and reach thousands of daily visitors
11 AUGUST 2009
NO 1472
A psychodynamic approach
For the purposes of this paper, the theories of Klein and Winnicott are used to analyse the case study of Roland. Klein placed great emphasis on the infant's relationship with the primary mothering figure. At first totally dependent on this figure, the infant, in 'phantasy' (Klein's spelling) splits the mother into the good mother who is present and able to provide continuous nurture, and the bad, absent mother who is not providing nurture. The infant finds the latter situation intolerable and cries out with distressed feelings of terror and fear of abandonment. This is what Klein called the 'paranoid-schizoid position'. To resolve the infant's distress, the mothering figure absorbs her infant's unbearable feelings and returns them to the child in a form that they can accept. The infant eventually becomes able to unify the good and bad mother and to realise that although the mothering figure may not provide continuously, she will return. Once the infant has reached this stage of acceptance, he or she is said to have moved from the 'paranoid-schizoid position' to the 'depressive position' from which the infant has the psychological basis to deal with what life holds. Klein thought that children who experienced inconsistent and unsatisfactory nurturing had great difficulty in making any satisfactory progress towards the 'depressive position'. She believed these children were emotionally ill-equipped to deal with the vicissitudes of life and remained in constant fear of being abandoned (Klein, 1998). Winnicott, drawing on Kleinian theory, believed that while the infant needed consistent parenting care, it should not be perfect care. According to Winnicott, satisfactory parenting figures, though human and capable of mistakes, offered care which was 'good enough'. If the child was cared for by a parenting figure who was ideal, rather than real, then they would be ill-equipped to deal with the imperfect world. 'Good enough' parenting figures provided what Winnicott called 'the facilitating environment': a stable physical and emotional environment where the child was safe and yet allowed sufficient emotional space to grow in a way which enabled him or her to build healthy trusting relationships and so become resilient enough to deal with life's experiences (Winnicott, 1965).
It is this 'good enough' parenting and the 'facilitating environment' which those who work psychodynamically in residential child care are attempting to re-create for the children they look after. All too often the young people placed in residential child care have not experienced the nurture required to progress from the paranoid-schizoid position to the depressive position. In Winnicottian terms they have either not been provided with good enough parenting or they have, in another category which Winnicott described, experienced good enough parenting which has been traumatically interrupted as a consequence of a change in family circumstances or as a consequence of emotional, physical or sexual abuse (Winnicott, 1965).
Achieving the 'facilitating environment' is a time-consuming and complex task and has implications for the training of residential child care staff. Residential child care workers need to be aware of the significance of 'transference'. Unhappy children entering a unit often express the fears and frustrations of their past by acting out. It can seem as if they hold residential workers responsible for all the emotional ills they are experiencing. In this they may be unconsciously 'transferring' on to the care worker feelings which relate to previous carers who are usually their parents (Rycroft, 1968). The worker, like the 'good enough' parent, processes the child's feelings and returns them in a way which they can tolerate. The unit becomes a place where painful emotions can be held safely while progress is made towards a more healthy emotional developmental stage. (Winnicott, 1971).
The residential child care worker must also be alive to the primitive infantile anxieties which a young person's behaviour can arouse in the worker herself. This is known as 'counter-transference' (Heimann, 1960). It is essential that residential child care workers do not act out their counter-transferential anxieties by responding to children in superficial authoritarian ways. Instead they should reflect on the feelings the child has aroused in them in order to gain a clearer understanding of how the child is feeling. Again, like the 'good enough' parent, the worker processes these feelings and gives them back to the child in a way that will re-assure him.
CHARLES SHARPE
Sharpe, C. (2006). Residential child care and the psychodynamic approach; is it time to try again? Scottish Journal of Residential Child Care, 5, 1. pp. 48-50.
REFERENCES
Heimann, P (1960). On countertransference. International Journal of Psychoanalysis, 33. pp.10-14.
Klein, M. (1998). Love, guilt and reparation. London: Vintage.
Rycroft, C. (1968). A critical dictionary of psychoanalysis. London: Penguin.
Winnicott,D.W (1965).Maturational processes and the facilitating environment.- studies in theories of emotional development. London. Tavistock.
Winnicott, D.W (1971). Playing and reality.
London: Routledge.
