Abstract

In 1964 Donald Woods Winnicott, a sixty-eight-year-old, once scintillating psychoanalyst in the twilight of his life, afflicted with severe heart disease and angina, his career fading toward darkness, enters into a therapeutic encounter with a two-year-old girl nicknamed “the Piggle,” who night and day struggles with gusts of psychotic rage and depression following the birth of a hated sister. It is my premise that in the treatment that follows it is not just that Winnicott heals the girl according to the traditional treatment paradigm; it is that in the process they act as change agents for each other. In an imperfect but effective therapeutic endeavor, old man and young child join together to overcome their mutual preoccupation with death and destruction and to set things right in a way that allows the Piggle to rejoin life stronger than ever and permits Winnicott to start to reconcile his remarkably lively life with his impending death. “Piggle” means “pickle.” Ironically, both parties here are in one, and each helps the other out of it.
Through many readings over many years, I have been struck by how much this story resonates with two plays in Sophocles’ Oedipus trilogy. In Oedipus at Colonus, Antigone guides her father, Oedipus, blind and approaching death, to a sacred grove where with her assistance he sheds his remorse and dies a death sanctioned by the gods. Both father and daughter are changed in the process. In Antigone’s case her maturation in courage, altruism, and morality becomes the subject of the final play, Antigone. In parallel fashion to the Sophoclean plays, I am suggesting, the Piggle became Winnicott’s Antigone, instancing a universal feature of therapeutic engagements: change occurs differentially in them, but each party is changed.
Bibliophilia and Transitional Phenomena
When I was seventeen I took Sigmund Freud for my first psychoanalytic lover. Who knew? There were no intellectual bones in my family’s body. At the time I, was stranded in a quixotic but not terribly atypical middle-class home where the family hyperbole never quite matched up with the frustrations and disappointments that littered and marred our floors, like the ever present sand tracked in on bare feet from the surrounding beachfront. I was in academic purgatory, attempting to derrick my decidedly tepid high school record into a realm that would allow me to pass as college material. A good friend, returning for Thanksgiving break from an engineering school of all places, brought great news from his token humanities course: news of Freud and psychoanalysis. I immediately purchased the Modern Library editions of Studies on Hysteria and The Interpretation of Dreams. Vienna never seemed closer to Bayview. Reading those works, I saw myself and my family, alternately grasping for some gold ring and trying to fight through the quicksand of self-defeat and depression. Pushing away in those iffy days from 100 Bayshore Drive with Freud as a guide, I launched my somewhat leaky, barely seaworthy carrack onto the conceptual waters of analysis for what has become a lifelong voyage.
When I was nineteen, I fell in love with Donald Woods Winnicott. I was gobsmacked! He seemed so far beyond Freud. What I encountered in Winnicott’s presence was not a gendered passion but, on the contrary, a genderless one, shimmering on the printed page, stoked by his incandescent psychoanalytic thinking. At one glance he offered me the possibility that my world and my sense of self could be in for radical change, though by what magic of method or mind I could not be sure. At the time I became so captivated by Winnicott I was working at the Yale Child Study Center as Sally Provence’s “bursary boy.” This was my scholarship job. It involved typing up process notes and research meeting summaries, and duplicating papers for Ernst Kris’s pioneering research project on the longitudinal study of first-born children. I read avidly whatever I typed or reproduced, and as I did so my work became much more than a work-study job. It became my informal sixth course. In shaping my shaky identity and pointing me toward psychoanalysis as a career, it was the defining experience of my undergraduate life.
