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Dw Winnicott Thinking About Children D. W. WINNICOTT THINKING ABOUT CHILDREN Edited by Ray Shepherd Jennifer Johns Helen Taylor Robinson Bibliography compiled by Harry Karnac A Merloyd Lawrence Book ADDISON-WESLEY Reading, Massachusetts -v- Many of the designations used by manufacturers and sellers to distinguish their products are claimed as trademarks. Where those designations appear in this book and Addison-Wesley was aware of a trademark claim, the designations have been printed in initial capital letters. Library of Congress Cataloging-in-Publication Data Winnicott, D. W. (Donald Woods), 1896-1971. Thinking about children / D.W. Winnicott: edited by Ray Shepherd, Jennifer Johns, and Helen Taylor Robinson. p. cm. "A Merloyd Lawrence book." Includes bibliographical references and index. ISBN 0-201-40700-0 ISBN 0-201-32794-5 (pbk.) 1. Child mental health. 2. Child psychology. 3.Child analysis. I. Shepherd, Ray. II. Johns, Jennifer. III. Robinson, Helen Taylor. IV. Title. RJ499.W493 1996 618.92′89--dc20 96-11007 CIP Copyright © 1996 by The Winnicott Trust by arrangement with Mark Paterson Bibliography © 1996 Harry Karnac Frontispiece portrait © Lotte Meitner-Graf All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Printed in the United States of America. Published in the U.K. by H. Karnac Books Limited. Addison-Wesley is an imprint of Addison Wesley Longman, Inc. Cover design by Suzanne Heiser Text design by Eric A. King Set in 10-point Palatino by Communication Crafts 1 2 3 4 5 6 7 8 9-MA-0100999897 First printing, June 1996 First paperback printing, December 1997 Find us on the World Wide Web at http://www.aw.com/gb/ -vi- This book is dedicated to the memory of Clare Winnicott, founder of The Winnicott Trust, whose work in the early stages made it possible -vii- 2 CONTENTS ACKNOWLEDGEMENTS xiii PREFACE xv INTRODUCTION xix PART ONE Observation, intuition, and empathy 1 Towards an objective study of human nature 3 2 "Yes, but how do we know it's true?" 13 PART TWO Early infant development 3 Primary introduction to external reality: the early stages 21 4 Environmental needs; the early stages; total dependence and essential independence 29 PART THREE The family 5 The bearing of emotional development on feeding problems 39 6 Sleep refusal in children 42 7 The effect of loss on the young 46 8 Out of the mouths of adolescents 48 9 The delinquent and habitual offender 51 10 A clinical approach to family problems: the family 54 PART FOUR Starting school 11 Mental hygiene of the pre-school child 59 12 The teacher, the parent, and the doctor 77 PART FIVE Case studies and observations 13 A clinical example of symptomatology following the birth of a sibling 97 14 Notes on a little boy 102 3 15 The niffle 104 PART SIX Adoption 16 Two adopted children 113 17 Pitfalls in adoption 128 18 Adopted children in adolescence 136 -x- PART SEVEN Psychosomatic problems 19 Contribution to a discussion on enuresis 151 20 Papular urticaria and the dynamics of skin sensation 157 21 Short communication on enuresis 170 22 Child psychiatry: the body as affected by psychological factors 176 23 On cardiac neurosis in children 179 PART EIGHT Autism and schizophrenia 24 Three reviews of books on autism 191 25 Autism 197 26 The aetiology of infantile schizophrenia in terms of adaptive failure 218 PART NINE Professional care of the growing child 27 Training for child psychiatry: the paediatric department of psychology 227 28 Notes on the time factor in treatment 231 29 The Association for Child Psychology and Psychiatry observed as a group phenomenon 235 -xi- 30 A link between paediatrics and child psychology: clinical observations 255 31 Child psychiatry, social work, and alternative care 277 GLOSSARY OF MEDICAL TERMS 283 ORIGINAL SOURCE OF EACH CHAPTER 287 4 BIBLIOGRAPHY OF WINNICOTT'S WORKS 291 List of volumes 291 Alphabetical list 293 Chronological list 311 INDEX 329 -xii- ACKNOWLEDGEMENTS The initial selection of published and unpublished papers for the present volume of Donald Winnicott's work was made by Clare Winnicott, Madeleine Davis, and Ray Shepherd. The Editors are grateful to Harry Karnac for generously allowing us to include his comprehensive bibliography of Winnicott's published works. This, we believe, will be of value to anyone interested in the great variety of subjects that Winnicott wrote about, as well as those concerned with the development of his thought. We also wish to thank our publishers, Cesare Sacerdoti and his assistant Graham Sleight of Karnac Books, and Merloyd Lawrence on behalf of Addison-Wesley Publishing Company and Merloyd Lawrence Books, for their attention to detail and their close and helpful support during the production of this book. Our agents, Mark Paterson, and in particular his associate, Mary Swinney, have