Date Posted: Friday, 2 February 2007

In our work with troubled children and young people we are often drawn to wonder what accounts for how they act and how they come to think and feel the things which they do about their previous and present experience. Sometimes their thoughts and their behaviour can seem unpredictable. In turn or indeed at the same time they may delight us, puzzle us, make us fearful for them and, for ourselves. They may invoke our envy, frustrate us and anger us. At times it can seem that the more we try to help them the more they resist our help. If care workers are to have any chance of helping these young people and themselves to enjoy a healthy relationship, it may be important that they should think about what has gone on before for the young people. This may gain them an understanding of how the young people they look after have come to be the way that they are. In doing this care workers will also begin to explore what has been termed the “inner world of the child.” The idea of the inner world has its base in psychodynamic theory. It is a world of unconscious as well as conscious feeling and thought. It has its beginnings in the pre-language stage of early infancy and in psychodynamic terms it is at the core of what it is to be an individual different from others.

There are a number of psychodynamically based theories of human development which have a specific focus on emotional development and which relate to the idea of the inner world of the child, including among others, those of Sigmund Freud, Melanie Klein, John Bowlby, Eric Erikson and Daniel Stern. I hope to consider all of these in turn in other articles, but to begin with I want to think about the inner world of the child, through some of the developmental theories of the English psychoanalyst, Donald Winnicott. I have started with Winnicott because he was interested in the work of those, including residential child care workers, who helped emotionally troubled youngsters. This interest is evident in much of his writing and his developmental model can be a useful one because it provides the child care worker with a straightforward starting point from which it is possible to compare other theoretical stances. It is my hope that this will help the reader build up her own general understanding of emotional development.

Cultural and social changes since Winnicott

Before considering Winnicott’s views on the development of the inner world further, we should take into account that though Winnicott thought that others, including the father and members of the extended family have vital emotional and practical roles in support of the mother-baby relationship, he almost invariably refers to the principal carer as being “the mother”. The kind of supportive structure surrounding the birth mother which Winnicott describes is still strongly in evidence, yet society has moved on since he was formulating his ideas about child development in the 1950s and 1960s and the nuclear family no longer has a monopoly as the accepted mode of child rearing. Nevertheless in order to avoid confusion in what follows in the main I use the convention of referring to the principal parenting figure as “the mother.”

It has also become increasingly clear that western culture has no controlling hold over what is the”right” child-rearing model or indeed the predominant one, and we should be mindful that patterns of child rearing differ from one culture to another. Indeed the idea that children can only flourish in western culture’s notionally typical nuclear family is a proposal now frequently challenged from within that culture. It is now more widely acknowledged that it has always been possible for a father, or the mother’s partner, or even more customarily, other family members to assume the maternal role which Winnicott assigned to the birth mother. Nonetheless, taking all this into consideration, Winnicott’s views on the rearing of children and their emotional development remain valid, influential and a corner stone of other subsequent child development theories, including developments in attachment theory.

What is the inner world of the child ?

Winnicott contended that the child’s inner world begins to develop in the early stages of infancy but significantly he believed that for some young children things have started to go wrong before the development of their inner world (Winnicott, 1960a). I will discuss this later. Winnicott held that what happened between mother and child during the infant’s first year was vitally important for a child’s healthy emotional development. For him the “ordinary devoted mother” or “good-enough mother” provides an environment which “facilitates” her baby’s natural maturational development (Winnicott, 1965 pp75-6). Winnicott’s principal premise was that if the newborn baby is to develop healthily, he needs someone, usually the mother, to provide the primary parental care. Winnicott understood that before the development of his inner world the baby was a jumble of instincts, fears and sensations which the infant cannot think about and therefore cannot differentiate. In short during the early stages of his life the infant cannot distinguish himself from his environment (which includes his mother) and so he is at the mercy of all the internal and external sensations which beset him in addition to the vacillations of pure feelings. For example, he will feel discomfort and pleasure. He will feel warm or cold. He will feel full or hungry. Yet at first he won’t be aware of feeling cold or hungry. Things will simply be acceptable or unacceptable. Winnicott thought that all these experiences are often very frightening for the newborn baby unless they are they are held by the mother. (Winnicott,1960a). Indeed in order to help the baby deal with these internal and external phenomena, Winnicott speaks of the mother’s function as one of “holding” the baby. He did not just mean holding the baby physically and providing comfort and nourishment, he also meant holding in another sense, that is having the capacity to “hold” those feelings the infant seems to find intolerable. Winnicott also saw the mother’s role of holding as “managing” or containing the child’s emotional experience until the child gradually learns to understand and contain his own feelings. At this early stage the child and mother are emotionally merged and as the mother learns to make sense of the child’s experience, she can begin to mirror this back to him so he can start to make sense of it himself. With the help and holding of the mother, the child progressively begins to bring together all the disconnected parts of his experience to the extent that he can begin to hold “himself” together. This according to Winnicott is the birth of the inner world. The child has developed an insight that there is a “self” and “not me” part of the world. It is at this stage – when the baby relinquishes the omnipotence of its cry for immediate attention and becomes increasingly able to wait because he trusts that nurture will eventually be provided – that integration occurs and this, whatever else subsequently happens to him in later life, with the exception of extreme trauma, will give him a sufficient emotional base to survive. Winnicott argued that for most children, given there is no thwarting or distorting of this process,the development of the inner world has usually occurred towards the end of a child’s first year.

