Playing and Reality
Therapeutic Consultations in Child Psychiatry
Although his ideas have as yet made little impact in the United States, D.W. Winnicott, who died early last year, was for the last fifteen to twenty years of his life by far the best known psychoanalyst in the British Isles. This was partly due to the mere fact of his being very English—to date most British analysts have been either émigré (Melanie Klein) or refugee (Anna Freud) Central Europeans, Scotsmen (Edward Glover and W.R.D. Fairbairn), or Welshmen (Ernest Jones). But the reason for his reputation also and more particularly was that he possessed to a remarkable degree the capacity for describing even highly sophisticated psychoanalytical ideas in simple, vivid, and homely language. As a result he was widely appreciated not only as a writer but also as a broad-caster and public speaker.
His gift for popular exposition was combined with another quality which must have derived from his own genius and not from his clinical experience or his knowledge of psychoanalytical theory. This was an extraordinary intuitive understanding of both mothers and babies, which enabled him to describe what mothers feel about their babies and what babies feel about their mothers with an intimacy and immediacy that was uncanny. When reading his The Child and the Family,1 particularly its first section, “The Ordinary Devoted Mother and Her Baby,” it comes as a repeated shock to remember that as a man Winnicott can never himself have been a mother, and that he could presumably no more remember his own babyhood than the rest of us can.
Although, when speaking professionally, Winnicott attributed his insight into mothers and babies to his analytical familiarity with transference and counter-transference phenomena encountered during the treatment of regressed patients and to his experience as a pediatrician—his Collected Papers2 are correctly subtitled “Through Paediatrics to Psychoanalysis”—he also openly admitted to a strong maternal identification in his own personality, even allowing Katherine Whitehorn to describe him as a Madonna in an article she wrote about him in the London Observer.
Not surprisingly, his unusual gifts and personality turned him into a cult figure with a “following” largely but not entirely consisting of adoring women. In both books under review, his descriptions of patients make it clear that a high proportion of his adult patients came to him already familiar with his ideas, and with faith in him personally, and that many of the children he treated were those of former and grateful patients. He was, indeed, one of those rare creatures who are correctly designated charismatic, a fact which creates difficulties in assessing the scientific value of his work.
There were, however, disadvantages in being an intuitive, English Madonna. First, it made him somewhat of an outsider, a loner within the psychoanalytical movement, with its predominantly intellectual, rationalist, and Central European style of thinking. He had no time for impersonal, mechanical abstractions such as the mental apparatus or cathexes and countercathexes, and in spite of his preoccupation with infancy, he was unable to accept Melanie Klein’s view that all psychopathology originates in the infant’s innate ambivalence toward the breast. As a result, he achieved full recognition within the British Psycho-Analytical Society only during the last years of his life.
Secondly, his intuitive understanding of the maternal-feminine in human nature was not matched by a corresponding feeling for the paternal-masculine. The index of Playing and Reality contains fifty-five entries for “mother” but only three for “father,” a disparity which is made all the more remarkable by the fact that in Winnicott’s view both culture and religion are derivatives of play. Even if one accepts Winnicott’s idea that the capacity to play originates in the infant’s initial interactions with its mother, the extension and imaginative elaboration of play into culture and religion must, it seems to me, involve the father as a person who performs some function other than that of an auxiliary mother—which is how Winnicott all too often conceives of fathers. Not only do fathers play with children (as opposed to infants) as much as if not more than mothers do, but our culture, in spite of the emancipation of women during this century, still shows obvious traces of being predominantly created and transmitted by men. And God, in spite of some of the new theologians still the central religious concept, remains persistently masculine.
Winnicott’s blindness to things masculine and sexual is responsible for the one disastrous passage in Playing and Reality. In a section entitled “Pure Male and Pure Female Elements” he asserts that “the male element does while the female element (in males and females) is” and correlates femininity with quiet identification with objects and masculinity with instinctual drives toward objects recognized as separate from the self. “This pure female element has nothing to do with drive (or instinct),” he writes. And even more curiously: “Exciting implies: liable to make someone’s male element do something. In this way a man’s penis may be an exciting female element generating male element activity in the girl.” This idea that being is feminine and doing is masculine, that calm is feminine and desire, even female desire, is masculine, reads strangely when one remembers that nowadays even ladies move, even if one assumes, as Winnicott does, that everyone is psychologically bisexual.
Such verbal confusion is, however, exceptional in Winnicott’s writings. In this passage he has, it seems, tried to extricate himself from the classical psychoanalytical assumption that all need for others is based on instinctual impulses and to find a theoretical explanation of the fact that human beings need quiet communion with others as much as they crave relief from instinctual tension. But he has chosen a peculiarly unfortunate way of doing so.
Thirdly, Winnicott’s reliance on intuition and identification rather than on intellect and observation proves a handicap when it comes to formulating theory. Playing and Reality is an attempt to construct a theoretical basis for Winnicott’s clinical insights, to legitimize his intuitive understanding by formulating it in terms acceptable to other psychoanalysts. Unfortunately, from this point of view it must be adjudged at least a partial failure. His main thesis, which I shall describe later, comes across clearly enough, but in many other respects the book is disappointing.
