CLASSIC

ARTICLE

To speak
daring new act. ground For
cian/psychoanalyst

openly

about
D. W.

feelings
of such

of hate
feelings
was truly

toward
to come the
extraordinary.

a patient
from the

in 1949
kindly
Winnicott

was a
broke

a statement in psychoanalysis

pediatriholding

Winnicott

by

stressing

importance

of

the

environment as a healing factor in treatment. He conceived of many of his patients as suffering from a developmental arrest that required a reactivation ofthe developmental process in the psychoanalytic setting. In that regard there was a maternal
paternalistic

cast
character

to much

of his writing
writings.

that
Indeed,

separated
Winnicotts

it from

the

more

of Freuds

experience

as

a pediatrician explication This

transference counter-transference.

undoubtedly

influenced

him

to focus

his attention
of reasons.

on a detailed
First,
it

of the early mother-infant classic article was influential the narrow

to the patient)

relationship. for a variety

view that

signaled

a shift from

Freudian Freud
patient

view ofcountertransference
Winnicott

(as the analysts

termed objective

to a broader

had

originally
work that

understood
was based from that personality widely coexists
paper is its

countertransference
on the analysts past. form understandable behavior. the narrow This in all quarters unconin and total(alvariant analysts In Hate of counter-

as an scious the

obstacle perception

to psychoanalytic of the that

as a figure in the sense

the

Counter-transference, is objective to the argue reaction many described). would

contribution clinician

Winnicott patients that actual

describes

a broader
it is an

transference normal istic though Freud

feelings

and
accepted with

form

of countertransference

is now
it frequently

A second
between

of Winnicotts and patient.

normalization
why

of hateful
a mother hates

This by listing

universalization
18 reasons

of countertrans-

ference

hate
his

is partially

accomplished

her
from dyad

infant and

from
pediatric

the beginning
observations

of that
to draw

relationship.
an analogy He

Here
between expands

Winnicott
the on this

borrows
analogy

mother-infant

the

therapist-patient

relationship. the
are to learn

throughout the paper by stressing Infants must learn to hate if they experience
hatred.

developmental
to love.

importance
Moreover,

of hate.
they must

hate

from

the

mother
this

to facilitate
was one evoked of the

their
early

own
papers

development
that led

of
to the was

A third

contribution

is that

widening
about the

scope
intense

of the indications
countertransference

for psychoanalysis.
by more evoked reader

Winnicott,
primitive

in writing
patients,

also expanding range

patients. that often that
this ences

the psychoanalysts
ways he uses of the the term their
have

and
term

psychoanalytic
the feelings the

therapists
by more should

therapeutic
primitive in mind of as keep

by suggesting Although used had

nature that

to manage the

psychotics,

members

British rather

School
loosely

of object
to apply

relations,
to what

including
we ordinarily

Winnicott,
think

borderline
patients.

or other
lost Winnicott
make them

severe
points

personality were
in several
to hate

disorders. regarded
passages
failures others

In particular, as psychotic
of the
in

transferences in borderline
that
parenting

as if quality out
suffered more

paper
their

patients
experi-

of

environmental prone Again

in those

who

work hate

with

them.

and

again
rather

and to induce hateful feelings he stresses the importance of

than defending against
it

acknowledging

within

the

clinician

VOLUME

S #{149} NUMBER

4 #{149} FALL

1994

WINNICOTT

349

through developmental capable The and this

to

denial

or reaction disturbances that a 9-year-old the approach

of hatred

formation. must others can

Children experience love their of trying

and

who being

have hated

grown before in which such out

up with they

these will be

of believing paper took this

them. clinical home He

his

contains to illustrate

a controversial boy into futility

in

example to shower points

wife

Winnicott uses love had recarticat a of with child not him

his wife vignette that

evoke

for 3 months. that

Winnicott a child the

further

in hopes and

will be curative.
Winnicott

feelings

before

growth

development taking the basic

were such principles ends He the the

possible. a child was certainly

Although into ones work

modern home with hateful

clinicians as useful

would

ommend Winnicotts ulate

a therapeutic in helping patients practical hate harbored view

be

project,

experience

heuristically

of clinical paper that of the

Most Moreover,

organized problem if the that so that conveyed conducted led feelings.

