Historical influences and modern descriptions

THE CONCEPT OF PSYCHOLOGICAL REGRESSION: Metaphors, Mapping, Queen Square, and

Tavistock Square

Jean Mercer Richard Stockton College

The term “regression” refers to events in which an individual changes from his or her present level of maturity and regains mental and behavioral characteristics shown at an earlier point in development. This definition has remained constant for over a century, but the implications of the concept have changed systematically from a perspective in which regression was considered pathological, to a current view in which regression may be seen as a positive step in psychotherapy or as a part of normal development. The concept of regression, famously employed by Sigmund Freud and others in his circle, derived from ideas suggested by Herbert Spencer and by John Hughlings Jackson. By the 1940s and ‘50s, the regression concept was applied by Winnicott and others in treatment of disturbed children and in adult psychotherapy. In addition, behavioral regression came to be seen as a part of a normal developmental trajectory, with a focus on expectable variability. The present article examines historical changes in the regression concept in terms of mapping to biomedical or other metaphors, in terms of a movement from earlier nativism toward an increased environmentalism in psychology, and with respect to other historical factors such as wartime events. The role of dominant metaphors in shifting per- spectives on regression is described.

Keywords: metaphor, regression, psychotherapy, development

Discussing what he called “the law of progressions and pathologies,” the psycholinguist Roger Brown pointed out that the concepts of progression and regression depend on the categories of behavior we create (“psychological kinds” or “human kinds”), rather than on self-organized classes (what Hacking [1999] has called “natural kinds”). Brown (1958) noted that in fact all the categories we regard as more primitive “are fallen away from the healthy, civilized, human adult . . . . There is a beautiful simplicity in the notion that all departures from ourselves are basically the same kind of departure” (p. 297). The present article examines the apparent “beautiful simplicity” of the concept of regression and shows the actual complexity of its historical vicissitudes.

Regression: Consistent Definition, Changing Implications

Regression has for over a century been a term used to describe an organism’s reversion to functioning in ways characteristic of an earlier period of life, temporarily or permanently abandoning patterns seen in more recent periods. References to regression may mean directly observable behaviors, or may indicate

Jean Mercer is an emerita member of the Psychology Program, Richard Stockton College, Pomona, New Jersey.

Correspondence concerning this article should be addressed to Jean Mercer, 134 E. Main Street, Moorestown, NJ 08057. E-mail: [email protected]

History of Psychology 2011, Vol. 14, No. 2, 174 –196

© 2011 American Psychological Association 1093-4510/11/$12.00 DOI: 10.1037/a0022710

174

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

cognitive or emotional changes only indirectly observable. The concept of re- gression has been used in plausible descriptive ways, for instance, to describe a child’s repetition of immature behaviors like bottlefeeding after having estab- lished mature drinking and eating habits. Regressive behavior of this kind has been described as an expectable symptom of separation from familiar people during infancy and toddlerhood or of other stressors. The term has also been used in speculative ways in attempts to explain events and processes during psycho- therapy, as well as with respect to spontaneous changes in adults under the influence of stress and frustration. In addition, regression has been considered as a possible source of growth, creativity, and recovery from mental illness.

As might be expected from these varying usages, definitions of regression have been criticized as vague or incomplete. As the psychiatrist J.F. Brown noted, “the behavior of an extremely regressed psychotic patient is not by any means the exact equivalent of the behavior of a very young child, although quite frequently psychoanalysts speak as if it were because the process of regression is inade- quately defined” (quoted by J. A. C. Brown, 1961, p. 172). An example of the inadequacy of definitions is that the regression concept has sometimes been accompanied by the idea of a form of recapitulation, and at other times has not. Recapitulation involves the assumption that repetition of early events can permit the alteration of a distorted developmental trajectory established in the first months or years of life; the recapitulation is thus in a modified form rather than a simple repetition of a previous developmental sequence.

It should be noted that recapitulation in this sense is unrelated to Haeckel’s description of ontogeny as a recapitulation of phylogeny, but instead is a reference to the idea that aspects of ontogeny itself can be recapitulated to attain a better outcome than the one that would have resulted from the original trajectory of growth. The regression concept does not necessarily require any form of recapit- ulation, however.

Metaphors for Regression: A Psychological Challenge

As Brown implied, regression is not a phenomenon of a “natural kind” (Hacking, 1999), but is a socially constructed concept, like many aspects of psychology. Except for its interest in phenomena that can be examined simply in their behavioral aspects, psychology has the problem of studying a wide range of events that are not directly measurable. The challenges of this situation are of necessity addressed by the use of models and metaphors drawn from other domains, an eventuality that has been discussed in some detail by a number of authors (e.g., Lakoff & Johnson, 1980/1998). William James suggested that human understanding is grounded in metaphorical thinking (Leary, 1990, 1992).

The use of metaphor is based on a transfer of information from one domain to another (metaphora � transfer). One cognitive domain is understood in terms of another through the process of mapping from the better understood to the less understood domain. As Lakoff (1993) has pointed out, “the metaphor is not just a matter of language . . . the language is secondary. The mapping [of one cogni- tive domain onto another] is primary in that it sanctions the use of source domain language and inference patterns for target domain concepts” (p. 208).

The necessary use of metaphor in psychology, comparing indirectly observ-

175PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

able psychological phenomena with more accessible events in the physical world, creates potential difficulty for understanding concepts like regression. The wrong choice of metaphor, or the misunderstanding of the compared physical phenom- enon, introduces possible errors into the subsequent view of the psychological structure or function.

The present article examines the role of changing metaphors in altered perspectives on regression from the late 19th century to the present. A brief discussion of metaphors in psychology is needed to introduce this examination.

Metaphors Relevant to Psychology in General and Regression in Particular

Root metaphors like mechanism or organicism (Pepper, 1942) are founda- tional for psychology, as they are for other natural and social sciences. Similarly, the Darwinian metaphor plays an important role in social science as well as biology. Metaphors specific to psychology have been discussed by Gentner and Grudin (1985), who noted, among others, the occurrence of “neural metaphors” mapping mind and behavior to brain, and “systems metaphors” mapping psycho- logical events to computer functioning. General metaphors for psychological events have been drawn from physics as well as from biology, with both Newtonian and field theories providing analogies.

With respect to mental illness as an aspect of psychology, Sarbin (1995) has discussed the use of metaphor in the examination of “unwanted conduct,” or the breaking of nonexplicit rules by individuals who are subsequently categorized as having one or another reason for their behavior, and needing or deserving one or another response to that behavior. The long-lasting Western metaphor for this situation, possession by demons, began in the 17th and 18th centuries to give way to a different metaphor, in which unwanted conduct was seen as a form of illness and thus as unintentional and not the responsibility of the sufferer. Initially, the metaphor was applied in such detail that somatic symptoms were defined as part of “unwanted conduct” seen as illness, but the concept of “mental illness” involved an adjustment of the metaphor such that “complaints by others of unwanted conduct” (Sarbin, 1995, p. 304) were sufficient to include mood and behavior under this biomedical rubric.

The biomedical approach, applied to the aspect of mental functioning we call regression, employs metaphors of physical illness and injury and maps psycho- logical problems to them. However, regression, with its implication of movement backward along a fixed path, is also easily considered in terms of the spatial metaphors suggested by Lakoff (1993), who regarded distance, space, and move- ment as essential to the many metaphors he considered to be derived from bodily experience. Metaphors from physics are related to this spatial approach.

Regression as Pathology: The Queen Square Construct

Before the general concept of regression was applied, Darwin and others had used the term atavism to describe individuals who appeared to function at a lower level than their conspecifics and who might be thought of as examples of regression to an earlier condition of the species. However, the functional begin- nings of the regression concept itself, as an idea applied to the life of the

176 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

individual rather than to group characteristics, are first seen in the writings of Herbert Spencer (1820 –1903) and of John Hughlings Jackson (1835–1911).

