This is the story of a disastrous encounter with psychoanalysis which severely blemished my middle years.

I was about thirty years old when I found myself to be in a state of terrible distress. It was the paralysis of my will, rather than the pain itself, which enabled me to infer, using my head, that I needed help different in kind from the support of friends. A knowledgeable acquaintance suggested that I consult D.W. Winnicott, without telling me that he was pre-eminent among British psychoanalysts.

I don’t think that living through an artificial self, which is what had got me into such an awful mess, is all that uncommon. The condition is difficult to recognise because it is concealed from the world, and from the subject, with ruthless ingenuity. It does not feature in the standard catalogue of neurotic symptoms such as hysteria, obsession, phobia, depression or impotence; and it is not inconsistent with worldly success or the formation of deep and lasting friendships. The disjointed components of the artificial self are not individually artificial.

What is it like to live in a state of dissociation? In a real sense, the subject is never corporeally present at all but goes about the world in a waking dream. Behaviour is managed by an auto-pilot. Responses are neither direct nor spontaneous. Every event is re-enacted after it has taken place and processed in an internal theatre. On the one hand, the subject may be bafflingly insensitive but this goes with extreme vulnerability, for the whole apparatus can only function within a framework of familiar and trusted responses. He or she is defenceless against random, unexpected or malicious events. Evil cannot be countered because it cannot be identified.

The short personal story which follows is so familiar in its outline that it may seem stale, but I cannot explain how I allowed such strange things to happen to me unless I tell it.

My parents separated from one another, with great and protracted bitterness, at about the time I was born, in 1926, and I hardly ever saw them together. In infancy I was looked after, in various country houses in Sussex and Kent, by nannies and governesses as well as by a fierce maiden aunt who shook me violently when I cried. My mother, though frequently in bed with what she called ‘my pain’, was a poet, playwright, pianist, composer and actress, and these activities took her away from home for long and irregular periods of time. When she rematerialised, we had long goodnights during which, as she sang to me, I undid her hair so that it fell over her shoulders. She used to parade naked in front of me, and would tell me (for instance) of the intense pleasure she got from sexual intercourse, of the protracted agony and humiliation she had suffered when giving birth to my much older half-sister, Ann, who grew up retarded and violent (screamed, spat, bit, kicked, threw), and of her disappointment when my father was impotent, particularly on their honeymoon. The intimacies we shared made me love her ‘over the biggest number in the world’.

My father was shadowy to begin with; he was an elderly man – always approaching sixty. I first perceived him as an invalid – disturbingly unlike other children’s fathers. But he had great personal authority, distinction and charm, which I could identify in the responses of other people to him. Occasionally he gave me superlative presents – a toy launch which got up its own steam, a flying model of a biplane.

Neither of my parents had a social circle. No one came to stay. There were no children next door to play with.

As a young child I believed myself to be special, endowed with supernatural, even divine, powers which would one day astonish the world. I also knew that I was worthless, with no gifts or rights, and that I looked fat, dull and unmanly. The achievements of others, particularly those of my older brother John, stood in for anything that I might achieve myself, and afterwards a series of distinguished men were to step into John’s shoes. I acquired a spectacular ability to not see, identify or shrewdly evaluate people or situations. Although passive and sickly, I enjoyed secret fantasies of violence. When asked what I was going to be when I grew up, I replied that I was going to be ‘a boy actress’.

When I was six, an abscess developed in my inner ear which eventually, in a climax of torture, burst through my eardrum. For years afterwards I often had to wear a bandage round the whole of my head to contain the discharge. I became 90 per cent deaf in one ear; I also started to get short-sighted and wear spectacles.

When just seven years old I was sent to a boarding school, for eight solid months of each year, without the elementary social or other skills that were needed. I could hardly read and had never dressed myself, so that doing up my back braces was painful and nearly impossible; it never occurred to me that I could slip them off my shoulders. The little boys were often beaten and kicked by the masters and I found this extremely frightening; one child was severely caned in front of the whole school. Lessons were an impenetrable bore. Occasionally I had severe panic attacks associated with strange fantasies – for instance, that I would soon die and be reincarnated as a rabbit in a hutch, unable to communicate with my parents or siblings.

When I was ten, my father, having inherited a peerage and a great deal of money, remarried and recovered a family estate of unsurpassable loveliness in a remote part of Southern Ireland. My stepmother, Nora, created a luxurious and beautiful home, full of light and flowers, in a mansion house which overlooked two large lakes with woods running down to them. With John and my sister Katharine I was cocooned, during the school holidays, in total complaisance by a full complement of servants, gardeners, handymen and farm hands, of whose irony I was never conscious. On the morning of my 11th birthday my father walked into my bedroom, still wearing his pyjamas, with a 20-bore shotgun under his arm. I learned to shoot snipe and play tennis.

