Psychiatric Disorder in Terms of Infantile Maturational Processes

In a lecture to the Philadelphia Psychiatric Society, Winnicott affirms the importance, in psychoneurotic psychoanalytic cases, of the analysis of the ‘three-person relationship’ (the Oedipus complex). But when more ‘psychotic’ elements emerge, deeper work of interpretation and understanding must follow. He discusses the analysis of deep depression, of the mourning processes and of the internally persecuting object in the more borderline patients. The ego of the patient needs to be functioning well for interpretation to serve. He proposes that three areas of his own theory—the functions of integration, personalization and the capacity to relate to objects—need to be considered since early environmental failures may cause psychotic-type difficulties. Analytic techniques of regression to dependence and holding then need to be worked through. He concludes that the processes of schizophrenic illness are the processes of early infantile maturation but in reverse. Important clinical illustrative material is given.