British object relations

Domain I · Psychodynamic & depth psychology · Fairbairn, Winnicott, Balint · 1940 · Britain

What it is

This is a body of theory and clinical stance, not a manualised therapy. No founder wrote a treatment manual, a set of phases or session counts. What they did leave is a clear clinical stance and a set of things they describe actually doing, and those are given below by author. Phases, sequencing…

Format

• Original formats. Winnicott and Balint practised psychoanalysis at about five sessions a week of roughly 50 minutes, on the couch, for years. Winnicott also gave one-off or a few “therapeutic consultations”, and treatment “on demand” at irregular intervals for children. Fairbairn gave up the couch:…
• Phase A: Consultation and assessment (1–3 sessions).

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• The level can change within a session.
• Working when self-contempt eases into self-compassion.
• Working when the patient can tolerate both closeness and space.
• Working when the patient can keep you in mind between sessions.
• Working when the oscillation slows and can be talked about while it is happening.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.