Splitting and Attachment: The Scottish Connection in Psychotherapy
Chapter 4 of Attachment, Intimacy, Autonomy by Jeremy Holmes
The scene: the canteen at the Tavistock Clinic; the time: the late 1980s; the characters: John Bowlby and Jock Sutherland, close friends for half a century, now in their late seventies and early eighties, respectively; silver-haired, vigorous, one on the small side, the other very tall; distinguished, successful, balanced, clever men; sitting face to face, deep in conversation. John, the more serious, meets Jock's eye with its eternal twinkle, wags his finger, and says, Jock, you know that is a post-Freudian statement!" [Haldane 1993]
One of the aims of this book is to explore what a post-Freudian statement might mean, and to look at the contribution of attachment theory to a post-Freudian state of affairs. I shall approach the subject via the theme of splitting, which can be either creative or pathological. I suggested in Chapter 1 that the patterns of anxious attachment, although restricting in some ways, were also adaptive in that they help the individual to survive in a suboptimal environment. Similarly, in the search for new paradigms, innovative thought often requires a degree of splitting and isolation as necessary precursors of creativity and discovery. By contrast, during the phase of Kuhn's (1962) "normal science," isolation becomes stultifying and retards progress. The contrasting and complementary personalities of John Bowlby and his colleague Jock Sutherland epitomize these two aspects of innovation and consolidation.
I start with a well-known literary account of splitting; mention briefly Freud's break with the conventional neurology of his day; and then, through looking at work of Klein, Bowlby, Fairbairn, and Sutherland, discuss how splitting has emerged as a central issue in contemporary psychoanalytic thought.
The beginnings of psychoanalysis can be dated to a professional split that occurred in 1886 (Ellenberger 1970). Freud, just 30, newly married, returned from Paris full of Charcot's ideas, and presented a paper on male hysteria to the Viennese Society of Physicians. Freud's reception was less than enthusiastic. Austrian medical chauvinism was offended by his espousal of French ideas that, the medical elders claimed, contained nothing they did not know already. Freud, eager for fame and in need of money to settle down, was discouraged by this rejection; turning away from the medical establishment, he began, with the help of first Fliess and then Breuer, to invent the theory and practice of psychoanalysis.
Meanwhile, also in 1886, another young man, a writer—this one Scottish rather than Jewish—also newly married and short of money, was living in Bournemouth in England (Holmes 1985). Like Freud, he was in the habit of attending closely to his dreams, which he used to furnish him with plots for stories, a mysterious process he attributed to his "Brownies" (Harman 1992a). One night he dreamed of a respectable doctor sitting unhappily at the window of his house, approached by two friends who ask him to come for a walk. At first he readily agrees, but suddenly he slams down the window "with an expression of such abject terror and despair as froze the very blood of the two gentlemen below" (Harman 1992b, p. ix). The dreamer cried out so much in his sleep that, much to his annoyance, his wife woke him up so that the rest of the story was lost. But the fragment, with two others that he could recall, was enough. He started writing furiously, and within three days the first draft of Dr. Jekyll and Mr. Hyde—the author was of course Robert Louis Stevenson—was completed.
Dr. Jekyll and Mr. Hyde (Harman 1992b) is the classic literary account of splitting, or, as Stevenson put it, of "man's double being"—multiple personality, somnambulism, and hypnotism being topics much in vogue in the 1880s, in literary as well as medical circles.
Looking at the story from a psychodynamic perspective, several themes immediately stand out. The episode at the window epitomizes the schizoid dilemma: Jekyll, lonely and troubled, longs for closeness, to tell someone what is happening to him; yet, when the possibility of doing so arises, he is smitten with terror and slams down the shutters of communication. The whole work, like a psychotherapeutic treatment, can be seen as a movement from secrecy and silence to open communication. The vehicle of this transformation is the quiet and receptive solicitor Utterson, whose name, like most in the story is highly significant (Hyde—hide is self-explanatory; Jekyll has jackal and kill hidden within its apparent innocuous respectability). It is Utterson's consistent concern that enables Jekyll eventually to utter his terrible tale of utmost ("utter") horror. Stevenson, too, was an "utter son"—a puer eternus, always a son, never a father—whose fateful break with his father's Calvinism was one of the turning points in his life, but whose genius for utterance, in words and on paper, were his salvation. Utterson's silent psychotherapeutic unobtrusiveness has the effect on his friends of "sobering their minds in the man's rich silence" (Stevenson 1886, p. 34), eventually enabling Jekyll to deliver his narrative in the form of a letter.
Hyde's crimes are usually thought of as murder, addiction, and lasciviousness, but the story opens with a horrific act in which, curiously, no one is seriously hurt. Running down a street, Hyde collides at the corner with a little girl coming in the opposite direction, and tramples on her. Her piteous screams and Hyde's indifference to them are what first alert Utterson to the man's evil nature.
