Gail A. Hornstein - To Redeem One Person Is to Redeem the World: A Life of Frieda Fromm-Reichmann

T HE F REE P RESS
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Copyright 2000 by Gail A. Hornstein
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ISBN-10: 0-7432-1569-9
ISBN-13: 978-0-7432-1569-5

In memory
of Barbara Rosenblum

Each one of us possesses a Holy Spark, but not every one exhibits it to the best advantage. It is like the diamond which cannot cast its luster if buried in the earth. But when disclosed in its appropriate setting, there is light, as from a diamond, in each one of us.

Rabbi Israel of Rizin

Contents

Prologue

There are no goals , only the goal ... to lift up the fallen and to free the imprisoned... to work toward the redemption of the world.

S eptember 28, 1948. The evening was mild. The air, misted with the memory of rain, smelled of catalpa and breeze. Paths through the grounds at Chestnut Lodge were deep in shade, the broad-brimmed trees thick with birds and leaves. A family-owned asylum in the Maryland countryside, the Lodge was often mistaken for a country estate. No fences or gates enclosed the sweeping grounds, but patients did not try to leave. Those not on locked wards walked aimlessly along the paths, watching offices in the main building flare to light in the sudden dusk. It was the first evening in weeks that no one needed seclusion or restraint, and the hallways echoed with the sound of nurses unclenching their teeth.

From the heavily screened porches at the south end of each floor, a white clapboard cottage was visible just across the path. A lamp at its side window illumined a figure at the desk. Frieda Fromm-Reichmann sat heavily in an old leather chair, a half-smoked Chesterfield in one hand, black coffee in the other, drafts of the book she was struggling to finish scattered like leaves across her desk. In less than a month, she would be fifty-nine. It had been thirteen years since she had come to work at the Lodge, and on nights like this, she could imagine herself still in Heidelberg. War and the ironies of psychoanalytic history had made hera woman, a Jew, a refugeethe most distinguished member of Chestnut Lodges staff, but no American questioned her place. For three decades, she had chosen to work primarily in hospital settings and with the most disturbed patients. She still spent hours each week with people considered beyond reach by most psychiatrists, although seniority now permitted her to treat only those who particularly interested her. For the first time in six months, she had taken on a new patient, a young woman who was, at that moment, sitting silently on a locked ward pretending not to be terrified, unable to imagine the relationship that would transform her life.

At sixteen, Joanne Greenberg was one of the youngest patients ever admitted to the Lodge. She had been seriously disturbed since the age of nine. Her behavior had the oddness we find so unsettling in mental patientsan embarrassing attentiveness to rules unknown to anyone else. Having finally become too strange to stay in school, she had been sent for an indeterminate stay at Chestnut Lodge.

There was little pattern to the strangeness, which frightened Greenbergs parents as much as the symptoms themselves. The pieces didnt seem to fit together. She refused to let anyone stand behind her, making for a slinking walk and a suspicious air. She claimed to smell odors and heard whispering from people who werent there. She spoke aloud to them sometimes, in a language no one could recognize. She ate bits of paint or wood, pieces of string, movie tickets, unprepared gelatin. Lightning petrified her. Sudden stomach pains made her double over in agony, but doctors could find no physical cause for the attacks. The plodding gait and stringy hair gave her a dull awkwardness, which seemed at odds with the biting sarcasm that took the place of ordinary talk. There was no family history of mental illness, no obvious trauma in childhood. Yet when people met Joanne Greenberg, they knew something was terribly wrong with her, even though the look on her face made them want to leave before they found out what it was.

Hidden behind the flatness, however, were unmistakable sparks of someone still present. These were rare in a schizophrenic, except in one still a teenager. Psychosis is unrelenting anguish, a torment beyond most peoples endurance, and those who end up as mental patients instead of suicides have found a way to blunt the edge. They pay a high price for this. As the lattice of lies, woven more and more tightly, blocks out the light, defenses turn parasitic, destroy the few remaining healthy parts, and then there is no way out.

Joanne Greenberg was too young to have reached that burned-out stage, but she was well on her way. Her absent stare had the look of someone What made her different from a typical schizophrenic was that the battle was still taking place. Trickles of feeling seeped through the brittleness and appeared as expressions on her face. Her indifference had a studied quality, as if she werent quite sure of it herself. People had yet to become interchangeable objects in her mind.

Frieda Fromm-Reichmann had built her reputation on the claim that no patient, however disturbed, was beyond the reach of psychotherapy. Even as a medical student, listening to wildly hallucinating patients as they screamed or raved, or sitting quietly by the beds of those who lay mute and unresponsive for days, she had been convinced that buried inside the avalanche of illness was a terrified person crying out for help. Her job was to do whatever was necessary to get that person out. She did not think of this as heroic or even particularly worthy of note; a physicians responsibility was to help patients, and she had chosen to do that work.

Friedaalmost everyone, even some patients, called her by her first name and it would be odd to refer to her in any other waywas legendary for her ability to gain the trust of even the most disturbed patient. But even she acknowledged that psychotherapy can work only if a person can stay present to the panic, at least a moment at a time. There has to be a tiny part of the mind that can separate itself from the terror long enough to see what it looks like. People who have reached the point of psychosis usually cant tolerate this; it feels too much like being in a collapsed mineshaft, told to crawl straight toward the danger just to see how bad it is. Literally paralyzed from years of fear, they choose the lesser evil, retreating to a place no one can reach.

Joanne Greenberg didnt end up like this. She began treatment with Frieda a week after arriving at Chestnut Lodge. Four years later, she was successfully attending college at nearby American University. Despite months on the disturbed ward, ripping her arms to shreds with jagged tin cans and crushing lighted cigarettes into the wounds, Greenberg made a recovery so complete she was able to marry, have children, and become an accomplished writer of novels and short stories.

It was highly unusual for a schizophrenic patient to recover at all, and the fact that Greenberg had been treated solely with psychotherapyno drugs, shock, or any other biological methodsmade her cure even more remarkable. But few people outside Chestnut Lodge knew of these events or would have believed them if they had. Frieda presented the case in disguised form in her book, Principles of Intensive Psychotherapy, and in various lectures to professional groups, but it was one among many clinical illustrations she used in the early 1950s, and she called no special attention to it. The successful outcome was satisfying to be sure, but it was also perplexing, and Frieda, always given to understatement, didnt endow it with any of the dramatic qualities it would later come to have.