Discussion of Hayuta Gurevich's Paper, “Contemporary Reading of Winnicott's ‘Regression to Dependence’ in the Language of Ferenczi”1

In her paper “Contemporary Reading of Winnicott's ‘Regression to Dependence’ in the Language of Ferenczi,” Gurevich is describing treatment of patients who are profoundly difficult to treat. But she is using a different lens than the conventional ones we employ when we use the phrase “difficult to treat.” She is not talking about diagnostic categories (such as narcissistic organization or primitive functioning). Rather, Gurevich is elaborating the experiential mode for the analyst or therapist of actually being a failing environment.

Using the work of Ferenczi, Winnicott, Green, and Bromberg, she is concerned with psychoanalytic treatment that is contending with experiences and events that have disrupted or shattered mental functioning. Gurevich uses the word “dissociation” to connote a shocked state of disruption in reaction to something that arrives and overwhelms the capacity to register or make meaning. Instead of meaning, there is a blankness and absence, vigilance, hyper-attentiveness, and retreats into alter worlds.

Gurevich is concerned with how to restore a psychological life that is dominated by dissociation and fragmentation. She emphasizes the inevitable enactment of trauma and the clinician impinging on the patient. Both the patient and the analyst carry their own dissociative responses to the impingements that are part of their histories. Gurevich contends that it is inevitable that the analyst will respond to the patient's dissociations with his or her own dissociative experience. The analyst's hate is an important factor. It is hate that carries the stamp of authenticity. This hate is necessary for the patient to encounter; it functions as the confirmation that the patient has an impact on and is registered by the other. It is the necessity of being experienced and recognized by an other that creates the possibility of being loved.

Gurevich is elaborating the clinical function as an attentiveness to one's experience as an environmental presence. The cha