Being Alive Anne Alvarez is an enormously influential psychoanalytic psychotherapist whose work on autism and severe personality disorders in children has been important internationally. Her book Live Company has been a source of inspiration over the years both for colleagues and generations of students. Her work is celebrated here by a group of distinguished psychoanalytic practitioners from around the world. Being Alive brings together assessment of Alvarez's work and evaluation of how her seminal ideas have influenced contemporary thinking and practice. Working from her experience with autistic, borderline and deprived children, she has been a bridge between schools of thought and academic disciplines. These chapters illustrate with both theoretical debate and clinical examples how each individual has been able to build on or connect up with her ideas to enrich their own work. It includes chapters linking different lines of thinking within psychoanalysis, demonstrating too how converging ideas from other disciplines such as neurobiology have borne out Alvarez's changes of tech nique in the consulting room. We live in exciting times, as is seen more and more in terms of cutting-edge research on the brain and in the way such research develops how the psychological affects the physical and how diffi culties encountered early in life are addressed in an approach, advocated by Alvarez, which combines both a psychoanalytic and a developmental view. This book will be of great interest to child and adolescent psychotherapists in training and practice, and also to clinical psychologists, psychoanalysts and psychiatrists working with autistic/severely disturbed children. Judith Edwards is a consultant child and adolescent psychotherapist at the Tavistock Clinic, and until 1999 was joint editor of the Journal of Child Psychotherapy. Photograph by Al Alvarez Being Alive Building on the work of Anne Alvarez Collected and edited by Judith Edwards First published 2001 by Brunner-Routledge This edition published 2013 by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Simultaneously published in the USA and Canada by Taylor & Francis Inc 711 Third Avenue, New York NY 10017 Rout/edge is an imprint of the Taylor & Francis Group, an imforma business © 2001 Judith Edwards Typeset in Times by DP Photosetting, Aylesbury, Bucks All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, orother means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Being alive: building on the work of Anne Alvarez / [edited by] Judith Edwards. p. cm. "List of publications by Anne Alvarez": p. Includes bibliographical references (p. ) and index. ISBN 1-58391-130-8 -ISBN 1-58391-131-6 (pbk.) 1. Child analysis. 2. Developmental psychology. 3. Alvarez, Anne, 1936-. 4. Alvarez, Anne, 1936-Bibliography. 5. Autistic children. 6. Borderline personality disorder in children. I. Alvarez, Anne, 1936-. II. Edwards, Judith, 1944-. RJ504.2 .B44 2001 618.92'8917-dc21 2001035707 ISBN: 978-1-583-91130-8 (hbk) ISBN: 978-1-583-91131-0 (pbk) And yet the books will be there on the shelves, separate beings That appeared once, still wet As shining chestnuts under a tree in autumn ... So much more durable Than we are, whose frail warmth Cools down with memory, disperses, perishes ... Yet the books will be there on the shelves, well born, Derived from people, but also from radiance, heights ... Czeslaw Milosz, Collected Works (Reproduced by kind permission of Penguin Books) This page intentionally left blank Contents Notes on contributors IX Foreword X111 Acknowledgements XX111 Introduction XXV PART I Mainly theoretical 1 1 Bridging the Atlantic for psychoanalysis: an appreciation of the contributions of Anne Alvarez 3 Neil Altman 2 Changing ideas of change: the dual components of therapeutic action 14 Peter Fonagy 3 A contribution to a technical frame of reference 32 Anne-Marie Sandler 4 Bisexual qualities of the psychic envelope 44 Didier Houzel 5 Neurobiology, developmental psychology, and psychoanalysis: convergent findings on the subject of projective identification 57 Allan N. Schore viii Contents PART II Mainly clinical 6 "Think outside, not inside": making an interpretation hearable 77 Peter Blake 7 From freezing to thawing: working towards the depressive position in long-term therapy with autistic patients 89 Bianca Lechevalier-Haiin 8 Deficits in the object and failures in containment 102 Maria Teresa Gallo 9 Thoughts about the concepts of cognitive development, reparation and the "manic position": two clinical examples 115 Gabriella Pansini 10 The sense of abundance in relation to technique 128 Maria Rhode 11 Liking liking doing 141 Elsa First 12 First love unfolding: developmental and psychoanalytic perspectives on first relationships and their significance in clinical work 153 Judith Edwards 13 Glimpses of what might have been: a traumatised autistic boy's struggle to have a mind 166 Trudy Klauber 14 On temporal shapes: the relation between primary rhythmical experience and the quality of mental links 179 Suzanne Maiello Anne Alvarez's published work 195 Author Index 199 Subject Index 203 Notes on contributors Neil Altman (USA) is co-chairperson of the Relational Orientation Post doctoral Program in Psychotherapy and Psychoanalysis at New York University, and co-editor of Psychoanalytic Dialogues: A Journal of Relational Perspectives. He is faculty and supervisor in the child analytic training program at the National Institute for Psychotherapies, and supervisor in the child analytic training program at the William Alanson White Institute. Peter Blake (Australia) is a senior clinical psychologist and a Tavistock trained child psychotherapist. Over the last thirty years he has worked in child and family teams in community health centres in England and Australia. He is the Foundation President of the Child Psychoanalytic Foundation, which is a charity based in Sydney, Australia. He is course director of the Sydney Observation Course and the Sydney child psychotherapy training, which is linked to the Tavistock Clinic. He is editor of the Child Psychoanalytic Gazette, has lectured in a number of Australian universities and is currently an honorary lecturer at the University ofWollongong. He is now in private practice in Sydney. Judith Edwards (Great Britain) is a Consultant Child and Adolescent Psy chotherapist who has recently completed a four-year term as joint editor of the Journal of Child Psychotherapy. She is an academic tutor on the child psychotherapy training at the Tavistock Clinic, and she also teaches child development research both at the Clinic and in Bristol. Her current clinical base is at a family consultation centre. Recent publications, apart from those in academic journals, include chapters on autism and on international developments in the Handbook of Child Psychotherapy: Psychoanalytic Approaches (eds Horne and Lanyado, Routledge 1999) and in Autism and Personality (Alvarez and Reid, Routledge 1999). Elsa First is an associate in Clinical psychiatry and core faculty member of the Columbia University Psychoanalytic Center's Parent/Infant Psy chotherapy Program, and is an Adjunct Clinical Associate Professor of