The Return of the Repressed
The strange case of Masud Khan
Robert S. Boynton
February 2001 the psychoanalytic world was shaken by a London Review
of Books article by Wynne Godley, visiting scholar at Bard Colleges
Levi Economics Institute, professor emeritus of applied economics at
Cambridge University, and onetime member of H.M. Treasury Panel of Independent
Forecasters (the so-called Six Wise Men). Saving Masud Khan
tells the story of Godleys lengthy psychoanalysis with
Within minutes of our first meeting, the therapeutic relationship had been totally subverted, he writes. In later sessions Khan violated every conceivable boundary between analyst and patient. He assaulted Godley with verbal tirades (And to think you people ruled the world!). He gossiped freely about his A-list social life (Rudolph Nureyev, Julie Christie, Peter OToole, Mike Nichols) and his other patients, going so far as to arrange a liaison between Godley (who was happily married) and a female patient (Khan said they were handmade for one another). The three of themtwo patients and their analysteven played poker together (Khan cheated). In less jovial circumstances, Godley witnessed a drunken row between Khan and his wife, the Royal Ballets beautiful prima ballerina Svetlana Beriosova, which ended with her kicking Khan in the groin and then passing out in the front hall.
The article was devastating because Khan had been one of psychoanalysiss best and brightesta senior training analyst, a director of the Sigmund Freud Copyrights, an Anna Freud protégé, and longtime collaborator with the most famous child analyst of the twentieth century, D. W. Winnicott (Khan edited and, some speculate, may have coauthored much of his mentors voluminous output of books and papers). With his impeccable pedigree he was the link between the legendary first generation and some of todays most important analysts. Indeed, Anna Freud insisted that Khan understood her fathers work better than anyone (other than herself, of course), and she defended him whenever he aroused the Societys ire.
The professional reaction to Godleys revelations has been swift and defensive. While it is no secret that equally serious violations of the professional boundary between analyst and patient plague analysis today, there remains the damning fact in his case that many of Khans contemporariesthe venerable Winnicott includedknew of his infractions at the time he was committing them but did nothing. This is like a return to the days of Freud and the earliest psychoanalytic pioneers. Everything is being criticized and re-evaluated here, everything is up for grabs, says Gregorio Kohon, an animated Argentine émigré and senior member of Londons Institute of Psycho-Analysis who studied with Khan in the early 1970s. Every family has secrets. And what we are witnessing in the family of psychoanalysis is nothing less than the return of the repressed. Kohon suggests that the present purging of the tradition may be the first steps of a return to the original promise of psychoanalysis.
Between 1895 and 1905 Freuds search for a cure for paralyzing nervous disorders developed into a full-blown science of the mind. According to his early theory, painful memories and feelings were repressed by the unconscious and found expression in patients physical symptoms. After trying hypnosis and other forms of suggestion, Freud discovered that a patient could alleviate his own problems by free-associating, thereby bringing these memories to the fore. But Freud noticed that in the process of doing so the patient would direct (or transfer) the intense emotions he associated with people from his past to his analyst.
Freuds discovery of transference (and countertransferencethe displaced emotions from his past that the analyst imposes on the patient) was the center of his theory of psychoanalysis. Carefully handled, transference was the key to psychoanalysiss curative potential, but only if the strict professional boundaries between patient and analyst were maintained. In Recommendations to Physicians Practicing Psycho-Analysis (1912), Freud described the boundaries necessary to regulate the confusion that improperly handled transference would wreak on the analytic relationship. The analyst must listen to the patients free association in a state of evenly suspended attention; he must remain opaque and resist the temptation to influence or improve the patient. The goal of psychoanalysis was for the analyst to use his own unconscious like a receptive organ toward the transmitting unconscious of the patient, Freud wrote. Improperly handled, the analyst and patient may reenact rather than analyze away the vexed relationships each had with figures from their pasts. The dangers inherent in the psychoanalytic relationship have never been denied.
* * *
While psychoanalysis sometimes seems in a state of perpetual crisis, even the most jaded observers believe the Khan-Godley affair comes at a defining moment in its history. Today nearly all of Freuds conceptstransference, countertransference, repression, the Oedipus complexare under scrutiny. The cumulative critiques by writers like Frederick Crews, Adolph Grunbaum, Frank Sulloway, and Peter Swales have forced psychoanalysiss defenders to reconsider its scientific basis as well as the standard story of its founding and development. Psychoanalysiss most sophisticated interpreters have acknowledged these failings, appropriated the critics insights, and tried to move on. Research in neuroscience is affirming many of Freuds ideas about the unconscious. Cultural critics draw insight from Freuds philosophical inquiries. Whether the new psychoanalysts perceive themselves as philosophers, scientists, or cultural critics, they agree that this is a particularly fertile moment for reenvisioning Freuds larger project. The questions at the heart of psychoanalysisits promise to throw light on why we do the things we do, why we have trouble doing what we want to do, and why we suffercontinue to compel.