Spencer’s Regression Concept

Spencer’s primary concern (Jackson, 1969; Spencer, 1898) was to state a basic assumption about change as a continuing and universal natural process; although some kinds of change were caused by immediate events, change would continue even if there were no obvious events to cause it. Ongoing change could go either toward a more complex and coherent state (evolution, or a movement from diffusion to concentration), or toward deterioration and decay (dissolution, or movement from concentration to diffusion.) Spencer alluded to the idea that dissolution or regression could occur as an aspect of mental illness but generally considered change in living organisms to involve dissolution only after death (Jackson, 1969).

Queen Square and the Regression Concept

The earliest use of regression as a concept in the study of physical and mental health is associated with the National Hospital for the Paralyzed and Epileptic, opened in Queen Square, London, in 1859. In 1926, it became the National Hospital for the Relief and Cure of Diseases of the Nervous System Including Paralysis and Epilepsy, and is presently the National Hospital for Neurology and Neurosurgery (Casper, 2009). The continuing influence of this institution is apparent in the recent publication of Neurology: A Queen Square Textbook (Clarke, Howard, Rossor, & Shorvon, 2009).

For the purposes of the present article, the characteristics of the National Hospital in the 19th century are of most interest. An examination of case notes from that period (Hunter & Hurvitz, 1961) shows patients with diagnoses that mixed psychological and physical causes and symptoms. As Hunter and Hurvitz commented when surveying these case notes, “hysteria and epilepsy were not as sharply differentiated as they are today, and fits which are recognizably epileptic were described as hysterical or hysteroid, especially those accompanied by automatic and other strange behavior but without the characteristics of grand mal” (p. 190). Nevertheless, possible psychological causes were recognized even where other explanations might be more plausible; a small boy with a variety of physical and mental symptoms was said to have had his problems caused by his fright when he dropped a bottle, with no suggestion that the bottle might have been dropped because of a brain event. Terminology that could discriminate between organic and psychological events (and thus use one as an effective metaphor for the other) was still in the process of development.

Similarly, treatments were not clearly defined as physical or psychological. Sulfur baths were used for general paralysis of the insane (GPI), while other forms of paralysis might receive counterirritant treatment such as ice bags applied to the spine. But some patients were treated with hypnosis by a staff member, or by the London hypnotist C. L. Tuckey, who in1897 was said to have suggested success- fully that a hysterically paraplegic patient would walk well (Hunter & Hurvitz, 1961).

Within this confused set of causes, symptoms, and treatments, the concept of

177PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

regression was formulated by the eminent John Hughlings Jackson (1835–1911), a leading Queen Square physician and a former student of the “Father of Modern Neurology,” Marshall Hall (Critchley, 1960).

Hughlings Jackson’s Use of the Regression Concept

Hughlings Jackson investigated the events triggering seizures, in which he took a special interest because of his wife’s experience of a fatal seizure disorder. His initial expectation was that seizure activity would be initiated by events in a lower part of the brain, but the evidence showed that cortical phenomena were responsible for seizure activity. Jackson interpreted this to mean that the nervous system was hierarchically organized, with higher areas capable of exciting or inihibiting lower parts of the system.

Elaborating on Spencer’s lead, Hughlings Jackson (1894/1958) adopted the view that both evolution and dissolution could occur over an individual’s life span. Applying this view to the development and functioning of the central nervous system, Jackson considered the nervous system to have a hierarchical organization which altered in the course of development until the complex voluntary functions of the cortex came to dominate under normal circumstances. This mature and healthy organization was subject to daily change in the form of alterations in arousal, waking and sleeping. However, diseases of the nervous system, such as epilepsy, could cause dissolution, or a longer-term regression to a developmentally earlier form of organizational hierarchy. The regressed form would be less flexible, complex, and voluntary than the normal mature organiza- tion of the nervous system (Meares, 1999).

Jackson’s relatively simple view of regression might have been expected to give way to the more complex analysis of nervous hierarchy, including the law of reciprocal innervations, discussed by C. S. Sherrington (1857–1952) (Granit, 1967; Sherrington, 1906), and to a considerable extent it did so among neurolo- gists. However, the Jacksonian model was preserved for years among authors concerned with matters at the boundary between medical and psychological concepts, such as seizure disorders and psychosomatic medicine.

The Context of Queen Square: Other Influences on the Regression Concept

Studies of biomedical events like those resulting from brain damage were essential to the view of regression represented by the early Queen Square group. However, other sources provided different motivations and frameworks for con- sidering regressive phenomena.

Beginnings of Cultural Studies

Romantic views of the world, like those exemplified by Rousseau and Chateaubriand many decades before Hughlings Jackson’s work, had categorized innocent, admirable, but intellectually impoverished minds like those of children and of “savages,” and had compared these with the less attractive minds of “civilized” and educated adults. The early 20th century saw a greatly increased interest in the thinking of children and of “primitive” peoples, an interest initially

178 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

associated with the belief that such information could give a better understanding of human evolution, but later pursued for its own value. The increased interest in non-European cultures was shown in anthropological investigations such as the Torres Strait expedition (Costall, 1999), in which a notable participant was W. H. R. Rivers, both previously and later associated with the Queen Square group and much influenced by Hughlings Jackson’s view of regression. Along with C. S. Myers, William McDougal, and C. G. Seligman, Rivers participated in anthropological work with peoples indigenous to the Torres Strait area north of Australia (Herle & Rouse, 1998). Psychological studies were included and em- phasized an interest in “racial” differences because these might be indicated by color categorization and sensory thresholds. This work foreshadowed the aban- donment of an evolutionary approach to cultural differences and thus a movement away from a view of regression as involving a less mature or less evolved condition.

War Neuroses

The trench warfare of World War I, with its constant anxiety about gas and shell attacks and the exposure of soldiers to the hideous wounds and lingering deaths of their comrades, caused posttraumatic conditions, including the inability to follow orders or to recover from the state of high arousal associated with battle. These conditions were referred to as “shell-shock” in accordance with the pre- vailing biological metaphor and were initially assumed to involve undetectable injuries from the pressure wave of an exploding shell. Less often, the psycholog- ically oriented term “War-Strain” was used (Smith & Pear, 1917).

W. H. R. Rivers and other former participants in the Torres Straits expedition became involved with the treatment of “shell-shock” at Maghull Hospital near Liverpool, where the director, Richard Rows, was influenced by Freud and was exploring psychological treatment for traumatized soldiers (Costall, 1999). Al- though it was common for victims to be described as having “lost their senses” or mental abilities, Rivers regarded “shell-shock” as a type of regressive reaction. In this he was in agreement with other authors who reported that the disturbances were “characterized by instability and exaggeration of emotion rather than by . . . impaired reason” (Pear, 1918; Smith & Pear, 1917).

Changing Metaphors: Queen Square and the World War I Context

Hughlings Jackson’s view of regression and of most phenomena of mental illness was clearly based on a medical or physical illness metaphor. Of the root metaphors suggested by Pepper (1942), some degree of “formism” seems char- acteristic of Hughlings Jackson’s thinking, with similarity between effects of damage to the nervous system and psychological regression as an essential concept. His approach was almost completely organismic, as was exemplified by its basis in the hierarchical organization of the nervous system. Nevertheless, spatial metaphors (cf. Lakoff, 1993) formed an essential part of the concept of regression, by definition a matter of movement from a later state to an earlier state, and easily mapped on to the “linear scales are paths” metaphor suggested by Lakoff.

The shift in thinking about regression suggested by Rivers’ work on war

179PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

neuroses involved a movement toward new nonmedical metaphors of mental illness. A parallel shift in metaphors involved the use of biological evolution as a framework onto which human functioning could be mapped. Spencer’s view of societal change, closely linked with the metaphor of biological evolution, never- theless included the concept of devolution or dissolution that was the foundation for Hughlings Jackson’s idea of regression. Dissolution or regression fit poorly into a framework that stressed natural selection and adaptation to environmental demands.