Although laid out as though it were a proper book with a developing argument, it is in fact a compilation of articles written independently of one another but strung together by linking passages to give it some semblance of unity. As a result it is tediously repetitive and in one important respect confusing and misleading. Since Winnicott does not expound those aspects of classical or Kleinian theory that he is either rejecting or attempting to reformulate, readers who are unfamiliar with the theoretical controversies and intellectual climate of the British psychoanalytical scene will often fail to appreciate what Winnicott is fighting against even though they may understand what he is fighting for.
For instance, Chapter 6, “The Use of an Object,” seems to me to be an attempt to formulate an alternative statement of Melanie Klein’s “depressive position” without accepting her ideas about the death instinct and innate envy. But Melanie Klein is not mentioned once in the chapter, though sentences like “It is not possible for me to take for granted an acceptance of the fact that the first impulse in the subject’s relation to the object is destructive” and “It is no good saying that a baby a few days old envies the breast” are pointless unless read as intended rejections of Kleinian theory.
Rather similarly, or perhaps conversely, Winnicott also offends against the conventions of scientific writing by failing to acknowledge to what extent his ideas resemble those of others. As a result he often writes as though he were being more original than in fact he is—or even than, if challenged, he would have claimed to be. For instance, according to Winnicott, “Psychoanalysis always likes to be able to eliminate all factors that are environmental, except in so far as the environment can be thought of in terms of projective mechanisms,” whereas he believes that whether “individuals live creatively and feel that life is worth living…is directly related to the quality and quantity of environmental provision at the beginning or in the early phases of each baby’s living experience.” But in fact only Kleinian analysts have sought to eliminate the environment, and Winnicott’s general position is and has been shared by numerous other analysts, notably by Erikson,3 Balint, Bowlby, and Spitz, to cite only workers whose ideas have developed independently of his.
But Winnicott makes no attempt to correlate his own ideas with those of others or to work toward a consensus of terminology. His theorizing remains, in spite of the occasional use of abstract nouns, a personal statement, too idiosyncratic to be readily assimilated into the general body of any scientific theory. He often sounds like a voice crying in a wilderness that is in fact inhabited, or like a visionary who is disguising himself as a thinker.
The essential thesis of Playing and Reality is nonetheless capable of abstract formulation. Psychoanalytical theory has always postulated the existence of two realms of experience, one psychical, subjective, located inside the self, and manifesting itself most nakedly in dreams, the other environmental, objective, and located outside the self. According to most formulations, the former, internal or psychical reality, is in inherent opposition to the latter (external reality), so that the developing infant has to learn to renounce its tendency to hallucinatory wish-fulfillment in favor of adaptation to the environment.
In Winnicott’s view, however, health and creative living depend on the establishment of a third “transitional” or “intermediate” realm, in which the subjective and objective are fused (or remain undifferentiated). In this transitional area, objects are felt to be parts of both internal and external reality, to possess both selfhood and otherness, and activities are both wish-fulfilling and adaptive. All playing, all culture, and all religion belong in this transitional realm, which only develops in so far as the mother responds sufficiently sensitively and promptly to the infant’s tendency to hallucinate the objects of its desire, to create for itself the illusion that it has subjectively created objects that objectively exist independently of it. To the extent that this illusion is successfully created, and premature disillusionment is avoided, the individual will feel at home in the world and have a creative relationship with it.
Although this concept of a transitional reality, which mediates between the private world of dreams and the public, shared world of the environment, is perhaps the most important contribution made to psychoanalytical theory in the last thirty years, it must be admitted that from a general, cultural point of view it is not entirely original. It is, after all, what the poets call Imagination, that “intermediate faculty” (Coleridge), which enables its possessors to inhabit a world of “both what they half-create and what perceive” (Wordsworth), to “half-create the wondrons world they see” (Young’s Night Thoughts, vi, 424).
Finally, in view of the fact that I have found it necessary to be some-what critical of Playing and Reality, it is a pleasure to end this review by reporting that Therapeutic Consultations in Child Psychiatry is Winnicott at his best. In it he describes simply and vividly, and with a minimum of theoretical comment, twenty-one therapeutic consultations with children, in which he makes contact with the patient by playing the “squiggle game.” In this game therapist and patient doodle together producing a series of drawings, which the therapist uses to understand and at times interpret the patient’s current anxieties and conflicts. Winnicott is consistently successful in getting across the atmosphere of each consultation, and it is a revelation to watch how rapidly he makes contact with each patient and how illuminating this technique of imaginative participation in child’s play can be. I cannot conceive of anyone reading these descriptions without being enriched in his understanding of his children, his patients, and indeed of himself.
Barnes & Noble, 1957.↩
Barnes & Noble, 1958.↩
Cf. Erikson (1953): "Mothers, I think, create a sense of trust in their children by that kind of administration which in its quality combines sensitive care of the baby's individual needs and a firm sense of personal trustworthiness within the trusted framework of their culture's style."↩
Barnes & Noble, 1957.↩
Barnes & Noble, 1958.↩
Cf. Erikson (1953): “Mothers, I think, create a sense of trust in their children by that kind of administration which in its quality combines sensitive care of the baby’s individual needs and a firm sense of personal trustworthiness within the trusted framework of their culture’s style.”↩