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This paper was given at a study day to commemorate the work of Mrs. Bick, to whose memory it is dedicated.
In this paper, rather than concentrating on the details of the analysis of Little Hans and of the early cases of Mrs. Klein which are well known to us, I want to refer to some qualities Freud and Klein shared which are relevant to my theme. Both had the courage to take a step into the unknown: both had the ability to make a creative adaptation when faced with a clinical problem (like the flash of inspiration that sent Melanie Klein to her own nursery for toys when faced with a child who simply could not express herself in words). For both of them this courage and creativity could be exercised only because they believed in truth of psychoanalysis: and although their ventures were rooted in conviction deriving from clinical work, they did not proceed without questioning and soul-searching. The courage to pioneer new fields, though not without thoughtful trepidation, persisted in the hands of Mrs. Bick and continues to be shown in the projects of those she trained; we see it in the work with autistic and psychotic children, with the severely deprived and latterly with the physically handicapped.
These advances have also been accompanied by doubts and dilemmas. Therapists are haunted by the question: can we push back and overcome practical difficulties without losing the essential qualities of analytic work? This applies to an area less dramatic than the extensions just mentioned — that of frequency. In this matter too, Mrs. Bick has played a part.
The view that four-or-five-times weekly treatment is the only desirable mode of child analysis poses a longstanding problem for therapists who work in public sector clinics, where patients cannot afford fees and where the numbers of those in need so far exceed the therapy hours available that intensive treatment is impractical. In this paper I follow convention by calling four-five-times weekly work “intensive treatment”. I