Abstinence and neutrality revisited: An examination of two child therapy cases. Axline's 'Dibs' and Winnicott's 'Piggle' (Virginia M. Axline, D. W. Winnicott).

摘要

Within psychoanalysis, the concepts of abstinence and neutrality continue to attract confusion and debate. For instance, contemporary discussion often calls for a widening, and in some cases, an abandonment of these concepts as inconsistent with the increased emphasis being placed on the relational component within various schools of psychoanalysis. It is important to remember, however, that many of these arguments and the alternatives they give rise to are premised upon a stereotyped understanding of abstinence and neutrality that differs from the original spirit of Freud's papers on technique. At a fundamental level, the role of psychoanalytic technique, including abstinence and neutrality, is to assist in creating the clinical environment most conducive to the patient's ability to understand himself or herself. Freud did not intend for this goal to be void of warmth, genuineness, spontaneity, or flexibility. The absence of these qualities has come to characterize arid stereotypes of technique and may result in extremes whereby positions of abstinence and neutrality are either discarded or rigidly adopted. This paper begins with a review of Freud's writings on abstinence and what has since come to be termed neutrality. Clinical material is then introduced from the arena of child therapy that illustrates the flexible and natural incorporation of technique, involving the combination of warmth, involvement, and self-restraint. Revisiting Freud's original recommendations and exploring the organic use of technique in these clinical cases allows an in-depth analysis of the clinical foundation of abstinence and neutrality. Increased clarity may prove useful in dispelling the myths that surround these terms, thereby reducing the dangers of their actual misapplication within the clinical milieu.