Winnicott’s Worlds: A History of Psychoanalysis and Childhood in Britain c.1920 – c.1975

Abstract

An extensive body of literature surrounds the life and work of psychoanalyst and paediatrician Donald Woods Winnicott, but few historians have turned sustained critical attention towards him. This thesis seeks to move beyond the proliferation of work whose purpose is to explain or celebrate Winnicott’s contributions to psychoanalysis and medicine. It aims to do more, also, than merely ‘put Winnicott in context’, or use external historical factors to explain Winnicott’s thoughts and actions. Rather, it uses the figure of Winnicott as an entry point into a series of worlds; as the anchor stitch from which to work up pictures of children’s medicine, private psychoanalytic practice, conceptions of psychiatric treatment, and training for medicine, psychiatry, and social work in Britain between c.1930 and c.1975. Winnicott saw tens of thousands of child patients during the course of his career. Though the larger proportion of his time was spent in his private practice, the vast majority of patients encountered him in clinics in children’s hospitals. These free clinics were attended by local poor and working-class families and patients who were usually young, under the age of ten. I trace a history of London’s children’s hospitals which develops into a focused discussion of Winnicott’s work inside the walls of The Queen’s Hospital for Children and Paddington Green Children’s Hospital. I chart a broad, long-term shift from the sick child as an object of Victorian philanthropy to the nervous child as an object of parental anxiety; identify the rheumatic or choreic child as a site for the convergence of the treatment of the body and of the mind; and relate the quotidian realities of clinic consultations to the emphasis of environment and motherhood in Winnicott’s thought, an emphasis which is itself a continuation of concerns around environmental dangers and childhood vulnerability. As a privately practicing psychoanalyst, Winnicott took on both child and adult patients, in rooms on Queen Anne Street and later in his home on Chester Square. I explore some of the ways in which children and childhood confounded the theoretical and practical underpinnings of traditional psychoanalysis. Moving in to focus on the logistics of child psychoanalysis in postwar London and utilising recent work in mobilities studies, I recast both the evolution of Winnicott’s practice (particularly the emergence of ‘therapeutic consultations’) and the general paucity of child analysis in London at mid-century as a function of its practical demands. Amongst Winnicott’s private patients were many people who had tried several other treatments before seeking his help. Sometimes this included physical therapies like electro-convulsive therapy or leucotomy – organically-oriented treatments to which Winnicott was vehemently opposed. I explore the ostensible status of psychoanalysis and biological psychiatry as diametrically opposed disciplines in mid-century Britain by examining Winnicott’s participation in debates about the physical therapies in medical journals. I root Winnicott’s objections to ECT and leucotomy in his specialist concern with children’s psychiatric care and in some of the more idiosyncratic elements of his psychoanalytic worldview before exploring published correspondence to expose competing theories of the mind and brain, differing conceptions of the nature and value of scientificity, pragmatic attitudes to medical treatment, and contrasting conceptions of ethics as they map imperfectly against disciplinary allegiance. Ultimately, British psychiatry continued to be characterised by eclecticism tempered by a deep division in ethical beliefs about mental health, suffering, and the nature of humanity. Finally, I discuss the teaching of psychoanalysis in relation to a series of training schemes, showing that the peculiar pedagogy of psychoanalysis had implications for the fate of psychoanalytic ideas and practices.

Date of Award	31 Dec 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Carsten Timmermann (Supervisor) & Ian Burney (Supervisor)