Around this time, my mother revealed that for years and years my father had been ‘the most terrible drunkard’. In response to my anxious enquiry she emphasised that he drank ‘until he became completely fuddled’. Meanwhile she had taken as a lover an ebullient young man, 15 years younger than herself, who emanated genius. This was William Glock, later to become the most versatile and influential musician of his generation. It was through his ears that I first heard and loved music and therefore started to learn the oboe. He soon fell in love with Katharine, and, sort of, with me (now aged 14) and we three drank a lot of rum and lime, with enormous hilarity.

When I was about fifteen, while John was fighting a gallant war over the Atlantic, my father started to drink again.

Heavy drinking is often associated with boisterous behaviour in a social context. My father never drank publicly at all and, drunk or sober, was never boisterous. He saw himself as a nobleman; and his style was that of a distinguished barrister, which is what he really was. But having suffered previously from delirium tremens, one or two shots caused him to collapse into bestial incoherence. He had convinced himself that if he was alone when he put the bottle to his lips no one would notice what was going on. I colluded with him in this, never referring to his drinking in any way. His drunkenness, when it occurred, was conspicuous and desperately embarrassing, whether he was in residence as a grandee in the Irish countryside or asleep in the Chamber of the House of Lords or visiting me at school. When he was not drinking, he recovered his authority completely. He was a fine violinist and during his abstinent periods, with Katharine at the piano, we played the great Bach double concertos together.

As my father started to deteriorate in earnest he became violently anti-semitic and, just as the war was ending, he used to say: ‘Would it really have been so bad if the Germans had come here?’ My stepmother confided to me, as my mother had done, that my father had generally been impotent and that she had a lover in Dublin.

For all the confidences I had received, for all my precocity and sense of having been through more than my contemporaries, I did not know, at the age of 17, that the vagina existed, supposing that childbirth was painful because it took place through the urethra. Nor did I know that men ejaculated.

I spent four supremely happy years at Oxford and owe my higher education entirely to Isaiah Berlin, who taught me philosophy, tête-à-tête, through 1946-47. I designed my first essay for him with a conscious intent to please but he was not to be seduced; he interrupted me at once and tore my work to pieces. A week later I adapted my first philosophical position to one which, so far as I could infer, must be closer to his, but he left me in shreds again. In response to his seemingly inconsistent criticisms, I invented ever more complicated structures which must, I supposed, be getting me closer to what he really thought. One day he asked me to repeat a passage and when I did so he burst into merry laughter exclaiming: ‘How gloriously artificial!’ I was deeply hurt but impelled thereafter to make the stupendous effort which, over a period of 15 months, was to transform my intellect.

All my old people faded away very sadly. Nora shot herself in the head with a shotgun; my father, his entire fortune squandered, died alone in a hospital where the nurses were unkind to him; my half-sister was committed to a high security mental institution at Epsom; my mother had a bad stroke and lived out her last six years hemiplegic and helpless, her mind altered. She told her nurses that they were ‘lower-class scum’ and complained that I was ‘marrying the daughter of a New York yid’. This yid was Jacob Epstein.

Soon after my mother died I had a dream. I saw her in a bathtub in which there was no water. She was paralysed from the waist down and instead of the pubic hair I had seen as a young child there was a large open wound. Through the upper part of the room there was a system of ropes, pulleys and hooks. Although the lower part of her body was inert, she could operate the ropes skilfully with her hands and arms in a way which enabled her to get her body to move, with extreme agility, about the bathroom. She was confined to the room because the whole contraption was slung from the ceiling and attached to the walls. Her lower half sometimes got left behind or forced into strange shapes against the walls or over the edge of the tub as she moved around.

Winnicott’s elegant white suit was crumpled; so was his handsome face. He reminded me of a very frail Spencer Tracy. His sentences were not always coherent but I experienced them as direct communications to an incredibly primitive part of myself; I want to say that we spoke to one another baby to baby. The crumpled face was a tabula rasa, impassive but receptive.

I described my impasse to Winnicott, adding that ‘my tears were tightly locked into their ducts.’ After desultory responses he asked me whether I had any ‘cot’ recollections. ‘Yes,’ I replied, scouring my mind and recollecting myself in a pram in a place where it could not, in reality, have stood – in the middle of a main road.

‘Was there an object with you?’ he asked.

‘Yes,’ I replied, ‘there was a kaleidoscope.’

‘What a hard thing,’ was Winnicott’s comment.

Winnicott next asked me if I would have any objection to seeing a Pakistani analyst. As I left he said, very kindly, ‘You have been very frank with me,’ adding: ‘I think you were a lonely child.’

I arranged an appointment with Masud Khan from my office in the Treasury, where I was now an economic adviser, and he met me at the foot of the stairs leading to his attic apartment in Harley Street. He was in his mid-thirties, a tall, erect and substantially built man with beautiful Oriental features. He had abundant black hair swept back over his ears and was slightly overdressed in the style of an English gentleman.