An additional change in metaphors during this period involved the beginning of a shift from the “brain metaphor” (mapping of mental illness onto aspects of reasoning) to the “heart metaphor” (mapping of mental illness onto aspects of emotion). Approaches to the war neuroses that had stressed loss of reasoning or of “the senses” began to change to perspectives that gave primacy to exaggeration of emotional responses and to changes at an unconscious, unintentional level. The “heart” metaphor chimed with the influence of the Counter-Enlightenment in German psychology and elsewhere (Berlin, 2000).

Regression in Psychotherapy: Pathological Regression as a Psychoanalytic Concept

The concept of regression is commonly associated with the work of Sigmund Freud (1856 –1939). Freud’s training in psychiatry and neurology, particularly his early work with Charcot (1825–1893) on “hysteria” or conversion disorders, initially established his preference for a biomedical model for psychological phenomena and his interest in Hughlings Jackson’s conceptualization of regres- sion. However, the development of psychoanalytic theory and practice demanded some changes in the regression concept as it had been used by Jackson and others at Queen Square. An increasing emphasis on psychological factors made different metaphors desirable.

Freud’s view of psychological regression did not assume demonstrable ner- vous system damage, but he did assume that regression could be spontaneous as well as brought about by environmental factors. When regression occurred, according to Freud, it could permit the removal of psychological barriers that were inhibiting mature mental processes. This conception of regression resembled mechanical relationships described by classical physical science, and particularly hydraulic processes, much more than it did any biological events. The Freudian approach to regression thus followed the model suggested by Helmholtz (Schi- emann, 2009) and started the regression concept on a transition from a biological or organismic metaphor to various mechanistic metaphors derived from physics.

Following Hughlings Jackson’s work and that of his colleague Josef Breuer (1842–1925), Freud applied the dissolution or regression concept both to indi- vidual development and to mental illness, referring to symptoms such as aphasia as the result of functional retrogressions equivalent to earlier organizational states (Freud, 1891/1953; quoted by S. W. Jackson, 1969). As is the case with most productive and long-lived theorists, Freud’s views of regression changed over time; S. W. Jackson’s (1969) summary of these changes is a helpful guide to Freud’s main uses of the regression concept.

180 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

Sigmund Freud’s Concepts of Regression

Topographical regression involved movement from the relatively mature and complex function of thought to the lower level of dreaming and hallucination, found during sleep and psychosis. Temporal regression, in Freud’s view, involved the “backward” movement of the libido from a frustrated present-day object to an object that had been satisfactory at an earlier point in development. The earlier stage was a period of fixation, making it attractive to the libido when reality became frustrating, and symptoms were associated with characteristics of the early period. Discussing this viewpoint, J. A. C. Brown (1961) described the association between frustration and regression in this way: “Frustration may bring about regression to a stage that was more successfully experienced in the past . . . and in each neurosis there is assumed to be a specific point of fixa- tion . . . [determining the stage to which regression would occur]” (p. 25). Formal regression as described by Freud involved a return to primitive forms of expres- sion and representation (Kilborne, 1998).

Metaphors in the early psychoanalytic view of regression. To adapt Hughlings Jackson’s view of neurological regression and apply it to psychological processes involved a primary alteration toward a root metaphor of mechanism, with Freud’s “hydraulic” model of mental functions reflecting the linear causal connections typical of such models. It is notable that in spite of his nativistic perspective on the orderliness of events in development, Freud’s approach to other aspects of development was strongly environmentalist, assuming that experienced events guided, facilitated, or blocked maturational change. Experiences of stress and frustration were thought to bring about psychological regression. The intro- duction of physical science metaphors, with their concepts of space, energy, movement, and impediment, like those described by Lakoff, permitted the devel- opment of psychodynamic theories as biological metaphors could hardly have done. However, psychoanalytic theory retained a mix of metaphors. Freudian theory used a biological model to characterize events of early personality devel- opment, with their predictable unfolding of stages and their sensitive periods when environmental influences are powerful, in a pattern parallel to embryonic and fetal development. Paradoxically, however, these events were also seen as capable of alteration through a process of regression much later in life, long after any sensitive period would have passed; only a shift from a biological to a physical-science metaphor would provide a rationale for this change in consid- erations about plasticity. In addition, to see regression as positive in any way would involve movement away from the mapping of regression onto physical illness or injury.

Psychological Regression as a Factor in Therapy: The Tavistock Square Approach

As the words “Queen Square” can be used to crystallize a biomedical metaphor for psychological regression, “Tavistock Square” can represent a rather different set of analogies in which regression follows nonbiological, but not necessarily Freudian, rules and in which it may be both a coping mechanism and a step in recovery. This approach emerged following a period in which British psychoanalysis developed and was used in both military and civilian populations,

181PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

a narrative far too extensive to be included in the present paper (but see, e.g., Greenberg & Mitchell, 1983). The new perspective was associated with an eclectic psychiatric group centering around the Tavistock Clinic (van der Horst & van der Veer, 2009), a group that included W. H. R. Rivers. Rivers had already foreshadowed the new approach when he followed his observation of soldiers’ reactions to trauma with the suggestion that regression has adaptive value, in that all stress reactions have the possibility of removing the individual from the traumatic scene (Rivers, 1922; Young, 1999); the idea of regression as a step in recovery was thus not wholly new even outside Freudian circles.

The Influence of W. H. R. Rivers

W. H. R. Rivers (1864 –1922), who had been an assistant to one of Jackson’s colleagues, Victor Horsely, was another Queen Square staff member to work with the regression concept. Before the war-time observations that later led him to consider the adaptive nature of regression, Rivers worked with a Queen Square colleague, Henry Head (Rivers & Head, 1908) on a study that provided further support for the concept of regression. This famous investigation involved the surgical division of a sensory nerve in Head’s arm, followed by meticulous testing over the next year or more as the nerve regenerated and sensory function recovered. The work of Rivers and Head showed systematic recovery of sensory abilities, with specific sensory modalities recovering earlier than others, rather than a gradual recovery of all modalities simultaneously. The first modalities to recover were sensations of heat, cold, and an unpleasant and lingering form of pain; these, Rivers and Head referred to as the protopathic system, and considered to represent primitive forms of response to the environment. Later, nerve regen- eration brought about recovery of the sense of touch and responses to warm and cool stimulation, as well as the sense of mild pain stimuli such as a brief needle prick. Rivers and Head referred to this group of senses as the epicritic system and considered it be evolutionarily more recent and thus less primitive than the protopathic system. Such a division into more and less primitive sensory experi- ences provided further argument in favor of the regression concept, as this evidence strengthened the Tavistock view that aspects of a normal adult’s re- sponses to the environment could be differentiated as regressive or otherwise.

Services at the Tavistock Clinic

The Tavistock Clinic for the Treatment of Functional Nervous Disorders opened in Tavistock Square, London, in 1920 and was intended to offer to traumatized and neurotic civilians psychotherapeutic services of the type used with shell-shocked soldiers by the founding psychiatrist Hugh Crichton-Miller (Dicks, 1970). A considerable interest of Tavistock staff was in “mental hygiene,” a concept relatively new at the time and used to describe “a range of minor troubles of emotion, thought, wishes, and conduct, [which] construed them as the consequences of disorders of “the nervous system” “ (Miller & Rose, 1988, p. 176). Mental hygiene involved the treatment of these minor problems at an early stage, with the goal of preventing their escalation to major difficulties from insanity to criminal behavior.