The theoretical debate has had implications for the practice of psychoanalysis, and the scandal about Kahn has revived several long-simmering disputes. Is the aim of psychoanalysis to cure or merely to comfort? Should analysts maintain a clinical, professional distance and respect the boundaries between themselves and their patients (as classical analysis insists upon)? Or should they strive for a so-called real relationship, eroding the boundaries in order to heal the patient? And, more specifically, many are questioning whether Khans behavior was so anomalous, or whether certain ideas within the British tradition itself unwittingly encourage such flagrant boundary violations. Did the very tradition that trained Khan as an analyst fail him as a patient? Was the saintly Winnicott to blame? Was Khanwho tormented so manyhimself a victim?
I was stunned when I read Godleys piece. Although skeptical about the scientific basis for and efficacy of psychoanalysis, I had always thought of the Winnicottian tradition that produced Khan as defined by its gentleness and empathymuch like Winnicott himself. Khan was especially popular among literary and creative people; he analyzed Christopher Bollas and Adam Phillips, analysts and prolific writers whose work explores what Phillips has called the post-Freudian Freud, or the wild Freud who champions creativity and the fully lived life over the stern Enlightenment Freud who prescribes rigorous interpretation and self-knowledge. I had previously written about Phillips, who, as one who was analyzed by Khan, and had authored an excellent monograph on Winnicott, clearly perceived himself as carrying on their tradition. From Winnicott to Khan, to Bollas to Phillips, the move is toward finding and enlarging the self, writes Linda Hopkins, a psychoanalyst who is writing Blessings and Humiliations, the first full-length biography of Khan. The aim of the new analysis is to help a person to feel alive, to be open to change, not to be cured of an illness. The analyst seeks to deepen and enlarge the scope of experience. It is better to be alive, real and mad than to be living from a false self.
But the monstrous Khan described by Godley bore no relation to the warm, whimsical man Phillips recalled so fondly to me. Did Khan have a split personality? Or were the conflicting accounts of Khans behavior merely proof-positive of his empathic talent for transforming himself into the analyst a patient neededthough perhaps did not want? Did Khan represent the perverse, reducto ad absurdum of Winnicotts ideas, or did he embody their the most perfect, logical expression?
* * *
I made an appointment to talk to Godley and one late-summer day drove ninety miles north of New York City to Bard College. The Levy Economics Institute is housed in a turn-of-the-century mansion looking down over an ornate Italian garden and out across the wide, green expanse of the Hudson River. At age seventy-seven, Godley has the unmistakable bearing of an aristocrat. Tall and slender, with a lean, handsome face, he is dressed with the nonchalance of those truly to the manor born: scuffed slippers, worn khakis, a frayed blue shirt and a baggy maroon wool sweaterno matter that it is a sweltering late-summer day.
Over lunch Godley tells me about Khan with a mixture of ennui and despair; his tone is so remote he might well be recounting someone elses analysis. During their seven years of daily analytic sessions, Godley says Khan discouraged him from recounting his childhood or past: everything of real significance, Khan assured him, was taking place between the two of them. Of course this gave him a license to interfere actively, judgmentally, and with extraordinary cruelty in every aspect of my daily life, writes Godley. Khan would occasionally show up at Godleys house, drunk and unannounced, to torment his stepdaughter (who was herself in analysis with Winnicott, Khans mentor) and harass his wife.
Godley wont allow me to record our conversation and seems as if he is trying to keep from mentioning any details beyond those hes already revealed. So when I pose what seems to me the obvious questionWhy didnt you simply leave Khan?he seems thrown off-script.
His eyes dart around the restaurant nervously before he looks down and speaks slowly, using words I later learn are paraphrased from another scriptan e-mail discussion he participated in with several analysts. I had been beaten into the ground and made a Faustian bargain, he says gravely. In return for my servitude I was granted an incredibly deceptive appearance of a life and of worldly success, which seemed to do everyone credit. It was doomed, of course. All this left me with a sense of shame which took a long time to discharge . . . he trails off. But dont you think that the real question is not why I stayed, but why Khan was admitted to the Institute of Psycho-Analysis in the first place?
Godley tells me about his unhappy childhood. Raised amidst great wealth by a distant, alcoholic father and an erratic mother (she would occasionally parade in front of her son naked while describing the intense pleasure she got from sexual intercourse), he felt unmoored from the start. After Oxford, where he was mentored by Isaiah Berlin (who became a lifelong friend), and a brief career as a professional oboist in Paris, Godley began a career at the Treasury. He married the sculptor Jacob Epsteins daughter, Elizabeth, who had previously been married to the artist Lucian Freud (Sigmunds grandson). Despite his successful career and marriage Godley was tormented by depression and hallucinations and sought help from the only analyst he knew of, D.W. Winnicott, then president of the British Psycho-Analytical Society. Winnicott referred him to Khan, who wasunbeknownst to Godleyboth Winnicotts protégé and patient.
