Human Nature

D. W. Winnicott

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317772279
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

First published in 1990. The ideas of Donald Winnicott are scattered through numerous clinical papers and short, popular expositions. He made only one attempt to write and overview of his ideas, and this is it. It remained unfinished at his death in 1971. It is an ambitious work. The chapters offer his perspective on most of the main issues in psychoanalytic theory - for example, psychosomatics; the Oedipus complex; infantile sexuality; the unconscious; the depressive position; manic defence; transitional objects; aggression. Winnicott has here made a major synthetic effort, one which is regarded as the best of his posthumous works. D. W. Winnicott can be said to be the most influential native-born British psychoanalyst and - with Klein and Fairbairn - the founder of the object relations perspective. His writings are among the most moving and evocative int he whole literature of psychoanalysis.

PART I

The Human Child Examined: Soma, Psyche, Mind

Introduction

I HAVE CHOSEN to look at human nature through a study of the child. Although in health the adult continues to grow, develop and change right up to the moment of death, there is a pattern already to be discerned in the child which will persist, just as the face remains recognisable throughout the life of the individual.

But, where is the child to be found?

• The child’s body belongs to the paediatrician.
• The soul belongs to the minister of religion.
• The psyche belongs to the dynamic psychologist.
• The intellect belongs to the psychologist.
• The mind belongs to the philosopher.
• Psychiatry claims mental disorder.
• Heredity belongs to the geneticist.
• Ecology claims an interest in the social milieu.
• Social science studies the family setting and its relation to society as well as to the child.
• Economics examines the strains and stresses due to conflicting needs.
• The law steps in to regularise and humanise public revenge on account of antisocial behaviour.

In contrast with the multiplicity of these various claims the individual human animal provides a unit and a central theme, and it is necessary for us to try to gather together in one complex statement the comments that can be made from the many vantage points.

There is no need to adopt one method and one method alone for the description of human beings. Rather it is profitable to become familiar with the use of each and every known method of approach.

In choosing a developmental approach to the study of human nature as the one that can focus the various points of view, I shall hope to make clear [how] first from a primary merging of the individual with the environment comes an emergence, the individual staking a claim, becoming able to be in a world that is disclaimed; then the strengthening of the self as an entity, a continuity of being, as a place where, and where from the self as a unit, as something body-bound and dependent on physical care [emerges]; then the dawning awareness (and awareness implies the existence of mind) of dependence, and awareness of the mother’s dependability and of her love, which comes through to the infant as physical care and close adaptation to need; then the personal acceptance of functions and of instincts with their climax, of the gradual recognition of mother as another human being, and along with this a change from ruthlessness to concern; then a recognition of the third party, and of love complicated by hate, and of emotional conflict; the whole of this being enriched by the imaginative elaboration of every function, and the growth of the psyche along with that of the body; also the specialisation of intellectual capacity, dependent on the quality of brain endowment; and again along with all this the gradual development of independence of environmental factors, leading eventually to socialisation.

It would be possible to start at the beginning and to work gradually forwards, but this would mean starting with the obscure and unknown and only later reaching to that which is common knowledge. This study of development will start with the child of 4 and will work backwards, reaching at long last the individual’s beginning.

Let me say a word about physical health. Health of body implies physical functioning appropriate to the age of the child, and the absence of disease. The assessment and measurement of bodily health is a task that the paediatrician assumes, that is to say, bodily health in so far as body functioning is not disturbed by emotion, by emotional conflict, and by the avoidance of painful emotion.

From conception to puberty there is a steady and continuous growth and development of function, and no one thinks of judging the physical development of a child except according to the child’s age.

Assuming satisfactory child care there can be said to be a standard rate of development. Charts are always being worked out for measurement. We can use the data collected and sorted out, being ready, however, to allow for wide individual variations within the health concept.

