A Conversation with Peter B. Neubauer

SA: Looking back, what would you say led you to a career in psychoanalysis rather than in some other discipline?

PN: When I was 15 or 16 years old I discovered Freud. I started to read him and thought, “This man makes sense he opens up new vistas.” In the “Introduction” and in some of the case histories, he wrote of the therapeutic soothing effect of finding out where problems came from and how solutions were made. I was moved. His words reflected my life situation during my own adolescence. I was feeling conflicted about many things so what he wrote about touched me personally. In addition, I had always been curious about people, about what made them do what they did, so his work touched me in that way too. Later on, when I went on to medicine, I brought an orientation toward psychiatry to my studies.

SA: It is true that troubled adolescents search for solutions. But they seek all kinds. What was it that made this particular kind of solution so engaging for you?

PN: I tried some others also. First, I became involved in political activity, but that wasn't satisfying. Then I became a Zionist, perhaps as a way of finding a new geographic homeland to replace the one I had. But these approaches were inadequate for me. I wanted to know; I wanted to find out. Analysts share the need to understand others and themselves, not simply to act. It was that need that pushed me in the direction of analysis.

SA: You're speaking of curiosity.

PN: Yes, curiosity, but not about just anything, like mechanics or nature. Curiosity about the human condition. I was always curious about that. I remember being told when I was seven or eight by the mothers of my friends that they liked to talk to me about the problems they were having with their children. It's not that I was so wise, but they knew I was curious and that I would be responsive. I was always a talker.

SA: You mean, even when you were so young, you were already defined by yourself and others as someone who was curious about and willing to discuss what went on between parents and children. When the troubled adolescence came along, perhaps it was natural for you to search for solutions through talking and knowing.

PN: I think that many analysts share such interests, an interest in the human condition and an interest in human interaction. Analysis is something more than merely achieving a specific goal. The engagement between people that leads to the exploration, the inquiry itself, is also interesting.

SA: Contemporary psychiatry tends to promote an interest in brain structure and physiology. Does that encumber our pursuit of the human condition?

PN: Not at all. Determining how chemicals may benefit man is very useful. It is important, however, to distinguish between brain and mind. It's wonderful that there are people who are interested in studying brain structure and physiology. They have their interest, and we have ours. Their interests are different from an interest in the human condition. If chemicals could turn a disturbed brain into a mind available for analytic inquiry, that would please all of us very much. I doubt that such a contemporary trend can inhibit people from being curious about the human condition for very long.

SA: So you achieved recognition as a person interested in people even in your earliest days, and you found that Freud's works were fascinating in general and useful during your own troubled adolescence. Were there any people in those early days who also stimulated or promoted your curiosity about the human condition?

PN: No. In the town where I spent my childhood and adolescence, nobody ever mentioned a word about analysis. I went to the books on my own. When I began medical school I found myself seeking out lecturers in psychiatry. I immediately felt at home in the psychiatric milieu. I recall Redlich lecturing in Vienna; I was very impressed with him. I listened to Adler once. Unfortunately, I never heard Freud while I was there. My interest was not shared by anyone I knew until I went to Switzerland.

In Switzerland, Prof. Klaesi, a student of Bleulers, took a liking to me and offered me a job in psychiatry. Prof. Klaesi was well known for having introduced somnafen therapy, a form of therapy that was to become widely used in the Soviet Union. He would offer mentally ill patients medication that put them into an altered state while a nurse sat by in attendance 24 hours a day. It was his idea that such a state would induce a feeling of dependence. This would force the patient to reach out toward the continuously available nurse, and he would become bound to her. Klaesi hoped that such a bonding would help lift the patient out of his mental illness. It's interesting to think of his technique in the light of present-day knowledge about object relations theory and the studies by people like Winnicott.

In Switzerland, I also found an analyst, Prof. Bloom. He was the only analyst on the staff. He gave lectures and illustrated the use of analytic thinking. We were only a small group of students who shared this interest in analysis. Once Hartmann came to give a lecture, but there was no formal analytic education there, and, for many reasons, they would not have accepted me for instruction even if there were.

When I came to America I continued my psychiatric training at Bellevue. I met a whole group of analysts there, for example, Bak, Fabian, Frosch, and Keiser. Prof. Bloom in Switzerland had also suggested that I contact Herman Nunberg in New York to pursue personal analytic training. Nunberg had spent some time in Switzerland, and he and Bloom knew each other. I applied for training at the New York Institute. Sam Atkins interviewed me, and I told him I would be seeing Dr. Nunberg. He said fine, go ahead. Applying was as simple as that in those days. There was very little bureaucracy. The year was 1944 or 1945. At Bellevue, I was also exposed to child psychiatry, and my interest in children developed.

SA: That was to be my next question.

PN: Lauretta Bender was there with her husband, Paul Schilder. There were many analysts and analytically involved psychiatrists. They were a very congenial group, very stimulating. I encountered an explosion of information, such was the ferment of interest going on in that place. Schizophrenia in children was discovered (until then no one believed that it was possible for children to be schizophrenic). You could see the infantile neuroses directly.

You could see where everything began. My curiosity turned toward development, so it was natural for me to add child analytic training to my program.

SA: It's quite a contrast. You came to analysis on your own, but it was the stimulation by others that brought you to child analysis.

PN: You're right. And they showed me how much you could learn and how much you could do with what you learned. Adult analysts had the view at the time—less so today—that child analysis was just an application of analysis, rather than real analysis. All you did was play with children. For me, children provided ways to discover origins, demonstrate new diagnostic categories, measure the minds in different ways, and establish new ways of helping adult as well as child psychiatric patients. Being exposed to the rich fermentation in that place was an extraordinary opportunity.

