29 minute read
Matthew Oyer Interview with Kirkland Vaughans and Martha Bragin
Matthew Oyer: I’m here today with Kirkland Vaughans and Martha Bragin, who have graciously agreed to sit down for an interview with me today. Hello, Kirkland and Martha. Thanks so much for joining me today for this interview. Is there anything you want to say right off the top, before we get into my questions?
Kirkland Vaughans: I think you should be clear that we’re talking about our work that took place in Brooklyn. I knew Martha from East New York and Brownsville. That’s where our work came together.
MO: Yes, so that’s where I was hoping to start. I’d love for you guys to tell me a bit about how you met and the work that you did together in Brooklyn.
Martha Bragin: I can give some of the background if it is helpful. The Brooklyn PINS Diversion Project began in 1987, as part of a new law that created mandatory diversion away from court-related services to all persons in New York State aged 16 or under who were brought to family court as in “need of supervision” (PINS). The youngsters had been accused of offenses ranging from truancy to armed robbery, gang violence, and violent attack. Our job at the program was to meet every child and family on the day that they came to court, and to within six weeks assess the root causes of the problems that had brought them there and provide noncarceral community-based solutions that could address the issues that we found.
We quickly learned that they were affected by three levels of violence: (1) structural violence, baked into the conditions of their lives; (2) social violence that maintains those structures; and (3) interpersonal violence in family and neighborhood relationships, in which social conditions manifest as deeply personal. In addition, the historical violence, transmitted through generations of struggle, that Kirkland writes about so eloquently, played a significant role. While the youngsters who came to our attention were labeled as the source of violence, their histories made it clear that they were in fact its survivors. Their concerned parents brought them to court as they engaged in active efforts to save their lives. We needed to connect to programs that could accept these families and provide the deep and multi-leveled understanding that they required and to keep working with them for a minimum of the 18 months or two years required by family court.
KV: We had not met at this point. worked with you in your doctoral program. So, when I saw the name associated with a Brownsville-East New York Agency, I thought ah ha! we’ve got a partner!
KV: Yeah, I worked with her while I was in Brooklyn. That’s right. I started the Child Program. It was an outpatient clinic in East New York, and we had another outpatient clinic in Brownsville. And our responsibility was to accept the referral or reject the referral. I don’t recall any rejections at all. It was like, why would you reject because every kid that Martha sent our way was really a kid who was desperate. It was like they wore a uniform to the rest of society, and the rest of society tended to look at the uniform and not the kid. The uniform was a civic symptomatology that would then get labeled conduct disorder, dysfunctional, high risk, those kinds of things. They didn’t see pain. They didn’t see depression. They didn’t see agony. They didn’t see confusion. And they didn’t see shame.
MB: One thing that I’m sure we succeeded in this partnership was to lift the conversation. So, we started out in 1987 being told we had a problem with “youth violence.” By the time we had our first major conference in 1992, which was called “Beyond Conduct Disorder,” we changed the label to “children affected by violence.” It wasn’t that the kids were violent; it was that they had experienced the violence of society in their lives and in their bodies. And their parents, their grandparents, and their communities had been doing their best to support and protect them, but they too were under relentless attack, through combined economic, social, and historic injustice, and that’s why the kids were suffering. We opened the conference by stating, “Ladies and gentlemen, our children are dying of sorrow.”
MO: What you both are addressing, what Kirkland called civic symptomatology, and, Martha, when you speak about changing the discourse and the direction of causality, what kind of effects did you see? Did you see this shift in discourse moving outward into the community, outward to other agencies? I think this is where change starts to happen, but I’m not as clear on the methods by which it should be disseminated.