I repeated to Khan the story of my impasse and in the course of telling it mentioned that I read a lot of newspapers. He looked up and asked me whether, if I read all these papers, I hadn’t read something about him. When I said that I hadn’t he assumed an expression of mock disbelief. A little later he broke into my narrative and asked irrelevantly: ‘Haven’t you got some connection with Epstein?’ At this I checked, expressing concern about the confidentiality of what I was telling him, since his question implied that he already knew something about me and perhaps that we had social friends in common. Khan did not answer directly. He grunted and tried to look impassive.

Khan next explained that he was going to get married to Svetlana Beriosova, the loveliest of the Royal Ballet’s ballerinas, in about ten days’ time; this was why I might have read about him in the press. At the end of the interview, he drove me slowly part of the way home in his Armstrong Siddeley. In the car he produced a book of poems by James Joyce from the pouch in the door and told me that he read them when he was stuck in traffic jams. He asked, ‘Did you never think of killing yourself?’ but answered the question himself: ‘You would not know whom to kill.’

It is astonishing to me, with the knowledge I now have, that Khan so intruded himself into that first interview, which should have held out the promise of a safe, private and neutral space in which a dialogue with its own dynamic could take place. Yet within minutes of our first meeting, as I can now clearly see, the therapeutic relationship had been totally subverted. He needed my endorsement, as will become increasingly clear; he also needed to intrude on me. I had no way of registering that there was something amiss in his expecting me to know about his forthcoming marriage (which implied that he would be leaving me for his honeymoon almost as soon as we had begun work) or in his showing me that he was a literary man who drove a smart car. But I did know that there was something completely wrong about the Epstein question; it had given me a sense of contamination, which I suppressed in a sickeningly familiar way.

Khan now distanced himself. I referred the following day to his ‘girl’ and he corrected me, ‘my future wife …’ adding: ‘You thought you were going to cuddle up with me, didn’t you?’ I did not, by a very long way, have the understanding or presence of mind to reply that this was an expectation which he himself had created; and I felt that it was, indeed, I who had intruded.

During the next few days my artificial self came, in stages, completely to pieces although my adult mind continued to function in a completely normal way; for instance, I continued to work in the Treasury without a break. The meltdown, which took the form of a series of quasi-hallucinations accompanied by storms of emotion, all took place at home, although I reported them to Khan. These waking dreams came to a climax after about three days. I ‘saw’ a blanket inside my skull which was very tightly wrapped around my brain. And it began to loosen! First intermittently, then decisively, the blanket came right away like a huge scab and I reached, as it seemed, an extraordinary new insight. My father had hated me! By appearing at my school when obviously drunk, he had maliciously used my love for him as a weapon against me! And he had cruelly separated me from my sister by sending me away to school. These ‘perceptions’ generated an outburst of infantile rage. While in this strange condition I saw, as in a vision, a sentence which was lit up, flickering and suspended in the air. The words were:

UNLESS HE JUSTIFIES HIMSELF I MUST SAVE HIM

The meaning I attributed, with partial understanding, to this sentence was that unless the parent is perceived by the infant as strong and self-sufficient, the caring process will go into reverse with the force of the ocean bursting through a dam.

No one, as I now know, has written with more penetration about the genesis of the artificial self than Winnicott. The birthright of every child is to receive, starting from the primal union, a uniquely empathetic response which nurtures its growth and establishes its identity. If this does not happen, the infant may come under an overpowering compulsion, as a condition for its very survival, to provide whatever it is the parent needs from the relationship. An incredibly destructive but deeply concealed reversal of roles then takes place.

My cathartic explosion was perfectly sincere and real. A fantastic distortion of my character that had governed my life up to that point, a bizarre mushroom growth, had been clearly revealed to me and I experienced a feelingfulness which had been blockaded for as long as I could remember.

By the time Khan returned from his honeymoon in Monte Carlo, I was having dreams about cars slipping backwards down icy pathways in the darkness. But I clung to the firm belief that another emotional breakthrough would soon occur.

It never did. What followed was a long and fruitless battle culminating in a spiral of degradation.

A crucial component of the analytic process resides in the patient’s ability to articulate thoughts, fantasies or images as they occur to him or her, especially any hostile thoughts he or she may have towards the analyst. Unless this happens, the primitive reversal of roles can never be undone. But it is extremely difficult, requiring great concentration, courage and trust, to express murderous thoughts and insults to their object. The way such insults are negotiated is one of the keenest measures of an analyst’s skill, character and fitness to practise; the artificial self knows all too well how to make others bleed.

As I come to describe Khan’s failure to pass this elementary test, I realise that I am in danger of making him seem a mere figure of fun. There was indeed something wholly ridiculous about him – as there was about Adolf Hitler. But he had a formidable and quick-acting intelligence, astonishing powers of observation and an unrivalled ability straightaway to see deeply below the surface. He was impossible to worst. He knew how to exploit and defy the conventions which govern social intercourse in England, taking full advantage of the fact that the English saw him instinctively as inferior – as ‘a native’ – and tried to patronise him.