Paediatrics was established chiefly on the study of physical diseases peculiar to childhood, with health as an absence of disease. Not long ago rickets was common, as well as many other disorders due to faulty feeding; pneumonia was a constant problem and frequently led to empyaema, now hardly ever seen in a London hospital; congenital syphilis was frequently diagnosed in a children’s clinic and was not easy to treat; acute bone infections had to be dealt with by drastic surgical operation and painful after-care. But in thirty years the whole picture has changed.

A hundred years ago there was an even worse state of affairs, an almost complete muddle as to diagnosis and causation, and the first job of the older generation of paediatricians was the sorting out of disease entities. In those days there was not much time or place for the consideration of health as such, nor for the study of the difficulties that beset the physically healthy child through the fact of growing up in a society that is composed of human beings.

Now, because of the advance in diagnosis and treatment of bodily disorder, we find doctors who are fully equipped to deal with bodily ailments also looking at the ways in which body functioning is disturbed by such things as anxiety, and by faulty home management.^*

A new generation of medical students is demanding instruction in psychology. Where shall they turn? Paediatric teachers themselves may have no understanding of psychology. There is in my opinion a real danger lest the more superficial aspects of child psychology be over-stressed. Either the external factor or heredity is blamed for everything. Psychiatric disease entities are collected and described in a clear-cut fashion that is false; tests of attainment or of personality are unduly reverenced; a child’s happy appearance is too easily accepted as a sign of healthy emotional development.

What has the psycho-analyst to offer? He offers no easy solution, but instead he confronts the young paediatrician, already about thirty years old and a married man with a family, with a new subject at least as big as physiology. Moreover he says that to reach a position in child psychiatry comparable to his high standing in physical paediatrics the paediatrician must undergo a personal analysis as well as a special training.

This is hard, but there is no way round and there never will be. The paediatrician hesitates at such a hazard, and prefers to stick to physical paediatrics even if he must go far afield to find enough physical disease to cure and to prevent. But the time is coming when no further expansion of physical paediatrics will be needed in this country, and an increasing number of young paediatricians will be forced into child psychiatry. I long for this day, and have longed for it throughout three decades. But the danger is that the painful side of the new development will be avoided, and an attempt will be made to find a way round; theories will be reformulated, implying that psychiatric disorder is a product not of emotional conflict but of heredity, constitution, endocrine imbalance, and crude mismanagement. But the fact is that life itself is difficult, and psychology concerns itself with the inherent problems of individual development and of the socialisation process; moreover in childhood psychology we must meet the struggles that we ourselves have been through, though for the most part we have forgotten these struggles or have never been conscious of them.

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* I would like to mention Guthrie, author of Functional Nervous Disorders in Childhood (1907), not because he reached to great heights but because he was a pioneer to whom I owe the special climate at the Paddington Green Children’s Hospital which made my appointment there in 1923 possible. After Guthrie’s tragic death I was to carry on the work of his department, and I was not aware at the time that it was because of my own leanings towards the psychological in paediatrics that I was appointed to the consulting staff of the hospital.

CHAPTER 1

The Psyche-Soma and the Mind

A HUMAN BEING is a time-sample of human nature. The whole person is physical if viewed from one angle, psychological if viewed from another. There are the soma and the psyche. There is also a developing complexity of inter-relationship between the two, and an organisation of this relationship coming from that which we call the mind. Intellectual functioning, like the psyche, has as its somatic basis certain parts of the brain.

As watchers of human nature we can discern body, psyche and mental functioning.

We will not fall into the trap laid for us by the common usage of the terms “mental” and “physical”. These terms are not descriptive of opposed phenomena. It is the soma and the psyche that are opposed. The mind is of an order special to itself, and must be considered as a special case of the functioning of the psyche-soma.^*

It is necessary to note the fact that it is possible to look at human nature in the three ways indicated, and to study the causes of the division of interest. It will be especially interesting to enquire into the very early stages of psyche-soma dichotomy in the infant, and the beginnings of mental activity.

