Elisabeth Geleerd

Introduction

Elisabeth Rozetta Geleerd Loewenstein (20 March 1909 – 25 May 1969) was a Dutch-American psychoanalyst who became one of the mid-century authorities on the analytic treatment of severely disturbed children and adolescents. Trained in medicine in Leiden and in psychoanalysis in Vienna and London, she belonged to the circle of analysts formed around Anna Freud, and she carried that tradition to the United States, where she spent five years at the Menninger Clinic before settling in New York.

Geleerd worked on what were then unpromising cases: children diagnosed with schizophrenia, psychosis and unexplained fugue states. She argued that such children were not simply unanalysable, and she set out to describe the specific defences their egos used against early, overwhelming trauma. Her 1958 paper on borderline states in childhood made her one of the first writers to take seriously the possibility of borderline pathology in young patients. She died in New York at the age of sixty, remembered by colleagues as an unusually empathic clinician and a forceful, independent thinker.

Early Life and Education

She was born in Rotterdam on 20 March 1909, the eldest of three children of Moses Geleerd, a successful ship chandler, and Bertha Geleerd, née Haas. The family was Jewish and secular; her father was an atheist. Her mother suffered from tuberculosis throughout Geleerd's childhood and died of it when Geleerd was nine or ten. She and her two younger brothers, Yap and Benedictus, were placed in the care of an aunt, an arrangement she later described as unhappy, and she returned to her father's house in early adolescence. Her father was distant and absorbed in business, but he supported her ambition to become a physician. Some years after her mother's death, Yap also died of tuberculosis, and these bereavements are usually credited with pushing her toward medicine.

She entered the medical school of the University of Leiden and qualified in the mid-1930s. Reference works date her medical degree to 1936, while the Library of Congress guide to her papers records the degree in 1934 followed by two years of externship at the Leiden medical school; the gap is not settled. A friend, the analyst Helen Tartakoff, judged that going to Vienna afterwards was "a revolt from tradition even in the 1930s," since Geleerd chose analytic training over the conventional academic psychiatry career that her medical credentials could have opened.

In 1936 she moved to Vienna and enrolled at the Vienna Psychoanalytic Institute, where her training analyst was Anna Freud. The Anschluss and the worsening position of Jews in Austria ended that phase in 1938, and she moved to London to complete her training at the Institute of Psychoanalysis, the training school of the British Psychoanalytical Society. In London she continued to work with Anna Freud, served as a psychiatrist at the Maudsley Hospital, worked with refugees at the Tavistock Clinic, and joined other analysts, including Ruth Mack Brunswick, in helping Viennese colleagues escape and resettle. Her father and surviving brother fled separately to southern France and Switzerland, severing her remaining ties to the Netherlands, a country she had found stifling and where she never quite felt at home.

Academic and Professional Career

Geleerd emigrated to the United States in 1940 and went to Topeka, Kansas, joining the staff of the Menninger Clinic, where she worked from 1940 to 1945. She served as child analyst at the Southard School, the clinic's residential school for children, and from 1943 to 1945 as its director of psychotherapy. Drawing on her wartime London experience, she encouraged parents to speak honestly with children about the war rather than shielding them from it, on the view that incomprehension was more frightening than knowledge.

She moved to New York in 1946 and married the psychoanalyst Rudolph M. Loewenstein on 13 July of that year; Loewenstein was a prominent figure in French and American analysis, known for his role in training Jacques Lacan. Their only child, Richard, became a psychiatrist. Geleerd entered private practice and, in 1947, joined the faculty of the New York Psychoanalytic Institute as a training analyst. From 1955 she served on the institute's educational committee, and through both roles she shaped its developing programme in child and adolescent analysis. She supervised several generations of child analysts, taught, and wrote while living with chronic illness for much of her adult life. She died in New York on 25 May 1969.

Major Contributions to Psychology

Childhood Psychosis

The core of her clinical reputation was the claim that psychotic children could be analysed if the analyst adapted technique to the child's defensive organisation. In an early paper of 1946 she argued that certain behavioural disturbances in children were themselves signs of psychosis rather than precursors of it, and that analysis might favourably influence the course of the disorder. A later case report, "The Psychoanalysis of a Psychotic Child," set out in detail how she worked with a child whose hold on reality was fragile.

