The featured paper is ‘Reparation in Respect of Mother’s Organized Defence against Depression’ by Donald Winnicott originally published in 1948. Winnicott cites a number of works in this short article which differs from some of Winnicott’s earlier articles that have been reviewed. Winnicott also draws on his significant clinical experience:-
‘For 25 years a pageant of clinical material has been passing in front of me in my hospital Out-Patient Department. In the course of the years there is not much change in the general pattern‘.
Winnicott goes onto describe the typical case of a young girl who is artistic and vivacious accompanied by a mother who is melancholic and argues that in the cases he has experienced the girl’s presentation is a response to the mother. He then argues that the children in these selected cases are firstly developing a response to the parent’s mood before responding to their own mood. Winnicott then suggests that this process is re-enacted in the therapy session. However these broad concepts are a reiteration of psychoanalytic principles and he later adds ‘I am describing a rather obvious phenomenon’. Winnicott goes onto suggest that these process are reenacted in the group setting and looks for an example in the ‘Psycho-Analytical Society’. Thus he paraphrases Glover in speculating that certain analysts may be describing their own fantasies in their patients although drawing cautions about such speculations. Winnicott then draws an interesting conclusion about the doctor-patient relationship in certain cases:-
‘I know that patients at times do produce the sort of things they feel I like getting………I believe that Jungian analysts tend to receive ‘Jungian type’ dreams, and Freudians but seldom receive these elaborate mystical formations‘.
Winnicott’s paper contains a number of reflections based partly on the writings of others but predominantly on his clinical experience and observations thereof. Thus it is difficult to categorise this paper although it makes for interesting reading. The paper could be classed as literature or philosophy but it does produce hypotheses that can be tested. Much like previously reviewed works of Freud, this paper is a starting point and additional work is required to test these hypotheses.
Steps to Treatment 5 (This is a model which needs validation before the several steps needed to create and trial informed treatments)
Donald Winnicott. Reparation in Respect of Mother’s Organized Defence Against Depression. 1948. Republished in Through Paediatrics to Psycho-Analysis. The International Psycho=Analytical Library. Edited by Masud Khan. The Hogarth Press and The Institute of Psycho-Analysis. 1978.
Steps To Treatment (STT)
STT = Steps To Treatment. An estimate of the number of steps between the results and translation into practice i.e. treatment. This is an opinion. A policy statement would have a value of 1 as this a guide for practice whereas a speculative model would get a much higher score as there are more steps between statement of the model and treatment (which would involve testing the model, informing treatment approaches and trialling these approaches for instance).
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