Donald Winnicott

Donald Woods Winnicott (7 April 1896–28 January 1971) was an English pediatrician and psychoanalyst who was especially influential in the field of object relations theory. He was a leading member of the British Independent Group (psychoanalysis)]] of the British Psychoanalytic Society, and a close associate of Marion Milner.^[1] He is best known for his ideas on the true self and false self, and the transitional object. He wrote several books, including Playing and Reality,^[2] and over 200 papers.^[3]

Early life and education

Winnicott was born in Plymouth, Devon to Sir John Frederick Winnicott, a merchant who was knighted in 1924 after serving twice as mayor of Plymouth,^[4] and his wife, Elizabeth Martha (Woods) Winnicott.

The family was prosperous and ostensibly happy, but behind the veneer, Winnicott saw himself as oppressed by his mother, who tended toward depression, as well as by his two sisters and his nanny.^[1] His father's influence was that of an enterprising freethinker who encouraged his son's creativity. Winnicott described himself as a disturbed adolescent, reacting against his own self-restraining "goodness" acquired from trying to assuage the dark moods of his mother.^[5] These seeds of self-awareness became the basis of his interest in working with troubled young people.

He first thought of studying medicine while at The Leys School, a boarding school in Cambridge, when he fractured his clavicle and recorded in his diary that he wished he could treat himself. He began pre-med studies at Jesus College, Cambridge in 1914 but, with the onset of World War I, his studies were interrupted when he was made a medical trainee at the temporary hospital in Cambridge. In 1917, he joined the Royal Navy as a medical officer on HMS Lucifer.

Later that year, he began medical studies at St Bartholomew's Hospital Medical College in London. During this time, he learned from his mentor the art of listening carefully when taking medical histories from patients, a skill that he would later identify as foundational to his practice as a psychoanalyst.

Career

Template:Psychoanalysis He completed his medical studies in 1920, and in 1923, the same year as his first marriage (to Alice Taylor), he obtained a post as physician at the Paddington Green Children's Hospital in London, where he was to work as a pediatrician and child psychoanalyst for 40 years. In 1923 he began a ten-year psychoanalysis with James Strachey, and in 1927 he began training as an analytic candidate. His second analysis, beginning in 1936, was with Joan Riviere.

Winnicott rose to prominence just as the followers of Anna Freud were battling those of Melanie Klein for the right to be called Sigmund Freud's true intellectual heirs. Out of the Controversial discussions during World War II, a compromise was established with three more-or-less amicable groups of the psychoanalytic movement: the Freudians, the Kleinians, and the "Middle Group" of the British Psychoanalytical Society (later called the "Independent Group"), to which Winnicott belonged, along with Ronald Fairbairn, Michael Balint, Masud Khan, John Bowlby, Marion Milner, and Margaret Little. Winnicott was trained by Melanie Klein but became increasingly independent in his thinking over the course of his career, ultimately contributing original ideas which emphasized the importance of play in psychological development.

During the Second World War, Winnicott served as consultant psychiatrist to the evacuations of civilians in Britain during World War II programme. During the war he met and worked with Clare Britton, a psychiatric social worker who became his colleague in treating children displaced from their homes by wartime evacuation. He divorced his first wife in 1951 and, in the same year, married Britton. After the war he also saw patients in his private practice. Among contemporaries influenced by Winnicott was R.D. Laing, who wrote to Winnicott in 1958 acknowledging his help.

Except for one book published in 1931 (Clinical Notes on Disorders of Childhood), all of Winnicott's books were published after 1944, including The Ordinary Devoted Mother and Her Baby (1949), The Child and the Family (1957), Playing and Reality (1971), and Holding and Interpretation: Fragment of an Analysis (1986).

Winnicott died in 1971 following the last of a series of heart attacks and was cremated in London. Clare Winnicott oversaw the posthumous publication of several of his works.^[6]

The Concept of Holding

'Donald Winnicott came to psychoanalysis from paediatrics, and...through his analysis with James Strachey',^[7] and his work with children and their mothers fed into the experience on which he built his most influential concepts, such as the "holding environment" so crucial to psychotherapy, and the "transitional object," known to every parent as the "security blanket."