KV: Some changes that I saw were that different community elements began to feel supported; they no longer felt alone with these issues, and as a result, became more supportive of children who were impacted. Schools, churches, with support assume more responsibility and sensitivity. I know that as a clinic director that that can be a scary thing, because too often we want to point the finger at someone. I remember I had a bright female clinician who was exceptionally good at working with kids and young folks who had violent experiences and who had committed violence. And she came to me and wanted to reject a patient because she was frightened that this person had all kinds of weapons at home and had acknowledged that he had committed violence. And I remember my response as the administrator was that the clinic will get in trouble, we’ll all get in trouble if anything happens with this person. And I took the patient because she was pregnant, and as I mentioned, it didn’t work therapeutically. And as it turns out, the patient and I worked together for two and a half years, but my initial response was “You gotta go,” the ship will sink, it’s all going to implode, and so I was frightened. It turned out, he and I worked very, very well together. We were able to get his weapons removed, all except one. This was the first time I experienced the patient interpreting the therapist’s fears and anxieties. This was determined by an episode in which he almost became very violent, and he said, “Dr. Vaughans wouldn’t want me to hurt you.” And he stopped in the middle of the story, and he said, “What are you sweating for? Look at your armpits.” He said, “I haven’t been violent since I’ve been here. You need to chill out.” And I said, “You’re absolutely right; I need to chill out.” [Laughs] We all grew as a result of this, through facing our shortcomings. I had a role in that; I wasn’t innocent of any of these applications myself. How do I keep my staff safe, how am I going to deal with the City Department of Health, the State, blah, blah, blah. So, facing our own vulnerabilities in this mandate that Martha described was to be really effective in our work and to work collaboratively in a real and sincere way.
MB: It was our job at the Diversion Project to create space that protected the community agencies that accepted our clients. So let me take a minute and walk you through the assessment process. We reviewed all available records, making needed referrals for any medical and educational supports that were needed. We screened for emergencies, then followed up by taking detailed histories from the child, all family members, and any community members the family wanted to include. By the final session, most families could work with us to create their own interpretation of how life, history, and adversity had created the presenting problems and were eager to move forward toward addressing them. We had a psychiatrist on staff who came from the UK and had studied with Winnicott— especially his ideas linked to deprivation and
delinquency. We also had the distinguished Rick Dudley, an African American forensic psychiatrist, who was far too senior to be on staff but did make himself available for teaching and consultation. We would do a very intensive, child-friendly, homicide/ suicide screening, and if a child was positive, they would see our psychiatrist. If he found a child determined to die, with a practical plan of how to make that happen, then they would go to Kings County Hospital, to a special unit supervised by a senior clinician there. Most children would respond by saying, “No, no, doc, I’ll come to my next appointment, everyone needs to chill”—but if they did want to die, then we could arrange a shortterm hospitalization before any community referral. We were trying to protect our partners by saying, okay, we will take this on, but that also meant being very, very strong. We knew that we were dealing with very depressed, desperately hopeless children, with families who often held down multiple jobs and worked their fingers to the bone just trying to protect them. We had a sacred obligation to get these children proper care.
A story: We have a kid who comes in, the mother is sure he has a firearm in the closet, and he’s apparently held it to someone’s head. So, he comes in, and I’ve got a young, beginning, skinny, white social worker assigned to the intake. But he had been through Dr. Dudley’s clinical training, and he knows the drill. He was very calm, and he asked what was going on. The kid starts cursing, yelling, and calling him names. He doesn’t respond, just acknowledges that the child is really distressed. He doesn’t react, just sits there patiently saying that he really does want to know what is going on. The child storms out of the room with his anxious mother trailing after him. Then, at six o’clock, he shows up in the office. “Is Mr. Ted here? I’ve got to talk to Mr. Ted.” I said, “Mr. Ted’s not here, but I’m here. What’s the problem?” He said, “You know that Mr. Ted, my social worker, he’s a weirdo. You could tell him anything.” [Laughs] So, I said, “What’s the anything?” The “anything” was that he had a firearm with him. I had to put it in a drawer and call the police to come collect it after hours. That way, I need not release any information about where the weapon came from. I asked the youngster if he was going to hurt himself or somebody else. He agreed to a short-term hospitalization.
KV: You mentioned Winnicott, and that story reminded me of a paper of his that I just love called “Delinquency as a Sign of Hope” (Winnicott, 2016). And to me, your story just put it right there.
MO: What strikes me is that in these stories, there’s a real hunger for psychoanalysis. “This guy’s crazy. You can say anything.” But part of what Kirkland is pointing to as well is that there are all these forces that really do interfere with one’s capacity to protect a space where a kid can say anything. I wonder if you guys have insight or thoughts about how that space can be protected, how it can be held open.
