“What makes it possible to accept the transience of life, to bear increasing losses, face the loss of one’s own life and yet go on growing, gaining or at least maintaining emotional and spiritual strength.” – Isca Wittenberg
When Isca Salzberger-Wittenberg was 11 years old, she wrote in her diary, ‘I want to help people when I grow up.’ When she died in December 2023, she was the oldest living child psychotherapist and had undoubtedly fulfilled her young self’s wish.
Over the course of a career that extended more than 70 years, Isca had a lasting impact on mental health services for children and adolescents at the Tavistock Clinic in London. She also helped shape the thinking of generations of child psychotherapists whom she trained.
Isca was one of the first people to undertake child psychotherapy training at the Tavistock Clinic, London, set up by John Bowlby and Esther Bick after the Second World War.
Isca’s contribution was all the more remarkable, having fled Nazi Germany as a child. But perhaps surviving the trauma of the Holocaust made her a particularly good guide for others experiencing loss. In her book ‘Experiencing Endings and beginnings,’ she wrote:
‘What makes it possible to accept the transience of life, to bear increasing losses, face the loss of one’s own life, and yet go on growing, gaining, or at least maintaining emotional and spiritual strength?’
For over fifty years, Isca worked at the Tavistock Clinic in London, where she eventually rose to be its Vice Chair. Her colleagues were some of the greatest names in psychotherapy such as Donald Meltzer and Neville Symington.
Isca had been in analysis with Dr. Sonny Davidson for four years when he tragically died. She reflected on why she had decided she wanted Wilfred Bion as her analyst.
Having taught infant observation for over 50 years, Isca explained her passion for it and why it was an essential part of understanding babies and their parents. She also revealed the challenges of working with one of the key creators of Infant Observation, Esther Bick.
Isca disclosed how her own experience growing up led her to gravitate towards helping adolescents experiencing mental health difficulties. She developed a young people’s counselling service at the Tavistock Clinic where, for the first time, they could refer themselves.
She also talked about her deep interest in spirituality alongside psychoanalysis and why, at 98, she was learning to play the piano!
Remarkably, Isca continued her work as a Consultant Psychoanalytic Child and Adolescent psychotherapist and Adult Psychotherapist from her home in North London until her passing.
Interview recorded 2019 with Jane O’Rourke
Obituary for Isca: Teacher, Supervisor, Colleague and Friend 1923-2023
President, The Institute of Psychotherapy and Disability; Board of Directors, International Society for the Study of Trauma and Dissociation; Founder and Patron, Clinic for Dissociative Studies
Isca Salzberger Wittenberg, the longest practising child, adolescent and adult psychoanalytic psychotherapist and theoretician in the UK and the first female Vice Chair of the Tavistock Clinic died on Dec 23rd, 2023, at the age of 100.
Her lifelong interest in mental health, beginnings and endings was informed by her childhood. The loved youngest daughter of a progressive Rabbi, Georg Salzberger of Frankfurt’s Westend Synagogue, and his wife, who looked after the distress of their community as Nazism took hold, she witnessed firsthand both the help that could be provided to people in times of distress as well as the devastation tragic endings could cause. She had to come to the UK from Germany, as a 16-year-old, having experienced the multiple traumatic betrayals and transformations caused by the holocaust.
She was only 11 when Hitler came to power, an age where her key aim for the future was to help people and her formative early adolescent years happened in this toxic environment, in which her father was also tortured in Dacchau. No wonder, despite her interest in helping all ages, she had a major contribution to make in the lives of adolescents. She saw from the tragic endings that happened that all endings highlighted awareness of mortality and loss, and, where possible, needed planning instead of happening without thought. She was aware of the need to mourn to deal with loss and bear pain and felt we all, as therapists, needed to experience the pain of the patient so it could be looked at and thought about.
She worked and trained as a social worker and nursery nurse in the UK before training as one of the first group of pioneering psychoanalytic child psychotherapists at the original Tavistock Clinic. It was at the Tavistock Clinic, where she trained and worked for over half a century, that she influenced the lives of future child psychotherapists and thereby all the children and families they worked with. She cared for the whole environment around a baby, child and adolescent, as well as having the capacity to deeply and rigorously focus on individual process at all ages, right into her 100th year.
My first two meetings with Isca highlighted for me what I continued to love in her. As a young mother, some half century ago, I moved, by lucky chance, next door to Susan Reid, one of the brilliant teachers and consultant psychotherapists on the child training at the Tavistock Clinic. She encouraged me to apply, which I did, and after the first years of preclinical training I was aware there was no house journal for the Tavistock Clinic. Tentatively, as I had editing experience, I raised the issue, and one afternoon, when my children were playing noisily in the back garden, Sue called me over the fence to introduce me to Isca Wittenberg, who I had, of course, heard of, read, but had never met. She not only warmly congratulated me on the idea for a house journal, especially as I was a trainee, but said she would back it with the executive, and what is more she would guarantee an immediate grant towards its publication. And so it happened, very quickly. Isca did not want it mentioned that she had backed it from the start. She had no narcissism over all the creative endeavours she was quietly behind, but which transformed the Clinic, the first and largest National Health Service Training and Treatment centre for child psychotherapy.
Theoretically, clinically, and administratively, Isca was quick to complete needed changes with the minimum of bureaucratic hurdles. Indeed, she created the Young People’s Counselling Service in which young people could refer themselves for a short intense period of work. This was lifesaving for hundreds of teenagers and nearly all child psychotherapy trainees would learn from this short-term work. I called her a quiet revolutionary in that she achieved dramatic change with minimum disruption. At a time when some only saw long term work as true analytic work, Isca achieved a major service innovation in which there would often be six sessions. This really was a focus on beginnings and endings.