182 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

Adjustment and eclecticism. This focus on early intervention brought Tavistock attention to child guidance, juvenile justice, and similar issues. Treat- ment at Tavistock resembled that by practitioners dealing with shell-shock and similar cases; it used many Freudian principles but rejected the primacy of sexuality and drew from other sources such as McDougall’s instinct psychology. A notable difference between this “new psychology” and conventional psychiatry was a concern with individuals’ adjustment and maladjustment rather than clear differentiations between normality and pathology. Criminality was considered a form of maladjustment (Miller & Rose, 1988). Similarly, the Tavistock staff member Ian Suttie (1935/1999) considered regression—in his definition, an adult’s childlike behavior—to be one of the possible solutions later personality development may employ in adjusting to this lifelong concern. Schizophrenia was suggested as a severe form of regression, and conversion disorders as a milder form of this type of problematic adjustment (J. A. C. Brown, 1961).

Outside Influences on Tavistock Square: Theoretical Sources of Psychological Regression

Changes in the thinking of psychologists and psychiatrists had direct effects on the development of the Tavistock Clinic’s position on regression as an important factor in psychotherapy. Some of these changes were associated with historical events outside psychology during the 1930s and 1940s.

Increasing Cultural Relativism, “Social Control,” and Environmentalism

Within a few years after the Torres Straits expedition, the framework of historical particularism had been offered by Franz Boas (1858 –1942), who opposed the idea of a scale from savagery to civilization that represented human phylogeny (Boas, 1904). Rather than stages at different levels in the development of culture, Boas emphasized a multiplicity of cultures; these could be compared on their complexity, and a taxonomy of cultures could even be possible, but “evolutionism” as a way to analyze differences between groups was seen as less and less acceptable (Davis, 2008; Verdon, 2007). These considerations argued against a simple view of progression and regression and foreshadowed later rethinking of regression.

This approach encouraged taxonomic efforts rather than the “evolutionistic” view of a continuum from the primitive to the civilized (Davis, 2008; Verdon, 2007). The questions asked under these circumstances focused on factors deter- mining behavior and the ways in which they might be manipulated for better social outcomes— considerations that arose from a strongly environmentalist view of the nature of human beings. This interest in “human engineering” or “social control” was fostered in the United States by foundations that supported groups like the Social Science Research Council (Biehn, 2009).

Effects of World War II

The Second World War was preeminently the war of morale, propaganda, and attitude change. Psychologists and psychiatrists of all combatant nations were engaged in attempts at attitude change at every level from the individual patient

183PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

to larger civilian or military groups, from therapy for “battle fatigue” (the new “shell-shock”) to attempts to persuade housewives to use less preferred foods in their cooking. In addition to general morale issues, the waging of total war brought traumatic experiences to civilian populations, at levels ranging from the sufferings of Jewish and other victims of the Holocaust to the terrifying experi- ences of civilians during the bombing of major British and European cities. An important feature from the viewpoint of psychology was the frequency of abrupt and potentially traumatic separations of children from their parents, whether in the form of the Kindertransport rescues of Jewish children in Germany, or the mass evacuation of British children from areas susceptible to bombing. These wartime events increased both the number of persons needing psychological treatment, and the number of psychologists and psychiatrists with relevant experience.

One effect of the war on the Tavistock Clinic was a strengthening of the Clinic’s connection with psychoanalysis. The war’s end brought to the clinic the involvement of the analytically trained John Bowlby (1907–1990) and John Rickman (1880 –1951). Following the war, Wilfred Bion (1897–1979) and his colleagues, who had been engaged in wartime morale issues, established the Tavistock Institute of Human Relations, with a new focus on group dynamics (The Tavistock and Portland NHS Trust, n.d.).

Gestalt Psychology and the Relocation of German Psychologists

Both before and after the Second World War, German psychologists, espe- cially those of Jewish identity, made their ways to Britain and the United States. To the famous Tavistock Square names mentioned earlier should be added one of exceptional importance: Kurt Lewin (1890 –1947). Known as a social psycholo- gist and member of the Gestalt school (but, of course, not a Gestalt therapist), Lewin had interests in human engineering and social control that linked his work with that of the Tavistock Institute. For example, Lewin and his colleagues had done experimental work on the functioning of groups under democratic and authoritarian structures (Lippitt, 1940). Lewin’s postwar lectures and concern with action research provided a framework for the work of the institute (Argyris, 1997; Neumann, 2005). Lewin’s work had for some years been much admired by Eric Trist, one of the founders of the Tavistock Institute (Trist, 1993; Trist & Murray, 1990). The interests of Tavistock members in Lewin’s field theory bloomed into the founding in 1947 of the journal Human Relations, comanaged by the Tavistock Institute and the Research Center for Group Dynamics at MIT (“About the journal,” 2006), the latter led by Lewin until his early death just before the journal began publication (Marrow, 1969). The first issue of Human Relations contained two articles by Lewin, one organized by the editors from the author’s notes (Lewin, 1947a, 1947b). As I will note later, the field theory approach had significance specifically for the concept of regression, providing a framework in which regressive behavior could be seen as normal coping efforts resulting from frustration.

The field theories proposed by Gestalt psychology considered many variables simultaneously and were able to include effects other than those of a simple mechanical nature (Ash, 1995; Henle, 1993). In addition, they posited rules of functioning that did not follow those of classical mechanics; the nature of a field

184 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

could cause it to function according to patterns different from those seen in another field (Lewin, 1951). As Tubert-Oklander (2007) has pointed out, “All the factors that take part [in a psychological field] are psychological events; thus physical, biological, social, or even imaginary occurrences enter the field only in terms of their impact on psychological functioning” (p. 117).

The ahistoric perspective of Lewin’s field theory gave a unique approach to the problem of regression. Rather than positing an actual regression to a less mature state, a field theory model makes it possible to assume that under some circumstances memories or beliefs about the past, whether veridical or not, can move to a more dominant position in current thought and behavior than they usually enjoy. Present experiences with the remembered or reexperienced material can then alter current thinking and behavior as they operate within the psycho- logical field. Regression as defined by psychological field theory can be consid- ered without the unparsimonious additions of fixation or libidinal pressure, and can be seen as a matter of dedifferentiation (regression) of the personality, resulting from frustration (Barker, Dembo, & Lewin, 1943). Although much of Lewin’s work was done outside the Tavistock Clinic, the later emphasis of Tavistock staff members (like Winnicott, Balint, and Laing) on regression shows a continuing mutual interest.

Regression as a Controllable Aspect of Psychotherapy: Development of Tavistock Square Views

The influence of psychoanalysis on Tavistock staff altered as psychoanalytic views changed, and this fact was reflected in the attitude toward regression. Although the initial Freudian approach had been to see frustration as a cause of spontaneous regression or of regression during psychotherapy, analytically ori- ented thinkers soon began to suggest that experiences of nurture and gratification might encourage psychological regression. Over several decades, this view moved toward the assumption that regression could be caused or facilitated by experi- ences resembling the caregiving events that are supportive of early development.

Neo-Freudian Thinking

Sigmund Freud’s conception of regression had emphasized its role as a disease process; his view of the therapist’s role had been that of an observer standing outside the system. Freud’s only attempt to encourage regression during treatment was to suggest that deprivation of physical gratifications could be helpful, presumably because the associated frustration was likely to trigger a regressive response (cf. J. A. C. Brown, 1961).

Sandor Ferenczi (1873–1933), originally a member of Freud’s inner circle, is reported to have begun his analytic work by following Freud’s view and suggest- ing that patients avoid physical gratifications. Around 1927, Ferenczi began to develop a more permissive “parenting” technique, encouraging patients to behave in childlike ways (Ferenczi, 1950). Regression to infantile behavior during anal- ysis was responded to by the therapist’s taking on the role of the loving parent. “In order to achieve the maximum identity with a loving parent which many patients had never known, Ferenczi allowed the patients to kiss and caress him, and

185PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

returned these attentions when it was desirable to establish a completely convinc- ing reaction” (Brome, 1968, p. 199).

