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The author purposes to show not only his present views and practices but also how he arrived at them through pediatrics. He succeeds admirably, and in an instructive and entertaining manner. Some informal autobiographical remarks are interspersed throughout this selection of psychoanalytic writings to make the book easy to read and stimulating.
The collection begins with two early (1931) papers derived from pediatric practice, A Note on Normality and Anxiety, and Fidgetiness, in which he discusses these common symptoms of childhood emotional disturbance. Illustrative case material is included. Here Dr. Winnicott reveals the sensitivity to the psychological problems and needs of his patients which soon drew him into analytic work.
The second part of the book contains several papers devoted to brief description, diagnosis, dynamic and genetic formulations with recommendations for management of the kinds of problems seen in a child guidance clinic or the consultation service of a pediatric department of a hospital, e.g., feeding problems and school difficulties. Of special interest is a nicely constructed 'set situation' using a right-angled shining tongue depressor at the edge of a table within easy reach of the child being held by the mother. Winnicott provides here a model for meticulous observation in a carefully controlled situation. From it he extracts a maximum of clinical information. Scattered throughout the discussions are the instructive remarks of a versatile and experienced therapist, well aware of what is possible and what is not in short-term therapy, and when analysis is or is not indicated.
The section continues with a paper, Ocular Psychoneuroses of Childhood, which discusses representative clinical varieties of eye symptoms. The effect on Winnicott of Melanie Klein's ideas and work begins to show in his paper, Reparation in Respect of Mother's Organized Defense Against Depression. In this, Winnicott describes the reactions of children to their