Integration and the good-enough mother

Winnicott called the process of the development of an inner world, “ego-integration”. Here the term “ego” refers to the capacity to organise and make sense of one’s own experience. As I’ve noted, Winnicott was arguing that babies are not born with an inner world – an ego – but develop one during the first year of life. He suggested that babies are born with an in-built tendency to develop and mature and that this tendency when matched with “good-enough mothering” carries the baby through these confused early stages to the point where integration has taken place. For Winnicott the development of an integrated inner world of the child was the wellspring of imagination and creativity throughout life (Winnicott,1960a).

Winnicott (1965b) also thought that the development of a child’s integrated inner world was dependant on the principal parenting figures being “good-enough” because to act as what might notionally be considered a “perfect” mother would inevitably shelter a child unduly from the risks inherent in life and leave him unable to develop the capacity to deal with life’s vicissitudes. To develop a healthy inner world the infant must begin to trust that the mothering figure (though she will not always be present, for she too has needs,) can be counted on to be sufficiently present to ensure that healthy nurture is sustained. [Students of Attachment Theory may wish consider this idea in relation to Mary Ainsworth’s concept of the “secure base” and her construct of different attachment patterns in infants (Ainsworth et al, 1978)]. Most babies do have a “good-enough mother”; do experience “good-enough” parenting ; do have good-enough experiences ; do achieve integration and so most babies have the basis for healthy emotional development, even though they may subsequently – as of course, we as child care workers also did, because we too have been infants – encounter all sorts of difficulties and develop various anxieties as childhood and adolescence take their course. However Winnicott felt that because most of us receive good enough parenting and so develop a good sense of ourselves we are able to cope and deal with these difficulties and anxieties. Nevertheless a small but significant minority of babies have a much more difficult time and, for a variety of reasons, may not develop sufficient integration to make a satisfactory start to their emotional lives. The development of an integrated inner world, that is ego-integration, is according to Winnicott a very critical achievement.

The incompletely integrated and the unintegrated child

If the development of an integrated inner world is not achieved at the appropriate stage, then there will be core emotional elements which will remain unintegrated. According to Winnicott, this inevitably means that there is a strong likelihood emotional problems will be evident throughout childhood, while others are being stored up for the future, for instance, at the onset of puberty.

The things which prevent the process of ego-integration occurring are usually linked with matters which have prevented the parents from providing good enough “holding”. For example if a mother’s situation is such that she is more pre-occupied by her own emotional needs to the extent that she cannot notice or respond to the needs of her baby, there is little chance of the baby feeling safely “held”. He is more likely to feel ignored, dropped and abandoned at a time when he does not have the capacity to think what it all means, or, to comprehend what has happened. If there is no one there to mediate and manage the baby’s chaotic experience, then the baby is left exposed to primitive instinctual fears and anxieties such as the fear of going to pieces or falling forever. These descriptions may seem dramatic but they describe what appear to be terrifying experiences for the baby. To remain in the unintegrated state without the prospect of relief may be extremely fateful for the baby because it means he cannot achieve any sense of predictability, or any understanding of people in his external world and in particular of himself. The American psychoanalyst, Eric Erikkson, whose theoretical propositions I will consider in more depth elsewhere, describes this unintegrated state as the failure of the infant to develop a sense of basic trust in his world. Erikson argued that such a failure is the source of the development of psychosis (Erikson, 1950).

