A Conversation with Eleanor Galenson

LL: How did you first become interested in psychoanalysis?

EG: My first real interest was stirred by a talk that Phyllis Greenacre gave at the Payne-Whitney Clinic on the children of successful fathers. I was very impressed with what she had understood, which was far more than I had ever heard, and I talked to her immediately after that meeting. I was in the process of thinking that I should probably get into psychoanalysis and possibly on into psychoanalytic training. At that time, I was at Payne-Whitney as a Commonwealth fellow. I had originally planned to go back into pediatrics after two years, but I knew as soon as I began psychiatry that I was in the right place.

I obtained analytic training in two phases. First was my personal analysis—a very preliminary, one-year stint with Eugene Pumpian-Mindlin. It was an odd way to begin because, although he eventually became a full-fledged analyst, at that time he had little or no analytic training himself. That contact with Pumpian-Mindlin was important. He was very bright, and although the treatment was unorthodox it had the makings of an analysis.

A training analysis followed. I wanted to go into analysis with Greenacre, but she had no time. Eventually I was steered to Bela Heksch. What I remember best from that analysis was how important it had been for me that my father had had what was supposed to be a coronary when I was seven or eight. It was diagnosed by an eminent cardiac specialist, and my father was told that he would be dead within the year. However, he continued to work and to have precordial pain. He had what would now be called cardiac neurosis. After two years, he was told that his heart was okay. He had episodes of what I now know was acute anxiety.

LL: Do you think that the presence of a real strain trauma in your life was one of the reasons why you became interested in the observation of actual children rather than only the backward projection of childhood experience?

EG: That experience was undoubtedly central. I still remember all the details—how it felt, hanging out the window waiting for him to come home. But there was another experience that I remember being told about rather than remembering directly: I was a failure-to-thrive child from age two months to two years. That was a bona fide illness. I remember being told of a famous statement made by an uncle of mine. He told my mother that there were a lot of graves over in the cemetery, and if I died there would be another. I think this anorexia had a lifelong effect, since it was such a real and intense experience.

My own very early experiences probably contributed to the strong response I had to Greenacre. She was the first woman for whom I felt unequivocal intellectual admiration. It's hard to separate what she said from the way in which she said it. She was an extremely effective speaker. There was an emotionality that she conveyed, a vividness. She had an enormous and special type of empathy that enabled her to present her material that way. Recently, when I was attending an analytic case presentation, I could not really understand the material until I stopped listening to the words and started listening to the “music.” That was the quality that Greenacre gave out. It was what made her charismatic as a lecturer. But from the very begining, I knew that what she said was right. I had never put my own early experiences into any usable form. With Greenacre, I felt for the first time that here was someone who was putting into words the essence of what I felt.

LL: How did you begin your own creative work?

EG: I began to work creatively rather late. I was pregnant during both the first and third years of my analytic training. Almost all my emotional interest and attention was focused on my children. I was very preoccupied, and I don't think I understood very much about analysis until later years, although my mentors did not pick up any weakness in my grasp of theory.

I owe my first serious attempt at analytic writing to my good friend Jacob Arlow. I had been invited to discuss a paper on a panel. Aferward, Jack came up to me and said, “I always thought you were beautiful, but I never thought you could think so well.” I had a lot of respect for Jack. I decided to write and wrote my first paper on play. I was using play, as all of us were, in treating children. Seeing nine children a day was a very intensive experience, and I had become comfortable with the medium of play and with talking about it. Play was not a strange land for me. My real problem was in trying to conceptualize the meaning of play.

LL: How did you become involved in the study of female development?

EG: Just at the time when I began to plan the nursery that I would run at Einstein, Herman Roiphe showed me a paper that was later published about a little girl in her second year when he had been studying in Mahler's nursery. The child had displayed a very early castration reaction. I was inerested. I had already written the paper on play and was interested in language development. I had done some work with Victor Rosen on delayed language development in psychotic children. These interests had led me to concentrate on the second year of life. Then Herman told me about the little girl. In this child with an early castration reaction, he had also observed an associated change in language development, although that was not what we later discovered during our joint research about the deletion of sex-linked words under the impact of the early castration reactions. Our mutual interest in the second year led to a collaboration. From the very beginning, in the research nursery funded by the Department of Psychiatry at Albert Einstein, we had two hypotheses, one having to do with sexual development and the other having to do with the development of language, thought, and play.

LL: Were you surprised by your findings about sexuality?

EG: I was surprised by the consistency, by the broad spread of the effect in both boys and girls, of their awareness of sexuality, its effect on every area including language development. It took 15 years to collect and go over our data. The data were collected by the residents, using 25 different categories of behavior. It was my job to examine the flow sheets and try to determine the commonalities.