The piece that popped out of the mimeograph machine back then and took my breath away was Winnicott’s “Transitional Objects and Transitional Phenomena” (1951). The paper’s blend of Winnicott’s idiosyncratic psychoanalytic thought about the earliest reaches of the infant/mother matrix and his distinctive poetic voice completely captured me. The work made sense and yet it made no sense to me. Such was its magic. As is the case with most profound loves, it has taken me a lifetime to barely grasp and fleetingly fix in consciousness what this protean paper was all about. It was like a Rosetta stone of the mind in all its developmental possibilities, normal and abnormal. It opened vistas that had been just beyond my consciousness. As all such passions must, mine for Winnicott became tempered over time by a greater appreciation of his humanity and its limits and by the appearance of other analytic mentors. Loewald, with his singular contribution to psychoanalytic developmental theory, “Superego and Time” (1962), followed some ten years later. After that the procession included Kris, Hartmann, Erikson, Sharpe, Klein, Anna Freud, and the Child Study Center troika, Solnit, Ritvo, and Provence, in no particular order.
Perhaps not surprisingly, what stood out for me immediately in Winnicott’s theorizing about transitional objects was the psychic significance of prosaic but cherished childhood objects like blankets and stuffed animals. I thought in particular of my own mundane transitional object, a one-eyed nappy brown teddy bear. He had one sparkling tintype button eye and one metal shell where the left eye had been. My sudden awakening to the bear’s transitional function in the infant’s differentiation from and yet identification with the soothing and nurturing mother carried with it a swell of affirmation. Over the years I came to appreciate that the one eye of my bear was not an isolated fact. I grew up partially blind to the dominant maternal role that my mother’s mother, my Nana, had played in nurturing me in early infancy. She had rescued me from my teenaged mother’s earnest but failed attempts at mothering. At four months I weighed a pound less than I had at birth. From high school student to motherhood turned out to be a nearly impossible stretch. Growing up, I had tended to attribute love to my mother that in fundamental ways didn’t belong to her. It belonged to my Nana, for whom over the years I had deep feelings that I could neither name nor place.
A point that often eludes analytic understanding is that the transitional object is really the first transference object. In part this is because Winnicott was at pains to hew to his own nomenclature and not cross-reference it with analysis proper. The transitional object gains special power and significance from also being the first nonhuman object in the love life of the child. It is ironic that as a vehicle for maturation and as a nonhuman object it paradoxically provides a bridge to an enhanced capacity for human love and stable trusting relationships that resonates in various ways throughout the life span. A passion for cloth leads to an expanded love life mixing psyche and skin. Winnicott tracked the evolution of the transitional object to the depressive position, to a development that I would term object constancy. This sublimation of hatred and hostility is central to the invention of the transitional object. With object constancy, inherent hostility toward the mother becomes internalized and neutralized in the name of love. This event is of significant import in the self-definition of both child and mother. Its crucial ramifications will be seen when I discuss the mutual effects that Winnicott and his young charge Gabrielle had on each other over the course of their consultation.
Winnicott at Colonus
In Sophocles’ Oedipus at Colonus (Roche 1958) it is Oedipus’s daughter Antigone, who, accompanied by her sister Ismene, guides her blind, guilt-stricken father to the sacred grove at Colonus to help ready him for an honorable death as sanctioned by the gods. Ultimately it is Antigone who arranges for her father’s absolution for unconscious acts; the patricide of his father Laius (“He was a stranger I encountered on the road”) and incest with his mother Jocasta (“I had no reason to think she was my relation”). Oedipus, with Antigone as his guide, was able to leave life not subject to a punitive, estranged death but experiencing an affirmative, existential demise replete with anticipatory mourning. It is buoyed by his knowledge of the strength and hope emerging in his daughter Antigone. The outcome is that both Oedipus and Antigone change in stature and morality. Paradoxically, both have become stronger and more human by the bond of love that has been restored and reasserted between them in the sacred grove in the twilight of Oedipus’s life. Antigone will go on to exercise her moral strength and altruism in the final play of Sophocles’ oedipal trilogy, Antigone, where she protests the strictures of Creon and the Theban state and celebrates her loving kinship with her dead brother Polynices by sacrificing her own life. Note: I am using the story of Oedipus throughout in the Sophoclean sense that disastrous things happen to children and parents of sick families. I do not hew to Freud’s misinterpretation of the Oedipus myth: that kids willy-nilly must savage innocent parents on their way to health. My experience leads me to believe that in healthy families, oedipal follies on the part of parent or child are but transient flights of imagination.