When I progressed in the clinical training and needed an adolescent training case, I met Isca for the second time, by chance, on the stairs at the Tavistock Clinic. She was Chair of the Adolescent Department at that time. Seizing the moment, I dared to ask her if she would be willing to be my tutor and supervisor. She beamed with delight and to my great surprise asked me very seriously, “Are you sure you really mean to ask me? I would love to but it seems a lot of people are frightened of me. I wonder why you aren’t”.
What I could relish and see in Isca in those first two meetings were characteristics that I have loved in her throughout her life. She had a spark, vivacity, and interest in whoever she met and whatever they were doing. She also had a fearlessness in asking, in a non-defensive way, how people felt about her comments or presence. She was aware she wanted to understand how, after years of close friendship, German Christian friends in her childhood could suddenly turn against her when Nazism took hold. She did not take relationships for granted. It was only when she asked me twice what I had “really” thought of a talk she had just given, that I could see the vulnerability that came from those experiences of betrayal and transformation.
When I presented sessions to her of my work with my adolescent training case each week for a year, I had the pleasurable feeling that she cared for my patient and me as a dyad and hoped that her questions and thoughts could aid our journey. Because of the pain she had gone through as a teenager she understood and empathised with the pain of young people who were faced with bewildering changes in their minds, bodies, and environments. She also enjoyed asking questions she did not have the answer for and reflecting on the way these also aided my capacity for self-reflection and curiosity. She had felt her own psychoanalyst, the famous Wilfred Bion, had used questions in a genuine non-authoritarian way. Indeed, I always felt Isca was the female principle for Bion’s theories. She added warmth to the containment of his questioning approach. Indeed, I first read Bion through a lens that came from Isca. Like Isca, he had a humbleness over his own ideas. When I had the chance to meet him personally at one of the famous summer parties for trainees and staff, held by the co-founder of the child psychotherapy training, Mattie Harris, he authentically announced to me, with a wry smile, that he was glad no-one could call him Bionic.
Isca, like Bion and several other great teachers, was not looking for clones, for Wittenbergers. She didn’t want divisiveness. She wanted healing thinking to aid people to have their own voice and did all she could to encourage that. She was genuinely shocked when she saw trainings which she felt used Kleinian psychoanalytic ideas in a punitive way. She loved her patients and her trainees. She also cared deeply about the very fabric of the Tavistock Clinic. One of her typical brave and endearing statements was on the ugliness of the therapy rooms in The Tavistock at that time. She made clear that neutrality in therapy rooms did not mean rooms had to be ugly! Ugly corridors and rooms transformed. Paintings appeared and the building provided greater hope to those entering it. As a Vice Chair of the Clinic, she was a creative and vigorous presence. The institutional greys and beiges were transformed with paintings on the walls and some carpets.. and this aesthetic transformation was thanks to Isca.
After the Tavistock Gazette was established, it became clear there was a dearth of institutional creative events like pantomimes or concerts that similar institutions like The Anna Freud Centre or The Maudsley hospital provided. Somehow there had been, at that time, a fear of the patient-analyst boundary being eroded by humour. Indeed, the first pressures on the newly created Tavistock Gazette were the worries “What would a patient say if they accidentally read about their analyst making jokes or vice versa?” When Dr Alexis Brook became Chair of the Tavistock and asked me to organise a concert, it was immediately apparent that Isca needed to be in a starring role to lessen the fears of trainees and junior staff at being seen to be having fun! And she obliged with grace and skill, from the very first to all the future pantomimes. She sang and spoke and performed beautifully and changed the atmosphere around such events.
Her particular interest in Endings, as a result of her holocaust experiences, allowed greater recognition for the deeper meaning of such issues. It was thanks to her that there developed proper rites of passage. Initially, qualifying as a child psychotherapist, in that period, for example, was just being told you had qualified and there was no graduation or leaving event! Proper concepts of leaving in schools, colleges and workplaces owe a lot to the subtle transformations Isca created. This was the period when children could have a lovely end of year celebration with their form teacher, not knowing she was then going to leave the school “because it might upset them”. She could be teased as well and could appreciate the humour in her returning again and again post-retirement to provide more ending events and workshops, something expressed in a sketch at a later pantomime called the “Never-ending ending workshop”.
She retained an interest in her past trainees long after they had left the clinic and provided strong support for the work, I was doing both in disability therapy as well as organised abuse at a time when this was a subject not found bearable. Because of her strong family history of service, with her father a leading Rabbi in the hardest of times, she understood the worst of what humans could do. We had also agreed that despite our different identifications with our mothers, we were father’s daughters. We recognised something of the character of each other’s father in each other, and my lovely father, the late Professor Stanley S.Segal, OBE, former Director of Ravenswood Village, knew how warmly I felt towards Isca. There was something about the immigrant gratitude to the new country that offered safety and the extra wish to be of service because of this that they had in common. There was also the hopefulness of aiding national development by such service.
We spoke to each other about our families and Isca’s pride in Jonathan and Raphael and her grandchildren was palpable. Unsurprisingly, she watched with excitement and awe at their development and their finding of their own voices. “Our Jonathan” and “Our Raphael” were warmly spoken about and her pleasure in their achievements and major societal contributions had an awe with it as if she did not take for granted that her love and containment had helped to provide any emotional strength. She had a similar respect and admiration for her husband Adi, who had a strong moral compass that matched Isca’s. It was not surprising to see the beauty of their garden and the way each plant and flower seemed to have its own growing space. The terrible traumas in her life seemed to have given Isca even more appreciation for what a good-enough mother could do in containing an infant’s fears so that even catastrophic events could later be processed. When I was a trainee, she once used the term “adopt”, in terms of a transitional taking responsibility for sharing pain. It is only now I realise the full depth and beauty of that concept. When Isca’s loved older sister died of cancer whilst a young mother of Jonathan and Raphael and asked her sister to look after them, in typical fashion, Isca transformed the grief and loss of her sister into extra love for the nephews who became her sons. Perhaps her deep non-possessive appreciation of the baby’s predicament and need for containment also shaped and aided Isca’s resilience and commitment and creative spark.
