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In terms of ‘modified analysis’, the important point is that the analyst finds himself “working as a psychoanalyst rather than doing standard analysis” (1962b: 168). As Winnicott (1962b: 169; emphasis added) puts it, “I do psychoanalysis when the diagnosis is that this individual, in his or her environment, wants psychoanalysis. I might even try to set going an unconscious communication, when conscious wish for analysis is absent…When I am faced with the wrong kind of case I change over into being a psycho-analyst who is meeting the needs, or tying to meet the needs, of that special case”. Furthermore, Winnicott held that an analyst who is trained in the standard psychoanalytic technique, is best placed for this type of non-analytic work. Winnicott (1962b: 169) was keen to point out that he based his analytic work on diagnosis, and that diagnostic criteria made it possible to differentiate clinically between patients who regress, in the course of treatment, as part of the transference relationship; and patients who are regressed (borderline or schizoid) and in need of a holding environment in the analytic setting. For the latter ‘management’ may become “the whole thing” (1954: 279) and: “In the very ill person there is but little hope of a new opportunity. In the extreme case he analyst would need to go to the patient and actively present good mothering, an experience that could not have been expected by the patient” (1954: 281-2). Where early environmental failures have not been altogether disastrous, Winnicott treats regression in terms of an unconscious belief, which may become a conscious hope, “that certain aspects of the environment which failed originally may be relived, with the environment this time succeeding instead of failing in its function of facilitating the inherited tendency in the individual to develop and mature” (1959: 128). If it is to be realized, however, faith in renewed experience has to be genuinely met – that is, within a setting that is “making adequate adaptation” (1954: 281). What the analyst does and how he behaves is no less important, here, than communicating with the patient in the transference by means of interpretation. Clinical regression means organized regression, whereby the analyst responds to the patient’s need for an internal as well as an external setting. This involves the provision of a living or potential space, wherein patients may find new ways of reclaiming themselves; hence “regression in search of the true self” (1954: 280). Overall, together with Guntrip (1961, 1968), Winnicott (1954, 1960) is generally regarded as having emphasized the essential importance of a failure of the mothering object (‘environmental deficiency’) in the early etiology of pathological development, which subsequently may result in the constellation of the false self: superficial, externally oriented, and basically inauthentic as opposed to the true self, implying integration of the individual’s conscious and unconscious internal world. Moreover, Winnicott’s treatises on developmental value of aggression (1951), use of the object (1969) and his theories of transitional objects and transitional phenomena (Winnicott 1953, 1965), transference-countertransference (1949) and others have wide ranging applicability in studies of development, clinical theory and technique and interdisciplinary studies of creativity and art.
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