Winnicott's Children

Independent Psychoanalytic Approaches With Children and Adolescents

Ann Horne, Monica Lanyado, Ann Horne, Monica Lanyado

• Publisher: Routledge
• Year: 2013
• Print ISBN:
  9780415672917
  9780415672900
• Edition: 1
• eBook ISBN:
  9781135129699
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Winnicott's Children focuses on the use we make of the thinking and writing of DW Winnicott; how this has enhanced our understanding of children and the settings where we work, and how it has influenced the way in which we do that work. It is a volume by clinicians, concerned about how, as well as why, we engage with particular children in particular ways.

The book begins with a scholarly and accessible exposition of the place of Winnicott in his time, in relation to his contemporaries – Melanie Klein, Anna Freud, John Bowlby – and the development of his thinking. The dual focus on the earliest experience of the infant and its consequences plus the 'how' of engaging with children – as good-enough mothers or good enough therapists – is picked up in the chapters that follow. The role of play is central to a chapter on supervision; struggling through the doldrums can be part of the adolescent's experience and that of those who engage with him; the role of psychotherapy in a Winnicottian therapeutic community and an inner city secondary school is explored; and a chapter on radio work links us personally with Winnicott and his desire to talk plainly and helpfully to parents.

There is a richness in the collection of subjects in this book, and in the experience of the writers. It will appeal to those who work with children – in child and family mental health settings, schools, hospitals, colleges and social care settings.

1
Winnicott in his time

Lesley Caldwell and Angela Joyce

Introduction

Donald Woods Winnicott (1896–1971) is known as the leading theorist of the Independent Group in British psychoanalysis. He was distinctive among psychoanalysts in making substantial contributions to psychoanalytic theory and practice, while widely disseminating the basics of a psychoanalytic approach through consistent interventions in public life: teaching, writing, BBC broadcasts, letters, short articles in newspapers and weeklies, and talks given to a variety of professional associations and government bodies. His influence was particularly significant in social work, residential care for children, child psychiatry, child psychoanalysis and psychotherapy. Apart from Freud and Jung he wrote more than any other psychoanalyst, and contributed significantly to developments in psychoanalysis at home and internationally. Throughout his life he maintained a commitment to bringing a psychoanalytic perspective to a wider public. This was clear in his work with evacuated children during the war years in Oxfordshire and in his presence in the widening forms of state provision for children and families that developed with the post-war growth of the welfare state.

We regard Winnicott’s theoretical development as closely linked to his work as a paediatrician and child psychiatrist on the one hand, and to his continuing dialogues in the British Psychoanalytic Society, especially his engagement with Klein, on the other. His first analysis was with James Strachey, the editor of the Standard Edition of Freud. Klein, an influential if controversial figure in psychoanalysis in Europe and Great Britain, was Winnicott’s supervisor for his first child training case in 1933 and his second analysis was with Joan Riviere, one of her closest collaborators (1938–43); however, he began to distance himself in the 40s and ‘Primitive emotional development’, given in 1945 to the British Psychoanalytical Society (BPAS), is an early public statement of difference (Davis 1987). His interest in cases where the ordinary clinical setting seemed ineffective was also of significance. In this work – which was being researched in London, in Europe and in the United States from the 30s on – Winnicott’s links with Ferenczi are clear although he does not appear to have ever quoted him.

He was deeply involved in psychoanalysis and in wider work with children and families, and committed to bringing the ideas of the one to the practice of the other. His openness and creativeness and a strong personal conviction enabled him to approach theory and technique in ways that continue to offer much to the contemporary practitioner. Many of his famous contributions – the anti-social tendency, transitionality, true and false self – are centred in the application of his account of early infantile life to later life stages and his insistence that the infant’s individuation and establishment of an awareness of separateness remains a major factor in later health and illness. Both ‘Primitive emotional development’ (Winnicott 1945) and ‘The observation of infants in a set situation’ (1941) argue for an analytic and paediatric interest in the interrelation of body, mind and psyche by hypothesizing about the probable psychological referents that accompany or produce minute shifts in physiological arousal in the infant.

Infancy

Freud’s account of infantile sexuality and psychosexual development and its foundations in the body-mind relation was taken further by the British school of psychoanalysis and its investigation of the pre-oedipal child, who, while there in Freud, was not elaborated in the theory. Winnicott was central to these developments. Infans is one who is not able to speak, one who is spoken of and spoken to. Infancy, seen literally as the period ending with the child’s first word, is a crucial period in the development of the psyche whose study sheds light on aspects of human functioning central for psychoanalysis.