However awful Godleys account, one shouldnt get the impression that Khan hated him. Quite the contrary. The strange thing is that Masud really loved Godley. He was one of his favorite patients, one analyst tells me. Indeed, Khan was as capable of generosity as he was of sadism. Even as he tormented Godley he also showered him with presents: a complete set of the Encyclopedia Britannica, a Leger lithograph signed by the artist, expensive first editions of books. Once, when Godley had the flu, Khan sent another patient (a physician) to his home to take care of him. I opened my eyes and saw this man, who I knew was Khans patient, leaning over me with a stethoscope. I tried not to giggle, but I found the whole situation absurd, Godley remembers. (Godley says that Khans destructive influence was eventually undone at the hands of a skilful, patient and selfless American analyst.)
Soon after Godleys article appeared, Donald Campbell, then the Societys president, launched a full-scale investigation, which included studying minutes of past council and committee meetings and interviewing senior members who had known Khan. A closed meeting was called to discuss the affair. It had two aims, Campbell tells me. First, to think about how the Society failed to protect Khans patients and psychoanalysis, and, second, to focus on the institutional issues and the unconscious collusion that took place, in order to better safeguard the practice of psychoanalysis in the future, he says.
When the confidential report was shared
with members (though not the public) it became clear that the Societys
collusion had begun with Khans training in 1946. Although he failed
to complete his first psychoanalytic case successfullya case,
moreover, supervised by Anna Freud herselfKhan was nevertheless
officially qualified as an analyst, which was a blatant violation of
the Societys rules. Reading the minutes [of Khans
evaluation sessions] one gets the impression that there is a certain
momentum to his getting through the training, the confidential
report observes. Thus blessed, Khan was on his way.
According to the investigation, members of the Society continued to collude with Khan even after he had an extremely public affair with a patient who was training with him to be an analyst. When her husbandwho was also training at the Institute, although not with Khancomplained to the Institutes president, it was some time before he was even believed and action was taken. (Khan later had an affair with a woman whose husband he was treating.)
The report also found a variety of less serious boundary violations. Khan dined regularly with the father of one of his high profile female patients. He frequently phoned patients in the middle of the night and barged into their homes, drunk and disturbed. I wasnt the only one, says Godley. Khan was a serial killer.
Tall (6'2";), darkly handsome, and impeccably tailored (Saville Row with a dash of the Raj), Khan was hardly the stereotypical, self-effacing shrink. He claimed to be a Pakistani prince and had a gold nameplate affixed to his door that read His Royal Highness Masud Khan. Eschewing the leafy Hampstead suburb favored by London analysts, he lived smack in the middle of the busy city, near Harrods in an elegant Hans Crescent apartment building. Sir Michael Redgrave and his family were neighbors. Khans apartment was filled with valuable Impressionist and post-Impressionist art, as well as a fine collection of first editions of contemporary French and English novels.
In 1959 he married the ballerina Svetlana Beriosova, through whom he acquired a far-flung set of celebrity friends. Rudolph Nureyev, Julie Christie, Peter OToole, Mike Nichols, Francois Truffaut, Princess Margaret, and Julie Andrews (Beriosova was her daughters godmother) attended parties where Khan circulated among guests performing instant analyses as a kind of party trickan act which inspired his friend, the literary critic Frank Kermode, to dub him a circus analyst. (In a further twist, Kermode became Godleys friend when they were scholars at Cambridge, and it was he who recommended Godleys memoir to the London Review of Books.)
Despite his considerable charm, Khan could also be ill-behaved and overbearing. He did rather outrageous things, much like an impetuous undergraduate or, worse still, the lord of the manor, Kermode tells me. He recalls an evening when Khan bullied Kermodes wife, reducing her to tears as the three shared a quiet dinner. Kermode warned Khan to stop or they would leave. When Khan didnt stop, Kermode got up to go, only to find that Khan was blocking his path. When I got up he said, You cant get out unless I move! I said, Oh, I can, actually. Ill just get up on the table and scatter your fine crystal and chinaware on my way out! Kermode had one foot on the table when Khan finally allowed them to leave. On another occasion Kermode was one of a dozen guests at one of Khans formal dinner parties. As the first course was served, Khan swept into the dining room with a black cape and cane and announced that he had an engagement at the Pakistani Embassy to attend. He told his guests to leave.
Khans manners were no better when he kept his appointments. The director Mike Nichols, a close friend in the 1960s, remembers a dinner party at which Khan spied a man flirting with a woman at the end of the table. You are wasting your time, sir! You are barking up the wrong tree! bellows Nichols, imitating Khans clipped Pakistani accent. Cant you see that she is a lesbian! On another occasion, Nichols says, Khan sent a chocolate cake to an obese man at another table at the restaurant, calling across to him as it was delivered, So that you might die sooner! Some suspected Khans mischief was designed to show off his Svengali-like powers of persuasion. Once, while drinking champagne with the French analyst Andre Green, Khan deliberately nudged the bottle off the table, sending it crashing to the floor. He then turned to the man at the adjacent table and demanded an apology, creating such a scene that the innocent diner eventually bought them a new bottle.
