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Margaret Little's collection of papers is a sometimes painfully candid account of her thinking and clinical work as an analyst, derived from her own life experience and her analyses with Ella Sharpe and Donald Winnicott.
Her most important contributions centre on her thoughts about countertransference and on her ideas about “basic unity”, a concept that she has developed largely through work with psychotic patients. She comes across primarily as a clinician who has challenged and extended the accepted notions on technique.
In the chapter on Countertransference and the Patient's Response she grapples with the difficulties of accepting and using the countertransference — which was a “forbidden” subject in her student days. She advocates an explicit use of the countertransference, suggesting that if a mistaken interpretation is made “Not only should the mistake by admitted (and the patient is entitled not only to express his own anger but also to some expression of regret from the analyst for its occurrence, quite as much as for the occurrence of a mistake in the amount of the account or the time of his appointment) but its origin in unconscious countertransference may be explained, unless there is some definite contraindication for so doing” (p. 44). She believes this will have “beneficial results” as it increases “the patient's confidence in the honesty and goodwill of the analyst showing him to be human enough to make mistakes”. One wonders what the “definite contraindication” might be. I believe that our patients have all too many opportunities to observe our humanity in our mistakes without our having to acknowledge and explain in quite the way Little suggests. I think she gives fair warning against “confessions” from the analyst but her suggestions offer the unwary therapist a great temptation to indulge in apology and explanation and to shun the pain of standing the patient's rage and resentment. The inclusion of explicit countertransference