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Paul Williams's essay was the 1995 winner of the Rosenfeld Clinical Essay prize of the British Psychoanalytical Society, inaugurated in the memory of Dr. Herbert Rosenfeld, whose seminal psychoanalytical work with psychotic, borderline, and severely narcissistic patients helped widen the scope of psychoanalytic praxis worldwide. Analyzed by Klein, Rosenfeld is also well known for his extensive writings on the creative use of countertransference in working with severely disturbed patients. The prize is awarded every three years to a member of the British Psychoanalytical Society for an essay on original clinical psychoanalytic work with borderline or psychotic patients. Mr. Williams is himself a psychoanalyst affiliated with the Middle, or Independent, group within the British Society, as are British discussants Harold Stewart and Mary Twyman. Arthur Hyatt Williams is a long-standing member of the Kleinian group in London. We thought it would be timely and illuminating to organize a clinical and theoretical discussion among American and British analysts that would focus on the unusual and fascinating clinical work that Williams describes in his essay.
The British Middle Group was formed following the “Controversial Discussions,” the name given to the formal debates between Kleinian and (Anna) Freudian analysts in London in 1943 and 1944 that were sponsored by the British Psychoanalytical Society. The often vitriolic discussions eventuated in a decision to split the training program at the British Society into two parallel courses of study, an “A” group for candidates wishing to become Kleinian analysts, and a “B” group for those partial to the teachings of Anna Freud. A third group, called the Middle, or Independent, group, consisted of analysts in training who preferred to pursue seminar work and supervision as their interests moved them, uncommitted to one of the two major courses of study. Middle Group analysts in particular have developed clinical theory