On Behalf of the Child: Winnicott’s Work During the War Years

Volume 2 of Winnicott’s Collected Works consists of material written between 1939 and 1945. Included are eleven letters to medical journals (British Medical Journal and The Lancet), three personal letters (to Roger North, Kate Friedlander, and Marjorie Frianklin), forty-two published papers of varying length—some intended for professional audiences and others for parents. Winnicott addresses a multiplicity of questions related to child rearing, some reflecting dynamic and “reality” issues and others focused on the psychological impact of external interventions on the child. Among his concerns are the effects of wartime evacuations; delinquency and (more generally) aggression; play; nursing; the risks of medical/surgical procedures and policies; infant feeding; homelessness; twinship; corporal punishment; and breast feeding. Also included are three book reviews, a report on the Q Camp for delinquents at Hawkspur Green, and the transcript of an oral report to the Home Office committee on children’s homes.

There is a striking difference in tone between Winnicott’s published professional papers and many of the letters and short statements in this volume. Winnicott’s papers, while at times declarative, typically have a transitional, playful quality. The implications of his ideas are rarely articulated at length; instead, readers are invited into a reflective space where what he says can be interpreted, revised, or ignored when it is unclear or jarring. There is room for us to play creatively with the clinical and theoretical meanings and implications of the positions he takes.

The letters, by contrast, are far less playful; Winnicott’s intent is more urgent, his tone quite definitive. He was, after all, trying to persuade—whether the Home Office, psychiatrists, social workers, other professionals, or the general public (parents in particular). While the specifics of his agenda vary from letter to letter, this volume, and indeed nearly all of Winnicott’s work on children, might be viewed as a passionate plea on their behalf. Winnicott urgently wanted the recipients of these missives to recognize childrens’ developmental capacities, as well as their vulnerabilities.

The volume provokes a range of reactions in me and will, I suspect, have this effect on other readers. Winnicott’s direct engagement with issues related to the war in general, and its impact on children in particular, was fascinating and somewhat new, although the positions he takes are mainly consistent with the Winnicott I know. Those familiar with Winnicott’s work may feel a sense of pleasurable recognition in discovering “their” Winnicott despite the fact that some essays focus on unfamiliar issues. There is delight to be found, for example, in Winnicott’s willingness to go out on a limb and advocate for the child (and for the parents) even when that advocacy collided with social policy. Yet there were also moments when I felt (as you may feel) a bit impatient—both with the thematic repetition across papers, and with the dated quality of some of the positions he takes (e.g., the short shrift given the father).

Winnicott began his medical career before the field of pediatrics had developed. To assert that infants have an emotional life requiring attention, that they are capable of developing psychologically based symptoms, was groundbreaking. As Dodi Goldman (1993, 2017) notes, Winnicott never felt like a “proper doctor”; he obtained his license from the Royal Academy of Physicians at a time when a medical degree was not required to practice. In this environment, Winnicott pursued his own course and became a “children’s doctor.” Notably, he was the first male practitioner ever to qualify as a child analyst.

Across a range of issues (both those raised by the war and others reflecting accepted medical and social practices at the time), Winnicott consistently emphasized the child’s naturally integrative processes. He also underscored the significant negative impact of a nonfacilitating environment on the child (and sometimes on the mother-child dyad). Winnicott consistently reminds the reader that developmental processes should be allowed to take shape free of external impingements and the intrusion of medical, social, or political policies.

It is worth noting that alongside Winnicott’s sensitivity to the damaging effects of environmental intervention lies a consistent emphasis on the child’s resilience. Winnicott held a deep conviction about the latter; he argues both against pathologizing the child and for the child’s capacity for what today we would call self-regulation. Winnicott’s broad definition of what is normal leaves plenty of room for both individual differences and vulnerabilities outside the realm of rigid sociocultural norms.

