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Winnicott's contributions to psychoanalysis are summarized and organized under several headings. Relevant bibliographical references are given in each section. Winnicott's work on inner reality and fantasy includes the concept of "primary unintegration." He traces the integration of various parts of the personality interrelating with an appreciation of time, space, and the properties of external reality in a process termed "realization." Fantasy is seen as defense against inner reality rather than outer reality. One aspect of the defense is the existence of a "false self" alongside a "true self," which the author compares with Erikson's "positive and negative identities."
Winnicott's description of the child's use of transitional objects is outlined, with emphasis on children's wish to preserve their creativity at the same time that they learn to participate in the consensual reality of adults. Winnicott's distinction between using an object and relating to an object is the subject of another section of the review. The author briefly describes Winnicott's contribution to the technique of therapy, stressing his consistency with general psychoanalytic principles and explaining his sensitivity to the need to tolerate extremely regressed states in patients who have been deprived of "good enough mothering." Lastly, the idea of creativity, not as a means to an end, but as a thing in itself is discussed. Psychotherapy takes place in the overlap between the therapist's and the patient's play. When the patient is in a state of not