Trampling on a child's feelings, an adult's indifference—this is the territory in which splitting arises. Jekyll, one might speculate, was somehow trampled on as a child and has split himself into two parts: a respectable, compliant, law-abiding part, and a hidden, vengeful part that compulsively now does to others what was done to himself. These unintegrated parts are symbolized in the story by the many different rooms that Jekyll inhabits, interconnecting in ways that emerge as the story unfolds, with the locked door or the ghastly operating theater turned laboratory finally smashed open by Utterson at the denouement. The avoidant individual similarly inhabits a divided house in which dependency needs, and his rage at their not being met are kept separate.
A striking feature of the story is the almost complete absence of female characters, and the same is true of Treasure Island and Kidnapped. The characters all appear to be bachelors, inhabiting a fog-bound Dickensian London world, a Gothicized version of the Edinburgh middle classes among whom Stevenson grew up: no wives, mothers, or other children (Stevenson, like Fairbairn, was an only child). The dynamic of Jekyll and Hyde is that of father and son. When Stevenson announced his atheism to his parents, his father responded by saying, "You have rendered my whole life a failure" (Holmes 1985). Hyde is consistently described as smaller than Jekyll, a child-man, who, at the end when he is unable to find the ingredients for the potion that will turn him once more into his creator, dresses up in Jekyll's clothes, which were
enormously too large for him in every measurement—the trousers hanging on his legs and rolled up to keep them from the ground, the waist of the coat below his haunches, and the collar sprawling wide upon his shoulders. [Stevenson 1886, p. 321
Here, unmistakably, is a little boy dressing up in father's clothes. The struggle between Jekyll and Hyde as each tries to claim supremacy at the end is the struggle between son and father: "Jekyll had more than a father's interest; Hyde had more than a son's indifference" (Stevenson 1886, p. 36). When Jekyll first takes the potion he feels a surge of liberation.
Younger, lighter, happier in body . . . a heady recklessness, a current of disordered sensual images running like a mill-race in my fancy, a solution of the bonds of obligation, a leap of nature . .. this too was myself. . . . Strip off the lendings and spring headlong into a sea of liberty. [Stevenson 1886, p. 53]
This is in contrast to his bonded, dutiful, fettered self,
I saw my life as a whole; I followed it up from the days of childhood, when I had walked with my father's hand, and through the self-denying toils of my professional life. [Stevenson 1886, p. 54]
Here we see Stevenson struggling with the irreconcilable split in his nature between ambition and pleasure, security and danger, between the wish for closeness but the fear of being trampled, the longing for freedom but the risk of being disinherited. Stevenson, a lifelong TB sufferer, ever conscious of the proximity of death, and the guilty possibility of punishment for his wish to escape from the coils of Calvinism, writes of "a creature eaten up and emptied by fever, solely occupied with one thought: the horror of my other self."
Reconciliation requires a female principle. For Stevenson his love of Fanny Osbourne, ten years his senior, a woman, as described in his Chapter on Dreams (Harman 1992a), married to another man, yet who loved him, but for whom he had to endure torture. A classical psychoanalytic interpretation of Dr. Jekyll and Mr. Hyde might focus on the oedipal struggle between father and son, the fear of castration, the masturbatory guilt (Jekyll seeing his hand, already betrayed to Utterson's clerk Guest by it, and realizing that for the first time he has not been able to expunge Hyde entirely)—"If I am the chief of sinners, I am the chief of sufferers also" (Stevenson 1886, p. 56). A contemporary perspective would emphasize how the schizoid split emerges from the lack of a container for Jekyll's rage and desire, which is therefore split off and projected into his alter ego.
The innovator, the creative schizoid, creates his own new forms. For Stevenson his dreaming, his creativity, the work itself, become the container that held together the discordant elements in his nature. Jekyll illustrates the dangers of the Frankensteinian project—the attempt to break the laws of nature by giving birth to oneself is doomed to failure. Only in death can the two split halves be united: "co-heir with him to death" (Stevenson 1886, p. 61). A world without women—and for Stevenson, the lighthouse builder's son, science was quintessentially a masculine enterprise—was doomed to perversity and horror:
That insurgent horror was knit to him closer than a wife, closer than an eye; lay caged in his flesh, where he heard it mutter and felt it struggle to be born. . . . In the agonised womb of consciousness these polar twins should be continuously struggling. (Stevenson 1886, p. 63)
We see in Utterson, in Jim in Treasure Island, and in David in Kidnapped Stevenson's central ego, frail but determined, likable, loyal, ever-youthful and—with his Scottish father and English mother—stuggling to hold the divergent elements of his nature together. Like Jekyll:
No more myself when I laid aside restraint and plunged in shame, than when I laboured, in the light of day, at the furtherance of knowledge or the relief of sorrow and suffering. (Stevenson 1886, p. 12)
In Stevenson's adventure stories the reader's sympathies are aroused more by the outlaws and blackguards—Silver and Breck and the highland clansmen—than with the forces of convention—Trelawny and the doctor, the Lowlanders, and the King's men. Innocents abroad, Jim and David are attracted first toward rebellion, and then reigned in by the need to survive and so conform. A similar polarity is played out between Jekyll and Hyde, which is no simplistic struggle between good and evil. Jekyll is portrayed, albeit sympathetically, as rather stuffy and a hypocrite: "I concealed my pleasures . . . committed to a profound duplicity of life" (Stevenson 1886, p. 66). Utterson, though good, is weak—an observer rather than an actor. Jekyll is attracted—and the reader is fascinated—by his alter ego, as an addict might be by his drug. As Hyde, he is free from conflict and doubt and can pursue his ruthless selfishness and hedonism, untroubled by conscience or guilt.
