CLASSIC ARTICLE

To speak openly about feelings of hate toward a patient in 1949 was a

daring act. For a statement of such feelings to come from the kindly pediatri-
cian/psychoanalyst D. W. Winnicott was truly extraordinary. Winnicott broke
new ground in psychoanalysis by stressing the importance of the holding
environment as a healing factor in treatment. He conceived of many of his
patients as suffering from a developmental arrest that required a reactivation
ofthe developmental process in the psychoanalytic setting. In that regard there
was a maternal cast to much of his writing that separated it from the more
paternalistic character of Freud’s writings. Indeed, Winnicott’s experience as
a pediatrician undoubtedly influenced him to focus his attention on a detailed
explication of the early mother-infant relationship.
This classic article was influential for a variety of reasons. First, it signaled
a shift from the narrow Freudian view ofcountertransference (as the analyst’s
transference to the patient) to a broader view that Winnicott termed “objective
counter-transference. “ Freud had originally understood countertransference
as an obstacle to psychoanalytic work that was based on the analyst’s uncon-
scious perception of the patient as a figure from the analyst’s past. In “Hate in
the Counter-transference,” Winnicott describes a broader form of counter-
transference that is objective in the sense that it is an understandable and
“normal” reaction to the patient’s actual personality and behavior. This total-
istic form of countertransference is now widely accepted in all quarters (al-
though many would argue that it frequently coexists with the narrow variant
Freud described).
A second contribution of Winnicott’s paper is its normalization of hateful
feelings between clinician and patient. This universalization of countertrans-
ference hate is partially accomplished by listing 18 reasons why a mother hates
her infant from the beginning of that relationship. Here Winnicott borrows
from his pediatric observations to draw an analogy between the mother-infant
dyad and the therapist-patient relationship. He expands on this analogy
throughout the paper by stressing the developmental importance of hate.
Infants must learn to hate if they are to learn to love. Moreover, they must
experience hate from the mother to facilitate their own development of
hatred.
A third contribution is that this was one of the early papers that led to the
“widening scope” of the indications for psychoanalysis. Winnicott, in writing
about the intense countertransference evoked by more primitive patients, was
also expanding the psychoanalyst’s and psychoanalytic therapist’s therapeutic
range by suggesting ways to manage the feelings evoked by more primitive
patients. Although he uses the term psychotics, the reader should keep in mind
that members of the British School of object relations, including Winnicott,
often used the term rather loosely to apply to what we ordinarily think of as
borderline or other severe personality disorders. In particular, transferences
that had lost their “as if” quality were regarded as “psychotic” in borderline
patients. Winnicott points out in several passages of the paper that patients of
this nature have suffered environmental failures in their parenting experi-
ences that make them more prone to hate others and to induce hateful feelings
in those who work with them. Again and again he stresses the importance of
acknowledging hate within the clinician rather than defending against it

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WINNICOTT 349

through denial or reaction formation. Children who have grown up with these
developmental disturbances must experience being hated before they will be
capable of believing that others can love them.
The paper contains a controversial clinical example in which Winnicott
and his wife took a 9-year-old boy into their home for 3 months. Winnicott uses
this vignette to illustrate the futility of trying to shower such a child with love
in hopes that this approach will be curative. He points out that the child had
to evoke feelings of hatred in Winnicott and his wife before further growth
and development were possible. Although modern clinicians would not rec-
ommend taking such a child into one’s home as a therapeutic project,
Winnicott’s experience was certainly heuristically useful in helping him artic-
ulate the basic principles of clinical work with hateful patients organized at a
primitive level.
Winnicott ends the paper with a discussion of the practical problem of
interpretation. He suggests that an analysis may be incomplete if the analyst
has not told the patient of the countertransference hate harbored by the
analyst in the early stages. Most clinicians today would view that type of
self-disclosure as ill advised. Moreover, such feelings will be communicated in
more subtle, nonverbal interactions throughout the treatment, so that verbal-
izing countertransference hate is not necessary for it to be conveyed to the
patient.
Treatment with seriously disturbed patients cannot be conducted in a
sanitized or superficial way. Passions will be stirred, and Winnicott led the way
for generations of clinicians to face intense countertransference feelings. With
the strong conviction that tolerating such feelings would ultimately be useful
to the patient, he broadened the horizons of psychoanalytic work.

GLEN 0. GABBARD, M.D.

