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James, M. (1962). Infantile Narcissistic Trauma—Observations on Winnicott's Work in Infant Care and Child Development. Int. J. Psycho-Anal., 43:69-79.

(1962). International Journal of Psycho-Analysis, 43:69-79

Infantile Narcissistic Trauma—Observations on Winnicott's Work in Infant Care and Child Development

Martin James

Introduction

Winnicott has two tools, either of which may be denied to the rest of us. He has unique empathy with the nursing couple, and he is through and through a scientist in intention. Since he is moreover not just a doctor but also a physician and paediatrician, the subtitle of his collected papers, 'Through Paediatrics to Psycho-Analysis', is well justified.

Winnicott's achievement is that for close on thirty years, as a lone voice, he has stressed the importance for prophylaxis of the mother's rôle in earliest infancy. His interest begins in the area where, for good scientific reasons, scrupulous writers like Anna Freud, Mahler, and Spitz have left off; fearing, for lack of observations, that they would merely be speculating.

Discussion of narcissistic trauma in infancy stopped at reconstruction because attempts at observation have for the most part been frustrated. Either, as with Klein, the infant is assumed to have psychological processes at work from birth and then reversibility of the processes can be assumed and attempted, or, as with Anna Freud, narcissistic trauma when diagnosed is accepted as a fait accompli. If this is done constitution is invoked and limited access for treatment is accepted.

This second approach to narcissistic trauma is that of descriptive psychiatry as well as of psycho-analysis generally speaking: for both disciplines it is an empirical fact that psychosis is not per se amenable to analytic measures. This is not to say that its consequences and individual psychotic defences cannot be better or worse handled.

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