(Joel Kanter is a Senior Therapist at Fairfax County (Virginia) Mental Health Services and is in clinical social work practice in Silver Spring, Maryland. He is currently editing the collected writings of Clare Winnicott. His edited volume “Face to Face with Children: The Life and Legacy of Clare Winnicott” will be published by Karnac Books in 2004.)
Abstract: While the work of Donald Winnicott is well-known to clinical social workers, most are unaware of his rich professional collaboration with his second wife, Clare, a pioneering social worker analysed by Melanie Klein who worked in child welfare, academia, government service, and psychoanalysis. This paper will review their work and lives together, outlining how their relationship expanded Donald's horizons in exploring the interface between psyche and environment.
While the work of Donald Winnicott--including his concepts of transitional objects and the holding environment--is well-known to psychoanalytic psychotherapists, most are unaware of his professional collaboration with his second wife, Clare, a pioneering social worker analyzed by Melanie Klein who worked in child welfare, academia, government service, and psychoanalysis over the course of a remarkable career. Known today largely for her accomplishments in compiling and editing her husband's papers, Clare Britton Winnicott was a creative, talented professional who expanded her husband's horizons, collaborating with him in exploring the interface between the psyche and environment.
In her 1984 obituary, the London Times described Clare as a "gifted social worker and psychoanalyst" who "will perhaps be best remembered for her profound and lasting influence on the development of services for deprived children …. (she) was an inspiring teacher, whose vivid examples of how children felt… frequently made a lifelong impression on students." Noting her receipt of the Order of the British Empire (OBE) for her "exceptional leadership" as the government official responsible for training staff in child welfare departments, the Times went on to describe Clare as "possessed (of) a special blend of seriousness and fun, augmented with a subtle mischieviousness" (London Times, 1984).
These qualities quickly impressed Donald Winnicott when they began working together with evacuated children in 1941 and a lively professional collaboration eventually evolved into a more personal relationship. In response to this wartime experience and his collaboration with Clare, Donald's approach to treating children evolved dramatically and he began a relationship with professional social work which continued until his death in 1971.
In this article, I will review the Winnicotts' initial wartime collaboration in Oxfordshire, describe the marital relationship that evolved from this experience, outline Donald's ongoing involvement with the social work profession, and discuss how Clare's influence can be seen on Donald's most notable contributions. This paper has been the result of voluminous research, involving a careful review of Clare's considerable array of published and unpublished writings, a lengthy taped interview with Clare, and interviews and correspondence with over 60 of Clare and Donald's close relatives, friends and colleagues. Using this assemblage of primary source material, I have been able to reconstruct many details of their professional collaboration---a collaboration, which, this research reveals, uniquely influenced Donald Winnicott.
Donald's and Clare's work with evacuated children in Oxfordshire was perhaps the defining experience of their lives and careers. Besides meeting each other, their respective professional talents emerged at a time when Great Britain was undergoing a dramatic change in its child welfare policies and programs. The work of Clare, Donald and others during the War established precedents which altered the course of children's services for the next 50 years.
Over six million people were evacuated from England's cities to the countryside during the early years of the War, especially after the Blitz in September 1940. Families agonized about these separations; should they put their child's physical safety ahead of their psychological needs for attachment? Fathers were off in the military and mothers were pressed into employment. In contrast to the United States, there was much anxiety about invasion and the bombings made the War a source of everyday anxiety. Even with the massive evacuations, nearly 8000 children were killed in Great Britain (Holman, 1995).
These urban evacuees, primarily working-class, were often unwelcome in middle-class homes which were required to accept these children. Many brought psychological problems with them from their homes, even more developed difficulties when faced with long periods of parental separation and, in some instances, even parental death. Throughout the country, rudimentary social work services were created to serve the needs of these children. When home placements failed, hostels (group homes) were established that could provide special care.
