Abstract
Donald Winnicott analysed the fundamental function of play in the growth and development of the individual, and the Rabindranath Tagore poem he cites is a delightful depiction of childhood play and its corresponding adult reality.
This paper will explore the role of play in social life, the development of interpersonal relationships, and psychotherapy or training. Reference will be made to Winnicott’s work, and to what biology — particularly the neurobiology of the mind — can shed light on.
Introduction
Donald Winnicott, paediatrician and psychoanalyst, was perhaps the first to reflect on the relationship between psychological and physical processes (Winnicott, 1958) 1 . The concept of psyche-soma that he proposed greatly anticipated what biology has taught us about mental functioning, advances that, according to Freud, could have confirmed or enabled modification of psychoanalytic theories 2 . In the seventh chapter of Playing and Reality, the location of cultural experience, Winnicott recalls how Tagore’s poetry 3 has accompanied his reflections since adolescence: ‘The quotation from Tagore has always intrigued me. In my adolescence I had no idea what it could mean, but it found a place in me, and its imprint has not faded’ (Winnicott, 1971: 129).
However, those interested in groups cannot fail to notice that the quote from Tagore at the beginning of the chapter does not fully align with Tagore’s text. All editions of Playing and Reality contain the phrase ‘On the seashore of endless worlds, children play’. Tagore’s text is: ‘On the seashore of endless worlds, children meet’. Certainly, the theme of this poem is play, but it is social play. This text compares children’s games with adult activities.
This seems curious. Is it an oversight? Out of analytical habit, we tend to think that every oversight hides a meaning. We know how much importance Winnicott attached to the function of the environment and relationships. Perhaps Winnicott was influenced by the impression left on him by the text, which so effectively depicts children’s play, and perhaps, in his recall, this prevailed over the whole. We should remember that in the field of psychoanalysis, attention to group functioning was still in its infancy. So why not try to understand and reflect on what Winnicott observed but did not have the opportunity to investigate? Why not propose a hypothesis for interpreting play in the development of the social individual?
Winnicott derived his model of development from his experience as an analyst and from observing mother-child pairs he encountered as a paediatrician 4 ; we can take advantage of the current expansion of knowledge about groups and biology, as well as the direct experience acquired in the profession.
This reflection will refer to concepts specific to neurobiology; to avoid weighing down the text, we will limit ourselves to brief references and bibliographical notes.
Playing
Referring to Tagore’s poem, Winnicott writes: ‘For a long time my mind remained in a state of no-knowing’ 5 .
In his encounter with psychoanalysis, with its progressive theoretical development, he found several successive interpretations of the meaning of Rabindranath Tagore’s sentence. We know how many meanings can be contained in a poem and that they can re-emerge over time.
Finally, ‘I realized, however, that play is in fact neither a matter of inner psychic reality nor a matter of external reality’. He argues that play is situated in a ‘transitional space’, originally the space between mother and child. The (good enough) mother grants the child a space of illusion which will gradually transform into an intermediate area between the external object (the mother, the breast . . . ) and the internal objects. An area that will become the playing area, where elements of external reality co-exist with elements of internal reality, where children meet, imagine, and build their own lives, an area where psyche and soma, sensations and thoughts, imagination, and reality meet. The area of ‘transitional objects’, real and simultaneously imaginary objects that characterize children’s behaviour, which have a particular value and that cannot be substituted by any other object, even if identical. The teddy bear, a blanket that accompanies sleep, calms anguish. And that is not an object, but a possession.
The play area, Winnicott argues, is the area of creativity, of the relationship between mother and child; it is the area in which the relationship with self-objects 6 develops. Among these are cultural objects.
Winnicott observes that playing is universal; it belongs to health; that healthy, happy children are spontaneously able to play; and that the lack of play indicates that something is wrong. Furthermore, Winnicott says that it is the possibility of living creatively that makes life worth living 7 .