“Hate in the Counter-Transference,” based on a paper read to the British Psycho-Analytical Society, February 5,
1947, was originally published in The International Journal of Psycho-A nalysis (1949; 30:69-74). Reproduced by
permission of the Winnicott Trust and The International Journal of Psycho-A nalysis.
Introduction copyright © 1994 American Psychiatric Press, Inc.

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350 HATE IN TIlE COUNTER-TRANSFERENCE

Hate in the Counter-Transference

By D. W. WINNICOTT

I n this paper
of the whole
I wish to examine
subject
one aspect
of ambivalency,
ment
the
of the
nature
ill individual,
of the emotional
but also
burden
must study
which
namely, hate in the counter-transference. I the psychiatrist bears in doing his work. What
believe that the task of the analyst (call him a we as analysts call the counter-transference
research analyst) who undertakes the analysis needs to be understood by the psychiatrist
of a psychotic is seriously weighted by this too. However much he loves his patients he
phenomenon, and that analysis of psychotics cannot avoid hating them, and fearing them,
becomes impossible unless the analyst’s own and the better he knows this the less will hate
hate is extremely well sorted-out and con- and fear be the motive determining what he
scious. This is tantamount to saying that an does to his patients.
analyst needs to be himself analyzed, but it
also asserts that the analysis of a psychotic is STATEMENT OF THEME
irksome as compared with that of a neurotic,
and inherently so. One could classify counter-transference phe-
Apart from psycho-analytic treatment, nomena thus:
the management of a psychotic is bound to
be irksome. From time to time”2 I have made 1.Abnormality in counter-transference
acutely critical remarks about the modern feelings, and set relationships and iden-
trends in psychiatry, with the too easy electric tifications that are under repression in
shocks and the too drastic leucotomies. Be- the analyst. The comment on this is
cause of these criticisms that I have expressed that the analyst needs more analysis,
I would like to be foremost in recognition of and we believe this is less of an issue
the extreme difficulty inherent in the task of among psycho-analysts than among psy-
the psychiatrist, and of the mental nurse in cho-therapists in general.
particular. Insane patients must always be a 2. The identifications and tendencies be-
heavy emotional burden on those who care longing to an analyst’s personal experi-
for them. One can forgive those who do this ences and personal development which
work if they do awful things. This does not provide the positive setting for his ana-
mean, however, that we have to accept what- lytic work and make his work different
ever is done by psychiatrists and neuro- in quality from that of any other analyst.
surgeons as sound according to principles of 3. From these two I distinguish the truly
science. [701 objective counter-transference, or if
Therefore although what follows is about this is difficult, the analyst’s love and
psycho-analysis, it really has value to the psy- hate in reaction to the actual personal-
chiatrist, even to one whose work does not in ity and behaviour of the patient, based
any way take him into the analytic type of on objective observation.
relationship to patients.
To help the general psychiatrist the psy- I suggest that if an analyst is to analyze
cho-analyst must not only study for him the psychotics or antisocials he must be able to be
primitive stages of the emotional develop- so thoroughly aware of the counter-transfer-