When I asked Khan why he wore a riding jacket which had a silly slit in the middle of his behind, he replied stiffly: ‘Ask the man who tailored it.’ When I said his flat was furnished like a hotel he referred reproachfully to ‘my wife’s superb style’, which I had failed to recognise, turning the flat, in my mind, into a ‘a shabby hotel’. I didn’t have the presence of mind to tell him that what I objected to was that his flat was like a smart hotel. Khan told me that he ‘wanted to give me a good start’ and went on to explain how the infant eats the breast but that the breast also eats the infant. Summoning up my courage (for I was also afraid of hurting him) I said: ‘This silly buffoon is talking drivel.’ To this Khan replied that, unlike some of his colleagues, he believed in paying back aggression from his patients in kind. And I was presuming to look for help ‘from the man whom in your mind you call a buffoon’ in a clipped, whispered and venomous tone, adding that I lived ‘like a pig’ in my own home. He wasn’t going to pretend, so he said, that things were other than they were; he had been sadistic towards me and for days and months afterwards he referred to this as ‘the sadistic session’.

Beriosova was often featured, scantily dressed, in press photographs. I wanted to know which bit of her was grabbed by her partner when he held her on top of a single outstretched arm, as well as other more intimate things. Khan told me that I was ‘using the analytic situation as a licence to articulate [my] intrusive fantasies’. And he soon became enraged. ‘You say that to me to annoy me,’ he said and then, after a pause: ‘Which it does.’ He then went into a tirade about my crude assault (‘You Englishman!’) on a being so precious to him. ‘I do know how to protect my wife,’ he said as though I had attacked her. At the least slight it was Khan’s invariable response to deliver a righteous speech, often finishing up with some withering coda such as ‘And to think you people ruled the world!’ Only now can I see how easy it was to bait him.

We hardly ever spoke of my childhood. Khan preferred, he said, to ‘work out of’ the material which was thrown up by contemporary experiences. Everything of significance that had happened in the past could be reinterpreted in terms of what was happening now. This gave him a licence to interfere actively, judgmentally and with extraordinary cruelty in every aspect of my daily life.

We entered a long period of painful stasis. ‘When is something going to happen?’ I would ask and he would reply: ‘I wonder too when something is going to happen. I have exhausted’ – these were his exact words – ‘every manoeuvre that I know. You are a tiresome and disappointing man.’

How did I account to myself for what was happening? I thought that everything unkind Khan said to me was justified and that I was learning to accept home truths; that this was extraordinarily painful but the essence of what a good and true analysis should be. We weren’t having one of those soppy analyses that the ignorant public imagines, where a pathetic neurotic talks about himself and is passively listened to, and endlessly comforted. The characteristic sensation I experienced was a smouldering rage which carried me from session to session. I felt like a kettle that had been left on the flame long after the water had boiled away.

Khan liked it when I moved up through the Treasury ranks, greatly overestimating the importance and significance of the positions which I held. Meanwhile he began increasingly to fill the sessions with tales about his own social life in London or, occasionally, New York. The stories were not good ones. Many were obscene and many were flat, but there was one feature common to every one of them: Khan had got the better of someone. He had rescued Mike Nichols from a man with a fierce dog in New York. He had fought physically with Peter O’Toole, using a broken bottle. He had got the overflow from his lavatory to pour a jet of water onto the head of a woman who was making her car hoot in the street below. Often it would be nothing more than an ugly exchange at a drinking party for which he needed my approval and endorsement. The following characteristic tale, being brief, must stand in for a limitless number of other stories that I can immediately recall.

A man comes up to Khan at a party and says: ‘Every night I go to bed with two beautiful women. I make love to one of them and then, if I feel like it, I turn over and make love to the other. Sometimes I make love to both of them at once.’ ‘Yes,’ Khan says, ‘but by the laws of topology there must always be one orifice which remains vacant.’

Very occasionally he appealed to me for sympathy. Princess Margaret had tripped him up over the way he had pronounced something. Lord Denning (it was Profumo time) had not replied to his invitation to come to dinner.

Khan always answered telephone calls during sessions. When Winnicott rang up I could clearly hear both sides of the conversation, so presumably he angled the phone towards me. Winnicott spoke respectfully to Khan, for instance about a paper which he had recently published. ‘I learned a great deal from it,’ Winnicott said deferentially. This particular conversation ended with a giggly joke about homosexual fellatio – the final two words of the conversation – accompanied by loud laughter.

A gynaecologist rang up during one of my sessions to enquire about a patient of Khan’s whom I shall call Marian and who was expecting a baby. Khan spoke harshly about her to the gynaecologist, closing the conversation with the advice: ‘And charge her a good fee.’ Khan kept me in touch with the progress of Marian’s pregnancy. She was not married, and as her confinement approached he referred to it bitingly as ‘the virgin birth’.

