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A wonderful panel at the 2013 Prague Congress of the IPA discussed the Kleinian concept of reparation. Led by a North American analyst, the panel engaged its international audience through its amazing clarity and close tracking of the connection between clinical data and theory. After the meeting, conversations continued, enthusiastically exploring aspects of the presentations.
A brief twenty years ago, at a similar panel, a North American analyst presented a patient for discussion by a modern Kleinian from London. In her initial discussion the Kleinian referred frequently to psychotic elements in the analysand's personality. The ensuing conversation centered around whether the analysand was psychotic from the viewpoint of descriptive psychiatry and analyzability. In an ever more frustrating debate that gave new meaning to the phrase “confusion of tongues,” and with hardly less affect than the child-adult sexual interaction to which Ferenczi (1949) was referring might generate, the presenter and members of the audience tried to defend the analysand's claim to sanity, while the discussant and others in the audience insisted on the richer understanding of the clinical material afforded by the Kleinian viewpoint. Informal talk after the meeting continued the debate—who was crazier, the patient or the Kleinian?
Another thirty years or so earlier, leading American analysts had dismissed Kleinian thought, contrasting their “ego psychology” with Kleinian “id mythology” (Rapaport and Gill 1958). Indeed, in reading Klein it is often difficult to tell whether she is referring to the analysand's conscious or unconscious picture of his own mental functioning or to the analyst's ideas about that mental life.