Unlike many of her fellow graduates from the London School of Economics' prestigious Mental Health Course (including the well-known Kleinian analyst, Betty Joseph), Clare deliberately avoided employment in child guidance clinics or mental hospitals. Out at a pub with her fellow students, she told them: "I've enjoyed this course enormously, but the last thing I'm going to be is a P.S.W. (psychiatric social worker). I want to be in the hurly burly of what's going on in the world." She "wanted to be in the thick of social work, not stuck away in a clinic" (interview with Clare Winnicott conducted by Alan Cohen, June 27, 1980).
After completing the Mental Health Course, Clare began working with evacuated children in Oxfordshire, an assignment that changed the course of her life:
I was sent to work in the Oxfordshire evacuation scheme, one day a week, by the person who was running my office. It was only a one day a week assignment, to work with Dr. Winnicott who was coming down once a week to be a consultant to the hostels which were set up for difficult children. The children who couldn't be kept in an ordinary billet were put into hostels... there were five hostels with difficult kids in. And I was told to go and work there once a week and sort things out.
I think the person who was my boss then actually briefed me by saying, "There's a difficult doctor working in that area. He comes down once a week. He doesn't believe in social work because he likes to do it all himself. But it's really in quite a mess and you must go and straighten the whole thing up." That's what I was told. So I did; I turned up one Friday to the hostel where he was visiting, and listened, wondering where I could come in and what I could do in this situation.
And I think that one of the things that I did achieve, fairly soon, was to help the staff in the hostels to make use of his expertise, his knowledge, in a way that they were not able to do. They used to say, "He comes down and talks to the children. He plays his pipe to them and we like him very much, but he doesn't ever tell us what to do." So I said, "Well let's never ask him what to do. Let's do the best we can in the present situation and then when he comes again tell him what we did and see if he's got any comment to make on it, and if we can therefore learn something from what we did." And that's how it really evolved.
And he always said, "You gave me a role and turned the job into a professional job." One thing I did was to stop him eating all the children's rations in one meal! The staff were inclined to save all the best food for him, and I just slipped in one day "I suppose you know you're eating the children's butter ration for a week?" He was absolutely horrified! So that's how I started in the hostel scheme. I did stick on to that until the end of the war. (Interview with Clare Winnicott conducted by Alan Cohen, June 27, 1980)
Soon Clare was working full-time in Oxfordshire, caring for over 80 children scattered among the five hostels. Donald visited on Fridays to consult with these hostels, but their jointly authored wartime article "The Problem of Homeless Children" (1944) explicitly stated that "in practice", the psychiatric social worker controlled "the whole of the work" and is the "one individual at the centre of the scheme." Clare even assumed much of the responsibility for the hostel maintenance and supplies:
I was asked to take on the administration of the hostels ordering equipment, seeing and reporting back building things that wanted doing, and I did accept that. And it was tremendously important to me that I did accept it because my credibility in the hostel situation was greatly enhanced by the fact that I had access to resources, other than just human resources. I mean I could get more equipment for them, or I could put orders in for more equipment (Interview with Clare Winnicott conducted by Alan Cohen, June 27, 1980).
Beyond these administrative tasks, Clare provided continuity to the hostels as staff came and went, played a key role in the placement and transfer of children, consulted regularly with hostel staff, and was the only person who knew "each child at every stage" (Winnicott and Britton, 1944, p. 157).
As noted in Clare and Donald's first jointly authored article (Winnicott and Britton, 1944), the social worker saw the child:
in his school and billet, and then in the hostel, and possibly in more than one hostel. If there is a change in hostel wardens, it is the psychiatric social worker who gives some feeling of stability during the period of change. ...She is also in contact with the child's home, visiting the parents whenever possible. She is thus able in some degree to gather together the separate threads of the child's life and to give him the opportunity of preserving something important to him from each stage of his experience. (Winnicott and Britton, p. 157)
In contrast, this article explicitly stated that the psychiatrist's role was limited to weekly consultation with the hostel staff, occasional interviews with difficult children and the provision of medical authority in problematic situations.