Being alive
For Winnicott, the fundamental human need is to be and become more fully oneself; to become more fully present and alive in relation to one’s thoughts, feelings and bodily states, to fully develop a humane and just value system. This full humanity corresponds to the capability to live every aspect of life in a full and satisfying way, neither mechanically nor purely cognitively, nor even just instinctively. A capability that develops through the relationship between the self and the external world, between the internal world and shared reality, where playing is in constant and delicate balance between real and imaginary: an imaginative and creative elaboration of the relationship between the self and external reality 8 .
However, we should note that any path of personal growth requires the existence of a relationship, of interaction with an environment capable of supporting growth. Initially, with a mother-environment that allows the infant to discover what it is looking for. Every mother knows how important environmental support is, not only from the child’s father, but from the entire network of relationships: family, groups, and social structures.
Growing up requires care. If things are going well enough, children can count on ‘good enough’ adults who are attentive to their needs, able to organize their experiences, capable of ‘withstanding’ children’s aggressive behaviour without retaliating, yet able to contain it. The capacity to concern depends, in turn, on having received good-enough care and on having developed a capacity to concern. However, this is not an automatic process but a feedback system, the outcome of which influences the behaviour that produced it, in a continuous process 9 (Winnicott, 1963).
This delicate balance can be menaced and destroyed. In a study on the abuse of drugs in US schools for the treatment of ADHD, Jaak Panksepp argues that the inability of children to play is the cause. This is due to the organization of today’s society, which does not allow for spontaneous play. Like Winnicott, Panksepp argues that play is important not only for development but also for the individual to become ‘fully human’. And he writes: ‘Can a fully social brain emerge without play or will it remain socially stunted for life?’ Quoting Plato on the role of play in the formation of the Citizen (Plato, The Laws [VII, 794]), he adds: ‘Although Plato advocated more social engineering than might be wise in a free society, his basic message was that without supervised natural play our children cannot become fully human’ (Panksepp, 2007: 63).
On whose authority does Panksepp assert this?
Basic Affective Systems
At birth, newborns’ immature brain structures interact with the welcoming environment. Their maturation depends on both the programmes encoded in their DNA and their interaction with the environment. Thus, within specific time frames, the functions that sustain life (such as sight, language, and linguistic structures) are activated. This development will continue until the brain is fully mature. The maturation of neural structures is gradual. It proceeds in steps and is completed around age 20, allowing learning and behaviour to develop, change, and become progressively more complex. And slowly, each of us grows and becomes, in an uninterrupted flow of neural signals, a continuous dialogue between neural structures, in this continuous discourse between first, second and third degree processes.
To represent the harmonious flow of signals between the body and the brain, neurologist Antonio Damasio uses the image of a symphony orchestra, in which the voices of the different instruments blend together to form harmony, ‘ . . . like the string player in the symphony orchestra who will play well or not depending on his colleagues, the conductor, his mood, and so forth’ (Damasio, 2003: 299).
The earliest learning and behaviours occur at the beginning of life. Jaak Panksepp’s research has identified the neural systems underlying ‘behaviour’.
Deep in the brainstem, a small cluster of cells — the periaqueductal gray — processes external stimuli as good/bad, pleasure/displeasure. Generating a simple pattern of automatic, motor-like behaviour of approach/distance 10 . The Basic Affective Systems originate at the same level: Search, Rage, Fear, Care, Panic/Grief, Lust and Play (Panksepp and Biven, 2012). From the first days of life, these systems establish an original pattern of behaviour, which we will examine briefly.
Play. Playing behaviour is activated by a specific system that activates early and interacts with other systems.
The Search System generates tension towards the object, a drive to find satisfaction for a need, and not towards an object (which must be found) 11 . It generates an aggressive drive that dissolves, leaving space for the relationship with the object. It is a consumer — sometimes aggressive — relationship. As Winnicott intuited, aggression is part of movement and begins with foetal motility; initially, it has no object (Winnicott, 1958). The aggression that arises from this system is easily but mistakenly assimilated to Rage, which instead corresponds to a different and distinct neural system and is directed at an object to which it reacts, a hostile, frustrating, threatening external object (as is the case with the Fear system).
