The Marginalian
The Marginalian

Pioneering Psychiatrist Donald Winnicott on the Qualities of a Healthy Mind and a Healthy Relationship

Pioneering Psychiatrist Donald Winnicott on the Qualities of a Healthy Mind and a Healthy Relationship

“I have always felt that a human being could only be saved by another human being,” James Baldwin wrote in one of his finest essays. “I am aware that we do not save each other very often. But I am also aware that we save each other some of the time.”

It is a powerful sentiment and a dangerous one, because if mutual salvation is not the byproduct of a healthy relationship but an expectation upon entering into one, it can bleed into destructive codependence. And yet we know from the neurobiology of limbic revision that “who we are and who we become depends, in part, on whom we love.”

Whether a relationship ends up rewiring or deepening unhealthy attachment patterns encoded early in life depends largely on the expectations we bring to it, and can change from one to the other as the expectations change. When we approach one another with curiosity and care without the expectation of curing each other, something paradoxical and miraculous may happen — the care may become the cure. The Latin of the word “cure” — cūra — means “anxiety,” which is also the root of “care” (to have cares, to be anxious), “curiosity” (an anxious inquisitiveness), and “secure” (without anxiety and care).

Art by Sophie Blackall from Things to Look Forward to

The pioneering pediatrician turned psychoanalyst Donald Winnicott (April 7, 1896–January 28, 1971) understood uniquely the interplay of the two in the making of secure and healthy relationships. Trained as a physician — a profession predicated on cures — Winnicott came to psychoanalysis skeptical of applying the disease model of medicine to the health of the psyche. For him, proper therapy offered not just a cure of symptoms but “a more widely based personality richer in feeling and more tolerant of others because more sure of [oneself]” — a radically countercultural notion amid a therapy culture predicated on curing pathologies.

Winnicott placed at the center of a healthy and secure relationship — between a therapist and a patient, as much as between two private human beings — what he termed care-cure. In the final months of his life, he developed this notion in a talk delivered to doctors and nurses in St. Luke’s Church, later included in the altogether fantastic posthumous collection Home Is Where We Start from: Essays by a Psychoanalyst (public library).

With an eye to what is at the heart of this care-cure concept, Winnicott observes:

We are talking about love, but… the meaning of the word must be spelt out.

One of artist Margaret C. Cook’s rare 1913 illustrations for Walt Whitman’s Leaves of Grass. (Available as a print.)

In spelling out the primary qualities of a true care-cure relationship — it must be non-moralistic, truthful, and reliable — Winnicott places especial emphasis on reliability as a way of protecting the other from unpredictability, since the root of suffering for many is that “they have been subjected as part of the pattern of their lives to the unpredictable.” (All trust is, in a sense, a handshake of predictability, and every breach of trust is devastating precisely because the other person has unpredictably withdrawn their hand.)

Winnicott considers the cost of unpredictability:

Behind unpredictability lies mental confusion, and behind that there can be found chaos in terms of somatic functioning, i.e. unthinkable anxiety that is physical.

To be capable of a care-cure relationship, with all its requisite predictability, one must therefore be free of mental confusion and balanced enough to show up in a reliable way. Winnicott offers a definition of a healthy mind that doubles as a fundamental definition of healthy love:

A sign of health in the mind is the ability of one individual to enter imaginatively and yet accurately into the thoughts and feelings and hopes and fears of another person; also to allow the other person to do the same to us.

Art from Birds by Brian Wildsmith

This imaginative interpenetration of experience is necessary for the greatest challenge of consciousness — understanding what it is like to be another. Without it, there can be no love, for we cannot love whom we do not understand — then we are pseudo-loving a projection. A sign of healthy love, therefore, is the ability to be reliable and responsible with — which is different from being responsible for — the thoughts and feelings and hopes and fears of the other.

Complement with Alain de Botton, writing a generation after Winnicott, on the qualities of a healthy mind and Adrienne Rich, writing in Winnicott’s day, on the mark of an honorable human relationship, then revisit Winnicott on motherhood, that fundament of our hardest-wired attachment patterns.

BP

Thomas Bernhard on Walking, Thinking, and the Paradox of Self-Reflection

Thomas Bernhard on Walking, Thinking, and the Paradox of Self-Reflection

“I: how firm a letter; how reassuring the three strokes: one vertical, proud and assertive, and then the two short horizontal lines in quick, smug succession,” the adolescent Sylvia Plath wrote in her diary as she contemplated free will and what makes us who we are. “This is the entire essence of life: Who are you? What are you?” proclaimed Leo Tolstoy in the diaries of his own youth a century earlier. These are abiding questions we all ask ourselves and answer with our selves, but also impossible ones. To hold up a mirror to oneself is to become both the looking-glass and the eye doing the looking — a sort of infinite Borgesian mirror of self-reflection reflecting itself. (Borges himself, in his own youth, danced with the paradox of self-awareness.)