Ferenczi’s methods were among the first to stress not only regression, but the recapitulation of early experiences and the alteration of the old developmental trajectory. As J. A. C. Brown (1961) noted, the patient in treatment with Ferenczi “relived his infantile experiences, with the significant difference that the revived experience was carried out in a more permissive . . . atmosphere” (p. 52). Similar approaches were later to be used by Tavistock associates such as Winnicott and Laing.

Psychoanalytic Views and the Independent Group

Several key members of the Tavistock Clinic staff belonged to the Middle or Independent Group of the British Psychoanalytical Society (Rayner, 1991; van der Horst & van der Veer, 2009). The latter organization, founded in 1919 by Ernest Jones, remained relatively homogeneous until the 1940s, when a series of “Con- troversial Discussions” (Steiner, 1985) resulted in a split into a group favoring Anna Freud’s leadership, a group following Melanie Klein, and an Independent group that tended toward the empiricist and pragmatic approach and avoided closed theoretical systems (Stewart, 2003). D. W. Winnicott and Michael Balint were leading representatives of the Independent group at the Tavistock, and took a particular interest in regression.

Donald Winnicott. Following the Second World War, the Tavistock psychoanalyst Donald Winnicott (1895–1971) discussed behaviors of adult pa- tients that he considered to be either withdrawal or regression. Commenting that the behaviors themselves were very similar (Winnicott, 1965/1992), for example, in the case of one patient, remaining silent and covering herself with rugs, Winnicott discriminated between the motivations and meanings of the two situ- ations. He considered that “in regression there is dependence and in withdrawal there is pathological independence” (Winnicott, 1965/1992, p. 149). Regression, properly handled, becomes a therapeutic agent and allows the analysis to proceed (Winnicott, 1954/1958).

In working with regression, Winnicott employed the concept of “holding,” which as a metaphor involved complete availability and responsibility to the patient. “Holding” also had a literal meaning, involving direct contact, in which the patient was allowed to cling to the therapist’s hands, to have his or her head held by the therapist, and to be offered food (Etchegoyen, 2005; “holding” was also described by Winnicott’s psychoanalyst-patient, Margaret Little [Little, 1987]). In a limited sense, “holding” was an imitation of experiences of depen- dency and caregiving that ideally occur early in development.

Michael Balint. Winnicott’s Independent Group and Tavistock colleague, Michael Balint stressed regression to primitive forms of experience during ther- apy, particularly to a state where the therapist’s actions and words were seen as critically important and as having meanings other than their conventional inter- pretations (Stewart, 2003). In direct work with regressed patients, he believed that the therapist should be unobtrusive, and limited physical contact to holding a hand or a finger. Balint (1968) also suggested the possibility of “malignant regression,”

186 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

which could function to achieve the patient’s instrumental purposes but which lacked a therapeutic benefit.

Treatment of Children and Adolescents

Following World War II, treatments were sought for the many orphaned children suffering from traumatic separations experienced during the course of the war, as well as for children with more ordinary emotional disturbances. Encour- agement of regression (in expectation of recapitulation) was an important treat- ment mode; as the Tavistock associate John Bowlby (1966) described this, “[some] believe that if the child is permitted to regress to completely infantile modes of behavior there is a chance of his developing afresh along better lines” (p. 50). Bowlby (1907–1990) noted, however, that the effectiveness of such treatment could not be established for many years, nor has it been established up to the present.

Other approaches incorporating therapeutic regression with children and adolescents included those of Bruno Bettelheim (1943, 1947, 1950, 1972, 1947, 1950, 1972; Zimmerman, 1993), Fritz Redl and David Wineman (1950), and Beate Rank (1949). The therapists Marguerite Sechehaye (1951) and Frieda Fromm-Reichman (1950) also maintained that regression was an essential part of treatment and was suitable for young psychotic clients.

Regression as a Positive Factor in Growth, Creativity, and Mental Health: Inside and Outside the Tavistock Clinic

In the view of C. G. Jung (1875–1961), regression to infantile behavior paralleled a psychological regression to primitive levels of thinking and feeling. Rather than loss of capacity, these events signal the possibility of accessing wisdom from an unconscious level of the mind, and therefore may enable the individual to find a creative solution to problems he cannot solve at the ordinary conscious level (Jung, 1983). As Brown (1961) commented, “facing such an issue [of coping difficulty], the individual may regress, but for Jung this is not necessarily a pathological step but rather a matter of “reculer pour mieux sauter” [or “to draw back in order to leap better”], since by regression into the more archaic levels of mind a creative adaptation may be reached. In effect the regression is seen as a strategic retreat to call up reserves from the collective unconscious which has possibilities of wisdom denied to consciousness. If, however, no creative solution is found during this period of regression and the individual continues to follow earlier or infantile patterns of behavior, the neurotic state has been reached . . . ” (p. 49).

Ego Psychology

The work of Heinz Hartmann and other ego psychologists examined psycho- logical functions in terms of their roles in coping and problem-solving (see Hartmann, 1950, 1956). Regressive thinking or behavior, triggered by frustration, was considered as potentially helpful for ego functioning. “Regression in the service of the ego” was the reversion to primitive functions that could support achievements in the arts, for example. Regressive phenomena in adulthood were

187PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

thus seen as often nonpathological, even desirable, as they contributed to the individual’s gratification and accomplishment.

Regression in Antipsychiatry

The concept of regression played a critical role in the work of the Tavistock associate R. D. Laing (1927–1989), whose analytic studies had been supervised by Winnicott, and of other therapists who were categorized as part of the patient-focused antipsychiatry movement.

These practitioners regarded severe regression, even to the point of psychosis, as part of a healing process by which patients could recover from the damage considered to have been done to them by their families (Kotowicz, 1997). One patient, Mary Barnes, and her therapist wrote an account of her period of severe regression as an example of appropriate support for recovery from mental illness (Barnes & Berke, 1971/2002). Both Mary Barnes and her therapists regarded her experience at the residential treatment center, Kingsley Hall, as metaphorically “going down and coming up” again in a cycle of dissolution and later progression. Her therapist Joe Berke, with the assistance of R. D. Laing himself, supported her in infantile habits of elimination and feces-smearing, spoon-fed her, and fed her with a nursing bottle.

Shifting Metaphors: Regression as a Positive Event

The idea that regression can be controlled and used for a patient’s benefit is arguably part of a mechanistic root metaphor. However, the metaphors that form part of the Tavistock Clinic and related modes of thought were clearly not based on a simple set of linear relationships involving aggregation (see Danziger, 1995), as were the hydraulic metaphors used in the Freudian view of motivation. Instead, this approach involved the field theory metaphor that is the mechanistic founda- tion of Gestalt theory. Field theories share some organismic characteristics, and the field theory metaphor foreshadowed systems approaches like those suggested by Pribram (1995) and many others, distancing the concept of regression from the spatial metaphors described by Lakoff.

In spite of the assumptions of time and space inherent in the word “regres- sion,” the Tavistock group at this point no longer assumed that regression phenomena involved a “linear scales are paths” metaphor that placed some forms of behavior closer to good mental health than others. A movement toward the “heart” or Counter-Enlightenment (Berlin, 2000) approach emphasized the dam- age done by attempts at reason and the appropriate primacy of irrationality, even regression, in shaping human life. In fact, a new metaphor began to equate regression and similar phenomena with desirable spiritual advancement and escape from the social restraints of adulthood in industrialized society.

Regression as an Aspect of Normal Development

While most other authors had focused on regression as a phenomenon of adulthood, Anna Freud (1895–1982) used the concept to denote common and readily observable child behaviors in response to trauma, separation, or frustra- tion. Although regression to infantile behavior by older children was little em- phasized in some of Freud’s work on defense mechanisms (for instance, A. Freud,

188 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

1937), other later work stressed the importance of this phenomenon (Freud, 1963). Freud referred to regression among the group of young children rescued from Theresienstadt at the end of World War II (Freud, 1960), whom she described as sucking, rocking, biting, and spitting, as well as losing bladder and bowel control at times.

