The Collected Works of D. W. Winnicott Edited by Lesley Caldwell and Helen Taylor Robinson

The Quest for Hope and a New Opportunity Through the Fundamentals

Winnicott’s thinking on regression came to the fore in his writings from the late 1940s and early 1950s. In 1954 it found a powerful and comprehensive expression in the two highly significant papers in this volume, as explicitly reflected from the outset in their titles. “Metapsychological and Clinical Aspects of Regression within the Psycho-Analytical Set-Up” (1954a) is the pathbreaking paper in which Winnicott presented before the British Psychoanalytical Society his conception of regression in psychoanalytic practice and the necessary adaptation required of the psychoanalytic work, particularly during deep regression in the treatment of severely disturbed patients. This is realized by providing in treatment “a new and reliable environmental adaptation which can be used by the patient in correction of the original adaptive failure [of the early maternal environment]” (1954a, p. 216). In “Withdrawal and Regression” (1954b), Winnicott formulates the essential aspects of therapeutic regression, especially its being regression to dependence even in regressions that are localized in momentary withdrawal states during the sessions. He depicts the vital therapeutic meaning of the analyst/therapist’s converting withdrawal into a regression, and emphasizes again that regression “carries with it the opportunity for correction of inadequate adaptation-to-need in the patient’s past history” (p. 289). Winnicott further addresses this notion of withdrawal and regression in chapter 8 of Human Nature (written mostly in 1954, though published posthumously thirty-four years later, in 1988). And the whole case history Holding and Interpretation in the present volume (first published posthumously in 1972 and then in 1986) is based on detailed case notes for the patient described in “Withdrawal and Regression,” seen in 1940–1941 and from 1953 until the middle of July 1955, and written up between January and July 1955.

It is in these 1954 writings that Winnicott offers his remarkable description, which seems borrowed from science fiction, of the defensive “freezing of the failure situation” and along with this the hope for a new opportunity—a hope that from now on will reverberate throughout his thinking and writings about therapeutic regression:

it is normal and healthy for the individual to be able to defend the self against specific environmental failure by a freezing of the failure situation. Along with this goes an unconscious assumption (which can become a conscious hope) that opportunity will occur at a later date for a renewed experience in which the failure situation will be able to be unfrozen and re-experienced, with the individual in a regressed state, in an environment that is making adequate adaptation. . . . In the very ill person there is but little hope of new opportunity. In the extreme case the therapist would need to go to the patient and actively present good mothering, an experience that could not have been expected by the patient [1954a, pp. 204–205].

It is interesting to consider that while Winnicott was putting forth his radical thinking on regression and the theoretical and technical transformations involved, he attempted during this period, and later, to draw on his continuity with Freud and to present his thinking on regression in the analytic situation as an extension of Freud’s work to areas that Freud himself had not addressed (Winnicott 1954a, 1964, 1969). He opens “Metapsychological and Clinical Aspects of Regression within the Psycho-Analytical Set-Up” (1954a) with the words “The study of the place of regression in analytic work is one of the tasks Freud left us to carry out” (p. 201), and in the paper he closely connects “Freud’s clinical setting” to the setting in which the work of regression is carried through. Only in his last years did he write, “Freud seems to me to be struggling to use what he knows to be true, because of his analytic experience, to cover what he does not know” (1969, p. 240). And at the very end of his life he asked for “a kind of revolution in our work. Let us re-examine what we do” (Winnicott, cited by Abram 2012, p. 312; 2013, p. 1).

Abram (2013) relates to these words:

Perhaps by now, so near to death, Winnicott was able to articulate something that he had been in the process of since 1945—a psychoanalytic revolution. Thomas Kuhn had only just published his book The Structure of Scientific Revolutions (1962), and although Winnicott never refers to this book, his use of this word at the beginning of these notes suggests that he intuited his formulations were moving psychoanalysis toward something new [p. 31].

In this regard, Phillips (1988) writes that Winnicott introduced important “innovations in psychoanalytic practice and technique followed by explicit assertions of the continuity of his work with a more orthodox psychoanalytic tradition,” which represent “in fact, a certain disingenuousness in the way Winnicott disguises his radical departures from Freud” (p. 5).

Mitchell (1993) argues similarly:

Winnicott had a tendency to introduce his extremely innovative contributions with references to nonneurotic psychopathology and therefore outside psychoanalysis proper. Over time, the contributions broadened in their implications, and it became clear that Winnicott had introduced a novel vision of the analytic process itself. He came to see regression as a central feature of the therapeutic action of analysis . . . and regression has everything to do with hope [pp. 206–207].