Ten years ago, at the age of 90, Isca wrote me a moving email in response to my birthday card to her, asking me to write something about her when she died. As a past tutee and supervisee of hers at the Tavistock and later a colleague, she wanted me to write not to address her distinguished theoretical, clinical and organisational contributions but for other reasons.
“Thank you for the beautiful card and beautiful words on it.
I hope you know that you have a very special place in my heart.
It may seem strange to you but I have often thought that when I die, I would like Val to write something about me for the Bulletin or maybe even a newspaper.”
She followed it up with a phone call asking me to read a memento of her at her 90th birthday party that could serve as the basis for an obituary. I arrived nervously to see my child psychotherapy colleagues there as well as Isca’s lovely family. Contributions were announced by one of her two loved sons, Rabbi Jonathon Wittenberg, and it became clear this was more a family event and that it was filled with excitement about ongoingness and was not the right time for historical accounts. Isca was not going to ask me to read what I had written, and her sons probably did not know I had been asked. She smiled at me shyly. She was right. At 90 she did not need to publicly consider her mortality further at that moment as she was well enough and still actively nurturing her grandchildren as well as receiving love from them. Seeing her thriving and interested in her grandchildren and friends with all her customary warmth and curiosity was warming as well as poignant, signalling the loss that would come. But we could speak about it after, and I could give her what I had written.
Isca rang me before her 98th birthday and after a brief interchange of deeply felt emails. She now had a fulltime carer and was clear she loved her house and was content to stay there. She had to give up playing her beloved cello as it had become too heavy, but she had returned to the piano and Beethoven and Bach sonatas. She had had one cataract operation and wanted the next to be able to see the notation adequately. She said one vocal cord had packed up in hospital and she was having speech therapy for the other. This was Isca. She acknowledged the reality and was willing to invest in what could be improved as well as to accept what could not. Typical Isca, she then asked me how I was, following the death of my son from cancer of the pancreas. Her emotional generosity and interest were remarkable at such an age. I was also deeply moved by her ongoing self-analysis and she told me she had written about developmental change that was needed in your 90s.
On 16 Feb 2021 Isca wrote:
My dear Valerie,
Thank you for your rich letter and especially for the poem… you have such a capacity to turn your sorrow into creativity. People may tell you that you are so strong, as they have to me but the pain is no less. I think we have both been given so much strength from our fathers.”
I replied:-
Thank you dear Isca- I do carry my father with me as a core of calm and love. You are right. We are indeed fathers’ daughters!”
I added:-
“Dear Isca, with it being 100 years of the Tavistock you have been in my mind-your spark and genuine interest. Your combination of knowledge without being rigid about it. Your willingness to act in the pantomimes and concerts and awaken creativity in trainees. I was truly lucky to have had you as my tutor and supervisor and enjoy going over the moment I stopped you on the stairs at the Tavistock and asked if you would be my tutor..
Love to you
Valerie
From Isca to Valerie:-
I will say no more than to tell you that I am proud to have had you as my tutee.
I shall stop now as I and my computer are
no friends.
Hope we may keep in touch,
With love,
Isca
I saw her carrying on her loved father’s sense of service, with resilience and reflection. However, there was also a key aspect of her mother. She described her mother at 90 watching Wimbledon, which she loved, and shouting with anger at the end of the game, “Why can’t I still play tennis?”. It was that irrepressible youthful spark of joy and curiosity combined with the seriousness of her undertaking that made her such a fine teacher and writer.
In the period she worked at The Tavistock Clinic, there was the benefit of several great clinicians and teachers working there-for example. Susan Reid and Anne Alvarez with their work on autism, Margaret Rustin and her development and shepherding of the child psychotherapy training (the only such NHS training), and her analytic exploration of children’s books, Gianna Williams on eating disorders. Then came the major organisational work and work with babies following the amalgamation with the Child Guidance Centre and bringing Dilys Daws, Eileen Orford and Juliet Hopkins. What Isca offered was her “invisible” mending and questioning of organisational and clinical splits, her creativity and her relational but firm emphasis on beginnings and endings.
She will be greatly missed-but has left a major legacy of her writing as well as in the hearts and minds of those lucky enough to be taught by her. The adolescent, whose therapy was supervised by Isca, came back to see me ten years later. He was shocked I remembered him. Such trauma he had gone through. “How could you remember? It was all so disgusting and painful”. And it was Isca’s teaching. Adopt the pain of your patient so you can hold it and look at it with them. It imprinted on my heart and helped me with working with extreme trauma later. And only now do I realise the extra depth of that word “adopt” and Isca’s loving and non-possessive maternal beauty. Thank you Isca.
Dr Valerie Sinason PhD MACP MInstPsychoanal FIPD
Formerly Consultant Psychiatrist to the Great Ormond Street Children’s Hospital and the Tavistock Clinic; Visiting Professor, Royal Holloway University of London, Director, Child and Family Training
When I was appointed as a Senior Psychiatric Registrar in 1966 to Great Ormond Street Children’s Hospital, having completed a four-year training at the Maudsley, I was delighted to meet the Child Psychotherapists working in the Department of Psychological Medicine, Isca Wittenberg and John Bremner. Having worked through the rotation of Children and Adolescent work at the Maudsley hospital, including Inpatient and Outpatient Children’s and Adolescent Services, apart from a brilliant exposition of the Squiggle Technique by Donald Winnicott, I had received very little supervision and skills development of psychotherapeutics work with children and young people, and had had to find my own way.
It was therefore an enormous pleasure to have supervision with Isca and John and to really understand the process of therapeutic work with children and young people. The detailed understanding of the engagement process, object relationships, the use and interpretation of play, and appreciating transference responses in children and young people, encouraged me to move forward with my application to complete a Psychoanalytic training myself. In turn this led to the group of my contemporaries to develop systemic Family Therapy approaches. The firm basis of therapeutic work with children and young people, supported by Isca and colleagues, reflecting the traditions of work developed by Anna Freud and Melanie Klein, was the core foundation for all my subsequent developments, and I am profoundly grateful to her.
