Marisa Pelella Melega – författare

Infant observation and its applications still constitutes the bedrock for understanding the origin of the human mind, and the training of all the authors is rooted in this method of observation as well as in the work of later object relations clinicians and theoricians (Klein, Bion, Winnicott, Meltzer etc). The authors from the São Paulo Mother-Baby Relationship Study Centre, working in the fields of infant, child and family psychology, cover a variety of interesting settings, such as: the seminar room where Esther Bick herself led a discussion group; the homes of observed babies; the consulting room with parents and children in therapy; a nursery; a child psychiatric hospital department; and a neonatal intensive care unit. The book ends with an innovative and timely chapter on research on the link between maternal reverie and the development of symbolic play in babies.

Post-Autism recounts in close and vivid detail the story of the author’s struggle to analyse and communicate with a pubertal boy who presented with a diagnosis of untreated infantile autism. Marisa Mélega, who was at that time a young and relatively inexperienced analyst, worked with Mário in São Paulo, Brazil, from 1978 to 1982 and during most of that period the case was supervised by Donald Meltzer, who had recently published his pioneering work Explorations in Autism, based on ten years of collaborative endeavour with a group of therapists. At that period the condition of autism was relatively little understood, and psychological therapies undeveloped.

This book is therefore of particular interest from several viewpoints: as a detailed record of autistic features and their manifestations in a teenage child; as an example of the potentialities of distance supervision; historically, as a basis for comparison with our current understanding of the condition and the efficacy of psychoanalytic treatment; and perhaps above all, as an intimate record of the making of a psychoanalyst, by means of a particularly difficult yet highly emotionally stressful relationship with a patient. As Melega writes in her introduction: ‘I received brilliant lessons from Donald Meltzer that have enlarged my general psychoanalytical capacity to investigate the transference and countertransference … to avoid sticking exclusively to verbalizations, and to search for my own oneiric images during the sessions in order to make analysing Mário possible.’

Despite his interest in the theoretical advances of psychoanalysis made during what he termed The Kleinian Development, Meltzer believed that clinical supervision was the only way to teach psychoanalytic practice. In effect he treated supervision as an art form just as he regarded psychoanalysis as an art form. The library of his supervision work, almost all recorded outside the UK, thus forms a valuable teaching model for future practitioners, as well as demonstrating Meltzer’s wealth of insight into both character development and analytic technique.

Marisa Pelella Melega draws on a broad spectrum of clinical and observational work, gathered over many years as a practising and teaching psychoanalyst based in Sao Paulo, Brazil. The role of symbol formation as a goal in psychoanalysis, and an indicator of developmental progress, has always been recognised. The post-Kleinian understanding of its operation has advanced since Bion's theory of thinking and Meltzer's elucidation of the role of 'dream life', which view the desire for knowledge as the resolution of emotional conflict, with symbol formation being the primary mental mechanism. Melega discusses illustrative examples from newborn infants, children of different ages, adolescents and adults, to illustrate her longstanding fascination with the process of symbol formation and its vicissitudes, including those transference moments at which symbols are forged during the analytic session.