Years later, Clare reflected on their collaboration:
I saw my first task as that of trying to evolve a method of working so that all of us, including Winnicott, could make the best possible use of his weekly visits. The staff living in the hostels were taking the full impact of the children's confusion and despair and the resultant behavior problems. The staff were demanding to be told what to do and it took time for them to accept that Winnicott would not, and in fact could not, take on that role, because he was not available and involved in the day-to-day living situation... Gradually it was recognized that all of us must take responsibility for doing the best we could with the individual children in the situations that arose from day to day. Then we would think about what we did and discuss it with Winnicott as honestly as we could... These sessions with him were the highlight of the week and were invaluable learning experiences for us all including Winnicott... His comments were nearly always in the form of questions which widened the discussion and never violated the vulnerability of individual members. After these sessions, Winnicott and I would try to work out what was going on from the mass of detail that had been given to us, and we would form some tentative theories about it. (C. Winnicott, 1984, p. 2-3)
Irmi Elkan, a psychiatric social worker who worked with Donald at Paddington Green Children's Hospital in London, joined Donald on one of his Friday visits to the Oxfordshire Hostels. She recalled that Donald and Clare's approach to this work "made a lasting impression" on her:
Donald and Clare practiced what they preached. They accorded the hostel foster parents the same respect that most of us accord all parents. They accepted them as equal partners whilst not ignoring personal difficulties and limitations. They made known their conviction that foster parents, like any other parents, should not be expected to bring up more than one family of children. (Elkan, 1984)
Their collaboration in Oxfordshire dramatically influenced Donald's perspective on professional teamwork. Confirming the observation of Clare's Oxfordshire supervisor that "he likes to do it all himself," Donald remarked in an unpublished 1943 address entitled "A Doctor Looks at Psychiatric Social Work" that he "deliberately worked for fifteen years without employing a psychiatric social worker." He went on to share his belief that in "psychotherapeutic practice, team work is bad" (Donald's emphasis). Yet, after sharing these views with an audience of social workers, Donald acknowledged that his views on collaboration had recently evolved. Offering a dozen examples of the value of social work interventions. He stated that the "social worker's main function, like the (doctor's), is to bear emotional burdens" which he viewed as a "heavy job." Perhaps referring to Clare's management of 80 troubled evacuees as well as the other responsibilities she assumed, Donald noted that "the psychiatric social worker has to be told to go away and take a proper holiday lest she become a case herself."
The crisis of war and the Evacuation stimulated many creative initiatives in work with children, notably Dorothy Burlingham's and Anna Freud's (1944) work at the Hampstead nurseries and John Bowlby's work in Cambridge with aggressive children (1944). Donald and Clare's work in Oxfordshire also became well-known across Great Britain; besides their aforementioned 1944 publication, their paper on the Oxfordshire "scheme" was the lead article in the first issue of Human Relations, an interdisciplinary journal published by the Tavistock Institute of Human Relations (Winnicott and Britton, 1947). In his classic volume, Maternal Care and Mental Health (1951), John Bowlby discussed the Oxfordshire work at considerable length, highlighting it as an effective model for serving troubled children.
The personal experiences of most British families with childhood separation and the 1945 well-publicized death of a foster child precipitated a well-publicized Home Office inquiry in 1946 known as the Curtis Committee. This high-profile committee examined 229 witnesses including John Bowlby, Susan Issacs, Donald Winnicott and Clare Britton. The report of this committee, formally entitled "The Report of the Care of Children Committee," but widely known as the "Curtis Report," identified over 100,000 children in need of placement in England and Wales. The report also recommended that each Local Authority establish a Children's Committee under the leadership of a "Children's Officer" who would organize services for each community (Holman, 1995). The Curtis Report was well-received by the British public and was largely implemented by the passage of The Children's Act of 1948, helping to integrate a haphazard array of children's services.