The idea that has gradually emerged for me over the last several years—that the Piggle can be considered Winnicott’s Antigone—unlocked a quandary that had dogged me over the forty years that I had been reading and rereading The Piggle. In the past I invariably came away from the experience feeling an aching unease. In rereading the book now, it occurred to me that perhaps because I am at approximately the stage of life (and then some!) that Winnicott was at when he engaged Gabrielle, I have been able to come to a more fundamental understanding of the work that brings me peace of mind and eases my tsouris. The book has received high praise from colleagues and critics for its author’s deft and innovative handling of his two-year-old subject caught in the depressive afterbirth of a sibling’s arrival. I could appreciate moments of brilliance in Winnicott’s vigorous and loving engagement in the “on-demand analysis” of the Piggle. I was particularly taken by his handling of the preambivalent issues of loving and hating having to do with her mother and her baby sister Susan: preambivalent because when Winnicott first meets her, the Piggle is literally and figuratively leading a black-or-white emotional life. There are no grays. She loves or she hates. She lacks the capacity to simultaneously hold both emotions toward her mother or her sister. Psychosis ensues and nightmares and daylight experience become interchangeable. She is beset by psychotic anxiety and depression that can be experienced as originating within her or outside her, in her mother or in Susan. Winnicott attributes her preoccupation with blackness to the body’s insides. I see it as more closely related to the Piggle’s mood. In particular I see it as a function of the disorder caused by her death wishes/fears. This is black unconscious territory, I think, that she shares with Winnicott as his body continually betrays him and death looms ever nearer. I wonder how much he may have decided to make this case the capstone to his legacy as an innovator in analytic development and as a champion of the Middle Group between the rival factions of Melanie Klein and Anna Freud. Perhaps his note-taking during sessions was “autobiographical” in that sense. On the other hand, did his awareness of the technical flaws in this treatment cause him to withhold its publication in his lifetime? For my part, having made him an analytic hero, calling attention to his tattered technique has been a painful and difficult task. Winnicott wrote The Piggle when he was struggling with end-of-life health issues. His influence on the psychoanalytic scene was fading. Just prior to his encounter with Gabrielle he had, after four decades, been eased from his position as head of pediatrics at Paddington Green Children’s Hospital, a painful loss (Kahr 1996). His health was also declining, two major heart attacks having left him hampered by chronic angina. Several years after this case, the reception of his presentation “The Use of an Object” (1969) to the New York Psychoanalytic Society turned into a debacle. His new contribution to object relations theory was harshly criticized by discussants representing the New York psychoanalytic establishment. This was another truly heartbreaking event for him, as it was followed by another near fatal heart attack. The Piggle is a flawed masterpiece. It is awesome and humbling to see the creative work that goes on consciously and unconsciously, despite those criticisms. It points up yet again how forgiving the analytic process can be, particularly in the hands of a master whose genius flows from his unconditional love and uncanny understanding of children. This is even when he seems rushed, to be talking too much, and seems unable to wait for the transference to develop.
DWW’s style with Gabrielle (I will continue to refer to him by his initials) seems mainly that of an analyst oriented to early-twentieth-century id psychology. Often, contrary to his robust emphasis in the text on words and interpretation, the therapeutic action seems to reside more in the context (a young girl in distress is ministered to by a kindly, attentive old man) than in the content of hours. With Winnicott’s obsessionally sexualized attention to the content of The Piggle, interpretation of Gabrielle’s play often seems off the mark, interrupting rather than furthering the flow of information. It also seem at times to overstimulate the girl. As time goes on, Gabrielle seems to be humoring him in her responses to interpretations: mixing up “cot” and “cat” when he seems to be pressing more blatant sexual meanings, not to mention winni-cot or winni-caught! While he attempts to couch his comments about love and procreation in what he thinks is her vernacular, they seem cognitively and developmentally far beyond her. There is a Kleinian adultomorphism about these interpretations. They seem made from the perspective of an adult attempting to peer into the mind of a child, rather than from the child’s more immediate experience. And that is not to mention his often seeming to go beyond the facts of the material. When DWW goes for deep id interpretations, plowing through defenses, he does not heed his own caution that the therapeutic experience for a child needs to be pleasurable (p. 175). He talks about fathers as thieves, men as robbers of mothers’ breasts, and daughters’ wishes to eat penises, when their play suggests more mundane concerns about restoring order and regularity in her family.
