A Letter from Winnicott to Bion: An Imaginative Conjecture to Illustrate a Paradigm Transformation

On the evening of October 5, 1955, Bion presented the paper Differentiation between the psychotic and non-psychotic personalities to the British Society of Psychoanalysis. Two days later, on October seventh, Winnicott commented on Bion's paper in a letter and in particular, discussed its clinical material. The author makes use of this exchange to examine how the transformations that took place in Bion's thought and Winnicott's contributions helped bring about a quantum revolution of the psychoanalytic paradigm. These may have facilitated the transition from an epistemological psychoanalysis (where what matters is what the analyst knows and what the patient comes to know about himself) to an ontological psychoanalysis (where the presence of the analyst becomes crucial-everything that the analyst is and the way in which he manages to become the patient's emotional experience). And what we witness in ontological psychoanalysis is a significant clinical transformation in which a theory of technique that focuses on interpretation can coexist with a theory of technique enriched, in the author's perspective, with new tools that make it possible to treat the most severely ill patients.