A More Usable Winnicott

In this article, I hope to amplify certain basic features of Winnicott's theories to provide a more elaborate explanation for the following: (1) the nature and primary source of anxiety in his model. (2) The major points of fixation and developmental arrest that give rise to pathological character formation. Here I detail the anatomy of the false self, as one principal way the psyche reorganizes to defend against anxiety, the awareness of depressive feelings, and a chronic incapacity to manage tension states. I also describe an alternative way the individual might achieve an alternate solution, with an emphasis on archaic forms of grandiosity. Finally, (3) I emphasize the role of affects, especially the consequences of the failures in their management, to give a crucial role to what I call the second dimension of caretaking failure. In the analytic work, this second dimension becomes not only important but, at times I claim, the leading edge of need.

I do not review Winnicott's developmental model in detail here. A more extensive review can be found in my papers, “Ordinary People,” and “The Capacity to use the Analyst.”

Winnicott (and to a great extent Kohut) viewed patients who suffer from developmental and self disorders as communicating their disturbance through their characters, their symptoms, and their seriously compromised object relating. They both see the adaptive/maladaptive character pathology as an admixture of need (the forward edge) and defense. The needs imbedded in the presenting personality—often distorted—have been carried forward in derivative form from earlier times. The defenses, for the most part, are motivated by the fear of retraumatization, exaggerated by the dread of reliving disappointments and the attendant unintegrated feelings. This latter anxiety is heightened because the patient's structure is frequently weakened due to the lack of a secure internal holding environment.

Both Winnicott (1958) and Kohut (1971) traced the source of these pr