Donald Winnicott and John Bowlby: Personal and Professional Perspectives

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A fascinating book that sets Bowlby and Winnicott in context and relation to one another to provide a new perspective on both, as well as providing a welcome testimony to their enduring legacy.

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DONALD WINNICOTT AND JOHN BOWLBY

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CHAPTER ONE: Winnicott and Bowlby: personal reminiscences

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Judith Issroff

Here, after more than three decades of silence, I pay tribute in personal fashion: by reminiscing, I hope to share a glimpse of the men, their personalities, experience, wisdom, and ways of being in this world. Through my unabashedly subjective views I hope to awaken enthusiasm to pursue their respective écriture in those who may not be familiar with their works. As both were wont to do, I ask myself questions and allow myself to associate freely while trying to answer them. In no way is my attempt to be considered didactic. Because I choose this approach—a patchwork “meandering design”, as Rycroft dubbed such essays (1992, p. 87)—there is no particular argument or linear structure, merely a series of topics and anecdotes comparing and contrasting them. Of course, I comment on areas of their work and their respective contributions. I have tried to separate personal memories from other comparative evaluations, although my chapter topics overlap.

How well did I know Bowlby and Winnicott? How well does one know anyone? To reminisce, I cannot but share some personal history. I am “expert” on neither Bowlby nor Winnicott, but a student, supervisee, and personal acquaintance, in particular between 1965 and 1970. Their contributions, personalities, and styles accompany me in my daily work and life; their wise adages reverberate along with the sayings of others from whom I was lucky to learn. The question “What were Bowlby and Winnicott like?” is answered as I recall my time with them. In their presence, as in their work, the two men were profoundly different.

 

CHAPTER TWO: Singing the same tune? Bowlby and Winnicott on deprivation and delinquency

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Christopher Reeves

Delinquency has never been a central concern for psychoanalysts in Britain, despite the involvement, during the 1930s, of Klein’s daughter Melitta Schmideberg and the once eminent analyst Edward Glover with the pioneering work of the Institute for the Scientific Treatment of Delinquency. Since both of these individuals subsequently fell out with the British psychoanalytic establishment, an interest in delinquency seemed for many years almost to suggest a hint of deviancy. When therefore Winnicott broached the subject in a paper presented to the British Psychoanalytical Society (of which he was then President) in 1956, he sounded, for him, unusually circumspect—almost apologetic. He chose to talk about the “antisocial tendency” in preference to delinquency and suggested that the topic posed “awkward problems” for psychoanalysis (Winnicott, 1956a). One of these problems, he suggested, was that conventional psychoanalytic treatment does not work with delinquents, even though psychoanalysis itself has something to say, and much to learn, about delinquency. However, he acknowledged that there was one British psychoanalyst who had already made a major contribution in this field (while incidentally—though he did not say so—remaining in fairly good standing with the majority of his psychoanalytic colleagues). He was referring, of course, to John Bowlby, who in 1944 had provided Ernest Jones, then Editor of the International Journal of Psycho-Analysis and currently short of copy, with a long research paper, indicating as he did so that the paper had previously been rejected by the British Journal of Medical Psychology as being deficient in the discussion of theory. But Ernest Jones apparently entertained no such qualms about its suitability for the Journal, and Bowlby’s famous paper, “Forty-Four Juvenile Thieves: Their Characters and Home Life” (1944), duly appeared. So well received was it that two years later it was printed as a separate monograph destined for a wider lay public. From then on, Bowlby became a household name. Among his fellow analysts he was dubbed “Ali Bowlby and his 40 Thieves” (Holmes, 1993, p. 21). Even Winnicott, with his habit of not acknowledging his indebtedness to others’ work while engaged in giving personal shape to his ideas and insights (Winnicott, 1945c/1958, p. 145), could not afford to ignore the impact on him of Bowlby’s contribution.