primitive
interpretation.

level.
with a discussion may today
feelings

Winnicott

of the

suggests patient
stages.

an analysis clinicians
such

be incomplete would
will

analyst by the type verbalto the in a the way With of

in

has
analyst

not

told
in the

countertransference

early

self-disclosure

as ill advised.

communicated

more
izing

subtle,

nonverbal

interactions hate seriously

way.

throughout is not disturbed necessary patients

will be

the for

treatment, it to be be Winnicott

countertransference Treatment with

superficial

patient. cannot and

sanitized or Passions

stirred,

for generations

of clinicians

to face

intense

countertransference

the strong
to the

conviction

that

tolerating
the

such
horizons

feelings

would

ultimately
work.

be useful

patient,

he broadened

of psychoanalytic GLEN 0.

GABBARD,

M.D.

Hate 1947,

in the Counter-Transference, was originally of the copyright published Winnicott Trust 1994 in The and

based

on

a paper

read Journal Press,

to the British of Psycho-A Inc. of Psycho-A

Psycho-Analytical (1949; 30:69-74). nalysis.

Society,

February

5, by

International The International Psychiatric

Journal

nalysis

Reproduced

permission Introduction

American

JOURNAL

OF PSYCHOTHERAPY

PRACTICE

AND RESEARCH

350

HATE

IN TIlE

COUNTER-TRANSFERENCE

Hate
By D.

in the
W.

Counter-Transference

WINNICOTT

I
of

n this paper I wish to examine one aspect of the whole subject of ambivalency,
hate that the in the counter-transference. (call him by this I a

ment

of the

ill individual,

but in doing

also

must

study

the
the

nature
psychiatrist

of the
bears

emotional the
he

burden
his work. the his the

which
What

namely, believe

research
phenomenon,

analyst)

task of the analyst who undertakes

is seriously and that weighted analysis

we
needs too.

as analysts
to However be

call
understood much

counter-transference
by loves psychiatrist patients less will what he

the analysis
of psychotics

a psychotic

cannot own conan it is

avoid the
fear

hating
he the motive

them, knows this

and

fearing

them,
hate he

becomes impossible hate is extremely

scious. analyst also This needs asserts that to be the

unless the analysts well sorted-out and

to saying analyzed, of a psychotic that himself analysis

and
and

better
be

determining

is tantamount

does

to his patients.
STATEMENT OF THEME

but

irksome and

as compared so.

with

that

of a neurotic, One could classify

thus:

inherently

counter-transference

phe-

Apart from the management be irksome. From acutely

trends shocks cause

psycho-analytic of a psychotic time to time2 remarks

with too drastic that

treatment, is bound to I have made

nomena

1.Abnormality
feelings, tifications and that

in counter-transference
set are relationships under and repression idenin

critical
in psychiatry, and of these the

about
the

the modern too easy electric

Beexpressed

leucotomies. I have

criticisms

the analyst. The comment on this is that the analyst needs more analysis,
and we believe this is less of an issue

I would the
the

like

to be foremost difficulty
and

in recognition in the
mental

of task of
in

extreme
psychiatrist,

inherent
of the

nurse

among psycho-analysts than cho-therapists in general. 2.

among

psy-

particular. Insane heavy emotional for

work

patients burden can forgive

awful

on

must always those who who

This

be a care this
not

The identifications and tendencies longing to an analysts personal

ences provide lytic work these in quality and the and from two personal positive make that development setting his work of any for other the love

beexperiwhich his anaanalyst. truly

them.

