methods.—When the author starts with the statement, “Of late, certain experiences have led me to question whether the need of the mentally ill patient does not express itself in language that is totally different from that of the physician who attempts to answer it,” one is tempted to ask where has Burrow been sleeping “earlier”—for even in the days of Protagoras and his masters (400 B.C.), this problem was very keenly discussed. His second statement anent the “increase of patients” and the “methods of psychiatrists,” as in any way causally related is a nonsequitur difficult to place. One might as well argue seriously that the burning of a barn by lightning was due to man's lack of understanding of electrical forces; a plain bit of evidence of the “Jehovah complex” quandary. How long since has “insanity” been “the disease.” This type of thoroughly irrelevant understanding makes it impossible for the reviewer to abstract this paper, since it became nothing but a juggling with words rather than with actual experience.” I think it will be conceded that nervous disorders and insanity are predominantly diseases of civilization” (p. 55). This is the type of fustian with which one can hardly argue. When one of the sons of an Egyptian monarch had a poliomyelitis (see in Dana's Neurology—Frontispiece) are we to assume that civilization caused his poliomyelitis ? Is a toxic paralysis of the vagus and hemolysis from'a cobra bite a result of civilization? Rannygazoo!!! Abstracts are not supposed to be criticisms, but how can one help it when one reads such rubbish.

(Vol. 8, No. 2)

1.   Hadfield, J. A. The Reliability of Infantile Memories.

2.   Flügel, J. C, and RADCLYFFE, E. J. D. The Pressey Crossout Test.

3.   Money-Kyrle, R. The Psycho-Physical Apparatus.

4.   Bennet, E. A. Fugue States.

1.   Hadfield, J. A. Infantile Memories.—Infantile memories have played a not inconsiderable rôle in psychoanalytic practice and theory. How far can they be relied on? This the author would attempt to discuss. They have been arrived at by the methods of hypnosis or by free association. There are objections which are here stated as (1) It is impossible for anyone to remember so far back in his life as the first or second year. (A purely gratuitous judgment.) (2) It is inconceivable that a child could have such thoughts and experiences as are ascribed to him. It is suggested, therefore, that these visualizations are pure imagination or have been suggested by the analyst. (Again what is imagination?

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and what is suggestion? Two difficult enterprises.) This paper would set out to discuss the reliability or otherwise of such infantile memories, and to discuss principles by which we may trust the truth of these “memories.” In general the author is in sympathy with the possibilities of such actual memory recoveries (as every psychoanalyst is constantly finding). Instances of such memory recoveries are here given. The author would cite as of value for the thesis (1) subjective conviction, (2) emotional tone, (3) new symptom production, (4) cure of symptom, and (5) everything fits into the general picture.

None of these five positive arguments is by itself sufficient proof of reliability. It is only the cumulative evidence, sometimes of all of them in the same case, which commands belief. Nothing in science is proved beyond doubt—not even the law of gravitation—and proof of these early memories is no exception. But when we have removed the objections to the possibility of the recovery of such memories; when in any particular instance we can demonstrate that such experiences do actually take place in childhood; and finally confirm their reality by the effects and results of the arousal of the memory, we can only conclude that, whilst scepticism is still justified, complete incredulity can only be the mark of prejudice.

2.   Flügel, J. C, and Radclyffe, E. J. D. Pressey Test.—Of value from the questionnaire angle but only of related interest psychoanalytically—especially, however, to be noted are certain confirmations of character traits as brought into prominence in psychoanalytic study.