Freud’s particular interest in regression had to do with its role in the ordinary course of child development, which is characterized by uneven progress (Freud, 1963). She noted the inappropriateness of basing assumptions about psychological development on the simple progressive pattern of physical development. Rather than involving progression alone, “the psychical side [involves] a second, addi- tional set of influences which work in the opposite direction, namely with fixations and regressions. It is only the recognition of both movements, progres- sive and regressive ones, and of the interactions between them that leads to satisfactory explanations of [developmental change]” (p. 128). Progressive and regressive changes in behavior should both be considered as parts of development toward real maturity, and regressive changes are to be expected in times of anxiety, illness, or separation. Thus, “it has to be considered legitimate for children to revert periodically, to lose controls again after they have been established, to reinstate early sleeping and feeding patterns . . . Far from interfer- ing with forward development, it will be beneficial . . . if the way back is not blocked altogether by environmental disapproval and by internal repressions and restrictions” (p. 139).

Anna Freud thus viewed regressive phenomena as a part of analytic work, as a defense mechanism, and as part of normal developmental change. The last of these possibilities was a major change from the Spencer-Hughlings Jackson concept of regression as a disease process and from the psychoanalytic view of regression as a matter of psychopathology, and was the beginning of a new focus in the study of development.

Other Developmental Viewpoints

Descriptions of normal steps in development by Arnold Gesell (1880 –1961) and his colleagues also integrated regressive events into a generally progressive pattern. Gesell (1939), who had completed a doctorate at Clark University under the influence of G.S. Hall, as well as pediatric training, referred to the organiza- tion of regressive and progressive events as “reciprocal interweaving,” in a parallel to Sherrington’s law of reciprocal innervation. As Gesell’s colleagues Louise Ames and Frances Ilg (1964) noted, “In practical everyday life, one of these two opposed types of response is likely to be thought of as immature or less desirable; the other, as mature and more desirable” (pp. 196 –197). This principle thus includes the idea that regressive events form part of normal development, and that in fact they are socially constructed as less desirable, rather than being thus as “natural kinds” (cf. Hacking, 1999). More recently, Heimann (2003) referred to regression periods (as just defined) as times of disorganization, and to periods of progression as reorganization; he considered regressive periods to signal devel- opmental advances and the emergence of new skills. Regression, in this sense, may refer to behaviors which share the disorganized qualities of earlier life, but not necessarily to behaviors which otherwise resemble the earlier behaviors.

189PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

Discussion and Conclusions

The basic definition of the term “regression” has remained stable since the late 19th century. However, rather than showing a “beautiful simplicity,” the impli- cations of the term have gone through extensive changes. Initially, regression was viewed both as pathological in nature and as following neurological rules. However, although regression continued to be considered as evidence of pathol- ogy, it came over several decades to be seen as having a useful function as a coping mechanism and as a part of the psychotherapeutic process, and to function according to patterns other than those suggested by neurology. During this period, stress and frustration were initially thought of as instigators of regression; meth- ods for the triggering or encouragement of regression were later posited to involve imitation of early experiences with dependency and nurturing care, and these methods were used in some types of psychotherapy. In the second half of the 20th century, regression came to be considered as a possible source of emotional growth and of creativity as well as evidence of pathology, and some thinkers came to regard even severe regression as a necessary and desirable event in recovery from mental illness. The most recent addition to thinking about regression considers it as a normal developmental process that alternates with periods of progress in a predictable way.

Changing Metaphors for Regression

Changes in the conceptualization of regression over more than a century were associated with changes in choice of metaphors— changes in the “mapping of significant relationships from the analogical domain to the . . . domain to be explained” (Gentner & Grudin, 1985, p.181). The metaphors employed when the term regression was first used to describe psychological phenomena were organ- ismic in their foundation on the hierarchical organization of nervous system functioning, as well as biomedical in their mapping of regressive phenomena onto physical illness or injury. This “Queen Square” perspective on regression initially made use of a biological evolution metaphor, as suggested by Spencer, but this gradually became less important as cultural relativism became an “antievolution- ary” influence. Nevertheless, the concepts of adjustment or adaptation, with their evolutionary implications, were increasingly applied to phenomena of regression. Finally, an initial “brain” metaphor, with its emphasis on conscious thought, began to yield to a “heart” metaphor concerned with emotional processes.

The Freudian approach continued to make use of a medical metaphor for regression and to see regressive behavior as a form of mental illness, mappable onto physical illness.

However, the organismic metaphor was changed to a mechanistic approach in which mental functions were mapped onto hydraulic processes, with space, pressure, movement, and impediment all used as analogies for psychological events. The “brain” metaphor continued to dominate this perspective; despite the interest in emotion as motivational energy, rational processes were seen as essential aspects of mental health.

Subsequently, the developing view of the Tavistock Square group was asso- ciated with a mechanistic root metaphor, but one that shared with organismic perspectives the acknowledgment that functions were defined in part by interre-

190 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

lations among elements. This hybrid metaphor emerged from mapping psycho- logical functions onto physical phenomena involving field characteristics. The integrated, unitary functioning associated with field theory suggested the influence of the “heart” metaphor. In addition, while these metaphors worked effectively to describe change and movement, they did not fit with the concept of directionality that usually is an important part of spatial metaphors. The absence of direction- ality (one state less desirable or mature than another) implied that regression could not be considered exclusively as an aspect of mental illness or mapped onto physical illness.

The consideration of regression as part of psychotherapy, characteristic of the late ‘30s and the post-World War II period, continued to be associated with the medical model implied by the need for treatment. However, the addition of recapitulation to regression suggests very different metaphors from those used earlier. Recapitulation (not in Haeckel’s sense, it should be remembered) implies one of two metaphors. One would be a highly mechanistic, highly spatial meta- phor, in which the individual’s developmental status can be “slid” along a predictable continuum from greater to less maturity and back again. The alterna- tive seems to be a root metaphor of similarity, characteristic of what Pepper (1942) called “formism,” in which corresponding patterns have some sort of equivalence, and nurturing treatment in later life is paralleled by development that resembles that of early life. As recapitulation was said to be triggered by experiences that reflected early, even prenatal, life, the suggestions seems to be that a “heart” metaphor is at work, stressing emotion rather than reason as a factor in psychological life. The source of this use of the recapitulation concept remains unclear.

“Spatial metaphors,” as described by Gentner and Grudin (1985), have received detailed attention from Lakoff (1993), who regarded distance, space, and movement as essential to the many metaphors he considered to be derived from bodily experience. The idea of regression, with its implication of movement backward along a fixed path, is easily considered in terms of the spatial metaphors suggested by Lakoff.

Lakoff discussed a metaphor he identified with the statement “linear scales are paths” and suggested that this metaphor includes a specific starting point (e.g., movement from bottom to top, from birth to death, etc.), as well as distance traveled, seen in terms of mapping onto quantity in general. Parts of this metaphor include the following: states are locations (bounded regions in space); changes are movements into or out of bounded regions; causes are forces that create move- ment; actions are self-propelled movements; means are paths; difficulties are impediments to motion (Lakoff, 1993, p. 202). Self-propelled movements include making progress (mapped onto forward movement) and undoing progress (mapped onto backward movement along the same path). Each of these parts of the statement “linear scales are paths” has been used as a metaphor for an aspect of regression; however, not all parts have been included in every approach to regression, nor is the metaphoric line always a straight one.

