Donald Winnicott: Fear of Breakdown

Eric De Kolb, Nervous Breakdown

On the whole the word can be taken in this context to mean a failure of a defence or organization. But immediately we ask: a defence against what? And this leads us to the deeper meaning of the term, since we need to use the word “breakdown” to describe the unthinkable state of affairs that underlies the defence organization […]

In the more psychotic phenomena that we are examining it is a breakdown of the establishment of the unit self that is indicated. The ego organizes defences against breakdown of the ego-organisation and it is the ego organization that is threatened.[…] in other words we are examining a reversal of the individual’s maturational process. 

 

[…] I content that the clinical fear of breakdown is the fear of a breakdown that has already been experienced. It is a fear of the original agony which caused the defence organisation which the patient displays as an illness syndrome.

[…]There are moments, according to my experience, when a patient needs to be told that the breakdown, a fear of which destroys his or her life has already been. It is a fact that is carried round hidden away in the unconscious[…] In this special context the unconscious means that the ego integration is not able to encompass something. 

[…]It must be asked here: why does the patient go on being worried by this that belongs to the past? The answer must be that the original experience of primitive agony cannot get into the past tense unless the ego can first gather it into its own present time experience and into omnipotent control now assuming the auxiliary ego-supporting function of the mother [analyst] In other words the patient must go on looking for the past detail which is not yet experienced. This search takes the form of a looking for this detail in the future. 

[…] the breakdown has already happened, near the beginning of the individual’s life. The patient needs to “remember” this but it is not possible to remember something that has not yet happened, and this thing of the past has not happened yet because the patient was not there for it to happen to. The only way to “remember” in this case is for the patient to experience this past thing for the first time in the present, that is to say, in the transference. This past and future thing then becomes a matter of the here and now, and becomes experienced by the patient for the first time. This is the equivalent of remembering, and this outcome is the equivalent of the lifting of repression that occurs in the analysis of the psycho-neurotic patient.  

 Winnicott, D. W. (1974). Fear of breakdown. International Review of Psychoanalysis, 1, 103-107.