One
do

those

do
does

if they

things.

mean, ever surgeons science.

however, is done as sound

that by

we have psychiatrists according what has the

whose

to accept and to principles follows value

work does

whatneuroof
3.

different

From
[701

I distinguish the analysts

objective
is difficult,

counter-transference,
and

or if

Therefore psycho-analysis,
chiatrist, even

although it really
to one

is about to the
not psyin

this

hate in reaction ity and behaviour

on objective

to the actual personalof the patient, based

any

way

take

him

into

analytic

type the

of psythe so

observation.

relationship To help
cho-analyst

to patients. the general

must not only

psychiatrist

I suggest psychotics
thoroughly

that
aware

if an

analyst he must

is to analyze be able to be

study

for

him

or antisocials

primitive

stages

of

the

emotional

develop-

of the

counter-transfer-

VOLUMES

#{149} NUMBER

4 #{149} FALL

1994

WINNICOTT

351

ence
reactions hate.

that

he can
to the

sort

out

and

study
phenomena

his objective
will include will at

If the ings
and

analyst

is going to him
for

to have is best
must

crude forewarned

feelbeing

patient.

These

imputed
so forearmed,

he
he

Counter-transference
be the important
1

tolerate

times

things
;

in the analysis.
T F

placed deny

in that hate that

position. really

Above exists

all he must in himself.

not Hate

1 vi i:
1 II

NI o
F

vv

M p [ II V

I)

T 0

A N A I. V S 1

T II E

that isjust /ied in the sorted out and kept

for eventual interpretation.

present setting in storage and able we to be the have

in of

has to be available analysts reached

ourselves, the fact

P
I wish to of as suggest

A 1 I F N T

If we are to become
that the the work patient can only
is

of psychotic down
and

patients primitive
another is but

must things
example

appreciate
capable the analyst

in the
feeling.

analyst
In

what
matter in

he

himself
of motive; of the obsesis

to very
this

obsessional
doing

will

tend
his

to be thinking
a futile

that the answer psycho-analytic

to many practice

obscure problems of lies in further analyresearch an attempt the work is on of his

sional pable mood opment

way.

A hypo-manic

patient

who

inca-

of being depressed, swing, and in whose the depressive

except in a severe emotional develhas not been feel guilt in a deep or responsibility, is work as an attempt

sis of the analyst. (Psycho-analytic perhaps always to some extent the part of an analyst to carry than get own analysis further his own analyst could A main is to maintain

position

securely won, who cannot way, or a sense of concern unable on in to see the analysts the part respect of the analyst of his own patient towards

the point him.)

to which

task of the objectivity

analyst of any patient in regard to all that case of this to hate the in our or-

to make reparation (the analysts) guilt tends to see the and the patient, a splitting in luck,
follow

the patient brings, and a special is the analysts need to be able

patient objectively.

feelings. analyst to expect and hate;

A neurotic as ambivalent

Are

there

not
work

many
in

situations

the analyst to show this patient, when someone Would experiences

is also dangerous relationship? love he will surely of characteristically and

of love gets the the

if a that

dinary analytic hate is justified? obsessional, some

analysis came

A patient was almost I felt bad a corner

and then

which the analysts of mine, a very bad loathsome about and

I

love, because analysts hate. psychotic of feeling

that same dent lyst the crude love-hate show This something the analysis

else
it not

is getting love-hate

to me

for the behis

years.
turned lovable,

is in a coincident he
analyst only

state
of the anasame hate is in

this until the patient

realized that

a deep
capable state Should at

conviction
of the coincithe

unlikeableness unconsciously wonderful

I could

had been determined. day for

tell felt too ill for

an active symptom, It was indeed later

that but know. him

a his
he

me
the

(much
patient

on)

when
that

actually

I and

moment

kill the
coincidence that

patient.
love giving and rise recurs to prob-

friends
had been

had

repelled us to

by him, let

This

of psychotics,

lems the

of analyst

management beyond hate which

which his resources.

can

easily This

take coinci-

was also an important day for him, a tremendous advance in his adjustment to reality. In the ordinary analysis the analyst has no difficulty hate. This with hate the management remains latent. of his own The main his own analvast reservoirs to the other and past reaeven

dence of love and ring is something aggressive primitive history mental finding love

to which is distinct and

I am referfrom the the in the

component impulse

complicating implies that

thing, of course, is that through ysis he has become free from of and sons unfelt unconscious to inner why hate as such: hate conflicts. remains belonging

of the patient there was an environfailure at the time of the first objectinstinctual impulses.

