Winnicott Critical Evaluation of Donald

Winnicott

Critical Evaluation of Donald W. Winnicott's Psychoanalytic Approach and Theories

The Infant, the Mother, and 'Transitional Objects' in Early Childhood Development

In his distinctive and controversial approach to patient treatment, the 20th century British psychoanalyst Donald W. Winnicott (1896-1971) focused on the fundamental importance of the establishment of healthy initial 'object relationships' in infancy: first between mother and infant, and second between the infant and a 'transitional object' (e.g., a blanket, stuffed toy, doll, or something similar) of the child's own choosing. At that second early stage, the 'transitional object' serves as an emotional substitute for the mother herself, a sort of 'portable mother' to the child, at least in an emotional sense, and far more easily handled, moved, mutilated, or otherwise manually manipulated by the child. The transitional object, then, gives the developing infant similar, sometimes greater, emotional security than its first object, the mother or other primary caregiver (Winnicott Playing and Reality 1950, pp. 1-4).

Healthy psychological development of the human infant, then, has mainly to do with the infant's initial relationship to its mother. This object-relationship to its mother is, in the earliest months of the infant's life initially distinct from, from, but later integrally connected with, its healthy relationship to the later transitional object that substitutes, in a sense, for the mother (pp. 2-7). A child's typical transitional object of the sort Winnicott describes might be, for example, a blanket, a teddy bear, or something else chosen from available toys or other household items (p.4).

As Winnicott further states: "The pattern of transitional phenomena [between the infant's initial focus solely on the mother to its initial focus on the transitional objects] begins to show at about four to six to eight to twelve months" (Winnicott, Playing and Reality 1950, p.4). In other words, the time of transition from mother-only focus to external object focus varies greatly from child to child. However, a child's choice of a transitional object and that object's extreme importance to the child, are readily apparent. "The parent gets to know its value and carry it round when traveling. The mother lets it get dirty and even smelly, knowing that by washing it she introduces a break in continuity in the infant's experience, a break that may destroy the meaning and value of the object to the infant" (p.4).

Prior to the infant's transitional object stage, however, the mother must first have created, very early on, the illusion (Playing and Reality pp. 10-13) that her own breast or breast-substitute is a part of the infant's self, fostering the infant's (necessary) earliest, feelings of comfort, mixed with equally necessary early feelings of omnipotence, a stage of development key to the infant's ability to next move in a healthy way to transitional object attachment (pp. 11-15). The infant, according to Winnicott, develops (or does not develop) its internal sense of psychological well-being, based on its earliest relationships to external objects, first to the mother's the breast or breast-substitute (i.e., the nursing bottle). That first object, by providing the infant with food and comfort on demand, offers it an early sense of fusion and omnipotence. That early sense is, according to Winnicot, key to the infant's later ability to make healthy distinctions between itself and others (pp. 5-6).

Later in childhood, continued healthy psychological development of the child requires further separation from the transitional objects of earliest life, e.g., the blanket, the teddy bear, the pillow, or other much-cherished item. However, if early external attachment to the mother's breast (in the infant's own perceptions, the breast actually feels like an internal object: the mother's breast is experienced by the infant as a part of himself or herself, not as a separate object. Therefore, in the earliest months of life, according to Winnicott, the sensation that the mother's nurturing breast gives to the child is actually one of nurturing or comforting itself, not of being nurtured or comforted by someone or something else) is in some manner absent, interrupted, damaged, or compromised, the child will experience developmental difficulties in terms of healthy attachment to future entities that also represent "otherness" from the child: pets, siblings and other family members, schoolmates, teachers, strangers (Playing and Reality pp. 26-37).

