Pioneering Psychiatrist Donald Winnicott on the Attributes of a Healthy Mind and Healthy Relationships – The Marginalian

“I have always felt that a man can only be saved by another man,” wrote James Baldwin in one of his best stories. “I know we don't always save each other. But I also know we save each other sometimes.”

It is a powerful and dangerous feeling, because if mutual salvation is not the result of a healthy relationship but an expectation when entering into one, it can spill over into a destructive relationship. And yet we know from the neurobiology of limbic feedback that “who we are and who we are depends, in part, on who we love.”

Whether relationships end up being remade or deepening unhealthy attachment patterns encoded early in life depends largely on what we bring to them, and can change from one to the other as expectations change. When we approach each other with curiosity and care without expecting a cure, something strange and wonderful can happen—care can be the cure. The Latin word for “healing” – you are — means “to worry,” which is also the root of “to care” (to have worries, to worry), “to be curious” (to ask with concern), and “to be safe” (without worry and care).

Pioneering pediatrician-turned-psychologist Donald Winnicott (April 7, 1896–January 28, 1971) had a unique understanding of how the two work together to create a safe and healthy relationship. Trained as a doctor – a career predicated on healing – Winnicott came to psychoanalysis skeptical of applying the medical disease model to mental health. For him, proper treatment provides not only a cure for symptoms but a “widely based personality that is rich in emotion and tolerant of others because it is more confident [oneself]” — a very counter-cultural view within a medical culture based on curing disease.

Winnicott placed at the center of a healthy and secure relationship – between therapist and patient, as between two independent individuals – what he called care-healing. In the last months of his life, he expressed this idea in a speech given to doctors and nurses at the Church of St. Luke, which was later included in an amazing posthumous collection. Home Is Where We Begin: Essays by a Psychoanalyst (public library).

That's what's at the heart of this care-healing sense, Winnicott notes:

We talk about love, but… the meaning of the word must be clarified.

When describing the main qualities of a true therapeutic relationship – it must be impartial, truthful, and honest – Winnicott especially emphasizes honesty as a way to protect the other from unpredictability, since the root of the suffering of many is that “they are placed under the pattern of their life in the unpredictability.” (All trust is, in a sense, a predictive handshake, and every breach of trust is more damaging because the other person unexpectedly withdrew their hand.)

Winnicott considers the costs of unpredictability:

After uncertainty there is mental confusion, and after that there can be confusion about somatic functioning, that is, unimaginable physical anxiety.

In order to be able to deal with care, and all the necessary predictions, one must be free of mental confusion and balanced enough to show in a reliable way. Winnicott offers a definition of a healthy mind that doubles as a basic definition of a healthy love:

A sign of mental health is one person's ability to enter thoughtfully but accurately into another person's thoughts and feelings and hopes and fears; and allowing someone else to do the same to us.

This thoughtful connection to experience is necessary for the greatest challenge of knowing – understanding what it is like to be another. Without it, there can be no love, because we cannot love what we do not understand – then we love the imagination. A sign of healthy love, therefore, is the ability to be honest and responsible – as opposed to being responsible – for the thoughts and feelings and hopes and fears of another.

Complete Alain de Botton, writing the generation after Winnicott, about the virtues of common sense and Adrienne Rich, writing on Winnicott's day, a sign of noble human relations, and revisiting Winnicott on motherhood, that foundation of our hard-wired attachment patterns.