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Adelaide M. Johnson. 'Factors in the Etiology of Fixations and Symptom Choice.'
Collaborative work in the simultaneous treatment of parents and children has convinced the author of the importance of the unconscious complicity of the parents in determining the level of fixation and symptom formation in the child. Fixation occurs at the point where the significant parent's regressive impulses are least successfully integrated. The parent projects his or her own guilt on to the child, thus giving it a double burden to bear, but at the same time unconsciously sanctions the expression of the guilt-laden impulse. The parent thus obtains an important vicarious satisfaction. Soon the sharing of guilt and satisfaction alike become necessary for the symbiosis of parent and child. It follows that successful treatment of the child is often impossible without treatment of the parent; while, equally, successful treatment of the child may make the treatment of the parent imperative. Johnson believes that most of the rigidly fixed symptoms of childhood are formed in the way described.