3.   Money-Kyrle, R. Physical Interpretation of Psychoanalytic Theory.—The author would here expose the craving that behaviorism and psychology should some day be correlated. He first would outline the physical, i.e., the somatic apparatus—i.e., the nervous system. He speaks only of external stimuli. Removal and avoidance are the checks. By using the word correlation the author would avoid psychophysical parallelism. He concludes as follows:

“In this paper I have tried to construct a plausible neural apparatus, the physiological processes of which could be correlated with the physiological processes discovered by the Freudian school. I am aware that the attempt has not been altogether satisfactory, but I am convinced that something on these lines is possible, and will one day be achieved. Such an event would be of great benefit both to physiology and to psychology: for, once the details of the parallelism have been worked out, any advance in one science will be immediately applicable to the other. But the temptation to twist psychoanalytical facts to fit physiological theories must be resisted. Our views on nervous mechanism are speculative; our knowledge of psychology is based on facts.”

4.   Bennet, E. A. Fugue States.—A clinical study of a married man of thirty-seven, a schoolmaster, surrounded by narrow theology, who

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made a fugue from the north to the south of England lasting three weeks. Minor thefts seemed to play some role in the flight. Three fugues took place. Hypnotism was used to uncover the mechanism.

The fugue state is really an attempt on the part of the repressed spontaneous attitude to assert itself as against the adopted ideal of the good little boy. In childhood “to bolt” out of the house, as he termed it, seemed the way of escape, and later it actually proved to be the road to freedom.

Unfortunately, from the psychopathological standpoint, the patient at this stage felt so much better that his treatment terminated. The analysis is not regarded as complete. There is one phase which, to the patient, described his pre-fugue frame of mind, viz. “If there is anything I want, then I will have it and damn the consequences,” and this points the way to what one would have found if analysis had been carried to earlier days. It is probable that the early spoiling by his mother accounted for the repression of his self-willed tendency, and it would also account for his attachment to his mother, which made him acquiesce in becoming the docile boy. It was this repressed self-willed phase which found expression in the fugue symptom.

It might be argued that because the analysis in this case did not reach the deepest strata of the personality that the symptom would readily recur. Experience in the treatment of similar fugue conditions, and of other hysterical manifestations, however, encourages one to believe that the insight into the symptom formation which has come through treatment has provided a framework, as it were, through which experience is viewed. The realities and demands of life impinge upon a sensitized personality; and the defense of dissociation is exchanged for the ideal of efficiency.

In the study of dissociation, whatever form it takes, we are facing once again the familiar and ancient philosophical problem of the “One and the Many.” Before we reach finality in our psychopathology of this and allied conditions, we must lose our dread of metaphysics and be prepared to view psychological phenomena from the standpoint of the philosopher.

(Vol. 8, No. 3)

1.   Gillespie, R. D. Psychological Medicine, Character and Temperament.

2.   Isaacs, Susan S. The Mental Hygiene of the Pre-School Child.

3.   Goitein, P. L. Organ Inferiority and the Castration Complex.

4.   Burrow, T. Group Analysis.

5.   Bryan, DOUGLAS. Notes on Cases of Fugue.

6.   Allen, F. H., and Pearson, G. H. J. Emotional Problems of Physically Handicapped Child.

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1.   Gillespie, R. D. Character and Temperament.—The author has succeeded one of the outstanding psychiatrists of Great Britain, Clouston, after a training with Meyer in Baltimore. This renders any contribution of his as of significance. This study would review the field of contemporary psychopathology in its survey of this enterprise. Biological, genetic-dynamic, biographical, personality types, integrations, and constitutional factors are all too lightly touched upon. It would appear the author would evade rather than grapple with the difficulties as seen in his summary which reads as follows:

(1)  “Idiosyncrasy” is suggested as etymologically a very desirable substitute for “personality” to connote the integration of traits of temperament and character in the individual.

(2)  Clinical experience in the direct observations of affective abnormalities affords no very useful hints for the detection and estimation of emotional states actually present. On the contrary, it seems rather to emphasize the complexity of the conditions involved. It follows that mere impressions gleaned at an interview may be very misleading. This emphasizes what is found with “normals.”

(3)  The usefulness of the conception of a “general intensity factor” in the emotional disposition is at present in doubt.

