Show Summary Details
Page of

(p. 241) Sixth Consultation 

(p. 241) Sixth Consultation
Chapter:
(p. 241) Sixth Consultation
Author(s):

Donald W. Winnicott

DOI:
10.1093/med:psych/9780190271435.003.0040
Page of

PRINTED FROM OXFORD CLINICAL PSYCHOLOGY ONLINE (www.oxfordclinicalpsych.com). © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Clinical Psychology Online for personal use (for details see Privacy Policy and Legal Notice).

Subscriber: null; date: 26 October 2020

Originally published in The Piggle: An account of the psycho-analytic treatment of a little girl (I. Ramzy, Ed.). London: Hogarth, 1977.

July 7, 1964

The patient was now two years and ten months old. I greeted her on the doorstep with: ‘Hullo Gabrielle’. This time I knew I must say Gabrielle, not Piggle. She went to the toys immediately.

Me: Gabrielle has come to see me again.

Gabrielle: Yes.

She put the two big soft animals together and said: ‘They are together and are fond of each other’. She was also joining two carriages of a train.

Me: And they are making babies.

Gabrielle: No, they are making friends.I

She was still joining up bits of trains and I said: ‘You could be joining up all the different times that you have seen me’. Her reply: ‘Yes’.

Obviously, there are many interpretations to do with the joining of parts of trains, and one can use this according to the way one feels is most appropriate at the moment, or to convey one’s own feelings. I reminded Gabrielle of my interpretation of last time about the curly hair having to do with Piggle having a baby of her own.

Gabrielle: Things I think about.

She then made a distinction (in some way or other, quite clearly) between telling and showing (reminding me of the song in My Fair Lady, ‘Show Me!’).

Me: You mean showing me is better than telling me about something.

(p. 242) Gabrielle took a little bottle and made a noise like the noise of water: ‘They make a big circle when you make a big splash’. She was lisping, and sometimes it was difficult to make out what she said: ‘I’ve got a little paddly pool outside’ (meaning in the garden) ‘and two greenhouses. There’s our big house, and then my small house’.

Me: The small one is yourself.

Gabrielle: Just you. [She said this three times and then:] Just Gabrielle. Just Winnicott.

She linked two carriages together.

Me: Gabrielle and Winnicott make friends, but still Gabrielle is Gabrielle and Winnicott is Winnicott.

Gabrielle: We can’t find our cat, but I saw one going for a walk. I saw one running round everything. What pulled this along?

I helped her, and she said: ‘Winnicott catching hold hands’.

There was a kind of establishment of identities here. I said something about Gabrielle and her several relationships with Winnicott, daddy, mummy, and the Sush Baba.II Gabrielle made a Gabrielle noise and said: ‘The Sush Baby makes a wa noise’, and another which she did with her hand across her mouth.

She was amused at this variety entertainment, using her hand on and off her mouth. She had blown a fart just before, and I said: ‘Perhaps that was a Gabrielle noise’. She then spoke in a recognizable, characteristic manner, and I said: ‘This has to do with daddy’. There had been other times when she has spoken in this special way when strongly identified with her father.

Gabrielle: Don’t talk that way [but we talked about daddy]. The Sush Baby isn’t old enough to talk. What’s this funny thing?

She held up a handle which was tied to some string. She wanted me to put it on the engine so that she could pull it around the room. She was pleased about this. I said something about its being a baby Gabrielle that she was remembering, and she said: ‘No, it’s a little sister’, then, suddenly, ‘Look at this lovely picture’ (a portrait of a very serious girl of six or seven, rather old-fashioned, that I keep in my room). ‘It’s a girl older than me. She is older than me like I am older than the Sush Baby. She [Susan] can walk without holding anything now’. (She demonstrated walking and running and walking and then falling down.) ‘And she can get up’ (also demonstrated).III (p. 243)

Me: So she doesn’t need her mummy all the time now.

Gabrielle: No. Soon she will grow bigger and do without mummy or daddy, and Gabrielle will be able to do without Winnicott or without anybody at all. Someone will say: ‘What are you doing?’ That’s my place. I want to go to your place. Get out of the way.

She was illustrating a King of the Castle game1 with Gabrielle establishing her own identity and expecting it to be challenged. She now took two carriages and rubbed them together wheel to wheel.

