Finding the Piggle:

reconsidering D.W. Winnicott’s most famous child case

edited by Corinne Masur, Bicester, Phoenix Publishing, 2021, 259 pp., RRP £28.99, ISBN 978-1-912691-63-0

Refresh! Look back and feel invigorated all over again. Like Little Jack or Jill Horner, Put in your thumb, and pull out a plum (I hope most readers still remember that nursery rhyme) … 1977 was the year that Donald Woods Winnicott’s account of ‘the psychoanalytic treatment of a little girl’ was first published, sadly, posthumously. The picture of ‘the Piggle’ on the cover of my Penguin edition published three years later shows the drawing of a little girl aged about five (the age at which she finished treatment – sixteen sessions ‘on demand’ from when she was two), dressed in a neat spotty blue blouse with a white collar, with a neat blue bow in her hair. What do those frank blue eyes tell us? In terms of appearance, so far so conventional, and possibly a five-year old girl in 2021 would look rather different.

But now in 2021 we have this fascinating update of a classic text. Have other things changed, beyond physical appearances? Has clinical practice developed and expanded? As Angela Joyce says in her fine Foreword, ‘ … . psychoanalysis is a living entity, and has and is evolving in different directions’ (xiv). Winnicott was a pioneer of change of course, with his firm emphasis on the relational aspect of self-establishment. As the well-known phrase goes, ‘There is no such thing as a baby, only a baby and someone’, or, As Joyce has it, ‘without maternal care’ (xvi). As a teacher of Winnicott’s work for many years at the Tavistock Clinic and as a great admirer of his capacity to move on rather than remain static, opening this book is a treat indeed. I was pleased to be asked to refresh myself by writing this review, and hope it will persuade readers to have a new look at how Winnicott helped the Piggle in a healthy way to reconcile the instincts of love and hate after the birth of her younger sister. As Juliet Mitchell writes in her book Siblings (Polity 2003, p. 29), ‘ … this is not a once-and-for-all achievement; it is one that has to be often repeated throughout life. Its accomplishment is witnessed when analytic patients, indeed all patients, all of us, come to discover the huge relief of that dreaded fate that we are “ordinary”’; at heart we are just like anyone else, as anyone else is like us. It is vital work for us all, this struggle to become ‘ordinary’. When I introduced adult trainees to Winnicott’s Hate in the Countertransference they voiced their intense relief, that they were ‘allowed’ to have contradictory feelings about their patients. In 2021 we would place more emphasis on environmental and intergenerational factors (chief in the Piggle’s case, Holocaust transmission on her mother’s side and the trauma of emigration from father’s). John Bowlby was also working on his ground-breaking theory of Attachment at the same time, and, as Sebastian Kraemer suggests, ‘ … more or less invented family therapy from scratch’ (personal communication). Was there a certain rivalry between Bowlby and Winnicott? Winnicott pays scant attention to the separation the little girl went through when her mother gave birth and recovered afterwards, (even though he knew of James and Joyce Robertson’s films about hospital and other separations for children, which radically changed hospital practice), majoring instead on oedipal rivalry. So, we are in for a treat here; further thoughts about psychoanalysis, children, internal and external worlds, and the development of theory and practice over more than forty years. As the saying goes, ‘What’s not to like?’ The Piggle, whose real name was Gabrielle, grew up, and became a psychodynamic psychotherapist, treating adults and children in her own turn, in London. As Valerie Sinason says, the ‘Piggle’ book was the Pied Piper that brought riveted readers into child psychotherapy training, more so than any course or training advertisements (personal communication). As she says, ‘Make way for more training places!’

Many people, from the second half of the twentieth century onwards, are more focussed on intergenerational, shared pathology. What indeed were the unconscious preoccupations of the parents affecting Gabrielle’s difficulties? But she was helped by Winnicott, or was she? Deborah Anna Luepnitz, who ‘discovered’ the adult Gabrielle (born 1961) asked the question (p. 30):

Do you believe those 16 sessions helped you?
(Laughs) It sounds a bit ungrateful, but I don’t. It was perhaps owned more by my mother than me.

Do you believe she believed it helped you?
Yes I do – yes!

Shortly after Winnicott died of his final heart attack in 1971, and the Piggle’s parents separated and eventually divorced.

So, there are new lines of enquiry here (aren’t there always!) in this wide-ranging voyage around Winnicott and his work. What more plums can I pull out for you? Luepnitz explores issues of loss and mourning in ‘The Name of the Piggle’ (Chapter 1, pp. 1–39). Gabrielle (as an adult) stated that she had suffered over the years – in her own estimation – from not fulfilling the potential suggested by a deeply sensitive and precocious girl. She ended up having learning difficulties in primary school, particularly in terms of reading, which would of course be an apt way of differentiating oneself from two spectacularly learned parents. Brett Kahr makes a remarkable historical contribution to the Winnicottian literature in The Piggle papers: An archival investigation, 1961–1977 wondering whether Winnicott sought to emulate Melanie Klein, in identification with his former teacher, publishing just one case as she had done in Narrative of a Child Analysis.

