Discovering the Inner Life of a Child

Abstract

Using Winnicott's concept of transitional space, joint attention, theory of mind, and a case vignette, the author describes techniques in elucidating and elaborating a child's play space, hence, psychic life. Explicating the child's theory of mind uncovers the dynamics, motives, conflicts, and unconscious material used by the analyst to form interpretations and encourage the child's self-reflective function (Fonagy & Target, 1996). Finally, a case vignette illustrates the enhancement of play space by elucidating the child's theory of mind.     

THE “AS‐YET SITUATION” IN WINNICOTT'S “FRAGMENT OF AN ANALYSIS”: YOUR FATHER “NEVER DID YOU THE HONOR OF”… YET

The author proposes a new hypothesis in relation to Winnicott's “Fragment of an Analysis”: that as early as 1955, in the case described in this text, Winnicott is creating the paternal function in his patient's psychic functioning by implicitly linking his interpretations regarding the father to the Freudian concept of Nachträglichkeit. The author introduces an original clinical concept, the as‐yet situation, which she has observed in her own clinical work, as well as in Winnicott's analysis of the patient described in “Fragment of an Analysis” (1955).     

Multiple Points of Intervention as an Approach in Child Psychotherapy

ABSTRACT

This article develops an integrated model that emphasizes multiple points of intervention in therapeutic work with children. It draws on nonlinear dynamic systems theory, Winnicott's theory of play and transitional space, elements of contemporary relational theory, client-centered therapy, Gestalt therapy, family systems, behavior therapy, selected aspects of cognitive behavior therapy, psychological education, and school consultations.     

Commentary on ‘The arms of the chimeras’ by Béatrice Ithier

In this Commentary I will first of all summarise my understanding of the proposal set out by Béatrice Ithier concerning her concept of the ‘chimera’. The main part of my essay will focus on Ithier's claim that her concept of the chimera could be described as a ‘mental squiggle’ because it corresponds to Winnicott's work illustrated in his book ‘Therapeutic Consultations’ (1971). At the core of Ithier's chimera is the notion of a traumatic link between analyst and patient, which is the reason she enlists the work of Winnicott. I will argue, however, that Ithier's claim is based on a misperception of the theory that underpins Winnicott's therapeutic consultations because, different from Ithier's clinical examples of work with traumatised patients, Winnicott is careful to select cases who are from an ‘average expectable environment’ i.e. a good enough family. Moreover, Winnicott does not refer to any traumatic affinity with his patients, or to experiencing a quasi‐hallucinatory state of mind during the course of the consultations. These aspects are not incorporated into his theory. In contrast (to the concept Ithier attempts to advance), Winnicott's squiggle game constitutes an application of psychoanalysis intended as a diagnostic consultation. In that sense Winnicott's therapeutic consultations are comparable with the ordinary everyday work between analyst and analysand in a psychoanalytic treatment. My Commentary concludes with a question concerning the distinction between the ordinary countertransference in working with patients who are thinking symbolically in contrast to an extraordinary countertransference that I suggest is more likely to arise with patients who are traumatised and thus functioning at a borderline or psychotic level.     

REVISITING DESTRUCTION IN “THE USE OF AN OBJECT”

“The Use of an Object” (1969a) has been widely recognized as among Winnicott's great papers and has deservedly received a good deal of attention. Much of that attention has focused on the importance that the paper gives to the role of destruction in bringing about the experience of externality. Yet the nature of that destruction has too often been assumed based on Winnicott's earlier writings. In the view that follows from that, destruction is equated with the aggression that fails to destroy the object, and the experience of externality is regarded just as the result of that failure. In offering a rereading of “The Use of an Object,” the author suggests that, while this aspect of aggression/destruction indeed plays an important role in the establishment of externality, it is only part of the story, and that the central contribution of “The Use of an Object” is Winnicott's attempt to offer a new theory of primitive destruction, one that provides an impulsive basis for separation/externality itself. This theory and Winnicott's ongoing attempts to develop it after “The Use of an Object” led him to rethink the very nature of the drives.     

CLINICAL WINNICOTT: TRAVELING A REVOLUTIONARY ROAD

The author contends that, contrary to the usual perception that Winnicott followed a linear progression “through pediatrics to psychoanalysis,” Winnicott's vision was always a psychoanalytic one, even during his early pediatric work. His place in the development of psychoanalytic theory is highlighted, and the author discusses such key Winnicottian concepts as transitional space, the false self, and the use of the object. Winnicott's unique approach to the form and value of analytic interpretation is particularly emphasized, and his thoughts on the treatment of depression are also addressed, as well as his distinction between regression and withdrawal. Included is a summary of convergences and divergences between Winnicott's thinking and that of Bion.     

