Psychotherapy

Klein, Mahler, Kohut, and Bowlby were all psychoanalysts trained hi orthodox Freudian practices. However, each modified psychoanalytic treatment to fit her or his own theoretical orientation. Because these theorists varied among themselves on therapeutic procedures, we will lhnit our discussion of therapy to the approach used by Melanie Klein.

Klein s pioneering use of psychoanalysis with children was not well accepted by other analysts during the 1920s and 1930s. Anna Freud was especially resistive to the notion of childhood psychoanalysis, contending that young children who were still attached to their parents could not develop a transference to the therapist because they have no unconscious fantasies or hnages. Therefore, she claimed, young

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children could not profit from psychoanalytic therapy. In contrast, Klein believed that both disturbed and healthy children should be psychoanalyzed; disturbed children would receive the benefit of therapeutic treatment, whereas healthy children would profit from a prophylactic analysis. Consistent with this belief, she insisted that her own children be analyzed. She also insisted that negative transference was an essential step toward successful treatment, a view not shared by Anna Freud and many other psychoanalysts.

To foster negative transference and aggressive fantasies, Klein provided each child with a variety of small toys, pencil and paper, paint, crayons, and so forth. She substituted play therapy for Freudian dream analysis and free association, believing that young children express then conscious and unconscious wishes through play therapy. In addition to expressmg negative transference feelings means of play, Klein's young patients often attacked her verbally, which gave her an opportunity to mterpret the unconscious motives behind these attacks (Klein, 1943).

The aim of Kleinian therapy is to reduce depressive anxieties and persecutory fears and to mitigate the harshness of internalized objects. To accomplish this ahn, Klein encouraged her patients to reexperience early emotions and fantasies but this time with the therapist pointing out the differences between reality and fantasy, between conscious and unconscious. She also allowed patients to express both positive and negative transference, a situation that is essential for patients' understanding of how unconscious fantasies connect with present everyday situations. Once this connection is made, patients feel less persecuted by internalized objects, experience reduced depressive anxiety, and are able to project previously frightening internal objects onto the outer world.

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