Retired counsellor, Supervisor and Head of Counselling Service Bath Spa University
I was sad to learn of Isca Wittenberg’s death. Many years ago after a serious illness I wrote to her as a friend suggested she might be interested in my writing about the process of recovery. In response to my letter I received an invitation to tea.
I remember the occasion with such warmth. She offered me delicious homemade cakes and we talked for a long time. She told me about some of the losses she’d suffered and the love and pride she felt for her family. She encouraged me to continue thinking and writing about recovery and told me about her work as the ‘Endings Lady’ at the Tavi, saying ‘No-one else wanted to do it’.
It was a one-off encounter but I was left with a very powerful memory of her.
Later I used her work on endings when I taught ‘Endings in Supervision’ for several years for the Severn & Thames Psychoanalytic Network where I had trained as a supervisor. The trainees always responded thoughtfully to her work.
I am grateful for the meeting with Isca and was very moved by your interview with her when she was ninety-six. What a rich life.
Child & Adolescent Psychotherapist
I am very sad about her loss and recall privately paid for supervision so well. I often tell the story that – and it is true – I left feeling black and blue having been admonished and corrected severely but I learnt more in a few sessions with her than many years with other supervisors who were affirming and ‘nice’ to me. She sometimes offered directions that I felt were absurd but when I took her advice the intervention actually worked! Amazing pioneer Isca there will be few to follow anything like you.
If you would like to write a tribute to Isca, please email: janeorourke@mindinmind.org.uk
From Paul Jenkins, former CEO of Tavistock & Portman NHS Foundation Trust
“In the year in which the Tavistock Clinic is celebrating its centenary it’s a great privilege to be able to pay tribute to the work of Isca Wittenberg whose career spans back to the earliest days of the development of child psychotherapist.
In her career Isca worked alongside so many important names from our history such as John Bowlby and Esther Bick and is still, today, practicing at the grand age of 98. Isca’s work stands out not only for its longevity but also for the deep humanity she has brought to the task of supporting young people in need grounded in her personal experience of having escaped the trauma of the Holocaust.”
Ricky Emanuel, Child and Adolescent Psychotherapist
“Isca is one of the last remaining child psychotherapists still alive who trained in one of the first cohorts of the child psychotherapy training at the Tavistock set up by John Bowlby and Esther Bick.
She was a refugee from Nazi Germany coming to this country when she was 16. She worked as a nursery nurse where she developed her interest in babies which she has never lost. She found a home for this interest in her life long devotion to infant observation, as well as her ability to find the infant in her patients and in the infantile aspects of group functioning.
She trained as a social worker in Birmingham where she excelled at her studies and was invited onto the staff to teach shortly after her qualification. She found her way to the Tavistock to train as a child psychotherapist and entered analysis with Wilfred Bion. He has been very influential in her work especially in his encouragement to find her own voice and be her own person. She embodies Bion’s concept of ‘K’ more than anyone I know, the desire to understand or get to know which is an ongoing process never completed. Isca has always been interested to find out more, to learn new things and to develop her mind.
She has deep-seated conviction about the value of connection, and she lives her life this way. Even at the age of nearly 98, she is still wanting to connect and share her ideas with others as well as hear from them what is happening “out there”. Her last book on Experiencing Endings and Beginnings is being republished and she felt she wanted to add to it about her experience of the last years of life, a profound ending experience when there can be a sort of return to infantile dependency for physical care.
How this is managed is so dependent on early beginnings and other endings throughout the life cycle. Despite everything she has gone through and witnessed she says she never has given up hope and this quality is so evident even in these last years of her life. Bion‘s maxim is that the purpose of development ( or analysis) is to enhance the person’s capacity to experience experience. Isca is still developing in this sense, experiencing endings and beginnings as fully as she can. She is an inspiration to all of us.”
David Morgan, Psychoanalyst, Consultant Psychotherapist & Fellow of British Psychoanalytic Society
“Isca was one of the first people that I saw lecturing at the Tavistock, as a young clinical psychologist I was bowled over by someone who could put things into words the way she was able too. So began an analytic career.
You never realise the effect a lecture or seminar can have on people who are new to psychoanalysis, one is lucky if someone engages with the mind in the way Isca did on that evening.”
This interview was recorded in 2019
Isca Wittenberg is a remarkable individual who’s devoted much of her life to the service of others and having reached 96 years of age, she continues in her work as a Consultant Psychoanalytic Child and Adolescent, as well as Adult Psychotherapist. Her 50-year career at the Tavistock Clinic, in London, where she eventually rose to be its Vice Chancellor – also led her to work with some of the greatest names in psychotherapy. Wilford Bion was her analyst, and she worked with John Bowlby, Esther Bick, Neville Symington and Donald Meltzer. She taught Infant Observation and was a senior tutor in the clinical training of child psychotherapists for over 50 years and has taught all over the world. She’s published psychoanalytic articles and three books including Psychoanalytic Insight and Relationships, which is still essential reading for all trainees.
You told me Isca that when you were 11 years old, you wrote in your diary, “When I grow up, I want to help people.” And, 85 years later, you’re still doing that – you’re still working.
What has driven you to do this work?
Two things I would say. First of all, I love babies and young children – from very early on. And, I was very much in touch and seeing the evidence of my father’s pastoral work.
He was a Rabbi?
Yes, a Rabbi. In fact, people came to our home, and they usually were very distressed or very poor, and he seemed to help them. And so, maybe I got the idea from that when I was 11 years old. But later, of course, there was also wanting to understand how people could be your friend one day and next day your enemy. And that must have, very much, later on, influenced my interest in wanting to understand people’s minds.