Me: Are they making babies?

Gabrielle: Yes. Sometimes I lie on my back with my legs up when the sun is out. Not making babies. I’ve got a sundress and white knickers.

She demonstrated lying on her back with her legs up in the air getting the sun.IV

Gabrielle: I’ve got new shoes. [Not the ones she was wearing at the time.]

She was undoing one of her shoes and pulling her socks off. There was an ‘on-off, on-off’ activity. She wanted me to look at it, her sock, putting her big fat heel to the hole.

Me: You are showing me big breasts.

Gabrielle: Like feet.

She undid the other shoe, and showed the other heel-pad. She made fun of all this as if one of her feet had gone, in some game she devised.

Gabrielle: It’s all on the wrong foot [this was a joke].

She had changed her socks, and so she went to the toys in the bucket. I said: ‘Gabrielle eats up all the world and so she eats too much’ (but at the time the bucket was not over-full). Gabrielle replied: ‘She doesn’t be sick’.

She had one shoe off and played at leaving out the sock. There was a complexity here to do with socks and shoes, and she persevered in a very skilled way, but did not succeed.V

Me: Isn’t it difficult!

Gabrielle: Yes it is.

Me: Gabrielle can’t quite do without mummy and she can’t quite be a mummy.

So she came to a large train, and she said: ‘I hope we didn’t come too early’. Then she talked about the reasons why she and her father were early. They had actually been around the shops so as not to be too early.

(p. 244) I felt I was now needed to help with a difficult shoestrap, and this was allowed; also the other one.

Gabrielle: I hear a big bang [actual].

Me: Is someone cross?

Gabrielle: No. The Sush Baby bangs.VI

Then she whispered that she would go and see her daddy, and she opened the door quietly and shut it again. In a minute she was back, her own self, not needing daddy. She was putting the toys away.

Gabrielle: The toys are all untidy. What will you say?

Me: Who?

Gabrielle: Dr Winnicott.

She put the big soft animals (dogs) away. The tidying process had been in great detail with sorting out of types of toys.

Gabrielle: Oh, the top came off; never mind; mummy’s at home.

Then Gabrielle put everything away neatly, and said: ‘You have a nice place for toys haven’t you!’ (Actually the muddle of my toys has a place on the floor under a bookcase.) She found one or two odd toys that had been left out and put them away: ‘I keep mine outside in the wastepaper basket’.

She was now going out the door, and there was no toy left around. She was some time out with her father in the waiting room, telling him what she had done, and he was talking about it. Then she was getting her father in. She said to him: ‘I want you to go inside’, but he was holding back. He said: ‘You go in to Dr Winnicott’.

We had now had three quarters of an hour, and I was ready to stop. Father said: ‘No, no, you go in to Dr Winnicott’.

Gabrielle: No! No! No!

Me: Come, because it’s nearly time to go. Come inside.

She came in and was very friendly.

She asked me whether I was going to have a holiday and what I would do. I said I would go to the country and enjoy myself. That was the end of the session and as she left she said: ‘When shall I come back?’ I replied: ‘In October’.

An important detail in this session was the moment of identity establishment, the King of the Castle game, following the experiments with separateness out of merging.

(p. 245) Comments

  1. 1. My knowing she must be greeted as Gabrielle.

  2. 2. Gradual development of identity theme.

  3. 3. A version of King of Castle statement.

  4. 4. Play at part objects leading to the idea of breasts (on-and-off games).

  5. 5. Greed turning into appetite.

  6. 6. Mess into tidiness. Adumbration of mess theme to come.

Letter from the Mother

‘She sleeps well at night again. Her only comment on the session was: “I wanted to tell Dr Winnicott that my name is Gabrielle, but he knew it already”. This was said with satisfaction’.2

Letter from Both Parents, Written by Mother3

‘I do not know why I have found it difficult to write to you; perhaps I have been rather mixed up with Gabrielle and not quite separated out, but I hope that this is resolving itself.

‘Gabrielle seems to have been very much better, by which I mean that she has been able to invest the outside world with meanings of her own, and has been able to make use of and enjoy whatever opportunities she has had.

