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(p. 201) Metapsychological and Clinical Aspects of Regression Within the Psycho-Analytical Set-Up 

(p. 201) Metapsychological and Clinical Aspects of Regression Within the Psycho-Analytical Set-Up
Chapter:
(p. 201) Metapsychological and Clinical Aspects of Regression Within the Psycho-Analytical Set-Up
Author(s):

Donald W. Winnicott

DOI:
10.1093/med:psych/9780190271367.003.0040
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date: 17 January 2021

This paper deals with regression in psycho-analysis, and shows how regression implies the existence of an existing ego organization facing a threat of chaos. Psycho-analytic theory proposes unfavourable situations can create fixation points in the emotional development of the individual, but when there is an ‘environmental failure situation’ personal defences organized by the individual will require analysis. With a regressed patient the analytic setting represents the mother with her technique, and the patient is an infant. The regression is an organized return to early dependence. Progress from primary narcissism starts anew in analysis with the true self gradually able to meet the original environmental failure situations in the transference without the organization of the defences that involve a false self protecting it. Psychotic illness can only be relieved by specialized environmental provision by the analyst with the patient’s ‘regression to dependence’ - Winnicott’s own term - and with due sense of the risk involved. With the regressed patient the word need, not wish, is correct. There are no reasons an analyst should want a patient to regress (except for grossly pathological reasons). The psycho-analyst familiar with psychoneurosis can find it difficult to understand regression and the theoretical implication of the patient’s expectations that belong to the need to regress. On recovery from regression the patient will then need ordinary analysis as designed for the management of the depressive position and of the Oedipus complex in interpersonal relationships.

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