Perhaps the most remarkable thing about Khans behavior was that it usually went unchallenged. One reason, suggests Kermode, was Khans intelligence. He recalls a standing-room-only lecture by Lacan at Londons Institute Français in the mid-1960s, when the French analyst was at the height of his fame. It was boring and went on for three hours. Finally, Masud strode up to the stage and interrupted him saying, No, youre explaining this incorrectly. Khan then proceeded to offer his own version of Lacanian theory while Lacan beamed with admiration. He was obviously quite fond of Masud, Kermode tells me.
When brilliance wasnt enough, Khan was skillful at manipulating his outsider status as a tall, dark, confrontational Muslim in a world of small, white, taciturn analysts. He continually used subtle measures to make all the superior Westerners feel very inferior, writes Judy Cooper, Khans patient and first biographer. Godley suggests Khans dual personaethe bully and the charismaticwere uniquely suited for exploiting British reticence and reserve. When not daring an opponent (or analysand) to call his bluff, he seduced them. Karl Menninger often told the story of Khans lecture at his clinic, after which he promised to send Menningeran avid horsemanfour Arabian stallions from his royal stables in Pakistan. Needless to say, they never arrived. Years later, when confronted by a colleague of Menningers, Khan didnt dispute the account. Dont you know? he explained, I always tell people what they want to hear.
* * *
How did Freuds science of the mind end up producing someone like Khan? How did Kahn thrive in the most exclusive precincts of the psychoanalytic world? One theory I heard as I talked with British analysts is that Khans adopted country provided peculiarly fertile soil for the iconoclastic practitioners of Freuds iconoclastic methods. Psychoanalysts and their patients were tolerated as part of a wild but harmless bunch of eccentrics in a land of eccentrics, writes Gregorio Kohon in the introduction to The British School of Psychoanalysis, his edited collection of the classic papers from the Independent tradition.
As distinct from the story of psychoanalysis in America, where renegades founded far-flung institutes dedicated to every conceivable variation of analysis, British psychoanalysis (or psycho-analysis, as it is known there) developed within the confines of a single official organization: The Institute of Psycho-Analysis. While there are many schools in BritainFreudian, Kleinian, Independent, Anna Freudian, attachment theorythey all exist (uneasily, at times) in one place.
And that place was the singlehanded creation of Ernest Jones. Today best known as the author of Freuds authorized biography, Jones had already established a successful neurological career when he grew frustrated by medicines inability to understand the quirks and pathologies of the mind. He read Freuds Dora in 1905 and met Freud himself in Salzburg in 1908 at the first Psycho-Analytic Congress, where Jones was presenting his paper, Rationalization in Everyday Life, in which he coined the term. Jones was subsequently analyzed by Sandor Ferenczi (psychoanalysiss most famous boundary violator, he was infamous for kissing and hugging his patients) between 1911 and 1913, and in 1919 he established the British Psycho-Analytical Society, over which he presided until 1944.
From the moment it was founded, the tension at the Society was between those who wanted to maintain Freuds project and those who wanted to depart from it. The two central debates were over child analysis and the role of the environment (sometimes called object relations)as opposed to libidinal internal drivesin diagnosing and treating mental illness.
Freuds British followers always emphasized psychoanalysiss applicability to children. This emphasis deepened in 1926 when Jones invited Melanie Klein to immigrate to London from Berlin. Kleins first paper, Notes on the Psycho-analysis of a Child Aged Five Years, argued that childrens fantasies were linked to their weaning and toilet training. Klein argued that the Oedipus complex emerged in the earliest months of life, rather than between age three and five years as Freud believed. Her most dramatic, though indirect, challenge to Freud came when she opened a 1927 symposium on child analysis with a vigorous critique of Anna Freuds Introduction to the Technique of the Analysis of Children. Many, including Freud, wondered whether Klein was breaking with psychoanalysisas Jung had done earlierrather than merely extending it.
World War II brought a deluge of European analysts to London, including Freud himself, who escaped from Vienna only after Jones, Princess Marie Bonaparte, and William Bullitt, the American Ambassador to France (both he and Bonaparte had been Freuds patients), struck a deal with the Nazis. When the Freud entourage arrived in London on 6 June1938, they were grateful but also fearful that Kleins ideas might already have supplanted Freuds own.
When Freud died in September 1939 the fighting among his children intensified. While some venerated Anna as a brilliant child analyst, others suspected her renown resulted from nepotism and resented her self-appointed role as guardian of her fathers legacy. And Anna rightly suspected that many of her fathers students disliked her. Even Jones, close family friend and savior, suggested in a letter to Klein that Anna was a tough and indigestible morsel [who has] probably gone as far in analysis as she can and has no pioneering originality.