There are many intimations of possible family disorder in the play: references to being cross (p. 44), which often in my experience refer directly to ongoing family matters; repetitive preoccupations with order in her lining up trains, trucks, and buildings; and messing and straightening up Winnicott’s play space. All of these may be more experience-near to family issues and her inner state. The implications of play disruptions for transference/countertransference dynamics seem to go unnoticed. Here, again, DWW’s interest in the psychology of procreation seems to outweigh Gabrielle’s and is a major contributor to the disruptions. Other than removing any mysteries about birth and genital anatomy (which Gabrielle seems to already grasp), it is hard to see what dynamic issues of any relevance are being addressed. Disruptions are abundant. I cite here only a few (pp. 9, 26, 28, 156). In a play disruption the analyst’s interpretation may engender anxiety by swamping ego defenses in place to prevent the very insights the analyst is purveying. Disruptions are also occasioned by “far out” interpretations, beyond the relationship and outside the room, creating a failure of empathy. The ensuing panic leads to a break in the play. At such times Gabrielle would often leave the room seeking rapprochement with her father or, at a minimum, open the door to where he was waiting. At one point in an early consultation Gabrielle seems put out at having been kept waiting, but Winnicott delves into the Kleinian depths rather than addressing her obvious pique. Toward the end of the consultation she protests an interpretation by fumbling with her cardigan, which for me conveys the sense that transitional phenomena are at work. These symptomatic transferential acts go unnoticed, replaced as they are by id psychological by-the-book comments. I was surprised that there are so few indications that he knew about or used ego psychology or defense analysis in his work with her. Gabrielle is nonetheless rescued from her anaclitic depression by Winnicott. She gets back on the developmental track to autonomy and health. This is a track that was littered throughout the sixteen-session consultation with numerous unexplored references to trains and train travel.
The report highlights one of the challenges of working in the action medium of play: how often in a session with a child (or an adult for that matter) we are at sea; how much of the material is obscure; how many “obvious” cues we miss in the moment; how meager and often iffy is the meaning we are able to extract from the dross of words and play. Winnicott showed an overreliance on information from secondary sources, the parents and particularly the mother’s notes. I wonder, too, how much the mother was the indirect beneficiary of her daughter’s treatment. My impression is that using this second-hand information was distracting and detrimental to the here-and-now of the play process. Perhaps Winnicott was just following the technical precepts of the time for engaging a family. Perhaps he was attempting a hybrid treatment, mixing the model of Little Hans’s treatment (by way of the parents) with his on-demand analysis of Gabrielle. Perhaps I am responding too much from the perspective of how technique has evolved over the last forty years. In any event, I think that most clinicians involved in intensive work today would stress the need to stick with the here-and-now of the play, while interpreting outside the play when possible. Nevertheless, throughout the consultation Gabrielle shows signs of recovering from the narcissistic blow of her sister’s birth and coming back to life, resolving her black, shitty, murderous depression. In the process, she establishes a sturdy depressive position while using DWW’s persona and play space as malleable but indestructible transitional phenomena.
There are two overlapping stories here. Both DWW and Gabrielle seem to have experienced a beneficial change by the end of their therapeutic contact. In the first, most obvious story we have the tale of a depressed, angry, and distraught Piggle, terrorized by a ragged psychosis with a sleep disturbance, a black mummy, and an ill-defined “babacar.” “Dr. Winnicott” rescues her from her mixture of precocious expressivity and psychotic depression. In the end, she emerges, healthy and self-possessed, as Gabrielle.
