Winnicott's children: The holding environment and therapeutic communication in brief and non-intensive work

Abstract

This paper discusses brief and non-intensive work using a Winnicottian framework for understanding the processes involved. The importance of play, communication and interpretation are considered within the careful establishment of a unique holding environment for each patient. Parallels are drawn with ordinary development and care of the infant and young child. Two clinical examples are given to illustrate these concepts. The first describes the treatment of parents and children following the accidental death of the youngest child, and the second describes time-limited work with a sexually abused and abusing teenage boy. The value of providing a range of psychoanalytic treatments to meet the range of needs of patients is discussed. The importance of conceptualizing such treatments in ways that do not imply that they are ‘diluted’ psychoanalysis is also stressed, particularly with a view to the increasing pressure on therapists to offer help to as many children as possible within limited treatment time.

Key Words:

• Winnicott
• brief psychotherapy
• non-intensive psychotherapy
• holding environment
• therapeutic communication
• play.