The Marginalian
The Marginalian

Winnicott on the Qualities of a Healthy Mind and a Healthy Relationship

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.


Published August 19, 2024

https://www.themarginalian.org/2024/08/19/winnicott-care-cure/

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