Freud insisted that mental life is somatically grounded, that the body and the mind of both adult and infant are interrelated, and later psychoanalysts have been concerned to map how, when, and in what way the mind develops. We now know that that the cognitive, emotional and socializing capacities are intertwined in the architecture of the brain (Luyten and Fonagy 2011) and its very functioning also begins a reflective process linked with the birth of human subjectivity, rooted in the body, and linked with sexuality, aggression and early mental life.

In his response to Winnicott’s The Theory of the Parent Infant Relationship (Winnicott 1960) Martin James, a close colleague, claimed that the study of infancy had been impeded first by being taken for granted, and second by a problem for the British Society:

Mrs Klein, to whom we must be grateful for it, forced us, however unwillingly, to be interested in infants, real infants, under six months. However she built her own metapsychology upon the idea of psychological reactions from birth and the valuable things she said are still obscured for most of us by an inability to accept her metapsychology. Interest in infants for a while became confused with an interest in her metapsychology.

(James 1962: 247)

Winnicott agreed. He thought Klein’s metapsychology was right but was applied too soon, to stages before the infant has become ‘for more than a moment occasionally an individual separate from his environment’ (Winnicott 1962c: 257). He stressed the ‘environment’ as both subjective and objective in thinking about a child’s mental state, and his insistence on the early importance of needs (ego relatedness) rather than desire was a form of theorizing predominantly interested in the implication for later health of early infantile experiences. Ego relatedness is linked implicitly with the environment mother who ‘holds’ the baby physically and psychically, lending her own good ego support. The term first appeared in 1956 in ‘Primary maternal pre-occupation’, a response to a symposium on pre-oedipal development, published in The Psychoanalytic Study of the Child (A Freud 1954: 16–71). Anna Freud had discussed the place of the drives from birth, developing her father’s concept of ‘anaclitic’ relating. Winnicott emphasizes her use of the term ‘need’ rather than desire and questions whether frustration and satisfaction are suitable terms in relation to unmet needs. For him this situation leads to ‘a distortion of development’ (Winnicott 1956c: 301) where the infant faces the most primitive anxieties of annihilation in circumstances which rupture the possibility of establishing the basis for a strong ego.

Winnicott’s account of human development makes fundamental the environmental provision that originates in the actual relations between mother and baby and gives considerable weight to physiological changes as part of the conditions for the emergence of an incipient psychical structure. In privileging the body and its handling in the acquisition of all the capacities of being human, this makes maternal care and the body fundamental to the development of mental functioning. Infantile sexuality is significant but only after the move from unintegration to integration has been affected and the baby comes to a realization of a world outside itself and the limits imposed by that world on the world of unlimited fantasy that preceded it.

He sees the tasks confronting the infant in sustaining his or her instinctual experiences as secondary to negotiating the existence of a self that can take on that negotiation. To ask when and how emotional responses register, and how such a registration is to be conceptualized, is to pursue a different set of questions from those of Freud or Klein. It amounts to a divergence about the origins and the form of human individuality and difficulty. Rather than a rejection of the Freudian schema, we see Winnicott’s account as a revision grounded in psychoanalysis, informed by the evidence of close continuing observation, combined with a willingness to speculate convincingly about what is observed.

Melanie Klein

Despite considerable unease with her approach by Freud himself and by others in Europe, Klein had assumed a very important position in the British Society by the time Winnicott qualified. She had been invited to London by Ernest Jones in 1926 and became a member of the BPAS in 1927 and of its training committee in 1929. Her ideas excited considerable interest but the paper ‘A contribution to the psychogenesis of manic-depressive states’ (Klein 1934) provoked a more critical reception. Her critics objected to the use of ‘phantasy’, her interpretation of the death instinct, the early dating of development of superego and the concept internal objects (King and Steiner 1991: 21), and after the Freuds’ arrival in London in 1938, and Freud’s death, the disputes with Anna were bitter and protracted. The ‘Controversial Discussions’ that took place in 1942–1943 were an attempt to confront the theoretical and technical differences that existed among members of the BPAS through ten open meetings; further closed discussions took place in committees of the society. An institutionalized division into three groups in 1946 in terms of representation on the Society and Institute’s committees remained in existence until 2006. Much of the theoretical dispute regarded the infant and what could be imputed to him/her and its implications for the psychoanalytic setting and what happens between analysand and analyst. This had consequences for the approaches to child analysis outlined below.