After the child was born, Khan started speaking of Marian as a suitable partner for me – although I was happily married and although, as I much later discovered, he had secretly invited my wife Kitty to an interview with him. Marian and I were ‘handmade for one another’. Khan induced me to take her out to lunch. ‘If she’s not really beautifully dressed, but really beautifully dressed, give her hell.’ I took her to Overton’s in Victoria where we ate seafood and had an amiable conversation without there being any spark between us.

We now started meeting à trois, Marian, Khan and myself. On one occasion we went to a literary group in Battersea where Khan gave a talk on ‘Neurosis and Creativity’. On another, Marian watched from the gallery while I trounced Khan at squash, breaking his nose with my racquet in the process; immediately following which Khan, bloody nose and all, insisted on playing, because he could win, a game of ping-pong. And the three of us spent a whole evening playing poker for matchsticks. Khan cheated; he grabbed half my growing pile of matchsticks when I wasn’t looking, although I didn’t allow myself to realise it at the time. He chortled that with the power he possessed over each of us he could ‘orchestrate the conversation at any level he chose’. At my next session he told me that this had been the happiest evening he had ever spent in his life.

At my next session! I was still seeing the man five times a week and paying him large fees. And I went on doing so until the end, although it is inconceivable that any therapy was taking place; for a long time now I was the one who was looking after him. Paying fees was part of keeping up the absurd fiction that a great patient was having a great analysis with a great analyst. ‘I have the virtues which are the counterpart of my defects,’ he was fond of saying. He had saved my life, the story went – and no one else could have done it. About this time Khan began to shower me with presents. He gave me a silver pen, a complete Encyclopaedia Britannica, a signed lithograph of sunflowers by Léger, an Indian bedspread, a Nonesuch Bible in three volumes, and several books, including The Naked Lunch.

Sometimes Beriosova was the hostess. Her physical movements were light and regal though she smoked heavily and drank a great deal of gin. On one occasion there were other analysands besides me present. Beriosova drank more gin than usual, retired to the Khan bedroom and screeched: ‘Get them out of here, get them out of here.’

One evening I found myself alone with Khan and Beriosova in their flat. Both of them were drunk. They left the room separately so that I was alone for some minutes. I heard a faint moan which was repeated more loudly; the moan turned into my own name – an inarticulate appeal for assistance from someone helpless and in severe pain. Going into the hall, I saw Khan, lying full length and motionless on the ground. In agony he whispered: ‘My wife has kicked me in the balls.’ As he slowly recovered his wind I supported him back to the drawing-room. Re-entering the hall I found Beriosova lying full length on the floor exactly where Khan had been. I tried to lift her up. (It must be easy to pick up dancers – they have no weight – I somehow thought.) But Beriosova was a substantial woman, inert and apparently insensible. I left the hall and on my return a few moments later she had disappeared. At the next session I observed to Khan that I might, at some stage, have to say that things had got so far out of hand that I would have to break off the analysis. His reply was that if it got that far, he would break off the analysis ‘one day’ before I did. So he won that trick too.

Eventually Khan irrupted into my home. He rang up announcing that he and Beriosova were going to call on us within the next few minutes. Khan fidgeted about the house and made a lot of suggestions as to how we should manage our minor affairs (I should mow the lawn diagonally, for example, or set the lamp which hung low over the dining-room table upside down). He teased Kitty’s younger daughter, then a patient of Winnicott’s, by doing a ludicrous imitation of her. For this he ‘got a tremendous rocket from Winnicott’ he later recounted with loud laughter.

We now started to meet quite frequently, and go to parties, as two married couples. It is part of the story that we often met celebrities and that I found myself in conversation with, say, Rudolf Nureyev and François Truffaut.

As a prelude to the final tale, I must record that Kitty, having had a miscarriage a year or two before, had reached the third month of an exceptionally difficult pregnancy in the course of which all hope of saving the child had been given up more than once. We had not yet had a child.

We went out to dinner à quatre to a Chinese restaurant in Knightsbridge. Khan outdid himself in a tour de force of meaningless aggression. The only precise things I can remember are that he bullied and insulted the Chinese waiters, for instance by openly ‘imitating’ them. (I use inverted commas because it was not a genuine imitation, but a high-pitched whine appropriate to a schoolboy joke.) Although I was incapable of any vital response, Khan’s behaviour was so extreme and unremitting, and there was so little space in which to move, that I began at last to feel something curdling deep within myself.

The next day Kitty came into the room and told me that Khan had rung her up and torn into her. She had a sharp pain in her womb.

The perception that, at the level of reality, Khan had made an attempt on the life of our unborn only child was painful beyond anything I can convey. I believe that one of the Nazi medical experiments was to inject ammonia into victims’ veins. I felt that the living, if deformed, armature inside myself was corroding.

