September 2013

Melanie Klein goes to college

Terry Burridge, September 2013

PDF

 

The psychoanalyst Melanie Klein based much of her work on her time spent watching babies and their mothers- particularly babies who were being breast fed. Form these observations she mooted the idea that the baby creates two breasts- a Good breast and a Bad breast. She argued that this split occurs in the baby’s imagination to help the infant psyche survive its responses to being fed .She suggests that the baby is torn between gratitude to a mother-breast who feeds and cares for him and his envy and hatred of the same breast. She argued that one could see from the infant’s play these two distinct attitudes. When the mother is attending to her baby, playing with him, feeding him, making him the centre of her world, then the baby feels love and gratitude. However when the same mother does not immediately attend to his every desire, the baby is filled with rage and bad feelings, with very little benevolence to mitigate this rage.

Klein argued that to allow itself to know that the mother who cares is the same mother who ignores him would be too much for the baby to manage emotionally. So he creates a Good mother and a Bad mother. One the baby loves, the other it hates. This she called the paranoid-schizoid position and saw it as representing a very primitive developmental stage in the baby’s emotional growth. When the baby is older and stronger, she argued, it is able to understand that there is only one breast-one mother. That the mother who feeds him is also the mother who ignores him. And vice versa. The implication of this realisation is that the baby learns that he can both love and hate the same object. (From this beginning comes the whole theory of Object relations- a major force in psychoanalytic thinking and practice.)

The next question then is, what has this to do with learning, teaching, and education? I want to suggest that this split between a Good breast and a Bad breast is present in the classroom-certainly at university level and very much so in the teaching of mental health nursing. There are many strands to learning. We take in new information. We have to allow ourselves to be taught. We have to find room for our new knowledge and reconcile it with what we already know. In some case this is easy. There is no emotional challenge involved in learning how to take someone’s blood pressure. It is a mechanical task. Giving an injection can be slightly more daunting because we fear hurting our patient. But with practice we learn this skill and give-mostly-painless injections! We are pleased because we have learned a new skill and are keen to practice it. (My students are always enthusiastic givers of injections whilst this is a novelty. Once qualified this enthusiasm wears off quickly. What was new is now routine.)

When it comes to psychiatric illnesses, however, we move to a different realm of knowledge. Take schizophrenia. What is it? Is it caused by too much dopamine in the system and therefore a bio-chemical disorder? Is it a statement about the relationship between the psychotic individual and a mad world? In which case it is a psychosocial problem. Is it a form of ego defence whereby the individual projects his madness into outside objects like voices, the radio, or television? So that he can deny his own madness? In which case it is a problem that requires a psychoanalytic treatment. Or is it cause by demons and evil spirits-in that case it requires a priest or holy man.

 

One of the exercises we use with our mental health students is Jo’s story. It is the story of Jesus put into a contemporary setting-with Jesus ending up in a secure unit! We give our students this story and invite them to comment on it. Responses run through   “Well Jo is obviously psychotic. Probably schizophrenic.” to “Possibly autistic?” to “Sounds a bit like Jesus” to “He’s not mentally ill at all. Just annoyed the wrong people.” After a while we say that this was the story of Jesus, put into a contemporary setting. The student’s responses are enlightening. For the committed Evangelical student this is anathema. How dare we suggest that Jesus was mentally ill? Our story is rubbish and has nothing about it that bears any resemblance to their Jesus. (Whenever I use this particular exercise, I make sure to have my emotional body armour on. I know how passionate some students can get!)

Other students look amused and thoughtful. Some are bored with the whole process and want to learn proper information about medication without wasting their time on idle speculation.

I use this example to highlight the difficulty of learning. In this case the knowledge on offer challenges many deeply held beliefs. We are seen as a threat to the student’s existing worldview. (The truth is, that we are not explicitly challenging any worldview. We simply invite the students to consider a case history. It is they who diagnose schizophrenia or similar. But in Kleinian style, the hatred is denied and projected into us the lecturers.  It is we who are dangerous, not the student’s own thoughts. Which is, of course, one model for psychosis.)