'Winnicott's three volumes of collected papers (1958, 1965, 1971), replete with clinical experience and paradox, are an inexhaustible source of ideas for psychoanalysis'.^[8] His theoretical writings emphasized empathy, imagination, and, in the words of philosopher Martha Nussbaum, who has been a proponent of his work, "the highly particular transactions that constitute love between two imperfect people." A prime example of this is his concept of the "good-enough mother" - the 'ordinary devoted mother...an example of the way in which the foundations of health are laid down by the ordinary mother in her ordinary loving care of her own baby'.^[9]

Part of that loving care was the mother's attentive holding of her child; and 'as Winnicott (1965) suggested, the therapist recreates a "holding environment", that resembles that of the mother and infant'.^[10] Winnicott described minutely 'the business of picking a baby up...gathering her together', and the way that the 'mother's technique of holding, of bathing, of feeding, everything she did for the baby, added up to the child's first idea of the mother'.^[11] Winnicott considered that the 'child's ability to feel the body is the place where the psyche lives could not have been developed without a consistent technique of handling', and he extrapolated 'the idea of "holding" and of meeting dependence'^[12] from the mother to the family as a whole, and to the wider world surrounding it. He saw as a prerequisite for healthy development 'the continuation of reliable holding in terms of the ever-widening circle of family and school and social life'.^[13]

Out of his work developed the subsequent belief that 'one of the most deeply therapeutic factors in an analysis is the extent to which a sensitive analyst parallels...the earliest relationship between a responsive mother and her infant'^[14] - a symbolic parallel. 'Of this Winnicott wrote: "A correct and well-timed interpretation in an analytic treatment gives a sense of being held physically that is more real...than if a real holding or nursing had taken place. Understanding goes deeper'.^[15]

The Anti-Social Tendency

Connected to the concept of holding is 'pre-delinquent behaviour, which Winnicott calls "the anti-social tendency". He says of this: {It] is not a diagnosis. It...may be found in a normal individual, or in one that is neurotic or psychotic'.^[16] Instead, Winnicott saw it as a cry for help, as a search for holding not previously found within the family itself. 'Antisocial activity for Winnicott is an expression of the delinquent child's sense of loss, a rupture of an earlier integration the child carried within him'.^[17] In response, the 'child whose home fails to give a feeling of security looks outside his home for the four walls...looking to society instead of to his own family or school to provide the stability he needs'.^[18]

The Sense of Being

One of the elements Winnicott considered could be lost in childhood was what he called the sense of being. 'For Winnicott, the sense of being is primary, the sense of doing an outgrowth of it...Premature development of the ego-function means doing too much, being too little'^[19]: a false sense of self. The 'capacity to "be", to feel alive...the baby's lifeline, what Winnicott calls its "going on being"' was essential if a person was not to be 'caught up in a false self and a compulsive cycle of "doing" to conceal the absence of "being"'.^[20] One antidote to the potential loss of being was the child's capacity for play.

Playing and Reality

A central theme running through Winnicott's work was the idea of play. One small example of this was 'Winnicott's "squiggle game" in his child consultations (Winnicott 1958: ch. 9). He would draw a shape and invite the child to make something of it; or, conversely, the child would draw a shape for Winnicott to do something with'.^[21] Later analysts would develop the idea in the sense of using 'these incomplete "shapes" in our work with patients...a half-way step to interpretation - for the patient to do something with - rather than the analyst monopolizing insight in a session'.^[22]

Another, more famous instance was the "spatula" game, where Winnicott would place a spatula within a child's reach for him to play with. 'You may be sure that if he is just an ordinary baby he will notice the attractive object...and he will reach for it'.^[23] Thereafter 'he will suddenly be overcome by reserve...[then] in the course of a little while he will discover what he wants to do with it'.^[24] From this Winnicott derived his idea of how 'the infant needs "a period of hesitation" in which to rediscover' - again a concept transferred to analytic work: ' the analyst needs to tolerate what Winnicott speaks of as "the period of hesitation"...allowing the patient to use the analyst as someone who is there to be found...[not] to be shoved down patients' throats'.^[25]

Winnicott came to consider that 'Playing takes place in the potential space between the baby and the mother-figure....In other words, the initiation of playing is associated with the life experience of the baby who has come to trust the mother figure'.^[26] Similarly, in analysis: 'Creative play does not necessarily mean always playing alone; and this is the nature of an analysis when all is going well'.^[27]