There are unexpressed

JOURNAL

OF PSYCHOTHERAPY

PRACTICE

AND RESEARCH

352

HATE

IN TUE

COUNTER-TRANSFERENCE

1.

Analysis

is my

chosen

job, my own myself

the

way

I feel the

I will

best

deal express

with

guilt,

chotic cleared called would a

(research) up when healing that add

patient.
I had what

The
is

difficulty
sometimes

way I can tive way. 2. 3. 4. I get place

in a constructo gain a work.

dream.

(Incidentally and in the

during

my analysis

paid, or I am in training in society by psycho-analytic things. rewards the patient,

I can see

years since the end of my analysis I have had a long series of these healing dreams which, although in many cases unpleasant, have at a new each stage one of them in emotional marked my arrival development.)

I am discovering I get immediate fication with progress,

and

through identiwho is making

still greater
[711

rewards some way of the treatment. 5. Moreover, expressing the hate.

ahead,

after I have is expressed

the ways

end of by

On this particular occasion I was aware of the meaning of the dream as I woke or even before I woke. The dream had two phases. In the first I was in the gods in a theatre and looking down on the people a long way below in the stalls. I felt severe anxiety as if I might lose
ing fall

as an analyst Hate

existence of the I think this is true no difficulty whatever, tient these

so that

end of the hour. even when there is and when the paanalyses for granted,
mentioned,

is pleased things
they

to go. In many can

are

a limb. This was associated with the feelI have had at the top of the Eiffel Tower that if I put my hand over the edge it would
off In aware ing on the that a play to the ground phase people I was now below. of in the the stalls related This dream were to what would be I was watchwas

be taken
scarcely

ordinary

castration
next the and

anxiety.

and the analytic work verbal interpretations emerging unconscious The analyst takes over or other of the helpful patients childhood. the success of those work These when things the patient are part

is done through of the patients transference. the role of one figures of the

going on on the stage through kind of anxiety now developed. was that I had no right This was not a castration

them. What

A new I knew

He cashes in on who did the dirty was an infant. of the description

side of my body at all. dream. It was a sense undermy diffipart of anxieunconI

of not having that part of the body. As I woke I was aware of having stood at a very deep level time. the
in my

what

was

of ordinary psycho-analytic work, which is mostly concerned with patients whose symptoms In have the a neurotic analysis quality. of psychotics, however,

culty at that particular the dream represented

ties scious that might fantasies develop of

The first ordinary

respect of

neurotic

patients.

quite a different type and degree of strain is taken by the analyst, and it is precisely this different strain that I am trying to describe.
ILLUSTRATION COUNTER-TRANSFERENCE ANXIETY OF

would fingers

be in danger of losing if these patients should

my hand become

or my inter-

ested in them. With this kind of anxiety I was familiar, and it was comparatively tolerable. The referred tient. This second to my patient part relation of the dream, however, pathat I of me to the psychotic

was requiring

Recently was spect culty

but

for of each

a period work. one and

of a few I made of my
with

days mistakes

I found in rediffiI had

should have no relation to her body at all, not even an imaginative one; there was no body that she recognized as hers and if she existed at all she could Any reference noid anxieties a body only feel herself to be a mind. to her body produced parabecause to claim that she had her. What she needed

doing

bad

patients. partly
a climax

The
that

was in myself
chiefly associated

it was to one

personal psy-

reached

in my relation

particular

was to persecute

VOLUME

S #{149} NUMBER

FALL

1994

WINNICOTT

353

of

me

was

that

I should

have

only

a mind of the

patients

who

have

speaking to her my difficulties

mind. At the culmination on the evening before

riences ference, experiences

which and

can have the

had satisfactory be discovered those been whose so

early in the very

expetransearly or dis-

dream I had become irritated and that what she was needing of me better than hair-splitting. This had sastrous
analysis tial stand represented the right side thing, my

had said was little had a difor the

essenThe this absence

deficient

torted that the patients mental patient analytic

analyst has life to supply In the

to be the first in certain environtreatment of the in

effect

and

it took
from was anxiety

many
my that by when lapse. and the

weeks

essentials. of the latter technique

to recover however, own in the of my

I should

underwas of to get

kind all sorts of things become vitally important treatment

dream body

that can be taken for granted in the of patients of the former type. tion the job I asked an analyst who confines to neurotics whether he does dark, and he said, an Why, ordinary no! is to provide

