The article reviewed here is ‘Clinical Varieties of Transference’, a transcript of a talk given by Donald Winnicott at the 19th International Psycho-Analytical Congress in Geneva 1955. Despite being fairly brief (just a few pages) the article is rich in ideas and I found it took some reading and rereading. As it’s one of his latter papers, there is a lot of referencing to his earlier work as well as that of his contemporaries. He first of all remarks that in initial years, psychoanalytic theory was developed through work with a group of patients who had passed through certain phases of development without difficulty as there had been ‘good enough infant care’. As a result
‘The earlier stages of the establishment of the ego could be taken for granted by the analyst‘
He then refers to the primary identification and describes it as a period in the infant’s development in which the individual has not been distinguished from the environment. On progressing from this primary identification, Winnicott outlines two possibilities – either there is a good-enough adaptation of the ego to the environment or there isn’t in which case
‘instead there develops a pseudo-self which is a collection of innumerable reactions to a succession of failures of adaptation‘
This pseudo-self he refers to as the false self which allows the real self to experience a ‘continuity of being’ but ‘cannot, however, experience life or feel real’. Then Winnicott suggests that in therapy session the analyst may make mistakes which are helpful in the therapeutic process but overall when the therapy is considered ‘good-enough’ then
‘raises a hope that the true self may at last be able to take the risks involved in its starting to experience living‘
There follows a period in which the ego can ‘experience id impulses’. He distinguishes the ‘objective anger’ at the analyst’s mistakes from the ‘negative transference of neurotic analysis’.
The ideas discussed here are profound and relate to the very practical aspects of the therapeutic process. While it would have been helpful to have excerpts from the therapy sessions to illustrate the points, this paper was derived from a talk where perhaps the primar aim was to disseminate practical insights to fellow therapists rather than develop the underlying theory at that point.
Donald Winnicott. Clinical Varieties of Transference [1955-1956]. Read before the 19th International Psycho-Analytical Congress, Geneva, 1955. Int J Psycho-Anal, Vol XXXVII, p386, 1956. Chapter XXIII (pp295-299) In D.W.Winnicott. Through Paediatrics to Psycho-Analysis. With an Introduction by M.Masud R.Khan. The International Psycho-Analytical Library. Edited by M.Masud R.Khan. The Hogarth Press and the Institute of Psycho-Analysis. 1978.
Steps to Treatment
STT3 (Advice is relevant to treatment but needs to be tested in intervention studies which then need to be incorporated into relevant policies if successful).
Steps To Treatment (STT)
STT = Steps To Treatment. An estimate of the number of steps between the results and translation into treatment. This is an opinion.
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