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WINNICOTT 351

ence that he can sort out and study his objective If the analyst is going to have crude feel-
reactions to the patient. These will include ings imputed to him he is best forewarned
hate. Counter-transference phenomena will at and so forearmed, for he must tolerate being
times be the important things in the analysis. placed in that position. Above all he must not
deny hate that really exists in himself. Hate
1’ vi i: NI o ‘1’ vv ; I M p [ T F I) T 0 that isjust /ied in the present setting has to be
1’ II F A N A I. V S 1’ II V T II E sorted out and kept in storage and available
P A 1’ I F N T for eventual interpretation.
If we are to become able to be the analysts
I wish to suggest that the patient can only of psychotic patients we must have reached
appreciate in the analyst what he himself is down to very primitive things in ourselves,
capable of feeling. In the matter of motive; and this is but another example of the fact
the obsessional will tend to be thinking of the that the answer to many obscure problems of
analyst as doing his work in a futile obses- psycho-analytic practice lies in further analy-
sional way. A hypo-manic patient who is inca- sis of the analyst. (Psycho-analytic research is
pable of being depressed, except in a severe perhaps always to some extent an attempt on
mood swing, and in whose emotional devel- the part of an analyst to carry the work of his
opment the depressive position has not been own analysis further than the point to which
securely won, who cannot feel guilt in a deep his own analyst could get him.)
way, or a sense of concern or responsibility, is A main task of the analyst of any patient
unable to see the analyst’s work as an attempt is to maintain objectivity in regard to all that
on the part of the analyst to make reparation the patient brings, and a special case of this
in respect of his own (the analyst’s) guilt is the analyst’s need to be able to hate the
feelings. A neurotic patient tends to see the patient objectively.
analyst as ambivalent towards the patient, and Are there not many situations in our or-
to expect the analyst to show a splitting of love dinary analytic work in which the analyst’s
and hate; this patient, when in luck, gets the hate is justified? A patient of mine, a very bad
love, because someone else is getting the obsessional, was almost loathsome to me for
analyst’s hate. Would it not follow that if a some years. I felt bad about this until the
psychotic is in a “coincident love-hate” state analysis turned a corner and the patient be-
of feeling he experiences a deep conviction came lovable, and then I realized that his
that the analyst is also only capable of the unlikeableness had been an active symptom,
same crude and dangerous state of coinci- unconsciously determined. It was indeed a
dent love-hate relationship? Should the ana- wonderful day for me (much later on) when
lyst show love he will surely at the same I could actually tell the patient that I and his
moment kill the patient. friends had felt repelled by him, but that he
This coincidence of love and hate is had been too ill for us to let him know. This
something that characteristically recurs in was also an important day for him, a tremen-
the analysis of psychotics, giving rise to prob- dous advance in his adjustment to reality.
lems of management which can easily take In the ordinary analysis the analyst has
the analyst beyond his resources. This coinci- no difficulty with the management of his own
dence of love and hate to which I am refer- hate. This hate remains latent. The main
ring is something which is distinct from the thing, of course, is that through his own anal-
aggressive component complicating the ysis he has become free from vast reservoirs
primitive love impulse and implies that in the of unconscious hate belonging to the past
history of the patient there was an environ- and to inner conflicts. There are other rea-
mental failure at the time of the first object- sons why hate remains unexpressed and even
finding instinctual impulses. unfelt as such:

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352 HATE IN TUE COUNTER-TRANSFERENCE

1. Analysis is my chosen job, the way I feel chotic (research) patient. The difficulty
I will best deal with my own guilt, the cleared up when I had what is sometimes
way I can express myself in a construc- called a “healing” dream. (Incidentally I
tive way. would add that during my analysis and in the
2. I get paid, or I am in training to gain a years since the end of my analysis I have had
place in society by psycho-analytic work. a long series of these healing dreams which,
3. I am discovering things. although in many cases unpleasant, have
4. I get immediate rewards through identi- each one of them marked my arrival at a new
fication with the patient, who is making stage in emotional development.)
progress, and I can see still greater [711 On this particular occasion I was aware of
rewards some way ahead, after the end the meaning of the dream as I woke or even
of the treatment. before I woke. The dream had two phases. In
5. Moreover, as an analyst I have ways of the first I was in the gods in a theatre and
expressing hate. Hate is expressed by looking down on the people a long way below
the existence of the end of the “hour.” in the stalls. I felt severe anxiety as if I might
I think this is true even when there is lose a limb. This was associated with the feel-
no difficulty whatever, and when the pa- ing I have had at the top of the Eiffel Tower
tient is pleased to go. In many analyses that if I put my hand over the edge it would
these things can be taken for granted, fall off on to the ground below. This would be
so that they are scarcely mentioned, ordinary castration anxiety.
and the analytic work is done through In the next phase of the dream I was
verbal interpretations of the patient’s aware that the people in the stalls were watch-
emerging unconscious transference. ing a play and I was now related to what was
The analyst takes over the role of one going on on the stage through them. A new
or other of the helpful figures of the kind of anxiety now developed. What I knew
patient’s childhood. He cashes in on was that I had no right side of my body at all.
the success of those who did the dirty This was not a castration dream. It was a sense
work when the patient was an infant. of not having that part of the body.
As I woke I was aware of having under-
These things are part of the description stood at a very deep level what was my diffi-
of ordinary psycho-analytic work, which is culty at that particular time. The first part of
mostly concerned with patients whose symp- the dream represented the ordinary anxie-
toms have a neurotic quality. ties that might develop in respect of uncon-
In the analysis of psychotics, however, scious fantasies of my neurotic patients. I
quite a different type and degree of strain is would be in danger of losing my hand or my
taken by the analyst, and it is precisely this fingers if these patients should become inter-
different strain that I am trying to describe. ested in them. With this kind of anxiety I was
familiar, and it was comparatively tolerable.
ILLUSTRATION OF The second part of the dream, however,
COUNTER-TRANSFERENCE referred to my relation to the psychotic pa-
ANXIETY tient. This patient was requiring of me that I
should have no relation to her body at all, not
Recently for a period of a few days I found I even an imaginative one; there was no body
was doing bad work. I made mistakes in re- that she recognized as hers and if she existed
spect of each one of my patients. The diffi- at all she could only feel herself to be a mind.
culty was in myself and it was partly personal Any reference to her body produced para-
but chiefly associated with a climax that I had noid anxieties because to claim that she had
reached in my relation to one particular psy- a body was to persecute her. What she needed

