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(p. 161) Letter to Oliver H. Lowry 

(p. 161) Letter to Oliver H. Lowry
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(p. 161) Letter to Oliver H. Lowry
Author(s):

Donald W. Winnicott

DOI:
10.1093/med:psych/9780190271374.003.0033
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Subscriber: null; date: 18 July 2018

Originally published in Rodman, F. R. (Ed.), The spontaneous gesture. Selected letters of D. W. Winnicott (Letter 62, pp. 100–103). Cambridge, MA: Harvard University Press, 1987.
Oliver H. Lowry (1910–96) was a biochemist and pharmacologist, and the dean of Washington University’s School of Medicine, in St Louis, Missouri.

5 July 1956

Dear Dr Lowry,

It was good of you to write me about the establishment of a Chair in Child Psychiatry. It would seem that you are to have priority. I have been pressing for some time for a Chair of Child Psychiatry in this country and it may interest you to know that I have asked for an ‘official announcement that there shall be a Chair of Child Psychiatry in 10 years’ time’. It has not yet been possible to get University or Paediatric acknowledgement of the need for such a Chair.

In the wording of my recommendation in this country, that there should be a Chair of Child Psychiatry in 10 years’ time, I have implied, as you see, that there is no-one here who is fit to hold this post. For the same reason I am not able to recommend someone for Washington. If I change my mind on this subject I will let you know, because indeed there are some over here who are developing rapidly.

In my opinion we should ask for a paediatrician who has had a recognised paediatric training to have added a recognised psycho-analytic training. If this issue is raised in this country there will be protests from the Jungians of whom there are a few who are outstanding, and also from some of the eclectics. I think you will agree with me, however, that we must put forward the claim for the psycho-analytic training, which at any rate in this country is very much better than any other comparable training scheme.

(p. 162) It seems to me that it is most important that child psychiatry shall not be a branch of adult psychiatry but of paediatrics, just as I feel that it is important that the Professor should have not only had a psycho-analytic training, but should also have had several years’ experience of child analysis.

In making these suggestions I am implying that selection plays a very important part. The selection for paediatrics and also for psycho-analysis should be sufficient. Even so I feel that there are not many who by temperament and personality can properly fill this very important post, whether it be in this country or in U.S.A.

I am implying that I think that the academic psychological qualification is not relevant.

You ask me to discuss further aims and long range objectives, and I would very much like to have time for personal conversation on this subject, which is one to which I have given a good deal of thought. It is difficult to get at good samples of one’s thoughts when one has been thinking over a subject for many years.

First in regard to psycho-therapy, the reason why I said that the candidate for the Chair should have had several years of practice in child analysis is that I feel that we must not expect or allow the Professor to fill his time with child analyses and the acute problems of management which belong to any active practice. If he were to keep up three analyses and a few short treatments alongside the occasional therapeutic consultation, I think he would have material for teaching without cluttering up his life with clinical burdens.

He would hope to surround himself with psycho-therapists, some of whom need not be qualified medically. Perhaps in your country they need to be, but we find it quite satisfactory over here to have a proportion, not more than 30%, without the medical qualification.

The teaching would have to be done on live material and on the discussion of the cases, chiefly those having psycho-analytic treatment.

What I feel you will gain by having psycho-analysts rather than statisticians or academic psychologists is that the word research will not come to mean vast projects with questionnaires and an army of investigators who do no good. The advances in our subject are being made at the front end of psycho-analytic treatment at the places where treatment tends to fail or tends to need modification or where we discover our relative deficiencies in training because of problems that do not resolve. Further, the Professor being a psycho-analyst will be in favour of the personal analysis of all those who are taking seriously to child psychiatry. I believe this is accepted in your country in a more universal way than it is over here, and that probably your Psychiatric Social Workers and whatever is equivalent to our Child Care Officers will have had personal analyses.

Something like what you are attempting takes place in this country at the Tavistock Clinic, 2 Beaumont Street, London, W. 1, to which I am not attached, (p. 163) but about which I hear a good deal. You could no doubt gain from contact with Dr John Bowlby who is the senior child psychiatrist at this clinic, where nearly everyone working has had a psycho-analytic training or an analysis by a psycho-analyst.

In regard to your question, can we aim at finding a person who is both the finest practitioner of child psychiatry and at the same time an outstanding investigator?—I am personally in favour of the former and not in favour of a compromise. I think that an experienced child psycho-analyst at the head of a team will be able to keep the research of the team members in channels which are economic and which do not involve futile investigations which as I have said earlier make no difference to the case, and I would add now that by making no difference these investigations do harm. I feel sure that this will be readily accepted by yourself, and I am told that in your country it is recognised that therapeutics is altered and spoiled by non-therapeutic investigation and that an investigation that spoils therapy is bad teaching.

I would certainly need much more opportunity for discussion if I were to make my opinion clear on this point, and indeed some of my views are not fully developed. In any case I have spoken rather dogmatically in order to deal with your letter by letter.

I would like to end by saying that the really difficult task of the child psychiatry Professor will be to coordinate the two halves of paediatrics, the physical and the psychological, yet it seems to me that he must try to do so in spite of the fact that he will be dealing with a dissociation in the community which plays itself out in the muddled management which the child with psycho-somatic illness usually gets. Here again, however, is a very complex subject which cannot be stated in a few words.

I am very glad that you wrote to me about this subject, to which I have done very much less than justice.

Yours sincerely, (p. 164)