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Themes relating to states of dependence and the impact of these on the dependent person, those upon whom they are dependent and the framework within which their lives are lived are central to Winnicott's work. Conscious and unconscious conflicts arising from these can have powerful effects on the emergent structure of the personality, relationships and the structures of society. Within this context Winnicott was particularly concerned with presentations of physical symptoms and the responses to them. Clinical material is presented where his ideas shaped the overall approach and to illustrate how adaptations of his techniques were used in response to the child patient, her family and the available resources of the therapist. This material is particularly noteworthy for its use of postal communications and the use of the imaginations of the therapist and patient.
The material is used to explore issues of dependence, dependability and interdependence in relation to psychosomatic presentations. The latter themes are expanded to reflect on wider societal issues as pathological responses to conflicts about dependence. The conclusion is that Winnicott's constructs are crucial in a climate of reaction against dependence as a fundamental component of the human condition.