I tried

into stalls body

relation were was the

to the watching. side

play related

that This

the right

people side

in the of my

his attenanalysis in Surely our

to this

particular

environment, He was orientated this provi-

patient and need to deny relationship producing ety, much

was therefore affected by her absolutely even an imaginative

and the dark would be extraordinary. surprised at my question. He was towards sion and ronment thing analysis of neurotics. But

of our bodies. This denial was in me this psychotic type of anxiless tolerable than ordinary castrathe

maintenance of an ordinary envican be in itself a vitally important analysis of a psychotic, more important which also in fact it than have to

tion anxiety. Whatever other interpretations might be made in respect of this dream result bered analysis of my having dreamed it and it was that I was able again and even to

in the

remem-

can be, at times, even the verbal interpretations

to take up this heal the harm

done to it by my irritability which had its origin in a reactive anxiety of a quality that was appropriate to my contact with a patient
with no body.
1721

be given. For the neurotic the couch and warmth and comfort can be symbolical of the mothers love; for the psychotic it would be more analysts
couch warmth is

true
is the

to say physical
the so on.

that

these

things

are

the

expression of love. The analysts lap or womb, and the

live warmth of the analysts

POSTPONEMENT INTERPRETATION

OF

body.

And

OBJECTIVE

HATE TEST

The without thing long

analyst about period

must

be the

prepared patient

to bear to know perhaps this he

strain anyThere ment ordinarily analysis greater can only it. Now certain sought needed seeks able reach over a must be

UNDER

expecting

what he is doing, of time. To do

is, I hope, a progression in my stateof my subject. The analysts hate is latent and of psychotics strain to keep I want to add is easily kept latent. In the analyst is under his hate latent, and he thoroughly in certain aware stages of of that

easily aware of his own fear and hate. He is in the position of the mother of an infant unborn or newly born. Eventually, he ought to be
ysis too

able
may little

to tell on the
never good

his

patient

what

he

has

been

do this by being

through

patients behalf, but get as far as this. There

experience in the

an analmay be
patients

past tory
lyst

to work relationship
to exploit

on.

What

if there infancy
transference?

be no satisfacfor the between anathose

analyses the analysts hate is actually by the patient, and what is then is hate that is objective. If the patient objective to reach objective or justified
it, else he

of early
in the

hate
cannot

he
feel

must
he

be
can

There

is a vast

difference

love.

JOURNAL

OF PSYCHOTHERAPY

PRACTICE

AND

RESEARCH

354

HATE

IN THE

COUNTER-TRANSFERENCE

It is perhaps

relevant

here

to cite

the

case

solution interpretation, sis. It was valued

this

in a crisis
[7S1

was

to make
were

the
in

correct
analy-

of the child of the broken home, or the child without parents. Such a child spends his time unconsciously notoriously into pens gains ones is that hope, looking inadequate home and for his to take to love parents. It is such a child What hap-

the

as if the boy correct interpretation for

which

that purpose
evolution

he of in

above everything. The important thing

paper is the way in

the
the

him.

after a while a child so adopted and then he starts to test out the he has found, and to seek proof It only of

of the boys personality engendered me, and what I did about it. Did I hit him? The answer is no, hit. But I should I had not known had not let him take him would have had all about know about and the by bodily

hate I never

environment

of his guardians ability to hate objectively. seems that he can believe in being loved after nine reaching During came the being second to a hostel hated. world for evacuated war a boy

to have done so if my hate and if I it too. strength, put him weather At crises and outside or the withthe time I

children,

sent from London not because of bombs but because of truancy. I hoped to give him some treatment during his stay in the hostel, but his
symptoms won

out anger or blame, front door, whatever

and

he

ran

away

as he

had age of How-

of day or night. There was a special bell he could ring, and he knew that if he rang it he would be readmitted and no word said about the past. recovered The He used this bell from his maniacal important thing him outside I said that me hate him. the what This as soon attack. is that door, had as he had each time,

always done from six when he first

ever,

everywhere ran away contact I could

since the from home. with see and him

I had

established in which

in one away of his

assault,

interview through he was

interpret

a drawing unconsciously

of his that saving

in running the inside

from

just as I put something; had made

I told him happened because

was easy

home and preserving his mother as well as trying to get away from world which was full of persecutors.

