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real and be truly a personal experience.

      Winnicott contrasts this feeling of personal experience with what he calls

      a false life built on reactions to external stimuli.⁶

      Throughout most of his professional life, Winnicott was particularly preoccupied with whether an individual’s experience was authentic or inauthentic. Many of the patients whom he treated had, for one reason or another, learned as children to be over-compliant; that is, to live in ways which were expected of them, or which pleased others, or which were designed not to offend others. These are the patients who build up what Winnicott called a ‘false self’; that is, a self which is based upon compliance with the wishes of others, rather than being based upon the individual’s own true feelings and instinctive needs. Such an individual ultimately comes to feel that life is pointless and futile, because he is merely adapting to the world rather than experiencing it as a place in which his subjective needs can find fulfilment.

      Although Winnicott’s suppositions about the subjective experiences of infants are impossible to prove, I find his conceptions illuminating. He is suggesting that the capacity to be alone originally depends upon what Bowlby would call secure attachment: that is, upon the child being able peacefully to be itself in the presence of the mother without anxiety about her possible departure, and without anxiety as to what may or may not be expected by her. As the secure child grows, it will no longer need the constant physical presence of the mother or other attachment figure, but will be able to be alone without anxiety for longer periods.

      But Winnicott goes further. He suggests that the capacity to be alone, first in the presence of the mother, and then in her absence, is also related to the individual’s capacity to get in touch with, and make manifest, his own true inner feelings. It is only when the child has experienced a contented, relaxed sense of being alone with, and then without, the mother, that he can be sure of being able to discover what he really needs or wants, irrespective of what others may expect or try to foist upon him.

       The capacity to be alone thus becomes linked with self-discovery and self-realization; with becoming aware of one’s deepest needs, feelings, and impulses.

      Psycho-analysis is also concerned with putting the individual in touch with his or her deepest feelings. The technique employed could be described as encouraging the individual to be alone in the presence of the analyst. This analogy particularly applies to the procedures used in the early days of psycho-analysis, before the analysis of transference became of such central importance (see Chapter 1). The use of the couch not only encouraged relaxation but also precluded eye contact between analysand and analyst. This prevented the analysand from being too preoccupied with the reactions of the analyst to what he was saying, and thus made it easier for him to concentrate upon his own inner world.

      Some analysts still believe that providing a secure milieu in which the patient can explore and express his most intimate thoughts and feelings is at least as important as any interpretations which they may offer. One analyst whom I knew personally illustrated this point with the story of a patient whom he saw three times per week over a period of a year. At every session, the patient lay down upon the couch and plunged straight into free association. At the end of the year, the man pronounced himself cured, and proffered his grateful thanks. The analyst declared that, during the whole of this period, he had offered no interpretations whatever. Even if this particular story is slightly exaggerated, the analogy with what Winnicott postulates as taking place between the secure infant and the mother is striking.

      As we have seen, patients in analysis can be helped to form better relationships with other people in the outside world by working through and understanding their relationship with the analyst. When a person is encouraged to get in touch with and express his deepest feelings, in the secure knowledge that he will not be rejected, criticized, nor expected to be different, some kind of rearrangement or sorting-out process often occurs within the mind which brings with it a sense of peace; a sense that the depths of the well of truth have really been reached. This process, which in itself contributes to healing, is facilitated by the analyst’s providing a suitably secure milieu, but is not necessarily dependent upon the analyst’s interpretations. The story of the patient who said he was cured despite, or because of, the silence of the analyst can be seen to contain a strong element of truth. The process of healing, in such cases, is very like the healing which may occur as part of the creative process in solitude.

      Integration also takes place in sleep. We are all alone when we are asleep, even though we may be sharing a bed with a loved person. When faced with a problem to which there is no obvious answer, conventional wisdom recommends ‘sleeping on it’, and conventional wisdom is right. Most people have had the experience of being unable to make up their minds when faced with a difficult decision, and of going to bed with the decision still not taken. On waking in the morning, they often find that the solution has become so obvious that they cannot understand why they could not perceive it on the previous night. Some kind of scanning and re-ordering process has taken place during sleep, although the exact nature of this process remains mysterious.

      Another example of integration which requires time, solitude, and, preferably, a period of sleep, is the process of learning. Students find that they cannot easily retain or reproduce material which they have tried to commit to memory immediately before taking an examination. On the other hand, material which has been learned at an earlier stage and ‘slept on’, is much more easily recalled. Some kind of reverberation around neuronal circuits must be linking new material to old material, and committing new material to the long-term memory store.

      Although we spend about a third of our lives asleep, the reasons why we need sleep are not fully understood. That we do need it is certain. As interrogators long ago realized, depriving prisoners of sleep is a relatively quick method of breaking them down. Although a few exceptional people can, without deterioration, survive without sleep for quite long periods, the majority of previously normal human beings exhibit psychotic symptoms like delusions and hallucinations after only a few days and nights without sleep. It is also worth noting that many episodes of mental illness are preceded by periods of insomnia.

      The integrating function of sleep may be linked with dreaming. In 1952, Nathaniel Kleitman discovered that there were two kinds of sleep, which can be shown by recording the electrical activity of the brain during sleep to follow a regular cycle. As subjects relax and fall asleep, the fairly rapid electrical waves which are characteristic of the brain’s waking activity are replaced by slower, more ample waves. These slower waves are accompanied by slow, rolling eye movements which can easily be seen through the closed eyelids of the sleeper, and which are entirely involuntary. It is possible to record these eye movements at the same time as the brain waves. When people first go to sleep, they enter quite quickly a stage of deep sleep from which it is difficult to rouse them. After about thirty or forty minutes, they begin to sleep more lightly; the sleeper’s breathing becomes faster and more irregular; there are small twitches of his face and fingertips, and his eyes make rapid movements as if he was actually looking at something. This phase of rapid-eye-movement sleep, or REM sleep as it is now called, lasts about ten minutes. Then the subject returns to sleeping more deeply. The whole cycle lasts about ninety minutes. Someone who sleeps for seven and a half hours generally spends between one and a half and two hours in this lighter, REM phase of sleep.

      A high proportion of people who are awakened during REM sleep recall a dream, whereas very few of those awakened during the deeper phases of sleep do so. In other words, it looks as if most people dream every night for short periods every ninety minutes or

      Following the discovery of the two varieties of sleep, it became possible to prevent people from dreaming whilst still allowing them an adequate period of sleep. Early experiments in depriving subjects of REM sleep suggested that not allowing dreams to occur produced a variety of symptoms, but later experiments have not confirmed this finding. However, those deprived of dreaming show an increased proportion of REM sleep to deep sleep when dream deprivation is discontinued.

      The same phenomenon has been observed in people taking barbiturates, amphetamines, or alcohol. When the drugs are stopped,

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