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Updated: Jun 5, 2025

Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Communicating and not communicating with self and other. words, silence and the incommunicado self
1University College London, Malet Street, London, WC1, UK. caldwell.lesley4@gmail.com.
Abstract:
This contribution begins from Winnicott's introduction of the incommunicado self in his paper on communication to suggest that interiority and the psyche come to constitute the infantile world through the earliest environment and through solitude. The capacity to be with others and to be alone originate in an earlier state where communication both makes no sense and yet contains the origin of the life source through the baby's bodily experience of self and world. The world beyond the baby enables this through an other's care. I link this with Bion's position on loneliness and his recognition that people may choose to live in contact with the unsynthesized and incoherent. Encouraging the unsynthesized, the formless, and the inexpressible in our patients offers ways of being an analyst that for me is the legacy of Winnicott and Bion.
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