You’re known, very much, for your focus on the importance of endings. Do you think that might be linked to the very traumatic experiences of being in the Second World War in Germany and escaping the Holocaust?
We escaped the Holocaust by escaping to the United Kingdom. But after a very, very difficult time.
You were sixteen – I think?
Yes. Well, it had been difficult much earlier, it got increasingly difficult under Hitler’s regime. So, that as school children we would go one direction and be met by children that were going to Christian schools, and they would spit in our face, and we saw also, people being attacked on the streets. So, all this must have contributed to it.
And in what way do you think those early experiences have contributed to your understanding….
Of endings, is what you wanted, really to know?
Well, it only dawned on me very late in life, at about 80, that it might have to do with us having to end our relationship with Germany because of Hitler. And ending our life in Germany, which was a complete break. And arriving in the United Kingdom with just suitcases to live with and friends who looked after us. So that was quite an enormous ending.
But there were endings before because people left Germany as refugees, Jewish people left, and our relatives left to go to our country. So, it was a lot of saying goodbye and maybe for the rest of your life. But later experiences too where there were a lot of endings. But if you ask me what happened right at the beginning, maybe this was already strongly inside me. But I had powerful experiences of losses later on in life, which also made me aware of how important it is that endings should be thought about and how often they are not thought about. Before they actually happen, that you’ve got to try to prepare yourself for that, whether it’s early in life or late in life.
And that is a question of people not preparing themselves for the losses or for the end of life, itself. And also, things being broken off suddenly or without any thought about how important that relationship might have been. How much it will be missed and to try and preserve it in your mind by actually mourning the loss.
So this is important in psychotherapy as well, isn’t it?
Very – you have it if you’re somebody in treatment. It’s intensive work. There’s a separation, either whether they come once a week, they wait and have to wait another week. There’s an ending and it’s difficult to bear and wait till the next time. And there’s an ending, if they come intensively, at the weekend, and much work usually is about the anger and the difficulty of being able to bear separation. And it evokes in them other separations they’ve had earlier in their life.
That reminds me of something that Neville Symington wrote about you. He said that you are able to bear and heal the pain of others because you have knowledge of your own pain.
I’m sure that’s terribly important, not that one talks about that to your clients because you have the pain inside you. But you certainly don’t share it with them. On the contrary, because you know how difficult it is, it’s possible to accept their pain and think about it with them. Help them to think about it and know that that is so important. I mean, people come to you because of their emotional pain. I do think I experienced a great deal of pain in my childhood already.
As I said, I was 11 when Hitler came to power and all the losses people experienced as a result of that, and then came to my father to get some help to think about.
Time and time again in your writings you emphasise the importance of facing emotional pain and staying with difficult feelings and the benefits that can arise from doing that.
That if you can’t do that, you’re in fact not in touch with say, a deep sense inside you. You may instead have physical symptoms in which the pain is expressed. And there is a fear of it being overwhelming and too much, but the work enables people to learn to bear pain, by first of all the psychoanalyst – psychotherapist – who adopts the pain of the patient and tries to see how it comes into the relationship between the client and yourself. And where it can be looked at as something a bit outside, not only inside, and therefore it can be, as I say, thought about. And as the therapist, it helps you to understand it and eventually to accept it in yourself. It enriches your feelings, in other words, because if you don’t do that there’s a whole aspect that is there but isn’t really able for you to be in touch with it in a helpful way.
Can you say more about enriching feelings – what do you mean by enriching feelings?
Well, if you don’t do it, you split off this part of yourself and so there’s an impoverishment if you like. It belongs to you, but it’s only expressed in a negative way and you try not to have it. So there’s a whole part of you missing and as you experience deeper feeling, deeper feelings, that enriches the other part of yourself that can then be more in touch with the positive life aspects of yourself.
When you were training you had Wilfred Bion as your analyst. I’m curious about what that experience was like for you?
People invariably ask me that. Actually, he was my second analyst. I was quite worried about going to him. Although I wanted to go to him because I thought he was such an original thinker, which attracted me to want to go to him. But his writings are so difficult to understand. All I can say – thank goodness he didn’t talk in the way he writes, because if he had done, I wouldn’t have understood a word! When in fact he spoke very down to earth and talked about the ordinary things in my life. But to see them in a different light.
He could see that I had a biased view of relationships in my life, of some particular relationships actually and that they could be seen in a different way. And quite ordinary things, he would say something which made you think why didn’t I think of that before – it’s so true – but you haven’t thought about it before. I mean, I had another analyst before him. A very nice, South African Jewish man [Sonny Davidson who died during her analysis] who was very warm and also not just bound by theoretical concepts. A very warm relationship. And in fact, when I came to Bion, I actually found him more of a Buddha, who sat there as a Buddha. A very thoughtful man, but not as warm as my previous analyst. He didn’t come over to me as warm.
Are there aspects of Bion’s theories that have particularly affected you, influenced you?
Well, not only myself, but others – but quite particularly the importance of containment, which was a big theme of his. That what happens in a relationship, needs to happen in the very first relationship namely between mother and baby. It’s for the mother to be able to bear and absorb the pain of her baby and be in touch with it. And to think about it and in a way that then will enable her, inside herself, to integrate it in herself and behave in a way that makes it acceptable for the baby to have some pain. But some of the worst aspects of the pain has been really been taken over by some positive thinking. So it becomes, in the relationship, the basis of this capacity to inside himself manage the pain.
So we come back to the importance of being able to manage emotional pain.
Absolutely, but also that people need help with it – when they’re very distressed. First of all, the baby needs help with very overwhelming anxieties, panic in fact. And of course, the neurological findings now show that in as far as the baby has good experiences including, particularly, also containing pain by his mother. There’s a development of connections made in the brain which help, then later, to have a brain that can learn and take in a way that others may not be able to. So the question of containment as a psychotherapist being able to contain the patient’s pain is really like the mother or father who’ve helped the baby to learn to accept it.