The transformation of Donald and Clare's relationship from a professional to a personal one is impossible to reconstruct with any accuracy. When they met in during the War, Donald was married to Alice, his first wife, and his time in Oxfordshire was limited. Gwen Smith, Clare's friend and colleague in Oxfordshire, commented that it "soon became clear that Friday had become a 'red-letter day'" (Remarks at Memorial Service, November 3, 1984). In a May 25, 1944 diary entry, Karl Britton, Clare's brother, wrote that she had discussed with him a job offer to work with refugee children, but was concerned that moving would disrupt her relationship with "Dr. Winnicott." Clare and Donald's personal relationship continued after the War. In December 1946, Donald wrote to Clare that:
my work is really quite a lot associated with you. Your effect on me is to make me keen and productive and this is all the more awful-because when I am cut off from you I feel paralyzed for all action and originality. (C. Winnicott, 1978, p. 32)
This letter suggests the interplay between the personal and professional dimensions of their relationship--a collaboration which resulted in two of the rare publications that Donald co-authored with colleagues (Winnicott and Britton, 1944, 1947).
Yet, openly consummating this relationship in marriage was a slow and difficult process. By some accounts, Donald had been unhappily married to Alice, his first wife, who has been described as a quite disturbed and unhappy woman (Kahr, 1995). Allegedly, Donald was reluctant to initiate the divorce process while his elderly father was still alive. However, after his father died on December 31, 1948, at the age of 93, Donald began to physically separate from Alice and often spent nights sleeping in his office. This period was extremely stressful for Donald and he suffered his first heart attack in 1949.
In August 1950, Donald approached Karl Britton, Clare's brother, and initiated a discussion of his relationship with Clare and his difficulties in obtaining a divorce (Diary entry by Karl Britton, August 25, 1950). The personal strain was evident and less than two weeks later, on September 5, 1950, Donald suffered his second heart attack. But these obstacles were overcome and Donald's divorce was granted on December 11, 1951. Several weeks later, on December 28, 1951, Donald and Clare were married. Gwen Smith, a wartime colleague, recalled Clare greeting the waiting guests with the remark that "I made him promise to live to be one hundred" (Remarks at Memorial Service, November 3, 1984).
By all accounts, the marriage was a fulfilling and loving partnership. After hiding their personal relationship for many years, "Clare-and-Donald" (so often identified with a single phrase by many friends and colleagues) quickly developed a busy social life with social workers, psychoanalysts and physicians from across Great Britain and throughout the world. They frequently entertained in their home and their parties were enjoyed by a wide circle of acquaintances. Pearl King (1984) recalled a party Clare and Donald hosted at the British Psycho-Analytical Society when Donald was President:
I can still see their friends and colleagues, sitting on the floor, listening to a folk singer and guitarist whom they had engaged for the evening. It was good fun. It had not been done before, nor has it been repeated.
With such activities, Clare and Donald shared with others the sense of play that pervaded their relationship. Reflecting the opinions of many others, Jimmy Britton, Clare's brother, found them "delightful company because they never lost their sense of play" (Letter to Anne Wyatt-Brown, February 17, 1992). As Clare commented in her memoir of Donald, they had:
never set out to play, there was nothing self-conscious and deliberate about it.... We played with things--our possessions--rearranging, acquiring, and discarding according to our mood. We played with ideas, tossing them about at random with the freedom of knowing that we need not agree, and that we were strong enough not to be hurt by each other... We each possessed a capacity for enjoyment, and it could take over in the most unlikely places and lead us into exploits we could not have anticipated. After Donald's death, an American friend described us as "two crazy people who delighted each other and delighted their friends." (C. Winnicott, 1978, pp. 29-30)
While these glowing accounts of their marriage are supported by many other recollections, the couple also experienced difficulties. As has been amply documented (Kahr, 1995), Donald had numerous professional interests and had difficulty refusing requests for professional involvement. Although Clare supported his professional activities, she also had to struggle for private time where she could be with Donald alone. In 1950, for example, Donald began meeting weekly on Sunday mornings with Masud Khan to edit his written work. Clare resented this intrusion into her only free day with Donald and would insist they end their activity at noon (Interview with Pearl King, June 3, 1995). In his later years, Donald would often spend his Saturday afternoons chatting with Harry Karnac in his bookshop; Clare would often ring the store to "retrieve" her husband (Interview with Harry Karnac, October 19, 1996).