The Freud-Klein debate came to a head during the 19431944 Controversial Discussions. In the midst of the Blitz, Britains psychoanalytic establishment waged a war of its own. Where many people found a new communality under the threats of war, Eric Rayner observes delicately in his study, The Independent Mind in British Psychoanalysis, the opposite happened to psychoanalysts in London.
Essentially, the Freud-Klein debate was over the primacy of caring versus confrontation in analysis. Anna Freud held that the point of child analysis was to help ill children, a goal she believed required a positive, caring connection. Given a childs limited verbal facility, Freud didnt believe it was possible for the classical transference relationship to develop; she conceived of child analysis as a process of play, which would help the analyst make various interpretations.
In contrast, Klein equated childs play with the psychoanalytic free association of adult patients and used it to work back to a childs early aggressive fantasies. Klein argued that this aggression was far more vicious than anything the Freudians could imagine. For Freud, the child is a selfish savage, observes the historian Peter Gay. For Klein, it is a murderous cannibal. Furthermore, Klein insisted on confronting patients directly with the meaning of their aggressive fantasiesa technique which downplayed the importance of the care Anna Freud believed essential for a successful analysis.
Aware that her confrontational method clashed with the more compassionate techniques of the Society, Klein told Jones she feared her concept of depression is for many people too painful and too difficult to accept and has therefore the effect of making them regress to former and safer positions. This safer position was precisely the territory in which Winnicotts analysis of Khan was conducted. The emphasis was on creating a secure situation, not so much for interpretation but so Khan could experience a reliable relationship with his analyst. The difficult feelings that undoubtedly arose between the two menKhans narcissism, and his intimidation of Winnicott; Winnicotts paternalism toward, and extreme dependence on Khanmay have required a more confrontational, structured analytical relationship in order to be resolved.
* * *
By the conclusion of the Controversial Discussions the chasm had so widened that the Society struck a quintessentially British compromise: they would agree to disagree on the nature of psychoanalytic theory and practice, ensuring only that future generations of analysts be exposed to both perspectives. They divided the Society into three groups: A teachers were drawn from the Society at large, and B teachers from Anna Freuds followers. Furthermore, the supervisor of a candidates first analytic case would come from his own group, but the supervisor of his second case would be an analyst who identified with neither the Kleinians nor the Anna Freudians. In precisely this safer position, a nether region between the Freudians and the Kleinians, between compassion and confrontation, the Middle Group (now called the Independent Group)among the most prominent of whom were Winnicott, Khan, Margaret Little, Marion Milner, W. R. D. Fairbairn, Nina Coltart, Michael Balint, and John Bowlbywas born.
From the start, the Middle Group was more concerned with the relationships between people than with the drives within them. While Freud and Klein had charted the tumultuous inner world, Middle Group analysts like Winnicott and Khan appropriated their insights and used them to understand interpersonal relationships.
Winnicott placed the environmentprimarily
the mother-child relationshipat the center of his work. For him
a mother has a dual responsibility: first, to protect the infant from
the environment; second, to survive the attacks of her murderous
cannibal, the Kleinian child. Winnicott called this protective
process holding and he extended its use to his adult
clinical practice. In his quest to develop a safe holding space
he often blurred classical formalities of psychoanalysis, taking phone
calls from patients during sessions and offering extended visits at
odd times. With some patients Winnicott literally held their
hands or heads, much as one might cradle a scared infant. For the most
troubled patients, like Khan, Winnicott believed that a safe holding
environment was all that analysis had to offer.
* * *
In the 1960s, at the height of Kahns
career, psychoanalytic London
Like many émigrés, Gregorio
Kohon was drawn to 1960s London by its openness to experimentation.
By day Laings students discussed
T.S. Eliots Four Quartets, Christian mystics, Sartre, and
Buddhist texts. By night they lived in makeshift communes, abandoned
houses they had occupied and rehabilitated. Kohon shared his house with
five roommates; two other Laing students and three patients who suffered
from various degrees of schizophrenia and psychosis. It was a
very unstructured institutional living situation. The idea was to create
a space for psychoanalysis in which patients didnt feel persecuted.
We were training and treating them by participating in their
lives, he says. Everyone shared the housekeeping tasks. One of
Kohons obsessive-compulsive flatmates would begin cooking dinner
at ten in the morning and become so involved in the recipes that by
ten that night the meal would still not be ready. Another ate only uncooked
grains; on his nights in the kitchen, Kohon resigned himself to uncooked
rice and rock-hard beans.
Like Laing, Khan was perceived as a revolutionary. As a clinician, Khan was known for taking on the tough cases, the patients whose previous analysts had given up on them. He used unorthodox methods, breaking the analytic frame by shocking a patient, sometimes violently. Anything to establish a real relationship.
Khan was an equally iconoclastic teacher. He was an abuser, but he was also one of the most inspired teachers Ive ever had, says Kohon. Hed walk into a seminar, point to a student and say, Ive been hearing a lot about you! And what he had been hearing was obviously from the couch! Now, if you are a student and a teacher says that to you, you dont dare open your mouth.