I rang up Winnicott and said, ‘Khan is mad,’ to which he said emphatically, ‘Yes,’ adding: ‘All this social stuff …’ He didn’t finish the sentence but he came round to our house immediately, saying that he had told Khan not to communicate with me again. As he said this, the telephone rang and it was, indeed, Khan wanting not only to speak to me but to see me, which I refused to do.

And that was the end of my ‘analysis’.

Ten years after the Chinese meal, having had an operation for cancer of the throat, Khan made a direct appeal to me, in a hoarse whisper, to visit him. When I arrived at his flat in Bayswater, a small Filipino servant pointed towards his drawing-room door saying: ‘The prince is in there.’ Khan had entirely changed his style; he had lost his beauty and now wore a black tunic and a necklace with a heavy ornament hanging from it. He was very drunk and insisted on talking pidgin French, which was completely incomprehensible. His companions were sycophants but there was one beautiful and elegant woman among them. From time to time he pointed to me and said: ‘He and I the same. Aristocrats.’

I hear that Khan slept at will with his female patients, became an even more serious drunkard and shortly before he died was struck off. And that Beriosova appeared drunk on the stage at Covent Garden, faded away and died, first separated then divorced from Khan. I have also discovered, to my astonishment, that throughout the whole time that I was seeing Khan, he was himself in analysis with Winnicott. And this has led me to reinterpret some letters which I sent to Winnicott at Khan’s instance, and the replies I received from him, as an aggressive flirtation between the two of them, using my body as unwitting intermediary.

It is now perfectly clear to me that, after seeing Khan daily for several years, and after untold expense and travail, no therapy whatever had taken place. What a trap! He had reproduced and re-enacted every major traumatic component of my childhood and adolescence. The primal union had been ruptured. The confidences which he reposed in me had made me special, just as my mother’s had; he had the same need as she to perform and be performed for. And the same destructive gymnastics that I had once had to negotiate, given the deep attachment I had to my deteriorating father, were played out all over again. For the second time, I was overcome by a compulsion to attempt the transformation of a drunken, anti-semitic, collapsing wreckage into a living armature on which to build myself.

HE COULD NOT JUSTIFY HIMSELF SO I WAS COMPELLED TO SAVE HIM

What I have written is not an attack on psychoanalysis, for which, as a discipline, I have the utmost respect. I could not have gained the insight to write this piece, nor could I have recovered from the experiences I have described, if they had not at last been undone at the hands of a skilful, patient and selfless American analyst beside whom the conceited antics of Khan and, indeed, Winnicott seem grotesque beyond words.

But what recommendation could I now make to someone in need of help? One answer might be: ‘Ask the President of the British Psychoanalytic Society.’ But this, it turns out, is precisely what I did, without realising it. And Khan himself was training analysts for years after my break with him. Yet his personal defects were so severe that he should never under any circumstances have been allowed to practise psychoanalysis. I understand that his disbarment, when after twenty odd more years it came, was the consequence not of psychoanalytic malpractice, but of his outspoken anti-semitism. This, it seems, was more important than the deep, irreparable and wanton damage he wrought, from a position of exceptional privilege and against every canon of professional and moral obligation, on distressed and vulnerable people who came to him for help and paid him large sums of money to get it.

Send Letters To:

The Editor
London Review of Books,
28 Little Russell Street
London, WC1A 2HN

letters@lrb.co.uk

Please include name, address, and a telephone number.

Letters

Vol. 23 No. 5 · 8 March 2001

Wynne Godley’s article (LRB, 22 February) underlines the fact that psychotherapy is a profoundly risky business with an irreducible shadow aspect. Suggestions that Masud Khan was just a rotten apple should be resisted. As Godley says, his professional connections with D.W. Winnicott and others were impeccable and he was the training analyst for several of today’s psychoanalytical luminaries. The problem is that, even nowadays, the private training institutions of psychotherapy, such as the British Psycho-Analytical Society, enjoy unreasonable and excessive independence. What regulation and vetting there is (of course content, to take an obvious example) is usually carried out by friendly professionals from related institutions. Moreover, there are serious defects in the systems of complaint and discipline. Several of these institutions have been very reluctant to use external advisers and assessors (such as lawyers) in ethics cases. In one case, ‘external’ was defined to mean ‘external to the society hearing the complaint’ and other psychotherapists from a friendly organisation were appointed. The Government is considering regulation and there have been private efforts in the Lords to bring this about. These efforts will prove useless unless the feudal arrangements of the psychotherapy world are opened to public scrutiny.

Andrew Samuels
Professor of Analytical Psychology, University of Essex

Wynne Godley’s terrifying account of psychoanalysis must serve as a warning to those who fear their handles may be grasped by analysts eager to open doors. Suffering distress, as Godley did, in my early thirties, I was directed to a (highly recommended) psychoanalyst who, after informing me that I should embark on a lengthy and expensive course with him, proceeded to ask, as I left my name and address: ‘Do you use the front bit?’ Realising that he had researched the ‘bit’ in question – an Hon., for which title I had as much responsibility as, say, a supernumerary nipple – I ran, never to return.