The view of regression as movement along a path connects with an essential metaphor derived from the perspective of Newtonian physics, with its emphasis on linear relationships and predictable connections between events. Newtonian physics provided useful metaphors for psychological phenomena involving drives

191PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

or similar motivational concepts, and provided support for thinking about regres- sion as a reversible psychological event or even as a therapeutic phenomenon. The “hydraulic” analogy, characteristic of Freud and later of the ethologists, made use of the idea that the pressure of drives could be blocked or displaced, and that a regressive return to the blocking event could free emotional expression and permit progression to better mental functioning. However, further development of the physical sciences, and the study of electricity, magnetism, and other field phe- nomena, offered alternative metaphors for mental functioning and mental illness. The use of either mechanical or field-theory physical science metaphors for regression suggested that mental functioning could move both backward and forward as a result of experience; regression was thus not necessarily patholog- ical, and in fact could be instrumental in producing progression. When physics is the “source domain” (Lakoff, 1993), an environmentalist rather than a nativist view is likely, yielding an increased emphasis on the control of regression for therapeutic purposes, characteristic of the Tavistock approach.

The recapitulation problem. When recapitulation, or repetition of devel- opment along preferable lines, is added to the regression concept, identification of relevant root metaphors becomes particularly challenging. The idea that regres- sion can be followed by redevelopment along a more desirable trajectory seems mechanistic in its suggestion of free movement in two directions along a linear path. However, the idea that both regression and recapitulation are triggered by environmental cues (for instance, in the form of actions that resemble maternal care of a young child) has its basis in an organismic view, because organisms can shift functioning under different circumstances, and because the idea contains a teleological view of the preferred outcome. It seems equally appropriate to choose what Pepper called “formism” as the root metaphor here. The basis of formism is the perceived similarity between phenomena, and apparent patterns or laws are seen as causal; these clearly apply to the use of parallel experiences to rework early development. It is difficult to conceive of a biological or physical model for recapitulation, and the metaphor remains unidentified.

References

About the journal. (2006). Retrieved from http://tavinstitute.org/humanrelations/about_ journal/aims.html.

Ames, L. B., & Ilg, F. L. (1964). The developmental point of view with special reference to the principle of reciprocal neuromotor interweaving. Journal of Genetic Psychol- ogy, 105, 195–209.

Argyris, C. (1997). Kurt Lewin Award Lecture, 1997: Field theory as a basis for scholarly consulting. Journal of Social Issues, 53, 811– 827.

Ash, M. G. (1995). Gestalt psychology in German culture, 1890–1967. New York: Cambridge University Press.

Balint, M. (1968). The basic fault. New York: Brunner/Mazel. Barker, R. G., Dembo, T., & Lewin, K. (1943). Frustration and regression. In R. G.

Barker, J. Kounin, & H. Wright (Eds.), Child behavior and development (pp. 441– 458). New York: McGraw-Hill.

Barnes, M., & Berke, J. (1971/2002). Mary Barnes: Two accounts of a journey through madness. New York: Harcourt Brace Jovanovich, Other Press.

Berlin, I. (2000). The Counter-Enlightenment. In I. Berlin & H. Hardy (Eds.), The proper study of mankind (pp. 243–268). New York: Farrar Strauss Giroux.

192 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

Bettelheim, B. (1943). Individual and mass behavior in extreme situations. Journal of Abnormal and Social Psychology, 38, 417–542.

Bettelheim, B. (1947). The concentration camp as a class state. Modern Review, 1, 628 – 637.

Bettelheim, B. (1950). Love is not enough. New York: Free Press. Bettelheim, B. (1972). The empty fortress. New York: Simon & Schuster. Biehn, K. J. (2009). “Monkeys, babies, idiots” and “primitives”: Nature-nurture debates

and philanthropic foundation support for American anthropology in the 1920s and 1930s. Journal of the History of the Behavioral Sciences, 45, 219 –235.

Boas, F. (1904). The history of anthropology. Science, 20, 513–524. Bowlby, J. (1966). Maternal care and mental health. New York: Schocken. Brome, V. (1968). Freud and his early circle. New York: William Morrow. Brown, J. A. C. (1961). Freud and the post-Freudians. Baltimore: Penguin. Brown, R. (1958). Words and things. New York: Free Press. Casper, S. T. (2009). Reflections on Queen Square. Retrieved from http://www

.dictionaryofneurology.com/2009/11/reflections-on-queen-square.html Clarke, C., Howard, R., Rossor, M., & Shorvon, S. D. (2009). Neurology: A Queen Square

textbook. Chichester: Wiley-Blackwell. Costall, A. (1999). Dire straits: The divisive legacy of the 1898 Cambridge anthropolog-

ical expedition. Journal of the History of the Behavioral Sciences, 35, 345–358. Critchley, MacD. (1960). The beginnings of the National Hospital, Queen Square (1859 –

1860). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1967925/pdf/ brmedj02924-oo23.pdf

Danziger, K. (1995). Generative metaphor and the history of psychological discourse. In D. E. Leary (Ed.), Metaphors in the history of psychology (pp. 331–356). New York: Cambridge University Press.

Davis, J. E. (2008). Culture and relativism. Society, 45, 270 –276. Dicks, H. V. (1970). Fifty years of the Tavistock Clinic. London: Routledge &

Kegan Paul. Etchegoyen, R. H. (2005). Fundamentals of psychoanalytic technique. London: Karnac. Ferenczi, S. (1950). The selected papers of Sandor Ferenczi. New York: Basic Books. Freud, A. (1937). The ego and the mechanisms of defence. London: Hogarth. Freud, A. (1960). Discussion of Dr. John Bowlby’s paper. Psychoanalytic Study of the

Child, 15, 53– 62. Freud, A. (1963). Regression as a principle in mental development. Bulletin of the

Menninger Clinic, 27, 126 –139. Freud, S. (1891/1953). On aphasia. New York: International Universities Press. Fromm-Reichmann, F. (1950). Principles of intensive psychotherapy. Chicago: University

of Chicago Press. Gentner, D., & Grudin, J. (1985). The evolution of mental metaphors in psychology: A

90-year retrospective. American Psychologist, 40, 181–192. Gesell, A. (1939). Reciprocal interweaving in neuro-motor development: A principle of

spiral organization shown in the patterning of infant behavior. Journal of Compar- ative Neurology, 70, 161–180.

Granit, R. (1967). Charles Scott Sherrington: An appraisal. Garden City, NY: Doubleday. Greenberg, J. R., & Mitchell, S. A. (1983). Object relations in psychoanalytic theory.

Cambridge, MA: Harvard University Press. Hacking, I. (1999). The social construction of what? Cambridge, MA: Harvard Univer-

sity Press. Hartmann, H. (1950). Psychoanalysis and developmental psychology. Psychoanalytic

Study of the Child, 5, 7–17.

193PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

Hartmann, H. (1956). Notes on the reality principle. Psychoanalytic Study of the Child, 11, 31–53.

Heimann, M. (2003). Regression periods in human infancy: An introduction. In M. Heimann (Ed.), Regression periods in human infancy (pp. 1– 6). Mahwah, NJ: Erlbaum.

Henle, M. (1978). Gestalt psychology and gestalt therapy. Journal of the History of the Behavioral Sciences, 14, 23–32.

Herle, A., & Rouse, S. (Eds.). (1998). Cambridge and the Torres Strait: Centenary essays on the 1898 Anthropological Expedition. Cambridge: Cambridge University Press.

Hunter, R. A., & Hurwitz, J. L. (1961). The case notes of the National Hospital for the Paralyzed and Epileptic, Queen Square, London, before 1900. Journal of Neurology, Neurosurgery, and Psychiatry, 24, 187–194.

Jackson, J. H. (1894/1958). The factors of insanities. In Selected writings of John Hughlings Jackson, Volume 2 (pp. 411– 421). New York: Basic Books.

Jackson, S. W. (1969). The history of Freud’s concepts of regression. Journal of the American Psychoanalytic Society, 17, 743–784.

