Patient O: Depressive anxieties very near to the surface – Part I
26th March 2026
This is part one of the second guest blog by Margherita Margiotti, a psychoanalytic psychotherapist with a deep interest in the theoretical and clinical contributions of Melanie Klein.
With the Melanie Klein Trust’s Getting to Grips with Kleinian Concepts series now well underway, I find myself thinking that the Melanie Klein archive is much more than simply a historical repository: it is a rich resource for today’s psychoanalysts; a living site of clinical and theoretical development and renewal. In the paper she presented at January’s event, Maria Rhode beautifully captured this quality, as she explored Klein’s groundbreaking work with ‘Dick’ and the unpublished notes in which she anticipated later ideas about autism, thinking, and symbol formation.
In my own recent exploration in the archive, I discovered some intriguing clinical notes from the 1940s concerning an adult patient whom Klein calls ‘O’. Elizabeth Bott Spillius describes the 1940s as heralding ‘a sea change in Klein’s approach’ (2007, p68) , as her interest in splitting, projection, and schizoid mechanisms in adult patients deepened and expanded. The following notes show some of this ‘sea change’ in action. They are contained in two separate files, PP/KLE/D.3 and PP/KLE/B.70. In a kind of eureka moment, I discovered that, when read together, these document a sequence of analytic work from Thursday 12th to Tuesday 24th March 1942. As such, they provide insight into the day-by-day unfolding of an analysis, with Klein interpreting at a psychotic level and mobilising depressive anxieties, while O simultaneously resists and carries out important unconscious work in his dreams.
Questions of technique were clearly at the front of Klein’s mind, particularly in the D.3 notes. This is perhaps no surprise, as these files date from the period between Klein’s return from Pitlochry (where she analysed Richard) in September 1941 and the formal beginning, in October 1942, of extensive discussions on technique in the British Psychoanalytical Society (later to be known as the ‘Controversial Discussions’). Readers can see Christine English’s blog post ‘Klein at Work: The interpretation of very frightening material’ (8/12/22) for a more detailed account of PP/KLE/D.3.
As these notes are copious and full of fascinating detail, I will present them across two posts. But let’s start with what Klein says about O’s background. O is not particularly disturbed, yet has much ‘unhappiness underneath’ from his childhood. He feels very little pleasure in life and, it seems to me, finds it painful to love and to experience the other feelings that accompany love. Initially he comes to analysis because of a difficult situation in his marriage, but soon his difficulties reveal themselves to be tied up with depressive anxieties, which he begins to feel when becoming aware of his identification with his children. O’s defences are particularly well organised – schizoid in quality – to avoid feeling unhappy and becoming attached. Klein says that O ‘gets away from love, or rather distributes it to a number of people, avoiding every tie and arranging his life accordingly’. It is no surprise that he constantly thinks of giving up his analysis, and that he fears being tied to it. Klein writes:
'His strongest method of keeping his balance is through intellectual achievement, and partly denial of emotions, partly distribution of kindness, friendliness, and love in small doses. Greatest fear in him is to be tied. In the first interview he had nearly decided not to come to analysis and wished to come only once a week. At the same time, very strong interest in the procedure of analysis and even great scientific satisfaction from following its processes. He is deeply interested in it, has partly consciously, and also unconsciously, strong conviction of [its] benefit already reaped, but is in constant flight from it, which he himself tries to counteract. He told K. [Klein] that he had thought he would tell her that he would leave in three weeks, to give her time to fill up the place, but then though, now he had told K., it seems too silly to do so. He had asked K in the first interview: could he come for several weeks or for a few months and just see how much good it is for him and then stop if he likes to do so. K. replied that he is free to go any time when he really comes to the conviction that he wants to do so. […] In the last month or so, material about internalisation had come up and been accepted by him. That was the point at which he wanted to give K. 3 weeks’ notice and go. […]. Recognition of his great unhappiness as a child, and altogether of the depression very near to the surface has been achieved, but again all this bringing out of emotions is exactly what O has managed all his life to get away from. To begin with, he was afraid it might upset his work, but he decided this is not really true. The great fear of being tied of course comes into the analysis, which has now become his greatest tie, and that contributes to the desire to break off.' [B.70, digital images 1–4 of 33]
O’s difficulties resonate with core problems of any ordinary analysis. O is ambivalent and finding ways out of analysis, alongside showing his interest in it and recognition of its value. His idea of giving Klein three weeks’ notice seems particularly telling about his state of mind: a combination of respect, considerate affection, and a fear of being tied down. Klein writes very detailed notes, offering a privileged view of his vacillations.
