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To Redeem One Person Is to Redeem the WorldReview - To Redeem One Person Is to Redeem the World
The Life of Frieda Fromm-Reichmann
by Gail A. Hornstein
Other Press, 2005
Review by Aleksandar Dimitrijevic
Jun 20th 2006 (Volume 10, Issue 25)

It is a sad fact that the name of Frieda Fromm-Reichmann has almost been forgotten and her contributions to the field of clinical psychoanalysis considered at best irrelevant, and at worst dangerous. Yet Fromm-Reichmann was instrumental in founding the first, and only, hospital devoted specifically to the psychoanalytic treatment of psychotic patients. For more than two decades Fromm-Reichmann was the hospital's most important clinician, researcher and author. Still, just half a century after her death, she is known only for her introduction of the concept 'schizophrenogenic mother', which she never considered to be very significant. Therefore, this biography, written by Gail Hornstein, is extremely important as it will, hopefully, reestablish Fromm-Reichmann's position not only in the history of psychiatry and psychoanalysis, but as an author relevant for contemporary psychotherapeutic approaches to psychosis.

The book is also important as an illustration of an excellent psychoanalytically informed biography. This "cradle to grave" biography obviously took Hornstein, a psychology professor, many years of meticulous work. It is obvious that she has studied everything available on Fromm-Reichmann`s work and life, but also a lot of material considering her relatives, friends and colleagues, who were important for her development. Hornstein has spent hundreds if not thousands of hours in the Chestnut Loge archives and presents us, the reader, with much previously unpublished information. The author is also careful to contextualize the biography: she puts Fromm-Reichmann in the perspective of her growing up in Central Europe, of her Jewish identity and its influence on her decision to pursue a career in medicine, of the First World War and her work with traumatized soldiers, and of working within the East Coast, predominantly WASP environment of the "Chestnut Lodge" hospital. Furthermore, Hornstein writes in detail about persons whom Frieda Fromm-Reichmann considered her teachers: Kurt Goldstein, Georg Groddeck, and Harry Stack Sullivan. Although this treatises of Fromm-Reichmann`s teachers is short it does reveal their profound influence on her; not in theory or therapeutic technique, but in her stamina and devotion to the principle that human contact, and psychotherapeutic relationship, can help patients overcome almost every traumatic experience, at any point of their lives. A kind of special emphasis is given to Freud's influence on Fromm-Reichmann, demonstrated during her career as an author: she never renounced Freud's ideas, in any of her work, but claimed to be improving them. It is strange that Hornstein did not provide more information on the possible, and probable, influence Frieda received from Erich Fromm, her one-time husband, and a very important, influential author in various branches of social science and psychoanalysis, but decided to study only their personal relationship.

By far the most important part of the book is the second half. Frankly speaking, this is the very reason the book was written after all. This part of the book is devoted mostly to the topic of psychoanalysis and psychosis. A full chapter is devoted to describing the founding of Chestnut Lodge as a psychoanalytic hospital specializing in treating psychotic patients. Many of the organizational details and psychotherapeutic strategies are revealed in detail. The first one that deserves to be mentioned here is the special emphasis on commitment. One should be aware that in Chestnut Lodge psychotherapy and treatment were synonymous. The staff, including doctors and psychologists, was living on the grounds of the hospital which made them available to the patients at a moments notice, day or night. In Fromm-Reichmann's case this meant something like fifteen hours of daily work, each week, excluding two summer months that she used as a vacation. Essentially Fromm-Reichmann was conducting something like ten to fifteen sessions, with hugely disturbed psychotic patients, every day. After that Frieda reserved her evenings, nights, and weekends for writing her papers.

The basic Chestnut Lodge strategy was to try to understand what symptoms meant, and not to ridicule or scorn them. The psychotherapeutic process itself included sometimes months of waiting for the first effort on the part of the patient to communicate. Often patients would mumble, keep silent or yell at the therapist for many sessions. Once the therapeutic communication was initiated, the process would sometimes last for years, or even decades. Usually, patients would be dismissed from the hospital but would continue to attend psychotherapeutic sessions.