Playing can also be seen in the use of a transitional object: 'In health there is an evolution from the transitional phenomenon, and the use of objects, to the whole play capacity of the child'.^[28] Lacan championed 'the value of a conception in which child observation is nourished by the most accurate reconsideration of the function of mothering in the genesis of the object: I mean the notion of the transitional object, introduced by D. W. Winnicott';^[29] and the notion has since passed into more or less general circulation - 'a transitional object...It's what we doctors call a teddy bear'.^[30] Therapists have since extended the concept to cover 'a whole range of transitional processes...self-object<->thumb<->blanket/sucky<->bear or other toy<->pet animal<->not self but other'.^[31]

Such 'playing with a "transitional object"...a transitional object to help him cope with separation'^[32] was for Winnicott a vital aspect of healthy development into independence. The alternative which he saw was the imitative leap forward to 'a rather ludicrous impersonation. Such incorporation of one person by another can account for that spurious maturity that we often meet with....There is the child, for instance, who, unconsciously fearing and fleeing from sex play, jumps right over to a spurious sexual maturity'.^[33] The result, for Winnicott, could be the creation of what he called 'the False Self....Other people's expectations can become of overriding importance, overlaying or contradicting the original sense of self, the one connected to the very roots of our being.^[34]

Thus to Winnicott, 'for maturity it is necessary the individuals shall not mature early...passed through all the immature stages, all the stages of maturity at the younger ages'.^[35] Where that had failed to happen, in the false self, the task of the therapist was to 'enable the patient to become able to play, after which psychotherapy may begin...it is in playing that the patient is being creative'.^[36]

Playing for Winnicott ultimately extended all the way up from earliest childhood to 'the abstractions of politics and economics and philosophy and culture...this third area, that of cultural experience which is a derivative of play'.^[37]

True self and false self

Winnicott used the term "self" to describe both ego and self-as-object. He describes the self in terms of a psychosomatic organization, emerging from a primary state of "unintegration" by gradual stages.

True self

“Only the true self can be creative and only the true self can feel real.”

For Winnicott, the True self is the instinctive core of the personality, the infant's capacity to recognize and enact its spontaneous needs for self-expression. A True self that has a sense of integrity, of connected wholeness. This spontaneous self and this experience of aliveness is the heart of authenticity. When the infant first expresses a spontaneous gesture it is an indication to the existence of a potential true self. Yet, the True Self begins to have life, through the strength given to the infant's weak ego by the mother's responsiveness. This developmental process is dependent on the mother’s behavior and attitude: the good-enough mother is repeatedly responsive to the infant’s illusion of omnipotence and to some extent makes sense of it. The True self flourishes only in response to the repeated success of the mother's optimal responsiveness to the infant's spontaneous expressions.

False self

When the person has to comply with external rules, such as being polite or following social codes, then a False self is used. The False self is a mask of the false persona that constantly seeks to anticipate demands of others in order to maintain the relationship. If the mother is "not good-enough," she is unable to sense and respond optimally to her infant's needs and instead, substitutes her own gestures with which the infant complies. This repeated compliance becomes the ground for the earliest mode of the False self existence. The compliant False Self reacts to environmental demands and the infant seems to accept them. Through this False Self the infant builds up a false set of relationships, and by means of introjections even attains a show of being real, so that the child may grow up to be just like mother, nurse, aunt, brother, or whoever at the time dominates the scene. The primary function of the False self is defensive, to protect the True self from threat, wounding, or even destruction. This is an unconscious process: the False self comes to be mistaken for the true self to others, and even to the self. Even with the appearance of success, and of social gains, there will also be unreality feelings, the sense of not really being alive, that happiness doesn't, or can't really exist.