In the first note available, from Thursday 12th March 1942 (D.3), Klein describes the emergence of negative feelings in O, including a distrust of her. O enters the consulting room and becomes suspicious of the drawn curtains, associating the atmosphere that they create with the ‘tricks of the trade’ and ‘internal persecutors’, which he described in the previous session as ‘the enemy within’ and ‘inefficient people in the conduct of our affairs in contrast to the external enemy we have to fight’. Klein takes up O’s projection:
'[…] After his remarks about the sinister impression, K. interpreted that the last material was concerned with internal persecutions, internal fears, and that now K’s room was probably filled with the same things. And also that these internal enemies and processes which K. interpreted to him are experienced by him as transferred onto her – she becomes the representative of them.' [D.3, 20–22/85]
Her interpretation releases feelings in him of gratitude and affection for Klein. She writes:
'A moment after this interpretation, O turned round, looking into K’s face and said with a voice more warm and friendly as she had ever heard in him: “I really hope that you had not believed that my remarks about tricks of the trade are of great importance. They are just fleeting associations. I really am very grateful to you for what you are doing for me, and I want you to know that.” After lying back again O says that he thought K. would probably be interested why he sat up. But he did feel that he wanted to look into her face and to tell her the affectionate feelings that he just had at that moment. (K. int[erpreted] that the fact that she giving him an int[erpretation] referring to the aspect of K. in wh[ich] she was mixed up with his internal affairs and so on, made it possible for him to compare these feelings and aspect of her with one nearer to reality, & allowed the friendly feelings to come up).' [D.3, 22/85]
He then cancels his next sessions, on 13th and 16th March 1942, due to work and feeling unwell. One could also understand these cancellations as part of O’s pathology. Given his ‘getting away from love’ and ‘avoiding every tie’, it must have been shocking for O to feel gratitude and attachment to his analyst. As his affection for Klein grows, so does O’s wish to get away from the analysis, as when he wanted to give her three weeks’ notice. Interestingly, Klein does not comment on these cancellations, but she does highlight the surfacing of depressive anxieties which O has defended against all his life.
On 17th March, as O returns to his analysis, he brings three dreams to Klein. It seems that important work has been happening unconsciously in O’s dreams, despite his cancelling the two previous sessions. From her detailed notes, one can see Klein closely interpreting the dreams’ unconscious content in relation to O’s internal situation: his attacks on his internal parents, his phantasies about the mother’s body and its contents, and his inhibitions ensuing from these unconscious phantasies – all phenomena that Klein discovered and recorded in her work with children.
I will give a summary of these three dreams, for the sake of brevity:
Dream 1: O lies in bed while his daughter sits on a chamber pot and defecates. She seems worried and O asks her why. She replies that she is dirtying her parents. In the dream, O reflects that he must say to Klein how accessible these thoughts are in children, as one can simply ask them.
Dream 2: O’s colleague and his female friend are standing in front of a jeweller’s. In the window is a document containing the colleague’s letter to the Director of Accounts asking to increase his salary, along with its rejection. A guinea fowl made of jewels flies out of the letter and is caught by a man. Then it flies off again and O catches it. Close to O, the bird grows and becomes much greener. O shows it to his colleague and female friend, and there is then another unpleasant woman with them. O is proud at how the bird has grown, but the others hardly pay attention to him. O feels annoyed and hurt.
Dream 3: O lies on the same bed as in the first dream. He lies together with a woman friend, with whom he had a relationship in the past, but they are both now dressed.