Jung, C. G. (1983). The essential Jung. Princeton, NJ: Princeton University Press. Kilborne, B. (1998). Ferenczi, regression, and shame. International Forum of Psycho-

analysis, 7, 225–228. Kotowicz, Z. (1997). R. D. Laing and the paths of anti-psychiatry. London: Routledge. Lakoff, G. (1993). The contemporary theory of metaphor. In A. Ortony (Ed.), Metaphor

and thought (pp. 202–251). New York: Cambridge University Press. Lakoff, G., & Johnson, M. (1980/1998). Metaphors we live by. Chicago: University of

Chicago Press. Leary, D. E. (1992). William James and the art of human understanding. American

Psychologist, 47, 152–160. Leary, D. E. (Ed.). (1990). Metaphors in the history of psychology. New York: Cambridge

University Press. Lewin, K. (1947a). Frontiers in group dynamics: Concept, method, and reality in social

science; social equilibria and social change. Human Relations, 1, 5– 41. Lewin, K. (1947b). Frontiers in group dynamics: II. Channels of group life; social

planning and action research. Human Relations, 1, 143–153. Lewin, K. (1951). Field theory in social science. (D. Cartwright, Ed.). New York: Harper

& Row. Lippitt, R. (1940). An experimental study of democratic and authoritarian group atmo-

spheres. In K. Lewin, R. Lippitt, & S. Escalona (Eds.), Studies in topological vector psychology (pp. 45–195). Iowa City: University of Iowa Press.

Little, M. I. (1987). On the value of regression to dependence. Free Associations, 10, 7–22.

Marrow, A. J. (1969). The practical theorist: The life and work of Kurt Lewin. New York: Basic.

Meares, R. (1999). The contribution of Hughlings Jackson to an understanding of dissociation. American Journal of Psychiatry, 156, 1850 –1855.

Miller, P., & Rose, N. (1988). The Tavistock programme: The government of intersub- jectivity and social life. Sociology, 22, 171–192.

Neumann, J. (2005). Kurt Lewin at the Tavistock Institute. Educational Action Research, 13, 119 –135.

Pear, T. H. (1918). The war and psychology. Nature, 102, 88 – 89. Pepper, S. C. (1942). World hypotheses: A study in evidence. Berkeley: University of

California Press. Pribram, K. (1995). From metaphors to models: The use of analogy in neuroscience. In

194 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

D. E. Leary (Ed.), Metaphors in the history of psychology (pp. 79 –103). New York: Cambridge University Press.

Rank, B. (1949). Aggression. Psychoanalytic Study of the Child, 3, 43– 48. Rayner, E. (1991). The independent mind in British psychoanalysis. London: Free Asso-

ciation. Redl, F., & Wineman, D. (1951). Children who hate. New York: Free Press. Rivers, W. H. R. (1922). Instinct and the unconscious: A contribution to a biological

theory of the psycho-neuroses (2nd ed.). New York: Cambridge University Press. Rivers, W. H. R., & Head, H. (1908). A human experiment in nerve division. Brain,

31, 323– 450. Sarbin, T. R. (1995). Metaphors of unwanted conduct. In D. E. Leary (Ed.), Metaphors in

the history of psychology (pp. 300 –329). New York: Cambridge University Press. Schiemann, G. (2009). Hermann von Helmholtz’s mechanism: The loss of certainty.

Dordrecht: Springer. Sechehaye, M. (1951). Autobiography of a schizophrenic girl. New York: Grune

and Stratton. Sherrington, C. S. (1906). The integrative action of the nervous system. New Haven: Yale

University Press. Smith, G. E., & Pear, T. H. (1917). Shell-shock and its lessons. Retrieved from http://

www.gwpda.org/medical/shshock/index.htm Spencer, H. (1898). First principles. London: Williams & Norgate. Steiner, R. (1985). Some thoughts about tradition and change arising from an examination

of the British Psycho-analytical Society’s “Controversial Discussions,” 1943–1944. International Review of Psychoanalysis, 12, 27–71.

Stewart, H. (2003). Winnicott, Balint, and the Independent tradition. American Journal of Psychoanalysis, 63, 207–217.

Suttie, I. (1935/1999). The origins of love and hate. London: Free Association Books. The Tavistock and Portland NHS Trust (n.d.). Our history. Retrieved from http://

www.tavi-port.org/Ourhistory Trist, E. (1993). Guilty of enthusiasm: An autobiographical view of Eric Trist, a founding

member of the Tavistock Institute of Human Relations. Retrieved from http:// www.moderntimesworkplace.com/archives/ericbio/ericbiobody/ericbiobody.html

Trist, E., & Murray, H. (1990). Historical overview: The foundation and development of the Tavistock Institute, 1941–1989. Retrieved from http://www.moderntimeswork- place.com/archives/ericsess/tavis1/tavis1.html

Tubert-Oklander, J. (2007). The whole and the parts: Working in the analytic field. Psychoanalytic Dialogues, 17, 115–132.

van der Horst, F. C. P., & van der Veer, R. (2009). Separation and divergence: The untold story of James Robertson’s and John Bowlby’s theoretical dispute on mother-child separation. Journal of the History of the Behavioral Sciences, 45, 236 –252.

Verdon, M. (2007). Franz Boas: Cultural history for the present, or obsolete natural history? Journal of the Royal Anthropological Institute, 13, 433– 451.

Winnicott, D. W. (1954/1958). Metapsychological and clinical aspects of regression within the psychoanalytic set-up. In Collected papers: Through paediatrics to psy- choanalysis. London: Tavistock.

Winnicott, D. W. (1965/1992). Notes on withdrawal and regression. In D. W. Winnicott, C. Winnicott, R. Shepherd, & M. Davis (Eds.), Psychoanalytic explorations (pp. 149 –151). Cambridge, MA: Harvard University Press.

Young, A. (1999). W. H. R. Rivers and the war neuroses. Journal of the History of the Behavioral Sciences, 35, 359 –378.

Zimmerman, D. P. (1993). The clinical thought of Bruno Bettelheim: A critical historical

195PSYCHOLOGICAL REGRESSION

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .

review. In J. M. Goldsmith & J. Sanders (Eds.), Milieu therapy: Significant issues and innovative applications (pp. 3–36). New York: Haworth.

Received June 1, 2009 Revision received December 14, 2010

Accepted December 27, 2010 y

Members of Underrepresented Groups: Reviewers for Journal Manuscripts Wanted

If you are interested in reviewing manuscripts for APA journals, the APA Publications and Communications Board would like to invite your participation. Manuscript reviewers are vital to the publications process. As a reviewer, you would gain valuable experience in publishing. The P&C Board is particularly interested in encouraging members of underrepresented groups to participate more in this process.

If you are interested in reviewing manuscripts, please write APA Journals at [email protected]. Please note the following important points:

• To be selected as a reviewer, you must have published articles in peer-reviewed journals. The experience of publishing provides a reviewer with the basis for preparing a thorough, objective review.

• To be selected, it is critical to be a regular reader of the five to six empirical journals that are most central to the area or journal for which you would like to review. Current knowledge of recently published research provides a reviewer with the knowledge base to evaluate a new submission within the context of existing research.

• To select the appropriate reviewers for each manuscript, the editor needs detailed information. Please include with your letter your vita. In the letter, please identify which APA journal(s) you are interested in, and describe your area of expertise. Be as specific as possible. For example, “social psychology” is not sufficient—you would need to specify “social cognition” or “attitude change” as well.

• Reviewing a manuscript takes time (1– 4 hours per manuscript reviewed). If you are selected to review a manuscript, be prepared to invest the necessary time to evaluate the manuscript thoroughly.

196 MERCER

T hi

s do

cu m

en t i

s co

py ri

gh te

d by

th e

A m

er ic

an P

sy ch

ol og

ic al

A ss

oc ia

tio n

or o

ne o

f i ts

a lli

ed p

ub lis

he rs

. T

hi s

ar tic

le is

in te

nd ed

s ol

el y

fo r t

he p

er so

na l u

se o

f t he

in di

vi du

al u

se r a

nd is

n ot

to b

e di

ss em

in at

ed b

ro ad

ly .