Stevenson was not alone in his concern with man's dual nature; the theme of the doppelganger was part of the zeitgeist (Ellenberger 1970, Miller 1985). While the splitting in Dr. Jekyll and Mr. Hyde is entirely psychological, the adventure books represent splitting at a social level. In Kidnapped the division is between the Highlanders and the Lowlanders, between Jacobites and Loyalists, the gulf between them symbolized by the Firth of Forth. It is only with the help of a pretty peasant girl—the only "love interest" to appear in either book—that David and Breck manage to reach safety. The pirates in Treasure Island tear each other apart in their struggle to the death for the buried gold—the mother's love, the breast, which these men deprived of women want above all—outwitted in the end by Ben Gunn, the holy fool, another projection of Stevenson's, who as a sickly child had access to his mother's "treasure" without having to win it by fighting.
Implicit in Stevenson then is the idea that man's dual nature is related in some way to the suppression of the female principle—his men are all in one way or another avoidant. They are out of touch with the feminine in themselves, just as avoidant children keep their distance from the nurturing object. Freud's project was to reconcile his clinical experience of splitting as manifest in the hysterics he had encountered at the Salpetriere clinics and in his consulting rooms at Berggasstrasse, with the Helmholtzian ideal of a scientific psychology. His early theorizing moved away from people and their interactions to the idea of psychic energy and its repression or expression. As Grotstein (1992) puts it:
Due to the constraints of his cartesian logical positivism, [Freud] travelled down the biological road and not exclusively the psychological one. In brief, Freud took the vertical splits of the hysteric's double consciousness and, in effect, rotated them to the horizontal plane, thereby imposing the System Consciousness atop the System Unconsciousness. [Grotstein 1990, p. vi]
The Freudian model was thus predicated on dominance and submission. The two sides of Freud's nature—Freud the innovator and Freud the consolidator—can be seen in the shift in his thinking from his early topographical model of the mind with its emphasis on the liberation of repressed psychic energy, to his later tripartite model with its emphasis on the control of instinctual forces. For Freud the subversive, energy resided in the unconscious, kept at bay by the powers of repression. The aim of therapy was the gradual releasing of repression, or at least finding a compromise between the pleasure-seeking unconscious and the castrating reality principle. With the tripartite model of the mind, Freud moved away from a purely energetic conception of the mind to one that contained at least one prototypical person-like internal object—the superego, a residue of parental prohibitions and restrictions as imagined by the self. Now the therapeutic task is not so much lifting of repression as reducing the unrealistic demands of this superego and reclamation of the vast areas of submerged self expropriated by the unconscious: "Where id is there ego shall be" (Freud 1933, p. 80).
The therapeutic movement in Freud's metapsychology is mainly in the vertical plane, uncovering deeper and deeper layers of the psyche. But already in 1921, the year Freud was writing The Ego and the Id, Yeats had seen in the horizontal plane how in the face of increasing splitting the "center cannot hold." The beginnings of a significant shift in the metaphors and ambiance of psychoanalysis was under way: from the subjugation of unruly impulses to the holding together of a fragmenting and incoherent system. Let us look at how three psychoanalytic inheritors—Bowlby, Fairbairn, and Sutherland—carried forward the story of splitting into the contemporary era.
John Bowlby's father came from exactly the class described by Stevenson. He was a successful London surgeon, a bachelor until he was 40, hard working, God-fearing, practical, and down to earth. Like Stevenson, Bowlby was rebellious and independent, but with an ambitious and conformist streak. During the war years Bowlby joined the War Officer Selection Boards, that "invisible college" of psychoanalysts and psychodynamic psychiatrists, headed by Jock Sutherland, that laid the foundations for psychodynamic psychiatry and psychotherapy after the war. Here the atmosphere was of openness and collaboration, in contrast to the esotericism of the psychoanalytic society at that time. Sutherland insisted that the selection boards be chaired by soldiers rather than psychiatrists; with his intuitive feel for group processes he saw that this would avoid the tendency to split off and marginalize psychological advice, and would, paradoxically, give the psychiatrists greater rather than less influence (Sutherland and Fitzpatrick 1944).
Sutherland and Bowlby emerged from the war as director and deputy director, respectively, of the Tavistock Clinic. They were a formidable pair: outstanding men in their different ways, close friends, at that time sharing a house together with their families in Hampstead. These were heady times of reparation and new vision. Sutherland soon set about building up the "Tavi" as an internationally known center for training in psychodynamic psychotherapy.