KV: I think your term, protected space, is first and foremost. I think that the therapists need to feel protected. And I talk about it in very simplistic ways. It’s like if we’re in a school setting, and the principal or dean brings a kid to a therapist and says, “Here.” The kid is on the spot; the therapist is on the spot. And there’s no way that I believe that that’s not going to undermine the efficacy of the treatment. Both are now being tested. The kid knows. He or she’s not blind to this phenomenon, they just don’t use the same vocabulary. They’re aware. So I think the idea of building, really forging them, knowing that that can happen is to be able to protect the therapist, so the therapist, in kind, can protect the patient. They protect the patient by saying, “This is a space in which we want to see what evolves here that can be helpful.” When black kids protest—black boys, but also lots of black girls—when they’re being reprimanded and they say, “You ain’t my father!” I hear that as a protest. Right? Where the hell is my father? But I hear responses like, “Well, now you’re suspended.” “You’re oppositional.” “You’re defiant.” So the space is undermined before the referral even gets made. “You are to be compliant, to be who we need you to be.” And the kid, even if they wanted to in their fantasy, they know it can’t be done. And so, it’s a mechanism of shaming and of othering right there. So I think the administrative staff need education and training about the power that rests in the school system.
Martha mentioned Winnicott, and Kenneth Clark, the black psychologist, also noted the same from the perspective of social psychology. They spoke in a very positive way: how these troubled, delinquent kids help the community so much, how they hold hope. That’s what they said, “These kids have not given up yet.” So, what Martha is describing is grabbing the strength and hope that are carried in these kids before they get killed off by our labels: “wilding” as a classical example. I remember arguments and fights that occurred at the time of the Central Park Five and after, justifications after that, “We’ve got to get tough.” We do have to get tough, but the toughness is in creating programs that can then protect and let kids know that they have a real opportunity. Not opportunity like they are going to make this amount of money or that amount of money, but that somebody really does care about them, and somebody’s going to mentor them to be the best that they can be. And I think failure is okay, failure’s okay for everybody. It’s not whether or not you failed; it’s whether or not you made an attempt. If you haven’t had the opportunity to make an attempt, that’s when the shame dissolves who you are. It just eats away like an acid. I think they don’t get that. We have to give them an opportunity.
MB: They get shut down and pressured to lie very, very early, just as the Exonerated Five were back in the day. I just did a paper (Bragin, 2021) in your journal [Journal of Infant, Child, and Adolescent Psychotherapy (JICAP); Dr. Vaughans is the founding editor]. It’s about kids who become involved, whether it’s in gangs in the US or in other armed groups around the world, in violent extremism. But, when you interview these kids, what they show you is their hope: they’re fighting for something. When they think that you want them to comply with the existing structure, they think that you don’t want to know the truth that they know; you can’t hear it. Then, they shut down. The paradox of hope is allowing them to tell us their truth, and we adults are making psychic space for that truth so that we can find a third way forward, (in Benjamin’s terms) beyond violence and toward creative action, together.
We have a social imaginary that is controlling the narrative, and then we’ve got real humans who are not reducible to that narrative but who are caught up in it. The PINS program allowed us to listen to children and their families and their truth, and to help them to live their truth and to figure out how to mourn their losses, acknowledge their suffering, and to celebrate their resistance and resilience. To value that is powerful.
MO: This was 1987 that the program started. I want to get a sense of then and now. What were the biggest challenges implementing a program like this, bringing psychoanalytic principles into a community setting in 1987, and how have those challenges changed today, for better and for worse, I’m sure?
KV: For me, the good news back then was that we had people who were analytically trained who were invested in youth. Now, it’s also my belief that they had to be re-trained, but a lot of this cadre is now gone. The young cadre is not being trained this way: they’re being trained in behaviorism, CBT, DBT, what Dorothy Holmes has referred to as the alphabet therapies. So they don’t get a sense of looking at the person inside, only at the symptomatology. So, in that way, trying to teach psychodynamic thinking is much more difficult because the students know when they go on externship or internship, they have to talk that talk, walk that walk, and it’s CBT and DBT. So even if they’re interested, they’re intimidated. If they don’t have enough CBT and DBT stuff on their resume, they’re
out to lunch. It’s like I’m whispering to them something that’s lewd, that’s of interest when I talk psychodynamically. I’ve even had students, who are on their internship, sign up to take an additional course to come back to me to get supervision on their internship because it’s only CBT and DBT and they don’t know what to do with these patients. So I end up supervising them on their internships unofficially. So the cadre is gone. The whole sense of creating a therapeutic environment for youth after they’re hospitalized, it’s out the window.