Contemplating spiritual experience: Winnicott's potential space,Tibetan bardo,and liminality

Abstract

In this paper, ways of contemplating and accommodating the unfamiliar, especially the “other” of spiritual experience, are considered. Some concepts from psychoanalysis, such as Winnicott's “potential space” and his notion of “holding,” are helpful in comprehending spiritual experiences that can easily be misunderstood, or “flattened out” to use Bion's phrase. Interesting and rather remarkable confluences in these concepts from psychoanalysis and from Tibetan Buddhism (bardo) and cultural anthropology (liminality) are considered in their functions of both enabling and comprehending these extraordinary and often life-enhancing experiences.     

A Comment on teurnell's “the piggle—a sexually abused girl?”

Abstract

In his comment on Teurnell's paper “The Piggle—a sexually abused girl?” the author points to the risk of organizing a complicated clinical material around one single idea and briefly describes other ways of understanding the material in Winnicott's book. To the author's mind, the richness and depth of the material and the subtleness and aesthetics of the interplay between Winnicott and the Piggle, in Teurnell's way of reading, collapse into one single question: the possibility of a sexual trauma. At the end of the comment the role of the Piggle's father is shortly discussed.     

Addicts to artists: The ‘good enough mother’ in the substance abuse clinic

Psychodynamic psychotherapy has had a bad reputation in substance abuse circles. Despite widespread use of behavioral interventions, outcomes remain relatively poor. The emerging trend is to incorporate relational and other psychodynamic approaches into addiction treatment. The article describes use of Winnicott's concepts of the ‘good enough mother’ and ‘play space’ in an outpatient ‘art group’.     

The emergence and unfolding of the psyche

This paper is a short exposition of Freud's concept of the sexual drive. My motivation for going back once more to the first introduction of sexuality understood as drive is the seeming lack of interest in the classical concept in much contemporary psychoanalytical thinking. To my mind, this prevents us from finding satisfactory solutions to such concepts as narcissism, sublimation and even the emergence and unfolding of the ego. Reading for example Winnicott's enchanting account of play, one gets the impression that Winnicott saw playing as something separate from instinctual satisfaction, from sexual fantasying and from physical sensation. Looking at this important activity in the life of young children from the point of view of drive theory, one might argue, that here we see one of the first expressions of sublimation. However, in order to fully understand this, I found it necessary to undertake a re-reading of Freud's theory of the sexual drive.     

Naughty Girls Commentary on Paper by Jackie L. Cohen

In response to Cohen's rich and evocative presentation of her case of Lisa, I offer some additional perspectives on the material. Labeling Lisa a “naughty girl,” I explore the relevance of Winnicott's notions of the antisocial tendency and of the pathology of self-sufficiency, something Corrigan and I have called the mind object. I have looked at the treatment in terms of the facilitation of regression to dependence and a child's reconnection to her body. Herzog's concept of father hunger leads me to an exploration of Lisa's finding the father in her therapist, which helps her separate from omnipotent internal objects and accept the individuality of the other. Finally, inspired by Cohen's characterization of her treatment of Lisa as “relational and action oriented,” I attempt to review what I believe is essential to child treatment and what is beautifully illustrated in Cohen's work.     

‘Though he slay me,yet will I trust in him’: a critical reconstruction of Winnicott's theory of value

This paper extrapolates an outline for a theory of value from Winnicott's reflections on war in ‘Discussion of war aims’ (1940). The author treats Winnicott's discussion as an occasion for a critical reconstruction of his theory of life‐values. He discerns an implicit set of distinctions in Winnicott's reflections on war, including different orders of value (existential, ethical, and psychosocial); a distinction between maturity and necessity; and a yet more fundamental distinction between violence and brutality. The paper argues, on the basis of these distinctions, that Winnicott allows for an understanding of one's encounter with the enemy as an ethical relation. The main argument of the paper is that the ethical attitude underpins recognition of the enemy's humanity. On a more critical note, the author argues that Winnicott doesn't adhere consistently to the ethical attitude he presupposes, that in certain passages he privileges the maturity of combatants over the humanity of the enemy.     

Expressive development and basic emotions

Abstract

One important emotion theory currently postulates an innate tie between specific infant facial expressions and a set of discrete basic emotions. The arguments and evidence relevant to this assertion are reviewed. New data are presented from a naturalistic study of one infant's early expressive development and a judgement study of infant facial, vocal, and body activity. These data challenge the innate tie hypothesis. Based on dynamical systems systems theory, an alternate conceptual framework is presented that may allow us to usefully retain the concept of basic emotions while accommodating the data on infant expressive development.     