Somatic Health

Bodily health implies good enough heredity and good enough nurture. The body in health is functioning at the correct age level. Accidents and environmental failures are being dealt with, so that in time their ill-effect will be erased. Development goes on with the passage of time, and gradually the infant becomes the man or the woman, not too early, not too late. Middle age arrives in due course, with new appropriate changes, and eventually old age curbs the various functions till natural death follows as the final seal of health.

Psyche Health

In a similar way, health of the psyche is to be assessed in terms of emotional growth, and is a matter of maturity. The healthy human being is emotionally mature according to the age at the moment. Maturity gradually involves the individual in responsibility for environment.

Just as physical maturity is an extremely complex matter if one takes into account the whole of physiology (for instance, the biochemistry of muscle-tone) so is emotional maturity complex. It will be the main aim of this book gradually to indicate the ways in which emotional development has been found to be complex, yet capable of being investigated by scientific method.

Intellect and Health

Intellectual development is not comparable with that of psyche and soma. There is no meaning to the term intellectual health.

The intellect like the psyche is dependent on the functioning of one special bodily organ, the brain (or certain parts of the brain). The basis for intellect is therefore the quality of the brain, but the intellect can only be described in terms of plus or minus unless the brain is deformed or distorted by physical illness. Developmentally the intellect itself cannot be ill, though it can be exploited by an ill psyche. The psyche, by contrast, can be ill itself, that is to say distorted by emotional developmental failures, in spite of a healthy brain basis for its functioning. The part of the brain on which the intellectual capacity depends is much more variable than that on which the psyche depends, being also a later arrival in racial evolution. Heredity and chance provide a brain that is below or above average in capacity for functioning, or chance or disease or accident (as for instance damage sustained during the birth process) provide a brain that is deficient or damaged; or an infective process during childhood (meningitis, encephalitis) or a tumour cause patchy residual interferences with brain functioning; or in the treatment (so-called) of mental disorder the neuro-surgeon deliberately cuts the brain about in order to disturb strongly organised defences against madness, defences that themselves constitute a painful clinical state. In any of these ways the intellect is affected or the mental processes are modified, although the body (apart from the brain) may remain healthy. In all cases, however, the health or ill-health of the psyche needs to be assessed. At one extreme a child with an intelligence quotient of 80 may be healthy in body, and may also show healthy emotional development - becoming indeed a valuable and interesting person, of good character and of reliable disposition, even capable of becoming a good marriage partner and parent. At the other extreme, a child of exceptional intellect (I.Q. 140 plus) though possibly talented and valuable, may, if the emotional development is disordered, be extremely ill, liable to psychotic breakdown, unreliable in character, and quite unlikely eventually to become a citizen with a home of his or her own.

It is now well known that in relatively healthy children the intelligence quotient, worked out as it is with exact allowance for chronological age, remains more or less constant. This is only another way of stating the fact that intellect depends fundamentally on brain tissue endowment. A description of the ways in which the I.Q. does not remain constant is no more than an enumeration of the ways in which there is a distortion of use of intellect, this distortion due on the one hand to disturbances of the emotional development and on the other to supervening brain tissue disease.

In any group of defective children there may be a few whose brain would allow for average or even superior ability, and for whom the correct diagnosis is childhood psychosis. The mental defect is then a symptom of early disturbance of emotional growth. This type of defect is not uncommon.

By contrast, the clinician meets with the child whose intellect is anxiety-driven and overworked, again as a result of emotional disorder (threat of confusion) and whose I.Q., which is high on test, comes down on the scale when, as a result of psycho-therapy or o...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Preface
• Editorial Note
• Acknowledgement
• Introduction
• Part I The Human Child Examined: Soma, Psyche, Mind
• II The Emotional Development of the Human Being
• III Establishment of Unit Status
• IV From Instinct Theory to EGO Theory
• Synopsis I
• Synopsis II
• Bibliography
• Index