While repression, as originally conceptualized by Freud, is essentially intrapsychic, the concept of splitting is necessarily interpersonal since split-off emotions are projected on or into the subject's significant others. The theme of splitting emerges strongly from experimental studies of insecure attachment described in the previous chapters. We can begin to see links between intrapsychic splitting and its interpersonal context—between the Klein-Bion model, which focuses on the inner world, and the Bowlby-Ainsworth one, whose target is the interpersonal environment. Thus, to maintain some contact with his attachment figure the avoidant child has split off his wish for intimacy and anger about separation—the beginnings, in extreme cases perhaps, of a Jekyll and Hyde divide that may erupt in later life when the trampled turns the tables and becomes the trampler. A related splitting occurs in ambivalently attached infants. On separation these children cling unhappily to their parent for fear of losing them again, splitting off competence and autonomy that the child may feel need to be suppressed for fear of further rejection.
Main (1995) suggests that in peer groups, avoidant and ambivalent children can form a system of mutual projection: avoidants tending to be bullies, while ambivalents are their victims. A similar pattern can be found in sadomasochistic marriages. Each person projects into the other the disowned part of oneself, which he or she both envy and cannot relinquish. This aspect of interpersonal theory of splitting is illustrated by the following two examples.
Andrew: A Present-Day Hyde
Andrew, a bricklayer, now 40, spent eleven years in prison after he followed an unknown woman back to her house from a bus stop and brutally attacked her with a knife, leaving her for dead. She dragged herself to a neighbor and eventually recovered. Andrew gave himself up to the police the next day. Subsequently he had little recollection of the event—"I just can't believe it was me that did that"—but did admit that he had been drinking heavily. His childhood was deeply unhappy. There were eight children, four boys and four girls. His parents fought incessantly, and the children were recruited as allies, with the boys on their father's side, the girls on their mother's; neither side was permitted to speak to the other for days on end. When Andrew was 16 his mother developed lung cancer, and over the next two years he watched her die a horrible death. Soon after her death he wandered away from home and lost all contact with his family. He married and had a child, but was unhappy. As the rows with his wife escalated he started to drink and it was then that the offense occurred. After a few years in prison he was transferred to Grendon Underwood, an unique experimental prison unit run on psychotherapeutic lines. There he learned that it was possible to talk about emotions. He discovered that he existed as a person, he said, and that other people also had feelings: "I went into Grendon Underwood an animal and came out a man." While he was there he fell in love with his prison visitor and after his release they married and had a daughter. He remained on indefinite parole. The marriage broke up, but they remained on good terms and he was devoted to his daughter. He asked for further help when he began to detect in himself the beginnings of the feelings of depression and violence, which he said had preceded the attack.
Andrew's attack contained the naked rage of a split-off infantile part of his personality when separated from his loved object—a typical avoidant/unresolved pattern. The separation started with the parental fights in childhood, and was tragically reinforced by his mother's death. As his first marriage began to fail the same feeling of schizoid isolation reemerged. The attack was also an enactment of the experience of violent rejection in childhood that often underlies avoidant attachment—like Hyde, the trampled turning trampler.
Vivienne: The Lady and The Tramp
Vivienne was in her mid-fifties, a highly respectable solicitor's wife who had grown up in a large working-class family whose lives revolved around a fundamentalist religious sect. She was close to her mother, but had terrible fights with her father in her teens when she had wanted to wear makeup and go to discos. When at 16 he caught her kissing a boy good-night on the doorstep she was beaten mercilessly. The next day she left home, not to return until his death some ten years later. Meanwhile she found a job in a solicitor's office and gradually a new personality emerged in which, Galatea-like, she acquired the airs and graces of a lady. She married a junior partner in the firm and, despite his many inexplicable absences on business, was devoted to him. They got on well as companions, but their sexual relationship never worked: he seemed to hold back and she was unable to let him know how strongly she desired him. Gradually she began to feel discontented and depressed. Feelings were never discussed between them; they continued to have dinner parties, play golf, and were stalwarts of the rotary club. Then she became convinced that her husband was having an affair with one of the secretaries at work. She challenged him about this but, as always, he remained silent. Word got back to her confirming her suspicions. She became wild with jealousy and fury, and tried to leave the marriage but could not bring herself to do so. Then, one evening, without really realizing what she was doing she put on a scruffy duffle coat of her son's, pulled a woolen cap over her head, put on some muddy boots, and left the house. She found herself drawn to her rival's home. There, outside her door was a shining white car. She picked up a rock and scratched the car all the way around, ending by smashing the windshield. She was not found out and, emboldened, she continued to enact her alter ego from time to time, especially when upset, often going to supermarkets and shoplifting, sometimes going into rough pubs and picking up men.
Finally, with the marriage in tatters, her husband insisted that they talk and seek help. The whole story came out, with much guilt and many tears, but also a note of triumph and glee in Vivienne's demeanor. Her husband had also split himself—ever kind and considerate on the surface, but full of misery and rage inside.