his own

inner

I was not very surprised when he turned up in the police station very near my home. This was one of the few police stations that did not generously know took him intimately. him in and My kept wife very him for He was of chil-

it was so true. I think these the point ofview mainly important the situation ing my temper dering This He
rooted few a stable ordinary

words were important from of his progress, but they were

in enabling me to tolerate

without letting out, without and every now and again full story cannot School.
remained life. used This to

losmurhere. deeply
of the from the

him. boys
relation things life

be told His
one episode illustrate

three months, three the most lovable and

months of hell. most maddening

went

to an Approved
to us has in his can be

dren, often stark staring we knew what to expect.

phase shilling by giving whenever him he went

mad. But fortunately We dealt with the first

freedom out. He had and only to

complete

general topic of hate justified in the present; this is to be distinguished from hate that only justified in another tapped by some action setting but which of a patient (child).
LOVE HATE

is is

ring police

up

and

we

fetched

him

from

whatever ocround,

station had taken Soon the expected truancy

charge of him. changeover turned

curred-the

symptom

M0TuERs AND

and the boy started dramatizing the assault on the inside. It was really a whole-time job for the the two of us together, took had or night, and place. to be and when made often the I was out at any only worst episodes Interpretation of day

Out of all the complexity of the problem of hate and its roots I want to rescue one thing, because I believe it has an importance for the analyst of psychotic patients. I suggest that

minute

VOLUMES#{149}NUMBER4#{149}FALL

1994

WINNICOTT

355

the hates know ing

mother the his this

hates mother, mother theme

the and hates I want

baby before him. to

before the Before refer to

the baby

baby can

F.

To feels baby,

a greater

or lesser

extent

a mother a to

developFreuds G. H. I.

that her own mother demands so that her baby is produced her mother.

placate

remarks. (1915)

In (where

Instincts and Their Vicissitudes he says so much that is original

The baby hurts her nipples even by suckling, which is at first a chewing activity. He is ruthless, treats paid servant, a slave. She has to love him, her as scum, and an unall,

and illuminating about hate), Freud says: we might at a pinch say of an instinct that it loves the objects after which it strives for purposes hates become
hate

excretions

satisfaction, but to say that it an object strikes us as odd, so we aware that the attitudes of love and be said relations This to characterize objects, of the I feel ego is true but and the are importbe may earragerelareto their

of

J.
K. L.

at any rate at the beginning, till he has doubts about himself. He tries to hurt her, periodically bites her, He His that all in love. shows excited having disillusionment love got is cupboard what he wants about love, he her. so

cannot

tion served

of instincts for the

as a whole

to objects....

ant. Does this not must be integrated

mean that the personality before an infant can early integration integration occurs of excitement or

M.

throws her away like orange peel. The baby at first must dominate, he must be protected must unfold needs tailed not from coincidences, at the babys rate and life all this

said to hate? However be achieved-perhaps liest at the height there is a theoretical whatever the infant done love in hate. I have in describing

earlier stage in which does that hurts is not used this the stage. word Is this ruthless accept0. N.

his mothers continuous study. [74] For instance, be anxious he does when not holding know

and deshe must him, at all what etc. she

At first

able? As the infant becomes able to feel a whole person, so does the word hate develop meaning as a description of a certain group of his feelings. The mother, however, from the word go. I believe possible that a mother may hates Freud under her infant thought it certain

does or what she pecially he cannot He is suspicious,

sacrifices for him. Esallow for her hate. refuses her good food,

P.

and makes her doubt herself, but eats well with his aunt. After an awful morning with him she goes out, and he smiles at a stranger, who says: Isnt he sweet! If she fails him he will pay her He excites mustnt her eat him at the start she out for ever. but frustrates-she or trade in sex with him. knows

circumstances have only love for her boy baby; but we may doubt this. We know about a mothers love and we appreciate its reality and
why

Q.
R.

power.
a mother

Let

me
hates

give
her

some
baby,

of the
even

reasons
a boy.