(4)  Instruments of precision, recording the physiological accompaniments of pronounced (abnormal) emotional states, are of little practical value in estimating the kind and degree of the emotional state present.

(5)  The only satisfactory method of estimating temperament and character is the biographical one (history-taking) checking by accounts from the patient's relatives and friends, and by observation if possible under social conditions of a restricted kind, e.g., in hospital.

(6)  Traits should not be taken at their face value, but should be as far as possible traced to the sources; and their relationship to other traits and to the total idiosyncrasy, i.e., their “setting” should be considered. This is what is meant by the “genetic-dynamic” analysis of traits.

(7)  A mental illness is broadly the result of maladjustment of the individual to his environment. It frequently consists in the exaggeration of certain traits of temperament and character which existed in the individual before he became recognizably “ill.” These traits are, therefore, maladaptive and increasingly so. Hence from the study of mental illness, the relative importance of certain traits for successful adaptation can be ascertained. The emphasis which comes to lie on certain traits and groups of traits is in some respects different from the values deduced from the theoretical considerations of normal psychology. There is some correspondence of certain groups of traits and types of mental illness. The prognosis of the latter depends as much on the preëxisting

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“idiosyncrasy “as on the type of illness that develops, from pathological exaggerations of traits being reversible, and others not.

(8)  The manner of integration of traits in the total idiosyncrasy is of special importance both in normal and pathological psychology.

(9)  The study of inheritance may lead to a clearer definition of unitary traits.

(10) A considerable change in idiosyncrasy may appear at one time or another in the course of the individual's life, the change being determined sometimes by endogenous (or even inherited) factors; and sometimes by a change in the environmental stimuli. Idiosyncratic, like physical, development may be accelerated or retarded by environmental influences, of which the family is the earliest and probably the most important.

2.   ISAACS, S. S. Mental Hygiene of Pre-School Child.—An extremely thought provoking discussion of the need for deeper psychological investigation of the individual child. Short but full of good sense.

3.   Goitein, P. L. Castration Complex and Organ Inferiority.—“In the course of an analysis of an incipient psychotic we came across an hereditary stigma that seems to have played some small part in the fabric of the disease, and which from its novelty and interest we consider worthy of record.” This is the author's introductory statement. He would speak in terms of an “organ inferiority.” The patient, twenty-one years of age, had made a dramatically superior series of academic achievements and then went to pieces. He became definitely dissociated, believed his appendix was on his left side, was bitter against the surgeon who “cut it off,” and then, in phantasy, grew it again on the opposite side. Thus the appendix meant the male organ. At nine, its removal, represented a castration. He had been masturbating unknown to anyone from the age of six, and on and off almost to the present time, a few weeks before his tripos, which again caused him to desist. Just as the original operation (de complaisance) signified to his Unconscious his father's punishment on him for his sins, when the urge came back again in the midst of the strain of examinations and he gave way (indeed the emergence of the psychosis may have precipitated the release of the inhibition), once again the talion punishment appeared, and he compromised by sacrificing the “phallus” of the right, and creating a new one on the left—the psychosis being such that “re-creation by imagination” was the dominant theme. A visit to the dentist a short while before and the use of “gas” probably served to remind him of a similar gas (chloroform) at the earlier operation, and the extraction of a tooth was similarly productive of the old resistance to castration. Indeed he struggled violently (unconsciously), so that the crown broke off in the attempt, the fangs still lying embedded in the jaw.

