Thursday, September 20, 2012

Shame, Aloneness, and Winnicott

More than theory or technique here at the Tampa Bay Institute for Psychoanalytic Studies (T-BIPS), we again and again emphasize the analytic attitude. Of great importance to this attitude is the avoidance of shaming our patients. Because disappointed longings often induce shame in the one who is disappointed (I am too greedy, I am too needy, It must be that I am so unlovable/so unworthy that I do not deserve what I long for) it becomes incumbent upon the analyst to strive toward being ever mindful of the reaction of our patients to any of our communications.

A very interesting discussion about Winnicott ensued last evening in the second year course Development of Shame taught here at TBIPS. We were reading about Being and so read Winnicott’s Capacity to be Alone and Playing: Creative activity and the search for the self. Candidates and students claimed to enjoy the discussion so much and to find it so illuminating that we toyed with the idea of writing a handbook, a kind of Winnicott for Dummies. We were especially taken with delineating the capacity to be alone with the capacity to be alone-in-the-presence-of-the-other.

The capacity to be alone results from the infant’s repeated experience with having its needs met in a timely fashion. Consequently, the infant has the expectation that what is needed will be forthcoming. Hunger and loneliness, then, are bearable because of the infant’s faith that these will eventually be resolved. An infant without this faith will be overwhelmed by the expectation of unrelenting hunger (or pain or loneliness). An adult without this capacity may strive to avoid unbearable feelings of want (overeat, become addicted to behaviors or substances, incessantly need to be in the company of others).

The capacity to be alone-in-the-presence-of-the-other is an even more sophisticated developmental achievement, also wrought from experience with caregivers. Does the caregiver allow the toddler to explore the world without undue intrusion and impingement? The capacity to be alone-in-the-presence-of-the-other is also linked to creativity and spontaneity, to very aliveness, if you will. Creativity in early childhood is fostered when the caregiver provides objects for exploration (pots, pans, blocks, etc) but does not insist on how these objects be explored (as opposed to uwanted intrusions like No, don’t line the blocks up like that, stack them like this). The caregiver, in the background, enjoys, sometimes even participates in, the child’s play. The child is given psychological space to enjoy the world and her/himself in the world but is not abandoned to the world. The caregiver in the background is ready to step in when needed.

Ideally, both adults in a partnership have developed the capacity be alone-in-the-presence-of-the-other, and then come together for mutual enjoyment, sharing, recognition, comfort and reciprocity. Adults who have not developed the capacity be alone-in-the-presence-of-the-other may constantly demand attention from the other, be jealous and resentful of time the other devotes to hobbies, work and friends, may feel chronically dissatisfied, and devitalized, may distort themselves to garner attention from others.

Most clinically apropos: how does the therapist give the patient enough space to allow for exploration, creativity and play in the therapeutic situation and still be in the background awaiting use should s/he be needed? This tricky tightrope is a huge challenge for the analyst. Winnicott intended to provide enough space for Ms X to allow her to spontaneously develop her own way in the world, but, as a few in the class noticed through Ms X’s repeated complaints, Winnicott failed to be sufficiently at the ready for joining with Ms X when she needed him to be more present. How does a therapist know when to give space and when to join in? It is not easy, but I think our patients tell us, by their words, tone, breathing, posture, facial expressions, etc, moment by moment, where we need to be if we can pay attention and learn to walk a very thin line, juggling on a tightrope.

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