As Winnicott further explains, in a developmentally healthy child, the fierce attachment to the transitional object of choice is eventually forgotten, as its importance is lessened through disuse exposure to other intermediate objects:

Its [the 'transitional object's] fate is to be gradually allowed to be decathected detached from], so that in the course of years it becomes not so much forgotten as relegated to limbo. By this I mean that in health the transitional object does not 'go inside' nor does the feeling about it necessarily undergo repression. It is not forgotten and it is not mourned. It loses meaning, and this is because the transitional phenomena have become diffused, have become spread out over the whole intermediate territory between 'inner psychic reality' and 'the external world as perceived by two persons in common' that is to say, over the whole cultural field"(p.5)

If the earliest attachment to the child's first external object, the mother, then, is a healthy one, the child's next attachment stage, to whatever sorts of early 'transitional objects' come next, will be of the sort that will allow the child, in good time, to healthily decathect from those early object attachments, in the same way, and through essentially the same psychological processes, that the earliest attachment to the mother is decathected.

The 'Good-enough Mother'

Winnicott's well-known phrase 'good-enough mother' means that, within a healthy mother-baby dyad, the core, interrelated, early developmental phenomena of mother-object relations and transitional object relations shall occur as a matter of course over a time period to be uniquely determined by this particular mother and child, without the mother's needing to "do" anything in particular, to act in ways other than she would act ordinarily, or to manipulate either her own attitudes and actions or the infant's environment. Her good-enough mother status will most certainly be the case, so long as she is ready, willing, and available to love and nurture her baby in the manner that comes naturally to her. The child of a good-enough mother, then, is bound to develop healthily: first in relationship to her; second in its relationships to transitional objects, and finally in its relationships to the outer world.

In Winnicott's view, new mothers of infants possess all of the instinctive knowledge necessary to be good-enough mothers, that is, they have a natural understanding of how best to care for their own babies, which cannot be taught and should not be tampered with, criticized, demeaned, or second-guessed - by childcare experts or any others. In fact, introducing doubt to a new mother about her good-enough mothering instincts can invite feelings of anxiety, and even, in a worst-case scenario, create enough of these within her, about her innate mothering abilities, to interfere with her own natural and instinctive ability to be a 'good-enough mother' to bring about the healthy development of her child. Within the whole of psychoanalysis, it would be difficult to identify theories besides Winnicott's less interventionist, and more fundamentally accepting, of the mother as good-enough, that is, perfectly adequate exactly as she is. For instance, as Winnicott tells new mothers in Winnicott on the Child (2002):

What you do and know, simply by virtue of the fact that you are the mother of an infant, is as far apart from what you know by learning as is the east from the west coast of England...Just as the professor who found out about the vitamins that prevent rickets really has something to teach you, so you really have something to teach him about the other kind of knowledge, which comes to you naturally"(p.19).

In that respect, Winnicott's same core philosophies: following a patient's lead; recognizing and respecting the instinctive knowledge of mothers, and encouraging new mothers to trust themselves (Winnicott on the Child 2002, pp. 19-20) all increase likelihood of a successful course of psychoanalytic treatment.

Casement (1991) notes, however, that while few psychoanalysts challenge this particular aspect of Winnicott's theory, in practice it is not always easy to achieve. In Learning from the Patient, he states:

Following the patient's lead has always been an important principle of psychoanalysis and analytic psychotherapy. but, in practice, there has been a tendency for some analysts to become inappropriately controlling through being dogmatic, which interferes with the analytic process. Learning to learn from the patient provides balance against this, helping to preserve the analytic space more clearly for the processes within it"(p.ix).

In his own practice Winnicott specialized in treating psychologically disturbed children, as well as their parents, and sought to give the parents, in the course of treatment, insight into their children's past developmental problems and how those were affecting the children now. Winnicott's patients included children who, for whatever reasons, had apparently experienced poor or inadequate early object relations to the mother (or other primary caregiver), and consequently with early and later transitional objects, leading to future adjustment difficulties and lingering issues of attachment and separation for the child (Playing and Reality 1950, pp. 6-25). Winnicott's clinical experiences in this capacity eventually gave him the raw materials "from which he subsequently built his psychoanalytic theories" (Donald Woods Winnicott 1876-1971-2000).