Winnicott was, of course, acutely aware of the psychological consequences of the war on those he treated (and on British society in general). The damaging impact of maternal separation figures large as a significant interference with the small child’s maturational processes. Winnicott goes so far as to ask whether the psychiatric risk of maternal separation might outweigh the physical dangers of keeping children in London during the Blitz. As Christopher Reeves notes in his excellent introduction to this volume, however, Winnicott was careful not to outright condemn the evacuations. His role as a public servant made him reluctant to explicitly criticize domestic policies.

I found it quite painful to read this material today; so many governments (the U.S. being particularly guilty) have escalated their callous indifference—indeed, sadism—toward immigrant and asylum seeking families forced to separate, often without hope of reunification. Neither the child’s nor the parents’ needs are taken into account when children are aggressively removed from the care of their parents, sometimes temporarily and sometimes forever. I can imagine Winnicott’s outrage and persistent attempts to influence public policy as it affects these children. Alas, I am quite certain that he would fail. In the years since Winnicott took up these issues, we have, if anything, become more complacent and less committed to protecting the needs of those most vulnerable.

That Winnicott would speak on behalf of the child and underscore the need for a consistent maternal holding environment is unsurprising. In line with his view of the “ordinary devoted mother,” Winnicott has a rather idealized view both of the mother and her capacity to sensitively respond to her baby’s needs (see, e.g., “Getting to Know Your Baby” [pp. 221–225]). Notable, and indeed groundbreaking then—and even now—is Winnicott’s recognition of the bidirectional nature of this attachment. It’s not only the child who suffers from separation; the mother herself needs to sustain contact with her child and suffers when deprived of it.

In an extraordinary break with the psychoanalytic tendency to view the mother as a potentially pathogenic object whose subjectivity, if recognized at all, is often damaging, Winnicott takes a distinctly empathic position toward her. The mother will herself feel pain if separated from her child, whether the separation is her decision or not. Winnicott anticipated the relational turn in his emphasis on this mutuality. Child and mother both suffer during periods of separation.

In a remarkable essay titled “The Deprived Mother” Winnicott describes the plight of mothers separated from their children during the Blitz:

the opinion has been expressed that mothers are having such a good time, being free to flirt, to get up late, to go to the cinema or to go to work and earn good money, that they will certainly not want to have their children with them again. . . . it is a well-known human characteristic to become flippant under threat of a grief that cannot be tolerated [pp. 35–36].

Winnicott both emphasizes and normalizes many emotional aspects here—mothers’ sense of relief, loss, anxiety, and envy (of the foster mother who now “has” her child). Winnicott’s mother, then, exists as a subject, herself vulnerable to a range of feelings. It’s worth noting that while he sometimes replaces the word “mother” with “parents” or “mother and father,” his concern was predominantly with the mother. Fathers figure far more marginally in this volume (with the exception of the short piece “What about Father?” [pp. 271–275]).

Winnicott’s commitment to child advocacy led him to take up a range of issues that went well beyond the traumatic impact of parental separation. He argues forcefully against shock therapy (a view expressed many times in this volume) and circumcision (though he does recognize that it may be allowed for religious reasons). Frontal lobotomies horrified him because of their damaging psychological impact. Indeed, imposing anything—even a possible “cure” from the outside in—runs the risk of obliterating the child’s personal sense of aliveness.

Many of the issues that Winnicott addressed have not disappeared; instead, they have taken new shapes, while remaining essentially the same. Governments seem largely indifferent to or unaware of the psychological impact of social policy and existential reality on the child. We are perhaps too caught up in the current pandemic to fully assess its potentially damaging psychological impact on the child. We’re worried about life-and-death matters, about keeping our kids (and ourselves) alive We have been forced to dramatically interrupt the child’s “normal” developmental processes in ways that may well have long-term consequences for at least some children (and their parents). I’m sure that Winnicott would have had quite a bit to say about the impact on the child of remaining quarantined at home, deprived of school, playmates, and free physicality. And about the mother who cannot meet her child’s social and emotional needs both because she is quarantined and because she herself is often trying to manage more than is possible (work, childcare, home life).

