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Dr Winnicott gave a communication based on an inter-change of drawings obtained in what he calls a therapeutic consultation. The patient was a boy of nearly 10 years. There was no common language between Winnicott and the patient and the verbalization was done through an interpreter (Miss Helka Asikainen).
This was a case of congenital syndactyly, hands and feet, a condition also present in the child's mother. The main message communicated by the child was that he needed to be accepted first of all as himself as born, and he showed this by his identification with webbed-footed water birds.
In a corresponding session with the mother Winnicott found that she had in fact at first rejected this one of her children because she could not bear the sense of guilt which she felt at having produced a child with her deformity when she knew too well the risk that she was taking. Soon she accepted the boy and became a very good mother to him but this was on the basis of having everything possible done to cure his condition. Out of the mother's sense of guilt there had come about a compulsive tendency towards full exploitation of remedial surgery.
As a result of the consultation a more rational attitude could be adopted and there was greater freedom for a discussion as to how far remedial surgery could be used and how far it would be expedient to accept the condition as a limited handicap in the life of this rather normal boy.