In effect, over the years Winnicott explored, described, and struggled, theoretically and clinically, with “any degree” of regression to dependence, especially in the treatment of severely disturbed patients and also in difficult treatment situations with neurotic patients (1949a,b, 1954a,b, 1955–1956, 1963, 1964, 1967, 1988a,b; see also Little 1985). While Balint (1968) divided therapeutic regression into two forms—benign and malignant—Winnicott “fully believe[d]” that regression must be allowed “absolutely full sway” (1954a, p. 202), even to the earliest stages of prenatal life and birth. For regression carries with it, within the analytic process, the hope and a new opportunity for reliving and correcting the original maternal failure and inadequate adaptation to need in the patient’s infancy, and the early traumatic unthinkable breakdown that happened at the time of early environmental failure. According to Winnicott, “All this can be very clearly demonstrated in psychoanalytic work provided one is able to follow the patient right back in emotional development as far as he needs to go, by regression to dependence, in order to get behind the period at which impingements became multiple and unmanageable (1949a, pp. 192–193; emphasis added).

There, by providing the needed environmental essentials of holding, adaptation to need, and reliability, which should have been provided earlier but were not available, he creates for the first time in the patient’s life a facilitating environment in which development can start anew. It is “carrying through” (1954a, p. 201) rather than working through.

Regression in the Present Tense

In Winnicott’s revolutionary clinical model of regression and its healing quality, “the self cannot make new progress unless and until the [frozen] environment failure situation is [unfrozen and] corrected” (1954a, p. 214) through the analytic setting and process. And a decade later—unless and until the massively dissociated traumatic origins of the unthinkable, not-yet-experienced breakdown are relived and experienced “for the first time in the present” in the treatment experience with the analyst (around 1963, published posthumously in 1974, p. 105). Psychoanalytic regression is not a linear return to the past. The regression to dependence and early psychic processes in treatment calls forth a radical possibility of actually influencing and altering the patient’s “past and future” in the present, by “allow[ing] the past to be the present. Whereas in the transference neurosis the past comes into the consulting-room, in this work it is more true to say that the present goes back into the past, and is the past. Thus the analyst finds himself confronted with the patient’s primary process in the setting in which it had its original validity” (1955–1956, pp. 297–298).

Further, Winnicott posits “that for Freud there are three people, one of them excluded from the analytic room. If there are only two people involved then there has been a regression of the patient in the analytic setting, and the setting represents the mother with her technique, and the patient is an infant. There is a further state of regression in which there is only one present, namely the patient, and this is true even if in another sense, from the observer’s angle, there are two” (1954a, p. 209).

This perspective moves beyond the space-time confines of traditional clinical psychoanalysis and techniques to encompass and influence primal stages and processes of development, so that the treatment process actualizes ² a new experiential possibility within a new psychic environment. The regression creates what has not existed and could not exist before. “In a peculiar way,” Winnicott writes, “we can actually alter the patient’s past, so that a patient whose maternal environment was not good enough can change into a person who has had a good enough facilitating environment, and whose personal growth has therefore been able to take place, though late” (1988a, p. 102).

And through Winnicott’s words that convey and describe this innovative clinical-technical thinking, there emerge his profound belief, hope, quest, and yearning for a psychoanalytic treatment that would offer a new opportunity for correcting past experiences and forward emotional development for all patients, especially severely disturbed patients. This “hope of getting at something here in the analysis which had never been before” (p. 316) can transpire if the analyst is willing to go back “in emotional development as far as . . . [the patient] needs to go” (1949a, p. 192); to meet and adapt to the very basic needs of the patient; to contend with the depth of the regression, the profound dependence, the “exacting,” specialized early environmental provision that is needed within each treatment of regressed patients; and to cope with the terrors involved.

Winnicott particularly relates to the need for therapeutic regression in the psychoanalytic treatment of schizoid, false self, borderline, and psychotic disorders, which constitute the third, most regressed grouping in Winnicott’s classification (1954a). (From my clinical experience, I would add patients with severe sexual perversions to this list of the most regressed group [Eshel 2005, 2013a, 2017]).

Winnicott was very much aware of the great difficulties met in the course of psychoanalytic work with long, deep, or “total” regressions to dependence, which around the same time bothered two of his contemporaries—Balint in London and Nacht in Paris. Balint (1968, with regard to the basic fault psychopathology) and Nacht (1963; Nacht and Viderman 1960) also dealt with the place of therapeutic regression in the psychoanalytic situation, but with rather restrained and cautious clinical-theoretical conclusions (Eshel 2013b). The last thirty years have given rise to several critical reflections on this way of working with more disturbed patients, and its utility and necessity have been questioned (Spurling 2008; Tyson and Tyson 1990) and criticized (Segal 2006). But Winnicott’s clinical thinking insists on the fundamental transformative importance of such regressions for the patient, the analyst, and clinical psychoanalysis. He therefore emphasizes that the analyst must be experienced as meeting the dependence and managing the regressed patient during this stormy, primal, and needy state. Referring to a severely regressed analytic case that he has “all the time in mind,” he movingly writes:

I cannot help being different from what I was before this analysis started. . . . This one experience that I have had has tested psycho-analysis in a special way and has taught me a great deal.