In her ambivalent attachment Vivienne had clung to her avoidant husband, while the rebellious side of her, which had erupted briefly in her adolescence when she left home, was split off into the tramp.
In both cases it was only when a suitable container had been found that these patients could begin to tell their story—for Andrew it was a benign institution, Grendon Underwood; for Vivienne it was the setting of psychotherapy. The process of therapy, the healing of splits, requires the finding of a center that can hold—in Bowlbian terms finding a secure base in which split-off affects can be first felt, and then put into words.
If Bowlby challenged the Kleinian view through observation and experiment, it was Ronald Fairbairn who questioned and extended Kleinian theory.
Bowlby and Fairbairn were both struggling with the constricting atmosphere of religion and middle-class mores in which they had been brought up. They found in psychoanalysis a system of thought powerful enough to rival these values, which at the same time provided both an account of their rebellion and a therapy to help resolve it. Both men had powerful, rigid, and successful fathers; their mothers showed features of "affectionless control" (Parker 1983), which can be precursor of avoidant (or, in Fairbairn's terms, schizoid) attachment (Sutherland 1991).
Bowlby was essentially a man of action and was always more at home with observable behavior than with hypothesized feelings. Fairbairn, by contrast, was a man of contemplation, who, because of his difficulty in micturition in public—a symptom he shared with his father and which neither managed to overcome—found it difficult to travel far away from home. But Fairbairn was a fearless inner traveler, and, in his relative isolation from the psychoanalytic mainstream, had no hesitation in discarding Freud's ideas where he thought them wrong, producing the most radical statement of object relations theory available (Greenberg and Mitchell 1983).
Fairbairn discarded drive theory altogether. Anticipating the findings of developmental psychology (Stern 1985), he saw the mother and infant interacting with one another as people from the moment of birth. Pleasure was a "signpost to the object," rather than the other way about, as Freud originally conceived it. (It is perhaps significant that both Bowlby and Fairbairn were not particularly sensual men, and both tended to downplay the importance of pleasure and sexuality in their theorizing). Fairbairn saw splitting as a fundamental defense, not as Klein imagined due to innate destructiveness, but as a response to environmental failure. The child represses not just his own impulses (which was Freud's view) but also internalized bad objects such as the mother who frustrates and rejects.
Andrew's attack could be seen not just as a desperate attempt to find a container for his unprocessed feelings of rage, but also as an eruption into consciousness of the painful feelings about the rejecting and later dying mother, projected into the unknown woman. Similarly, women who have been sexually abused as children will often choose as partners abusive men, and may evoke a psychologically abusive transference with their caregivers. It is as though there is a compulsion to find an object with whom the drama of attachment—however painful—may be reenacted.
For Fairbairn, what is repressed is not just an impulse, but a whole dynamic structure comprising the affect, the ego that feels and responds to it, the relationship to the object to which it is directed, and the resulting behaviors. Split-off dynamic structures cannot be modified by the impact of external reality, especially the soothing and modulating influence of the mother; they become sequestered, and when released they emerge in a primitive and often destructive form. This viewpoint links Fairbairn with contemporary integrative models of psychotherapy like those of Ryle (1995) and Weston (1992), which combine psychoanalytic and cognitive perspectives. They postulate a reciprocal relationship between affects and cognitions, the latter having a soothing and shaping effect on the former. For Fairbairn the split is within the ego itself, not between conscious and unconscious, or between ego and id. This splitting of the ego may be more or less organized, ranging from a vague sense of separate selves or parts of the self, through subpersonalities, to the Jekyll-and-Hyde–like phenomenon of multiple personality.
Fairbairn's position led him to a radically different view of dreams from that of Freud, much more akin to Jung's, and one that I believe most analytic psychotherapists use in practice, whatever their theoretical allegiance. As Fairbairn (1952) puts it,
Dreams, and for that matter waking phantasies [are] essentially dramatizations of endospychic situations involving both (a) relationships between ego-structures and internalized objects and (b) interrelationships between ego-structures themselves. [p. 170, my italics]
Stevenson's window dream dramatizes his longing for closeness and companionship, and his dread of it—his wish to be close to his internalized mother, but his fear that to get close would unleash all the rage and fury he felt in response to her rejection. The pulled-down window represents the typical schizoid or avoidant defense. Fairbairn had been thoroughly thrashed by his mother as punishment for an episode of sexual curiosity with his cousin, and on another occasion for asking questions about a blood-stained sanitary towel. Had he dreamed Stevenson's dream—as he well might—it would have encapsulated the schizoid conflict based on the feeling that his love is inherently destructive.
Fairbairn was also ahead of his time in seeing beyond the Oedipus complex to a more basic internal conflict between the exciting and rejecting mother, projected in the older child onto the actual mother and father, respectively, without needing to postulate, as Klein did, a precocious neonatal knowledge of adult relationships and genitalia.
