· The capacity to be alone is a highly sophisticated phenomenon and has many contributory factors. It is closely related to emotional maturity
· Ego-relatedness refers to the relationship between two people, one of whom at any rate is alone; perhaps both are alone, yet the presence of each is important to the other
· Gradually, the ego-supportive environment is introjected and built into the individual's personality, so that there comes about a capacity actually to be alone.
· If the patient cannot play, then something needs to be done to enable the patient to become able to play, after which psychotherapy may begin. The reason why playing is essential is that it is in playing that the patient is being creative.
· There is no need for the therapist to organize chaos all the time. Sometimes that behaviour covers and substitutes a real need for rest and empathic listening.
For example I have a patient deeply emotionally detached [who] tries to understand how to handle relationships. For that reason I proposed [to] him to join a group and indeed he accepted. He is in the group for 3 months and now he feels angry with other members because they talk and they do not allow time and space for him and others. When I asked him (in individual session) what do you want from others when they see that you are not talking? He replied "to give space to my silence. I do not want [them] to tell me anything but I need [them] to respect my silence and accompany me in that. I want to stay all in silence for some minutes in order to feel what I feel, to touch the depth of my sorrow that I cannot otherwise demonstrate."
At the previous session I "played", as Winnicot says, with him. I showed him a video from the web. In that video a man was seeing a woman from a distance and then tried to reach her by walking [across] a street. A car hit him, some glass from a window broke [and reached the woman]. However, they did not reach each other. The message was that all of that was only in the man’s fantasy. While my client was watching the video he cried and I did not ask him anything except one comment, "It seems that you at least reached out to something." So I was company, a silent company to his noisy loneliness.
Winnicott, D. (1958). The capacity to be alone. Int.J.Psa., 39:416-420.
Winnicott, D.W. (1956). D.W. Winnicott, Playing and Reality, London: Tavistock, Chap. 4 Playing: creative activity and the search for the self.