The environment’s activation of the Care system is fundamental to the individual’s harmonious development. The Care system is activated in adults in response to the infant’s needs, while the Panic/Grief system is activated in infants by the absence of the caregiver. The adult’s caring behaviour shuts down the Panic/Grief system, thus allowing a relationship and a transitional area to be established. We note that in The Capacity to Be Alone (Winnicott, 1958), Winnicott states that this refined ability depends on the mother’s availability and her caregiving technique. As we have already mentioned, it is the protective environment that allows the mother to best express her caregiving abilities.
If we consider caregiving abilities, we see that the ‘good enough’ mother plays a fundamental role: the role of the mother as a mirror (Winnicott, 1971: 111), in that fundamental process of development which is looking: to be looked at, to be ‘found’, as in the game of hide-and-seek so beloved by children. And consequently, the role of mirror neurons 12 .
The action of mirror neurons, which are activated by ‘embodying’ the actions of others, allows us to experience emotions that resonate within us as if we were physically participating in the actions and intentions of others. According to Ammaniti and Gallese (2014), mirror neurons could indicate the biological substrate that enables us to experience ourselves and others as bodily selves, and may also play a role in the phenomenon of projective identification, in both emotional and cognitive attunement. Let us return to the interactions that give rise to the playing area.
Two areas of playing
According to Winnicott, a playing area is also created between patient and analyst 13 . The ‘orchestra’ of our brain processes all messages in the same way, whether they come from our perception of the shared world, the world of reality on which we all agree, or from our perception of the internal world, which is unique and personal. Neurons, whether they belong to a squid, a snail, or a poet, all have the same structure. They transmit signals between neurons, forming communication networks 14 , circuits that allow continuous dialogue between the structures of our body and create the harmony that is health.
Who directs the orchestra? What are the musical scores, instruments, and harmony?
What happens when we work with groups, using the tools of psychoanalysis? Can a space for interaction be created between the leader and participants, and among the participants themselves? And how can biology interact with the concepts of group theory? What happens in this ‘orchestra’ made up of different components and conditions?
We are used to thinking that reason and intellect are the best guides for all our actions 15 .
In Descartes’ Error, neurologist Antonio Damasio (Damasio, 1994) describes behavioural changes resulting from brain damage, drawing on famous cases and detailed research. This research has shown that reason is based on emotions rather than intellect. If the neural pathway that enables dialogue between intellect and emotions is interrupted, the intellect can no longer guide behaviour. So, when you need to make a quick decision, it is best to listen to your body and the signals it sends you, because they are the best guides and never lie. Then we can calmly reflect: remembering, repeating, and reworking are third-level processes that require adequate time. In this way, if the flow between processes is not altered, when harmony reigns, the intellect can educate the emotions and make them well-targeted (Damasio, 1999).
But to do this, we need to recover the deposits of our memory, our memories. Memories are not stored in specific places, as in mnemonics, but rather correspond to signals in neural circuits that form memories.
Eric Kandel 16 Kandel, (1999, 2006) reminds us that if psychotherapy works and brings about change, it is a learning process. His studies have enabled us to understand something of what happens in our work as psychotherapists and to draw conclusions about which theoretical models to use, for which type of psychotherapy, and for which subjects.
We work on memories through the repetition of ‘patterns’ that, when repeated during sessions, allow us to rework and rethink them. This is not just a cognitive process, but one that is accompanied by emotion 17 .
There are many forms of memory, but for our purposes, we will examine only long-term memory.
A first distinction in long-term memory is between implicit (or non-declarative) and explicit (or declarative) memory. The many forms of non-declarative or implicit memory do not require conscious attention; they are expressed automatically. Explicit-declarative memory, on the other hand, refers to memories that require conscious attention to recall and is subdivided into autobiographical and semantic memory.
The concept of the implicit does not coincide with that of the ‘repressed unconscious’: repressed or denied content is rejected and pertains to autobiographical memory. Implicit content may have been recorded at an unconscious level, a process we could link to certain characteristics of the unconscious discussed by Freud in The Unconscious (Freud, 1915).