The second story has to do with Winnicott’s preparing for his death. There have been fleeting references to his sleepiness, his difficulty capturing the process in the notes he took during sessions, and in remarks about the heat. These seem to be veiled references to his failing health. It is during the last third of the consultation that the Piggle clearly morphs into Gabrielle and becomes Winnicott’s Antigone. And so, more and more, DWW and Gabrielle function as agents of change for each other. It is Winnicott, after all, who in the tenth consultation introduces his “death day” (p. 124). While from the beginning death has been in the minds of both, this seems to be a countertransferential stretch from the preceding material. True, it is the Piggle who in the fifth consultation asks how old DWW is. Children and grownups usually do this only when something about the habitus of the analyst draws attention to the issue of age. Gabrielle’s focus when she asks the questions seems to be on “growing up,” an increasing emphasis in her resolving struggle with regression, and by implication DWW’s “growing down.”
There is a telltale gap of a number of months between the tenth and eleventh sessions when Winnicott is unable to see the Piggle on demand, as per the treatment contract. No explanation is given, but I would speculate that the delay was occasioned by cardiac issues of the sort that led to his death. Throughout the consultation Gabrielle shifts between “Dr. Winnicott” and “Winnicott” in addressing him. In her prescient childish manner, it seems that when he is the doctor she sees him projectively as both healer and the family’s guru. When he is just plain Winnicott or Mr. Winnicott, he is a person, new object, and friend. When she returns for her eleventh consultation an integration has occurred. Gabrielle is healed, self-possessed, clearly in charge, and well on her way to resolving her difficulties. In the second consultation there is a passing reference to the blue Optrex Eye Wash lens. This instrument for tired, inflamed eyes (no doubt used by Dr. Winnicott) makes for a very interesting play prop. Now, in the eleventh consultation, the lens plays a major role. Gabrielle gazes through the cobalt blue eye cup and sees a blue Winnicott. The man, not the doctor. He is anxious, depressed, “blue,” with blue jacket, blue hair, more resigned to his mortality. This is one of the only times that Gabrielle comments directly on his appearance. She tells DWW she just wants him to listen. She announces a new stage in her relations with her sister Susan. Over the course of the session a tension develops between Gabrielle’s attempts at expression and DWW’s need to prematurely enforce meaning. He does it, in his usual style, within the play rather than finding a way to comment on the latent play meanings from the outside.
Over the last five sessions there is a consolidating sense that the Piggle has become Gabrielle, and in making that transformation she further becomes the personification of DWW’s life redemption. Her needs have been met, and the task is now, as it has been at some latent level throughout the contact, to shore up DWW’s sense of his place in the analytic pantheon. In the course of the consultation he “rediscovers” in Gabrielle most of his original concepts and affirms them in the course of the treatment. Theoretically, any given session of any given treatment is open to new interpretations and new discoveries, but here DWW is content with finding confirmation of his theoretical discoveries in the material. In the sixteenth and last session, he notes the difference in Gabrielle’s attitude. She is friendly. She is done. Even before that, in the sixth consultation, when he talks of making babies (p. 77) Gabrielle talks about making friends. Friendship is as warm as love usually gets at her age with someone who is not a parent. She orders the toys in the play space. He interprets her love for him, a love that is cloaked in shyness. I think it would have been even better had DWW at that point acknowledged his love for her, his angel. Here he is a childless man with a great gift for understanding and connecting with children. He is able to do that through his love for them. This is a love that at such an early age Gabrielle may be able to more mutedly reciprocate but not be able to express in words. So “daughter” Gabrielle unconsciously becomes a vehicle for solace, resolution, and confirmation of DWW’s place in the psychoanalytic world, even as she eases the way, now his Antigone, with all her transitional characteristics of hope, love, and indomitable spirit, for DWW to prepare for a quiet exit from this world. Winnicott’s rescue of Gabrielle from the netherworld of depression seems simultaneously to lift his “blue” depression (as she sees it through the Optrex lens) and bring a measure of acceptance of the end