On Hating Others
On Winnicott, 02
Winnicott opens his paper “Hate in the Countertransference” (1949) with an ethic: One who works with psychosis must be able to manage their own hate. The paper is an attempt by Winnicott to talk about some things that, in his experience, come up during his work with psychotic patients during analysis. But these lessons are not exclusive to psychoanalysts and their patients. He extends this to psychiatrists and, in short, everyone who loves or cares for someone experiencing psychosis. This paper is a paper on technique — but more importantly it is an exercise in ethics.
Countertransference — An Phenomena of Identification
Early on in the paper, Winnicott gives us three phenomena which he thinks of as ‘countertransference’:
- Feelings which the analyst feels towards her patient which are repressed. These feelings are therefore not yet analyzed or recognized by the analyst. This aspect is thus an abnormality in the treatment, a hindrance on the side of the analyst;
- On the other hand, countertransference could refer to feelings the analyst imparts onto the patient which provide the positive interactions between the two. In fact, Winnicott claims that this is precisely what sets analysis apart from other, ordinary interactions. Love born from guilt, for instance, may function in this way;
- Finally, there is the objective countertransference. This is a slippery term, but an important throughout the paper. By objective countertransference, Winnicott is referring to those feelings or sets of feelings which the analyst has in relation to the personality of his analysand. This particular phenomena of countertransference is that the analyst’s feelings only make sense insofar as they are responding to actual, material, and real behaviors and transferences emanating from the person of the patient.
Whatever the mode of the particular countertransference dynamic, Winnicott is sure of one thing: it “will at times be the important things in the analysis.” So the feelings that the analyst has towards his or her analysand are among the most considerable aspects of the treatment, of the patient’s journey to getting better.
Of particular interest to Winnicott, it is the objective transference, among which is the feeling of hate, that manifests most strongly in relation to antisocial and psychotic patients. This is where Winnicott is most concerned in this paper: hate in the objective countertransference in the treatment of psychosis and antisocial personalities. At this point, we may ask Winnicott: Given his focus on countertransference, for whom does the analysis take place, the patient or the analyst?
Winnicott would surely say both. But how? And what does this mean for the posturing of the clinician, if he must at all times analyze his own feelings towards the people he works with? Does this not take the focus off of the person who comes for relief of mental suffering? We will return to this question later on. For now, Winnicott wants to tell us something of the quality of the relationship which is both general to human interaction and unique to the analysis of psychosis.
Loving and Hating Simultaneously
If the therapeutic relationship and setting is for the patient the place where she can feel most real, most herself, she must be able to learn to tolerate all of her feelings and experiences. She must, in Winnicott words, be able to tolerate ‘going on being’. For Winnicottian practice, it’s enough to know for now that most neurotic people come to psychotherapy because of something which was not available to them in childhood. In some way, each person’s relationship with their important adult figures was unsatisfying. Those early relationships stultified going on being, and the person was never able learn to ‘be who they are’, nor even wonder what that might look like.
A classic example is the individual who is afraid of feeling anger. So they feel resentment instead. Rather than allowing themselves to be angry in response to their partner doing something they thought offensive, they would rather passively accrue degrees of resentment over time, because that is an experience they were ‘allowed’ to feel early on. Anger, in this person’s childhood home, was not tolerated. In fact, it was something to be feared; it meant a loss of control, a loss of being itself.
So the patient comes into the clinic to feel real again. This is the case of the neurotic. For the psychotic, however, who may have suffered absolute deprivation, there was never a feeling of being real and alive in a concrete way. Experience has fragmented to such an extent due to continually traumatic and deprived early experiences that the person cannot recover what was once lost for the neurotic — a feeling of being at some point which is only frustrated — because that experience was never had at all.
In the classic treatment of the neurotic, the analyst “exploits” their earlier developmental successes, for there are always some, even if in wilting residue, stunted and suffocated. It is there, this ‘going on being’, this feeling real. For the psychotic, the analyst’s office and therapeutic presence is altogether new. The couch, in this situation, and the analyst’s warmth, are not stand-ins for the good mother. They are the good mother. There is no repetition here, only novelty.
