Holding and Psychoanalysis

Book excerpt: In Holding and Psychoanalysis: A Relational Perspective, Joyce Slochower brings a contemporary relational framework to bear on Winnicott's notion of the analytic holding environment. She presents a fresh, thought-provoking, and clinically useful integration of Winnicott's seminal insights with contemporary relational and feminist/psychoanalytic contributions. Seeking to broaden the concept of holding beyond work with severely regressed patients, she addresses holding in a variety of clinical contexts and focuses especially on holding processes in relation to issues of dependence, self-involvement, and hate. She also considers clinical work with patients "on the edge" - patients who seem deperately to need a holding experience that remains paradoxically elusive. Slochower begins her study by questioning the therapeutic limitations of an interactive style. There are times, she proposes, when certain patients simply cannot tolerate evidence of the analyst's separate subjective presence and instead need a holding experience. Though this holding function is essential to work with difficult patients, it enters into the treatment of all patients, whether as figure or ground. Slochower's relational understanding of holding leads her to consider the impact of holding on patient and analyst alike. Throughout, she emphasizes the analyst's and the patient's co-construction, during moments of holding, of an essential illusion of analytic attunement; this illusion serves to protect the patient from potentially disruptive aspects of the analyst's subjective presence. Slochower's case vignettes helpfully illuminate the intersubjective aspects of the holding process, including the clinical picture when a holding frame fails. She elaborates her thesis by considering the therapeutic function of holding in mourning. And she concludes her study with a cogent examination of the theoretical and clinical limitations of working with a holding process. A welcome reprise on an essential Winnicottian theme, Holding and Psychoanalysis broadens and deepens our understanding of the therapeutic role of the analyst's holding function.