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Collected Papers: Through Paediatrics to Psycho-Analysis

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Collected Papers: Through Paediatrics to Psycho-Analysis D. W. Winnicott r F.R.C.P.(LOND.) Collected Papers THROUGH PAEDIATRICS D. W. Winnicott TO PSYCHO-ANALYSIS F.R.C.P.(LOND.) PUBLISHERS BASIC BOOKS, INC. NEW YORK 141 Collected Papers THROUGH PAEDIATRICS TO PSYCHO-ANALYSIS PUBLISHERS BASIC BOOKS, INC. NEW YORK 141. Generated for Gregory Christian Gabrellas (University of Chicago) on 2012-02-14 15:46 GMT / http://hdl.handle.net/2027/mdp.39015001782716 Public Domain, Google-digitized / http://www.hathitrust.org/access_use#pd-google 4-39 \r' .. '9 \ t \ ' O 58 Hw/ Published in the United States of America, 1958 Fust published in the United States of America, 1958 by Basic Books, Inc., New York 1958 by Basic Books, Inc., New York Library of Congress Catalog Card Number: 57-12962 Printed in Great Britain Library of Congress Catalog Card Number: 57-12962 Printed in Great Britain Generated for Gregory Christian Gabrellas (University of Chicago) on 2012-02-14 15:46 GMT / http://hdl.handle.net/2027/mdp.39015001782716 Public Domain, Google-digitized / http://www.hathitrust.org/access_use#pd-google Contents preface page IX ACKNOWLEDGEMENTS X PART 1 Contents I A Note on Normality and Anxiety 1931 3 II Fidgetiness 1931 22 PART 2 III Appetite and Emotional Disorder 1936 33 IV The Observation of Infants in a Set Situation 1941 52 V Child Department Consultations 1942 70 VI Ocular Psychoneuroses of Childhood 1944 85" PREFACE page ix VII Reparation in Respect of Mother's Organized Defence against Depression 1948 91 ACKNOWLEDGEMENTS X VIII Anxiety Associated with Insecurity 1952 97 IX Symptom Tolerance in Paediatrics: a Case History 1953 101 PART 1 X A Case Managed at Home 1955 118 I A Note on Normality and Anxiety 1931 3 PART 3 II Fidgetiness 1931 XI The Manic Defence 1935 129 22 XII Primitive Emotional Development 1945 145 </ XIII Paediatrics and Psychiatry 1948 157 PART 2 XIV Birth Memories, Birth Trauma, and Appetite and Emotional Disorder 1936 Anxiety 1949 174^ III 33 XV Hate in the Countertransference 1947 194 • IV The Observation of Infants in a XVI Aggression in Relation to Emotional Set Situation 1941 52 Development 1950 204^ v Child Department Consultations 1942 70 XVII Psychoses and Child Care 1952 219 VI Ocular Psychoneuroses of Childhood 1944 85" XVIII Transitional Objects and Transitional Phenomena v 1951 229 v' VII Reparation in Respect of Mother's XIX Mind and its Relation to the Organized Defence against Depression 1948 91 Psyche-Soma 1949 243 VIII Anxiety Associated with Insecurity 1952 97 v XX Withdrawal and Regression 1954 255 >/ IX Symptom Tolerance in Paediatrics: XXI The Depressive Position in Normal a Case History 1953 101 Emotional Development 1954 262 • XXII Metapsychological and Clinical X A Case Managed at Home 1955 118 Aspects of Regression within the Psycho-Analytical Set-Up 1954 278 V PART 3 • XI The Manic Defence 1935 129 XII Primitive Emotional Development 1945 145 ../ XIII Paediatrics and Psychiatry 1948 157 XIV Birth Memories, Birth Trauma, and Anxiety 1949 174~ XV Hate in the Countertransference 1947 194J XVI Aggression in Relation to Emotional Development 1950 204~ XVII Psychoses and Child Care 1952 219 XVIII Transitional Objects and Transitional Phenomena 1951 229~ XIX Mind and its Relation to the Psyche-Soma 1949 243 ../ XX Withdrawal and Regression 1954 255 ../ XXI The Depressive Position in Normal Emotional Development 1954 262 .., XXII Metapsychological and Clinical Aspects of Regression within the Psycho-Analytical Set-Up 1954 278../ Generated for Gregory Christian Gabrellas (University of Chicago) on 2012-02-14 15:46 GMT / http://hdl.handle.net/2027/mdp.39015001782716 Public Domain, Google-digitized / http://www.hathitrust.org/access_use#pd-google CONTENTS CONTENTS XXIII Clinical Varieties of Transference 1955 295~.~ XXIII Clinical Varieties of Transference XXIV Primary Maternal Preoccupation 1956 300 XXIV Primary Maternal Preoccupation XXV The Antisocial Tendency 1956 306 XXV The Antisocial Tendency XXVI Paediatrics and Childhood Neurosis 1956 316 XXVI Paediatrics and Childhood Neurosis BIBLIOGRAPHY 322 INDEX 326 BIBLIOGRAPHY 322 1955 295 • 1956 INDEX 326 300 1956 306 1956 316 Generated for Gregory Christian Gabrellas (University of Chicago) on 2012-02-14 15:46 GMT / http://hdl.handle.net/2027/mdp.39015001782716 Public Domain, Google-digitized / http://www.hathitrust.org/access_use#pd-google Chapter XV Chapter XV Hate in the Countertransference1 [1947] in this paperI wish to examine one aspect of the whole subject of ambi- valence, namely, hate in the countertransference. I believe that the task of the analyst (call him a research analyst) who undertakes the analysis of a psychotic is seriously weighted by this phenomenon, and that analysis of psychotics becomes impossible unless the analyst's own hate is extremely well sorted-out and conscious. This is tantamount to saying that an analyst needs to be