In the May issue of the Washington School of Psychiatry newsletter, Jon Frederickson interviews Joel Kanter on his new book on Clare Winnicott.

JF: What influence did Clare Winnicott have on Donald’s work?

JK: When I first heard about Clare, I thought she was a subordinate social worker and he was the psychiatrist running the Oxfordshire projects during the second world war.  In fact, he was a consultant who came in once a week and she ran the whole operation for these evacuated children.  She influenced his ideas on transitional objects, antisocial behavior in children, and therapeutic consultation.  She figured out how to do it and he conceptualized it.  Many of Donald’s most important ideas came out of their collaboration and her creative ideas.  For instance, the term ‘holding’ which Winnicott first used in 1968 came from Clare’s 1954 paper.

JF: One of the things that impressed me was her advice to social workers doing casework.  She showed them how to avoid becoming a therapist, yet communicate on an unconscious and indirect way to the childrens’ underlying emotional issues in very sensitive ways.  It was a very subtle role that she outlined.

JK: There is a spectrum of helping interventions.  At one end is psychoanalysis with an analyst who is exploring only the patient’s internal life and at the other end you have the social worker in the middle of the person’s external life, and directly intervening in it.

JF: As you know, the social worker’s role is often conceptualized mistakenly as offering only concrete services but without an understanding of the emotional meanings of that relationship, how to recognize them, and how to work with them.  Clare seemed to have an incredibly clear way of talking to social workers about the meanings of their role and how to talk to the children about their relationship.

JK: I think of that role as the “transitional participant”.  The social worker embodies a certain set of wishes the child has, and, as such, serves as a bridge between reality and the fantasy world.  When childrens’ lives are so disrupted, the social worker provides the continuity.  The social worker meets them when they have to go into foster care.  When they have to move, the same social worker meets them and takes them to the next home.  The social worker is in contact with the parents.  The social worker becomes the psychic embodiment of life experience.  When someone accompanies them through all these changes, hospitalizations, etc. it has an incredible impact.

JF: Yes, remember that beautiful example of Clare reminding the kids that their parents were still thinking about them.  But then when she visited the mother, the mother assumed her children no longer thought of her.  Clare tells her how the children are doing, what they say about the mother.  Then she asks the mother if there is anything she wants Clare to bring the children as a reminder of her.  Reminding the mother that her children had not forgotten her.  Helping the mother hold her own child in her mind.

JK: That mother could go to a therapist who could advise her to write a letter.  But a ‘transitional participant’ has a totally different impact.  Because the mother, in meeting the case worker, meets her child through the presence of the worker who has seen her child.  The same advice coming from a therapist would not carry the same weight at all.

JF: I hadn’t realized what a great term this is, ‘transitional participant.’  Obviously this draws from Sullivan’s concept of the participant observer.  Fromm thought this was a terrible term.  He said we’re really not so outside of what we’re observing.  So he preferred the term ‘observing participant.’  Here you’re talking about the transitional participant to convey the concreteness of actually being there.