No one has paced this labyrinthine paradox more elegantly, nor reached its center with richer insight, than the Austrian novelist, playwright, and poet Thomas Bernhard (February 9, 1931–February 12, 1989) in his novella Walking (public library) — his unusual 1971 masterpiece exploring the nature of thinking and the impossibility of accurate self-reflection.

Painting of Thomas Bernhard, with photographer’s reflection. Thomas Bernhard House. Photograph by Mayer Bruno.

Half a century after The Wind in the Willows author Kenneth Grahame asserted that to walk is “to set the mind jogging” and a generation before Rebecca Solnit defined walking as “a state in which the mind, the body, and the world are aligned,” Bernhard writes:

If we observe very carefully someone who is walking, we also know how he thinks. If we observe very carefully someone who is thinking, we know how he walks. If we observe most minutely someone walking over a fairly long period of time, we gradually come to know his way of thinking, the structure of his thought, just as we, if we observe someone over a fairly long period of time as to the way he thinks, we will gradually come to know how he walks… There is nothing more revealing than to see a thinking person walking, just as there is nothing more revealing than to see a walking person thinking… Walking and thinking are in a perpetual relationship that is based on trust.

Art by Shaun Tan for a special edition of the Brothers Grimm fairy tales.

In a brilliant conceptual twist, which turns the mirror of self-reflection into a Möbius strip, Bernhard adds:

However, we may not ask ourselves how we walk, for then we walk differently from the way we really walk and our walking simply cannot be judged, just as we may not ask ourselves how we think, for then we cannot judge how we think because it is no longer our thinking. Whereas, of course, we can observe someone else without his knowledge (or his being aware of it) and observe how he walks or thinks, that is, his walking and his thinking, we can never observe ourselves without our knowledge (or our being aware of it). If we observe ourselves, we are never observing ourselves but someone else. Thus we can never talk about self-observation, or when we talk about the fact that we observe ourselves we are talking as someone we never are when we are not observing ourselves, and thus when we observe ourselves we are never observing the person we intended to observe but someone else. The concept of self-observation and so, also, of self-description is thus false.

Art from What Color Is the Wind? by Anne Herbauts

Bernhard extends this logic to the vastest questions about how the native limitations of our consciousness shape our perception and interpretation of reality:

Looked at in this light, all concepts (ideas)… like self-observation, self-pity, self-accusation and so on, are false. We ourselves do not see ourselves, it is never possible for us to see ourselves. But we also cannot explain to someone else (a different object) what he is like, because we can only tell him how we see him, which probably coincides with what he is but which we cannot explain in such a way as to say this is how he is. Thus everything is something quite different from what it is for us… And always something quite different from what it is for everything else.

Walking, translated into English by Kenneth J. Northcott, is a stunning read in its unparagraphed totality, fusing philosophy’s depth of thought with poetry’s contemplative spaciousness. Complement this fragment with Hannah Arendt on time, space, and the thinking ego, Lauren Elkin’s manifesto for peripatetic empowerment, and Solnit’s indispensable Wanderlust, then revisit former U.S. Poet Laureate Tracy K. Smith on the persistence of the self and the great physician, etymologist, poet, and essayist Lewis Thomas on how a jellyfish and a sea slug illuminate the mystery of the self — the most original, science-governed, yet deeply poetic perspective on the subject I’ve ever encountered.

BP

A Heron’s Antidote to Fear of Death

They didn’t imagine it, the dying dinosaurs, that they would grow wings and become birds, become the laboratory in which evolution invented dreams and the cathedral in which it invented faith.

“There is grandeur in this view of life,” Darwin consoled himself as his beloved daughter was dying, for he knew that death is the engine of life, that across the history of natural selection the death of the individual is what ensured the adaptation and survival of the species. And yet against this natural grandeur, we suffer the smallness of our imagination about death, as about the myriad small deaths punctuating life — the losses, the endings, the falterings of hope — forgetting somehow that every ending is a beginning in retrograde, that what may seem like a terminus may be a transformation.

Great white heron, Holbox Island. (Available as a print.)

These are the thoughts thinking themselves through me as I watch a great white heron rising from the water’s edge, from this boundary line between worlds, this lapping memory of how life emerged from non-life.

Because my bird divinations began with its great blue cousin, I cannot help but ask the majestic white bird for a message.

Combing the eleven pages of Audubon’s ornithological text about the species, I follow the usual process and let the words rearrange themselves into this koan from the unconscious:

The final card from An Almanac of Birds: 100 Divinations for Uncertain Days, available as stand-alone print benefitting the Audubon Society.

Working on this divination, I was reminded of a long-ago counterpart — one of Mary Oliver’s least known poems, found in her 2003 collection What Do We Know (public library) and read here by 19-year-old poet, artist, and heron-lover Rose Hanzlik to the sound of Debussy’s “Reverie.”