himself analysed, but it also asserts that the analysis of a psychotic is Hate in the Countertransference~ irksome as compared with that of a neurotic, and inherently so. Apart from psycho-analytic treatment, the management of a psychotic is [1947] bound to be irksome. From time to time I have made acutely critical remarks about the modern trends in psychiatry, with the too easy electric shocks and the too drastic leucotomies. (Winnicott, 1947, 1949.) Because of these criti- cisms that I have expressed I would like to be foremost in recognition of the extreme difficulty inherent in the task of the psychiatrist, and of the mental nurse in particular. Insane patients must always be a heavy emotional burden on those who care for them. One can forgive those engaged in this work if they do awful things. This does not mean, however, that we have to accept whatever is done by psychiatrists and neuro-surgeons as sound according to principles of science. Therefore although what follows is about psycho-analysis, it really has IN THIS PAPER I wish to examine one aspect of the whole subject of ambi­ value to the psychiatrist, even to one whose work does not in any way take him into the analytic type of relationship to patients. valence, namely, hate in the countertransference. I believe that the task of To help the general psychiatrist the psycho-analyst must not only study for the analyst (call hitn a research analyst) who undertakes the analysis of a him the primitive stages of the emotional development of the ill individual, but also must study the nature of the emotional burden which the psychiatrist psychotic is seriously weighted by this phenomenon, and that analysis of 1 Based on a paper read to the British Psycho-Analytical Society on 5th February, 1947. psychotics becomes impossible unless the analyst's own hate is extremely well Int. J. Psycho-Anal., Vol. XXX, 1949. 194 sorted-out and conscious. This is tantamount to saying that an analyst needs to be himself analysed, but it also asserts that the analysis of a psychotic is irkson1e as compared with that of a neurotic, and inherently so. Apart from psycho-analytic treatment, the management of a psychotic is bound to be irksome. From time to time I have made acutely critical remarks about the modern trends in psychiatry, with the too easy electric shocks and the too drastic leucotomies. (Winnicott, 1947, 1949.) Because of these criti­ cisms that I have expressed I \\Jould like to be foremost in recognition of the extreme difficulty inherent in the task of the psychiatrist, and of the mental nurse in particular. Insane patients must always be a heavy emotional burden on those who care for them. One can forgive those engaged in this work if they do awful things. This does not mean, however, that we have to accept whatever is done by psychiatrists and neuro-surgeons as sound according to principles of science. Therefore although what follows is about psycho-analysis, it really has value to the psychiatrist, even to one \Vhose work does not in any way take him into the analytic type of relationship to patients. To help the general psychiatrist the psycho-analyst must not only study for him the primitive stages of the emotional development of the ill individual, but also must study the nature of the emotional burden which the psychiatrist 1 Based on a paper read to the British Psycho-Analytical Society on 5th February, 1947. Int. J. Psycho-Anal., Vol. XXX, 1949. 194 al ro F ICHII Generated for Gregory Christian Gabrellas (University of Chicago) on 2012-02-14 15:47 GMT / http://hdl.handle.net/2027/mdp.39015001782716 Public Domain, Google-digitized / http://www.hathitrust.org/access_use#pd-google HATE IN THE COUNTERTRANSFERENCE HATE IN THE COUNTERTRANSFERENCE bears in doing his work. What we as analysts call the countertransference bears in doing his work. What we as analysts call the countertransference needs to be understood by the psychiatrist too. However much he loves his needs to be understood by the psychiatrist too. However much he loves his patients he cannot avoid hating them and fearing them, and the better he patients he cannot avoid hating them and fearing them, and the better he knows this the less will hate and fear be the motives determining what he does to his patients. knows this the less will hate and fear be the motives determining what he does One could classify countertransference phenomena thus: to his patients. 1. Abnormality in countertransference feelings, and set relationships and identifications that are under repression in the analyst. The comment on this is that the analyst needs more analysis, and we believe this is less of an issue among psycho-analysts than among psychotherapists in general. One could classify countertransference phenomena thus: 2. The identifications and tendencies belonging to an analyst's personal ex- periences and personal development which provide the positive setting for his analytic work and make his work different in quality from that of 1.
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