‘She is not so shy, but she finds it very difficult to make contact with other children, though she longs to do so very much, and suffers from rebuffs. She suffers very much from disillusionment, because she pins a lot of hopes on such contacts.

‘She gets on remarkably well with her sister, despite some lightning attacks—such as knocking her flat in the middle of the street, announcing that she was tired of having a little sister. Apart from such occasions, she treats her as a person, with a compassionate understanding that is most impressive.

‘There is still quite a bit of what seems to me somewhat spurious fantasy: I do not know how far she is taken in by it herself, and how far it is a legitimate and effective defence against somewhat inquisitive parents.4

‘Only these last few days she has again been unable to go to sleep, has been again visited by the black mummy, and has been talking more about going to Dr Winnicott. She seems very preoccupied with being poisoned; and she ate a berry that she insisted was poisonous, telling us how ill she was going to be. She also insists that her “brrr” is stuck inside her, though she does not seem to (p. 246) suffer from physical constipation. But all this has not been manifest for the rest of the summer. It meant a lot to her to have your telephone number.

‘You seem to have made so very much difference to her, and set things in motion again when they seemed to have rammed themselves into a most debilitating vicious circle. She even seems to look more like the solid little girl she was before Susan was born, and somehow continuity appears to have been re-established’.

Letter to the Parents from Myself

‘I received the postcard from Gabrielle. I think you would like me to see her again, and I will keep a time for her. You may feel, however, that it would be a good idea to leave things for a few weeks, in which case I hope you will let me know.

‘From what I have seen of Gabrielle, and from your letter, I do feel that we must not just think of her in terms of illness. There is much that is healthy in her. Perhaps you would let me know what you want me to do’.

(I have to remember here my bias belonging to the fact that I had no vacancy for a new treatment case; but also I did feel that these parents had some special reason for not relying on the developmental process which in this child might see her through apart from the provision of a treatment.)

Letter from the Parents

‘Thank you for your letter and the offer of an appointment, which we would be pleased to keep.

‘We also feel that Gabrielle can no longer be thought of as a very sick little girl; so many more areas of herself seem to have come to life again. And yet there are very marked pockets of distress and anxiety, which sometimes seem to lead to her cutting off all feeling altogether—and so living a very articulate, but two-dimensional life.

‘When we last wrote to you, she was just beginning to have difficulties in going to sleep again, after having been quite all right during most of the summer; and she is now up regularly for about three to four hours after bedtime.

‘She now has a “Nice black mummy”, who cuts her nails (you may remember how she used to scratch her face at night when in distress, and she has done this lately). The black mummy, however, came to cut off her thumb with a carving knife. But she said that she would tell Dr Winnicott that the black mummy had gone.

‘At the moment she is extremely concerned about her parents dying; but she talks of this in a very feelingless, blank sort of way. To her mummy: “I’d like (p. 247) you to be dead”.—“Yes. You would also be sorry”.—“Yes. I’ll keep your photo in my suitcase”.

‘She gives hints of the most disgusting things happening between her parents, and was deeply shocked and upset when she saw more than usual of her mother when changing for a bath. Though these seem fairly usual preoccupations, her distress and subsequent cutting off of feeling, and worry about them at night, seem to us to indicate that a little help may still be needed.

‘We took her to a nursery play group where, as we told you, she finds it difficult to make any contact, though she seems to want to: “Mummy, take a book. I’ll be bored, and then I won’t know what to do, and then I won’t know anyone, and then I won’t want anyone to look at me” ’.

Notes:

Marginal Note I Concept of ego relatedness.

Marginal Note II She was dealing with the border-line between merging and separateness.

Marginal Note III Conscious learning on the operation of the maturational processes.

1. ‘Psycho-Somatic Illness in Its Positive and Negative Aspects’ [CW 7:1:6].

Marginal Note IV Masturbation with fantasy of a form of intercourse between persons.

Marginal Note V Recognition of immaturity and relative dependence.

Marginal Note VI Identities becoming clarified.

2. This detail shows how important it was that I caught her first message, on the doorstep, and I knew I must say Gabrielle and not Piggle or a name that might have to do with one or another of her many roles. D. W. W.

3. Telephone conversations not reported here.

4. Could this join up with my being kept ignorant with respect to the black phenomena? D. W. W.