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Research of the Holiday Kind

Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne

Sarah E. Shea, Kevin Gordon, Ann Hawkins, Janet Kawchuk and Donna Smith
CMAJ December 12, 2000 163 (12) 1557-1559;
Sarah E. Shea
Sarah-the-Shea, Ann-the-Hawkins, Janet-the-Kawchuk and Donna-the-Smith are with the Division of Developmental Pediatrics and Kevin-the-Gordon is with the Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, NS.
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Kevin Gordon
Sarah-the-Shea, Ann-the-Hawkins, Janet-the-Kawchuk and Donna-the-Smith are with the Division of Developmental Pediatrics and Kevin-the-Gordon is with the Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, NS.
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Ann Hawkins
Sarah-the-Shea, Ann-the-Hawkins, Janet-the-Kawchuk and Donna-the-Smith are with the Division of Developmental Pediatrics and Kevin-the-Gordon is with the Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, NS.
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Janet Kawchuk
Sarah-the-Shea, Ann-the-Hawkins, Janet-the-Kawchuk and Donna-the-Smith are with the Division of Developmental Pediatrics and Kevin-the-Gordon is with the Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, NS.
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Donna Smith
Sarah-the-Shea, Ann-the-Hawkins, Janet-the-Kawchuk and Donna-the-Smith are with the Division of Developmental Pediatrics and Kevin-the-Gordon is with the Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, NS.
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Jump to comment:

  • Pooh is not ADHD/OCD but has an ADDICTION issue
    Mary R. Wisely
    Posted on: 27 May 2010
  • Psychopathy of the Heffalump
    Chris Rigby
    Posted on: 30 November 2009
  • Kanga and Roo
    Victoria L Baker
    Posted on: 18 March 2009
  • Neurodevelopmental perspective on A.A. Milne - the effect on regular readers
    Janice P A Crimes
    Posted on: 01 February 2007
  • Re: Fine tuning of the diagnosis of Pooh
    Maria Cresione
    Posted on: 16 May 2006
  • Whither humor?
    Quincy G. Ryan
    Posted on: 13 March 2006
  • Poorer Outcome, eh?
    Matt H.
    Posted on: 10 March 2006
  • Winnie the Pooh: A Case Study in Sublimated Fecal Incontinence and Anal Eroticism?
    David L Baker
    Posted on: 10 January 2006
  • Fine tuning of the diagnosis of Pooh
    Leo J Bastiaens, MD
    Posted on: 13 May 2002
  • point well taken!
    Yasmin N. Loewe
    Posted on: 10 May 2002
  • Posted on: (27 May 2010)
    Page navigation anchor for Pooh is not ADHD/OCD but has an ADDICTION issue
    Pooh is not ADHD/OCD but has an ADDICTION issue
    • Mary R. Wisely

    Winnie the Pooh is an addict, more specifically, honey. He doesn‘t need psychostimulants (also addicting) but rehab and maybe some methadone. His mind is little not because of shaken bear syndrome, but because the honey is rotting his brain cells. His lack of focus, poorly laid out plans, and ADD behavior are also a result of the addiction (like someone who is stoned all the time), as well as his weight (like the munchi...

    Show More

    Winnie the Pooh is an addict, more specifically, honey. He doesn‘t need psychostimulants (also addicting) but rehab and maybe some methadone. His mind is little not because of shaken bear syndrome, but because the honey is rotting his brain cells. His lack of focus, poorly laid out plans, and ADD behavior are also a result of the addiction (like someone who is stoned all the time), as well as his weight (like the munchies). He spends his entire day looking for honey, bothering other characters for their honey, getting into trouble because of the honey, and even fearing imaginary creatures (the Heffalumps) because he’s trippin on the honey. Look in his home and I’m sure you will find a bunch of empty jars of honey (like looking through an alcoholic’s house).

    Owl has a mild autism (Asperger’s Syndrome or PDD-NOS depending on that speech delay). He monologues, is socially awkward, has special interests (such as books), etc.

    Piglet suffers from many different phobias. He wouldn’t leave the house if Winnie the Pooh didn’t drag him out. He’s afraid of everything.

