Harold Stewart qualified first as a medical doctor, and then trained as a general practitioner.
Interested in the psychical suffering of patients and challenged by the difficulties presented by psychosomatic patients, he was initially attracted by hypnotherapy as a clinical therapeutic tool. His reflections on his experiences with hypnosis became important psychoanalytic contributions to the understanding of the hypnotic states, and to the dynamics of the transference-countertransference between the patient and the hypnotist.
In one of his studies, Stewart argued that the “hypnotic state could only exist as long as the hostile feelings of the subject towards the hypnotist were not made explicit” (in 1992, p.10). Furthermore, he described a kind of unconscious folie-à-deux taking place between the hypnotist and the patient: at times, the doctor would feel both powerful and elated, as if in control of the patient. On other occasions, the doctor would feel that the patient was in control of him, and that he was being turned by the patient into a helpless observer. The collusion between hypnotist and patient did not facilitate the analysis of the negative transference, resulting in enactments, resistances, manic denials and hostile attacks. How to deal with negative transferences, potentially malignant impasses and what were the factors in facilitating psychic change in psychoanalysis remained his main concerns for the rest of his psychoanalytic career. (International Journal of Psycho-Analysis, 1963, 44: 372:4; and 1966, 47:50-3; see also, 1969, ‘The nature of the controlling forces in the hypnotic relationship’, in L. Chertok (ed.) Psychophysiological Mechanism of Hypnosis, Berlin: Springer Verlag).
In an earlier paper, his discussion of the Oedipal myth was exemplary: Stewart, analysing in particular detail the theme of collusion in the text of Sophocles’ play Oedipus Rex, revealed how Jocasta was in full awareness of the two transgressions present in the play, the murder of her husband and the incest with her son (International Journal of Psycho-Analysis, 1961, 42: 424-30). He proposed that “these crimes were committed as a means of dealing with an internal, persecutory, murderous maternal, superego figure” (in 1992, p. 29). Mother and son, through their unconscious collusion, denied any knowledge of their complicity in these crime. This text was presented at a Scientific Meeting of the Society prior to its publication, the first time a candidate presented a paper while still in training.
Stewart’s contributions, gathered in his book Psychic Experience and Problem of Technique, were characterised by the detailed attention paid to the clinical situation in psychoanalysis. Divided in two parts, Theory and Technique, the collection of his papers reflect his major interests and principal subjects: the experience of dreams and the situation of transference; the notion of inner space; the experiencing of thinking; the important theme of transference interpretation, its different modalities and types; other agents of psychic change in psychoanalysis, and perhaps essential to his thinking, the concepts of the basic fault (Balint), and the question of therapeutic, benign and malignant regressions in the process of psychoanalytic treatment.
Following Michael Balint, Stewart suggested that the analyst “avoid interpreting everything first as a manifestation of transference” (International Journal of Psycho-Analysis, 1989, 70:221-30 – in 1992, p. 116), which seemed to have been the prevailing fashion in the technique of interpretation for some time. He emphasised, also inspired by Balint, the need for the analyst not to occupy a position of omnipotence, accepting the analysis as the mutual sharing of an experience – which constituted an important therapeutic agent in its own right.
Stewart emphasised that it was necessary always to maintain a rigorous psychoanalytic stance; in this context, he considered the importance of the silence of the analyst, his non-interpretative interventions within a non-persecutory psychoanalytic frame, which would promote a benign regression, avoiding the over-excitement potentially provoked by the interpretations of sexual phantasies and conflicts. The analyst has to be strong enough and firm enough so as to be able to bear the regression of the patient, holding back interpretations that would disrupt this process and intensify the patient’s dread of surrender and destructive envy.
In his last paper, (Agents for psychic change, International Journal of Psycho-Analysis, 1990, 71:61-70), Stewart partly summarised his analytic stance thus:
…not everything therapeutic can be laid at the door of the immediate verbal, interpretative understanding of conflicts and defences… the non-verbal and pre-verbal aspects of early experiences and phantasies also need expressing, and sometimes this can only occur in a regressed state; the verbal understanding and interpretation will follow (in 1992, p. 139).
Gregorio Kohon 2015
Psychic Experience and Problems of Technique (Foreword by Pearl King) – Tavistock/Routledge, London and New York, 1992.
Michael Balint – Object Relations Pure and Applied (with chapters by Andrew Elder and Robert Gosling), Routledge, London and New York, 1996.