Brazilian Society of Winnicottian Psychoanalysis (SBPW)
International Winnicott Association (IWA)
Jiandanxinli Uni

Winnicott’s Wheel of Life: Introduction to a revolutionary program  for treating mental health disorders

December 12th, 2019 to February 27th, 2020

GENERAL INTRODUCTION

This course is an introduction to one of most significant recent developments for the treatment of mental disorders, one rich in possibilities for new research and applications. This development is based on the contributions of D.W. Winnicott, the British pediatrician, psychiatrist, psychoanalyst and social worker who created a new independent revolutionary program in the various fields of mental health care he was active in as a clinician: pediatrics, child psychiatry, psychoanalysis and social work. Winnicott’s engagement in the this wide-ranging revolutionary research was motivated by two things he had gleaned from his patients: 1) the disorders he was treating in these fields had in common that they were all related to interruptions of the maturational processes of individual human beings which are due to disturbances in the relationships with other human beings, i.e., with the human environment, and 2) traditional research and treatment programs were ineffective in helping individuals with such kind of troubles. The program that Winnicott thought up was based on the results of his research on the three following points: 1) what happens in human development, and how, in each stage of human life as the wheel of life turns from conception to death, 2) what may go wrong, and how, in growth and development, and 3) what can be done about it and how to provide for the needs of individuals who have suffered a maturational breakdown. This course will address these points in an orderly and articulated fashion, based on the Dias-Loparic interpretation of Winnicott, offering professionals in the fields of mental health care mentioned above – as well as the general public, including parents and school teachers – a broad perspective of his clinical theory and practice, and a good starting point for further studies.

Course Outline

Lecture 1. Lessons Winnicott gleaned from his clinical practice

Summary: This lecture will present Winnicott’s clinical activities in different areas of mental health care – pediatrics, psychiatry, psychoanalysis and social work – and examine what he learned from his patients and their symptoms about the nature and the etiology of their troubles. His discoveries may be summarized in four points: 1. A human being is a time sample of human nature; 2. Human life is a journey from dependence to independence along a wheel that starts turning at conception and stops at death; 3. The main issue encountered on this journey is the problem of existence, that is to say, of starting-to-be, of going-on-being and of becoming a whole person in relationships with other whole persons and with groups; and 4. All other problems arise from the problem of existence and the processes of maturation themselves.

Bibliography: 

Winnicott, D.W. 1954/1988a, Human Nature, General Introduction.

Winnicott, D.W. 1965b: The Family and Individual Development, Chapter 12. 

Lecture 2. Winnicott’s revolutionary programs

Summary. Winnicott developed revolutionary programs for solving the problem of existence, i.e., of attending the needs that arise from and from the maturational processes themselves, which take place over different periods and corresponding stages along five lines of development: personal integration, physical growth, mental development, socialization and cultural life. All of Winnicott’s programs are based on his maturational etiology, according to which severe and repeated interruptions of the maturational processes by the environment on any of the five lines and at any stage result in reactions that can become patterns of life and, thus, engender symptoms of maturational disorders. Specific programs were designed for treatment in each of the four areas of his clinical activity. Winnicott’s concepts of patient, analyst, and therapeutic setting and procedures are all based on this theoretical background and aim at helping patients rid themselves of reactions to interruptions and to start a spontaneous and creative way of living.

Bibliography: 

Winnicott, D.W. 1954/1988a, Human Nature, Introduction to the Part I.

Winnicott, D.W. 1971a: Therapeutic Consultations. Introduction, Part One.

Loparic, Z. 2013. “From Freud to Winnicott: Aspects of a Paradigm Change”. In Abram, J. (Ed.), 2013: Donald Winnicott Today, pp. 113-156. London: Routledge. Available online in Loparic Collection.
Loparic, Z. 2017. “Achievements of Winnicott’s Revolution”. In Loparic, Z. & Ribeiro, C. V. (Eds.) 2017: Winnicott and the Future of Psychoanalysis. São Paulo: DWW editorial. Available online in Loparic Collection.
Loparic, Z. 2018. “Winnicott’s Paradigm Shift in Psychoanalytic Theory and Practice". In Joyce, A. (Ed.) 2018: Donald Winnicott and the History of the PresentUnderstanding the Man and his Work. London: Karnac. Available online in Loparic Collection.