As I went through the data on the 65 children, I found surprising similarities. We began to realize that we were dealing with across-the-board findings such as the band-aids the

girls requested, their stealing pencils, their playing horsey, their masturbatory activity. I was very interested in structural similarities between seemingly different behaviors, such as a ball dropped into a hole as being similar structurally to defecation.

Then we began studying children before their discovery of genital difference and found that we were able to date the onset of urinary and anal awareness by observing derivative behaviors. For example, urinary-derivative behavior consisted of a child's playing with faucets and pouring instead of drinking at the table. These structural similarities provide a way of thinking about play. Every area of these children's lives seemed to be influenced by the early genital psychosexual phase they were going through. It helped to know Mahler's view about how children try to find in the outside world what they are experiencing within their own bodies.

LL: To form your hypotheses about infantile sexuality, then, you had to form a series of hypotheses about play and its relation to drive development that had not been formulated before.

EG: These hypotheses about play had been formulated in part. Mahler had come up with the idea of the child's externalization of inner experience. Then, from another direction, that of the linguists, came the idea of structural similarities. I simply put that idea together with Mahler's idea to find a way of categorizing play. This combination was enormously helpful. In this way, we were able to study psychosexual development through behavior, language, and play.

LL: How have your findings concerning early female development affected your work with adult women?

EG: While I was working with children, I was also seeing adult patients. A number of women were graduate students in whom I saw the equivalent of the little girl's experience during her phase of preoedipal acute castration anxiety. In my adult female patients' examination anxiety, intellect now stood for the phallus. The castration anxiety was clearly connected with anxiety about separation and anxiety about bodily intactness as well. This linkage was consistent with my own personal experience.

Another thing I became aware of in our research was the great importance of the father's validation of the girl's femininity. I saw that often a girl's receiving a doll or a doll carriage when she was at the height of her preoedipal anxiety was crucial in her turning very strongly and erotically toward the father. He was the one who acknowledged her femininity. She sought him out, and he responded, and them came her increasing interest in dolls. My father was extremely loving and gave me dolls, dolls, dolls, and from early on I liked to make doll's clothes. My pleasure in that experience contributed both to my later interest in observing children and to the satisfaction that I found in being a mother. Having children was something that I never doubted I wanted to do from my earliest years.

My father was very affectionate toward me, and that affection protected me from much of the competition with my brother and my mother, which would have defeated me. I was never considered a beauty by my mother, but somehow or other I got the idea—from my father, I think—that I could get up before an assembly at school and recite poetry with pride. I remember the great satisfaction I had in having an audience. The audience may be your father. It should be your mother, but if not, it is your father. Also, part of my confidence came from the fact that, for whatever reason, I've always had a good sense of my own body. I danced from very early on, ice skated, and was very athletic. Maybe I became an athlete in order to be accepted by my brother. My body has always served as a source of pleasure. My intellect was more of a problem; I didn't have much confidence in my intellectual abilities. I knew, though, that I was good at many things. For example, though my brother was quite hypochondriacal, I was counterphobic and daring. My brother's hypochondriasis probably also led to my choice of a medical career.

LL: That accounted for your deciding to become a doctor?

EG: My choice of vocation came from two other sources: my father's tacit support of my taking care of the dolls he had given me; and my cousin, John Garlock, was an outstanding physician, much admired by my mother. He was the first Jewish resident at New York Hospital and later became head of surgery at Mt. Sinai. The summer after my father was proclaimed all right, my brother broke his leg while playing football and was operated on by John. My brother was in a cast for the next six months. That period was a nightmare and changed the character of my family. They were preoccupied with medicine and thought of John as a genius. I think my going to medical school was probably in part because being a doctor was so special to my family.

LL: You said earlier that one of your main interests when you began your research nursery was in language development. Where has that taken you?

EG: I have studied interferences with language development over and over again. I can remember talking to my good friend Justin Call long ago about our peculiar early finding that girls drop male-female labels while in the throes of early castration reactions. We are still puzzled by that finding. In our study of deaf children, we found that they are delayed in urinary- and anal-phase development as well as in language development. I think—not everyone agrees with me—that their delay in language development is a function, not only of their impaired hearing, but also of the distortion of the mother-child relationship, a distortion that takes place very early in these children.

LL: These are deaf children of hearing mothers, or of deaf mothers, or of either?

EG: Of either. The delay is worse when the mothers are deaf. Their behavior with the children is very deviant. In their own development, they had the same problems their children are having. The mothers hold their children always facing the world, never facing themselves, even when giving them the bottle. Their rationalization is that since the children cannot hear, they should be able to see the world. The rationalization covers up the fact that these mothers either do not have the need or do not have the capacity for intimate contact with their children. Their relationship is never a comfortable, truly symbiotic one. The child remains distant. When you work with deaf children, you have to substitute for the maternal object.