A. B. C. D. E.

The

baby

is not

her

own

(mental)

con-

ception. The baby is not the one of childhood play, fathers child, brothers child, The baby The baby pregnancy is not magically produced. is a danger to her body and at birth. in

I think that in the analysis of psychotics, and in the ultimate stages of the analysis, even of a normal person, the analyst must fmd himself in a position comparable to that of the mother of a newborn baby. When deeply regressed the patient cannot identify with the analyst or appreciate his point of view any more than the fetus or newly born infant can sympathize with the mother. A mother has to be able to tolerate hating her baby without doing anything about it. She

etc.

The baby is an interference with her private life, a challenge to preoccupation.

JOURNAL

OF PSYCHOTHERAPY

PRACTICE

AND

RESEARCH

356

HATE

IN THE

COUNTER-TRANSFERENCE

cannot she may

express do, she

it to him. cannot

If, for hate

fear

of what

appropriately

most careful is incomplete not been patient for the stages.

timing. But I believe an analysis if even towards the end it has possible for the analyst to tell the

when hurt masochism, to the false

by her child and I think theory

she must fall back on it is this that gives rise masochism in

of a natural

what he, the analyst, did unbeknown patient whilst he was ill, in the early Until the interpretation is made the to some extent in the who cannot understand position what

women. The most remarkable thing about a mother is her ability to be hurt so much by her baby and to hate so much without paying the child out, and her ability to wait for rewards that may or may not come at a later date. Perhaps she is helped nursery rhymes she sings, enjoys but fortunately does by some of the which her baby not understand?

patient is kept of infant, one he owes

to his mother. S
U M M A R V

An analyst

has

to display

all the

patience

and

Rockabye Baby, on the tree top, When the wind blows the cradle will rock, When the bough breaks the cradle will fall, Down will come baby, cradle and all. I think a small infant; not knowing in the words, is not of a mother (or father) playing with

tolerance and to her infant, wishes as needs,

reliability of a mother has to recognize the has to put aside

devoted patients inter-

other

ests in order to be available tual, and objective, and has to give what is really be only given patients needs. There may which (even is the analysts unconsciously)

and to be puncto seem to want because initial period cannot by the be expected of the patient is no capacity of the in be pa-

the infant enjoying the play and that the parent is expressing hate perhaps in birth symbolism. This rhyme. Sentimentality as it contains in a mother of view. whether a denial of is no good a human the

a long point

of view cannot root

appreciated

a sentimental

useless for parents, hate, and sentimentality

tient. Acknowledgment because at the primitive that is being looked with cannot for for identification tainly the patient

there

at all from the infants point It seems to me doubtful child as he develops is capable full extent environment. If this ysis cannot the analyst
PRACTICAL INTERPRETATION

the analyst, and cersee that the analysts

of tolerating

of his own hate He needs hate is true, a psychotic be expected unless the

in a sentimental to hate. patient in analhis hate of hate him.

OF

hate is often engendered by the very things the patient does in his crude way of loving. In the analysis (research analysis) or in ordinary type analyst important of duced psychiatric management of patient, (psychiatrist, to study quality those who patients. in a great of the strain mental the ways and work Only more is put nurse) in which hate this with in psychotic on the and it is anxiety are severely way proill can

to tolerate analyst can

PROBLEM

psychotic

also

If all this is accepted there remains sion the question of the interpretation analysts a matter hate to the patient. fraught with danger, This and

for discusof the is obviously it needs the

there be any hope of the avoidance of therapy that is adapted to the needs of the therapist rather than to the needs of the patient

1. British MedicalJournal Physical Therapy icalJournal, May

correspondence of Mental Disorder. 17, 1947; 1:688

(1947); British

and Mcd-

2. Leucotomy. Spring 1949;

British 3,2,35

Medical

Students

Journal,

VOLUME

S #{149} BER 4. NUM

FALL

1994