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The alternative clinical outcome: permanent regression and merger

Winnicott did not specify which variables determine whether the outcome of too-good mothering will be the child's rejection of the mother or "permanent regression and merger" with her. These variables are bound to be complex, involving, as they must, the child's temperament and his relationships with other family members as well as the effects of significant life events. Another relevant variable is likely to be gender. The girl's need to achieve a separate identity from her mother may push her into a rejecting role, while the boy's gender difference may more easily allow him to continue a passive merger role with less fear of engulfment by his mother. Certainly, clinical experience provides many examples of immature boys with over-responsive mothers and of adult men who benignly, but narcissistically, assume that their female partners' needs and wishes coincide with their own.

Immature children, who remain partially arrested in a transitional relationship to their mothers, tend to be slow to speak and to continue to assume, long past the usual age, that their mothers know all about them and are wholly responsible for their lives. They tend to enjoy passive pursuits like TV, reading, and computers and do not make close friends. This arrested adjustment can serve as a successful defence against the rage inherent in recognizing separateness and against the entry into triangular relationships which separateness involves. It can lead to unreality feelings and may break down in latency and adolescence in ways which bring the child to psychotherapy. Unless a break-through to self-and object-awareness occurs, a particular type of narcissistic outcome ensues: the child has been "worse than castrated" through the failure to discover the self-agency needed for the sustained pursuit of desire and for the constructive use of aggression. This view of Winnicott's has been amplified by Hamilton (1982) but has been disputed by Stern (1985, p. 218) who argues that the over-attuned mother can delay the infant's move towards independence but cannot interfere with "individuation". The risks inherent in over-responsive mothering have not been widely understood.

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