Emma Tennant
London W11

Vol. 23 No. 6 · 22 March 2001

I read Wynne Godley's painful account of his analysis with the late Masud Khan (LRB, 22 February) with concern, anger and regret at the maltreatment of a patient by a psychoanalyst. In order to understand the reaction of the British Psycho-Analytical Society, of which Masud Khan was a member, I have talked to older colleagues. Although there were rumours of inappropriate professional behaviour by Masud Khan, a case of malpractice could not be brought on the basis of rumour. I believe that attempts were made to encourage patients and ex-patients to come forward with a complaint, but none did so. Colleagues who knew Masud Khan said that he was knowledgable and intelligent and could be sensitive and insightful. Some patients felt helped by him. Sadly, his behaviour towards other patients was totally unacceptable. When Khan himself provided evidence of his professional misconduct with patients, his contempt for colleagues and his anti-semitism in his last book, When Spring Comes: Awakenings in Clinical Psychoanalysis (1988), he was expelled within months from the British Psycho-Analytical Society.

Today, we endeavour to protect patients in a variety of ways. We now respond to third-party complaints (when there is more than one), rather than waiting for a patient to come forward, by interviewing the analyst concerned. We also have a designate analyst who is available to talk to family and friends who may be concerned about a patient and/or their treatment. We have developed a Code of Ethics and Guidelines, which has established standards of practice and a system of investigating alleged offences. If a patient wants to file a complaint they can come in confidence to our Ethical Committee. In sufficiently serious cases, legal counsel and non-analysts are welcome to represent complainants and respondents at ethical hearings.

The patient and selfless analyst Wynne Godley found to undo the consequences of his disturbing experience practised the kind of analysis we teach and practise in the British Psycho-Analytical Society.

Donald Campbell
President, British Psycho-Analytical Society, London W9

Wynne Godley ends by saying: ‘What I have written is not an attack on psychoanalysis, for which, as a discipline, I have the utmost respect.’ It is unbelievable how every sad story about analysis is seen as exceptional and successful analyses are seen as the rule. Most of the problems Godley describes have some relation to the structure of psychoanalysis, which favours secret, uncontrolled, unequal relationships in which helpless and slightly disturbed people let themselves be manipulated by somewhat deranged self-declared geniuses. When will people realise that a ‘skilful, patient and selfless analyst’ is the exception, and that even these exceptions will in time lose touch with reality, because there is so much pure hype and make-believe in psychoanalytic theory?

J.P. Roos
University of Helsinki

It seems clear, as Wynne Godley points out, that the traumas of his childhood were repeated under Masud Khan's care and that Khan himself was too ill to be practising psychoanalysis. It is a tragic and disturbing story, especially since Khan was an exceptionally gifted clinician and a profound thinker, breaking new ground in psychoanalytic theory. Unfortunately, such instances of malpractice and abuse do occur. The British Confederation of Psychotherapists – an umbrella organisation representing psychoanalysts, analytical psychologists, psychoanalytic psychotherapists and child psychotherapists – was established in 1993 to maintain and encourage high standards of professional practice, training and selection. We have also ensured that in all our member societies codes of ethics and complaints procedures conform to the Human Rights Act.

The recent Psychotherapy Bill, introduced by Lord Alderdice, which has been going through the House of Lords, marks an important initiative to ensure better standards of care through strengthening the self-regulation of the profession.

Coline Covington
Chair, British Confederation of Psychotherapists, London NW2

On the face of it, Wynne Godley’s article provides sound ammunition for the increased regulation of psychoanalysis. There is no guarantee, however, that regulation and training will be a cure-all. As Andrew Samuels well knows (Letters, 8 March), a substantial number of those who practise psychoanalysis and its next-door neighbour, psychoanalytic psychotherapy, are already regulated by the UK Council for Psychotherapy. Regulation has not solved the problem of poor standards of education throughout the profession. How many psychoanalysts are aware that Winnicott’s formulation of the true and false self is highly problematic? To put the argument at its simplest: how can either the analyst or the analysand distinguish between what is true and what is false? Godley describes vividly and movingly the anguish caused by psychic conflict, yet all the states of mind he experiences are ‘true’ of and about him. This is not a new point of view – it is an obvious implication of the work of Lacan or Post-Modern theory.

Kirsty Hall
London N10

Why did Winnicott, one of the most influential psychoanalysts since Freud, refer patients to Masud Khan even when he knew a great deal about Khan’s personal and professional problems? I have spent the last six years working on a biography of Masud Khan and, as a practising psychologist and lay analyst, I would like to add something to Wynne Godley’s account.

