CHAPTER FIVE Holding Jan Abram to identify the myriad functions of the mother’s role for her new: born. The theory of holding evolved up until Winnicott’s death and has now become one of those concepts that is associated with containing. ‘There is often a misperception that holding is “just holding” and less com- plex than Bion’s theory of container-contained, but holding is one of the key concepts in Winnicolt’s clinical paradigm as it defines the essential function of the parent-infant relationship. Tes of holding emerged in Winnicott’s work in the mid 1950s The holding environment Winnicott’s focus is on the emotional holding-the-baby bination with the physical feeding, bathing, and dressing. The infant, Winnicott says, only understands love that is expressed in human terms “by live, human holding... we are more concerned with the mother holding the baby than with the mother feeding the baby” (Winnicott, 1955, pp. 147-148). This emphasis is to stress that if the mother is totally engaged through her identification with her baby (primary maternal pre- ‘occupation), then feeding will be something that occurs as a consequence of the emotional engagement. DOK: 10.4324 /9781003382409-9 6364 AN ABRAM It is because of the holding environment ~ or through the holding environment - that the infant is facilitated to develop the capacity to inte- grate experience and develop the sense of “Iam me” (“Me”). Winnicott suggested that the I AM process is a “raw moment” because the new infant feels infinitely exposed. Therefore, the mother's full identifica. tion with her infant is necessary, which means the I AM moment can be endured. This is during the very earliest stages of Absolute Dependence ~ the holding phase. By 1960, Winnicott’s definitive statement on holding appears in his paper “The theory of the parent-infant relationship”. The holding envir- ‘onment necessarily includes the father. Satisfactory parental care can be classified roughly into three overlap- ping stages: a. Holding b. Mother and infant living together. Here the father’s function (of dealing with the environment for the mother) is not known. c. Father, mother, and infant, all three living together Winnicott, 1960, p. 589) “Living together” refers to the infant's ability to separate “Me” from “Not-me” and to see mother and father as separate, whole people. But this can only occur as a consequence of a successful holding by the parents from the beginning. This leads to an appreciation of reality and toa “three dimensional or space relationship with time gradually added” (Winnicott, 1960, p. 589). The holding function The function of holding means that the mother is able to discern her infant's needs rather than impose on the infant what she thinks they need. This ability to recognise the infant as a separate, evolving per- sonality is key to the infant’s emotional development of self. Awareness of body as distinct from emotions gradually evolves through sensitive holding. The environment must be reliable, not in a mechanical way but rather with an emphasis on reliability. This relates to the mother’s empathy emanating from her deep identification with her infant's sense of helplessness. The protection from physical and psychological insult takes account of the infant's acute skin sensitivity, visual sensitivity, and sensitivity toHONG 65 gravity, because the infant at the very start snot yet aware of distinction between self and other. Good-enough holding at the beginning, carried out by the mother, with the father enabling her total dedication to the infant, will mean that the infant will also be protected from trauma. If the holding envir onment is not good enough, the infant will suffer a psychic break in the continuity-of-being, a traumatic rupture that could result in psychosis. In fact, for Winnicolt the psychotic or borderline patient has indeed suffered carly psychic trauma because of the deficiency of holding during the holding phase. Personalisation An important aspect of holding is what Winnicott refers to as “hand- ling” ~ the way the mother handles her infant in the day-to-day details of infant care, Her enjoyment of her infant and her desire to handle and hold are an expression of love. This function leads to the psyche-in-dwelling- in-the-soma (Abram, 2007, pp. 263-274), which depicts a process of per- sonalisation. This means that the infant comes to feel, because of loving, handling, that their body is themselves and thatthe sense of self is centred in the body, The term “personalisation” is used to accentuate the opposite of deper- sonalisation ~ the condition in which the individual experiences a mind- body split and does not feel integrated with their body: “Being loved at the beginning means being accepted...the child has a blueprint for nor- ality which is largely a matter of the shape and functioning of their body” (Winnicott, 1971, p. 264). In his very late work, Winnicott stressed. “acceptance” as a sign of being loved and how this is shown in the phys ical care of the infant, which starts long before the actual birth experience. ‘The beginning of that part of the baby’s development which | am calling personalisation, or which can be described as an indwelling of the psyche in the soma, is to be found in the mother’s ability to join up her emotional involvement, which originally is physical and psychological Winnicott, 1971, p. 264 In the analytic situation, itis the analyst's attention — in combination with the physicality of the environment, the couch, the warmth, the aesthetics of the room ~ that mirrors the mother’s actual body and her psychic pri- mary maternal preoccupation.66 AN ABRAM Therapeutic management The holding environment is a form of management, Winnicott wrote, for the child and adolescent whose symptoms are antisocial. The staff working in children’s residential therapeutic communities also required a specialised form of holding (see Britton and Winnicott, 1947), The analyst's attention, along with and including interpretative work, constitutes the holding environment of any given psychoanalytic treatment. Only from the fact of holding can a potential space be realised and a sense of self start to flourish