The aforementioned Curtis Report also recommended new training initiatives for social workers and residential staff in Great Britain's emerging child welfare system. To this end, the British Home Office and the social work program at the London School of Economics established the nation's first program for training social workers in "child care" in 1947. As Clare had become a leader in the emerging child welfare field, she was appointed the first "Lecturer in Charge" of the new "Child Care Course." As she had no background in academia, this appointment was a particular recognition of her unique experience and abilities.
From 1947 through 1958, the Child Care Course at the London School of Economics, under Clare's direction, educated a generation of social workers who worked with children in need across the United Kingdom. As was the practice in British social work education, the Child Care Course was an intensive one-year postgraduate program that integrated classroom instruction, individual tutorials and field work in several agencies. The curriculum which Clare designed included classes in child development, pediatrics, legal issues in child welfare, and sociology. Clare taught a core class entitled "Care of the Deprived Child."
Donald, too, taught in this program since its inception, offering 10 lectures annually in a class entitled "The Inter-relation of Physical and Psychological Aspects of Development." In 1955, he began offering an additional 5 lectures on "Adult Personality Patterns." Also, on a regular basis, Donald invited his past and present students to observe clinical consultations with infants at Paddington Green Hospital.
The Child Care Course also included individual tutorials, often with Clare, and brief periods of practice experience with agencies and residential care programs. Only a dozen or so students were enrolled each year and Clare interacted with each participant in a personal way. Each year, Clare hosted parties for the students. Initially, these were held at her flat in Chelsea with Donald in attendance, but after her 1951 marriage these were held at their Chester Square home. These occasions were quite memorable for their informal festivity. One student recalls arriving early and finding Clare and Donald working together in the kitchen making a batch of marmalade; another recalls Donald playing the piano and leading everyone in song (Interviews with Diana Williamson, November 21, 1996; Joan Vann, May 29, 1995).
During these years, Donald's involvement with professional social work continued to expand. He also was invited to teach in the London School of Economics' Mental Health Course (in social work); this affiliation continued until months before he died and was the most significant opportunity to lecture in his career. He also was in continual demand as a speaker at social work conferences and began to publish in social work journals. In a transition to a generic social work model, the Child Care Course was dissolved in 1958. The termination of this course had a special impact on Clare and Donald; it ended a ten year collaboration in social work education.
In spite of this professional disappointment, Donald and Clare frequently traveled together across Great Britain lecturing at conferences and meetings of child care agencies and organizations. They played a notable role in the formation of the Association of Child Care Officers (ACCO). The initial meeting of this group in 1948 was convened by some of Clare's first students at LSE and Donald soon volunteered the use of his consulting room at Paddington Green Hospital for committee meetings for the next decade. In 1966, both Clare and Donald were awarded the only honorary memberships granted by this organization (Thomas, 1970).
Given his tenuous status as an independent in the British Psycho-Analytical Society, Donald basked in the appreciation and respect he received in the child care and social work world. Perhaps unlike his fellow analysts, social workers were comfortable "dropping by" Clare and Donald's Chester Square home. Joan Cooper, a colleague of Clare's at the Home Office in the 1960's, offered this typical recollection:
At the end of a day's clinical work at Paddington Green Hospital, Donald, exhausted, would come home and lie flat on the floor relaxing. Clare would be in the kitchen preparing the evening meal. If I missed my train at Victoria Station, I would sometimes drop in to learn to relax--not to eat. Their quiet little suppers were important to them. (Interview with Joan Cooper, May 27, 1995)
Teasing out Clare and Donald's contributions to one another is an impossible task. Kay McDougall, a social work colleague at LSE, and Pearl King, an analyst colleague at the British Psycho-Analytical Society, used exactly the same phrase to describe their interaction: "they sparked each other off" (Interviews with Kay McDougall, June 3, 1995; Pearl King, June 3, 1995). Similarly, John (Jock) Sutherland, the Medical Director of the Tavistock Clinic, wrote that Clare "had a great natural empathy which filled in with (Donald's) and they did a great deal for each other" (Personal correspondence, March 7, 1989). Marion Milner (1985), a supervisee and friend of Donald's, wrote that Clare's "gifts of liveliness, sense of fun, even mischieviousness, combined with a deep seriousness, met the same in Donald Winnicott and she undoubtedly had a great influence on his work" (p. 4). And, as noted earlier, Donald himself wrote Clare in 1946 that his "work is really quite a lot associated with you" (C. Winnicott, 1978).