You developed a young people’s counselling service at the Tavistock, where, for the first time young people could refer themselves for therapy. I’m interested in why you gravitated to work with adolescents.
I was working with adolescents in a way that was actually a question of circumstances. Before we moved to the building near Swiss Cottage, I mean by ‘we’, the service, the clinic, moved. The building where we’d been before in Beaumont Street, was too small to contain yet another aspect of the work, in terms of adolescents. And so, it was decided that a psychiatrist, Dr Hunter and his wife, who was a social worker, and I as a psychotherapist, would move to a different building and start an adolescent unit. Which later on, in the Swiss Cottage, in the NHS building, and became a very big department, adolescent department.
I think I was maybe also interested in it because I really didn’t have a normal adolescence in any kind of way because of the times we lived in. So maybe there was a curiosity about that. So I was very pleased to be working with adolescents. Also, of course, they undergo such enormous changes in their bodily development and their mental life, so they’re very interesting.
But the question is why did we start this counselling unit? Just before that, for some years, I had been going to Sussex University for one day a week where they wanted a psychotherapist to see patients that the doctors in this student health service had seen and it didn’t seem to be a purely somatic problem, and they wanted to refer these patients, student patients, to me to see them for an assessment. And to help them, I decided, I was only there one day a week what could I do? Take one patient on and see them intensely? No, that didn’t make sense. And, so I decided that I would offer them three sessions in that given time. And I was amazed how much work could be done because they knew the time was very limited, and so I think it heightened their wish to, or their need to, communicate.
Also, it required on my part, after the first session and the second session, to go home and think very much about the session that we’d had. Which I’d write up on the train going back, to think, well what was the main theme? How did it come up within the session in relation to me? An example that comes to mind, is a young man who was referred to me after he made a suicidal attempt. I knew from the doctor that he was living with a woman, the person that had her household there. He was the only student there and that he had been drinking a lot, and then he woke up even more depressed than he was before and more despairing. So he drank a lot more and took some pills, not actually that many.
So this is what I knew about him. He came to the session, which was for an hour, 40 minutes late, and he’s made an impression of not really being all there and I asked him ‘Why are you late?’ And he told me that he’d drunk again and, ‘And what makes you drink?’ I asked, and he told me it was so despairing, and I said, ‘And you’ve taken all the pills and drunk again? I think the first thing you need to do is go and see the doctor next door and go to the hospital, you’re in a bad state. But I think it’s also interesting that you’ve done this on the eve before coming to see me. As if you’re desperate to be helped and looked after.’
That was the beginning, and then I asked, ‘Tell me about your family?’ He told me, ‘Oh my mother was wonderful when I was a baby. She loves babies. But when the next boy was born, and she had several babies in the course of time, all her love went to that baby, and I was left all at the side.’ So I said, ‘I’ll see you when you come out of hospital.’
So here is what happened, he put himself as someone that I had to look after. Making the demand of, ‘I want to be the baby otherwise, I’ll die.’ Coming to university was like being pushed out of the mother’s lap and having to be alone again. And he couldn’t bear that.
So the very basis of our work was shown in his behaviour towards me. So I think in the first session, and Freud actually said – everything is in the first session – if only we could understand it. But some people make it that clear, so that I can work with that, in a short time, and see where we get and what’s needed. I’ll never forget that case, and of course, I’m afraid even in these days and with student health services in the universities, there are a lot of suicides, especially in the first year.
I’m curious as to what happened to that young man?
I really needed immediately for him to be seen by a doctor. He went to hospital, and when he came out of it, and he said, he was very much complaining about his mother, was so abandoning of him. It turned out, he enjoyed being in the hospital and his mother came. So she wasn’t so neglectful as he painted her. It was his experience of her but it wasn’t true. So, I could see his fantasy as opposed to the reality. And we worked with the fact that we had three sessions and there would be an end then – for the time being. If he needed more consultations with me I was prepared to see him and decide more with him.
But it seemed to me, it would be useful if he would in fact live in college, where there’s a building where people live, students live, and there’s someone there who looks after him in terms of what he needed. So that would be a much safer place for him. Although, he would have to learn, to learn about his jealousy of the others that were there and that’s what he did, and I didn’t hear from him anymore. It seems, somehow, he managed.
I’m struck by the really interesting and very important people that were around in the Tavistock Clinic when you were there. Donald Meltzer, John Bowlby, Melanie Klein. It must have been a very exciting time for you?
It was, no question. Melanie Klein wasn’t physically there, but she was, her theories and her enormous development of something of value, you’re mainly exploring the life of an infant from birth. But Anna Freud’s clinic, although she did very valuable, valuable work with children, and also explored separations, did not cover the first few months. She didn’t seem to think in terms of the relationship at the beginning of life, and Melanie Klein claimed that from the beginning of life the baby has fantasies and has a mind that works, that develops fantasies about what is going on. And how the mother behaves with the baby is absolutely fundamental to his further development, with the very early period.
So Melanie Klein was very important to us, in terms of what she had discovered about early development and how that affected development in childhood, and later on in adult life.
I’m curious about what it might have been like working with John Bowlby?
Well, that was earlier of course, before I was at the Tavistock. I was still in the smaller unit on Beaumont Street. I came there actually, originally, when I thought of becoming a social worker. I’d taken a training earlier at Birmingham University and studied social sciences and much later I came to the Tavistock where Bowlby was in charge of the department of children and parents, and he was a very lovable man and very informal. I remember Christmas parties at the Institute of Psychoanalysis, where he danced the Scottish wheel. He was a Scot of course.
He was essential in terms of child psychotherapy training. He supported it. He got funds from America even, to help students who couldn’t pay the fees to train, and I was one of those – very fortunately because at that time my parents couldn’t afford the fees.
We owe a lot to him and the work he did in terms of helping psychotherapy training to be established at his clinic. And of course, he did wonderful work in terms of exploring not only attachment, which was his main thing, but also separations.