offered unfailing help. Our thanks go also to Ann Glynn, who was responsible for typing the book; and to Eric and Klara King of Communication Crafts, who helped in the final preparation of the book for publication. Finally, for their help in establishing sources and references for some of the papers we would like to thank -xiii- Geoffrey Davenport, Librarian of the Royal College of Physicians; Jill Duncan, Librarian of the British Psycho-Analytical Society; Catherine Teale and Robert Greenwood at the Library of the Royal Society of Medicine; Margaret Walker, Librarian of the Tavistock Centre and Institute of Human Relations; and the staff of the British Medical Association Library. -xiv- 5 PREFACE The topics of the papers in this volume range from earliest infancy to adolescence, but they are held together by the author's own theory of child development. For Winnicott, facts were the reality. He wrote in the simplest vernacular; he wrote as he spoke, simply, and in order to relate. This makes these papers accessible to parents and the general reader, as well as to professionals concerned with children. A number of the papers in this collection have never previously been published; the rest are works that are otherwise difficult to access since they appeared in journals or in books that are no longer in print. For nearly fifty years Winnicott was deeply engaged in paediatrics, child psychology, child psychiatry, and psychoanalysis. He held office as President of the Paediatric Section of the Royal Society of Medicine and was awarded the James Spence Gold Medal for Paediatrics in 1968. He was also Chairman of the Medical Section of the British Psychological Society and was twice elected President of the British Psycho-Analytical Society. All this was in recognition of an originality founded in great common sense and also of his understanding of children and their families, in their whole setting and at their particular stage of development. A striking feature of Winnicott's work was his great power of observation and description so that what he writes has an air -xv- of extraordinary familiarity--one feels that one has known what he reports all along. Winnicott held that the innate potential for growth in a baby (and he was aware of the damage to innate potential, or the restrictions of potential in the baby, too) expressed itself in spontaneous gestures. If the mother responds appropriately to these gestures, the quality of adaptation provides a growing nucleus of experience in the baby, which results in a sense of wholeness, strength, and confidence that he calls the "true self". The growing strength of the "true sell" enables the infant to cope with more frustration and relative failure on the part of the mother, without loss of liveliness. If a mother is unable to meet her baby's gestures appropriately, the baby develops a capacity to adapt to and comply with the mother's "impingements"--that is, with the mother's initiatives and demands--and the baby's spontaneity is gradually lost. Winnicott called such a defensive development the "false self". The greater the "mis-fit" between mother and baby, the greater the distortion and stunting of the baby's personality. Stressing that the decisive phase in the infant's development is the achievement of a unitary self capable of objectivity and creative activity, Winnicott described transitional stages between initial subjectivity and growing objectivity in the infant based on the development of the self through the growing capacity for symbolization and cultural experience. These are the barest bones of some of Winnicott's main contributions to the theory of child development. On the basis of his theory he was able to make contributions to a wide range of problems of concern to those trying to help children and their families. Winnicott maintained a central role for both innate and internal, as well as external, influences on child development. Therefore, he emphasized the role of trauma and deprivation as well as that of intra-psychic conflict in the formation of psychopathology. He attributed health and creativity to the quality of early care-taking, primarily by the mother and supported by the father. This gives hope to those trying to help, such that when ill-health and breakdown occur, the regressive disintegration of the personality is not seen as irreparable. Not just re-growth, but new growth is possible in Winnicott's theories. -xvi- * * * 6 The Editors have followed the policy adopted for all the hitherto published works of Donald Winnicott: namely, to make few changes to the writings that Winnicott left, in order to preserve the characteristics of Winnicott's style, which often shows the development of thought--or the process of forming thought--in full flow.
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