You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The author asserts that clinical understanding is guided by background theories. These can be categorized according to whether they focus more on internal or external factors, or, to put it differently, the way they relate to Winnicott's distinction between created and found. Using clinical material from various authors in three areas—trauma, borderline pathology, and neurosis—Scharff illustrates the defining features of these two approaches to understanding the patient, as well as the conflicting tensions between them, which must be reconciled in clinical practice.
One of several examples is a vignette taken from Britton. A four-year-old girl whom he treated had witnessed her parents having a fight, culminating in the father's physical attack of the mother, who then tried to commit suicide and was hospitalized. In playing with animal toys during her session, the child constructed two separate units divided by a barrier; on one side, she placed a pig family analogous to her own, with parents, herself, and her newborn sister. On the other side, she placed wild animals. The pig father attacked the pig mother while she was feeding the baby pig. The girl briefly touched the crocodile on the wild side and tried to heighten the wall between the two groups of animals. Britton interpreted to her that she was afraid her own furious