The Subjective Importance of Accommodation and Non-Accommodation: Expanding Brandchaft’s Idea of Pathological Accommodation

ABSTRACT

This paper is an expansion of Brandchaft’s notion of pathological accommodation. In a pathological accommodation a child is exposed to immutable primary caretakers unable to perceive the child’s subjectivity while at the same time demanding that the child meet the needs of the caretakers. As a result, the child abandons much of his desires and striving in order to maintain the needed ties to the caretakers. I am introducing both the idea of pathological non-accommodation and the subjective importance of both accommodation and non-accommodation in their non-pathological forms. In pathological non-accommodation the child attempts a precocious self-sufficiency overplaying their separateness and distinctness at the expense of taking in the emotionally organized help, information and nurturance they need to thrive in the world. Healthy accommodation and non-accommodation entail having good enough caretakers promoting a child’s developing emotionally organized judgments regarding their comforts and discomforts around the vast array of playful and worked on interactions within the child’s emotional surround. Examples of early healthy accommodations are turn taking, imitation and other forms of learning. Examples of early healthy non-accommodation are averting one’s gaze, crying, displaying displeasure, learning to say “no” and more complex oppositional behavior as development proceeds. A case example is given of work with a patient who combines both pathological non-accommodation and pathological accommodation.

KEYWORDS:

• Pathological accommodation
• pathological non-accommodation
• development
• Brandchaft
• Trevarthen
• Winnicott

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Michael Reison

Michael Reison, Ph.D., is graduate, faculty member, analytic supervisor and analyst at The Massachusetts Institute for Psychoanalysis, and is a Clinical Instructor at the Cambridge Health Alliance/Harvard Medical School, Department of Psychiatry.  He maintains a private practice in Arlington, MA.