Here I give only a quick overview of the very detailed interpretative work that starts on 17th March and continues in the following two sessions. O’s associations begin with his second dream: he links the guinea fowl to the peacock – a bird he likes – and then remembers disliking the swan meat he was once given to eat as a child. Klein comments that the guinea fowl has grown nicely through contact with O, and she links the peacock and guinea fowl to aspects of the parents he has internalised. O agrees that it feels like the guinea fowl is something internal, and he wonders if the indifferent woman in the dream represents Klein and his anxiety that she may not like or take an interest in him. Klein suggests that the little bird stands for things that he wants to possess, like the mother and the father’s genitals, or the whole mother and father. At this point, O tells Klein of a little brooch he bought for his daughter the day before he had the dream. He is conscious of wanting to please his daughter and worries that she may not like the jewel, or that his wife may be envious. Klein writes:
'The little girl said that she wants to put the jewel into her mother’s jewel case, and he was pleased that she trusted her mother, but O didn’t trust her [the mother]. […] K suggests that his colleague stands for an aspect of O, one which O. did not develop much, and that was to look after his interests, here representing greed, which O. has very strongly repressed and counteracted. The demand on the director is various things which O. has wished to get from Father and Mother, particularly the possession of Mother, of Father’s penis etc and which had been refused. […] This seems quite true to O. and also the feeling that the bird stands for so many things he must have wished and not asked for, and yet took them in his mind.' [B.70, 9/33]
O further associates and Klein interprets his wish to rob mother and father of their ‘precious genitals’, to have these special yet stolen possessions grow inside him, and in turn to display them and have them appreciated. She interprets how O’s professional and personal ambitions are greatly limited by these phantasies. She writes:
'Now K could show to O details about his actual work and his ways in producing it. Restrictions of his ambitions, which are very great in relation to his very great gifts. Also his restrictions in capacity for production. Now interpreted as the bird inside him which he would like to show but cannot, or at least he can only do so in a very restricted way, because it really was not his possession. It was the bird, the penis, the breast, which did not belong to him. He caught it from the man and from the woman, and it now represents the thoughts, the knowledge, the interest in his mind, his greatest possession.' [B.70, 10/33]
After more associative material, Klein points to the anxiety in the first part of the dream:
'Klein suggests that O’s lying on the bed indicates the child’s jealousy, possibly in relation with the bed situation in relation to the father, i.e. jealousy of the sexuality between the parents. At this moment, O mentions the third part of the dream […] he now thinks that the fact that they were both dressed demonstratively demonstrates the opposite, that they were undressed. Now he also thinks that this dream was probably before the second, but it had only appeared later to his mind, and he understands that the reason for that was that it contained the explanation of the child’s defecation […]. Klein brings together the earlier part with this one. In one aspect, the contents of the body are something marvellous, they are the bird, and with the bird being the good products and standing for the good faeces and all the products of his mind he makes up for the injuring faeces […]. O was extremely struck with the clarification of this dream. He said it has seemed so obscure and so silly looking at it rationally, that he would not have thought that one could clarify it so well. He does not express so much his appreciation, but it is very obvious that he admired K, and also felt satisfied with the interpretations. But it is also clear that depression in connection with the material had come up more strongly.' [B.70, 13–15/33]
Like with her child patients, Klein interprets O’s anxieties at the level of what she calls ‘the deeper layers of the mind’. By doing this she wants to free up his capacity to love and to bear his feelings, and so to move forward in his life in a less emotionally restricted way. As his depressive feelings become more available to O, so his unconscious efforts to escape from analysis continue. It seems significant that on 19th March he becomes confused about the time of his session. Klein writes:
'O had made a mistake and came at the same time as the day before when it had been arranged that he should come later, and this meant that he had lost half of his time. He has done this repeatedly in former weeks and K has interpreted that the later hour, once a week, is to him a frustration, while O maintains that it is a convenience to him […]. He was depressed about having lost half of his time and now it was short.' [B.70, 15/33]
Klein seems to encourage O to deepen his relationship with himself and to make contact with feelings he perhaps does not expect to have. In my next blog post – part two – I will describe how this unfolds in the sessions leading up to 24th March 1942.
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References:
Elizabeth Spillius (2007), Encounters with Melanie Klein. Routledge.