There is a children’s psychiatric center near my home, and every time I pass, without fail, I see two police squad cars out there. Every time. Without fail. Any time of the day. Always two police squad cars. So, that suggests to me—I’ve never been inside—but it suggests to me that it’s gone back to a very legalized, monotonized, behavioral focus. So I would say it’s more difficult today. I know that Martha caught hell, I caught hell, and more than that, the kids caught hell, but I could find people like Martha back then, whereas now I feel like I would be hard put because people have gotten tired, they’ve gotten worn out. You have to know how to play in the mud. The professors may say, “I don’t want to play in the mud anymore,” but that’s where you’ve got to stay. My wife and I were at a party a few months ago, and there was a young white woman with an eight-month-old daughter in her arms and about a four-year-old son. And they’re walking towards us, and my wife and I started laughing because there was a puddle between us, and the mother stepped a little bit faster, and I said, “It’s too late.” That kid headed straight for that puddle and enjoyed himself. We just laughed. The mother looked like it was a catastrophe, but it’s no catastrophe. No kid is going to walk past a puddle. It’s not going to happen. It’s still a requirement for this work to play in the puddle, even more so, I would say. And that’s more difficult these days. The environment has changed, the culture has changed to wipe out this way of looking at kids. Fix them and be gone.
MB: I’m going to speak again to the external side of what’s going on here. So, first of all, PINS Diversion was a great place to train people in doing a psychodynamic assessment, working with families to understand their experience, what a child’s acting out behavior represented, and how to address it, with families and children affected by violence. We kept strict records of our assessments, referrals, and results, that included circling back to families for their views of our effectiveness. We tweaked referrals and practices based on community reports, in a process that today is called “monitoring, evaluation, accountability, and learning” (MEAL).
However, in recent years, this program and others like it fell victim to a controversy regarding the nature of evidence in clinical practice. As we all know, the gold standard for evidence in medicine, particularly in the prevention or treatment of disease, is a randomized controlled trial, which ensures that every aspect of sample and care is standardized except for the presence or absence of a very specific intervention. This is, of course, really important for the creation of vaccines or the treatment of disease.
However, children’s development is interactive from birth. Brains and bodies develop as a product of unique interactions between the new human being and its caregivers, influenced by culture and community and affected by myriad protective factors as well as risks created by adversity. Biopsychosocial interventions must therefore also be complex—too complex to lend itself to an intervention addressing one symptom only. A recent policy paper by the Alliance for Child Protection in Humanitarian Action therefore recommends MEAL processes as a better standard to use to judge the effectiveness of biopsychosocial programs for children. However, in the US, complex interventions that have not undergone a clinical trial are considered to be without evidence and discarded in favor of manualized interventions designed to address specific behaviors (regardless of how small the effect size, or whether the evidence for effectiveness was actually gathered with the population that we are working with in mind, and not another one).
Right now, the PINS program runs based on a series of short-term and limited interventions, rather than the complex ones that were engaged in those early days in the 1980s, 1990s, and early 2000s. I am hopeful that the discussion of the nature of evidence for effective practice is just beginning.
What I do is a combination of lending my voice to discussions like these in the international community, and, here in the US, running a small program out of Silberman School of Social Work at Hunter College, where I try to teach the ways of working that my research tells me are developmentally sound and culturally relevant, as well as the value of learning from, and accountability to, the communities and the humans within them with whom we are working.
I should shut up now and let Kirkland talk.
KV: Well, no, you shouldn’t shut up. I like what you do, Martha. I deeply respect the work you’ve done. Your articles in JICAP have brought so much to light. It gave credence not just to the work, but to the population that this work impacts, that we can work with this population. For me, up until the point when you began to write, there were a few other folks out there, but there was a quiet dismissal. It wasn’t loud. Nobody was saying, “Screw these kids. These kids are no good.” It was a quiet dismissal. It was more like, “Why would one go there?” There was a woman, Barbara Lerner. She wrote Therapy in the Ghetto (Lerner, 1972) about psychotherapy in the slums in Chicago, and she showed how effective psychodynamic therapy was with poor black people in the Chicago slums. Rarely do I see her referenced. There’s a giant book, Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change, it comes out every few years, and it says whether or not your research is good. They reviewed her work and found that it was quite outstanding. And yet her work has been ignored. I see Martha’s work in the same way, except it’s beginning to be read and to impact other areas.