This kind of work included a specific psychotherapeutic technique. Fromm-Reichmann insisted that the most important aspect of the psychoanalytic process was the forming of the relationship. Indeed she would more often answer the communication than interpret it. Of course, given that the patients were severely disturbed the usual psychoanalytic setting could not always be maintained. Analysts of Chestnut Lodge would keep sessions while walking with their patients, over lunch, over coffee, sometimes in their consulting rooms or sometimes on the locked wards.

In the early 1950s, Chestnut Lodge became a research institution as well. Some of the most important research projects on the psychodynamics of psychotic process were held there. Frieda Fromm-Reichmann was included in many of these projects until her death in 1957. One of the most important examples is her research on the phenomenon of intuition, which showed that intuition was not a supernatural or paranormal phenomenon, but a consequence of subliminal perceptions of patients' non-verbal behavior.

If fame could ever have been associated with Frieda Fromm-Reichmann`s name it came after the publication of the novel I Never Promised You a Rose Garden, written by a former patient of Fromm-Reichmann's, whose name turned out to be Joanne Greenberg. Greenberg's novel described her psychotherapy with Frieda, and documented a complete recovery after a schizophrenic breakdown after several years of treatment in various hospitals. The book intrigued many readers and thousands were writing to the publisher hoping to be able to get in touch with Frieda, hoping to find a solution to their own, or their relatives' problems. The popularity was such that in 1984 the story was adapted into a film, with Bibi Anderson playing Frieda Fromm-Reichmann, and 1997 saw book sales reach five million.

Still, even during Frieda's lifetime there were many controversies about her approach to psychoanalysis. Many psychiatrists expressed a deep skepticism whether a non-biological approach to psychosis could ever be effective, and psychoanalysts thought her techniques not "psychoanalysis proper". Frieda's contribution at Chestnut Lodge itself was such that after her death people realized that only a person of rare and special talent and endurance could achieve such dramatic results. For decades she had accepted cases too difficult for others, and it seemed that her unique approach required a therapist as talented as she herself was.

There were also controversies about her as a person: during her last years she was haunted by progressive deafness, an inherited problem that her parents suffered from as well. During those years, she also found out that she knew almost no one but patients. Her family members lived either in Europe or in Israel, and her friends were further and further away. Ironically, the greatest controversy about her life may be the way she died. In 1957 Frieda was discovered dead in a bathtub, and although there was no evidence many of her friends suspected she had committed suicide.

In the following decades, Fromm-Reichmann's The Principles of Intensive Psychotherapy was one of the most important textbooks for students of psychology and psychiatry alike. But, after the mid-80s the book came to be regarded more as an example of the history of psychotherapy. It is a sad fact that most contemporary psychologists and psychiatrists have not even heard of Frieda Fromm-Reichmann, or if they have can say little of substance about her work.

If there is a living legacy of her work, it is embodied in the "International Society for the Psychotherapy of Schizophrenias and other psychosis" (www.isps.org). This organization, which by now has several national branches, conducts research, organizes conferences, and publishes books devoted to psychological approaches to psychotic phenomena. Gail Hornstein's book will prove to be an important ally in the fight to remember the importance of Fromm-Reichmann's ideas and theories. If To Redeem One Person Is to Redeem the World, which is a product of several years of extraordinary scientific commitment, written with elegant style, and persuasive interpretation of data, reaches a wider audience in this paperback edition, readers will inevitably be affected by Fromm-Reichmann`s personal and professional ethos: an unrelenting insistence that there is no human being whose condition is beyond hope.

 

2006 Aleksandar Dimitrijevic

 

Aleksandar Dimitrijevic, Faculty of Philosophy, Department of Psychology, Belgrade, Yugoslavia.


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