Beating an undead horse: Toward a conceptualization of nuisance in the analytic process

Winnicott (1945a) suggested that some types of aggressive behaviour of the child returning from sustained separation from their parents may be regarded as an expression of hope, one in which they can yield their forms of defensive self-sufficiency to trust a parent again. The author parses Winnicott's later various approaches to understanding both instinctual and reactive aggression and how applying his later views can obfuscate the meaning of aggression in nuisance-making behaviour. The author offers a specific definition of nuisance in the analysis of adults and how it manifests itself in the analytic context. In the adult patients he describes, anger and hostility have become featured as expressions of grievance or greed regarding earlier ruptures in an experience of the parent's or analyst's registration of the patient's needs for attention. He considers two clinical contexts involving the conscious reluctance to agree with the analyst's interpretations as well as making demands on the analyst outside the setting as forms of nuisance. He explores how the analyst needs to hold two psychic realities - the patient's hope that is expressed in their nuisance-making as well as the analyst's limits in absorbing the patient's own self-destructive hatred of dependency. Holding these two realities helps to transform these self-destructive bids for attention into an opportunity for mourning. The analyst is required to work with his or her own subtle experiences of disturbance including hostility, helplessness and the pull to act out roles in the patient's earlier life.