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doi:10.1111/jpc.12747
EDITORIAL
Transitional objects and thumb sucking
Charles M Schulz’ iconic 1950s portrayal of his insecure character Linus sucking his thumb and snuggling his blanket brought the security blanket to popular attention. The Peanuts comic strip in which they appear followed Donald Winnicott’s seminal article on transitional objects and transitional phenomena.1 The Linus portrait is intriguing, because it not only shows the oft-observed conjunction of thumb-sucking while holding the transitional object, the blanket, but also shows his pet dog Snoopy asleep on Linus’ knee. Some authors have suggested pets can be a form of transitional object. Winnicott was a brilliant paediatrician who observed children with meticulous attention; subsequently he became a world famous child psychiatrist and a psychoanalyst. His article is well worth re-visiting.1 He observes that newborn children tend to put their fists and thumbs in their mouth early. Later they often become attached to a teddy (like Winnie-the-Pooh), doll, soft toy, blanket or hard toy. Winnicott developed the terms transitional objects and transitional phenomena to designate things of value in the transition between the-baby-linked-with-themother as a unit and the baby as a separate entity. He later calls it the ‘not-me v me’. As a psychoanalyst, Winnicott is not slow to notice that thumb sucking, which he calls oral erotism, is often associated with genital self-stimulation (masturbation). This association had long been known to paediatricians. In the late 1870s, thumb sucking was mentioned in the literature of diseases of children. By 1910, paediatric textbooks referred to thumb sucking as a disease. It remained so until around 1950.2 The early paediatricians’ abhorrence of thumb sucking suggests Winnicott may have been on the right track. Winnicott’s description of transitional objects is fascinating.1 The child sucks their thumb and takes an external object such as a blanket, part of a sheet, a handkerchief or napkin (diaper or nappy) into the mouth using the other hand. The child then sucks the cloth or smells it or rubs it against the cheek. The texture and smell are important. The child, not the parents, names the object; the name may be descriptive, e.g. Ted or
blankie, or may sound something like Mama (as twins, we both used muslin squares as transitional objects in slightly different ways and called them ‘minnas’). The transitional object is often vitally important for going to sleep and as a defence against anxiety. Parents learn the value of the object and, if they value their own peace, learn to bring it along when travelling. Washing the transitional object may change its smell or texture in ways that the child finds unacceptable. A clean nappy may be able to be substituted while washing the fetid old nappy. A unique blanket may be harder to wash. One suggestion is to cut the blanket into two or more pieces, with the child’s informed consent of course, so that one portion can be washed while another is in use. This also provides some insurance against loss or mishap. Winnicott describes how the infant assumes rights over the transitional object, which parents and others deny at their peril.1 The object may be cuddled affectionately one moment, loved excitedly or mutilated at different times, and needs to survive this loving and hating. It must never change unless at the infant’s instigation or with the infant’s assent. Winnicott says we see the object coming from without, but the baby does not. However, the baby does not see it as coming from within either: it is not a hallucination.1 What Winnicott is saying here is that the transitional object helps the infant distinguish what is part of the mother (the breast or total maternal care), part of the baby (the thumb) and what is external (the object). A child care worker described a 3-year-old boy who walked around with a teddy bear with the inventive name of Bear Bear tucked down his shirt like a baby kangaroo. When the care worker was taking the boy to an activity, he addressed Bear Bear and asked if he would like to come, too. ‘Bear Bear’s not real, you know’, the child said earnestly. What constitutes a transitional object? Is a dummy or pacifier one? A pet? A toy car? One sports-mad 3-year-old would not go to bed unless he was clutching his cricket bat. The importance to the child and the nature of the child’s relationship with the object is probably the critical factor in saying whether or not it qualifies as a transitional object. The concept of the traditional object is an important one for paediatricians to consider. Nowadays it is routine to ask the parents of a child being admitted to hospital whether the child has a special toy or blanket and to ensure the parent does not forget it in the drama of the admission. A wise paediatrician said he used to tell mothers who had to temporarily leave their very small hospitalised children to give the child, to hold, something they know belonged to the mother such as a purse, scarf or even keys. The idea was that even a preverbal child would think, ‘She’ll have to come back for this, so I know she’ll be back for me’. A child psychiatrist whose advice was sought about troubled children with sleep disturbance suggested hot water bottles, which proved highly effective. These examples show that psychoanalysis is not all theory without practical value but can help paediatricians to achieve a
Journal of Paediatrics and Child Health 50 (2014) 845–846 © 2014 The Authors Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
845
Transitional objects
D Isaacs and S Isaacs
deeper, more rewarding and clinically useful understanding of infant and child behaviour. Prof David Isaacs Editor-in-Chief Children’s Hospital at Westmead Sydney, New South Wales Australia Dr Stephen Isaacs Retired Child Psychiatrist London, UK
References 1 Winnicott DW. Transitional objects and transitional phenomena – a study of the first not-me possession. Int. J. Psycho-Anaysisl. 1953; 34: 89–97. 2 Gillis J. Bad habits and pernicious results: thumb sucking and the discipline of late-nineteenth-century paediatrics. Med. Hist. 1996; 40: 55–73.
A family newly arrived from Sudan attends Refugee Clinic photograph by Jan Colgan.