 

CHAPTER THREE: Reflections on Donald Winnicott and John Bowlby

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Bruce Hauptman

These reflections delve deep into the recesses of my memory: thirty-five years ago. Some elements are as fresh to me as if they had happened hours or days ago: they have that sort of power and clarity of experience, “imprinted” on my brain. Others have been mulled over, reviewed, lectured about, influenced by new ideas, experiences and discussions, and, most important, clinical applications, successes, and failures. Those perhaps suffer from hindsight revisionism, a form of natural distortion that occurs when an amalgam of original and new elements contends for place in one’s memory, leaving an admixture, possibly or hopefully made richer by the infusion of rethinking and reformulating, producing a richer ideological compost. The attempt to put into practice what I learned and assimilated so long ago has stood the test of time. It is upon that footing—hopefully a reasonably solid one—that I comment here and offer my humble observations about my experience with these two respected and important figures.

 

CHAPTER FOUR: Bowlby and Winnicott: differences, ideas, influences

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Judith Issroff

Few would disagree that Winnicott and Bowlby were perhaps the two most influential pioneering British child psychiatrists and psychoanalysts of the past century, although technically Winnicott was a community paediatrician, not a psychiatrist, and Bowlby had worked in a residential school and been a teacher who had read psychology prior to taking his medical degree. Without aspiring to comprehensive or in-depth considerations of the broad scope of their work and its developments, because its range was great, this chapter touches on a number of topics and looks in greater detail at their respective attitudes, styles, links to others, mutual provocations, differences, and influences.

Bowlby and Winnicott were among the first to recognize that human infants enter the world predisposed to participating in social interaction. Their work addressed both healthy “securely attached” development with its consequent reflection in the inner world and the ravages caused by neglect, deprivation, and insensitive parenting. They showed how these early experiences pave the way for understanding a developing dependent infant’s and child’s absolute need for continuity of “good-enough” care (Bowlby, 1940, 1953; Winnicott, 1945a, 1945b, 1945c, 1949d, 1967b, 1984, 1986b, 1987a, 1988a, 1988b). Accordingly, they traced the adverse developmental consequences of loss of appropriate personal environmental provision, trauma, and mourning.

 

CHAPTER FIVE: A duty to care: reflections on the influence of Bowlby and Winnicott on the 1948 Children Act

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Christopher Reeves

Towards the end of chapter 2, which was devoted to an examination of the differences between Bowlby and Winnicott over the understanding and treatment of juvenile delinquency, I drew attention to the social and political climate in Britain within which many of their ideas took shape, in particular to the introduction of the Welfare State legislation during the period of the Attlee Administration between 1945 and 1951. In this connection I alluded to the new perception of a “duty of care” on the part of the government towards its youngest citizens enshrined in the provisions of the 1948 Children Act. I suggested that the setting up of the wartime emergency evacuation scheme had been indirectly responsible for this development. These allusions to this important social and political development were necessarily brief in the context of that chapter. I now want to consider them further in the context of the contributions of Bowlby and Winnicott.

I have used the phrase “a duty to care” rather than “a duty of care” for the title of this chapter for three complementary reasons. First, this phrase better indicates what the British Government in 1948 came to regard as the dimensions of its newly assumed responsibility than what is conveyed nowadays by “a duty of care”. Second, Bowlby, Winnicott, and Winnicott’s future wife, Clare Britton, all of whom played a major part in articulating and giving practical substance to this new sense of government responsibility, clearly regarded this obligation as entailing the assumption of some real, direct, quasi-parental responsibility for the welfare of children deprived of parents, not just a degree of administrative oversight linked to the acknowledgement of ultimate accountability, such as is usually implied nowadays by the phrase “a duty of care”. Third, I shall be suggesting towards the end of this chapter that legislative developments in respect of the welfare of children since the 1948 Act, up to and including the legislation currently being enacted in the British Parliament, even though they can be said to take their point of departure from the assumptions about care implicit in this earlier landmark Act, nevertheless show a gradual shift in perception on the part of a government concerning the relationship that should exist between young people, their families, and the state, and the mutual rights and responsibilities of each—a shift that can best be described as moving from an active governmental “duty to care” towards a more neutral “duty of care”. It is implicit in my thesis that such a shift would probably have represented an unwelcome development in the eyes of the two men who are the particular object of this study. However, I shall largely refrain from conjecturing how Bowlby and Winnicott might have reacted to current developments in child provision and thinking and concentrate instead on the context and issues of childcare they actually encountered during their professional careers.