MO: Some of what you both have spoken about are these external pressures— from government, from funding sources for research, and from the scientific paradigms themselves—that exert themselves on psychoanalysis and on clinics that want to support psychoanalytic practice, but I think Kirkland was starting to point to before some of psychoanalysis’s internal problems, in terms of how it has made itself available, the ways it has theorized or not on race, socioeconomic issues, gender, and sexuality. Anecdotally, I meet lots of social workers who are interested in psychoanalysis and pursue psychoanalytic training, but it’s often accompanied by a turning away from what is so special about social work, which is the broad, social, community orientation. They go into psychoanalytic training, they open private practices—I have a private practice, I’m not disparaging the decision—but there’s a shift away from attention to the collective into this very individual thing that has always been there with psychoanalysis.
KV: Most of my career has been community-based mental health, but I also have a private practice. When I went to NYU [New York University], Bernie Kalinkowitz, who was the founder of NYU Postdoc, turned to me and asked me if I was still involved in community-based mental health, and I defensively responded, “Yes, I am.” And Bernie said, “Oh great, great, I’m glad.” And I was surprised to hear a psychoanalyst really be supportive of community-based mental health, and I appreciated it. Honestly, I cannot understand how the psychic and the social can be disconnected. If I were to believe that, I would believe you can separate heads or tails on a coin; there’s just one side or the other. I don’t want it to sound arrogant, but to me, this is just a reality.
MB: I so appreciate your saying that. Going back to an earlier point of yours, Kirkland, about what we needed to do to create our own ability to work effectively with these youngsters. Work with families affected by such high levels of violence can be especially challenging when practitioners and clients are living within the same systems of structural and institutional violence that the families are. We had to learn about this from Chilean psychoanalysts Janine Puget and Elizabeth Lira. We are all incubated in this system whether as survivors, witnesses, or accomplices. Even as the straight, white, cisgender, “ablebodied” among us were particularly affected by blindness and denial, all of us were affected by being part of a society that denied the reality of structural and social violence embedded in everyday life. We are all blinded by the violence that renders history, culture, and class invisible along with the scholarship illuminating strengths and protective mechanisms inherent in BIPOC cultures’ capacity to survive.
It happened that during the same period that I was developing the Diversion program, I was invited by MADRE, a women’s organization, to work in countries in conflict in Central America, Eastern and Southern Africa, Southeast Asia, and the Middle East. MADRE’s capacity exchange program recruited US-based women of many ethnicities to learn from successful organizers in countries in conflict, while sharing our own expertise. I began to bring the learning from these experiences back to our program to help us gain perspective. In that process, I became aware that Freud’s greatest gift was taking ideas he obtained from around the globe, through his interest in anthropology and his correspondence with Indian philosophers and incorporating them into his thinking. The ideas that he tests in 1896 were already available. Remember that in 1492, the “known/ civilized world” was centered in the global south. The idea of an unconscious mind was ubiquitous, as were such concepts as conflicting passions, with both sexuality and aggression part of the psyche of all humans. So psychoanalysis actually brought to Europe and the European mind some knowledge that is more universal and not particularly white. And if we keep that in our mind, then we can start thinking differently about psychoanalysis. The idea that the past lives in the present, that the parents and their parents before them are remembered in some way in all that we experience, and that if we encounter violence in the world or are forced to break society’s boundaries, we must find societal methods to symbolize the unsymbolizable in order to be able to join the peaceable community again. These are all part of the knowledge that was brought to psychoanalysis in its early days and are part of the international psychoanalysis so often ignored in the US. A vibrant Indian psychoanalysis provides global leadership in understanding the importance of caste, class, and cultures; a popular psychoanalysis in the South American continent takes the lead on issues of politics, economics, and social justice. Newly emerging Southern African and Central American psychoanalytic thinkers are exploring their “Atlantic” cultural practices and communal methods. All of these ideas are part of our psychoanalytic worldview and heritage. We need to reclaim and rejoin our heritage, our present and our future. The good news for me is that my diverse band of graduate students, and others like them, are eager to interrogate their own histories and traditions and make psychoanalysis their own. Every day that I teach, I learn from them. These kids are smart, insightful, and ready to forge a new world. But yes, in earlier times, these aspects of psychoanalytic thinking, as embedded in culture, class, and history, were often “whited out” in the US—obscured from view.
