Donald Winnicott

Donald Woods Winnicott (7 April 1896–28 January 1971) was an English paediatrician, psychiatrist, sociologist and psychoanalyst.

Early life and education

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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,^[1] 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.^[2] 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.^[3] 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

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 paediatrician and child psychoanalyst for 40 years.

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. By the end of World War Two, a compromise established 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, and Margaret Little.

Winnicott's career involved many of the great figures in psychoanalysis and psychology, not just Klein and Anna Freud, but also Bloomsbury figures such as James Strachey, R. D. Laing, and Masud Khan, a wealthy Pakistani émigré who was a highly controversial psychoanalyst.

During the Second World War, Winnicott served as consultant psychiatrist to the evacuee programme.

He divorced his first wife in 1951 and, in the same year, married Elsie Clare Nimmo Britton, a psychiatric social worker and psychoanalyst.

Winnicott's treatment of psychically disturbed children and their mothers gave him 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." He had a major impact on object relations theory, particularly in his 1951 essay "Transitional Objects and Transitional Phenomena," which focused on familiar, inanimate objects that children use to stave off anxiety during times of stress.

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 ideal of the "good-enough mother," the imperfectly attentive mother who does a better job than the "perfect" one who risks stifling her child's development as a separate being.

Winnicott died in 1971 following the last of a series of heart attacks and was cremated in London.

Major concepts

Stages of development

In his work with psychologically disturbed children and their mothers, Winnicott developed some of his most influential theoretical concepts, allowing him to construct his vision of what psychotherapy should aim to achieve. Central to understanding the notions of his view of object relations and the ideal therapeutic holding environment, are the notions of subjective omnipotence, objective reality, the transitional object and the transitional experience. In a person’s development these are extremely important because according to Winnicott, the effects of these stages span vastly beyond infancy and explain adult dysfunction: an autistic or self-absorbed individual remains in the subjective omnipotence phase, while a person superficially adjusted but not unique or passionate has not progressed past their objective reality.

The transitional experience is, therefore, crucial to a person’s development, as it allows them to connect their self-expression with the subjectivity of others. It is at this point that a child progresses from the symbiotic relationship with their mother to individualization and departs from both purely subjective and purely objective points of view.

Early development

According to Winnicott, a newborn child exists in a stream of unintegrated, comfortably unconnected moments. This existence is pleasant and not terrifying for the child. According to Winnicott these early experiences are crucial to a proper development of personhood. The person responsible, according to Winnicott, for providing this framework is the mother, and if this environment is not provided by her, the deficiencies will manifest themselves later in the child’s life. The infant progressively develops from an unintegrated drift into being able to distinctly identify surrounding objects.

Holding environment

For the consolidation of a healthy self of an infant it is crucial that the mother is there when needed. But even more important consequences arise when she recedes when she is not needed. Holding environment is a psychical and physical space within which the infant is protected without knowing he is protected. When a baby is born, the mother is extremely occupied with the infant. Under optimal circumstances the mother moves away from this state of maternal preoccupation and therefore provides an environment in which the infant is free to move and learn through experience. For the infant it means that it begins to realize that there is an outside world (objective reality) which is not always there to fulfil his desires. He has never observed feelings of dependency before, as his mother was always there for him. And there are also other people with their desires and agendas which can be in contradiction with his.

By meeting the child’s need, the mother protects him from negative movements in the outside world. He just reacts on impulses, which are usually answered.

But what happens if the mother does not provide the holding environment in which the child can grow and become a healthy self, or provides too much stimulation, for example to painful levels? The child's psychological development ceases and experiences impingement. He could feel ignored, because his desires are not answered and could experience problems in his own subjectivity. The child can even become traumatized.

Subjective omnipotence

During this progress, the child experiences a phase Winnicott referred to as subjective omnipotence. This experience takes place when the mother-child relationship is entirely symbiotic and the child experiences everything subjectively. At this point the baby feels as if it is merged with the mother. The baby considers themselves all-powerful and the center of existence. This is because, to the baby, whatever they wish occurs. For example, when the child is hungry, they cry and the mother responds. From the baby’s perception, the breast then appears. To the baby, it is as if the desires for the breast made it appear—almost as if they created the breast from their own desire. The mother’s responsiveness is a key factor during the subjective omnipotence phase, because she is in a state of, as Winnicott calls it, primary maternal preoccupation. This primary maternal preoccupation means that the mother adapts her entire existence and subsequent behavior to whatever the baby expresses as a wish or desire. Because the mother’s state allows her to be so responsive, the baby experiences a moment of illusion, as Winnicott calls it. The moment of illusion, is the infant’s belief that, based on his experience, his wish for the object created exactly that object. (Conversely, it is important to consider the view of autism as centred in issues of cognitive development; many individuals with autism have significant learning disability. Therefore, in respect to Winnicott's notion of 'subjective omnipotence', the baby/child may be seen to remain at this stage, but this is a symptom, and not a cause, of autism, which current medical opinion would now agree is an issue of non-typical organic neurological development, and not in any way relevant to the baby's relationship with its mother. Likewise, a mother who intuits that her baby is learning-disabled may stay longer in the state of 'primary maternal preoccupation'- a natural occurrence, as the child seems more vulnerable than neurotypical children.)

Objective reality

Progressively, the mother begins to recede as she becomes interested in her own personhood. Winnicott felt that this was an essential stage that leads to the child realizing they are not omnipotent as they believed in the subjective omnipotence phase. It is at this point that the baby learns they are dependent on the mother, and that other people coexist with them. The child experiences this stage in such a way that Winnicott entitled it objective reality. During objective reality the child becomes aware that objects that he relates to, mainly the mother, are separate and not in their realm of control.