As we have said, the maturation of neural structures is gradual and closely linked to the relationship with the environment. The maturation of the basal ganglia allows the formation of implicit memories, which generate automatic motor programmes that are particularly stable and difficult to modify. For semantic memory to form, the inferior parietal lobe must develop, while the medial surface of the temporal lobe allows the formation of autobiographical memory, which occurs around the second/third year of age. At the last level of stratification, the prefrontal lobes are the last to develop, reaching full maturity around age 20, representing the highest level of transcription and registration (Solms, 2018: 249–266).
After this examination of the possible contribution of biology to understanding mental processes, let us try to combine these reflections with clinical practice.
Theory and practice
The following observations have been developed over the years, through scientific literature and personal experience. The author has had the opportunity to combine his private practice with a long history in teacher training 18 . This has been an opportunity to apply to the world of education a suggestion made by Balint, who observed that, in certain cases, the emotional aspect could not be overlooked: the psychological implications of their work. These professionals include doctors, social workers, and teachers.
The training experience was conducted in groups 19 , using various methods, including traditional lectures, but above all, group leadership techniques.
It was observed that teachers at different school levels exhibit very different characteristics and dispositions, depending on the nature of their educational tasks. High school teachers respond with enthusiasm and interest when the proposal refers to third-level processes, while primary school teachers respond to proposals in first- and second-level processes. This guided the choice of group methods for each subject type. While for high school teachers (teachers of literature but also of other subjects), playing is above all a cultural experience 20 , teachers in the first stage of schooling (preschool and elementary school) feel at ease with psychodrama, which is easy to associate with ‘how children play’.
We might now ask ourselves what the possible outcomes of the different types of intervention might be in general terms. There are many theoretical models, each with corresponding objectives and outcomes. The objectives of psychotherapy (cure), training (development, growth), and theoretical research (the quest for knowledge) differ.
The group leadership model proposed by Foulkes requires group participants to sit in a circle and the leader to interact with both the group and the individual. In this way, visual interaction enables the type of learning associated with mirror neurons. This would lead to an enrichment of the Self in relation to others and the formation of a network of relationships.
Where the influence of external stimuli is reduced (similar to the use of a couch), we can assume that this condition suggests to the Brain-Mind to process mainly stimuli that come from internal content. This is the case in some group leadership techniques based on a principle of abstinence/or where the spatial arrangement of participants makes visual contact difficult, if not impossible, and in the action of mirror neurons. A limitation in visual exchanges between participants will tend to significantly reduce variables related to elements of the shared world. As a result, participants may feel uncomfortable, if not overwhelmed by an excess of internal content that is difficult to manage in a training course. This may suggest that participants should be chosen with care and that attention be given to the capabilities of the target audience.
The so-called Tavistock Model, which adheres to a rather radical principle of ‘abstinence’, seems to favour the regression of the entire group to an unconscious part of the group culture, to shared unconscious content. This model has produced very interesting results from the point of view of group research, and the identification of basic assumptions has become a cornerstone of understanding how groups function in basic assumptions (BA), with their biological correlates.
It is not difficult to identify a correlation between the basic assumptions described by Wilfred Bion (Bion, 1961) and the behavioural patterns generated by basic affective systems. The basic assumption of Fight or Flight (BAF/F) stimulates reactions and feelings that correspond to the Rage (Fight) system and Fear (Flight) system. The basic assumption of Dependence (BAD) refers to the Panic/Grief system and the related Care system.
Lawrence, Bain and Gould (1996) associate the basic assumption Me-ness (BAM) to a phase of development in which the individual begins to deal with what is distinct from himself; a phase that could correspond to the Me-not Me formation described by Winnicott; ‘In using the idea of “Me-ness” we are harking back to the time when an infant becomes a unit able to distinguish between the inside and the outside’.