 

CHAPTER SIX: Postscript: from past impact to present influence

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Christopher Reeves

In chapters 2 and 5 I have kept mainly to an historical approach because I believe that the contributions of Bowlby and Winnicott in the fields of child care and child mental health have to be viewed in the context of their times and the social issues that they were confronting. To do otherwise is to risk misrepresenting, even trivializing, their work. However, in a book devoted to a demonstration of the abiding importance of these two key figures of twentieth-century British psychoanalysis, it would be remiss of me not also to consider what relevance their views might hold for contemporary childcare theory. So, we need to ask the question: are their ideas and recommendations of the 1940s and 1950s of merely historical interest, or do they have continuing relevance today?

One way of attempting to answer this question would be to draw a direct comparison between what they themselves consistently advocated and what currently obtains in British childcare legislation and practice. I have mostly resisted the temptation of speculating overmuch on what Bowlby and Winnicott themselves might have made of changes in childcare legislation in the decades subsequent to their deaths, although at various points I have alluded to changes that could be seen as a reversal of developments of which they clearly approved. In this connection I particularly pointed out how the post Seebohm Social Services Acts of 1971 and 1972 that ushered in the conglomerate Department of Health and Social Services that we still inherit, and introduced the era of the generic social worker, dismantled a crucial piece of the 1948 Children Act. This dismantling Winnicott would doubtless have resisted as forcibly as his widow did, since it undermined a key principle enshrined in the earlier Act: namely, that a child’s social welfare and mental health needs should comprise a distinct and separate concern of state-funded social welfare. The same could perhaps be said of the gradual demise of another aspect of child welfare provision that began in roughly the same period: the progressive closure of cottage homes and family group homes as alternatives to foster care. This also, I suspect, would have been opposed by Winnicott—though not by Bowlby—as being unrealistic and doctrinaire.

 

APPENDIX A

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Masud Khan’s version of how he came to meet John Bowlby and thus accepted for training as a psychoanalytic candidate should be treated with a great deal of suspicion and circumspection (Hopkins, 2004). Bowlby was never an admirer of Khan’s. Khan “lived in the interface between fact and fiction, truth and metaphor, reality and fantasy” (Judy Cooper, quoted by Boynton, 2002/2003). Robert Stoller, Khan’s friend to whom he entrusted his diaries and work books, wrote in a letter composed immediately after Khan’s death, “any obituary [I would have written] would be unacceptable. I would have stomped up and down in my anger at Masud’s lying … his total fabrication of the clinical material in the last book” (Boynton, 2002/2003). This applies also to parts of Khan’s Work Books and clinical material. Masud said to me: “Truth? Who needs truth? That’s for literature.” Khan’s depiction of this alleged meeting is highly out of character for John Bowlby, and his acceptance as a candidate should not be blamed on Bowlby any more than the responsibility for Khan’s flagrant pro-fessional—and personal—misconduct be mis-attributed to Winnicott. Winnicott’s explicit attitude was recorded by John Davis, who recollects “asking him once naively why the GMC were more likely to order a doctor to be struck off the medical register for committing adultery with a patient (or a patient’s mother!) than, for instance, for removing the wrong leg when carrying out an amputation. ‘It is because,’ he said quite lightly, ‘doctors can only help their patients if they love them: and the patient and those who care for her must know for certain that such love is safe—not exploitative of dependency: otherwise, they couldn’t accept it’” (J. Davis, 1993, p. 97).

 

APPENDIX B

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George Lyward

George Lyward was as original and eccentric an educator– therapist as Winnicott a paediatrician–psychoanalyst. Turning down the headmastership of one of England’s most prestigious public schools, he ran, instead, a community for gifted misfits in a rambling old house set in large grounds in Kent countryside near Tenterden. Many of the boys were ill. Some of his unorthodox but effective methods are described in Mr Lyward’s Answer (Burn, 1953).