Although controversial, Khans techniques were more or less in keeping with the 1960s experimental culture of people like Laing, and even of the far tamer Independent School of analysts. In the wake of Winnicotts ideas about the importance of the analytic relationship, a number of analysts experimented with the analysts side of that coupling. The stereotypical passive analyst was out of fashion. In her seminal paper, Slouching towards Bethlehem . . . or Thinking the Unthinkable in Psychoanalysis, Nina Coltart describes a patient who brooded silently day after day until Coltart became so filled with rage she screamed at him. I simply and suddenly became furious and bawled him out for his prolonged lethal attack on me and on the analysis, she writes. This outburst of mine changed the course of the analysis.
One hears sometimes that the Independent Group is not a middle group but a muddled group. There is some truth to this, writes Gregorio Kohon. While analysts in the Independent tradition pride themselves on their clinical skills, they confess they are often less theoretically rigorous than, say, the Kleinians. This flexibility, they argue, allows them to be more alert, more available for their patients. They consider the Independent analysts ability to listen, to open himself to his patients experience, one characteristic that sets the Independents apart from (and often above) other schools. Unimpeded by rigid theory, they are reputed to be the mavericks of psychoanalysis. Dislike of system-building, often characteristic of empiricism, can bring about neglect of coherent theory, which at best can give strength to the practice of a difficult technique in the face of adversity, writes Eric Rayner in his study of the group.
Kohon makes the point more bluntly. What other people might see as their handicap is in fact the Independents strength. What they have to offer is primarily but not exclusively a professional stance, a professional attitude. This is what allows the necessary distance of the analyst from the patient, he writes.
But what happens when an analyst fails to maintain a professional attitude, fails to respect the distance between the analyst and the patient, as Khan did? Is it an accident that the very theoretical scaffolding which helps an analyst keep his distance from a patient was alien to the tradition that trained and treated Khan?
If you dont have a good theory of the interaction process, you are at the mercy of it, says Peter Fonagy. This doesnt mean you need the right theory, but you need to have a firm and good theory to hold on to. Otherwise the interpersonal encounter with the patient is so powerful that it simply washes you away. The trouble with the Independents is that they have been so keen on the experiential aspect of analysis they forgot about the psychological mechanisms. They didnt know what the hell was going on and some got washed away.
Getting washed away by the power of the analytic relationship has been one of the occupational hazards of psychoanalysis since its inception. Freuds first collaborator, Joseph Breuer, fled from Anna O. when she aroused sexual feelings in him. In The Future Prospects of Psychoanalysis, Freud labeled this experience countertransferencethe process in which an analysts emotions, positive or negative, are aroused by the patientand diagnosed it as a neurosis which an analyst must overcome in order to do his job properly.
Since Freud, there have been three main attitudes towards countertransference, explains Robert Young, a Texas-born, London-based analyst who was formerly the publisher of Free Association Books and a Cambridge don. He sums up the history of countertransference for me, citing several papers he has written on the subject. An analyst can get rid of his countertransference through analysis and concentrate on the patients transference. He can try to exploit it in a controlled way, as Freud says when he advocates using the therapists unconscious as an instrument for fathoming the patients unconscious. Or he can, more or less, just go with it, and treat this unconscious-to-unconscious communication as the only authentical communication between analyst and patient, he tells me.
One of the clinical techniques the Independents are most proud of is their use of countertransference. Given the emphasis on this interrelation between patient and analyst, countertransference has developed as the source of the most important clues for the formulation of transference interpretations, writes Kohon. The notion that analysts should go with it, that they should rely on their countertransferential responses to the patient for importantperhaps the most importantdata was in vogue during Khans training. For the Independents, countertransference went from being pathological, to being normal, to being essential. In the wrong hands, the danger of relying on countertransference is clear. Basing all interpretations on countertransference feelings denies what the patient has to say, Kohon warns.
* * *
Speculation about Khans fifteen-year analysis with Winnicott has become a mini-industry, studied by those looking for the seeds both of Khans self-destruction and of psychoanalysiss flaws. Theirs was a complex relationship, alternating between filial indulgence and collegial rivalry. Winnicott, the chief theorist of childhood, hadnt been able to have children with either of his two wives (the first of whom was psychotic) and longed for a son. Khan meanwhile was ashamed of his mother and grieving for his father, not to mention his first two analysts. By the time he started analysis with Winnicott, Khan had been so traumatized by the loss of Sharpe and Rickman that when Winnicott (who had suffered several heart attacks) would occasionally fall asleep during Khans session, Khan would start up, anxiously looking behind the couch to make sure his thirdanalyst hadnt died. To complicate matters further Winnicott also analysed Khans first andsecond wives. During one period Khan felt that Beriosova (his second wife) needed Winnicott more than he did and lent his sessions to her.
