Daily Archives: January 6, 2009

Fidgetiness

The featured paper is ‘Fidgetiness’ by Donald Winnicott originally published in 1931. This is a fairly brief paper but is one that gives further insights into Winnicott and is interesting from a historical perspective. Winnicott tackles the problem of fidgetiness in children and the possible treatment although he refrains from a definition of the term.

Winnicott sees that there are three types of fidgetiness – ‘common anxious restlessness’, tics and chorea. Again given his background as a paediatrician this paper has a medical slant as much of the material deals with the assessment and management of chorea at a time when Rheumatic Fever was quite prevalent. Winnicott writes that if the correct diagnoses are not made then

‘A mistake may mean either that a child who is not liable to heart disease is kept in bed when he would be better up and about, or else that a child with chorea is punished at school for fidgetiness that is not under voluntary control and made to do drill and play games just when the heart should be allowed the maximum rest’

Winnicott first examines the fidgetiness secondary to anxiety and identifies markers including urinary frequency, sleep disturbance, colic and occasional night terrors as aiding in the diagnosis. Winnicott also contrasts this with chorea in that

‘Whereas the movements of chorea possess the child, the movements of the anxious child are part of the child’s effort to master the anxiety’

Winnicott then goes on to discuss tics and chorea the latter being a more detailed discussion. Winnicott then discusses diagnosis before finishing with a few case studies with Rheumatic Fever either correctly or incorrectly having featured as the main differential. While this paper could loosely be referred to as a case series, as in another of his papers reviewed here there are no references to support his arguments. It would be interesting to see how some of these children might get categorised currently with contemporary diagnoses.

STT2-5

References

Winnicott D.W. Fidgetiness.  (1931). In ‘D.W.Winnicott. Through Paediatrics to Psycho-Analysis’. The International Psycho-Analytical Library. Edited by M.Masud R. Khan. The Hogarth Press and the Institute of Psycho-Analysis. 1978.

Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.