He had a research department, in which he had Jimmy Robertson – a psychologist – who would study separation by actually filming what happens to a child. The first film he did was of a child in hospital, a young child in hospital. I forget how old she was, but certain she was well under school age, maybe she was three, but I’m not sure about the age. And he filmed what happened when this child was hospitalised and how her behaviour of having been a very happy child at home, because he filmed her there already with the mother and father. How it gradually, from being just shocked to be in hospital and at that time wasn’t what we’ve got now, in terms of visiting. And so the deterioration in her behaviour, her alienation from the mother and her being angry but also just shutting down and becoming withdrawn and lifeless in her behaviour, like in a deep depression.
It’s a film that was shown to hospital staff, later, all over the country. And it took years until it had its effect. The effect, I think largely due to this film, it was decided that there should be visiting every day and for many hours if wanted. And eventually, it turned out not only be this but also mothers being able to stay in the hospital with their children and was to a large extent the result of this. So it was done with Bowlby’s initiative.
Do you think Bowlby has got enough recognition at the Tavistock, for his work?
I think there was a time when he was not liked so much by the Kleinians, because he did not agree with or certainly didn’t develop in the way that she was developing the understanding of the relationship between mother and baby from the beginning of life. So, it’s a very different conception about, in fact their relationship, whether it’s just a attachment based on animal studies or whether it’s actually a mind that is being explored from the beginning and needs help from the mother in order to lessen the child’s anxiety.
So there was this split between the Kleinians and people who believed in attachment. Do you think it’s possible to be both, to agree with attachment and also to agree with Kleinian theory?
I think there was a time when this was like that [a split]. I think today it’s different, we’re happy to look at both Bowlby and Klein’s work.
So you taught infant observation at the Tavistock for over 50 years. You took over from Esther Bick’s seminar, I think. She discovered the benefits of observing infants in their home for the first year or two of life, and the benefits that can bring to psychoanalytic training. Why is infant observation so important for child psychotherapists to learn do you think?
Well, it is linked to what I’ve just talked about, that Melanie Klein put the emphasis on the very early development of the personality. Development that tremendously influences childhood and adulthood of this person. So, I think when you’ve done infant observation it is such an important part of the training. We used to do it and I think it’s still done as a pre-clinical training before you start seeing patients. If you think this is the basis of further development and you haven’t actually – you know it may be by theory, but you haven’t experienced it – you have to experience it by doing infant observation in which you sit, don’t film, but your mind films what is going on. Trying to observe in the greatest of detail, every movement, every expression, every cry, every changing of the baby’s position in the mother’s lap and so on. How the baby is put to sleep; how the baby is picked up; everything, absolutely everything, in the hour that you’re there.
You don’t write it down, because you should observe all the time. Not only observe, but also taking the feeling conveyed by what you see and the feeling that you experience in yourself. And then, when you write it down at home, the observation, you have a chance then to take it to your seminar, which is a very small seminar, very few people – so they have a lot of time to contribute and think. And you discover, both in terms of the leader of the discussion, how you learn to observe better because they ask you, ‘What did the mother do then? And, ‘What did the baby do then?’
So your actual questions are what you keep in mind in your observations, and in fact that the observations become better as people go along and do it more. And it’s then discussed in an analytic way to really understand the feelings exchanged between mother and baby, and it’s just amazing what you see if you really look at it in such detail and over time. To understand the baby’s movements, it’s crying, it’s smiling. How the mother looks at it or doesn’t look at it. All these things become so important and crucial to development.
It’s something that people who haven’t done it, really don’t fully take in and know. And you use it even with adults who get the deepest kind of experiences and feelings. The most primitive feeling, which only through Klein we understood and through Esther Bick, who was responsible for the seminars, and she had an incredible interaction with what the babies might be feeling – incredible! And we learned an enormous amount in the seminars from her and I did them twice for two years and watched how she was doing.
And then when she came to actually give it up, when she was in considerable age and she thought she couldn’t do it anymore, and I sat in her seminar again, and she said, well, she’d like me to take over the group. And I saw the seminar students being shocked, and they went downstairs afterwards, as I did, and I saw them hovered in a group and discussing this. And I thought I must do something right now and I said, ‘I know you’re very disappointed, but I’m afraid I’m going to be the person – because that wasn’t said by Esther Bick at the time – I’m the person who’s going to take it over. We’ll just have to do the best we can together.’ And we did – later on.
I’m wondering why Esther Bick chose you?
I think that’s purely lucky that I was just available. I don’t think she particularly liked me. I think it was just lucky, I was around to do it. But I’m grateful she did.
That sounds very self-effacing to me.
Well, as I say, she actually didn’t particularly like me. I never had that impression. I had her actually supervising one of my cases, intensive cases, and I remember how I sat there presenting, reading my notes about having seen my patient and how her face would go from having been friendly to getting grimmer and grimmer, and her jaw sinking down and she obviously didn’t like at all what I was telling her. But I had to go right through to the end of it, reading it before we could discuss it. She was very critical, very critical, which I try as a seminar leader not to be, try my best not to be.
What do you think your students have gained from you as a teacher?
Well, you know people usually don’t say much, but just even now, I got a letter this last week from somebody who said how coming to see me in my seminars and my teaching, and what a privilege it’d been for her. I was quite amazed and I was very pleased of course, very nice, very nice to write after very, very many years.
I must say, I’m very lucky, my patients, my ex-intensive patients most of them are keeping in touch with me, year after year. My adolescent training case, who actually was supervised by Meltzer, sends me roses or other flowers every Christmas. Still, after I don’t know how many years, but certainly very many. I saw her last in 1960.
1960?
Yes
The last time you saw her.
I do keep nice contact with people, or they keep with me rather – both ways.