For most of his fifteen-year analysis, Khan was Winnicotts de facto secretary (an independently wealthy man, Winnicott also had a paid, full-time secretary), performing various editorial tasks for his many books and articles. The first definitive evidence of their collaboration was a joint review of Ronald Fairbairns Psychoanalytic Studies of the Personality for The International Journal of Psycho-Analysis, which they composed in Khans second year of analysis. While Winnicott was an indifferent scholar and professed to know little about Freud, Khan had an encyclopaedic knowledge of the literature. Five times a week Khan would lie on Winnicotts couch for analysis; most afternoons he would stop by Winnicotts study to work on his papers. As writer and editor the relationship was extremely productive; as analyst and patient it was a dismal failure.
Why it failed has been the subject of heated debate. Some have suggested that Winnicott immediately realized that Khans narcissism made him essentially unanalyzable. As per his theory, Winnicott may have concluded that all that remained for Khan was a prolonged treatment of holding. But this may have been the worst possible treatment. Dr. Glen Gabbard, an expert on boundary violations in psychoanalysis, suggests that Winnicott failed by not confronting Khan directly. If there is anything about the Winnicott tradition that leads to boundary violations, it has to do with the way it is reluctant to deal with a patients aggression. A common theme in the boundary violations I have studied is the disavowal of aggression in both analyst and patient. The analyst tries to, essentially, love the patient to health, while not recognizing that the excessive love of the analyst for the patient is often a defense against the analysts hate, and can undermine the treatment, he tells me.
Donald Campbell, who was until recently the Societys president, believes there was good reason Khans analysts might have harbored complex hostility towards their patient. Campbell was a student of Khans and remembers how the charismatic Pakistani disturbed students with ridicule and abuse. One should note how much Winnicott was intimidated by Khan, whom he saw as a kind of biographer, interpreter, and apologist for him. Seduction and sadism were important parts of Khans repertoire for relating to people. I would not be surprised if Winnicott had been affected as well, he told me.
Undoubtedly Winnicotts intellectual dependence on his patient hurt Khans analysis. Brett Kahr, a psychotherapist who is writing a biography of Winnicott, faults him for putting his needs ahead of Khans. He took advantage of Khans brilliance, his industry, and his vulnerability by treating him primarily as an unpaid secretary, rather than as a patient first and foremost, he says. How on earth could Khan have believed that Winnicott cared fully about him as a person, rather than as a mere administrative aid? Clearly their relationship stifled Khans creativity. It was only after Winnicotts death in 1971 that Khan published his own four books.
Kahrs most significant conclusion is that their unhealthy relationship was not anomalous, but has actually been quite common in the history of psychoanalysis. He calls it the Secretarial Neurosis, the process by which patients and disciples are turned into secretaries. Winnicotts own analyst James Strachey turned to him for help in the preparation of The Standard Edition, just as Stracheys own analyst, Sigmund Freud, had called upon Strachey to undertake extensive translation works for him. Freuds teacher, Jean-Martin Charcot, had earlier prevailed upon him to translate his neurological writings into German, he writes.
Far from an exception, Kahr argues that Khan was part of a long, de facto counter-tradition in psychoanalysis: a guild in which boundary violations between patient and analyst are the rule, not the exception, where the patients wish to have a realrelationship with his psychoanalyst is realizedrather than analyzed away. While these analysts were trained to maintain a strict analytic frame with their patients, their ownexperiences of analysis taught them otherwise. The intimacy and love Khan experienced in his analysis with Winnicott may have taken a markedly different form when he tried to apply these lessons to Godley, the otherwealthy, aristocratic Englishman in his life.
Khans descent into madness accelerated when his mother and Winnicott died only months apart in 1971. Beriosova moved out a few months later. He had just received the proofs for Winnicotts last book, Playing and Reality, when he learned of his mentors death. I enjoyed a protected childhood with him, Khan wrote in a letter to his friend, the analyst Robert Stoller, when Winnicott died. Now I must assemble myself and become an adult. Khan was forty-seven years old.
The final blow came when the will was read and he learned that Winnicott had appointed his wife, not Khan, as his literary executor. After years of selfless editorial service, Khan felt cruelly cast out. His already heavy drinking intensified. He became sexually involved with a number of his patients and was seen hitting a girlfriend in public. Khan even turned against his mentor. At a conference on Winnicotts work Khan announced to a stunned audience of analysts that Winnicott had been sexually impotent.
Khans behavior grew more erratic. At a conference in Geneva he slipped out from one of the panels and stole an expensive watch from a boutique, spending the night in jail until one of his colleagues bailed him out. His sadistic and sexualized relations with others intensified. When the analyst Susie Orbach (a.k.a. Princess Dianas shrink) and a colleague met with Khan as part of their training, he received them from a throne-like chair and proceeded to gossip about his patients sexual habits. At one point he showed us a sword, which he claimed he had used to kill a dog a patient had brought with him to a session. I knew then that I was in the presence of someone who was deeply troubled, she says. On their way out, Khan gave them a book by the Marquis de Sade. Khans behavior during these years, says the director Mike Nichols, reminded him of the way his friend, the novelist Jerzy Kozinski, acted before committing suicide. There was a certain extremeness and desperation, says Nichols. Masud became an indescribable creep, a nightmare. He essentially destroyed Svetlana.
