Margaret Fries was a pioneer, even among the small group of women in medicine in the 1920s. From Barnard's class of 1916, she progressed to medical school and a pediatric internship at the New York Infirmary for Women and Children. This internship sent her into the homes of very poor families where her interest in cultural and environmental considerations developed as she sought to understand the total child within its family and community. After completing her pediatric residency at Bellevue Hospital, Fries became an attending physician at the New York Infirmary, and eventually the director of the Pediatric Service. During her tenure she became engaged in research focused on children with psychiatric problems, and established a child guidance clinic in 1928 while working very closely with Alfred Adler who introduced her to the idea of the unconscious.
Margaret Fries was among one of the first psychoanalytic baby observers to use film for research and education.
At this point the aim of preventing behavioral problems in children became the focal point of Fries's life work. She began a well baby clinic that provided support services to parents to improve their relationship with their babies. To her amazement she found that by a few months of age there was already such an entrenched mutual patterning between the mother and infant that an even earlier intervention was needed beginning with the mother and neonate and then with the pregnant mother-to-be. Fries initiated a research project with pregnant women and a follow-up of their children to test the hypothesis that a combination of both maternal care and the child's constitution accounted for the behavioral outcomes she observed in the clinic. Her findings were reported in “Behavioral Problems of Children Under Three Years of Age” in the Academy of Pediatrics Journal, 1928. While the critical importance of maternal care and its impact on babies is recognized today, in the late 1920s and early 1930s it was only beginning to be appreciated. Behaviorism was at its peak and the influence of B.F. Skinner was considerable. It was not until 1951 (20 years after Fries began her work), that the World Health Organization published the groundbreaking Maternal Care and Mental Health by John Bowlby, which described the devastating effects of maternal deprivation and emphasized that the infant needs to experience a warm, intimate and continuous relationship with the mother.
Fries came to believe that psychoanalytic training was necessary in order for her to gain a deeper understanding of the children and the families she was counseling. In 1930, after 10 years at the New York Infirmary, Fries left for Vienna to undergo a personal analysis with Anna Freud. She treated a delinquent child under the supervision of August Aichhorn, and Edith Sterba supervised her analysis of a child's case. After returning from Vienna, Fries completed the required course work in child and adult analysis as well as her own analytic treatment and became a member of NYPSI in 1939.
Fries became increasingly passionate and energetic in advancing her views on the important role of early intervention, establishing well baby clinics where parents could come for consultation, publishing many articles in popular magazines on child rearing as well as papers in pediatric, obstetric and psychoanalytic peer reviewed journals. She also initiated programs in schools to assist with child consultations, taught classes on child development for teachers, conducted seminars for lawyers on divorce, the placement of children, and the psychological problems of prisoners.
Fries also made a series of seven films, with the help of her husband, the photographer Paul Woolf, to document the different interactions of mother-infant pairs as they related to each other in everyday situations. Against the backdrop of the child's culture and family milieu, these films traced the child's psychological and physical development over time. Fries's interest in the role of culture in child rearing was reinforced by her correspondence and friendship with the anthropologist Margaret Mead, and illustrated by two films on Navaho family traditions and child development she made with the Harvard anthropologist Clyde Kluckholn. Margaret Fries was among one of the first psychoanalytic baby observers to use film for research and education; followed by a group that includes Rene Spitz, the Robertsons, Sylvia Brody, and Margaret Mahler.
Fries's unwavering commitment to teaching psychoanalytic principles to parents, educators, and those in the wider mental health community was matched by her unabashedly vocal view that it was a failure in adult psychoanalytic training that child analysis training was not a requirement without which, she argued, the adult patient could not be as effectively helped. Despite criticism from some of her psychoanalytic colleagues for her “extra-analytic” activities, Margaret Fries remained a forceful advocate for psychoanalysis in her work with students, teachers, social workers, pediatricians, lawyers and, above all, parents and children until her death in 1987. Fries's voice was strong and purposeful; the ring of her voice continues to be as true and meaningful today as it was when she began her work over 90 years ago.
Patricia Nachman, Ph.D., is a member of NYPSI, a child and adult psychoanalyst in private practice, the former director of the Margaret Mahler Observational Nursery, and former senior research scientist in the Laboratory for Developmental Processes headed by Daniel Stern.