John Bowlby suggested I visit there, along with identifying other unconventional educational establishments. At that stage I did not know that he had himself been a teacher in a residential school, but in retrospect I acknowledge my debt to Bowlby who was responsible for ensuring that I did not overlook the immense importance of school life in the practice of child psychiatry. Both Bowlby and Winnicott, as well as Sutherland and Derek Miller, accepted and practised the extension of psychoanalytic thinking to include a critical analysis of society as playing a weighty role in the construction of influences on an individual and his family’s inner world. Lyward (1958), like Winnicott, would deliver himself of sage but cryptic comments and questions: “Consider the function of the full stop” might occupy a morning’s discussion; or “The answer to the management of delinquent behaviour lies in time and space”, reminiscent in its koanic qualities of Winnicott’s “We must remember the creativity of salivation” (Issroff, 1993).

 

APPENDIX C

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In 1963, while reviewing Jung’s autobiography, Winnicott developed “a splitting headache”, went to sleep where he was on the floor, and dreamt a dream (1963a) which he described in three parts:

1. There was absolute destruction, and Winnicott was part of the world and of all people, and therefore he was being destroyed. (For him “the important thing in the early stages was the way in which in the dream the pure destruction got free from all the mollifications, such as object relating, cruelty, sensuality, sado-masochism, etc.”)

2. Then there was absolute destruction, and he was the destructive agent. Winnicott perceived this as a problem for the ego, how to integrate these two aspects of destruction?

3. The third part now started, and in the dream he awakened. As he awakened, he knew he had dreamt that he was both part of what was being destroyed and the agent of this absolute destruction. He decided that he had solved the problem of how to integrate the two aspects of destruction by using the difference between the waking and the sleeping states. Because here he was awake, in the dream, and he knew he had dreamed of being destroyed and of being the destroying agent. There was no dissociation, so his three “I”s were altogether in touch with each other—he remembered dreaming the first and second parts.

 

APPENDIX D

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Reality and fantasy

The healthy child becomes capable of the full dream of genital sexuality. In the remembered dream there can be found all the kinds dream work that were carefully worked out by Freud. In the remembered and unending dream the full consequences of the instinctual experience must be met. The boy who takes his father’s place cannot avoid dealing with:

•  The idea of the death of the father and therefore of his own death.

•  The idea of castration by the father or castration of the father.

•  The idea of being left with full responsibility for the satisfaction of the mother.

•  The idea of a compromise with the father along homosexual lines.

•  In the girl’s dream she cannot avoid dealing with:

•  The idea of the death of the mother and therefore of her own death.

•  The idea of robbing the mother of her husband, of his penis, of her children, and so the idea of her own sterility.

•  The idea of being at the mercy of the father’s sexuality.

•  The idea of a compromise with the mother along homosexual lines.

 

APPENDIX E

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Although at the time I was in no way conscious of any connection, when recalling these stimulating and fascinating discussions initiated by Bowlby, I became aware of their enduring influence on my “road less travelled” professional life. Accordingly, I would like here to pay tribute to the enduring influence of John Bowlby’s seminar about the possible social role of a child and family psychiatrist by giving one illustration that led to formal constructive developments: conceivably in time these ideas, which were deliberately drawn up as widely as possible, could have further positive consequences in a number of conflict-ridden highly complex situations. While at a personal level I may feel deeply pessimistic, nonetheless, I believe that one cannot choose to go on living without behaving optimistically.

A conference on “Conflict Resolution: Building Tolerance for Diversity” was held in 1994 under the auspices of the World Federa-tion of Mental Health, the Washington Institute for the Victims of Trauma, and the patronage of the Grand Mufti of Egypt, organized by the El Azayam Hospital, the World Federation of Islamic Psychiatrists, the Egyptian Ministries of Health, Religion, Education, Security and Tourism, and the Foreign Service of Egypt, the Egyptian Psychiatric Federation, the Cairo High Institute of Social Work, and other Egyptian organizations, the American Cultural Centre in Cairo, the Israeli Foreign Ministry, and the Palestinian Red Crescent Association. Dr Fathi Arafat and Dr Judith Issroff co-chaired ground-breaking discussions held at the Palestinian Red Crescent Hospital that did enable some joint work and many further meetings to occur.

 

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