VOLUME S #{149}
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WINNICOTT 353

of me was that I should have only a mind patients who have had satisfactory early expe-
speaking to her mind. At the culmination of riences which can be discovered in the trans-
my difficulties on the evening before the ference, and those whose very early
dream I had become irritated and had said experiences have been so deficient or dis-
that what she was needing of me was little torted that the analyst has to be the first in
better than hair-splitting. This had had a di- the patient’s life to supply certain environ-
sastrous effect and it took many weeks for the mental essentials. In the treatment of the
analysis to recover from my lapse. The essen- patient of the latter kind all sorts of things in
tial thing, however, was that I should under- analytic technique become vitally important
stand my own anxiety and this was that can be taken for granted in the treatment
represented in the dream by the absence of of patients of the former type.
the right side of my body when I tried to get I asked an analyst who confines his atten-
into relation to the play that the people in the tion to neurotics whether he does analysis in
stalls were watching. This right side of my the dark, and he said, “Why, no! Surely our
body was the side related to this particular job is to provide an ordinary environment,
patient and was therefore affected by her and the dark would be extraordinary.” He was
need to deny absolutely even an imaginative surprised at my question. He was orientated
relationship of our bodies. This denial was towards analysis of neurotics. But this provi-
producing in me this psychotic type of anxi- sion and maintenance of an ordinary envi-
ety, much less tolerable than ordinary castra- ronment can be in itself a vitally important
tion anxiety. Whatever other interpretations thing in the analysis of a psychotic, in fact it
might be made in respect of this dream the can be, at times, even more important than
result of my having dreamed it and remem- the verbal interpretations which also have to
bered it was that I was able to take up this be given. For the neurotic the couch and
analysis again and even to heal the harm warmth and comfort can be symbolical of the
done to it by my irritability which had its mother’s love; for the psychotic it would be
origin in a reactive anxiety of a quality that more true to say that these things are the
was appropriate to my contact with a patient analyst’s physical expression of love. The
with no body. 1721 couch is the analyst’s lap or womb, and the
warmth is the live warmth of the analyst’s
POSTPONEMENT OF body. And so on.
INTERPRETATION
OBJECTIVE HATE

The analyst must be prepared to bear strain UNDER TEST

without expecting the patient to know any-
thing about what he is doing, perhaps over a There is, I hope, a progression in my state-
long period of time. To do this he must be ment of my subject. The analyst’s hate is
easily aware of his own fear and hate. He is in ordinarily latent and is easily kept latent. In
the position of the mother of an infant un- analysis of psychotics the analyst is under
born or newly born. Eventually, he ought to greater strain to keep his hate latent, and he
be able to tell his patient what he has been can only do this by being thoroughly aware of
through on the patient’s behalf, but an anal- it. Now I want to add that in certain stages of
ysis may never get as far as this. There may be certain analyses the analyst’s hate is actually
too little good experience in the patient’s sought by the patient, and what is then
past to work on. What if there be no satisfac- needed is hate that is objective. If the patient
tory relationship of early infancy for the ana- seeks objective or justified hate he must be
lyst to exploit in the transference? able to reach it, else he cannot feel he can
There is a vast difference between those reach objective love.

