Philosophy, psychiatry and neuroscience: three approaches to the mind. A synthetic analysis of the varieties of human experience

This study concerns the major clinical findings and theoretical concepts of Melanie Klein, W. R. D. Fairbairn, and D. W. Winnicott in relation to Freud's theoretical elaboration of psychical phenomena. A vague set of pronouncements early on in the book about the interelationships of these investigators are later transformed into a highly lucid and interesting account of the way in which clinical material in the analytic session reshaped the theoretical domain of psychoanalysis after Freud's death. The more exciting elements of the book include Hughes's linkage of the personal analyses of Harry Guntrip with Fairbairn, and later with Winnicott (the former analysis is based on Guntrip's lengthy unpublished record of over 1,000 analytic sessions). A further dimension to the inner workings of the psychoanalytic scene in Britain in the post-World War II era is Hughes's discussion of the case study of 'Susan' in Marion Milner's important book The hands of the living God (1969)-this patient lived in the Winnicott household for seven years during Milner's treatment of her, and Winnicott's posthumously published The piggle provides, as Hughes puts it, "clinical material bearing on the issues with which Milner's Susan had been grappling for close to two decades". Hughes's critical approach is refreshing, although not convincing in most places. For example, when she refers to "the downright sloppiness that plagued the work of Melanie Klein", one feels that Hughes has not prepared the ground properly. In the context of Hughes's analysis, the charge simply does not hold. But more serious problems abound in her discussions of the development of Freud's instinct and structural theories. Hughes focuses rightly on the theoretical importance of Freud's unfinished and posthumously published 'Project for a scientific psychology' (1895). But she seems oblivious to the fact that the roots of the instinct theory can be found in Freud's 'Project' (endogenous Q[uantity] is not protected by a shield against stimuli), or that it evolved through three specific stages. In the first, the sexual and self-preservative (ego) instincts were given equal weight in shaping human behaviour and experience; in the second, beginning with the paper on narcissism (Freud, 1914), the self-preservative instincts were defined with reference to libido turning back onto the ego; in the third, the death and life instincts were posited as fundamental (1920) and Freud returned full circle to ideas that were embedded in the 'Project', especially with regard to the separation oftwo of the key psychical systems-memory and consciousness. Hughes is certainly sensitive to the issue of the English rendering of "instinct" for the German concept Trieb versus the more preferred use of "drive" by the English-speaking purists. But in general she seems unacquainted with the current issues on the English translation of Freud, although several important papers of Ormston published in the last decade are in her bibliography. One significant item in the translation debates concerns Freud's structural hypothesis. Ornston, for example, supports the position that the so-called structural theory may in fact be James Strachey's invention, not Freud's. As Strachey is given more than adequate coverage as Freud's principal translator in the early chapters by Hughes, her unqualified assumption that Freud's structural theory is a fundamental "paradigm" of the Freudian system is a serious oversight. Her strategy of analysing the differences between Freud's theoretical concepts and those of Klein, Fairbairn, and Winnicott is not entirely successful because she does not prepare the Freudian ground properly. On the other hand, the increasing interplay between clinical and theoretical material after the chapters on Freud and Klein sustains attention to the very end.