Fairbairn disliked the term analysis, and thought synthesis would have been a better term for the integration of split selves that he saw as the essential therapeutic aim. For Fairbairn the neurotic is trapped within a closed system, and the task of the therapy is to transform this into an open interpersonal system. He emphasized the real contribution of the therapist—her empathic understanding, reliability, beneficence, and acceptance, leading to a reduction in hatred and therefore a diminished need for splitting. Patient and therapist are seen as an attachment system, and the need for sensitive attunement is inherent in his view of the successful therapeutic process.
Behind his closed window, Jekyll is a caricature of the evil genius of modern science. Fairbairn and Bowlby are good examples of "positive splitting." By remaining geographically and intellectually at a distance from psychoanalytic hurly-burly, Fairbairn was able to develop his own conceptual framework open-mindedly, with no pressure to adopt any particular line or dogma. Similarly, Bowlby continued to use psychoanalytic ideas creatively through out his working life, integrating them with those of systems theory and developmental psychology without being too concerned about whose vested interests he would be threatening. The British Psychoanalytic Society of the 1950s and 1960s was, by contrast, a closed system that split off its dissidents, viewing them as "internal saboteurs" (to use Fairbairn's phrase) that were at best ignored, or at worst expelled.
Bowlby was an experimentalist using psychoanalytic ideas to understand human development; Fairbairn was a theoretician determined to improve and extend the psychoanalytically based model of the mind. Jock Sutherland saw the potential of psychoanalysis to help understand group dynamics and influence social policy.
Sutherland seems to have been a natural group leader. Tall, good looking, cultured, immensely hardworking, liked by almost everyone, very amusing with a capacity to use humor to defuse difficult situations, his energy is testified by a career that spanned sixty years. No sooner did he complete one phase than he was on to the next: graduate psychology student, medical student, psychoanalytic candidate, chairman of the War Office Selection Boards, director of the Tavistock Clinic, founder of the Scottish Institute for Human Relations, visiting professor at the Menninger Clinic, and, in his eighties, producing his first full-length book, the biography of Fairbairn. Sutherland brought a remarkable consistency and coherence to whatever problem he was considering, whether it was the selection of officers for the army, the relationship of a patient to his analyst, the role of a psychotherapeutic clinic in the National Health Service, or the position of the central self vis-a-vis its subselves.
Fairbairn and Klein were interested in the way in which outer reality was influenced by the inner world, Bowlby with the impact of that outer world on the developing personality. Sutherland, who possessed "outsight" (Holmes 1992) as well as insight was concerned with the interplay and interdependence of outer and inner, especially within organizations.
Sutherland starts from a basic faith in the supportive and healing power of social groups: "Man as a person is sustained by his social relatedness" (Sutherland 1966, p. 343). Like Bowlby, he thought systemically as well as psychoanalytically, and had been influenced by Kurt Lewin's ideas on the social field (King 1989). He visualized a system as having central "organizing principles" (Sutherland 1980), as needing a well-organized hierarchy if these are to be realized, and he saw above all the need for open communication between different parts of the system. He thought in terms of selves rather than egos and emphasized the "powerful urge of the self to possess its autonomy" (Sutherland 1991, p. 166). His psychoanalytic perspective led him to see early environmental failure resulting in internal bad objects, but his systemic view enabled him to see that these failures can be counteracted by a healthily functioning family and social group system—another point that has subsequently been confirmed experimentally (Rutter 1985):
Outer objects tend to be perceived in terms of inner ones. Normally, however, the outer objects do not behave as badly as the inner ones. When the former are introjected again they are therefore less presecutory: social learning occurs. [Sutherland 1971, p. 111]
But when affect is too disturbing, either because of its intensity or because of the failure of the social group to contain it, "inner objects are split off and are unmodified by external reality" (Sutherland 1971, p. 72). This leads to impoverishment of the central ego, and to the Hyde-like possibility of enactment of these unmodulated roles and affects.
In psychotherapy this hidden aspect of the self is evoked by the relationship with the analyst, who has to create sufficient intensity for the split-off affect to be reexperienced but not to be overwhelming. If the therapist can then respond in an accepting, but not indulgent way, bad affects and roles no longer need to be split off but can be integrated into the personality. The therapist acts like an effective parent, neither intruding upon nor neglecting the patience feelings, and by his modulatory response enabling affect to be contained within the envelope of the patient's autonomous self. Once again we will return to the case of Katherine to illustrate this point.
