Holding and Interpretation: Fragment of an Analysis

by D.W. Winnicott, M. Masud Khan

In his illuminating introduction, Masud Khan, to whom Dr Winnicott's case notes were entrusted, relates this definite text of Holding and Fragment of an Analysis to an earlier phase of the treatment of the same patient described by Winnicott in his paper 'Withdrawal and Regression', also included in this volume.The case documents the therapeutic care of a highly gifted professional man who suffered a psychotic breakdown with acute depression, and who, through analysis, and hospital treatment, was gradually helped to recovery. It is remarkable for many Dr Winnicott's skill at 'holding' the patient in the analytical sessions, and providing guidance through sensitive interpretation; his ability to re-enforce the patient's sexual and ego functions; his instinctive recognition of the value of silence (as a way of showing trust, and of not destroying by intent); his capacity to accept the paradox that verbal communication can be both meaningful and a negation of psychic reality; and, not least, his acute judgment of when to stop the analysis.

Genres: Psychology, Psychoanalysis, Nonfiction

208 pages, Paperback

First published December 1, 1986

About the author

Donald Woods Winnicott was an English pediatrician, psychiatrist, sociologist and psychoanalyst.

Reviews

[Micah · Rating 3 out of 5]

This book seemed unusual to me in that it's a detailed transcript of an analysis. It doesn't seem to have a very auspicious beginning - at the start it's noted that the patient, who has suffered a psychotic break, tends to fall asleep during sessions and his major symptom is that he's boring! But as the book continues I did find it interesting. The patient is depressed, de-personalized, dissociative and disintegrated, has feelings of unreality and is unable to play, be spontaneous, feel excitement and emotion etc. I won't give away the details but the sleeping is a form of withdrawal and regression, during which Winnicott must "hold" him, and much turns on his hidden rage, his ambivalence towards rivalry, his father's death, and his hopelessness about being loved for himself. By recognizing the patient's need for dependence, Winnicott seems to bring him closer to independence and the capacity for initiative and originality.

[Lewis Elliott · Rating 4 out of 5]

I’m a firm believer, as a psychotherapist, and a relatively new one at that, to interact with the ‘classics’. Typically, I find therapy’s texts with case studies/transcripts to be exciting and powerful in delineating theory and praxis; however, I found myself not quite moved by this text by Winnicott. I often enjoy articles and perspectives by Winnicott, so perhaps it’s just I was not interested in some of the more classic psychoanalytical features that feel tired.

It’s also true that the therapeutic process is often slow in pace, so perhaps I’ll analyze my resistance to the text (haha).

Overall, I’d still recommend reading for Winnicott’s self awareness, willingness to fail and acknowledge his humanity (while still being therapeutic and concise), and his use of classic therapeutic skills (I.e. active listening, challenging, paraphrasing, etc).

[Noebonaerense90 · Rating 4 out of 5]

Aún sin un desmenuzamiento teórico pormenorizado, este libro permite vislumbrar que fina sintonia y amor por la clínica tenía Winnicott.

[Ash · Rating 2 out of 5]

Winnicot has some good ideas for a psychoanalyst, but this record of one patent is tedious and badly out of date. If a modern editor could put some of it in perspective, then it might make an interesting historical study. But no modern psychotherapist should be basing their practices on the contents of this book.

[Autumn · Rating 2 out of 5]

FYI - there's a big difference between psychoanalysis and psychotherapy. This is not your basic psychotherapy book. Only a few specially trained people are doing psychoanalysis now.
I found this book tedious and boring. But the last 10 pages of Winnicott's discussion of the patient were very interesting.

[Sergio Gomes]

Here we have another case of Winnicott published in book form. Details for submitting Masud Khan, his heir theoretical and case presentation is theorized that the text "withdrawal and regression."

[Macy · Rating 3 out of 5]

Granted, this book was somewhat outdated and very specific as it was one person's case, but I found some of the interventions to be particularly useful regarding my current work with clients.