Int. J. Psycho-Anal., 26:137-143 (IJP)
Primitive Emotional Development1
D. W. Winnicott
It will be clear at once from my title that I have chosen a very wide subject.
All I can attempt to do is to make a preliminary personal statement, as if
writing the introductory chapter to a book.
I shall not first give a historical survey and show the development of my ideas
from the theories of others, because my mind does not work that way. What
happens is that I gather this and that, here and there, settle down to clinical
experience, form my own theories and then last of all interest myself in looking
to see where I stole what. Perhaps this is as good a method as any.
About primitive emotional development there is a great deal that is not known or
properly understood, at least by me, and it could well be argued that this
discussion ought to be postponed 5 or 10 years. Against this there is the fact
that misunderstandings constantly recur in the Society's scientific meetings,
and perhaps we shall find we do know enough already to prevent some of these
misunderstandings by a discussion of these primitive emotional states.
Primarily interested in the child patient, and the infant, I decided that I must
study psychosis in analysis. I have had about a dozen psychotic adult patients,
and half of these have been rather extensively analysed. This happened in the
war, and I might say that I hardly noticed the blitz, being all the time engaged
in analysis of patients who are notoriously and maddeningly oblivious of bombs,
earthquakes and floods.
As a result of this work I have a great deal to communicate and to bring into
alignment with current theories, and perhaps this paper may be taken as a
beginning.
By listening to what I have to say, and criticizing, you help me to take my next
step, which is the study of the sources of my ideas, both in clinical work and
in the published writings of analysts. It has in fact been extremely difficult
to keep clinical material out of this paper, which I wished nevertheless to keep
short so that there might be plenty of time for discussion.
The following is my highly condensed personal statement.
I
First I must prepare the way. Let me try to describe different types of
psycho-analysis. It is possible to do the analysis of a suitable patient taking
into account almost exclusively that person's personal relation to people, along
with the conscious and unconscious phantasies that enrich and complicate these
relationships between whole persons. This is the original type of
psycho-analysis. In the last two decades we have been shown how to develop our
interest in phantasy, and how the patient's own phantasy about his inner
organization and its origin in instinctual experience is important as such.2We have been shown further that in certain cases it is this, the patient's
phantasy about his inner organization,
My especial thanks are due to Dr. W. Clifford M. Scott for his help both in the
work on which this paper is based and in the preparation of the paper itself.
1 Read before the British Psycho-Analytical Society, November 28, 1945.
2 Chiefly through the work of Melanie Klein.
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that is vitally important, so that the analysis of depression and the
defences against depression cannot be done on the basis only of consideration of
the patient's relations to real people and his phantasies about them. This new
emphasis on the patient's phantasy of himself opened up the wide field of
analysis of hypochondria in which the patient's phantasy about his inner world
includes the phantasy that this is localized inside his own body. It became
possible for us to relate, in analysis, the qualitative changes in the
individual's inner world to his instinctual experiences. The quality of these
instinctual experiences accounted for the good and bad nature, as well as the
existence, of what is inside.
This work was a natural progression of psycho-analysis; it involved new
understanding but not new technique. It quickly led to the study and analysis of
still more primitive relationships, and it is these that I wish to discuss in
this paper. The existence of still more primitive object relationships has never
been in doubt.
I have said that no modification in Freud's technique was needed for the
extension of analysis to cope with depression and hypochondria. It is also true,
according to my experience, that the same technique can take us to still more
primitive elements, provided of course that we take into consideration the
changes in the transference situation inherent in such work.
I mean by this that a patient needing analysis of ambivalence in external
relationships has a different phantasy of his analyst and the analyst's work
from the one who is depressed. In the former case the analyst's work is thought
of as done out of love for the patient, hate being deflected on to hateful
things. The depressed patient requires of his analyst the understanding that the
analyst's work is to some extent his effort to cope with his own (the analyst's)
depression, or shall I say guilt and grief resultant from the destructive
elements in his own (the analyst's) love. To progress further along these lines,
the patient who is asking for help in regard to his primitive, pre-depressive
relationship to objects needs his analyst to be able to see the analyst's
undisplaced and co-incident love and hate of him. In such cases the end of the
hour, the end of the analysis, the rules and regulations, these all come in as
important expressions of hate, just as the good interpretations are expressions
of love, and symbolical of good food and care. This theme could be developed
extensively and usefully.
