Winnicott´s Life Wheel: Introduction to a revolutionary program for treatment of mental health disorders

This Course has the objective to present an introduction into one of most significant recent development regarding the treatment of mental disorders, which is rich in possibilities for new research and applications. This development is based on the contributions by D.W. Winnicott, British pediatrician, psychiatrist, psychoanalyst and social worker. They amount to a new independent revolutionary program for the fields of mental health care in which he was active as a clinician. Winnicott´s engagement in the revolutionary research of such a wide range, was motivated by what he learned from his patients, namely that 1) disorders he was treating in any one of these fields had much in common: they were all related to interruptions of the maturational processes of individual human beings which are due to disturbances in the relationship with other human beings, with the human environment,  2) traditional research and treatment programs are ineffective in helping individuals with such kinds of troubles. The program that Winnicott produced was based on the results of his research concerning the following three points: 1) what happens and how in human development at all stages of human life, all along the LIFE WHEEL turning from conception to death, 2) what may go wrong in growth and development and how, 3) what can be done and how to provide for the needs of individuals who have suffered a maturational breakdown. The present course will address these points in an orderly and articulated way, thus giving
the professionals in the fields of mental health care mentioned above as well as the general public, including parents and school teachers, a wide perspective on Winnicott´s clinical theory and practice and a good starting point for further studies.

Outline of the Course

Lecture 1. Winnicott´s clinical practice

Abstract: This lecture will present Winnicott´s clinical work realized in the different areas of mental health care, namely, pediatrics, psychiatry, psychoanalysis and social work, and examine what he learned from his patients and their symptoms about nature and etiology of troubles they were in.
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 program

Abstract: Winnicott´s revolutionary program is based on his theory of the maturational processes in facilitating environments. In order to develop and to integrate as whole persons human individuals need to be cared for by other human beings. Intrusive interruptions of the maturational processes by the environment at any stage result in reactions which may become patterns of life and, thus, constitute maturational disorders. Winnicott´s clinic is the theory of settings and procedures which aim at helping the patient to get rid of reactions and to start a spontaneous and creative way of life.

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 Present. Understanding the Man and his Work. London: Karnac. Available online in Loparic Collection.

Lecture 3. The theory of maturational processes

Abstract: The theory of maturational processes is the backbone of Winnicott´s thinking and practice. It consists in the study of the development of the inherited human potential in the subsequent periods of dependence, those of absolute dependence, relative dependence, on way toward independence, interdependence and old age. In all periods and stages the behavior of the environment (mother´s holding, mother, father and infant
living together etc.) plays a crucial role for the process to be successful.

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

Abstract: In this lecture will be studied the many kinds of facilitating environment which changes, widens and becomes more and more complex as the maturational processes go forward. The first environments are the mother´s womb and the mother´s lap, and then comes the family, the school, the group, the society and eventually the humankind and the human history.

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

Lecture 5. Maturational disorders in the early stages of life

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

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

Lecture 6. Maturational disorders in the later stages of life

Abstract: Disorders in the later stages of life include those of reactive depression, paranoid states, antisocial tendency, neurosis, adolescence troubles, social conflicts and others. Symptomatology, nature and etiology of these disorders will be presented in the lecture.

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

Abstract: The Winnicottian patient is the individual who suffers from one or more maturational disorders, being burdened by the maturational needs which have not been attended in due time. Suffering make him send signals to the environment asking for help, that is to say, for communication, understanding, management and care.

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

Lecture 8. The Winnicottian therapist

Abstract: The Winnicottian therapist is the duly trained professional who accepts to be in charge of a Winnicottian patient and to meet the patient´s unattended maturational need. This does not mean just providing analysis of the meaning of his symptoms, but also or instead of it offering many other ways of caring, behaving according to his needs, playing roles, taking attitudes, allowing the patient to regress in transference to absolute dependence and so on. In essence, the work of the Winnicottian therapist requires the readiness to take over to himself the burden of the patient´s life, a task which implies a special personality structure, in particular the capacity of standing in other person´s shoes (cross-identification).

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

Lecture 9. Winnicottian settings and treatment procedures

Abstract: Models for the Winnicottian professional settings are natural mother and family environments. Treatment procedures include the orthodox standard analysis as well as the summation of all details of management, which reproduce in many ways the early and the earlies mothering techniques. Another important aspect of Winnicott´s therapeutic work is the prevention of the maturational disorders.

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

Lecture 10. Examples of Winnicott´s clinical work

Abstract: This final lecture will discuss a series of short examples of Winnicott´s management, caring, behavior, assuming position, role playing and so on in treating patients presenting various kinds of maturation disorders, namely, the cases of 1) a psychotic patient breaking Winnicott´s valued vase, 2) a small boy biting Winnicott´s finger, 3) a 5 year boy being reborn in transference, 4) Winnicott treating an antisocial boy.

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.