What this means for transference, Winnicott tells us, is the following:
I wish to suggest that the patient can only appreciate in the analyst what he himself is capable of feeling. In the matter of motive: the obsessional will tend to be thinking of the analyst as doing his work in a futile obsessional way…. [and so on].
And a psychotic patient?
Would it not follow that if a psychotic is in a ‘coincident love-hate’ state of feeling he experiences a deep conviction that the analyst is also only capable of the same crude and dangerous state of coincident love-hate relationship? Should the analyst show love, he will surely at the same moment kill the patient.
The ‘love-hate’ feeling that the psychotic feels will give “rise to problems of management which can easily take the analyst beyond his resources” and indicate environmental failure during the first few moments of life.
Psychoanalysis for the Analyst
At this point, Winnicott takes us on an interesting detour concerning the ethical duty of the analyst, which is indeed a recurring theme of this paper.
If the analyst is to manage being imbued with love-hate feelings from the analysand, she must recognize it in herself that these things exist. In other words, she comes to terms with Winnicott’s third kind of countertransference: objective. The analyst really does hate her patient, and it is justified (a statement elaborated upon in the form of a list later on). What does the analyst do with this hate? If it isn’t managed, it will impede on the treatment and direct it without the analyst’s knowledge.
To show this, Winnicott gives an example of a patient experiencing persistent and severe psychosis to whom he gives a rushed and violent interpretation without recognizing the hate that governed it. It then took months for the analysand to gain his trust again and the psychotherapy could continue its momentum.
Winnicott’s answer is that the clinician herself must be in her own analysis, which will supply her with her own space to experience and tolerate painful emotions. And any clinician will say that one of the most intolerable of feelings is the hate towards a psychotic patient.
One’s own personal work cannot be dispensed with. Indeed, Winnicott even goes so far to say that psychoanalytic research — the writing and reading of books and papers — is an attempt to take one’s own analysis further than one’s analyst took oneself.
On Hating One’s Patient
So why is the analyst’s hate of the analysand justified? What makes it objective? Winnicott, speaking of the mother’s hate for her infant, tells us frankly the following reasons, of which I’m only including a few [1]:
The baby is a danger to her body in pregnancy and at birth.
The baby is an interference with her private life, a challenge to preoccupation.
He is ruthless, treats her as scum, an unpaid servant, etc.
He shows disillusionment about her.
He is suspicious, refuses her good food, and makes her doubt herself, but eats well with her aunt.
Those are good reasons to hate someone, Winnicott assures us. And there is no use — indeed there is only harm — when the mother and/or the analyst denies such uncomfortable feelings. And if the psychotic patient never experienced a mother’s love extending beyond that hatred, the analyst must be the first one to do this: they must be the first one to show that love and hate can exist in a relationship without one overtaking the other.
Surely, the parent (in most scenarios) does not explicitly show their hate regularly and with the passion with which they feel it. Indeed, Winnicott tells us, such hatred is sublimated, in the forms of nursery rhymes, discipline, and so on. (We all know how “Rock-a-bye Baby” ends.) [2]
Laplanche [3], following Freud, claims that messages of love, such as kissing or rubbing, from parent to child, are laden with latent content of the adult world of sexuality which the child does not yet understand, but is subjected to. The same could be said of hate. Neither love nor hate — as adults understand them; i.e., as social emotions, requiring two subjects — can be said to be present from the beginning. The parent must love and hate so the child can learn to do so.
Hate in the Transference
But who hates first, the analyst or the patient? If countertransference is a response to the projections and transference of the patient, why does Winnicott compare the analyst’s hate to that of the mother’s, which is present “from the word go”?
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 analysis of psychotic patients. I suggest that the mother hates the baby before the baby hates the mother, and before the baby can know his mother hates him.
Must the analyst hate the patient before the patient knows of this hate?