Winnicott's Influences and Challenges

Winnicott's theories and method were far from unchallenged by his professional peers, however, including several renowned European child psychoanalysts who had first immigrated to London during the war years. Among his chief challengers, and major professional competitors of that period were the likes of Melanie Klein and Anna Freud:

child analyst Melanie Klein, moved to London in 1926 and soon had many followers: Winnicott had further analysis with one of them, Joan Riviere. The Kleinians' belief in the paramount importance, for psychic health, of the first year of a child's life, was shared by Winnicott. But this view diverged somewhat from that of Freud and his daughter Anna (herself a child analyst!) who both came to London in 1938, refugees from the Nazis in Austria. A split within the British Psycho-Analytical

Society was threatened between the orthodox Freudians and the Kleinians; but by the end of World War Two in 1945 a typically British compromise established three more or less amicable groups: the Freudians, the Kleinians and a "Middle" group, to which Winnicott belonged"(Donald Woods Winnicott 1876-1971-2000).

After first moving to London, Melanie Klein was, in the early 1930's, one of Winnicott's original psychoanalytic mentors. Later Winnicott analyzed Klein's son, although he did not do so under her supervision, as she had originally requested that he do (Rodman 1987, p. xiv). Later on in his career, however, Winnicott's professional relationship with his former mentor became frosty. The major source of disagreement between him and Klein had to do with Klein's unwillingness to support Winnicott's view that the "actual mother and her actual behavior" (Rodman, p.xx) were crucial to healthy human development.

While rejecting the principles of peers like Melanie Klein, Winnicott acknowledged that Sigmund Freud had single-handedly created the conditions of possibility for work by all future psychoanalysts, including himself. As Rodman (the Spontaneous Gesture 1987) explains:

The role of external reality was brought into question by discovery that reports of Sexual molestation in childhood usually were the result of Oedipal fantasies rather than actual events. That opened the world of fantasy to careful study and launched

Freud on his great work of demonstrating that a person's instinctual urges and infantile neuroses color and shape the course of life. This point-of-view...[was] regarded as the backbone of psychoanalytic theory...Klein probably represents its apotheosis. By virtually excluding external reality from a formative role in development, her theory achieves the impression that the technique it generates will benefit the patient through shattering insights. Winnicott, firmly rooted in the psychoanalytic tradition but also a practical observer of children and their parents in distress, could bring in external reality as an influence without sacrificing the significance of the child's fantasy life in the process" (p.xx).

Two key differences between Winnicott's approach to psychoanalysis and that of Sigmund Freud himself, however, are (1) the stages of human development on which they mainly focus, and (2) their respective emphases on early instinctual life (in Freud's case) and "relational structure of infant to mother" (in Winnicott's case) (Rodman, the Spontaneous Gesture 1987, p. xxvi). Further, in comparing Melanie Klein's 'internal object', to his own 'transitional object' Winnicott states (Playing and Reality 1950): "The transitional object is not an internal object (which is a mental concept) - it is a possession. Yet it is not (for the infant) an external object either"(p.9),

Moreover, as Rodman (1987) explains, Winnicott focuses on the earliest stages of infancy and childhood, particularly the infant's relationship to its mother, and 'transitional objects' (Winnicott, Playing and Reality 1950, pp. 1-7) as the major keys to all later development, good or bad. Freud, on the other hand, is not nearly as concerned with infancy in and of itself, or with either mother-infant or object relations as indicators of later emotional health. Second, as Rodman (1987) states of Winnicott: "His theory of health is not defined [as is Freud's] by the absence of pathology. He is interested in more than that. He wants to define a healthy life in positive terms"(p.xix).

Winnicott's view of infant-mother, and infant-object relations as pivotal to healthy human development likely sprang from his early clinical work within his initial medical specialty of pediatrics. From there, he became interested in child psychiatry. Rodman (1987) states: "His Wednesday clinics, which gradually evolved from traditional pediatrics to child psychiatry, were part of the continuity of his medical experience, which amounted eventually to about 60,000 cases"(p.xiv). Therefore, "A s a pediatrician with a vast experience he could not help being rooted in the empirical reality of early infant development. This aspect of his knowledge perfectly complemented what he was learning in child analysis and in the process of reconstructing the early life of deeply disturbed adult patients"(p.xx). Further, as Goldman (2002) concurs: "Winnicott, for his part, was never comfortable thinking about development as coming either from the inside out or the outside in. His primary area of interest was the overlap -- what he termed the 'intermediate space -- between internal and external realities."