that awaits us all. Both in their way have recovered from separation, loss, and death—loss as Gabrielle’s theme and DWW’s being his impending death. At the end they play at killing each other. But the morbidity of the topic has been drained away for both of them. Gabrielle ends by presenting DWW with two great gifts. Up to this point she has dramatized her “bryyyyyh” bad dreams, but now she brings in a full dream report in which DWW joins her and her family, including parents and grandparents, in a swimming pool. All the train travel, all the distance between Oxford and London, has been condensed. In the dream DWW has become part of the family: a grandparent or godfather perhaps! What a sweet synthesis on Gabrielle’s part. The second gift is her making of their kite—a connection when they are apart and also an allusion to her old friend’s appointment in some not too distant Samara. In the unconscious of both she becomes the angel of death, helping to prepare him to shed his mortal coil. Paradoxically, as Gabrielle progresses she needs him less as an object (an omniscient doctor, healer) and sees him more as a new object, mostly stripped of fantasied projections, possessing the transcendent qualities of kindness, durability, and passionate curiosity. Someone she can now leave to his fate while she skips on with her life.
There is something developmentally universal about the concept of an Antigone. It springs from the earlier invention of the transitional object. Winnicott, in “The Use of an Object” (1969), almost in passing makes the connection between the transitional object and the analyst as an object of transference. The transitional object as the first transference object prepares the child to deal with the harsh realities of loss and the unknowns that life will bring. At the end of life Antigones help the dying to accept their finitude and ready themselves for the journey into a timeless unknown. They facilitate, as the original Antigone did, anticipatory mourning. As the end of life nears, assuming it does not end abruptly and without warning, everyone should have an Antigone, or a chorus of Antigones. As with the transitional object, gender is irrelevant and the dynamics are usually unconscious. Freud had one in his daughter Anna. Max Schur, his personal physician, may also have overlapped in this function. Hospice care takes Antigone to an institutional level, as do many contemporary extended care facilities.
I was a neophyte Antigone at four, bringing tea, water, and cookies to my beloved aunt Corrine as she was dying of cancer in her bedroom beneath the eaves of my grandparent’s house. I lifted and realigned her flagging spirits, and she mine, as she slipped away from a world that lacked a loving place for her. While she was able, she read to me, reinforcing the beneficial and transitional qualities of the printed page for tempering loss with the magic of imagination and the time travel of history and memory. Reading has always been a daily grace note to my life, whatever crises may be churning around me. There is a line that would take too long here to trace that goes from the original transference love of the transitional object up through human object love by way of sublimation to altruism. Hope, wisdom, and wonder are transitional properties that operate at the end of life, and even earlier, on both sides of the therapeutic divide. Just as Gabrielle and Winnicott are both changed by their encounter, so analyst and analysand are subject to change. Loewald and Winnicott provide complementary models of how mother and infant shape their earliest developmental matrix, each a subject to the other’s object. An implication of these models that we repeatedly rediscover is that if we are open to the impact of a treatment, whether or not it seems valid, we will see that both parties evolve. This may occur at different rates and to different degrees, but the vector of change is usually in the direction of adaptation and altruism. Along the way the properties and function of the muse are spun off —the muse being the embodiment of the creative energies countering our destructive tendencies, bundling equanimity and passion into our search for beauty or a heightened reordering of our experience. Altruism is the first cousin of Antigone: the capacity to maintain ideals and morality in the face of, and beyond, mortality. Antigone ultimately sacrifices her life for principles of a higher morality. We hope for the wisdom and humility to stretch beyond the self and accept our place in an ongoing vast unconscious and unknowable evolutionary drama. Winnicott gave the Piggle life. In the end, Gabrielle, as his Antigone, partnered with him in fashioning not just a kite to fly in the blue sky above his blue Optrex-enhanced depressed mood, but a transitional vessel at the ready for his upcoming voyage into the great next.