II
Before embarking directly on a description of primitive emotional development I
should also like to make it clear that the analysis of these primitive
relationships cannot be undertaken except as an extension of the analysis of
depression. It is certain that these primitive types of relationship in so far
as they appear in children and adults come as a flight from the difficulties
arising out of the next stages, after the classical conception of regression. It
is right for a student analyst to learn first to cope with ambivalence in
external relationships and with simple repression and then to progress to the
analysis of the patient's phantasy about the inside and outside of his
personality, and the whole range of his defences against depression, including
the origins of the persecutory elements. These latter things the analyst can
surely find in any analysis, but it would be useless or harmful for him to cope
with principally depressive relationships unless he was fully prepared to
analyse straightforward ambivalence. It is at least as true that it is useless
and even dangerous to analyse the primitive pre-depressive relationships, and to
interpret them as they appear in the transference, unless the analyst is fully
prepared to cope with the depressive position, the defences against depression,
and the persecutory ideas which appear for interpretation as the patient
progresses.
III
I have more preparatory remarks to make. It has often been noted that, at five
to six months, a change occurs in infants which makes it more easy than before
for us to refer to their emotional development in the terms that apply to human
beings generally. Anna Freud makes rather a special point of this and implies
that in her view the tiny infant is concerned more with certain care-aspects
than with specific people. Bowlby recently expressed the view that infants
before six months are not particular, so that separation from their mother does
not affect them in the same way as it does after six months. I myself have
previously stated that infants reach something at six months, so that whereas
many five months' infants grasp an object and put it to the mouth, it is not
till six months that the average infant starts to follow this up by deliberately
dropping the object as part of his play with it.
In specifying five to six months we need not try to be too accurate. If in a
certain case a baby of three or even two months or even less reaches the stage
of development that it is convenient in general description to place at five
months, no harm will be done.
In my opinion the stage we are describing, and I think one may accept this
description, is a very important one. To some extent it is an affair of physical
development, for the infant at five months becomes skilled to the extent that he
grasps an object he sees, and can soon get it to his mouth. He could not have
done this earlier. (Of course he may have wanted to. There is no exact parallel
between skill and wish, and we know that many physical advances, such as the
ability to walk, are often held up till emotional development releases physical
attainment. Whatever the physical side of the matter, there is also the
emotional.) We
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can say that at this stage a baby becomes able in his play to show that he
can understand he has an inside, and that things come from outside. He shows he
knows that he is enriched by what he incorporates (physically and psychically).
Further, he shows that he knows he can get rid of something when he has got from
it what he wants from it. All this represents a tremendous advance. It is at
first only reached from time to time, and every detail of this advance can be
lost as a regression because of anxiety.
The corollary of this is that now the infant assumes that his mother also has an
inside, one which may be rich or poor, good or bad, ordered or muddled. He is
therefore starting to be concerned with the mother and her sanity and her moods.
In the case of many infants there is a relationship as between whole persons at
six months. Now when a human being feels he is a person related to people, he
has already travelled a long way in primitive development.
Our task is to examine what goes on in the infant's feelings and personality
before this stage which we recognize at five to six months, but which may be
reached later or earlier.
There is also this question: how early do important things happen? For instance,
does the unborn child have to be considered? And if so, at what age after
conception does psychology come in? I would answer that if there is an important
stage at five to six months there is also an important stage round about birth.
My reason for saying this is the great differences that can be noticed if the
baby is pre-mature or post-mature. I suggest that at the end of nine months'
gestation an infant becomes ripe for emotional development, and that if an
infant is post-mature he has reached this stage in the womb and one is therefore
forced to consider his feelings before and during birth. On the other hand a
premature infant is not experiencing much that is vital till he has reached the
age at which he should have been born, that is to say some weeks after birth. At
any rate this forms a basis for discussion.
Another question is: psychologically speaking, does anything matter before five
to six months? I know that the view is quite sincerely held in some quarters
that the answer is 'no'. This view must be given its due, but it is not mine.
The main object of this paper is to present the thesis that the early emotional
development of the infant, before the infant knows himself (and therefore
others) as the whole person he is (and they are), is vitally important: indeed
that here are the clues to the psychopathology of psychoses.
IV
PRIMARY PROCESSES
There are three processes which seem to me to start very early: (1) integration,
(2) personalization, and (3), following these, the appreciation of time and
space and other properties of reality-in short, realization.
