Community-based management of psychotic clients: The contributions of D. W. and Clare Winnicott

While the term management connotes images of impersonal care, D. W. Winnicott repeatedly used this term to describe the responsive environmental holding that is central to all human development. Influenced by observations of how normal mothers and families address the physical and psychic needs of children, he and his wife, Clare, a distinguished British social worker, operationalized this concept in finding and supporting facilitating environments with a wide range of disturbed children and adults. Using case material from a contemporary community program for the mentally ill, this paper will review the Winnicotts' important, but often neglected, perspectives on the environmental management of psychotic adults.Presented at the Washington School of Psychiatry, January 14, 1989. I would like to thank Janice Quiter and the Archives of Psychiatry of The New York Hospital-Cornell Medical Center for their assistance in researching the D. W. Winnicott collection.