Katherine (Continued): The Gendered Self
Katherine was all too aware of the futility to which Fairbairn was so sensitive. After splitting up with her husband in Australia she had returned to look after her octogenarian mother, with whom she found it impossible to communicate in any meaningful way, but to whom she still felt deeply tied. To recapitulate: She had had an unusual and very unhappy childhood. Her parents had owned a small school in the 1930s, in theory idyllic, but the reality, at least for Katherine, was very different. In the course of therapy she began to recover some positive memories of her mother's stroking her, but then she had been removed from her parent's part of the house at the age of 3 and placed in the dormitory with other pupils: "I was cast into outer darkness." Typically for ambivalent children, no protest was permissible. Her mother, who had been crippled with polio, became remote and unavailable; she refused to kiss or cuddle her own children, as she said this would make the other children jealous. Her father beat and sexually abused her, as he did several of the other pupils. The transference soon reproduced her family situation. The therapist was seen either as a cruel and heartless father who intruded on her and caused her unbearable pain with his interpretations, or as a benign version of the all-powerful father who could, if only he would, set everything to rights with his perfect understanding, love, and admiration. At other times he was the crippled mother who was indifferent to her daughter's cries for help. On one occasion when she was again insisting that the therapist should help her more, she said that there was a "big part" of her missing. He commented that perhaps what she was out of touch with was her womanliness; she had been unable to identify with her mother's femininity because of her rejection, and also because her mother had not felt confident with this aspect of herself. Perhaps what terrified her was the thought that she might have some aspect of her abusive father alive inside her. Could "big part" represent the genital that had abused her? She was amused by this, immediately having an image of herself wearing a codpiece; at the next session she said she had felt much more herself for a few days after this episode.
Katherine exemplifies the clinical reality of splitting of the ego—the lost self, the crippled mother self, the persecuting and persecuted self in relation to her father—and the way in which these were evoked in therapy. It illustrates the therapist's attempt to help the patient get in touch with a central integrative self, which is almost invariably a gendered self. With the interpretation of her womanliness she moved from seeing herself as a woman to the thought "I am a woman." Here, momentarily, was a true meeting of therapist and patient—it was the coming together of tone, timing, content, and receptiveness that made this interpretation helpful. Similar things had been said before with little impact.
Jekyll's monstrous creation of Hyde from within himself is an aberration, a schizoid defense against unattuned desires. When, too late, he finally finds his voice in his last letter to Utterson, his two halves come together in death. At this therapeutic nodal point Katherine could see her split selves as springing from a secure unitary biological core; she could see the possibility of integrating the many false selves which she had created and to which, temporarily at least, she was no longer in thrall.
Sutherland had a subtle appreciation of psychotherapy's role in society. Just as the task of the central self is to integrate subselves into a network of intercommunicating parts of the personality, so the job of the psychotherapy clinic is that of a secure base that can provide training, teaching, and monitoring in relation to other agencies such as psychiatry and social work:
The psychotherapeutic clinic has a unique role as a control mechanism picking up critical data on damage done within the current social processes. Use cannot be made of the role, however, unless the clinic is integrated with a wider group of institutions in the community. . . . The location of the clinic within its social space therefore assumes a new importance. . . . It has to become one component within a constellation of units—an institute or school of human relations . . . which together share the task of advising on the means to a better society. [Sutherland 1966, p. 345]
In Sutherland's organizational model there are three essential principles, each of which is democratic rather than hegemonic; psychoanalysis is emphatically not seen in some imperial role extending its powers of domination thoughout its kingdom. First, the deliverers of care—family doctors, psychiatrists, social workers —are seen as central, just as in War Office Selection Boards the army remained in control, with the psychoanalysts in an advisory role. This model is vitally different from the view not uncommonly held in psychoanalytic circles of "psychoanalysis unlimited." As Sutherland (1971) put it,
The attitude sometimes conveyed by psychoanalysts that this kind of work [i.e., social work] is a poor substitute for what more thorough-going analysis might achieve is more a professional fantasy than an established fact. [p. 75]
Second, his model is pluralistic; psychoanalysis works alongside marital therapy (Sutherland set up and continued to be closely involved with the Tavistock Institute for Marital Studies throughout his career), family therapy, group therapy, and social therapies as part of a therapeutic team in which each member has its own unique contribution. Third, his model is open; there has to be open and continuous communication between the center and the periphery.
With his open-minded attitude, working predominantly within the National Health Service—whose dynamics as an organization was another area where Sutherland made an important contribution—rather than the private sector, and through his appreciation of sociological and systemic approaches as well as psychoanalytic, Sutherland succeeded in throwing open the window of the stuffy intrigue-filled rooms of psychoanalysis. His aim of creating a relationship of mutual respect between psychoanalysis and psychotherapy, psychiatry, social work, and the other helping professions is a continuing source of inspiration and struggle. Without explicitly espousing it, his attitudes embodied the principles of secure attachment: responsiveness and the calm exploration of protest and difference.
Running through this chapter there have been two interrelated themes that I will now summarize.
We can imagine that the post-Freudian remark for which Bowlby was accusing—or perhaps complimenting—Sutherland represented his wish to integrate the psychoanalytic perspective with the emerging attachment paradigm. I suggested in Part I that regulation of affect in the parent–child relationship is a crucial determinant of secure or insecure attachment. Mothers who can modulate their infant's primitive emotions of excitement, rage, disappointment, satiation, boredom, and resistiveness enable the infant to integrate emotion into the developing self—Sutherland's "organizing principle."