It’s too soon for us to assess the impact of all this on us, no matter on our children. But there will be an impact. I think with horror of a brief video taken of a physician as he returned home, still dressed in scrubs, from the hospital during the pandemic. His toddler ran to hug him, and he, worried about potential transmission, stopped the toddler with a loud “no.” The child stopped, bewildered, and the physician father sank to the ground, weeping.

Winnicott argued that it was more emotionally damaging for children to be separated from their parents than to remain with them in London during the Blitz. Might he argue today that children should be allowed to go to school, socialize, and hug their potentially infected parents despite the medical risks, on the grounds that the psychological damage being done outweighs the physical risk? I’m not sure I would agree, but it’s a position that deserves consideration.

As Reeves notes in his introduction, early signs of Winnicott’s gradual pushback against Klein—and his attempt to distinguish himself from her—can be found in this volume. Reeves suggests that these signs “tend to manifest themselves in the topics he chose to write about and the way he addressed them, rather than in anything openly stated in contradiction to her teachings” (p. 10).

Alongside many wonderful pieces (short and long) in the volume, there are a few surprising—and disturbing—essays to be found. They address the role of corporal punishment in institutional (hostel) settings, a practice called “birching” in the U.K. That Winnicott not only did not condemn but seemed to support this practice is quite jarring. Reeves suggests that Winnicott’s position reflected his wish to empower those in charge of children (e.g., hostel staff) along with concern about “administrative oversight operating as impingement” (p. 18).

Perhaps. But I find Winnicott’s acceptance of the practice quite disturbing. Yes, in part it reflected that time and place (the early 1940s in Britain); but, still, Winnicott’s advocacy of “birching” seems at odds with the essence of his belief system. Corporal punishment is, above all, an environmental impingement—often a traumatic, violent one. While hitting acting-out children may have allowed those in charge to manage their jobs and feelings, I remain perplexed at Winnicott’s failure to acknowledge its potentially traumatic effect on the child. ¹

There are two important theoretical papers in this volume. One, “Primitive Emotional Development” (1945), is widely discussed, and Reeves’s introduction elaborates on its implications. The other is the 1941 essay “The Observation of Infants in a Set Situation” (pp. 121–139). It is in part, as Reeves notes, an oblique commentary on (and critique of) the Kleinian position. But it is also, in my view, a very early and important statement of Winnicott’s clinical weltanschauung.

In the “set situation” paper, Winnicott describes a quasi-experimental paradigm that introduces the baby to a shiny spatula (what Americans call a metal tongue depressor). He then observes and theorizes the baby’s response to it and to both mother and the stranger (who was Winnicott).

He delineates a three-phase process. After a period of hesitation during which the baby eyes the spatula but doesn’t dare take it, the baby takes a chance. Tentatively picking it up, the baby mouths and cautiously plays with it. As the mother and Winnicott watch but don’t interfere, the baby’s hesitancy falls away and the baby appropriates the spatula with increasing pleasure and abandon. Eventually the spatula is dropped, perhaps accidentally. But a new game then ensues as the spatula is picked up and returned to the baby, only to be deliberately tossed aside again and again. The game continues as the baby flings the spatula away with increasing gusto, until eventually he or she loses interest in the spatula altogether and throws it determinedly away.

Winnicott has many interesting things to say in this paper about babies, development, and unconscious fantasy. In my view, however, most important is that the paper implicitly presents a new clinical paradigm. A careful reading of the paper reveals what will become, decades later, the essence of Winnicott’s clinical position: the therapeutic element does not lie in what the analyst (or mother) does with or for the patient (baby). What is mutative is instead the creation of an opportunity for the baby (or patient) to live through “the full course of an experience” (p. 135) in the presence of a benign and facilitative other.