Her explanatory framework was ego psychology: rather than treating hallucinations and withdrawal as noise, she read them as defensive operations protecting a vulnerable ego against unbearable anxiety arising in the earliest mother-child relationship. That reading implied a clinical posture of patience and precision about defence rather than confrontation, and it supplied the rationale for attempting analytic work with children whom most psychiatrists of the period would have considered beyond reach.

Borderline States in Childhood

In 1958 she published "Borderline States in Childhood and Adolescence," building on Margaret Mahler's description of autistic, psychotic and "third group" children and linking that residual third group to what adult analysts were calling borderline pathology. In doing so she became one of the first psychoanalysts to argue that borderline organisation could be identified and treated in childhood. The notion was taken up and elaborated by analysts working in the 1960s and 1970s, and it remains part of the background of later debates about personality pathology in young people.

Adolescence and Ego Vicissitudes

Her writing on adolescence treated it as a period in which the ego's defences are reorganised under pressure rather than simply reactivated. She described the swings of idealisation and denigration, asceticism and impulsivity, characteristic of the years in which earlier compromises break down, and she insisted these could be understood structurally rather than merely managed. Her discussion of amnesia and fugue states, written with Frederick J. Hacker and David Rapaport during her Menninger years, applied the same logic to dissociative conditions in young people, tracing them to specific defensive functions.

A Freudian Critic of Kleinian Technique

Geleerd belonged to the classical Freudian wing of child analysis and was a persistent critic of the Kleinian school, though not a wholesale rejecter of it. She accepted the significance of the first year of life and was most receptive to Kleinian ideas where psychosis was concerned. She dissented sharply, however, from what she regarded as an excessively permissive technique that granted children "all possible freedom of observation," arguing that severely disturbed children needed a far more deliberate and bounded analytic frame. Her 1963 evaluation of the posthumously published Narrative of a Child Analysis by Melanie Klein set her objections out at length.

Major Publications

Geleerd wrote comparatively few books, and much of her influence travelled through papers and through the volume she assembled to illustrate classical child analytic work.

The Child Analyst at Work (1967), edited by Geleerd and published by International Universities Press, a collection of case reports intended to give analysts something that had not previously existed in print, a portrait of Freudian rather than Kleinian technique.
"Contribution to the Study of Amnesia and Allied Conditions," with Frederick J. Hacker and David Rapaport, The Psychoanalytic Quarterly 14 (1945): 199–220.
"Borderline States in Childhood and Adolescence," The Psychoanalytic Study of the Child 13 (1958): 279–295.
"Evaluation of Melanie Klein's Narrative of a Child Analysis," International Journal of Psychoanalysis 44 (1963): 493–506.
"Child Analysis: Research, Treatment and Prophylaxis," Journal of the American Psychoanalytic Association 12 (1964): 242–258.

Impact and Legacy

Geleerd's historical position is real but uneasy, and it cannot be described honestly without acknowledging that much of her diagnostic world has been redrawn. The category of childhood schizophrenia that anchored her best known work has largely disappeared from Anglo-American practice; most of the children she wrote about would today be classified on the autism spectrum or within other neurodevelopmental conditions understood as strongly heritable. The etiological language in which she framed her cases, which located the damage primarily in the mother-child relationship, belongs to an era in which such claims were made without controls and did real harm to families, whether or not it was intended to. Her therapeutic claims rested on uncontrolled case reports: she reported that analysis "may have favorably influenced the course" of psychotic illness, which by contemporary standards is not evidence of efficacy. The construct she popularised for children, borderline organisation, has also been questioned for its stability and for the risk of pathologising ordinary developmental turbulence.

Her defenders make several points in reply. Her critics read her as a theorist of maternal blame, whereas her papers dwell less on parental causation than on describing what the child's ego was doing and how the analyst could meet it, a focus continuous with later attachment-informed and mentalisation-based clinical work. Her insistence that disturbed children can be thought about rather than merely contained was not a universal view when she wrote it. Her reviewers judged The Child Analyst at Work an excellent portrait of classical technique, albeit diffuse because it was assembled from previously published papers. Above all, her legacy is institutional: she trained many of the American child analysts of the following two generations and helped build the child training programme at the New York Psychoanalytic Institute.

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Anna Freud, whose Vienna circle shaped Geleerd's training and whose tradition she defended.
Melanie Klein, whose technique Geleerd criticised at length.
Margaret Mahler, whose account of disturbed children Geleerd extended to borderline states.
Psychoanalysis, for the wider tradition within which she worked.