Child psychiatry hardly existed until the 40s and, in Bellevue there was a whole new area of understanding, seeing, diagnosing, knowing about development. Child guidance clinics grew around the question of what could be done for children. American child psychiatry made a unique contribution with the development of the child guidance clinic. It was an American idea, you know; in Europe they only decided what was good or bad about the children, but America tried to do something about what was wrong. We wanted to provide services for children and, what's more, a variety of services for many different disorders. There existed a spirit in those days that has disappeared to a large degree now, an explosion of interest in creating new deliveries of services.

I became involved in trying to do something for children. Analysts like Marion Kenworthy and Viola Bernard were in the leadership of such activities. I was a charter member of the New York Council of Child Psychiatry, the Academy of Child Psychiatry, the Association for Child Analysis, the National Infant Psychiatry Center, and the International Colloquiums of the Anna Freud Center. Nunberg had asked me to help organize the Psychoanalytic Research and Development Fund, an association that led to important bonds with other analysts and a stimulating engagement in the study of psychoanalytic issues.

Anna Freud's work in London was inspirational, of course, and here in New York Marianne Kris became a major catalyst for my involvements. I was inspired by Anna Freud's personal style, the clarity of her thoughts, her focus on the developmental processes, and her readiness to explore unknown territories of the mind.

She was quite a remarkable person, and, happily, she was always available to discuss patients or papers with me. I would send her something I was writing, and she would invite me to fly to London for the weekend to talk it over. The more I knew her, the more I was convinced that she saw herself as involved in two tasks. On one hand, she wanted to be a guardian of her father's work, to protect it and maintain it. On the other hand, nothing excited her more than the opportunity to explore and propose new ideas. Recently, a biographer of Anna Freud suggested that she had merely altruistically surrendered to her father. That does not fit with my experience. She was always excited about psychoanalysis as a discipline of new possibilities, not merely one that was preoccupied with confirmations of what had already been discovered.

SA: These two orientations seem related to what you described as Anna Freud's two tasks.

PN: Perhaps. And it may have something to do with the wariness many adult analysts had of some portion of her work. They felt that somehow by applying her curiosity to the developing mind she was stepping outside of the central interest in analysis. Here's an irony: her biographer criticized her for surrendering to her father; the establishment criticized her for being excessively innovative.

I personally believe that different moods go along with each orientation. An aura of pessimism permeates that exclusive look backward. We trace symptoms to trauma, so we see the sorry state of affairs in childhood. When looking forward one can have a certain optimism; outcomes are far more variable, so there is room for hope.

Marianne Kris was a part of the optimistic circle. She was supportive of patients, supervisees, everyone—to a fault. She was often criticized for being insufficiently critical. She was allied to the view that encouraged the forward movement, the multiple possibilities inherent in growth. She paid attention to what might have appeared to be even minor expressions

of progress or expansion, and she would move in to faciliate it. She was very much a “lady”, in the old-fashioned meaning of that word—compassionate, supportive, available.

In a sense her clinical stance could be differentiated from that of Berta Bornstein. Berta Bornstein quickly moved toward interpretations. As soon as she had some grasp of the pathologic core, she would go after it. It was important for her to understand the origin of the neuroses. Marianne Kris, on the other hand, was less interested in where the disorder came from; she was more involved with where it might go. What I described as the differences between the genetic and the developmental orientations seem very well exemplified in these two extraordinary child clinicians.

We are immersed in an explosion of new ideas these days—new models of thinking about the mind, new information, new approaches. Naturally, we should be cautious about what we accept of all this experimentation, but the widespread concern about so many different schools is probably exaggerated. I know we are worried that there are not enough patients out there for the clinical work, at least for the clinical work as defined by the traditionalists. Naturally, there must always be room to implement what we already know, but there must also be room to search for additional models to apply our technique and increase our knowledge. I think we strive these days to do more than just undo the repressed. For example, we also work to overcome deviations and arrests.

SA: But why are there fewer?

PN: Two answers are usually given. One is the reluctance of parents to bring children every day, especially with our economy in some decline. The other is the increasing competition from other forms of treatment. I suppose if child analysts could accept more modest compensation for their work there might be many more children to analyze. Another problem may arise from the conventional “rules” of child analysis, that is, that the children must be seen four or five times a week. There is no doubt that many children must be seen so often for analysis to be effective. But, perhaps it is time to rethink our views about frequency so as to tailor our treatment to the requirements of individual patients rather than adhere to a rule system derived from data collected at an earlier time.

Analysis was originally five times week; it was a great step to reduce it to four times. Can't we base our analytic work on the needs of the patient? One patient may require five times a week; others may be able to establish the necessary process less frequently. There are differences between patients; we have to investigate the nature of those differences to determine how far we can go and what aims we can establish with different people while still holding on to the essential core of analysis.

SA: Again you refer to the essential core. What are some of those components in that core as you see them?

PN: Well, first there is the unconscious, the unconscious in topographic terms, and the dynamic unconscious reflected, for example, in fantasies. The first essential component is the recognition of the power of the unconscious on the mind.

A second is to esteem the defenses and hence the resistances in the course of the analysis.

SA: Esteem?

PN: Yes, to esteem a patient's resistance. Resistance is not simply opposition to what an analyst wants to do. It is a necessary expression of who the patient is. It is important that we never forget that.

SA: If you insist on the unconscious on one hand and the defenses on the other, I suppose conflict must be part of what is essential for you as well.

PN: Yes, that goes almost without saying, like infantile sexuality and the drives. Some would include the transference neurosis as the essential feature in the therapeutic process, but I am not so certain I would include it. I believe that the transference varies from patient to patient. Some begin in transference, others develop it in the middle, and some toward the end; a few patients work successfully without transference being a dominant feature.