Like the set situation, the consulting room is constant: the patient arrives and leaves at a predictable hour; the analyst is present and available to the patient, who is allowed to initiate the conversation (pick up the spatula) in his or her own way and time. This perspective on analytic process stands in sharp contrast to one organized around the powerful effect of interpretation—of analyst as actor. In Winnicott’s view, the analyst is more a facilitating environment than an instigator of insight. Therapeutic action lodges most essentially in the patient’s developing capacity to access and articulate from within. This shift is dependent on the analyst’s capacity to remain an emotionally receptive presence.

This dramatic clinical and theoretical shift goes beyond the structure of the treatment setup and to the heart of Winnicott’s reformulation of the analytic position and the nature of therapeutic action. In metaphoric terms, Winnicott’s spatula represents an interpretation, both tantalizing and threatening. Interpretations originate “outside” the patient and yet must also be created by the patient. The analyst should not deliver them with certainty but instead should offer them tentatively and playfully, as their use and symbolic meaning can be formulated only by the patient. This is, of course, in part a rebuke of the Kleinian model. ²

Winnicott is suggesting that it is developmentally (and analytically) appropriate for the baby/patient to hesitate before appropriating the object/interpretation. There is in analytic process something akin to the baby’s anxious pause before taking the spatula (stage of hesitation)—namely, the patient’s perhaps anxious reluctance to wholeheartedly embrace an interpretation. For Winnicott this hesitancy does not represent a resistance to be interpreted or overridden, but is instead a normal part of analytic process that must be allowed to develop and shift in its own way and time. Therapeutic action will lie in the patient’s capacity to live through and then move beyond the period of hesitation toward an ability to play with, make over, even reject (throw away) the analyst’s interpretive offerings.

Winnicott’s analytic paradigm, then, is organized around the establishment of a protected space within which the patient’s process is allowed to unfold with minimal disruption or interruption. It embodies enormous respect for the patient’s capacity to sort out what is useful from what is not and to encompass the former in his or her own way and time. This idea was to become the core of Winnicott’s clinical stance.

Inserted in the “set situation” paper is a whole paragraph in parentheses, as if no more than an aside. It underscores Winnicott’s reluctance to take an authoritative analytic position. It’s also a not-so-veiled rebuke of Klein:

I have frequently made the experiment of trying to get the spatula to the infant’s mouth during the stage of hesitation. Whether the hesitation corresponds to my normal or differs from it in degree or quality, I find that it is impossible during this stage to get the spatula to the child’s mouth apart from the exercise of brute strength. In certain cases where the condition is acute any effort on my part that results in the spatula being moved towards the child produces screaming, mental distress or actual colic [p. 123].

A forceful interpretive style forecloses the possibility of analytic play—that is, of shared creative exploration of dynamic meaning. It establishes a narrowed, “tilted” view of the analytic relationship that limits the possibility of mutual engagement around the patient’s experience. Indeed, this early paper contains the seeds of a statement that Winnicott was not to fully make until 1969:

It appals me to think how much deep change I have prevented or delayed in patients in a certain classification category by my personal need to interpret. If only we can wait, the patient arrives at understanding creatively and with immense joy . . . [1969, p. 86].

Overall, then, I find this volume to be at once rich, a bit repetitious, and at times rather troubling. It gives us a first-hand glimpse of Winnicott’s response to—and attempt to influence—domestic policy in tandem with his developing capacity to assert his own position and differentiate himself from Klein. Many of his essays are an impassioned plea on behalf of the child’s needs and for a minimum of environmental intrusion by physicians and others. How I wish that we had his voice with us today—a voice that would forcefully push back against public policy (in the U.S. and elsewhere) and its appalling indifference to the child’s needs. Indeed, I might best summarize the volume by invoking the title of Winnicott’s second book—The Maturational Processes and the Facilitating Environment. A shadow was cast when I encountered essays that disrupted a Winnicott who was “mine,” most particularly when he abandoned the child in support of the institutional use of “birching.” But that makes Winnicott quintessentially human, doesn’t it?