The notion of ‘unconscious phantasy’ was a crucial theme and in one of the position papers Susan Isaacs argues for unconscious phantasies (a term seldom used by Freud) as the most primitive layers of mental life. They are non-verbal, non-visual representations of the object or of the internal world based on bodily experiences and the most primitive unconscious phantasies are seen as full of implicit meaning, of meaning latent in impulses, affects and sensations. They are highly emotionally charged and the basis of a partial object relationship from the beginning (Isaacs 1943, in King and Steiner 1991: 243). As the primary content of unconscious mental life they precede repression, but others saw unconscious phantasy as existing only after repression is established as a basic defence mechanism in the child.

At the time of the meetings Winnicott was one of five training analysts of the Klein group and he contributed little to the discussions themselves, but by 1945 he was moving away from Klein’s exclusive concentration on the internal world and unconscious phantasy by ascribing a fundamental place to the environment. The dialogue between Klein and Winnicott was central to much of British psychoanalytic thinking in the post Second World War period. John Padel, an Independent Group analyst, said:

… they both wrote more than others – they presented more papers. Second, both are looked on as founders of the object relations school of psychoanalysis. Third, they were both charismatic personalities and attracted followers. … There is another reason for considering Klein and Winnicott together. They both performed on the same stage with reference to each other.

(Padel 1991: 325)

The American analyst Aguayo proposes that the post-war divergence between Winnicott and Klein ‘grew from the affinity and mutual influence operating between them in Winnicott’s Kleinian phase’ (broadly up to 1951) (Aguayo 2002). It was his attention to the baby’s need of the real mother and her centrality in the baby’s functioning and development that set him apart from Klein and her followers, who failed to see that the conditions for earliest psychic growth reside in the fundamental character of the infant’s absolute dependence on the mother.

Winnicott’s growing interest in a theory of aggression that argues for its initial separateness from destructiveness also separated him, and many others, from Klein’s attention to destructiveness in the service of her version of the death drive. These contrasting emphases have consequences for what is interpreted in a session, a reduction in the analysis of aggression in the transference and the interpretation of the negative transference (Aguayo 2002: 1145). Winnicott’s changing theory from the 30s onwards is rooted in analytic debates on one side and in his own wartime experiences with evacuated children, his growing attention to the mother-child relation, and the mutual interrelation of his paediatric and analytic experience.

Charles Spezzano (2004) highlights Winnicott and Klein’s respective accounts of the bases of human life, and of the aims and the task of psychoanalysis, by describing Winnicott’s theorizing on the unconscious as starting from excitement and Klein’s from anxiety. He proposes that the Kleinian baby and patient are prey to destructive phantasies with accompanying anxiety and guilt. This will be understood by, and have their effects on, the analyst as one who has to negotiate the transference relationship and its oscillation between the wish to make contact and the anxieties associated with that contact. In discussing Klein’s posthumously published paper, ‘On the sense of loneliness’ (1963), Kristeva, who sees it as a response to Winnicott’s 1958(a) paper ‘The capacity to be alone’, writes:

We have here a good example of the back and forth exchange between Klein and Winnicott, an example that displays the originality of both analysts as well as their debt to each other. While Winnicott situates the capacity to be alone in a world of ecstasy we will see that Melanie never distanced herself from a tone of desolation that strikes at the very heart of the serenity she had gained.

(Kristeva 2001: 261n.36)

Kristeva and Spezzano, like Aguayo, identify a very different theoretical orientation in their ideas of the human subject and their philosophies of human nature and it is a difference that has definite implications for how an analysis is conducted.

Anna Freud

Winnicott and Anna Freud came from different psychoanalytic traditions and were opposed in the ‘Controversial Discussions’. But he later shared her view of child analysis as restoring the child to the path of ‘normal development’ (A Freud 1966) although he had agreed with Klein’s early criticism (Klein 1927) of Anna Freud’s ‘preparatory period’. (Anna Freud herself had revised it after the 1927 Symposium on child analysis in London!) In his review of Indications for Child Analysis and Other Papers (Winnicott 1969a: 511) he argued for her theoretical evolution through her clinical experience and her openness to the writings of others (Winnicott 1969a: 511). He valued her work in the Hampstead War Nurseries (Winnicott 1969a: 512) and shared her concern with the impact of the environmental factors on the child’s inner world, recognizing the state of the child’s internal development as critical to such influences. Both were public figures. Winnicott was known through his radio broadcasts and his talks to associations outside mainstream psychoanalysis. One of Anna Freud’s first publications was a series of lectures to teachers and parents in the 1920s in Vienna (A Freud 1930) where she had trained as a teacher, ran a nursery school (the Jackson Nursery) and started child analytic work...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• Contributors
• Acknowledgements
• Foreword
• Prologue: On reading Winnicott
• Introduction
• 1 Winnicott in his time
• Part I Concepts
• Part II Transitional themes
• Part III The outside world
• Index