    I really think it more summarizes the major psychological disorders…

    Pooh -- addiction

    Owl -- mild autism

    Piglet -- phobias

    Eeyore -- depression

    Tigger --- ADHD

    Rabbit -- Control Freak

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
  • Posted on: (30 November 2009)
    Page navigation anchor for Psychopathy of the Heffalump
    Psychopathy of the Heffalump
    • Chris Rigby

    I am deeply concerned that you omitted the Heffalump from your clinical analysis. I fear that this omission might play right into Its hands, and actually cause direct deterioration in Its condition.

    The Heffalump suffers from obsessive behaviour, to wit, extreme secrecy. No- one is aware of having seen It, and yet everyone seems to know of Its existence. This kind of Howard Hughes-ian behaviour is not helped...

    Show More

    I am deeply concerned that you omitted the Heffalump from your clinical analysis. I fear that this omission might play right into Its hands, and actually cause direct deterioration in Its condition.

    The Heffalump suffers from obsessive behaviour, to wit, extreme secrecy. No- one is aware of having seen It, and yet everyone seems to know of Its existence. This kind of Howard Hughes-ian behaviour is not helped by your obstinate refusal to delineate its condition, and in my opinion, will push It into further secrecy and obsession.

    The worst outcome would be the Heffalump emerging into psychopathic disorders, perhaps even sowing the seeds of a serial killer. We've all heard the quotes of neighbours : "Well, he never went out much. He kept himself pretty much to himself".

    Socialise the Heffalump! Don't let a potential killer emerge...

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
  • Posted on: (18 March 2009)
    Page navigation anchor for Kanga and Roo
    Kanga and Roo
    • Victoria L Baker

    I was deeply surprised that you neglected to raise the issue of whether or not Kanga - in her role as over protective single parent isn't perhaps a candidate for Munchausen Syndrome By Proxy. Certainly her obsessive concern for Roo's health and the possibility of sniffles and sneezles would at least bear looking at.

    Competing Interests: None declared.
  • Posted on: (1 February 2007)
    Page navigation anchor for Neurodevelopmental perspective on A.A. Milne - the effect on regular readers
    Neurodevelopmental perspective on A.A. Milne - the effect on regular readers
    • Janice P A Crimes

    Your paper is fascinating. Whilst my interest is general rather than academic I am concerned that, as a devotee and regular reader or Pooh texts, my emotional and intellectual health may be in jeopardy. Furthermore, might my personal influence on my students (160 individuals from 4 to 17 years of age) and their parents, become negative and/or manic rather than positive because of my reading habits and devotions.

    ...

    Show More

    Your paper is fascinating. Whilst my interest is general rather than academic I am concerned that, as a devotee and regular reader or Pooh texts, my emotional and intellectual health may be in jeopardy. Furthermore, might my personal influence on my students (160 individuals from 4 to 17 years of age) and their parents, become negative and/or manic rather than positive because of my reading habits and devotions.

    To clarify, I most admire the actions of Tigger. I aspire to his bounciness and its consequences (eg crushing of Rabbit's breakfast), but spend more time marvelling at and reflecting on Eeyore's philosophies of gloom.

    Should I seek professional counselling?

    Janice Crimes

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
  • Posted on: (16 May 2006)
    Page navigation anchor for Re: Fine tuning of the diagnosis of Pooh
    Re: Fine tuning of the diagnosis of Pooh
    • Maria Cresione

    While I find all these diagnosisi valid and well thought out, I feel that there is a slight connotation that what these individual characters portray is a "bad thing." I personally feel that, for children especially, there is an undeniable need to understand these "disorders" that by seeing them exhibited it allows them to better comprehend as well as interpret the world that they currently live in. Moreover, these differe...