The fourth basic assumption of BAO (Turquet, 1974) would correspond to feeling lost in an oceanic feeling of unity, a powerful union with an omnipotent force. However, we would like to propose another hypothesis: namely, that this manifestation of group activity could correspond to the paradox of the capacity to be alone in the presence of someone at a very early stage. Recently, Ogden (2024) critically examined Winnicott’s (1958) text on the capacity to be alone. Winnicott writes: ‘Being alone in the presence of someone can take place at a very early stage, when the ego immaturity is naturally balanced by ego support from the mother’ (Winnicott, 1958: 32). For Winnicott, the capacity to be alone . . . is a highly sophisticated phenomenon . . . It is closely related to emotional maturity’ (Winnicott, 1958: 36). In this regard, Winnicott compares the satisfaction of children’s playing with the experience of an adult at a concert or theatre (Winnicott, 1958: 34). And we could compare it to the experience of participating in major musical or sporting events, to the intense feeling of belonging that comes with those experiences without this corresponding to a dissolution of personal identity.
And what happens in psychodrama 21 , where playing is literal?
In psychodrama, the orchestra of our brain makes full use of the instruments at its disposal, in an experience that is commonly felt to be gratifying. Whatever model originated from Morenian psychodrama, what is staged is something similar to children’s play. But with important differences: children’s play corresponds to the paradox whereby play is both absolutely real and imagined (‘With withered leaves they weave their boats’), while the psychodramatic experience is structured according to precise guidelines. And it is on stage that the implicit appears; sensations and perceptions appear that are as if they were there, available to be recalled for that occasion; and these are sensations and perceptions that had not been thought of or transformed 22 . Representation in a scenario seems to allow, in the here and now, the release of sensory memories, as well as repressed memories, where the implicit can open the door to the repressed. What emerges from the representation can be uncomfortable or painful, and since third-level processes are not immediate and require slow reflection, any consideration can be quickly ‘chased away’ from consciousness. For this reason, some authors suggest combining the psychodramatic experience with a reflective space in order to work on what the psychodramatic scene reveals.
All these are general concepts. Specifically, we will refer to psychoanalytic psychodrama, particularly one of the models developed by the Société Psychanalytique de Paris 23 , where Lacan worked: that of the Société d’Etudes du Psychodrame Pratique et Théorique (SEPT) 24 .
Psychoanalytic psychodrama uses the tools of psychoanalysis to interpret what the play reveals. It follows precise methods. In therapeutic psychodrama, the focus is on emotions linked to personal memories. In training experiences, the focus is on difficulties encountered in professional life.
At this point, we will take a closer look at the techniques of psychoanalytic psychodrama, which have had a significant positive impact on managing the psychological implications for primary school teachers.
Psychoanalytic psychodrama
According to Anzieu, psychodrama corresponds to Tagore’s Beach of Endless Worlds and enables the reconstitution of the transitional area (Anzieu, 1978). Anzieu also argues that therapeutic psychodrama has an ‘undoubted capacity for narcissistic restoration’.
According to this hypothesis, ‘narcissistic restoration’ could correspond to the process of healing from deprivation x + y + z described by Winnicott (Winnicott, 1971: 132). In this process, the psychotherapist would act by repairing the break in the continuity of existence, just as the mother repairs the break in her child’s ego: ‘This mending of the ego structure re-establishes the baby’s capacity to use a symbol of union; the baby then comes once more to allow and even to benefit from separation’.
But how does this repair occur?
The hypothesis that psychodrama allows regression to repressed content is not entirely satisfactory: experience shows that psychodramatic playing brings implicit memories to the surface, allowing reflection on what has happened. We will try to confirm this hypothesis by describing the setting in which psychoanalytic psychodrama takes place and illustrating the techniques used to conduct it through clinical vignettes.
A story is represented in the psychodrama scene: it does not tell the ‘real’ story, but rather the ‘imaginary’ one. We know, in fact, that autobiographical memories are formed when they are accessed and transformed by the continuous processing of neural circuits. In the play, the body-a very concrete ‘reality’-allows the perceived, the denied, and the ‘symbolic’ to be released.
Participants and the leader are seated in a circle on movable chairs to represent the scene’s setting. At the beginning, one of the participants asks to talk about a situation he/she has experienced and briefly describes it. In therapeutic psychodrama, this will be something personal, while in Balint psychodrama, it will relate to the profession.