Transitional experience

The middle ground between objective reality (also called the “not-me”) and subjective omnipotence (the “me”) is what Winnicott called the transitional experience. This experience is a transitional zone between the self and the real world. Central in the transitional experience is the transitional object that inhabits this zone, which to the infant represents the mother or her breast when she is absent. This object can alternatively be referred to as the first “not-me” possession—a teddy bear, a blanket, etc. The child does not experience this object as created by themselves, nor as entirely detached, but instead the transitional object is a fantasy. It is a way for the child to maintain a connection to the mother while she progressively distances herself. According to Winnicott, this experience is marked by anxiety and it is important for the child to have an object as a defense to this anxiety.

Transition refers to aiding the child while the mother separates. The transitional object as described by Winnicott is very ambiguous as transitional has a double meaning. The object is both a fantasy created by the child to feel connected to the mother, while at the same time it a mixture between the mother in the subjective phase and the mother in the objective phase. The child clings to the transitional object as it transitions between the two phases, while they find a balance between their own subjectivity and accommodation to others. The transitional experience as described by Winnicott is the phase where the infant can develop the creative self while still feeling protected.

Good-enough mother

Winnicott asserted that “there is no such thing as a baby - only a nursing couple”. He clearly stated that the inherited potential of an infant cannot become an infant, unless linked to maternal care. He describes primary maternal preoccupation (1956), the psychophysiological preparedness of a new mother for motherhood, as a special phase in which a mother is able to identify closely and intuitively with her infant, in order that she may supply first body-needs, later emotional needs, and allow the beginnings of integration and ego-development.

Winnicott formulated and developed the idea of the good-enough mother. The good-enough mother is a mother whose conscious and unconscious physical and emotional attunement to her baby adapts to her baby appropriately at differing stages of infancy, thus allowing an optimal environment for the healthy establishment of a separate being, eventually capable of mature object relations. Winnicott sees the key role of the good-enough mother as adaptation to the baby, thus giving it a sense of control, subjective omnipotence and the comfort of being connected with the mother. Furthermore, the mother can be viewed as a container for the infant's bad objects, as the child projects these into the mother. A critical ability for her is in accepting and surviving this onslaught with equanimity. This holding environment allows the infant to transition at its own rate to a more autonomous position.

Three key aspects of the environment identified by Winnicott are holding, handling and object-presenting. The mother may thus hold the child, handle it and present objects to it, whether it is herself, her breast or a separate object. The good-enough mother does this to the general satisfaction of the child. The good-enough mother is described as responding to the infant's gesture, allowing the infant the temporary illusion of omnipotence, the realization of hallucination, and protection from the unthinkable anxiety (primitive agonies) that threatens the immature ego in the stage of absolute dependence of development. Failure in this stage may result, ultimately, in psychosis.

The good-enough mother tries to provide what the infant needs, but she instinctively leaves a time lag between the demands and their satisfaction and progressively increases it. As Winnicott states: "The good-enough mother...starts off with an almost complete adaptation to her infant's needs, and as time proceeds she adapts less and less completely, gradually, according to the infant's growing ability to deal with her failure" (Winnicott, 1953). The good enough mother stands in contrast with the "perfect" mother who satisfies all the needs of the infant on the spot, thus preventing him/her from developing.

The good-enough mother's behaviour can be described with another Winnicottian concept, namely graduated failure of adaptation. Her failure to satisfy the infant needs immediately induces the latter to compensate for the temporary deprivation by mental activity and by understanding. Thus, the infant learns to tolerate for increasingly longer periods both his ego needs and instinctual tensions.

Winnicott sees the micro-interactions between the mother and child as central to the development of the internal world. After the early stage of connection with the mother and illusions of omnipotence comes the stage of relative dependence (objective reality) where children realize their dependence and learn about loss. The mother’s failure to adapt to every need of the child helps them adapt to external realities. As the infant develops, the good-enough mother, unconsciously aware of her infant's increasing ego-integration and capacity to survive, gradually becomes less empathic. She unconsciously "doses" her failures to those that can be tolerated, strengthening the infant's developing ego, clarifying the difference between "me" and "not-me," and helping the baby relinquish omnipotence. The baby begins to acquire a sense of reality, increasingly sees the mother as a separate person, and develops a capacity for concern. This way, the mother helps the child to develop a healthy sense of independence. Failure in this stage may result in formation of a False self.

The trick of the good-enough mother is to give the child a sense of loosening rather than the shock of being 'dropped'. This teaches them to predict, and hence allows them to retain a sense of control. Rather than sudden transition, this letting go comes in small and digestible steps, in which a transitional object may play a significant part.

The final phase of development, to independence, is never absolute as the child is never completely isolated. The mother's role is thus first to create illusion that allows early comfort and then to create disillusion that gradually introduces the child into the social world. Winnicott recognized that the child needs to realize that the mother is neither good nor bad nor the product of illusion, but is a separate and independent entity.

The Good-Enough Mother in the Psychotherapeutic Context

The idea of the good-enough mother is also important in the psychotherapeutic context. It constitutes a basic model for the therapist's healthy attitude towards the patient. Winnicott believed that an analyst has to display all the patience and tolerance and reliability of a mother devoted to her infant, has to recognize the patient’s wishes as needs, has to put aside other interests in order to be available and to be punctual, and objective, and has to seem to want to give what is really only given because of the patient’s needs. Therefore, the psychotherapist should provide a holding environment, so that the client might have the opportunity to meet neglected ego needs and allow the True self to emerge. In addition, a psychotherapist trying to understand a patient tries to build a mental picture of the patient’s mother. The therapist tries to find out how far and in which direction the patient's mother deviated from the good-enough mother ideal.

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.

References

External links

• The Winnicott Foundation, London
• The Squiggle Foundation, London
• Winnicott.net
• D.W. Winnicott