HERON RISES FROM THE DARK, SUMMER POND
by Mary Oliver

So heavy
is the long-necked, long-bodied heron,
always it is a surprise
when her smoke-colored wings

open
and she turns
from the thick water,
from the black sticks

of the summer pond,
and slowly
rises into the air
and is gone.

Then, not for the first or the last time,
I take the deep breath
of happiness, and I think
how unlikely it is

that death is a hole in the ground,
how improbable
that ascension is not possible,
though everything seems so inert, so nailed

back into itself —
the muskrat and his lumpy lodge,
the turtle,
the fallen gate.

And especially it is wonderful
that the summers are long
and the ponds so dark and so many,
and therefore it isn’t a miracle

but the common thing,
this decision,
this trailing of the long legs in the water,
this opening up of the heavy body

into a new life: see how the sudden
gray-blue sheets of her wings
strive toward the wind; see how the clasp of nothing
takes her in.

Great white heron, Holbox Island. (Available as a print.)

Complement with the poetic science of what happens when we die and astronomer Rebecca Elson’s magnificent poem “Antidotes to Fear of Death,” then revisit the great blue heron as a lens on our search for meaning.

BP

Between the User and the Used: Zadie Smith on Instrumentalism

Between the User and the Used: Zadie Smith on Instrumentalism

The great paradox, the great pain of human relationships is that they are so often not relational: two lonelinesses colliding without real contact, one or both orienting to the other not as a person but as a projection, mistaking for intimacy its myriad illusions — admiration, adoration, desire. It is always dangerous and damaging, and we are almost never aware — or never willing to listen to the parts of us who are aware — that it is happening until the delirious turbine of the dynamic has spat us out with a concussing confusion and a dislocated heart.

We use each other all the time, of course, in benign ways — to draw inspiration from another mind, to see the world with another set of eyes, to broaden the repertoire of the heart. But such uses are more akin to the relationship between symbionts: two differently specialized organisms nurturing each other with their strengths. The damage happens when the relationship takes on the form of parasite-host or predator-prey, when the user devours the used and discards them after their use.

It can be hard to see these dangerous dynamics from the inside of our own lives, but we can shine a sidewise gleam on them through the lives of others, real or imagined. The great gift of all the works of the imagination — literature, theater, film — is that they hand us our experience back to ourselves, annealed and clarified, unfiltered by self-judgment or pride. This is why, as Zadie Smith observes in her magnificent essay collection Dead and Alive (public library), the people about whom such works are most curious are “the conflicted, the liars, the self-deceiving, the wilfully blind, the abject, the unresolved, the imperfect, the evil, the unwell, the lost and divided” — the people almost all of us have at some point loved, or been.

In one of the essays, anchored in the movie Tár, she paints a haunting portrait of one such dynamic: The protagonist, a narcissistic and image-conscious composer, has had some passionate involvement, never clearly detailed, with another woman and has terminated it abruptly, leaving her lover reeling with heartache and confusion, gaslighting her and giving the world the impression it never happened in order to rinse the knowledge that she has done harm:

First, like any bad guy, [Tár] attempts to cover her tracks. We watch her emailing everyone she knows in the music community to warn them of an unstable young woman called Krista Taylor, who may be spreading untrue rumours about her. Then checking Twitter to see if said rumours have broken out into the world. We begin to get the picture. Krista is a young, aspiring conductor. Tár was her mentor. Also (secretly) her lover — although only briefly… We never meet Krista, but from our glimpses of the many pleading emails she sends Tár’s assistant, we gather that an affair that proved seismic for Krista barely registered on her older lover’s radar… For Tár, it’s as if it never happened at all. She is already on to the next distraction.

Art from An Almanac of Birds: 100 Divinations for Uncertain Days. (Available as a print and as stationery cards, benefitting The Audubon Society.)

It is one of the most discomposing experiences in life, having felt a profound connection with someone only to discover it had been trivial to them — a fleeting fantasy, a frivolous experiment, a use. Smith writes:

There’s a word for this behaviour: instrumentalism. Using people as tools. As means rather than ends in themselves. To satisfy your own desire, or your sense of your own power, or simply because you can.

In the end, the instrumentalizer is left with the emptiness of her own incapacity for connection. We find Tár “stripped bare at last, with no theory, no defence, no prefabricated arguments,” faced with the aftermath of her lies, facing the final truth:

There is no redemption. Nothing to be said or done except feel it.

The paradox, and perhaps the redemption, is that the user always loses more than the used, for one has chosen erasure and the other is left with life — experience that is, however painful, lived. The person who is truly alive will always choose experience over erasure, for experience is the pulse-beat of aliveness while erasure — the disavowal of experience by means of denial, dissociation, and deceit — is always a living death.

BP

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