**5.4 Donald Winnicott**

According to Donald Winnicott, maternal "holding" is both a physical and an emotional act. The good enough mother contains and manages the baby's feelings and impulses by empathizing with him and protecting him from too many jarring experiences. How she carries, feeds, speaks, and responds to her baby expresses her defensive holding and understanding of her needs and experiences.

Winnicott explored the early infant-maternal experience and relationship, drawing attention to the "importance of personal and environmental influences in the development of the individual's" [34].

According to this author, maternal provision protects (the young infant) from physiological insult by taking account of the infant's sensitivity to touch, temperature, sound and light, falling, and lack of knowledge of the existence of anything other than the self.

Using a theory about child-parent relationships is a means of explaining the needs and experiences of adults.

One advantage of using Winnicott's theory for quality-of-life intervention is that its primary concern is the growth and development of the human being.

The child-parent relationship can be an inspiring metaphor for psychological maturation. As a result, it is possible to associate such theoretical ideas with meeting the daily needs of individuals who are candidates for a QoL intervention program.

Some points should be highlighted:


Let us look at two examples to understand the practical application of this concept with all its elements above:

#### *5.4.1 Depression following an abortion*

A social worker receives, in his office, a young woman with depression after an abortion.

She remains silent throughout the session, avoiding looking directly at the professional.

The session's atmosphere is tense as if there is no air for both of them.

The second session similarly takes place, with the young woman exuding anguish. In the third session, the social worker, in a holding way, said: "I don't know exactly how you are feeling, but I have the impression that starting to talk seems like some-

thing frightening for you. But I can wait, in no hurry, for your moment."

The young woman remains silent but sheds a tear in each eye [37].

#### *5.4.2 The mother is suspected of abusing her son*

A hospital social worker waits in her office for a mother referred by the emergency physician.

The doctor suspects that the mother physically abuses her two-year-old son. The doctor tells the social worker that the mother is cold and arrogant.

The social worker feels apprehensive and afraid while waiting for the mother.

When this professional becomes aware of her emotional state, she thinks the mother may be apprehensive and afraid.

Soon after, she returns to her normal state and receives her mother in a natural and welcoming way. In other words, the social worker could hold these disturbing feelings within herself and welcome the mother without judging her [37].

In the first example, the social worker's welcoming attitude offered security for the patient to express her emotion. Although she remained silent, she shed a tear as a sign of interaction with the professional.

In the second example, the social worker was gentle with herself, realizing that she was apprehensive and afraid. She soon realized these feelings were not her own. This awareness allowed her to feel free and open to receiving the patient without judgment.

The quality of life manager is expected to have this kind of sensitivity when approaching his target audience.

## **6. Recommendations**

The objective of this chapter was to present the concept of psychodynamics as a tool for quality-of-life interventions.

However, mastering this concept requires theoretical and practical study, which is beyond the limits of this chapter.

As the original idea was to motivate readers to broaden their horizons, we recommend seeking the supervision of a psychoanalyst.

The International Psychoanalytical Association is a reliable source to guide professionals interested in this topic.

#### **7. Conclusions**

Psychodynamics is related to the quality of life through the concept of psychological maturity. Our study revealed that psychologically mature individuals had higher quality of life scores than immature ones. The WHOQOL-bref scores had a positive correlation with mature ego defenses and a negative correlation with pathological object relations, suggesting that psychological maturity is associated with quality of life. This chapter also provided original psychodynamic guidelines (Freud, Klein, Bion, and Winnicott) to improve the psychological maturity of the participants and, consequently, their quality of life. The common ground among these guidelines is the concept of holding, which can promote human development. Thus, quality-of-life interventions can consider the role of psychodynamics in their programs.

## **Conflict of interest**

The authors declare no conflict of interest.

## **Author details**

Benedito Miranda1 \* and Mário Louzã<sup>2</sup>

1 Brazilian Association of Psychiatry, Botucatu, Brazil

2 University of Sao Paulo, Brazil

\*Address all correspondence to: beneditomiranda.botucatu@gmail.com

© 2022 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

*The Role of Psychodynamics on Quality-of-Life Interventions DOI: http://dx.doi.org/10.5772/intechopen.108653*