Winnicott evokes here a passage from Freud’s Instincts and Their Vicissitudes to answer this chicken-or-egg problem, which would be useful if quoted in full:
We might at a pinch say of an instinct that it ‘loves’ the objects after which it strives for purposes of satisfaction, but to say that it ‘hates’ an object strikes us as odd, so we become aware that the attitudes of love and hate cannot be said to characterize the relation of instincts to their objects, but are reserved for the relations of the ego as a whole to objects…
Here, Winnicott’s dilemma is solved. The infant cannot be said to ‘hate’ (or ‘love’, Laplanche would add) its mother before integration (emergence of the ego) has occurred; because love and hate are contextual terms formed in relation of ego to object, not of instinct/drive to object. Hate occurs only within a horizon of meaning that comes from without, through relation, with others. Thus, the mother may ‘hate’ the infant from the get-go, because she has developed the capacity to hate; but the infant only expresses ‘ruthless love’ (instincts towards which satisfaction is the aim but will seem particularly violent, like teething or suckling or needing attention).
So the same might be said of the analyst’s hate towards the psychotic patient: At a point before integration occurs, the patient cannot be said to feel hatred towards the analyst.
So whence does the hatred emerge? This is a question that plagues us as we read this paper, and Winnicott does not answer it clearly. As mentioned earlier, many of the feelings which are common to the parent-child dyad are absent from the psychotic’s (or antisocial’s) personal biography, and so are created (not re-created/repeated, as in the treatment of the neurotic) for the first time.
If this is so, then the hatred must come from the analyst before it can emerge in the patient. For the patient may demonstrate ruthless love, but he cannot yet hate the person of the analyst. Why, then, does Winnicott title his paper, “Hate in the Countertransference”? Wouldn’t it be more apt to call it “Hate in the Transference”?
Or, perhaps Winnicott is not asking that question at all. Perhaps he recognizes that even a psychotic patient with an extremely traumatic and relationally bereft personal history and childhood knows something of hate and love. So our initial question isn’t as relevant as the following one: How can the patient learn to tolerate and make sense of their hate if the analyst does not commit herself to the same ethic?
Near the end of the paper, Winnicott wonders,
It seems to me doubtful whether a human child as he develops is capable of tolerating the full extent of his own hate in a sentimental environment. He needs hate to hate.
If this is true, a psychotic patient in analysis cannot be expected to tolerate his hate of the analyst unless the analyst can hate him.
By allowing for one’s own hate to enter into the countertransference and by tolerating this disturbing experience, the analyst allows the patient to do so as well. It is painful to hate one’s clinician.
And what does the analyst do with his hate? How will the patient know that the analyst is experiencing hate towards her, the analysand? A bridge, so to speak, must be built between the hatred of the analyst and the hatred of the patient, and it is the analyst who functions as a container for hate so that the patient can do this as well. For this, Winnicott, tells us,
… I believe an analysis is incomplete if even towards the end it has not been possible for the analyst to tell the patient what he, the analyst, did unbeknown for the patient whilst he was ill, in the early stages. Until this interpretation is made the patient is kept to some extent in the position of infant — one who cannot understand what he owes to his mother. (Emphasis mine.)
This is not to exploit the patient so that they will feel shame for being rude or cruel or overly loving to the therapist. This to show the patient that love and hate can exist for the same person at the same time. “Yes I hated you because you said mean things to me, I couldn’t go for drinks with friends because I had to stay late to work with you, and you called me in crisis. But I also remained devoted to your cure and your treatment.”
This gives the opportunity to make meaning of the analysand’s own experience of hate for himself: “And I hated you because you did not cure me right away, you did not reduce my fees, and you were late for that one session. But I must also love you because you were consistent and reliable.”
Thus the analyst opens a bridge of mutuality between the two parties, and the patient can begin to make meaning and sense of their intolerable feelings, such as hate.
Notes
[1] This list, and the candor of the article in general, is what contributed to the unpopularity of the this paper when it was first presented in 1947 at the British Psycho-Analytical Society. Later on, when analysts learned to tolerate their own hate, the paper gained notoriety for its very honesty and integrity.
[2] “Rock-a-bye baby, in the tree top, / When the wind blows the cradle will rock, / When the bough bow breaks the cradle will fall, / Down will come baby, cradle and all.”
[3] J. Laplanche, Life and Death in Psychoanalysis (1970).