You’ve written that you’d like to extend the psychoanalytic understanding of human relationships to include the spiritual aspect of human beings. There’s a deep interest in spirituality running through your work. Is that linked to you being from a long line of Rabbis? I know you said your father was. And I think your Grandfather?
It’s in me, I think because of my upbringing in a religious family and a father who as a Rabbi who was very liberal in his thinking. On a Sabbath he would often read to us, either from the bible or from Shakespeare. He was quite authoritarian as well, but otherwise he was also quite widely liberal – in the sense of the meaning of the word.
I think if you’re brought up in a Jewish, practising Jewish household, then everything in life is related to God, whatever it is, and to people. Whether it is the bread you eat and which you bless and thank God for; whether it’s the wine you have or whatever you do, it is all related to something beyond this world, with a sense of gratitude and positive things in life. And I think that’s in me. And I’m grateful for that.
As regards people in analysis, I think they know so much that psychoanalysis does not go together with religion, usually, and in theoretical language, it’s not touched on really, it’s rather agnostic to such thinking of religious life.
So actually, I spent many, many years getting quite old in order to think how I can link both the psychological way of thinking and a religious – anyway – a spiritual life so that it enables me to think about what’s beyond this life, beyond this planet. Which has a mystery.
I think it’s the question about interrelatedness, that it strikes me that you’re very much a person who’s very curious about others and your relationship with others and how we are all connected with each other, in some way. And also you write about our connection with nature and the universe.
Yes.
And it’s not something that you normally encounter in psychoanalytic writings.
So many people do relate to nature in a very emotional way. Trees, for instance, are evoking in us often feelings of strength, of protection, protection from the sun for instance; to the sea; to rivers. I think very many people do. The question is whether, it’s really, whether it’s just nice, or it has meaning for you? That it makes you think of, what’s the source of energy? What’s the source of life? And you’ve got it in nature in the most fantastic way. You put something in the earth and it grows, it blossoms – it also fades away. Trees are, actually, unlike that, they go on for a very long time. But flowers, no, they change very rapidly.
So, it makes you think about life. Is everything in life transitory? What is growth? And to think of the end, as well and the fading away. Although nowadays, of course, we’re beginning to go to the moon and other planets. But there are enormous horizons well beyond our reach.
You’re now mainly working in private practice doing brief and long-term psychotherapy and supervisions. Has the nature of your work changed, as you have got older?
Well, first of all, I must say I only do very little work.
You see about five patients a week you said.
I see five patients once a week, that’s not much. I used to work very many hours in the day. I don’t call that much, no. But I’m very glad to do it because I love my work. I wouldn’t take on any new patients. I might do a consultation with somebody new, but that’s all, and then refer them to somebody else. But the question arises whether it’s fair for me to do the work at all because I don’t know how long I will live. It can’t be all that long, although people live longer. But..so we’re very much talking about ending, both ending them coming to see me, and the ending of my life that they’re having to face, that I won’t be available.
I think many people in the analytic world would feel this isn’t the right thing to do, but they want to come. The patients that I’ve had for a long time and working really at being able to do the work inside themselves, rather than relying on me. And they want to come and I’m very happy to see them, and they are developing in the right direction and just thinking about themselves and able to deal with that pain for situations.
In your book, which is focusing on endings, you write, ‘What makes it possible to accept the transience of life, to bear increasing losses, face the loss of one’s own life and yet go on growing, gaining or at least maintaining emotional and spiritual strength.’ What do you think is the answer to that?
I’m not sure that it’s possible for everybody. But I do think, just basing what I’ve said all along, it is a matter of really being grateful for what you’ve got and every day we experience it as a gift. That life is a gift – rather than something we deserve. And why am I alive? I mean, by sheer accident that one is alive, and to learn to be grateful for that. If that can happen to be pro-life but accept it as a gift that doesn’t last forever, and I think, I hope, that people can come to that point through the work we do in terms of in their own family, being grateful for what has been given to them by their parents, but accepting that they’ve lost their parents.
In many people, around 50, they’ve lost their parents and then face that it is their turn next to die. Before then they thought their parents were there – I don’t have to face and think about it. But the death of a mother or father quite often puts that there’s no longer a barrier. Although, you can still forget about it most of the time.
I’m struck by you continuing to evolve and learn new things. For example, you’ve told me you started to learn the piano just over three years ago. Quite an achievement for a 96 year old.
Yes, people think so. Also, I published my last book at the age of 90 and I’ve been asked actually to extend it a bit. So, I think I’m very fortunate that I can do that. In fact, I’ve made – but that’s not why I learned the piano – I’ve learned the piano because I had been playing the cello for many years, but I couldn’t manage this physically any more. I’ve got a problem with mobility and I couldn’t carry such an instrument.
So I had to give up the music which I played since the year of seven. I’ve really played an instrument; a cello I started at 14, quite late, but I played it throughout my life until a few years ago. I missed making music and I have a beautiful piano. So I thought, why not learn to play the piano? And so I did. And amazingly, I’m making progress. I’ve actually heard that it’s very good for the mind and it’s wonderful. If I’m worried about something I can go to a piano and completely lose myself in the music. You need utter concentration and it’s a wonderful thing. But I really missed making music and this gives me the opportunity to do it, and yes, I go on wanting to do new things, as far as I can.
If you had any advice to give to the younger Isca, just starting out on her career, what would you say to her?
I’m not sure. I think I knew which direction I wanted to go. I don’t think I needed anybody’s advice for it. I was going to helping people, do social work, to teach, teaching at university and then I wanted to understand minds better, and I love children. So, that was my path, I was very lucky that it was like that.
Would you change anything?
No, not much.
And what would you like child psychotherapists most to know about what you’ve learned from your work over the last 60 years?
That each mind is different. Each individual is different. They have their own history and this makes the work enormously interesting and that everybody is important and worthwhile helping.
Thank you very much Isca for spending the time with me. I’ve really enjoyed meeting with you.
Thank you.
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