A great deal that we tend to take for granted had a beginning and a condition
out of which it developed. For instance, many analyses sail through to
completion without time being ever in dispute. But a boy of nine who loved to
play with Ann, aged two, was acutely interested in the expected new baby. He
said: 'When the new baby's born will he be born before Ann?' For him time-sense
is very shaky. Again, a psychotic patient could not adopt any routine because if
she did she had no idea on a Tuesday whether it was last week, or this week, or
next week.
The localization of self in one's own body is often assumed, yet a psychotic
patient in analysis came to recognize that as a baby she thought her twin at the
other end of the pram was herself. She even felt surprised when her twin was
picked up and yet she remained where she was. Her sense of self and
other-than-self was undeveloped.
Another psychotic patient discovered in analysis that most of the time she lived
in her head, behind her eyes. She could only see out of her eyes as out of
windows and so was not aware of what her feet were doing, and in consequence she
tended to fall into pits and to trip over things. She had no 'eyes in her feet'.
Her personality was not felt to be localized in her body, which was like a
complex engine that she had to drive with conscious care and skill. Another
patient, at times, lived in a box 20 yards up, only connected with her body by a
slender thread. In all practices examples of these failures in primitive
development occur daily, and by them we may be reminded of the importance of
such processes as integration, personalization and relization.
It may be assumed that at the theoretical start the personality is unintegrated,
and that in regressive disintegration there is a primary state to which
regression leads. We postulate a primary unintegration.
Disintegration of personality is a well-known psychiatric condition, and its
psychopathology is highly complex. Examination of these phenomena in analysis,
however, shows that the primary unintegrated state provides a basis for
disintegration, and that delay or failure in respect of primary integration
predisposes to disintegration as a regression, or result of failure in other
types of denfence.
In any case, integration starts right away at the beginning of life, and in our
work we can never take it for granted. We have to account for it and watch its
fluctuations.
An example of unintegration phenomena is provided by the very common experience
of the patient who proceeds to give every detail of the week-end and feels
contented at the end if everything has been said, though the analyst feels that
no analytic work has been done. Sometimes we
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must interpret this as the patient's need to be known in all his bits and
pieces by one person, the analyst. To be known means to feel integrated at least
in the person who knows one. This is the ordinary stuff of infant life, and an
infant who has had no one person to gather his bits together starts with a
handicap in his own self-integrating task, and perhaps he cannot succeed, or at
any rate cannot maintain integration with confidence.
The tendency to integrate is helped by two sets of experience: the technique of
infant-care whereby an infant is kept warm, handled and bathed and rocked and
named, and also the acute instinctual experiences which tend to gather the
personality together from within. Many infants are well on the way toward
integration during certain periods of the first 24 hours of life. In others the
process is delayed or set-backs occur because of early inhibition of making
greedy attacks. There are long stretches of time in a normal infant's life in
which a baby does not mind whether he is many bits or one whole being, or
whether he lives in his mother's face or in his own body, provided that from
time to time he comes together and feels something. Later I will try to explain
why disintegration is frightening, whereas unintegration is not.
In regard to environment, bits of nursing technique, faces seen and sounds
heard, and smells smelt are only gradually pieced together into one being to be
called mother. In the transference situation in analysis of psychotics we get
the clearest proof that the psychotic states of unintegration had a natural
place at a sufficiently primitive stage of the emotional development of the
individual.
It is sometimes assumed that in health the individual is always integrated, as
well as living in his own body, and able to feel that the world is real. There
is, however, much sanity that has a symptomatic quality, being charged with fear
or denial of madness, fear or denial of the innate capacity of every human being
to become unintegrated, depersonalized, and to feel that the world is unreal.
Sufficient lack of sleep produces these conditions in anyone.3
Equally important with integration is the development of the feeling that one's
person is in one's body. Again it is instinctual experience and repeated quiet
experiences of body-care that gradually build up what may be called satisfactory
personalization. And as with disintegration so also the depersonalization
phenomena of psychosis relate to early personalization delays.
Depersonalization is a common thing in adults and in children, it is often
hidden for instance in what is called deep sleep and in prostration attacks with
corpse-like pallor:?She's miles away, ' people say, and they're right.
A problem related to that of personalization is that of the imaginary companions
of childhood. These are not simple phantasy constructions. Study of the future
of these imaginary companions (in analysis) shows that they are sometimes other
selves of a highly primitive type. I cannot here formulate a clear statement of
what I mean, and it would be out of place for me to explain this detail at
length now. I would say, however, that this very primitive and magical creation
of imaginary companions is easily used as a defence, as it magically by-passes
all the anxieties associated with incorporation, digestion, retention and
expulsion.
V