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A further motive for the focusing of the Unconscious upon the appendix was a wish to be like a younger and dearly-loved brother (i.e., dead); for the patient, on admission, imagined himself dead but ready, it appeared, to rise resurrected. Now it transpired that this brother, to whom he had homosexual attachment, died of an acute appendix; indeed he showed symptoms at the age of nine and a half years, about the same time as his brother, the patient. Both were examined by the surgeon together—this being the first time the patient had been medically examined, and stripped naked for the purpose, a procedure he invariably hates. The surgeon, despite the symptoms, refused to operate on the brother, but did so very soon on our patient. He was cured; the brother, however, not long after developed a second attack and died before an operation could be performed. The impression was intense; the loss and circumstance saddened the patient at the time, and there can be little doubt that the present castration-fears and death-desires are directly related to the original wish. The wish is to be like the brother in (psychic) death, with his penis (appendage) unremoved, or at least re-creating a new one in revenge on the father. From brother he now turned to his mother for erotic anchorage. The subsequent powerful maternal-fixation (certainly evident in the psychosis today) gives evidence further of this hatred of the one and this desire for the other, the two ever in conflict. Delusions are prominent, and once again the dominant delusion in the fabric of his disease is a fear that chloroform (or gas) is being sprayed into the room by unknown hands.

In any case, the one delusional idea was but a stone in the corner of the psychosis that the phantasy-builder had rejected, but which we would reclaim, for the one point upon which we think we may rightly lay stress (to the exclusion of other and extraneous psychological material) is, that an inherited organic inferiority has succeeded, in part, in producing the castration-complex of at least one analyzed case.

4.   Burrow, T. Group Analysis.—An exposition of the author's well known theme of the necessity for group analysis.

5.   Bryan, D. Fugue.—Clinical records of some cases of fugue, of psychoanalytic import in but a few slight data.

6.   Allen, F. H., and Pearson, G. H. J. Emotional Problems of Physically Handicapped Child.—An intensely interesting study from the humanistic point of view. It deals with physical disabilities such as:

Harelip and cleft palate; osteitis, right hip with immobilization; bilateral optic atrophy with blindness; ankylosis right elbow; poliomyelitis with deformity; Friedreich's ataxia; pseudohypertrophic muscular dystrophy; congenital heart disease; traumatic hemiplegia. Case histories of these are given.

The conclusions are:

(1)  Physical disabilities occurring in the

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early years of life affect the personality largely as they are utilized by the underlying relationships between the parents and the child. When they occur later in childhood the child reacts to them in the same manner as he has learned to meet other new and difficult situations.

(2)  It is as essential to treat the relationships between the child and his parents and the attitude of the latter towards the disability at the time of its occurrence, in order that the personality may not be crippled, as it is to treat the disease itself. Such a crippling of the personality is probably a more serious menace to the future happiness of the individual than a very marked physical disability.

(Vol. 8, No. 4)

1.   Garnett, A. Campbell. Instinct, Intelligence and Appetite.

2.   Van Loon, F. H. G. Protopathic-Instinctive Phenomena in Normal and Pathological Malay Life.

3.   Money-Kyrle, R. Morals and Super-Men.

4.   Harris, Henry. Mental Deficiency and Maladjustment.

1.   Garnett, A. C. Instinct, Intelligence, and Appetite.—The author begins by saying that instinctive behavior is always characterized by intelligence. This might be called a Bergsonian contradiction. The author, while not mentioning names, says this of it. He passes to the gestalt psychological conception to evade the paradox. No psychoanalytic meat in this discussion.

2.   Van Loon, F. H. G. Protopathic-Instinctive Life.—An anthropological phantasy.

3.   Money-Kyrle, R. Morals and Super-Men.—Morals are here defined, rather narrowly, as the totality of human inhibitions. He discusses types of inhibition. Normal means something for this writer. What is not stated; except that he is rare. A contradiction, but how can anyone who thinks in such static terms get anywhere.

4.   Harris, H. Mental Deficiency and Maladjustment.—Maladjustment as a concept, mental deficiency in the light of this, biological considerations, psychological considerations, social considerations. This is the program. A valuable and well constructed paper, but of no definite interest for the psychoanalytic student.

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Article Citation

Jelliffe, S.E. (1932). British Journal of Medical Psychology. Psychoanal. Rev., 19(3):345-354

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