Tuesday, 7 January 2014

The Good Enough Mother/Daughter/Caregiver

Dr. Donald Winnicott (1896-1971) was a British pediatrician and psychoanalyst who developed the theory of the "good enough mother" - a theory that, in my opinion, is highly relevant to caregivers of all ages. 
Winnicott described his theory this way:
"The good-enough mother...starts off with an almost complete adaptation to her infant's needs, and as time proceeds she adapts less and less completely, gradually, according to the infant's growing ability to deal with her failure" (Winnicott, 1953)
Winnicott is using the word 'failure' to represent those instances when the mother, or caregiver doesn't meet every need of her charge, but rather allows her child to try and perhaps fail.  It is these 'failures' of the mother that allow the child to become adapted to the world, self-sufficient and free of total dependency on another.  

Caregivers move back and forth between supporting and letting go all the time.  At times of crisis, we are 'perfect mothers'.  But in times of relative calm, we let go a little and become 'good enough'.  Winnicott describes how damaging it is for the child when the mother is not capable of being 'good enough' - ever.  He thought that the true self of the child and the mother could be discovered in the trusting space of possibility when all parties are relaxed enough to play.

There's a pretty good Wikipedia page on Winnicott and I had to share this snippet for its delicious applicability to caregiving: 

A central theme running through Winnicott's work was the idea of play.  Winnicott thought that playing was the key to emotional and psychological well-being. By "playing," he meant not only the ways that children of all ages play, but also the way adults "play" through making art, or engaging in sports, hobbies, humor, meaningful conversation, et cetera. At any age, he saw play as crucial to the development of authentic selfhood, because when people play they feel real, spontaneous and alive, and keenly interested in what they're doing. 

Winnicott must have been a superb caregiver himself.  By all accounts, he was a great listener and a compassionate man.  He was a nurturer and an enabler.  He certainly knew what it meant to 'hang out', to 'be real', to wile away the hours with a shared interest over a cup of tea. 


For Winincott, the self was a very important part of mental and emotional well-being which played a vital role in creativity. He thought that people were born without a clearly developed self and had to "search" for an authentic sense of self as they grew.[38] "For Winnicott, the sense of feeling real, feeling in touch with others and with one's own body and its processes was essential for living a life."

Caregivers intuitively feel 'real' and we are naturally aware of our own bodies in relation to others'.  We are in touch with others constantly and so feel 'real'.  I've blogged before about being real as a caregiver and how irony is not part of our natural state of being.  
Winnicott wrote:   
a mother is neither good nor bad nor the product of illusion, but is a separate and independent entity: The good-enough mother ... starts off with an almost complete adaptation to her infant’s needs, and as time proceeds she adapts less and less completely, gradually, according to the infant’s growing ability to deal with her failure. Her failure to adapt to every need of the child helps them adapt to external realities.,
Dr Winnicott’s teachings boiled down to the fact that a good enough mother was better than the perfect mother.  Sometimes caregivers, especially in the case of Alzheimer's or dementia, move through a journey going in the opposite direction.  We may begin with 'good enough' and end in a pull towards 'perfection'.  But what if 'good enough' was the gold standard for all caregivers?

What if, in leaving space for possibility, for failure, for authentic exchange, we may preserve our true selves and that results in good care?  Reading Winnicott, I want to go out and play.  I want to risk something for the sake of living in the moment. I want to seek out those intimate moments when I trust enough to let go my loved one's hand or to look away as they attempt a new skill.  Because at the end of the day, there is dignity in enabling imperfect humanity. 
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