The featured paper is a very brief one by Winnicott – ‘Anxiety Associated with Insecurity’. Winnicott wrote this paper in response to one by Dr Rycroft – ‘Some observations on a case of Vertigo’ in 1953 in which the author comments on the role of balance in maintaining posture. The latter point is focused on by Winnicott who questions a notion proposed by Rycroft that anxiety in infancy is a matter of semicircular canal physiology. Instead Winnicott suggests that there are several types of anxiety in infancy that are influenced by the relationship with the caregiver. He further suggests three types of anxiety that may result from the relationship – ‘unintegration’, ‘lack of relationship of psyche to soma’ and ‘the centre of gravity of consciousness transfers from the kernel to the shell from the individual to the care’. Winnicott then defines ‘good enough care’ in terms of the three anxieties described above. He then suggests how the different anxieties can be distinguished by additional features such as pain. While this paper is interesting in describing ‘good enough care’, Winnicott has not demonstrated this in the paper with research and it must necessarily remain in the domain of conjecture although being supported by Winnicott’s own clinical experience. Therefore Winnicott’s paper offers a structure for considering anxiety although these conclusions require an evidence base and therefore necessarily form a starting point for discussion where further work must be undertaken to test these hypotheses.
Donald Winnicott. Anxiety Associated with Insecurity . In ‘Through Paediatrics to Psycho-analysis’. London. The Hogarth Press and the Institute of Psycho-analysis. 1978.
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