In 1976 Khan was diagnosed with cancer and had part of a lung removed. That same year he was divorced by Beriosova. In 1977 the Society withdrew his right to train students, but not his right to analyze ordinary people. The analysts of tomorrow were safe from Khan, but the civilians, the patients of the day, were not. In 1987 the cancer spread and his larynx and part of his trachea were removed. He became agoraphobic, rarely leaving his apartment.
Somehow he continued to write, and in 1988 he published The Long Wait. The book was rumored to have several offensive sections, and when it appeared, the Societys ethics committee immediately ordered twenty-five copies.
They were not disappointed. The books central case study, A Dismaying Homosexual, described Khans treatment of Mr. Luis, a suicidal, gay Jew. Khans railing culminates with a particularly loathsome speech: Yes, I am anti-Semitic. You know why, Mr. Luis? Because I am an Aryan and had thought all of you Jews had perished when Jesus, from sheer dismayand he was one of youhad flown up to Heaven, leaving you in the scorching care of Hitler, Himmler and the crematoriums.
Khan was too ill to travel to the Society, so was struck off in absentia. Determined to have the last word, he resigned before receiving official word of his expulsion. The Society immediately began receiving anonymous bomb threats which could only be coming from Khan. Although he was at the time agoraphic, alcoholic, riddled with cancer, and confined to his bed, Khan so frightened the Society that the president hired a security guard. That was precisely the kind of terrorism that Khan could plant in somebodys mind, recalls Kohon.
The man the analyst Charles Rycroft called the damaged Archangel died on 7 June 1989. Khan was defiant to the end. In The Long Wait he tells of an impetuous patient who confronts him with the fact that the Society had, prior to expelling him, forbidden Khan to train new analysts. I could not care a damn about it, he replies. I am sought after from all over the world. And even if I were not, I can return to my ancestral estates in Pakistan, make no mistake about it!
* * *
What happened to Masud Khan? Some answers may lie in his personal papers, which are sealed until at least 2039. But those who have seen them caution that they may pose more questions than they answer. He had three levels of diaries, some of them written in code. So it isnt clear how they relate to each other, which ones are true and which ones are fantasy, Judy Cooper, Khans patient and first biographer tells me.
Linda Hopkins, Khans second biographer, believes he suffered from an undiagnosed bipolar disorder, although she suspects his upbringing and analysis hindered him as well. She argues that Khan was neither an anomaly nor the result of a fatal theoretical flaw in British psychoanalysis. Rather, she contends that Khan was a genuine paradox: a brilliant clinician and theorist who helped some patients and tortured others; a man who inspired love and admiration from analysts like Adam Phillips and Christopher Bollas and fear and loathing in others. Philosophically-inclined analysts talk about paradox all the time, but when theyre confronted with someone like Khan who is a genuine paradox, they dont know what to do with him, she says.
One day, while reading about Khan, I stumble on a letter from his friend Robert Stoller that suggested the possibility of the ultimate paradox: that Khan may actually have fabricated the case studies he writes about in The Long Waitthe very cases that record the behavior, such as in A Dismaying Homosexual, for which he was banished from the Society he so loved.
In a letter composed immediately after Khans death, Stoller wrote, any obituary [I would have written] would be unacceptable. I would have stomped up and down in my anger at Masuds lying . . . his total fabrication of the clinical material in the last book.
I begin to wonder. Was even Khan capable of such bizarre, self-destructive behavior? To being hoist by a petard that wasnt really a petard, but a pseudo-petard, which he had planted, and then convinced his opponents to use against him?
When I try this theory on Cooper she directs me to some lines from the first chapter of her book: Khan seemed to live in that transitional space between inner and outer experience that he understood so well. It could be said that he lived in the interface between fact and fiction, truth and metaphor, reality and fantasy. Others suggest that this was precisely the kind of paradoxical finale Khan would have loved; that he would have savored the sheer absurdity of it.
* * *
As my lunch with Wynne Godley draws to a close I explain my theory of Khans self-sabotage and ask whether he believes Khan fell victim to his own extreme deviousness . . . whether he was ultimately incapable of saving himself from himself.
By way of answer he explains the title, Saving Masud Khan, that he gave to his London Review of Books article. Khan was always telling his patients that he had saved our lives. He said that nobody else could have done it and that we should be thankful to him. And, of course, we believed him, he says. I dont know much about psychoanalysis, but I gather that Winnicott had a theory that a baby who isnt taken care of properly feels he has to save his mother. That the uncertainty of his environment is an indication not that he is in trouble, but that she is, he explains.
But you and Khans other patients werent able to save him, were you? I ask. Well, Godley says, smiling for the first time today, it certainly wasnt for lack of trying. <
Originally published in the December 2002/January 2003 issue of Boston Review