KV: You’re right. What I came up under is what Martha’s describing. And it impacted me in that I was dismissive of a lot of the teachings; it just didn’t make sense, it didn’t apply. And I recognized that even in our psychology programs, it was the same. And it seemed to me that students of color were missing out on significant parts of their education, while white students were being miseducated because you couldn’t have conversations back then about this. It was dismissed as, “That’s cultural,” as if that has nothing to do with how the mind operates. We saw culture in a very simplistic way: how an East Indian or a Native American might dress, a black with jazz or hip hop, not as a part of the person and a way the mind is structured. To me, it’s who we are, it’s a part of our makeup; our identity is very profound. Recently, I gave a talk about my treatment with a ten-year-old black boy, and he’s attending an all-white school district, and he’s the only black person there. So, he’s a very, very smart kid, and all of the sudden, he’s being written up, suspended, threatened with expulsion in this private school. And the one teacher, a Jewish woman, that had talked with him about this the prior year had left, and he felt so abandoned. So I talked to his mom, and I said, “Listen, this is not a battle that we should fight.” And he moved to a public school district that has diversity and to a black church, and he’s performing there, and the preacher knows him. It’s not like this kid is mentally disturbed, but to get him back on his developmental track, he needed to use his cohorts and be able to identify with them, not be put in a position of “something is wrong with you, you’re here by yourself.” And the kid said to me after about twelve weeks, “Listen, my mind doesn’t hurt anymore.” That’s what he said to me. “I’d like to see you again, but I’m not so sure about that.” And I said, “Let’s talk. We call that ambivalence. Part of you feels this way, part of you feels like that.” And he said, “Well, I’m in trouble or I’m in pain if I accept to see you, and I don’t want that trouble and pain anymore, but I would like to see you.” So I said, “Well, we can do other things. We have what we call check-ins, just, ‘How you doing?’, and we have talks that way.” Mom agrees we can have check-ins whenever he wants, wouldn’t have to be in pain, wouldn’t have to be in trouble. And with that, the kid dismissed me. He’s doing well. He doesn’t need me there every week. He’s doing very well on his own. He told me about the preacher and the programs there. He’s participating actively. He’s not being singled out. In effect, that’s what I said to him, “I won’t be singling you out.” So I felt like the termination was a good one, our work together was good. He turned me onto a book where he’s reading about the other, a kid going to a school where he doesn’t belong. I’m so interested in Martha’s work with narrative. Helping the patient to tell his story. To me, that is analytic: helping the kid tell his story. It’s just that it’s not recognized without all the analytic terminology. Martha said, “Tell your story. I want to hear it. I’m interested in hearing your story.” And the more this person can tell their story, they begin to hear themselves. Whereas before, it was forbidden. Nobody wanted to hear it. There was an article written in volume one of Psychoanalytic Psychology entitled “The Conspiracy of Silence” (Danieli, 1984). It’s about how Jewish people who survived the Holocaust were treated even by people in our field. “We don’t want to hear it. You fix that.” Judith Herman in her book talks about how it takes a political movement to understand trauma. And I think she’s right. Psychoanalysis needs to look at social justice and its role in either supporting it or undermining it. There are no bystanders here.
MO: That sounds like a good place for us to stop. Thank you both so much for sitting for this interview and for the remarkable bodies of work you both have generated, envisioning and elaborating the space for a community psychoanalysis. z
REFERENCES
Bragin, M. (2021). The paradox of hope: A psychodynamic approach to understanding the motivations of young people engaged in violent extremism. Journal of Infant, Child, and Adolescent Psychotherapy, 20, 1-14. https://doi.org/10.1080/1 5289168.2021.2007685
Danieli, Y. (1984). Psychotherapist’s participation in the conspiracy of silence about the Holocaust. Psychoanalytic Psychology, 1(1), 23–42. https://doi.org/10.1037/07369735.1.1.23
Lerner, B. (1972). Therapy in the ghetto: Political impotence and personal disintegration. The Johns Hopkins University Press.
Winnicott, D. (2016). Delinquency as a sign of hope. In The collected works of D. W. Winnicott (pp.91-98). Oxford University Press.
