Anaclitic Therapy in North American Psychoanalytic and Psychiatric Practice in the 1950s-1960s

The term anaclisis (deriving from the Greek, ‘to lean on’) was first introduced into psychoanalytic theory as a translation of Freud's usage of the term Anlehnung. The term designates the early relationship of the sexual instincts, which at first are dependent on organic sources, to the self-preservative instincts. Hence an anaclitic type of object choice is that which is based on the object of the self-preservative instincts, usually an object serving a parental figure. This is opposed to the narcissistic object choice in which the individual chooses an object that symbolizes an aspect of themselves. In 1945, in Psychoanalytic Study of the Child, René Spitz published the first of a series of studies on infant behaviour in a nursery, entitled ‘Hospitalism’, describing the syndrome caused by the continuous institutional care of infants (Spitz, 1945). In his subsequent article published in 1946, with Katharine Wolf, Spitz defines a new psychiatric syndrome — anaclitic depression. The authors claim that this syndrome is related to the loss of the love object, together ‘with a total inhibition of attempts at restitution through the help of the body ego acting on anaclitic lines’ (Spitz & Wolf, 1946, p. 340). Following this publication, the concept of anaclitic depression became widely accepted and served as the basis of additional studies examining the effects of separation in infancy and maternal deprivation (Bowlby, 1951). In the two decades following Spitz's publications, which popularized the usage of the term ‘anaclitic’, the concept of anaclitic therapy became accepted in the United States and in Canada. This form of therapy, which has hitherto not been the focus of historical interest, provides a fascinating glimpse of the history of North American psychiatry and medicine, and raises interesting questions as to the usage of regressive techniques in psychoanalysis and in biological psychiatry.