846
Journal of Paediatrics and Child Health 50 (2014) 845–846 © 2014 The Authors Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Copyright of Journal of Paediatrics & Child Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
doi:10.1111/jpc.12747
EDITORIAL
Transitional objects and thumb sucking
Charles M Schulz’ iconic 1950s portrayal of his insecure character Linus sucking his thumb and snuggling his blanket brought the security blanket to popular attention. The Peanuts comic strip in which they appear followed Donald Winnicott’s seminal article on transitional objects and transitional phenomena.1 The Linus portrait is intriguing, because it not only shows the oft-observed conjunction of thumb-sucking while holding the transitional object, the blanket, but also shows his pet dog Snoopy asleep on Linus’ knee. Some authors have suggested pets can be a form of transitional object. Winnicott was a brilliant paediatrician who observed children with meticulous attention; subsequently he became a world famous child psychiatrist and a psychoanalyst. His article is well worth re-visiting.1 He observes that newborn children tend to put their fists and thumbs in their mouth early. Later they often become attached to a teddy (like Winnie-the-Pooh), doll, soft toy, blanket or hard toy. Winnicott developed the terms transitional objects and transitional phenomena to designate things of value in the transition between the-baby-linked-with-themother as a unit and the baby as a separate entity. He later calls it the ‘not-me v me’. As a psychoanalyst, Winnicott is not slow to notice that thumb sucking, which he calls oral erotism, is often associated with genital self-stimulation (masturbation). This association had long been known to paediatricians. In the late 1870s, thumb sucking was mentioned in the literature of diseases of children. By 1910, paediatric textbooks referred to thumb sucking as a disease. It remained so until around 1950.2 The early paediatricians’ abhorrence of thumb sucking suggests Winnicott may have been on the right track. Winnicott’s description of transitional objects is fascinating.1 The child sucks their thumb and takes an external object such as a blanket, part of a sheet, a handkerchief or napkin (diaper or nappy) into the mouth using the other hand. The child then sucks the cloth or smells it or rubs it against the cheek. The texture and smell are important. The child, not the parents, names the object; the name may be descriptive, e.g. Ted or
blankie, or may sound something like Mama (as twins, we both used muslin squares as transitional objects in slightly different ways and called them ‘minnas’). The transitional object is often vitally important for going to sleep and as a defence against anxiety. Parents learn the value of the object and, if they value their own peace, learn to bring it along when travelling. Washing the transitional object may change its smell or texture in ways that the child finds unacceptable. A clean nappy may be able to be substituted while washing the fetid old nappy. A unique blanket may be harder to wash. One suggestion is to cut the blanket into two or more pieces, with the child’s informed consent of course, so that one portion can be washed while another is in use. This also provides some insurance against loss or mishap. Winnicott describes how the infant assumes rights over the transitional object, which parents and others deny at their peril.1 The object may be cuddled affectionately one moment, loved excitedly or mutilated at different times, and needs to survive this loving and hating. It must never change unless at the infant’s instigation or with the infant’s assent. Winnicott says we see the object coming from without, but the baby does not. However, the baby does not see it as coming from within either: it is not a hallucination.1 What Winnicott is saying here is that the transitional object helps the infant distinguish what is part of the mother (the breast or total maternal care), part of the baby (the thumb) and what is external (the object). A child care worker described a 3-year-old boy who walked around with a teddy bear with the inventive name of Bear Bear tucked down his shirt like a baby kangaroo. When the care worker was taking the boy to an activity, he addressed Bear Bear and asked if he would like to come, too. ‘Bear Bear’s not real, you know’, the child said earnestly. What constitutes a transitional object? Is a dummy or pacifier one? A pet? A toy car? One sports-mad 3-year-old would not go to bed unless he was clutching his cricket bat. The importance to the child and the nature of the child’s relationship with the object is probably the critical factor in saying whether or not it qualifies as a transitional object. The concept of the traditional object is an important one for paediatricians to consider. Nowadays it is routine to ask the parents of a child being admitted to hospital whether the child has a special toy or blanket and to ensure the parent does not forget it in the drama of the admission. A wise paediatrician said he used to tell mothers who had to temporarily leave their very small hospitalised children to give the child, to hold, something they know belonged to the mother such as a purse, scarf or even keys. The idea was that even a preverbal child would think, ‘She’ll have to come back for this, so I know she’ll be back for me’. A child psychiatrist whose advice was sought about troubled children with sleep disturbance suggested hot water bottles, which proved highly effective. These examples show that psychoanalysis is not all theory without practical value but can help paediatricians to achieve a
Journal of Paediatrics and Child Health 50 (2014) 845–846 © 2014 The Authors Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
845
Transitional objects
D Isaacs and S Isaacs
deeper, more rewarding and clinically useful understanding of infant and child behaviour. Prof David Isaacs Editor-in-Chief Children’s Hospital at Westmead Sydney, New South Wales Australia Dr Stephen Isaacs Retired Child Psychiatrist London, UK
References 1 Winnicott DW. Transitional objects and transitional phenomena – a study of the first not-me possession. Int. J. Psycho-Anaysisl. 1953; 34: 89–97. 2 Gillis J. Bad habits and pernicious results: thumb sucking and the discipline of late-nineteenth-century paediatrics. Med. Hist. 1996; 40: 55–73.
A family newly arrived from Sudan attends Refugee Clinic photograph by Jan Colgan.
846
Journal of Paediatrics and Child Health 50 (2014) 845–846 © 2014 The Authors Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Copyright of Journal of Paediatrics & Child Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