Winnicott's psychoanalytic theories, methods, approaches, and instincts were unique, for three key reasons. First, he was the only child psychoanalyst among his peers to have practiced pediatrics before turning to child psychiatry as a later specialty. Second, Winnicott alone focuses on infancy as the most crucial stage of life, from which either healthy or unhealthy psychological development in humans springs. Third, he uniquely identifies the mother as the source of an infant's first, most important, object relationship. As Winnicott further explains: "A baby is held and handled satisfactorily, and with this taken for granted is presented an object in such a way that the baby's legitimate experience of omnipotence is not violated. The result can be that the baby is able to use the object, and to feel as if this object is a subjective object, created by the baby...All this belongs to the beginning, and out of all this come the immense complexities that comprise the emotional and mental development of the infant and child" (Mirror-role of mother and family in child development, 2002).

Illustrations and Case Studies

The manner in which Winnicott put his theories into psychoanalytic practice, in his clinical efforts to help developmentally disturbed children and their parents, is evident from various case studies and illustrations offered by Winnicott in Playing and Reality (1950). One such example involved a seven-year-old boy with an unusual attachment to string.

According to his parents, "...the boy had become obsessed with everything to do with string, and in fact whenever they went into a room they were liable to find that he had joined together chairs and tables; that they might find a cushion, for instance, with a chair joining it to the fireplace" (p. 17). The parents, Winnicott adds, were relieved to finally discuss their son's unusual obsession, especially since "...the boy's preoccupation with string was gradually developing a new feature, one that had worried them instead of causing them ordinary concern. He had recently tied a string round his sister's neck (the sister whose birth provided the first separation of this boy from his mother)"(p. 17).

Besides his parents, the family of this boy consisted of two sisters, an older one who was mentally retarded and attended a special school, and a younger sister, whose birth, when the boy was three years and three months of age, had caused his first separation from the mother when she left for hospital to give birth. That separation was followed by another from the mother, when the boy was three years and eleven months (this time, the mother was hospitalized for an operation. Yet another separation from the mother took place when the boy was four years nine months old, this time for two months while the mother, who suffered from serious depression, was treated for it in a mental hospital (Winnicott, Play and Reality 1950, p. 16).

Winnicott summarizes his treatment of this child and his string-obsession symptom in the following way:

explained to the mother that this boy was dealing with a fear of separation, attempting to deny separation by his use of string, as one would deny separation from a friend by using the telephone. She was sceptical [sic], but I told her... I should like her to open up the matter with the boy...developing the theme of separation according to the boy's response.

Moreover, from the moment that she had this conversation with him the string

Play ceased. There was no more joining of objects in the old way...she felt the most important separation to have been his loss of her when she was seriously depressed; it was not just her going away...but her lack of contact with him because of her complete preoccupation with other matters.

A year after she had had her first talk with the boy there was a return to playing with string and to joining together objects in the house. She was in fact due to go into hospital for an operation, and she said to him:'I can see from your playing with string that you are worried about my going away, but this time I shall only be away a few days, and I am having an operation that is not serious.' After this conversation, the new phase of playing with string ceased" (Play and Reality 1950 pp. 17-18).

Another case history discussed by Winnicott in Playing and Reality (1950), in a chapter on the early origins of creativity (pp.65-103), this one involving a successful middle-aged adult male (pp. 72-80) further reinforces the importance of healthy early object-relations with the mother early in life. In this instance, Winnicott explains how the male patient, who was not homosexual, nevertheless kept speaking about he himself having "penis envy" during his therapeutic session. The patient added that, though he knew he was in fact a man, what he pictured in his own mind right now was himself as a girl (yet still somehow himself) sitting where he sat now. He hesitated to bring up that which he was at present picturing in his mind, since he would be thought mad (p. 73).