Masud Khan was Winnicott’s principal disciple and together they helped to evolve analytic technique at a time – the 1960s – when there was a general questioning of dogma. Analysts in France, the US and London were challenging the idea that change occurred only through insight, and looking at the importance of relationships and environment. This seems so obvious now that it may be hard to remember a time when it was new. It was a period of experimentation, which might make it easier to understand why Winnicott and others initially tolerated Khan’s unorthodox behaviour. In addition to his many problems, Khan was also an extremely talented psychoanalyst who had a reputation for saving patients who had been pronounced incurable by other analysts. This reputation is supported by a number of analysands I have interviewed, especially those from the period before Khan’s major deterioration after Winnicott’s death in 1971.

Khan often referred to himself as a paradox and people who knew him well tend to agree. He was a living example of Winnicott’s theory that when we get access to the deeper parts of a person’s self, we find multiple selves which are incompatible with each other. As Khan wrote, ‘one can explicate a paradox, but one cannot resolve it thereby.’

Linda Hopkins
Radnor, Pennsylvania

I, too, had an encounter with Masud Khan when, on a trustworthy recommendation, I approached him towards the end of his life, not as a patient but as a trainee psychotherapist looking for a supervisor. His behaviour at the meeting was, to say the least, eccentric; having some idea of what was appropriate in a training analyst, like Emma Tennant (Letters, 8 March) I took flight. However, my reasons for wanting to work with Khan were based on his undeniably brilliant writing on psychoanalytic matters and I still recommend these to trainee psychotherapists today.

Salley Vickers
Brentford, Middlesex

Vol. 23 No. 7 · 5 April 2001

The prevailing response of the psychoanalytic community (in the broader sense) to Wynne Godley’s story (LRB, 22 February) is very predictable. How dreadful that such things happened in the past! But look what we’ve done to ensure that they could not happen now! However much we appreciate the earnestness with which the therapists insist that these things will not happen again, and their well-intentioned attempts to put structures in place to ensure that this is so, the idea that such measures will do much to raise the consciousness of psychotherapy – and in that sense to protect the public – is comic.

Whatever else he did, Freud reminded us of the ubiquity of self-deception and the infinite cleverness with which it clothes itself. Codes of ethics, established standards of practice, systems of investigation, transparency and accountability are all very well, but self-deception insinuates itself into these very structures, all in the name of standards. ‘doesn’t a professional set of standards enable a profession to forget about standards?’ the psychoanalyst and philosopher Jonathan Lear asks. It is despite this new culture of ‘strengthened self-regulation’ that openness of mind, existential vigilance and sceptical sensibility sometimes survive.

Robin Cooper
Philadelphia Association, London NW3

Vol. 23 No. 8 · 19 April 2001

In her response to Wynne Godley’s story (Letters, 22 March), Kirsty Hall appears to confuse ‘true’ with ‘real’. There can be no doubt that Godley’s states of mind at the time of his analysis with Masud Khan were real, but it is clear that they did not constitute the ‘truth’ of Wynne Godley (other than in the merely tautologous sense that it is true that at the time these were real states of mind). Hall seems to think that considerations of truth, in the sense of being able to ‘distinguish between what is true and what is false’, are simply irrelevant. But however deeply and perhaps irresolvably vexed it may be, without some discriminating notion of truth the whole enterprise of psychoanalysis collapses into being a remunerated hand-holding exercise by what Ernest Gellner memorably described as ‘merchants of hope’. In this scenario the truth of what you are or what you think you are doesn’t matter as long as you come out of the analytic encounter feeling good about yourself. The logic of this blurring of true/false is potentially fatal; among other things it enables the step whereby the merchant of hope becomes, as in the case of Khan, a merchant of abuse.

Christopher Prendergast
Cambridge

Vol. 23 No. 12 · 21 June 2001

I am currently on the couch for analysis, and would like to remind anyone who will listen that the purpose of analysis, as Wilfred Bion often said, is to relieve mental pain – and I have been much relieved of mental pain by psychoanalysis. Mikkel Borch-Jacobsen's criticisms follow on the heels of Wynne Godley's account of his analysis with Masud Khan (LRB, 22 February) as well as an earlier Borch-Jacobsen review in similar vein (LRB, 13 April 2000). All these pieces purport to be devastating critiques of analysis. They are not. Of course the LRB is not unusual in its faddish rejection of psychoanalysis, but then repetition is always a symptom of neurosis.

Adam Roberts
London N8

send letters to

The Editor
London Review of Books
28 Little Russell Street
London, WC1A 2HN

letters@lrb.co.uk

Please include name, address and a telephone number

Read anywhere with the London Review of Books app, available now from the App Store for Apple devices, Google Play for Android devices and Amazon for your Kindle Fire.

Sign up to our newsletter

For highlights from the latest issue, our archive and the blog, as well as news, events and exclusive promotions.

Newsletter Preferences