Abstract
This article presents and analyses a set of notes written by the psychoanalyst Melanie Klein following an operation in 1937. The notes, entitled Observations after an Operation, act as a case study of the intersection of psychical, material and social relations as they play out in the immediate aftermath of surgical intervention. Using a close reading method, the article contextualises an analysis of Observations after an Operation by linking it to Klein's wider corpus of theoretical work. It deals in turn with the representation of anxiety mechanisms in the patient experience, drawing upon Klein's notes on the similarity with 'anxiety-situations' in early childhood; with Klein's changed relation with both external objects and their counterparts in the individual's mental landscape; with the role of sensation in phantasy, and the connection to bodily pain; with the doctor-patient relationship and the way this is perceived as being embodied in material objects, played out across two dreams experienced by Klein during her recovery; with the emphasis on illness as a form of mourning; and with the creative potential that the experience offers for a renewed structure of object relations. The article concludes that a greater attention to the role and representation of material objects, using psychoanalytic object relations theory as a starting point, can enhance how we collectively understand and assess the psychical impact of healthcare settings upon the patient. It also invites other scholars across the critical medical humanities to consult and analyse the newly available text upon which this article is based.
Highlights
Materiality, tied up as it is with affective and sensory phenomena, matters beyond its tangible limits
Observations after an Operation is, I argue, a newly unearthed, important piece of evidence demonstrating the importance of object relations to the patient experience
Its framing of illness and recovery as a potentially transformative restaging of early experience is key: ‘everything that can contribute to the elucidation and exact description of the infantile danger-situations is of great value, from the theoretical, and from the therapeutic point of view’ (Klein, 1998b, p. 213)
Summary
Materiality, tied up as it is with affective and sensory phenomena, matters beyond its tangible limits. We can read Observations after an Operation as an early source which works in conversation with this ensuing development within object relations theory, in which the body as both an internal and external object becomes the focus and the borderland of the intermingling of experience and phantasy. Phantasising the mother-doctor These revivals of infantile anxiety find their expression in Klein’s profoundly symbolic dreams They are triggered by objects in the sickroom but quickly internalised – an alteration and transformation which swiftly converts material experience into mental representation. This splitting into bad and good objects is, paradoxically, part of the process of an integration of external objects’ constituent parts, as Klein later explored in ‘Envy and Gratitude’ (1957) It is in this context that the medical staff plays a significant role in Klein’s representation of her object relations following the operation. Klein’s notes help us think about how anxiety and other emotions may be thingable: experienced as external, material objects
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