I am spinning a pun on the famous pediatrician Winicott’s “ good enough mother” but not really!
What did he mean by that concept? Let’s explore because this has a very direct bearing on the subject matter
Winnicott thought that the “good enough mother” early on, tunes in completely with the infant because the later has no way of communicating except “crying”. She has to be like an “empath” who can read her infants mind and feel perhaps the same emotions what her child is experiencing.She is entirely devoted to the baby and tries to take care of its needs. As time goes by, however, the mother allows the infant to experience small amounts of frustration.
We can continue what else goes on in the mother – child duo but we are using this concept as a yardstick to measure “psychiatric care”.
Let’s refocus on the “patient- psychiatrist” first encounter- I need to qualify that I would be using the word “newborn/infant/toddler” to signify the “patienthood” and not the patient as a person and also psychiatrist as a “provider” and not as an individual.
Patienthood is born when a patient meets “the good enough” psychiatrist. Coming to see a psychiatrist is a “big step” in willingness to accept one’s helplessness in not being able to cope with the conflicting demands of life both within and without.
If the patient “feels” being held by the psychiatrist’s presence – it’s a good start. The way a “good enough “ psychiatrist is able to do that, is by giving an undivided attention to the patient. This kind of attention is not available outside a “loving relationship”. There is a “catch-22” here , because psychiatric illnesses attack the “ capacity to form loving intimate relationships “. This “capacity” is contingent upon the ability to accept one’s vulnerabilities to hurts and pain which is unavoidable in the struggle to develop intimacy. “A good enough” psychiatrist can at the very least provide with a “sample of this much needed relationship”to satisfy that need” to give some hope to the patient, that intimacy is possible.This simple explanation does run the risk of ridicule,by the likes of William Schofield, who writes in his critique of our profession “Psychotherapy- the purchase for friendship”, that, psychotherapist not trained as a specialist in therapeutic conversation, can fall unwittingly into the role of moral counselor or morale coach, and can be seduced into the chronic role of “best friend.