Throughout Clare's writings, themes and language commonly associated with Donald's work emerge repeatedly. In some instances, her references to certain ideas clearly preceded his discussion of similar concepts. A notable example of this is Clare's observations of transitional objects. During the War, Clare traveled to London to seek out the parents of the children in the hostels. When she found them, she asked them to prepare a note or "give me something to take to them" (Interview by Alan Cohen, June 27, 1980). In recollections of "Jane," an adolescent evacuee in her care, Clare specifically notes the significance of a gift of grapes from Jane's abusive mother. Also, after Jane stole a valued ring of a hostel parent, Clare asked her to lend Jane her ring on Sundays--to tell Jane "it's very precious to me but you could have it one day a week" (Interview by Alan Cohen, June 27, 1980).
In 1947, Clare's unpublished case notes of her work placing a foster child in an adoptive home illustrate how Clare supported the child's use of a toy duck in the transition to a new home. Several years later, in 1950, Clare describes this phenomenon in evocative detail:
The moment of uprooting is just when a skilled child-care officer is need to see that what a child clings to in the past is brought with him and accepted in the new environment. ....there are many stories, which now, it is hoped, belong to another era, of children clinging to their own clothes and being given an anesthetic to enable the clothes to be removed, or favourite but filthy teddy-bears and other possessions being taken away and burned, but these did not belong to the past, and something became damaged and lost when the familiar things were taken away. These possessions stood for everything the child brought with him from the past and he could not afford to lose so much. (C. Britton, 1950)
In May, 1951, Donald presented his classic paper "Transitional Objects and Transitional Phenomena" to the British Psycho-Analytical Society (D. W. Winnicott, 1953). In the aforementioned 1950 paper, Clare also presents many of the core ideas about delinquency that Donald more fully articulates in his 1956 paper, "The Antisocial Tendency:"
As the child-care officer comes into the lives of these children, she must first be able to sort out the whole situation carefully until she finds the alive bit from which new growth can come. For the alive bit is the thing the child is clinging to as the focus of his feelings. It may be hidden in a memory, or a fantasy, or a habit. It will certainly be at the point of tension. The delinquent act is in many cases an unconscious effort to deal with loss... The depression and grief of a child who has lost a loved parent shows that he is alive and dealing with his loss, and that with help recovery is possible. Perhaps the most difficult children to help are those with nothing alive about them. Here the only thing is to wait and watch for signs of life--encouraging the slightest effort, which may be made perhaps towards the possession of something, or a sudden desire to sit next to somebody special. (C. Britton, 1950)
As Donald commented, he had "avoided the immensely exacting organised antisocial case during the early stages of my career, but in the war became forced to consider this type of disorder through the work I was privileged to do with evacuated children in Oxfordshire" (1988, p. 2).
Clare's experience with evacuated children also led to her first solely authored paper, "Children Who Cannot Play," written and published in 1945. This publication presages Donald's classic work Playing and Reality (1971) which discussed the significance of play inhibitions over 25 years later.
Finally, Clare emphasizes the concept of "holding" in her 1955 paper "Casework Techniques in the Child Care Services":
(Social workers provide) a reliable medium within which people can find themselves or that part of themselves about which they are uncertain. We become, so to speak, a reliable environment, which is what they so much need--reliable in time and place; and we take great trouble to be where we have said we would be at the right time. ....we take deliberate trouble to remember all the details about the client's life and not to confuse him with other clients. We can "hold" the idea of him in our relationship so that when he sees us he can find that bit of himself again which he has given us. This is conveyed by the way in which we remember details and know exactly were we left him in the last interview. Not only do we hold a consistent idea of the client as a person, but we hold the difficult situation which brought him to us by tolerating it until he either finds a way through it or tolerates it himself. If we can hold the painful experience, recognizing its importance and not turning aside from it as the client relives it with us...., we help him to have the courage to feel its full impact; only as he can do that will his own natural healing processes be liberated.