FROM EXTENSION TO REVOLUTIONARY CHANGE IN CLINICAL PSYCHOANALYSIS: THE RADICAL INFLUENCE OF BION AND WINNICOTT

This paper addresses the radical departure of late Bion's and Winnicott's clinical ideas and practices from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis. The profound significance and implications of their thinking are explored, and in particular Bion's conception of transformation in O and Winnicott's clinical‐technical revision of analytic work, with its emphasis on regression in the treatment of more disturbed patients. The author specifically connects the unknown and unknowable emotional reality‐O with unthinkable breakdown (Winnicott) and catastrophe (Bion). The author suggests that the revolutionary approach introduced by the clinical thinking of late Bion and Winnicott be termed quantum psychoanalysis. She thinks that this approach can coexist with classical psychoanalysis in the same way that classical physics coexists with quantum physics.     

Experiences in difference: An exploration of the usefulness and relevance of psychoanalytic theory to transcultural mental health work

Abstract

This paper presents accounts of work with mental health service users in a multicultural residential setting and, explores some of the difficulties involved in working from a psychodynamic perspective in such a setting. It argues that a psychoanalytic understanding of the role of phantasy in the experience of difference, upon which ideas of culture and identity are constructed, can be helpful to practitioners concerned with addressing the consequences of their clients' experience of racism and other forms of discrimination. Particular reference is made to Winnicott's writings on play, transitional space and the location of cultural experience.     

The Integrated Therapy of Family Members—A Case Report

Winnicott's concept of the “transitional space” is used in an effort to develop a conceptual unity between intra- and interpersonal dynamics. It is proposed that in their work together, the members of a therapy group develop a shared psychic “group space” derivative from the interaction of the “transitional space” of each, and within which the actual interpersonal transactions and influences take place. Possible underlying bases for such a theoretical concept are considered, as well as its implications for group therapy.     

Between a suffering body and a body in a state of need: Aulagnier’s theory of discourses on the body applied to primitive mental states

ABSTRACT

In her theory of discourses on the body, Aulagnier makes the comparison of the concept of ‘a suffering body’ and the concept of ‘a body in a state of need’. The last type is what she thinks is often found in addiction, anorexia and in borderline states, conditions marked by a radical negativity. On the other hand, ‘a suffering body’ is a concept that indicates a relation and two bodies, mother’s and child’s, that communicate. Suffering and infantile sexuality is a first attempt to accept separation by weaving a net of fantasy over the abyss of lack and separation. If pleasure and suffering are lacking as representations, the sensory reactions may exist physiologically but without psychical existence. The concepts of ‘a suffering body’ and 'a body in a state of need' will enable us to think about important structural differences between neurotic-, borderline- and psychotic conditions. As a foundation for her concepts lies a metapsychological elaborations of three kinds of processes for representation: the primal-, the primary- and the secondary process.     

Clinical concepts

In this section authors have written about the Winnicottian concept that they value most in their everyday working lives. This provides a valuable insight into the ways in which Winnicott's work is being used as a springboard for new ideas, as well as enlightening familiar ground. It is striking to see how the original Winnicottian idea takes on new form as it is taken up by new generations of clinicians. Despite the absence of a Winnicottian training school, his pervasive impact continues to influence current theory and practice.     

The Mania of Existence: Klein,Winnicott, and Heidegger's Concept of Inauthenticity

This paper offers a new interpretation of Heidegger's concept of inauthenticity (Uneigentlichkeit) in Being and Time. It breaks from the “conformity interpretation” of inauthenticity, according to which the anonymity of the inauthentic person is due to her conformity to das Man. Rather, it argues that the anonymity of the inauthentic person is due to “existential mania” – a state in which a person denies her death and anxiety, understands her abilities to be limitless, and is perpetually active. It shows how this existential mania – and the anonymity to which it gives rise – is analogous to the mania described by the object relations psychoanalyst Melanie Klein. Finally, drawing on D. W. Winnicott's discussion of mania, it shows how both the inauthentic person's conformity to das Man, and her existential mania, give rise to anonymity.     

MOTILITY,AGGRESSION, AND THE BODILY I: AN INTERPRETATION OF WINNICOTT

Among the central ideas associated with the name of Winnicott, scant mention is made of motility. This is largely attributable to Winnicott himself, who never thematized motility and never wrote a paper specifically devoted to the topic. This paper suggests both that the idea of motility is nonetheless of central significance in Winnicott's thought, and that motility is of central importance in the development and constitution of the bodily I. In elaborating both these suggestions, the paper gives particular attention to the connections between motility, continuity, aggression, and creativity in Winnicott's work.