The treatment and management of this case has called on everything that I possess as a human being, as a psycho-analyst, and as a paediatrician. I have had to make personal growth in the course of this treatment which was painful and which I would gladly have avoided. In particular I have had to learn to examine my own technique whenever difficulties arose, and it has always turned out in the dozen or so resistance phases that the cause was in a counter-transference phenomenon which necessitated further self-analysis in the analyst. . . .

The main thing is that in this case, as in many others that have led up to it in my practice, I have needed to re-examine my technique, even that adapted to the more usual case [1954a, p. 203].

Elsewhere, in a very different tone, Winnicott characteristically addresses this point through the baby:

I am still referring to the very early stages. Certainly there is something that happens to people when they are confronted with the helplessness that is supposed to characterize a baby. It is a terrible thing to do to plant a baby on your doorstep, because your reactions to the baby’s helplessness alter your life and perhaps cut across the plans you have made. This is fairly obvious but it needs some kind of restatement in terms of dependence. . . . We could almost say that those who are in the position of caring for a baby are as helpless in relation to the baby’s helplessness as the baby can be said to be. Perhaps there can be a battle of helplessness [1988a, pp. 102–103].

On a Note of Fiction: “Because I am Alone in another Person’s Night”

I could have concluded by returning to the analogy of nanotechnology and the debate over its potential future implications—is it science fiction (and a risky venture), or a real revolutionary scientific prospect? This question slowed down actual nanotechnology research for a quarter of a century after Feynman’s visionary talk. Similarly, it can be asked about Winnicott’s nano-psychoanalytic clinical-technical theory of regression—is it psychoanalytic fiction (even illusionary and risky) or a truly revolutionary treatment prospect? But because of the two intriguing passages I just quoted from Winnicott, especially the last one about helplessness, I would like to conclude with a piece of literary fiction that touches and resonates with them. I am not bringing the story as psychoanalytic material or as support for Winnicott’s ideas, but as an invitation to further consider unresolved questions that refuse to “settle down” into conventional psychoanalytic interventions.

At the beginning of Clarice Lispector’s riveting story “The Foreign Legion” (1992), a family is seated around a table on which there is a chick that they were given as a Christmas present. A mother, father, and four sons are looking at the helpless chick, trying in vain to find the “right” attitude in the face of its terrified squeaks:

There we were, and no one was worthy of appearing before a chick; with every chirp it drove us away. With each chirp, it reduced us to helplessness. The constancy of its terror accused us of a thoughtless merriment which by now was no longer merriment, but annoyance. The chick’s moment had passed, and with ever greater urgency it banished us while keeping us imprisoned. . . .

I never knew that so much terror could exist inside a creature. . . . To chirp terror. . . . It was impossible to give the chick those words of reassurance which would allay its fears . . . [p. 88].

The chick turns into something that terrorizes the people around it by its relentless helplessness, chasing them away by means of its terror while at the same time holding them in its grip by means of this terror.

The younger boy could stand it no longer.

Do you want to be its mummy?

Startled, I answered yes. I was the messenger assigned to that creature which did not understand the only language I knew. . . . My mission was precarious and the eyes of four children waited with the intransigence of hope for my first gesture of effective love. . . . I opened my mouth, I was about to tell them the truth: exactly how, I cannot say.

But if a woman were to appear to me in the night holding a child in her lap. And if she were to say: Take care of my child. I would reply: How can I? She would repeat: Take care of my child. I would reply: I cannot. She would insist: Take care of my child. Then—then, because I do not know how to do anything and because I cannot remember anything and because it is night—then I would stretch out my hand and save a child. Because it is night, because I am alone in another person’s night, because this silence is much too great for me, and because I have no choice. So I stretched out my hand and held the chick [pp. 89–90].

Being “alone in another person’s night” ³ and depths of terror and despair may reduce us to great helplessness. But because we are there, within, struggling with helplessness that does not disguise itself as power, or knowledge, or willful decision, we may finally be able to take a true hold of the frightened chick or the lonely and needy mother and child within (Amir 2017; Eshel 2020).