I have deliberately used the word "hold" in what I have been saying, because, while it obviously includes "acceptance" of the client and what he gives us, it also includes what we do with what we accept. (C. Britton, 1955)
Again, "authorship" of this concept cannot be established. Although the term "holding" appears intermittently in Donald's lectures at the Institute for Education and LSE (1988), he does not make this concept a central focus of a professional paper until "The Theory of the Parent-Infant Relationship" in 1960.
One of Clare's analysands, Mr. C., clearly recalls her telling him that the concept of "holding" was her creation (Personal interview). As Clare rarely sought credit for any idea or concept--and was preoccupied with preserving Donald's legacy--this comment may have special significance. Unlike Donald, Clare derived little, if any, satisfaction from creating professional terminology; concerned with communicating with a wide range of persons, Clare insisted on using commonplace language that could be easily understood. In this regard, after Donald's death, Clare told Emanuel Lewis, one of Donald's former analytic supervisees, a story about how Donald wrote Charles Schulz, the cartoonist, and asked if Linus' blanket could have been evoked by his concept of the transitional object. Clare smilingly told Lewis that Donald received a two-sentence reply from Schulz along these lines: "Dear Dr. Winnicott: I have never heard of you or your idea of a transitional object. My drawings of Linus' blanket comes from observing children." (Comments by Emanuel Lewis, October 18, 1996). In contrast, Clare always referred to the transitional object in her teaching as the "first treasured possession."
Of course, one could argue that Clare's whole perspective on children and helping relationships was shaped by Donald's influence; that if ideas appeared in her papers before Donald's, it was because she had gleaned these ideas from him. Yet her accounts of her work in Oxfordshire, as well as the observations of such distinguished colleagues as Marion Milner, John Sutherland and Pearl King, express a creative spirit and independence of mind that render this hypothesis improbable.
Soon after the War, at a 1946 conference on the "Evacuation," Clare demonstrated her playful independence as she poked fun from the lectern at what she viewed as Donald's grandiose recommendations:
Now for the question which Dr. Winnicott brought up. "How do we feel about applying the knowledge gained through hostels to the wider field of children in homes of all kinds?" Quite frankly, I am appalled at the thought of even trying to think it out, let alone trying to apply it! (C. Britton, 1946)
These are hardly the comments of a submissive acolyte. Milner (1985) makes a similar point in her remembrance of Clare:
The fact that she could actually say to him--and also tell us, who were their friends--what she had told him: that is, that he suffered from "delusions of beneficience," does, I think give a vivid glimpse of the creativeness of their relationship and the area of fun and honesty in it. (p. 5)
Yet, Clare was also an effective interpreter of Donald's ideas. Her various essays on her husband and his work succinctly highlight the central elements of his thinking (Winnicott, 1978, 1983) and her sole analytic paper, "Fear of Breakdown: A Clinical Example" (1981), provides evocative illustrations and discussions of some his most important concepts. The latter is particularly noteworthy for its description of the use of a transitional object in the analysis of an adult patient. Similarly, readers will find passages throughout her many social work papers which are evocative of Donald's concepts (C. Winnicott, 1964).
At the same time, Donald was undoubtedly influenced by Clare and her social work profession. Perhaps uniquely in the world of psychoanalysis, Donald was actively engaged with the social work profession, delivering hundreds of lectures at LSE, speaking at dozens of social work conferences, and regularly publishing in social work journals (Winnicott, 1953, 1955, 1959a, 1959b, 1963a, 1963b, 1970). Donald's identification with social work is perhaps best expressed in the following passage in the final issue of the social work journal Case Conference (1970):
...I would like to use this last chance to appear in Case Conference to give the bare bones of a sort of belief which I believe is a common denominator among social workers and psychotherapists.
