So as it turns out the famous analyst who stated that all analysts hate and fear their patients was Donald Winnicott; his 1947 paper “Hate in the Countertransference” explores the topic. This paper is freely available online [pdf] and is not a difficult read.
I’m going to riff off a couple of aspects of the paper in a moment, but first I’ll give you my overall impression. Whenever I read something old I find I am often jolted out of the work by some attitude or event that is weird, incongruous, or unacceptable by modern standards. Sometimes I can identify with the text completely; sometimes it’s like it was written by an alien.
For example, if you are a fan of early 20th century detective fiction, as I am, you can be enjoying a gripping Dr. Thorndyke mystery, only to come up short against a whole bunch of anti-Semitism, racism, and sexism. Or you can read The Pillow Book and nod in agreement with lists that could appear on Buzzfeed (“Things that give one a hot feeling: A fat person with a lot of hair”) but be totally turned off by Sei Shonagon’s contempt for those of lower social status. Or there’s a Barbara Pym novel where the protagonist talks about how innocent and happy the model on her knitting pattern looks, and you realize she’s talking about something like this:
I had a couple of those moments reading this paper. This is not surprising – it was written the year before my mother was born, after all – but there are some pretty major “Wait – what?” moments up ahead, so stay tuned.
Winnicott starts from the assumption that all analysts hate and fear their patients, but ordinarily this hate remains latent, or as he puts it “hate is expressed by the end of the hour”. He claims that it is in treating psychotic patients that the hate of the analyst becomes active.
Of course, people with psychotic conditions are not generally treated only with psychoanalysis anymore. (I wonder if Winnicott’s hate for his psychotic patients came about because without anti-psychotic drugs he couldn’t do an awful lot for them.) Anyway, Winnicott argues that the patient can only see in the analyst what he/she expects to see – the depressed patient sees guilt, the anxious patient a judge – and the psychotic, combining both love and hate, sees both in the analyst, bringing the analyst’s latent hate to the surface.
With me so far? Winnicott kind of tosses off the “people with psychosis experience both love and hate at the same time for the same object” thing as if it’s obvious, so I’m assuming that was a prevalent view of psychosis at the time. It is important for the rest of the paper, so let’s just accept it for now.
Winnicott argues that the analyst’s feelings for the patient are among the patient’s symptoms. He tells an anecdote about a patient he strongly disliked; when the patient improved he became likeable again. His dislike for the patient, he contends, was one of the patient’s symptoms.
This is a powerful insight which Winnicott goes on to illustrate with another, more disturbing anecdote. Winnicott tells the story of a troubled child he and his wife cared for for a few months. (Winnicott worked with evacuees during WWII, most of them children escaping the bombing of London and the south coast.) The 9-year-old boy came from an abusive home and acted out by continually running away. Eventually the running away stopped; but the child became more difficult in other unspecified ways – according to Winnicott, “the boy started dramatizing the assault on the inside”. Winnicott never clarifies what he means by this, but makes it clear that caring for the boy was frustrating and difficult for the family.
…The important thing for the purpose of this paper is the way in which the evolution of the boy’s personality engendered hate in me, and what I did about it. Did I hit him? The answer is no, I never hit. But I should have had to have done so if I had not known all about my hate and if I had not let him know about it too..(…)…I said that what had happened had made me hate him. This was easy because it was so true…[these words] were mainly important in enabling me to tolerate the situation without letting out, without losing my temper and every now and again murdering him.
The point of the story is to illustrate that acknowledging his hate for the boy made him better at being his foster parent – that if he hadn’t acknowledged his hate and made the child aware of it he wouldn’t have been able to control his anger.
I know that parenting standards have changed for the better since the mid-20th century, but I can’t help but think this is an awfully low bar to set. I suppose that telling a disturbed, traumatized child under your care that you hate them is better than physically abusing them, but neither is what I would call ideal. The fact that Winnicott not only congratulates himself on his self-control and healthy self-insight that prevented him from beating a child under his care, but that he thought it was necessary for the child to know he was hated, is a terrifying little window onto what was considered normal parenting in mid-century Britain.
Another “huh?” moment comes at the end of a what is actually a very insightful list of reasons a mother hates her baby (even a MALE baby, Winnicott helpfully adds):
“He excites her but frustrates – she mustn’t eat him or trade in sex with him”
This is, of course, a nod to the famous Oedipus complex, but I must say that I find the phrase “trade in sex” to be enormously illuminating.
Winnicott shows no sign of being troubled by the power imbalance between analyst and patient, even as he acknowledges it – “hate is expressed by the end of the hour”, meaning the analyst controls the frame of the interaction, decides when it begins and ends, and can remove him/herself from it without penalty. When he tells the boy under his care that he hates him, he never acknowledges how horrible that must have been for an abandoned and traumatized child to hear. Similarly the paper is threaded through with assumptions of male supremacy of which Winnicott seems unaware. He takes it for granted that a mother might hate her infant daughter but not her infant son and that sex for women is a transaction.
It’s too much to expect a man who was 51 in 1947 to be a modern 3rd-wave feminist. It’s still unsettling to read something which is so insightful in some ways and so tone-deaf in others.
So maybe we can take Winnicott’s insight – that the hatred the analyst feels can provide clues as to the treatment of the patient, is important and needs to be acknowledged for the treatment to be successful – and expand on it in ways that he couldn’t. Maybe the biases and prejudices of the analyst can illuminate the social conditions that are making contributing to the patient’s problems.
Just a thought.
This post is getting really long and I haven’t gotten into how it relates to the Britzman talk I went to a little while ago, so maybe I will return to this subject later.
What do you think? Is Winnicott’s approach to the foster kid an acceptable way to deal with the unconscious hate he is feeling? Do you think Winnicott’s acceptance of inequality supports or undermines his main point? What classic paper of psychoanalysis should I read next?