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In a symposium on Enuresis at the Royal Society of Medicine on April 21st (Psychiatry and Pædiatric Sections) D. W. Winnicott opened the discussion with a short paper in which he drew attention to the relation of this symptom to normal and abnormal emotional development.
Enuresis could be associated, he said, with any diagnosis from normality to dementia precox, and could only be properly placed by a study of the unconscious associated phantasy, and of the degree and quality of the compulsiveness of the symptom and of the underlying anxiety. Anxiety was always to be found in ultimate analysis, though in the more difficult cases anxiety was often not clinically manifest.
No analysis of an adult or of a child would be considered satisfactory if enuresis remained as a symptom. However, in no case would there be no enuresis to analyse, since in the emotional development of every individual the excretory processes, the ingestion and the digestion and all the