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(p. 125) Fragments Concerning Varieties of Clinical Confusion 

(p. 125) Fragments Concerning Varieties of Clinical Confusion
Chapter:
(p. 125) Fragments Concerning Varieties of Clinical Confusion
Author(s):

Donald W. Winnicott

DOI:
10.1093/med:psych/9780190271374.003.0027
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date: 26 April 2018

Winnicott considers matters concerning the clinical psychoanalytic setting, and in particular that confusion that he believes is a feature of obsessional behaviour. In health, muddles can be sorted, but in illness, he sees it as an organised defence. He recognizes that some depressed patients can be obsessional at times, and that some can become temporarily depressed. He points out that depression as a clinical state is not ‘the depressive position’. The patient’s failure to reach the depressive position underlies depressive and obsessional states equally. He believes that confusion as an organised defence must be analysed to arrive at the centre of the individual, where there is a primary chaos, the primary state of unintegration. He considers that the patient’s capacity to tolerate mood is central to their development. Depression then implies hope.

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