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354 HATE IN THE COUNTER-TRANSFERENCE

It is perhaps relevant here to cite the case solution in a crisis was to make the correct
of the child of the broken home, or the child interpretation, [7S1 as if the boy were in analy-
without parents. Such a child spends his time sis. It was the correct interpretation that he
unconsciously looking for his parents. It is valued above everything.
notoriously inadequate to take such a child The important thing for the purpose of
into one’s home and to love him. What hap- this paper is the way in which the evolution
pens is that after a while a child so adopted of the boy’s personality engendered hate in
gains hope, and then he starts to test out the me, and what I did about it.
environment he has found, and to seek proof Did I hit him? The answer is no, I never
of his guardians’ ability to hate objectively. It hit. But I should have had to have done so if
seems that he can believe in being loved only I had not known all about my hate and if I
after reaching being hated. had not let him know about it too. At crises I
During the second world war a boy of would take him by bodily strength, and with-
nine came to a hostel for evacuated children, out anger or blame, and put him outside the
sent from London not because of bombs but front door, whatever the weather or the time
because of truancy. I hoped to give him some of day or night. There was a special bell he
treatment during his stay in the hostel, but his could ring, and he knew that if he rang it he
symptoms won and he ran away as he had would be readmitted and no word said about
always done from everywhere since the age of the past. He used this bell as soon as he had
six when he first ran away from home. How- recovered from his maniacal attack.
ever, I had established contact with him in one The important thing is that each time,
interview in which I could see and interpret just as I put him outside the door, I told him
through a drawing of his that in running away something; I said that what had happened
he was unconsciously saving the inside of his had made me hate him. This was easy because
home and preserving his mother from assault, it was so true.
as well as trying to get away from his own inner I think these words were important from
world which was full of persecutors. the point ofview of his progress, but they were
I was not very surprised when he turned mainly important in enabling me to tolerate
up in the police station very near my home. the situation without letting out, without los-
This was one of the few police stations that ing my temper and every now and again mur-
did not know him intimately. My wife very dering him.
generously took him in and kept him for This boy’s full story cannot be told here.
three months, three months of hell. He was He went to an Approved School. His deeply
the most lovable and most maddening of chil- rooted relation to us has remained one of the
dren, often stark staring mad. But fortunately few stable things in his life. This episode from
we knew what to expect. We dealt with the first ordinary life can be used to illustrate the
phase by giving him complete freedom and a general topic of hate justified in the present;
shilling whenever he went out. He had only to this is to be distinguished from hate that is
ring up and we fetched him from whatever only justified in another setting but which is
police station had taken charge of him. tapped by some action of a patient (child).
Soon the expected changeover oc-
curred-the truancy symptom turned round, A M0TuER’s LOVE

and the boy started dramatizing the assault AND HATE

on the inside. It was really a whole-time job

for the two of us together, and when I was out Out of all the complexity of the problem of
the worst episodes took place. hate and its roots I want to rescue one thing,
Interpretation had to be made at any because I believe it has an importance for the
minute of day or night, and often the only analyst of psychotic patients. I suggest that

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WINNICOTT 355

the mother hates the baby before the baby F. To a greater or lesser extent a mother
hates the mother, and before the baby can feels that her own mother demands a
know his mother hates him. Before develop- baby, so that her baby is produced to
ing this theme I want to refer to Freud’s placate her mother.
remarks. In Instincts and Their Vicissitudes G. The baby hurts her nipples even by suck-
(1915) (where he says so much that is original ling, which is at first a chewing activity.
and illuminating about hate), Freud says: “we H. He is ruthless, treats her as scum, an un-
might at a pinch say of an instinct that it paid servant, a slave.
‘loves’ the objects after which it strives for I. She has to love him, excretions and all,
purposes ofsatisfaction, but to say that it at any rate at the beginning, till he has
‘hates’ an object strikes us as odd, so we doubts about himself.
become aware that the attitudes of love and J. He tries to hurt her, periodically bites
hate cannot be said to characterize the rela- her, all in love.
tion of instincts to their objects, but are re- K. He shows disillusionment about her.
served for the relations of the ego as a whole L. His excited love is cupboard love, so
to objects.... “This I feel is true and import- that having got what he wants he
ant. Does this not mean that the personality throws her away like orange peel.
must be integrated before an infant can be M. The baby at first must dominate, he must
said to hate? However early integration may be protected from coincidences, life
be achieved-perhaps integration occurs ear- must unfold at the baby’s rate and all this
liest at the height of excitement or rage- needs his mother’s continuous and de-
there is a theoretical earlier stage in which tailed study. [74] For instance, she must
whatever the infant does that hurts is not not be anxious when holding him, etc.
done in hate. I have used the word “ruthless N. At first he does not know at all what she
love” in describing this stage. Is this accept- does or what she sacrifices for him. Es-
able? As the infant becomes able to feel a pecially he cannot allow for her hate.
whole person, so does the word hate develop 0. He is suspicious, refuses her good food,
meaning as a description of a certain group and makes her doubt herself, but eats
of his feelings. well with his aunt.
The mother, however, hates her infant P. After an awful morning with him she
from the word go. I believe Freud thought it goes out, and he smiles at a stranger,
possible that a mother may under certain who says: “Isn’t he sweet!”
circumstances have only love for her boy Q. If she fails him at the start she knows
baby; but we may doubt this. We know about he will pay her out for ever.
a mother’s love and we appreciate its reality R. He excites her but frustrates-she
and power. Let me give some of the reasons mustn’t eat him or trade in sex with him.
why a mother hates her baby, even a boy.
I think that in the analysis of psychotics,
A. The baby is not her own (mental) con- and in the ultimate stages of the analysis, even
ception. of a normal person, the analyst must fmd
B. The baby is not the one of childhood himself in a position comparable to that of
play, father’s child, brother’s child, etc. the mother of a newborn baby. When deeply
C. The baby is not magically produced. regressed the patient cannot identify with the
D. The baby is a danger to her body in analyst or appreciate his point of view any
pregnancy and at birth. more than the fetus or newly born infant can
E. The baby is an interference with her sympathize with the mother.
private life, a challenge to preoccupa- A mother has to be able to tolerate hating
tion. her baby without doing anything about it. She