The division of the True and False self is linked to Sigmund Freud's notion of self, which is divided into a central part powered by instincts and an outward-turned part that relates to the world. According to Winnicott, in every person there is a True and False self and this organization can be placed on a continuum between the healthy and the pathological False self. The True self, who in health expresses the authenticity and vitality of the person, will always be in part or in whole hidden; the False self is a compliant adaptation to the environment. Whereas the True self feels real, the False self existence results in a feeling unreal or a sense of futility. When the False self is functional both for the person and for society then it is considered healthy. The healthy False self feels that that it is still being true to the True self. It can be compliant but without feeling that it has betrayed its True self. In contrast, a self that fits in but through a feeling of forced compliance rather than loving adaptation is unhealthy. In a case of a high degree of a split between the True self and the False self, which completely hides the True self, there is a poor capacity for using symbols and a poverty of cultural living. One can observe in such persons extreme restlessness, inability to concentrate and a need to react to the demands of the external reality, while remaining uncomfortable with themselves.

Criticism

'As theoretician, he [Winnicott] is often elusive, but partly because his writings up to 1960 often had the subsidiary aim of trying to get Melanie Klein to modify her views'.^[8] From a Kleinian viewpoint, 'Donald Winnicott, who was always extremely respectful of Melanie Klein's work, could not stomach the notion of envy', just as he had led the Independent's 'common repudiation...[of] the loathsome notion of death instinct'.^[38] To the hardliner, such retreat from the harsh realities she had uncovered represented 'nothing but resistance against accepting the reality of her conclusions concerning infantile life'.^[39]

Winnicott was certainly insistent that 'I know that babies and children scream and bite and kick and pull their mothers' hair';^[40] and at one point provided '18 reasons why a mother hates her children, among which is "He is ruthless, treats her as scum, an unpaid servant, a slave"'.^[41] Nevertheless, what has been called 'his identification with an ideal mother'^[42] could perhaps lead to a derivative idealisation of family life: indeed, arguably, with 'the theoretical icon of the mother and child Winnicott sometimes uses psychoanalysis to redescribe a traditional theology...psychoanalysis was incorporated into a Christian empiricist tradition'.^[43] Related to this may be the way 'Winnicott's work has been described as a flight from the erotic'.^[44] While Winnicott's stated aim was to give 'young mothers...support in their reliance on their natural tendencies',^[45] in practice idealisation of what he insisted was only the good enough mother might perhaps become another perfectionist yardstick for parents to be found wanting by.

A further criticism, linked to what may be seen as his Wordsworthian Romanticism, his cult of childhood, of continuity of growth and play, was the danger that 'Winnicottians become rigorously spontaneous'^[46] - perpetually applauding the way 'There was no compliant playing here!'.^[47]

From another standpoint, however, the problem was that Winnicott was too close to Klein. To the ego-psychologists, 'The English object-relations people (D. W. Winnicott...and others), who predate and foreshadow the Kohut and the Kernberg groups, are equally wrong-minded...and are tinged, to varying degrees, with the "Kleinian heresy"'.^[48] Similarly for Lacan, despite his personal respect for Winnicott, the latter was implicated in the 'contradiction between the pre-Oedipal intrigue, to which, in the opinion of certain of our modern analysts, the analytic relation can be reduced, and the fact that Freud was satisfied with having situated it in the position of the Oedipus complex...lead[ing] to a propedeutics of general infantilization.^[49]

Winnicott's 'own childhood experience of trying to make "my living" by keeping his [depressed] mother alive'^[50] may have fed into his later concept of the False Self, and of how 'a threat of breakdown of the family structure... in some cases leads to a premature emotional growth and to a precocious independence and sense of responsibility... but this is not health, even if it has healthy features'.^[51] When he claimed 'I was sane, and through analysis and self-analysis I achieved some measure of insanity',^[52] it may have been to the experiential roots of much of his own theorising that, for better or worse, he was referring.

At the end of the day, Winnicott is one of the few twentieth-century analysts who, in stature, breadth (and minuteness) of observations, and theoretical fertility can perhaps legitimately be compared to Sigmund Freud: 'some genius analysts, such as Freud and Winnicott...learned naturally how to learn from their patients. I believe that the majority of ..therapists are more ordinary, sincere hard workers - not necessarily brilliant'^[53] - "good enough".

Further reading

• D. W. Winnicott, Collected Papers: through Paediatrics to Psychoanalysis (London 1958)
• D. W. Winnicott, Maturational Processes and the Facilitating Environment (London 1965)
• Adam Phillips, Winnicott (Harvard 1988)
• Michael Jacobs, D. W. Winnicott (1995)

References