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Winnicott had a delightfully idiosyncratic way of engaging paradox and playing with ideas. Indeed, it was Winnicott’s wont to turn clinical phenomena on their heads; he regularly surprised us by introducing the unexpected as he reconceptualized psychodynamics. His clinical formulations were at once refreshing, wise, and unexpected.
What at first examination appears pathological or regressive is instead a complex unconscious emotional communication that, when named and understood, has enormous therapeutic potential. This way of inverting psychopathology is evident across much of his thinking.
Winnicott’s “Fear of breakdown” was a particularly important version of this kind of re-invention. Fear of a future breakdown is actually the sequelae of unprocessed historical trauma: what looks like fear of a yet-to-be experienced event is an expression of un-remembered primitive agonies. Encoded – if at all – procedurally, those terrors lack the verbal links required to process, no matter work through, their impact. A frightening future resonates – indeed, reevokes – unbearable past experiences. Because this early breakdown cannot be consciously accessed, no matter named, it is evaded (sometimes by analyst as well as patient); the analytic couple may even retreat to a false self analysis in an unconscious attempt to occlude what lies beneath.
Winnicott noted that other fears – of death, emptiness, and nonexistence – are sometimes similarly experienced. Only when the dyad touches what was disavowed can the patient move beyond these early terrors.
… if the patient is ready for some kind of acceptance of this queer kind of truth, that what is not yet experienced did nevertheless happen in the past, then the way is open for the agony to be experienced in the transference, in reaction to the analyst’s failures and mistakes … (Winnicott, 1974, p. 105)
Ironically, then, access to fear of breakdown implies hope and opens the way to change: As defenses soften, it becomes possible to encom