The classical "triangle of defense" (Malan 1979), in which the aim of therapy is the uncovering of a hidden impulse, whose surface manifestation is anxiety, needs to be replaced with a "triangle of affect." Underlying neurotic disorders is not so much a repressed sexual or aggressive impulse as a split-off feeling and its relational context. In infancy and childhood modulation leads to integration, while failure of maternal responsiveness results in defensive avoidance of feelings in order to maintain some sort of contact with the object. These feelings are thus not subject to the modifying influence of reality. This can result in later life in Hyde-like explosions of primitive affect; disowning of exploratory competence; or projection of parts of the self, resulting in a hostile worldview and feelings of inner impoverishment or futility.
This leads to a model of psychotherapy in which regulation of affect becomes the central theme. "Where id is, there ego shall be" is interpreted as bringing the impersonal "it" (i.e., unmodulated, unprocessed affect) within the orbit of the autonomous active experiencing self (cf. Eagle 1984) via relational experience. The main function of transference is to evoke and reexperience split-off affect, which is then available to the modulatory influence of the therapeutic process. The timing and tone of interpretations is as important as their content since their therapeutic effect depends on their capacity to promote the modulation and maturation of primitive affective states. The modulatory influence comprises the impact of the setting, the soothing and accepting response of the therapist, and the efforts of the patient to comprehend painful feelings.
The aim of therapy is, through the discovery of meanings, the integration of experience into a shared narrative between patient and therapist. The therapy oscillates between the formation of an attachment bond and the developing story of that attachment. Painful losses are neither denied nor overwhelming. The importance of a shared narrative is underpinned by the observation that autobiographical competence is a mark of secure attachment. Narrative capacity requires a containing boundary and a sense of continuity across time—a movement from the past, however painful, through the present toward the future. Splitting arises where no common boundary between attached and attachment figure can be found, or where the rupture between the generations is so great that no continuity in time can be established.
Splitting and Pluralism
Contemporary societies face increasing fragmentation and splitting along lines of class, race, wealth, religion, and geography. A "confusion of tongues" (Ferenczi 1932) is similarly to be found within psychotherapy as different forms of therapy proliferate and compete. Psychological splitting is a commonplace of current psychotherapeutic practice. The attempt to resolve splitting by a vertical model, in which a dominant authority brings recalcitrant fragments under its sway, is no longer to be relied upon. Whether it is the dominance of one nation by another, of the psychotherapy movement by psychoanalysis, or of the self by a harsh superego, integration will not be achieved that way. A pluralistic politics and a pluralistic psychology are urgently needed, embodying the systemic principles of firm boundaries combined with open communication based on mutual recognition and respect. The Bowlbian categories of avoidance and ambivalence capture the two catastrophic ends of these dilemmas. Avoidance leads to isolation, lack of communication, mutual suspicion, and unprovoked aggression; ambivalence, based on intrusive contempt for boundaries leads to helplessness and fear of assertiveness, which is experienced as biting of the helping/feeding hand.
Bowlby's drive toward the post-Freudian thought exemplifies benign splitting in which new ideas are forged in situations of relative isolation. Sutherland was the great reconciler, seeing the need for a collaborative relationship between different approaches, each retaining its identity but allowing for cross-fertilization.
Sutherland and Bowlby combined their pluralistic nonsectarian message with strong tribal loyalties. Bowlby was equally at home in the sophistication of Hampstead as in the wilds of Skye; he would have been lost without either. Each Hogmanay (New Year's Eve) the Sutherlands would give a huge party with vast supplies of food and whiskey and lots of reel-dancing. Sutherland had a great respect for tradition but was never hidebound by it.
Sutherland saw that psychoanalysis had most to offer the psychotherapy community when it develops an interactive relationship with other institutions. The attempt to dominate the helping professions is based on an omnipotent fantasy and leads to unrealistic wish-fulfilling dreams; the avoidance of the rest of the psychological community leads to sequestration and a closed society. Like a good parent, psychotherapeutic institutions need to offer attunement, modulation, regulation, communication, instruction, and example, not domination or avoidance.
Both Bowlby and Sutherland were "utter sons," returning at the end of their lives, near their journey's end, to tell the stories of the explorers who had influenced them as young men (Haldane and Trist 1992): for Bowlby, Darwin; for Sutherland, Fairbairn. Each brought to their subject some reverence, but also an empathic understanding of their specific sufferings, limitations, and weaknesses. The pluralistic spirit that Bowlby and Sutherland represent requires a respect for the tradition and often painful experience of each unique strand in a common society. If Jekyll had been able to face and accept his Hyde-self there would have been no need for them to split apart. Bowlby and Sutherland were seeking a wider or even universal message, but never lost a sense of rootedness-- in the body, in a locality, in history. Like good psychoanalysts, by celebrating the patterns and particularity of the past, their work points us to the future. They saw how, in Rilke's (1964) words,
As a traveler
On the last hill, for the last time seeing
All their home valley, turns, and stands, and lingers,
So we live, forever taking leave.