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356 HATE IN THE COUNTER-TRANSFERENCE

cannot express it to him. If, for fear of what most careful timing. But I believe an analysis
she may do, she cannot hate appropriately is incomplete if even towards the end it has
when hurt by her child she must fall back on not been possible for the analyst to tell the
masochism, and I think it is this that gives rise patient what he, the analyst, did unbeknown
to the false theory of a natural masochism in for the patient whilst he was ill, in the early
women. The most remarkable thing about a stages. Until the interpretation is made the
mother is her ability to be hurt so much by patient is kept to some extent in the position
her baby and to hate so much without paying of infant, one who cannot understand what
the child out, and her ability to wait for re- he owes to his mother.
wards that may or may not come at a later
date. Perhaps she is helped by some of the S U M M A R V

nursery rhymes she sings, which her baby

enjoys but fortunately does not understand? An analyst has to display all the patience and
tolerance and reliability of a mother devoted
Rockabye Baby, on the tree top, to her infant, has to recognize the patient’s
When the wind blows the cradle will rock, wishes as needs, has to put aside other inter-
When the bough breaks the cradle will fall, ests in order to be available and to be punc-
Down will come baby, cradle and all. tual, and objective, and has to seem to want
to give what is really only given because of the
I think of a mother (or father) playing with patient’s needs.
a small infant; the infant enjoying the play and There may be a long initial period in
not knowing that the parent is expressing hate which the analyst’s point of view cannot be
in the words, perhaps in birth symbolism. This
(even unconsciously) appreciated by the pa-
is not a sentimental rhyme. Sentimentality is tient. Acknowledgment cannot be expected
useless for parents, as it contains a denial of because at the primitive root of the patient
hate, and sentimentality in a mother is no good that is being looked for there is no capacity
at all from the infant’s point of view. for identification with the analyst, and cer-
It seems to me doubtful whether a human tainly the patient cannot see that the analyst’s
child as he develops is capable of tolerating the hate is often engendered by the very things
full extent of his own hate in a sentimental the patient does in his crude way of loving.
environment. He needs hate to hate. In the analysis (research analysis) or in
If this is true, a psychotic patient in anal- ordinary management of the more psychotic
ysis cannot be expected to tolerate his hate of type of patient, a great strain is put on the
the analyst unless the analyst can hate him.
analyst (psychiatrist, mental nurse) and it is
important to study the ways in which anxiety
PRACTICAL PROBLEM OF
of psychotic quality and also hate are pro-
INTERPRETATION
duced in those who work with severely ill
psychiatric patients. Only in this way can
If all this is accepted there remains for discus-
there be any hope of the avoidance of therapy
sion the question of the interpretation of the that is adapted to the needs of the therapist
analyst’s hate to the patient. This is obviously rather than to the needs of the patient
a matter fraught with danger, and it needs the

R E F E R E N C E S

1. British MedicalJournal correspondence (1947); and 2. Leucotomy. British Medical Students’ Journal,
“Physical Therapy of Mental Disorder.” British Mcd- Spring 1949; 3,2,35
icalJournal, May 17, 1947; 1:688

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