The Hampstead Clinic at work. Discussions in the Diagnostic Profile Research Group.

Minutes of the Hampstead Clinics Diagnostic Profile Research Group during a fifteen-month period (1964-1965) are reviewed and discussed. A wide range of topics were considered and discussed, with a special focus on the affective life, object relations, and ego functions of atypical children in comparison to the early ego functions and differentiation of normal and neurotic children. These lively clinical and theoretical discussions, and their implications for therapeutic work with a wide range of children, demonstrate the multifaceted leadership and contributions of Anna Freud as teacher, clinician, and thinker, and of the Hampstead Clinic as a major center for psychoanalytic studies.DISCUSSION GROUPS WERE A SIGNIFICANT AND VALUED FEATURE OF THE Hampstead Child-Therapy Course and Clinic.1 These groups focused on a wide range of clinical and theoretical issues bearing on child development and psychopathology. A major group was the Diagnostic Profile Research Group, informally called "the Profile Group." Its original aim was to consider, correct, amplify, and articulate the categories of the diagnostic profile. Later, discussions centered on children for whom the profile categories and descriptions were found wanting. Here the aim was to enhance the profile's comprehensiveness. In time, the Profile Group examined changes in children as a function of psychoanalytic treatment, making use of the comparison of original profiles with the "terminal profiles" drawn by therapists at the end of treatment. These meetings were also used to discuss still-unpublished papers, observations of toddlers in nursery school settings, and consideration of topics of more general, theoretical interest. The convener of these weekly meetings was Dr. Humberto Nagera. Miss Anna Freud was the unofficial chairperson. The participants included the Hampstead Clinic's therapists, research staff, student therapists, supervisors, analysts in the London psychoanalytic community, and visiting guests from abroad.The diagnostic profile, originally called the "developmental profile," occasionally the "metapsychological profile," was Anna Freud's format for making sense of material obtained at the diagnostic assessment of children and adolescents (A. Freud, 1962; A. Freud, 1965; H. Nagera, 1963; M. Laufer, 1965). The profile offered a psychoanalytic schema for assessing children, with the aim of considering the salient determinants of their personalities and psychopathology, and for considering optimal interventions. The schema began with attention to the child's external reality and proceeded to a consideration of more "internal" aspects of the child's life, such as the nature of his drive development, ego and superego functions, and the nature of his conflicts. An important consideration was the extent to which he was proceeding along relatively normal pathways or was somehow stuck at earlier phases of development. In time, the diagnostic profile became the final document of all children assessed at the clinic. Later, a schema for the "terminal profile" was developed to offer a picture of the child at the end of his treatment.From May 1964 to July 1965, 1 took minutes of the weekly meetings of the Profile Group, a rotating task for student therapists. These minutes were sent for approval and corrections to the major quoted participants. Corrections and emendations were then incorporated into a final form of the minutes.2 These latter, corrected minutes are the basis of this review. At that time, the Hampstead Clinic had received a grant from the National Institute of Mental Health (Bethesda, Maryland) for "the Assessment of Pathology in Childhood" via the diagnostic profile, hence the value accorded to the accuracy of reported discussions. Despite the fact that these discussions were not recorded verbatim, with the minutes undoubtedly more organized than the actual meetings, they offer glimpses of the Hampstead Clinic and Miss Freud "at work" during a most productive, stimulating period of the Hampstead Clinic. …