This chapter on its own is a truly admirable example of meticulous and ethical research, and the author had the support and help of the adult Gabrielle throughout her studies. The now sadly late Christopher Reeves in his chapter ‘Reappraising Winnicott’s The Piggle: a critical commentary’ (pp. 101–163) offers his thoughts about the use of time; is analysis on demand OK? Can a child’s therapy be intensive without being extensive? And let’s not forget the contribution of Anna Freud. Justine Kalas Reeves in her chapter ‘A child analyst looks at The Piggle in 2020’ (pp. 211–227) views Winnicott as having been a ‘developmental object’ for the family. Winnicott had intended to write more about what he called ‘psychoanalysis partage’ – work with parents or shared psychoanalysis – but workaholic as he was, even in retirement, he did not get round to it before he died. Kalas Reeves also touches on the rather inflexible demands we may make on families. This may change in a post Covid world where, love it or loathe it, the screen plays its part in our interactions.

I helped to set up and run a Family Centre for many years and we tried to respond to the family’s demands rather than our own. Like the adult Gabrielle, we frequently found that it was the parents who had unconsciously come for help although they had referred their child. ‘When the parents realise what has, in fact, been tormenting their child and manage to change their approach to him or her, it is almost certain that the child’s symptoms will disappear,’ said Abe Brafman (personal communication). And in ‘Inviting the Piggle into therapy: a contemporary perspective’ (pp. 229–248), Zack Eleftheriadou discusses the racial and cultural issues which the adult Gabrielle had also retrospectively pondered. And Laurel Silber’s chapter ‘Child analysis is shared: holding the child’s relational context in mind’ (pp. 195–210) emphasises the relational context: this relational emphasis placed the child’s attachment needs at the forefront, a bold claim within the world of classical psychoanalysis, then a one-person model (p. 195). A rich meal indeed.

No doubt about it, Winnicott, alongside Freud, Klein and Bion, was a creative genius, and as Masur concludes in ‘Final thoughts’ (pp. 249–250), ‘any critique here is made exclusively in the interest of providing further life for the seminal case of The Piggle.’ What a playful book this is, full of gems which I too have used in the interests of helping therapists find their own way. We are reminded that all analysts and therapists working with adults and children risk distorting the patient’s truth by making too much sense of it. In other words, a perfectly honed (if somewhat prefabricated) interpretation may result in the therapist giving her/himself a pat on the back, and a nod to the internal supervisor, but it may mean nothing or not very much to the patient. This idea has been something of a relief for adult psychoanalytic students I have taught.

Some of Winnicott’s techniques and interventions may give us pause to question, but most aspects of his work are rightly recognised as the outpourings of an intuitive genius. What would Winnicott himself think if we could conjure him up now? He is pictured always with suit, shirt and tie; a neat, unassuming sort of person, conventional and modest, his own inevitable narcissism under surveillance. (What would he have made of sweatpants and leisure wear?) He would nevertheless I think welcome this further ‘playing with ideas’ and enjoy being part of the ongoing discussion and appreciation of young children’s hugely rich psychological world. Jenny Sprince and Paul Pengelly, in recalling their Tavistock pantomime days, said: ‘One child psychotherapist soprano claimed to have learned more theory from taking part in the pantos than from all the seminars and lectures she’d attended during her training’, (Waddell & Kraemer, 2020, p. 309). Fun may be the way forward. The aforementioned Brett Kahr did resurrect Winnicott for a posthumous interview and cup of tea, even two, at London’s 87 Chester Square (Kahr, 2016) in which Winnicott’s life and work were discussed in fascinating detail. This was before this present book was published, but let’s resurrect him once more. Here he is, looking first at the cover of the book, which shows him seated while Gabrielle plays with ‘the babacar’ on the floor at his feet. He welcomed discussion with his peers, and I like to think that he would have welcomed this new exploration, in his generous and pioneering way. He was a paradigm shifter par excellence, but also left room for others to grow.

Criticisms? Well, nothing that stands out, except no mention of the Squiggle Game. Why not? Luepnitz’ chapter shows us two of Winnicott’s own drawings (p. 28) when he and Gabrielle played together, but none of hers, nor the drawings they could have made together in the spirit of the Squiggle enquiry. Maybe they didn’t use this technique of his? Now, who knows? Plenty of not-knowing, as Bion would say. Maybe there is some repetition as different people circle around the case, but the book is no poorer for that. I’m grateful for having had this opportunity to recommend this book and write about one of our most creative forbears. I want, without I hope too much idealisation, to leave the last words to him:

Therapy takes place in the overlap of two areas of playing, that of the patient and that of the therapist. Psychotherapy has to do with two people playing together. The corollary of this is that when playing is not possible then the work done by the therapist is directed towards bringing the patient from a state of not being able to play into a state of being able to play. (1971, and p. 162 in this book)
So play on! This is the way we keep our profession lively, and this book contributes to that state of liveliness.