The leader invites the participant to continue the story by asking questions to identify the theme, which will be developed in a series of representations. It will not be a picture of the past: what will be represented is not a replica of what happened but a filter of the participant’s subjectivity and autobiographical memory.
The scene’s setting is defined—it could be a room, a study, or an outdoor environment. With the help of chairs, the elements that characterize it are defined, such as the positions of doors and windows, desks, chairs, and anything else that allows us to ‘imagine’ and represent the scene. The elements of the setting appear as precisely recorded perceptual memories, which come to mind when describing the scene.
In a group for school psychologists, psychologist A asks to discuss an encounter she had with a student with whom she is having difficulties. She explains: ‘I was in the interview room’. The setting is described: there are no windows in the so-called interview room, but there is a broom, a bucket, and everything else you need for cleaning. In other words, visual memory reveals that the interview room is a storage room, plastically disqualifying A’s work.
Similarly, we discover that in many interviews defined as ‘confidential’ (between psychologist and teacher or between teacher and parents), the description of the setting holds many surprises: in the introduction, it was said that ‘no one else is present’, but we find ourselves in the teachers’ room, or the computer room, or some other busy place. If we point out that several people are present, the response is, ‘But no one is listening’.
In a psychotherapy group, a person recounts an episode that had been told to her by her parents, in which she was a baby in her cot under the kitchen table, with the door closed, at the end of the corridor. The scene depicts the parents’ bedroom on the other side of the flat. The chairs are arranged, and . . . everything has to be repositioned, because the corridor and kitchen would be inside the wall or beyond it. Unreachable.
Once the setting has been defined, the characters in the show are chosen from among the participants, and their characteristics are described: physical appearance, clothing, age, and stage position. The choice of characters often reveals something different from what had been told, suggesting a ‘thought’ that has not yet been ‘thought’ or that is unthinkable.
Nursery school teachers. The person leading the activity chooses participants to play the roles of a child and his grandfather; a large, burly man is chosen for the child, and the smallest, most petite girl in the group is chosen for the grandfather. As the activity progresses, the meaning of this paradoxical choice becomes clear: the child tries to dominate his grandfather and every adult, including the teachers.
Exchange of roles. To help the interpreters understand what they must say and do in their assigned roles, the protagonist exchanges places with them and shows them the words, gestures, and attitude of the character they must ‘embody’. The role swap is not only at the beginning and between the protagonist and the interpreters; during the performance, each participant in the group can dub those on stage by passing behind them, expressing thoughts they attribute to the character or comments on the scene. As we have said, mirror neurons embody the intentions of others, not just the gesture. This role exchange is clearly based on phenomena of identification and projective counter-identification. At the end of each scene, each participant can express their opinion on what has happened.
At the end, the leader reconstructs the original story from what emerged from the staging.
In psychodrama, emotions can explode in a powerful, unequivocal force. In training experiences, the focus is on the difficulties encountered at work, but this does not mean that feelings and emotions do not emerge: strictly personal issues are not addressed, even though we are well aware of how emotionally engaging some episodes in the caring professions can be. In primary school, it is easy for seemingly pragmatic difficulties to hide a deep, perhaps inevitable, discomfort. Sharing it in a group can make it tolerable.
Conclusions
It is clear what Winnicott meant by the playing area and what his approach to patients was; the same applies to Bion. But in the case of groups, how is the inevitable transitional area that forms between people in a relationship formed and managed? The image of the symphony orchestra is very evocative and is appropriate for adult life. We can imagine something similar in conducting groups: someone conducts, and the group responds. It is important that the conductor knows the music and the orchestra members, that the orchestra members recognize its value, and that there is an implicit agreement between the orchestra and the conductor. Extending this metaphor, we could say that it is desirable for group leaders to be experienced and attentive, and to know themselves and their own characteristics. They should have clear objectives and know how to choose the participants for the group. They should know how to choose the right script for both parties in order to achieve good-enough results.
