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Although the British psychiatrist and pediatrician Donald W. Winnicott died in 1971, his creative contributions to the clinical practice of psychoanalysis continue to enrich our field. The publication of a new book, Between Reality and Fantasy (1978), gives evidence that Winnicott's theory of the transitional object has found a secure place in the study of infantile personality development. His emphasis on the importance of environmental provision at a time when analysts were largely preoccupied with the vicissitudes of and defenses against instinctual forces helped psychoanalysis achieve a deeper grounding in its study of object relations and their wider cultural context.
Now Mrs. Clare Winnicott has made available for publication a lengthy case history, The Piggle: An Account of the Psychoanalytic Treatment of a Little Girl. This book was recently published under the careful and sensitive editorship of one of Winnicott's former students, Ishak Ramzy, and offers a fascinating account of a successful treatment, as well as a glimpse at the clinical style of a brilliant psychoanalytic practitioner and theoretician.
Winnicott's only other detailed account of an analytic case was also published posthumously under the title of “Fragment of an Analysis,” in Tactics and Techniques in Psychoanalytic Therapy (1972) edited by Peter Giovacchini. There is an obvious contrast between the two cases in the fact that the patient in the “Fragment” was a 30-year-old male physician, while the Piggle was only two years, four months old, when her treatment began. Yet the similarities between these two patients are also striking in that each changed over from a state of withdrawal to creative living during the course of analysis.
It is specifically the discussion of the Piggle's analysis which concerns me here. Part of the interest in this account lies in the relative unorthodoxy of Winnicott's technique. The Piggle lived too far from London to be able to participate in full scale analysis,