mkt
 

  Book Review
 Clinical Klein
 R D Hinshelwood
 

     


Published by Free Associations Books London (1994)


 
 Reviewed by Anthony Cantle

I suspect that for many people, and here I include myself, their first contact with Melanie Klein’s ideas, other than from her original papers, came through Hanna Segal’s book Introduction to the work of Melanie Klein. Thirty six years on it is still regarded as a classic text, serving as an invaluable primer to Mrs Klein’s own papers and one which is deservedly described as essential on the reading lists of countless courses within and beyond psychoanalysis. Other, more recent, titles have extended and deepened our understanding of Klein and have in turn become recommended reading. For example, and selectively so, the two later books from Hanna Segal on Klein (1979) and a Kleinian approach to clinical practice (1981) together with the three collections published by the New Library of Psychoanalysis, Melanie Klein Today Volumes One & Two (1988) and Clinical Lectures on Klein and Bion (1992), the first edited by Elizabeth Spillius and the second by Robin Anderson. The last two decades has seen the rapid development of a growing canon of papers and books that have advanced Kleinian thinking in exciting and clinically innovative ways and Bob Hinshelwood’s prolific scholarship reflects this.
In 1989 Hinshelwood’s Dictionary of Kleinian Thought was published which, as Hanna Segal observed in her review of the book…….”did for the development of Klein’s thought what Laplance & Pontalis did for Freud”. She went on to describe Hinshelwood’s Dictionary as “a work of great devotion”.
 Hanna Segal is surely right when she speaks of devotion as it seems no time at all since Hinshelwood gave us two editions of his Dictionary, itself an essay in accomplished erudition, and now we have his latest book Clinical Klein which he describes as complementary to the Dictionary. Beyond admiring the polymathic qualities of Hinshelwood’s writing one surely has to be inspired by someone who, in addition to being a practising psychoanalyst, founded and edited the International Journal of Therapeutic Communities and the British Journal of Psychotherapy, who fulfils all the usual teaching and supervision commitments, and who can then still find the time and the sheer stamina to be so additionally creative!

Before saying more about the content of this very interesting book, I want to make a more general point about Hinshelwood’s gift for technical clarity and elaboration in the service of communicating with his readers. For those familiar with the Dictionary you will find in Clinical Klein the same accessible, controversial and lively style of writing. Hinshelwood has proved admirably successful in the central task of reaching and making contact with his readers. A small yet typical example of Hinshelwood’s wish to look after the reader in a thoughtful and respectful manner can be found in the Introduction to the book which Hinshelwood calls “A guide to the baffled reader”.

Hinshelwood has an economical style that gets to the point and earths ideas and observations in a pithy manner. Consider, for example, his reference to the vexed question of whether the infant has a psychological nature at all at birth. Hinshelwood writes….”Margaret Mahler (1975), for instance, put the psychological birth of the human infant at around nine months of life, and this is accepted as the orthodox view among many psychoanalysts in the United States. However, this often seems unrealistic to mothers, and to anyone acquainted with babies”.

The central foundation of this book is built upon and extends the indicative method by which psychoanalysts of all persuasions have through generations sought to convey, with variable success, the experience of understanding their patients. For Hinshelwood it is Kleinian writers in particular whom he says….”have tried to demonstrate their concepts in the detailed record of the processes in their clinical work. Their writing is an indicative method”.

It is to these previously published records that he returns for the guts of his book and deliberately so. As Hinshelwood says….”they are available for you to go and consult for yourself in any particular instance to check my version and my views”. The clinical examples cited resonate well with the various themes and concepts under discussion and Hinshelwood weaves together theory and practice in a comprehensive and sensitive manner so that every now and then one finds oneself seeing and appreciating something familiar but from a fresh angle or with a shift in emphasis that spurs one to think some more.

The clinical examples he explores are distinctive for two further reasons. First, about a third are actually from cases described by Mrs Klein herself. As Hinshelwood says….”one so often hears that Klein’s writings are baffling, we might be led to the conclusion that we should not use them for the expositional purpose of this book. However, I think that to overlook her writings robs us of extremely sensitive and detailed clinical observations”. Hinshelwood’s commitment to first principles in his choice of Klein’s own clinical illustrations corresponds appropriately with calling part one of his book “The Foundation”, through which he traces the origins of Klein’s subsequent contributions to their first principles, namely the legacy of genius that was Freud. Secondly, the remaining clinical examples chosen by Hinshelwood allow us a glimpse of history as Klein’s own ideas and concepts are both used and developed with impressive clinical acuity by those representing the generations that have followed her. They make for a formidable collection of clinicians and include Paula Heimann (for a while), Joan Riviere, Wilfred Bion, Roger Money-Kyrle, Herbert Rosenfeld, Hanna Segal, Donald Meltzer, Betty Joseph, Edna O’Shaughnessy, Henri Rey, Eric Brenman, Murray Jackson, Leslie Sohn, Ruth Riesenberg Malcolm, Irma Brenman Pick, Ronald Britton, Michael Feldman and John Steiner.

The clinical examples are very helpfully listed at the front of the book under their respective chapter numbers. Incidentally, listed in this way they somehow acquire a wholly unintended, yet curiously fascinating appearance; one which would not be out of place on the front of a book by Oliver Sacks or P.D.James. For example, “attacked by worms,” “The man who assaulted his buttocks”, “the twisted carrots”, the man who was nine feet tall” and “the man who planted sweet peas”.

Parts two and three of the book involve thirteen chapters arranged under two section headings; ‘Melanie Klein’s Contributions and Emotional Contact', and ‘the ‘K’ Link’. The subjects covered in these chapters include Klein’s work with children, internal objects, the depressive and paranoid-schizoid positions, the mind as apparatus for evacuation, projective identification, the death instinct and envy, omnipotence or reality, counter-transference, knowing and being known, Oedipal knowing, being moved, impasse and the organisation of the personality, change and development and the evolution of Kleinian technique.

The book ends with a short but particularly useful chapter entitled “Reflections; Progress and History” where, inter alia, Hinshelwood formulates seven points that represent an understanding that he describes as “distinctively Kleinian” in its approach to the patient and his mind. Whether or not you agree with his formulation this book is distinctively original, full of interesting ideas and will I am sure become widely read and recommended.



References:

Anderson, R. (Ed) (1992) Clinical Lectures on Klein and Bion.
The New Library of Psychoanalysis.
London: Tavistock/Routledge

Hinshelwood, R.D. (1989) A Dictionary of Kleinian Thought.
London: Free Association Books. (Revised
Edition. 1991).

Segal, H. (1964) Introduction to the work of Melanie Klein.
London: Heinemann. (Revised edition Hogarth, (1973).

Segal, H. (1979) Klein. The Harvester Press. (Revised edition
London: H. Karnac (Books) Ltd. (1989).

Segal, H. (1981) The Work of Hanna Segal: A Kleinian Approach
To Clinical Practice. London: Jason Aronson..

Segal, H. (1993) Review of A Dictionary of Kleinian Thought by
R.D. Hinshelwood. Int.J.Psychoanal. Vol 74. Part 2.

Spillius, E. (Ed) (1988) Melanie Klein Today: Developments in theory and
Practice. Volume 1: Mainly Theory. The New Library of Psychoanalysis. London: Tavistock/Routledge.

Spillius, E. (Ed) (1988) Melanie Klein Today: Developments in theory and
practice: Volume 2: Mainly Practice. The New Library of Psychoanalysis. London: Tavistock/Routledge.

 

Anthony Cantle



 



 


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