While Winnicott suggested that most of us have experienced “good- enough” parenting and are satisfactorily integrated, he did not believe that all the children and young people living away from their birth family and who were being looked after by residential child care workers in children’s homes were unintegrated. He concluded that many of these had received “good-enough parenting” in early infancy, and that at some time, or at some times, this had been withdrawn, and so their inner and external world, which had held out so much hope for the future had almost been divested of all this promise as a consequence of the traumatic events such as family breakdown and its consequences. However, as far as Winnicott is concerned it is important to recognise that most of these children are ones who have experienced a loss and are not children who have suffered deprivation since birth or soon afterwards. Something which they had been led to believe as a fundamentally good part of themselves – of their inner world – has been taken away. Often children like this can seem the most difficult to tolerate since they tend to express their sense of loss in extreme ways and yet for Winnicott these were the ones for whom most hope could be held since there was a part of their inner world which, as a consequence of their experience of “good-enough parenting”, is inhabited with the potential to engage with and to trust their external world. One such kind of child is described by Barbara Dockar Drysdale – a psychotherapist influenced by Winnicott and who during the 1960s and 1970s worked with children and young people placed in therapeutic communities – is the “archipelago child”. This is a child who has experienced a disrupted childhood during which there have been islands of “good-enough caring” broken up by periods of neglect and abuse (Dockar-Drysdale, 1993). It is a task of the residential child care worker Dockar-Drysdale argued to help a child build effective bridges between these healthy parts.

Residential child care workers also work with unintegrated children and young people. The unintegrated child does not have this sense of loss, because he has not experienced good enough parenting at all. What has not been put into a child’s inner world in the first place cannot be taken away. The inner world of the unintegrated child has not developed because his complete lack of good enough caring has not allowed him to build a structure, an inner world, strong enough to hold together all his primitive feelings in a way that will allow him to survive without the care and support of others. Barbara Dockar-Drysdale, described the unintegrated child as “the frozen child”; one whose apparent social adeptness masks a state of panic and rage which can erupt for what seems no reason. Children like this are unable to show remorse or any concern and lack warmth because they are unable to experience or internalise healthy emotional approaches from others because neglect and abuse have characterised their earliest engagement with parenting figures (Dockar-Drysdale, 1993).

The relevance of the child’s inner world to those who work with children and young people

Winnicott indicates that those children and young people whose inner world can be characterised as one of extreme anxiety and fear and who have been unable to develop and sustain a coherent and healthy inner world will be significantly influenced by poor and sometimes traumatic early nurturing experiences (Winnicott, 1960). Those who are involved with trying to help children and young people in the care system are engaged with the fears and anxieties these youngsters are experiencing. They are , young people who Adrian Ward (1998) suggests, may be out of touch with the level and nature of their fearful and sometimes angry feelings. Their inner world is barren or chaotic and they are unable to express themselves in the way that most young people are. It is particularly important for the care worker to engage with the inner world of the young person if she is to be any help to him. Ward suggests this can only be done if the care worker has insight of her own inner world. In doing this Ward argues it is possible for the worker to have some empathy for the child’s feelings yet he also points out that this empathy should not spill over into over-identification with the young person (Ward, 1998). In order to make a healthy engagement with a young person, the worker needs to have insight of her own inner world and to acknowledge that this brings something to her relationship with a young person. If this can be achieved, I would argue that her relationship with a young person becomes a real one which will allow both people in the relationship to grow. The worker may then help a young person achieve something for himself by being ‘with’ him emotionally rather than doing something ‘to’ or indeed sometimes “for” him from a position of unquestioned adult authority. Like the “good-enough” mother of the infant the care worker absorbs the young person’s confused terrors and returns them to him in a way that he can tolerate.

Charles Sharpe, 2004; revised June, 2010 and March, 2013

References

Ainsworth,M.,Blehar, M., Waters, E. & Wall,S.,(1978) Patterns of Attachment : A psychological Study of the Strange Situation Hillsdale, USA : Erlbaum>

Dockar Drysdale, B.(1969) Consultation in Child Care London : Free Association Books, 1993 pp33-40

Erikson, E.H. (1950) Childhood and Society London : Penguin Books, 1965 pp239-267

Ward, A. (1998) ‘The Inner World and Its Implications’ in Intuition is not Enough : Matching Learning with Practice in Therapeutic Child Care (Ward, A. and McMahon, L. eds.) London : Routledge pp 11-27

Winnicott, D.W. (1960) ‘The Theory of Parent-Infant Relationship’ in The Maturational Processes and the Facilitating Environment (Winnicott, 1965) London : Karnac, 2002 pp37-55

Winnicott, D.W. (1960) ‘Ego Distortion in Terms of the True and False Self’ in The Maturational Processes and the Facititating Environment (Winnicott, 1965) London : Karnac 2002 pp140-152

Wider Reading

Bowlby, J.(1969) Attachment London : Penguin Books

Freud, S.(1905) ‘Three Essays on the Theory of Sexuality’ in On Sexuality and other works : The Penguin Freud Library Vol 7 London : Penguin Books 1977, pp 88-170

Klein, M.(1921-45) Love Guilt and Reparation and other works London : Vintage

Stern,D. (1985) The interpersonal World of the Infant New York : Basic Books.