Whatever we do in social work is related to quite natural things that get done in child care and in baby care. The difference is that in a professional setting, which carries its own limitations and allows its own freedom within the framework, we do the same things that are done in child care and we do nothing else.... The essential part of the theory of the emotional development of the human individual has to do with the earliest stages when dependence is very much a fact and adaptation to need is the main environmental function. In personal or in social illness, these early phenomena tend to reappear and demand new enactment in a professional setting....
When the social worker is not able to see his work in terms of the natural evolution of the maturing child in the environment that has its own evolution relative to a child's personal growth, then the social worker has stepped outside his or her social work job. There may be friendship, teaching, authoritarian indoctrination, charity, vindictiveness, religious conversion, political transmutation, or pharmacological modification of a client's neuro-physical apparatus. None of these things, however, is social work, which by definition is derived by direct route from an understanding of the emotional development of the human individual in the long steady climb out of absolute dependence and toward independence.
I suppose this is a kind of faith. Faith in human nature. It seems to me to have value as a basic social work principle. I think Case Conference has illustrated this principle.
Psychoanalytic scholars of Winnicott (with the exception of Jacobs [1995]) have been loath to acknowledge his active participation in and identification with professional social work, even though he explicitly acknowledges this in dozens of papers (Kanter, 1990). Besides enhancing his appreciation of adolescence, delinquency, holding environments and transitional objects, Donald's engagement with social work--largely facilitated by Clare--undoubtedly had a considerable impact on his ideas about clinical interventions. After intensive pre-War experience in child psychoanalysis, Donald rarely treated child patients in psychoanalysis after the War (Kahr, 1996). Instead, his approach shifted dramatically toward a consultative approach with parents and other caregivers (D. W. Winnicott, 1971); this method was perhaps first outlined in the Winnicotts' papers on the Oxfordshire experience (Winnicott and Britton, 1944, 1947) and later elaborated in Donald's 1955 paper "A Case Managed at Home." This paper was first published in a social work journal, but was also included by Donald and Masud Khan in his first collection of analytic papers (D. W. Winnicott, 1958).
As Susanna Isaacs Elmhirst, a pediatrician and psychoanalyst who worked closely with Donald at Paddington Green Children's Hospital, recently noted:
between (Donald and Clare), they developed (in Oxfordshire) unique experience and skill in devising and supporting environmental changes which nourished the emotional and physical growth of children. Out of this lively mutual co-operation, involving various non-medical and often non-parent, adults, gradually developed Winnicott's "Monday afternoons" at the Green. (In Kahr, 1996, p. xviii-xix)
These pediatric consultations at Paddington Green attracted visitors from around the world and became a model for interdisciplinary collaboration.
Often using the term "management," Donald repeatedly identified the advantages of social work interventions in working with severely troubled children and adults (Kanter, 1990). In a characteristic passage, he noted that the psychoanalyst is relatively impotent with severely disturbed patients unless "he steps outside his role at appropriate moments and himself becomes a social worker" (D.W. Winnicott, 1963, p. 219). He added that "psychiatrists and psychoanalysts constantly hand over (psychotic patients) to the care of the psychiatric social worker (because) they can do nothing themselves" (p. 227).
In a 1970 talk to a group of child psychologists and psychiatrists, Donald made a similar point about working with children:
Social workers have been carrying the burden of the practice of child psychiatry all these years, and it is to social work that we must look for an extension of psychiatric practice to cover all types of case and to engage in preventative work. (Winnicott, 1996, p. 281).
Such views could not be more explicitly expressed.
In the context of his strong
identification as a psychoanalyst--twice elected President of the
British Psycho-Analytical Society--Donald Winnicott's views on the
value of social work intervention deserve more recognition than
they have received, even within the social work profession. And
Clare's impact on Donald's thinking and practice has rarely been
acknowledged; nor have her profound insights received the attention
they deserve in their own right. Looking back, Donald became part
of Clare's world in social work while Clare became part of Donald's
world in psychoanalysis. In doing so, both enriched their
respective professional domains. Since the emergence of both
professions a century ago, no comparable collaboration between
leaders in these professions has occurred.
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