To learn is to risk. If I learn to do this thing. I will be expected to do it next time. And the time after. And I may not want that responsibility. What happens if I fail? Or don’t want to have to know that I know something? If I allow that Jesus could be seen as being psychotic, what happens to my faith? If I allow that my psychotic patient might be like Jesus, what happens to the way in which I nurse?

I remember doing studying Theology at Teacher’s Training College, many years ago. I went to college as a Christian fundamentalist, certain in my faith. I was taught by that most dreaded species a Liberal! My lecturers did not share my worldview. They interpreted the bible and Christianity in an altogether different way to me. Thus they wee the enemy. To be engaged in battle with at every possible opportunity- in the hope that they would see the error of their ways! I spent three years with my emotional hands covering my ears, lest I become contaminated by their heresy. (Many years later and I find their view entirely reasonable and probably too conservative-but that is another story!) I could not listen their teaching because y whole world view was based on the need for certainty that fundamentalism provided. To accept their views would have meant opening myself to a world of not -knowing. And that was intolerable at that time.

So it is for our students. What does it mean to take in new knowledge? How do I decide what knowledge to take in and what knowledge to spit out? Can I trust my teachers to have my best interests at heart (a Good breast) or will they feed me poison (A Bad breast)? It seems to me that in the same way that a mother has to support her baby so that it can feed, so we as teachers have a similar responsibility to our students. How they use the feed is outside our control, but we do have a responsibility to provide the most favourable conditions in which a feed can occur.

Bibliography

Klein, M. 1988 Envy and Gratitude and other works 1946-1963 London: Virago 

Comment by Olivia Sagan on September 3, 2013 at 16:09

 

Indeed - re-reading Melanie Klein with education is mind has much to offer, so thank you for this reminder! So much of learning is about taking in (trusting in the good) or spitting out - we chew on something; regurgitate facts; digest meaning; sometimes need bite size chunks or a more substantial 'diet' ... some lessons make us sick and others are more satisfying...there are many other examples, on the tip of my tongue...but nuff said for now.

You might enjoy this book by Britzman, I found it an inspiration:

http://www.sunypress.edu/p-3728-after-education.aspx

Comment by Jill Anderson on September 3, 2013 at 16:20

We develop a taste for certain subjects. . .cram for exams. .. .  

Comment by Olivia Sagan on September 3, 2013 at 16:44

...which some have no stomach for, yet others relish....

the list goes on!

Going back to Terry's post:

 

How they use the feed is outside our control, but we do have a responsibility to provide the most favourable conditions in which a feed can occur

 

indeed...yet we also, I might add, can help the learning process by grasping how toxic some learning envrionments can be - and by helping our students to develop an awareness of how we all, from time to time, poison our own learning, or, alternatively, gorge ourselves on junk.

 

Comment by Jill Anderson on September 3, 2013 at 19:02

For those who are interested, the first chapter of 'After Education' by Britzman (recommended by Olivia above) is online here: http://www.sunypress.edu/pdf/60717.pdf

Comment by Terry Burridge on September 4, 2013 at 13:01
I've only just read Olivia's comments. I like the idea that we all poison knowledge / learning at times. Isn't that part if Klein's view of envy? New knowledge isn't always palatable so we make it sour milk. Or it upsets our stomach and we sick it up.
Comment by Olivia Sagan on September 5, 2013 at 10:34

Yes, quite. I think this is a fascinating line of thought.

The destructive power of envy, and how 'spoiling' occurs. Gives us to understand better the efforts made sometimes, by students, at self-sabotage - for example. Another psychoanalytic angle comes from Bion, also within the Object Relations school, who writes about unconscious attacks on thought itself - the ways in which we cannot bear the 'linking' and cohering of thoughts, words and ideas and the symbolic 'bringing together'. Lovely stuff.