Another of our findings was that neither deaf mothers nor their deaf children play with toys. My early work with play helped me to understand those deaf children who could not progress even to the stage of using a toy as a concrete symbol for semisymbolic play because the relationship with the mother was of such poor quality and self and object were not well distinguished. We engaged the children in regressive activity. We fed them bottles, held them, rocked them—provided them with tactile, kinesthetic, primitive kinds of experiences they had never had.

LL: Recently you have been working with very young gender-disordered boys. What have you been finding?

EG: It has become evident that there are several different kinds of gender disturbances, which range from very benign to very malignant. There is no doubt that a child with a serious gender disturbance that is manifest by the end of the second year has a history of disturbance that began much earlier, during the first year of life. There is a quality of concreteness in the thinking of these children and in their general behavior. They don't play in the ordinary way. They enact plays, for example, probably because their anxiety about disidentifying with the mother results in an unstable maternal attachment. The boys cannot disidentify with mother and retain their phallicity at the same time. Instead they surrender their phallic quality and remain caught in an overly intense symbiotic relationship with the mother.

The relationship has an unusual quality to it. The boy seems to get the mother's thinking and fantasies by osmosis. How he becomes tuned into the mother's wishes is very hard to explain. He imitates the mother's actions and facial expressions to an incredible extent yet does not seem to truly internalize her emotionally. He is the mimic of later life. The difficulty in his individuation, in the development of his own self-representations is a very serious one, because he has a problem not only with genital representation but with the total self and object representation. The genital problem is only the final aspect of the total problem.

These boys adopt all the feminine accoutrements—the mother's pearls or beads or bags, anything that smells of her. The attachment is based on very primitive qualities—taste, kinesthetic sense—all the perceptual modalities. The boys develop an armamentarium of fetishistic objects that serves to protect them against intense separation anxiety. Why do they have such great separation anxiety? Probably the major reason is that they are sitting on a dangerous load of very primitive hostile aggression that threatens the maternal object relationship. Their fantasies, the figures they draw based on their fantasies, are all of monsters or sharks that could devour mother. Lots of blood and gore. The boys have to defend themselves against this oral aggression as best they can. Their defense takes the form of an infantile fetishistic attachment to the mother. The way to deal with these children in therapy is to help them and their parents to recognize and tolerate their anger at the mother, which has to emerge in very small quantities or they go into panic states. The children's anxiety and rage is very great, and the mothers need to be helped to tolerate it.

LL: You work with the mothers as well.

EG: Always. Either the mother or the father is in the therapy room at every session, and the parents are seen separately in addition. There is no doubt that the mothers of these children are dealing with their own very deeply repressed aggression. It comes out mostly in the form of “I am afraid of what will happen to my child” or “I am afriad of my father's rages.” The mothers often have a history of important depressions. For example, one mother told me, “I went back to work early after he was born because it was important to my career.” It turns out that the mother had fantasies of strangling the child and went back to work to escape from her infanticidal wishes. These were barely conscious at the time and were recollected at a much later period after treatment of the boy had been underway for two and a half years.

LL: What might be remembered later as the child's reaction to the separation with the mother going back to work would actually be related to the mother's earlier reaction toward the child.

EG: Yes. Also, you have to look at the relationship of the mother to her mother to get the real flavor. The mother of the gender-disturbed child is often bound in a sadomasochistic relationship with her own mother; she has never felt that her mother approved of her. The son is somehow supposed to make up to the grandmother for the mother's shortcomings. Such mothers have to make the boy into a female because they have come to connect hostile aggression with maleness. In their families of origin, the parental relationship was such that the girl (the mother of the gender-disordered son) never went on to form a satisfactory relationship with her father. It's a three-generation issue.

LL: Much has been written recently about burnout in psychoanalysis. You have been creative for a long time. How do you account for your continuing creativity?

I never tire of going to our nursery and watching children. I focus on one child, and at the end of 10 minutes I am very deeply engrossed in that child and curious about the meaning of that child's behavior. I seem to be able—I don't know why—to screen out other things that are going on and concentrate on that child. Children know that. That's what makes one a good therapist for young children: to be able to communicate to the child that you have eyes and ears only for that child and for no one else.

In connection with my adult patients, this morning I was talking to a colleague who has seen a few of my adult patients for medication. He told me that they all love me. “Boy, they hang on to you,” he said. I think the secret is not just that they are dependent people, but that I find most people very interesting. Yes, I'm tired after a week's work with the accumulation of paying attention, but I never get tired while I'm attention, trying to figure them out.