Winnicott by Adam Phillips

Author:Adam Phillips
Language: eng
Format: epub
Publisher: Penguin Books Ltd
Published: 2007-02-11T16:00:00+00:00

IV

For Winnicott the mother-infant relationship was becoming the primary model for the psychoanalytic situation; it was, quite literally, the source of analogy in his work. His new ideas about early development and psychosis as an ‘environmental deprivation disease’ necessarily involved modifications of the classical psychoanalytic technique Freud had invented for the analysis of neurotics. If, as Winnicott now believed, the mother herself played such a decisive role in the infant’s development, then when the earliest relationships were recreated in the analytic setting new demands would be made on the analyst. What the patient transferred on to the analyst from his past, and how the analyst was to respond, were becoming pressing questions in the British Society. The Klein group insisted that the analysis of psychotic patients required no essential modification of classical technique. Winnicott made explicit his own sense of these issues in what was, by psychoanalytic standards, a radically self-revealing paper, entitled ‘Hate in the Countertransference’ (1947).64 In the analysis of psychotics, he wrote, ‘quite a different type and degree of strain is taken by the analyst’, and it was to an understanding of this strain that Winnicott turned his attention.

The analyst of a psychotic adult patient must, Winnicott writes, ‘be prepared to bear a strain without expecting the patient to know anything about what he is doing, perhaps over a long period of time. To do this he must be easily aware of his own fear and hate. He is in the position of the mother of an infant unborn or newly born.’65 (My italics.)

In this new model of the analytic setting, devised for the psychotic patient, the setting is not symbolic of the mother’s care as it would be with a neurotic patient, it is the mother’s care. It cannot represent something that never existed. The earliest experiences of the psychotic patient – the mothering that should have facilitated the processes of integration, personalization and realization – ‘have been so deficient or distorted that the analyst has to be the first in the patient’s life to supply certain environmental essentials’.66 The analytic setting provides the medium for growth that was absent for the patient at the very beginning. The implicit analogy, as usual with Winnicott, is with simpler forms of organic life; the belated provision of the right soil for the plant (and the analogy, of course, suggests the risk that the analyst will begin to identify himself with a fantasy of the all-powerful mother). Freud had invented the psychoanalytic method for neurotic patients which was characterized by the analyst’s interpretation of the patient’s repressed unconscious. Winnicott was describing a setting that restored an environment – restored it for the first time, so to speak – in which development could start up again. A regression was supposed to occur in which verbal interpretation was secondary to care in a broader, maternal sense; and at certain stages in the treatment, as one would find as the mother of an infant or small child, ‘the analyst’s hate is actually sought by the patient’.

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