 

Comment by Marjorie Lloyd on September 5, 2013 at 11:30

To learn is to risk - I like that a lot  - thanks Terry

Comment by Terry Burridge on September 5, 2013 at 16:28

I'd forgotten Bion's work on linking. Thanks for the reminder, Olivia. i find that another useful way of thinking about psychotic processes- as against psychosis per se. I see that reluctance to engage in linked thinking so often, both Organisationally and psychically in my patients.(I sometimes wonder whether some of our instutions aren't more psychotic than the patients they hold!)

Add a Comment

You need to be a member of Mental Health in Higher Education Hub to add comments!

Join Mental Health in Higher Education Hub

Blog Posts

QMU launches the world's first Masters in Mad Studies

Posted by Jill Anderson on December 1, 2020 at 11:50 0 Comments

Queen Margaret University, Edinburgh is launching the world’s first master’s degree in Mad Studies. The MSc Mad Studies course is primarily a course for graduates with lived experience of mental health issues. It has been hailed by a leading international Mad Studies academic as the most exciting piece of curriculum development in the last 20 years!

Mad Studies is a recognised academic discipline that explores the knowledge and actions that have grown…

Continue

Unlearning through Mad Studies: disruptive pedagogical praxis

Posted by Jill Anderson on October 26, 2020 at 19:00 0 Comments

Medical discourse currently dominates as the defining framework for madness in educational praxis. Consequently, ideas rooted in a mental health/illness binary abound in higher learning, as both curriculum content and through institutional procedures that reinforce structures of normalcy. While madness, then, is included in university spaces, this inclusion proceeds in ways that continue to pathologize madness and disenfranchise mad people.

This paper offers Mad…

Continue

Stepchange: mentally healthy universities

Posted by Jill Anderson on October 16, 2020 at 15:48 0 Comments

Earlier this year, UUK published a refreshed version of its strategic framework, Stepchange: mentally healthy universities, calling on universities to prioritise the mental health of their students and staff by taking a whole university approach to mental health.

The Stepchange approach and shared set of principles inform the …

Continue

Think Ahead gets funding to boost its intake.

Posted by Jill Anderson on October 16, 2020 at 15:41 0 Comments

Fast-track mental health social work provider Think Ahead will expand its intake by 60% from next year following a government funding boost of at least £18m.

The Department of Health and Social Care has agreed a contract with Think Ahead to increase the number of trainees for its 2021 and 2022 cohorts from 100 to 160, with…

Continue

Transforming Mental Health Social Work videos

Posted by Jill Anderson on October 16, 2020 at 15:39 0 Comments

Health Education England has commissioned 11 videos centered on real-life experience of specialists in the social work field.

See the video playlist.

Transforming mental health social work - conference report

Posted by Jill Anderson on October 16, 2020 at 15:37 0 Comments

In February 2020 Health Education England and Skills for Care put on two major conferences about the role and development of mental health social work. 

Download the conference report.

Leadership in mental health social work - web pages

Posted by Jill Anderson on October 16, 2020 at 15:33 0 Comments

A section of the Skills for Care website has been developed for mental health social workers and AMHPs

View the web pages here.

Social work education and training in mental health, addictions and suicide: a scoping review protocol

Posted by Jill Anderson on October 16, 2020 at 15:29 1 Comment

Social workers are among the largest group of professionals in the mental health workforce and play a key role in the assessment of mental health, addictions and suicide. Most social workers provide services to individuals with mental health concerns, yet there are gaps in research on social work education and training programmes. The objective of this open access scoping review is to examine literature on social work education and training in mental health, addictions and…

Continue

Mental health nurse education: perceptions, access and the pandemic

Posted by Jill Anderson on October 16, 2020 at 15:25 0 Comments

With World Mental Health Day this Saturday, a new Nuffield Trust report discusses how more people might be attracted to apply to study mental health nursing, and the reasons why they might currently be less likely to do so.

Co-author Claudia Leone picks out some  key findings.

© 2024   Created by Jill Anderson.   Powered by

Badges  |  Report an Issue  |  Terms of Service