D.W. Winnicott, a psychoanalyst of extraordinary grace and originality, left a body of work distinguished by fierce independence of mind, profound playfulness and technique, and passionate intelligence. Holding and Interpretation, a verbatim record of his sessions with a psychotic patient, vividly illustrates his enormous contribution to psychoanalytic theory and technique, his skill at “holding” the patient in the analytic session and providing guidance through sensitive interpretation. It is a rare working portrait of one of the true giants of psychoanalysis—“a very vast subject,” as he said, “which has the great charm of being really useful.”
This book seemed unusual to me in that it's a detailed transcript of an analysis. It doesn't seem to have a very auspicious beginning - at the start it's noted that the patient, who has suffered a psychotic break, tends to fall asleep during sessions and his major symptom is that he's boring! But as the book continues I did find it interesting. The patient is depressed, de-personalized, dissociative and disintegrated, has feelings of unreality and is unable to play, be spontaneous, feel excitement and emotion etc. I won't give away the details but the sleeping is a form of withdrawal and regression, during which Winnicott must "hold" him, and much turns on his hidden rage, his ambivalence towards rivalry, his father's death, and his hopelessness about being loved for himself. By recognizing the patient's need for dependence, Winnicott seems to bring him closer to independence and the capacity for initiative and originality.
I’m a firm believer, as a psychotherapist, and a relatively new one at that, to interact with the ‘classics’. Typically, I find therapy’s texts with case studies/transcripts to be exciting and powerful in delineating theory and praxis; however, I found myself not quite moved by this text by Winnicott. I often enjoy articles and perspectives by Winnicott, so perhaps it’s just I was not interested in some of the more classic psychoanalytical features that feel tired.
It’s also true that the therapeutic process is often slow in pace, so perhaps I’ll analyze my resistance to the text (haha).
Overall, I’d still recommend reading for Winnicott’s self awareness, willingness to fail and acknowledge his humanity (while still being therapeutic and concise), and his use of classic therapeutic skills (I.e. active listening, challenging, paraphrasing, etc).
Winnicot has some good ideas for a psychoanalyst, but this record of one patent is tedious and badly out of date. If a modern editor could put some of it in perspective, then it might make an interesting historical study. But no modern psychotherapist should be basing their practices on the contents of this book.
FYI - there's a big difference between psychoanalysis and psychotherapy. This is not your basic psychotherapy book. Only a few specially trained people are doing psychoanalysis now. I found this book tedious and boring. But the last 10 pages of Winnicott's discussion of the patient were very interesting.
Here we have another case of Winnicott published in book form. Details for submitting Masud Khan, his heir theoretical and case presentation is theorized that the text "withdrawal and regression."
Granted, this book was somewhat outdated and very specific as it was one person's case, but I found some of the interventions to be particularly useful regarding my current work with clients.