Meetings of the New York Psychoanalytic Society

September 25, 1979. RECONSTRUCTION OF AN ACCIDENT EXPERIENCED DURING THE RAPPROCHEMENT SUBPHASE: INNOVATIONS IN RESPONSE TO PHASE-SPECIFIC ARREST. Dr. Muriel Chaves Winestine.

During the first two years of analytic therapy with a motorically precocious boy, Dr. Winestine reconstructed an accident (falling backward down a steep flight of stairs) that had occurred in the child's twenty-first month of life. The reconstruction permitted Dr. Winestine to apply Dr. Mahler's observations on the rapprochement subphase to the understanding of this young patient. The discrepancy between the infant's physical precocity and his phase-specific emotional dependence on his mother, as well as the accident itself, interfered with the successful negotiation of his anal phase. What resulted, according to Dr. Winestine, included a faulty neutralization of aggression, a paucity of imaginative play, and a failure to successfully master the precocious (and therefore discrepant) motor development which, in turn, were responsible for faulty structural development. This led Dr. Winestine to make innovations in treatment technique which aimed at a better resolution of the dyadic, independence-dependence conflict epitomized in the rapprochement crisis.

The boy was referred for treatment by the staff of his kindergarten at the age of five years and four months because of an inability to adapt to his surroundings. He was isolated and preoccupied with issues of cleanliness and messiness. He refused to participate in planned and group activities, drank and urinated with inordinate frequency, and was not affectionate with his teachers. The parents (recently separated), after being alerted to watch for symptoms at home, reported the following: increased physical and emotional constraint, fear of noises, sleeplessness, and withdrawal to bed with complaints of stomachaches when upset. He also spent a great deal of time by himself reading and writing numbers and letters, and this seemed a cor