Lecture 3. The theory of the maturational processes

Summary. This lecture will provide more details on Winnicott’s theory of maturational processes, which is the backbone of his view on the nature and etiology of maturational health problems. It will study the development of inherited human potential in one’s relationship of dependence with the environment, which takes place along five lines of the development and subsequent periods, namely, absolute dependence, relative dependence, towards independence, interdependence and old age. In all periods and respective stages, the behavior of the environment (e.g., the mother’s holding; or the mother, father and infant living together) plays a crucial role in helping the process to be successful.

Bibliography: 
Dias, E. O. 2016. Winnicott’s Theory of the Maturational Processes. London: Karnac. Chapter 2.

Winnicott, D.W. 1965a: Maturational Processes and Facilitating Environment, Chapter 3.

Lecture 4. The theory of the facilitating environment

Summary. This lecture will address the many facilitating environments that change, widen and become increasingly complex as the maturational processes advance. The first environments are the mother’s womb and the mother’s lap, followed by the family, the school, the group, society and, eventually, humankind and human history. 

Bibliography: 

Winnicott, D.W. 1965a: The Maturational Processes and the Facilitating Environment, Chapter 7.

Lecture 5. Maturational disorders in the early stages of life

Summary. All disorders considered by Winnicott are maturational disorders, that is to say, distortions or interruptions in the processes of maturation. The early stages of human life are those that establish a “unit personality”. Environmental impingements and subsequent interruptions of the continuity of being during these stages result in intolerable and unthinkable anxieties. Psychotic disorders are organized defenses against such anxieties.

 Bibliography: 

Winnicott, D.W. 1988b. Babies and their Mothers, Chapter 8. 

Lecture 6. Maturational disorders in the later stages of life

Summary. Disorders in the later stages of life include reactive depression, paranoid states, antisocial tendencies, neurosis, adolescent troubles, and social conflicts, among  others. The symptomatology, diagnosis and etiology of these disorders will be presented in the lecture.
Bibliography: 

Winnicott, D.W. 1958. Through Paediatrics to Psychoanalysis, Chapters 21 and 25.

Winnicott, D.W. 1989. Psychoanalytic Explorations, Chapter 13.

Lecture 7. The Winnicottian patient

Summary. The Winnicottian patient is the individual who suffers from one or more maturational disorders, burdened by maturational needs which have not been attended in a timely manner. Suffering makes him or her send signals to the environment asking for help, that is to say, for communication, understanding, management and care.

Bibliography: 

Winnicott, D.W. 1958. Through Paediatrics to Psychoanalysis, Chapter 23.

Lecture 8. The Winnicottian therapist

Summary. The Winnicottian therapist is the duly trained professional who agrees to be in charge of a Winnicottian patient and to meet the patient’s unfulfilled maturational needs. This does not mean simply analyzing the meanings of his or her symptoms, but also (or even in lieu of such analysis) to provide many other ways of caring – behaving according to needs, playing roles, taking attitudes, allowing the patient to regress in transference to dependence, and so on. In essence, the work of the Winnicottian therapist requires readiness to temporarily take upon oneself the burden of the patient’s existence, a task that requires a special personality structure, in particular the capacity of standing “in the other person’s shoes” (cross-identification).

Bibliography: 

Winnicott, D.W. 1965a: The Maturational Processes and the Facilitating Environment, Chapter 14.

Lecture 9. Winnicottian settings and treatment procedures

Summary. The models for the Winnicottian professional settings are natural environments such as the mother and the family. Treatment procedures include orthodox standard analysis, and the summation of all details of management that reproduce and develop in many ways the early and the earlies mothering techniques. Another important aspect of Winnicott’s therapeutic work is the prevention of maturational disorders.

Bibliography: 

Winnicott, D.W. 1958. Through Paediatrics to Psychoanalysis, Chapter 22.

Lecture 10. Examples of Winnicott’s clinical work

Summary. This final lecture will discuss four brief examples of Winnicott’s management, care, behavior, unassuming position and role playing in treating patients that present various kinds of maturation disorders. They are, 1) a psychotic patient who breaks Winnicott’s valued vase, 2) a small boy who bites Winnicott’s finger, 3) a 5-year-old boy who is reborn in transference, and 4) Winnicott’s treatment of an antisocial boy.

Bibliography: 

Little, M. 1990. Psychotic Anxieties and Containment, Chapter 5, p. 43.

Winnicott, D.W. 1958. Through Paediatrics to Psychoanalysis, Chapter 13, p. 168; Chapter 15, pp. 199-200.

Winnicott, D.W. 1971. Playing and Reality. Chapter 3, pp. 49-50.