    Show More

    While I find all these diagnosisi valid and well thought out, I feel that there is a slight connotation that what these individual characters portray is a "bad thing." I personally feel that, for children especially, there is an undeniable need to understand these "disorders" that by seeing them exhibited it allows them to better comprehend as well as interpret the world that they currently live in. Moreover, these different characatures allow children to relate to. On the other hand I can see that in certain instances this "It's ok to be worried, look Piglet is" attitude could lead to problems, but again I think programs that demonstrate various parts of the human pysche play a vital role to child as well as human mental development. Thanks

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
  • Posted on: (13 March 2006)
    Page navigation anchor for Whither humor?
    Whither humor?
    • Quincy G. Ryan

    Sorry for spelling "humor", without the "u" so beloved of in the Commonwealth. Sadly, these days most Americans have been forced to cut back on our vowel usage.

    I possess a BA in both Political Science and History from the University of Colorado. This has no relevance to the issue at hand, save for their paving the way towards my Masters of Education from Regis University.

    Humo(u)r presents and excell...

    Show More

    Sorry for spelling "humor", without the "u" so beloved of in the Commonwealth. Sadly, these days most Americans have been forced to cut back on our vowel usage.

    I possess a BA in both Political Science and History from the University of Colorado. This has no relevance to the issue at hand, save for their paving the way towards my Masters of Education from Regis University.

    Humo(u)r presents and excellent opportunity for students and educators alike to view their ideology from an abstract position. Humor (sic) serves as a mirror through which we may observe the absurdities of our professions without the interference of lawyers. Frankly, any profession from a street-corner hot-dog salesman to President of the United States that cannot "take a joke", as it were, ought to be examined very, very closely.

    The capacity for humour (when in Rome) requires a higher level of intelligence than found in other mammals. While what we consider to be funny may be subjective, creating or appreciating humor is an abstract concept in itself. Abstract thought can only be achieved through higher brain function. In short, "hunting and gathering", though necessary, isn't funny. Perhaps this is why so few cave-drawings came with punch-lines.

    I submit that it is not insignificant that the men behind "Monty Python's Flying Circus" were educated at either Cambridge or Oxford.

    No doubt that the members of that merry band would have had a field day with members of a profession dedicated towards mental health, that failed to recognize a good joke when they read it. Their's was the theatre of the absurd, and while the article in question was most certainly absurd, it was also very funny, as its intent was to highlight the absurdity of a profession not generally seen as humorous.

    So, sit back in the couch, tone down "stimulus-response", and dare I say, smile.

    Show Less
    Competing Interests: None declared.
  • Posted on: (10 March 2006)
    Page navigation anchor for Poorer Outcome, eh?
    Poorer Outcome, eh?
    • Matt H.

    Hello. I would like to inform you of a small...how should I say this?...disrespect I guess I should call it about the comment you made about single parent families. I am a 16 year old son of a single mother and I do not condone the statement about Roo: "Roo is growing up in a single-parent household, which puts him at high risk for Poorer Outcome. We predict we will someday see a delinquent, jaded, adolescent Roo hangi...

    Show More

    Hello. I would like to inform you of a small...how should I say this?...disrespect I guess I should call it about the comment you made about single parent families. I am a 16 year old son of a single mother and I do not condone the statement about Roo: "Roo is growing up in a single-parent household, which puts him at high risk for Poorer Outcome. We predict we will someday see a delinquent, jaded, adolescent Roo hanging out late at night at the top of the forest, the ground littered with broken bottles of extract of malt and the butts of smoked thistles." Thank you for that. I have to say that I have turned out just fine in my single parent household. My mom has done a great job raising me. And I think those comments about a child of a single parent household being a "delinquent, jaded, adolescent," because I sure as hell am not a deliquent. I demand a recant of that statement. Making the assumption that a single parent does not cut it is preposterous. Thank you for your recant.

    Conflict of Interest:

    The statement about Roo and single parent households.

    Show Less
    Competing Interests: None declared.
  • Posted on: (10 January 2006)
    Page navigation anchor for Winnie the Pooh: A Case Study in Sublimated Fecal Incontinence and Anal Eroticism?
    Winnie the Pooh: A Case Study in Sublimated Fecal Incontinence and Anal Eroticism?
    • David L Baker

    Winnie the Pooh: A Case Study in Sublimated Fecal Incontinence and Anal Eroticism?

    Re Sarah E. Shea, Kevin Gordon, Ann Hawkins, Janet Kawchuk, and Donna Smith 'Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne.'

    I am afraid that the authors of this, otherwise excellent, article have missed the most glaring element of all in this sorry clinical saga. The name of this p...

    Show More

    Winnie the Pooh: A Case Study in Sublimated Fecal Incontinence and Anal Eroticism?

    Re Sarah E. Shea, Kevin Gordon, Ann Hawkins, Janet Kawchuk, and Donna Smith 'Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne.'

    I am afraid that the authors of this, otherwise excellent, article have missed the most glaring element of all in this sorry clinical saga. The name of this poor unfortunate creature is, after all, 'Pooh' (colloquially known as, and pronounced 'Poo') and given the cited and convincing evidence of his fixation on food, and in particular honey, this clearly adds up to a classic case of sublimated Fecal Incontinence* and Anal Eroticism.(*It should noted that the scurrilous use of 'code brown' is to be avoided in referring to this disorder (see Adam T. Fox, Michael Fertleman, Pauline Cahill, & Roger D. Palmer: 'Medical Slang in British Hospitals' in Ethics and behaviour: 2003, Vol. 13, No. 2, 173-189, at http://www.leaonline.com/doi/abs/10.1207/S15327019EB1302_04;jsessionid=iafjqvt2frzcu5op0I?cookieSet=1&journalCode=eb 10th Jan 2006, accessed at 11.45 am GMT)

    And here, perhaps, we can turn to Freud for valuable extra assistance. Since the unconscious mind of Pooh and several other denizens of the Hundred Acre Wood represent nothing less than a 'bubbling cauldron of fears, conflicts, distorted perceptions and guilt-initiated emotions' described by Freud in cases of sublimation and regression. (see Korn, Errol R., and Johnson, Karen: VISUALIZATION: THE USES OF IMAGERY IN THE HEALTH PROFESSIONS, Dow-Jones Irwin, Homewood, Ill., 1983. http://www.lucidexperience.com/HypnoPapers/502.html 10/01/06 accessed at 12.05 am GMT)

    In fact, the following passage from Jensen's 'Gradiva' and Other Works' (1906-1908 Volume IX:) http://www.nyfreudian.org/abstracts/abs_volumes/vol-09.htm (accessed 10.20 am GMT 10/01.06) offers the potential to establish a causal and decisive linkage between the character/name of the poor unfortunate Pooh (or 'Poo') as an expression of sublimated Anal Erotism and latent Fecal Incontinence vis: "The relationship between character and anal eroticism is discussed. The people that Freud describes are noteworthy for a regular combination of the 3 following characteristics. They are especially orderly, parsimonious, and obstinate. These people took a comparatively long time to overcome their infantile fecal incontinence, and even in later childhood they suffered from isolated failures of this function. Anal erotism is one of the components of the sexual instinct which, in the course of development and in accordance with the education demanded by our present civilization, has become unserviceable for sexual aims. It is therefore plausible to suppose that these character traits of orderliness, parsimony, and obstinacy, which are so often prominent in people who were formerly anal erotics, are to be regarded as the first and most constant results of the sublimation of anal erotism. Freud theorizes that the permanent character traits are either unchanged prolongations of the original instincts, or sublimations of those instincts, or reaction formations against them."

    Now, while it is clear that Pooh (AKA 'Poo') is not the most orderly, and parsimonious of creatures (although it must be granted that he does strive very to be so) he more than makes up for this deficit with his obstinacy, and besides I refer critics back to his alter ego name!!!)

    I therefore humbly submit this additional diagnosis in order to correct one glaring omission from the profile of the key figure, Pooh, in the original article.

    Dr David Baker

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
  • Posted on: (13 May 2002)
    Page navigation anchor for Fine tuning of the diagnosis of Pooh
    Fine tuning of the diagnosis of Pooh
    • Leo J Bastiaens, MD, child and adolescent psychiatrist

    Dear Madams and Sirs,

    I read with great interest the study by Sarah E. Shea and collegues. However, I am disappointed by some of their conclusions.

    As a general psychiatrist, pediatric psychiatrist and cognitive therapist, I was astounded when I read Winnie the Pooh to my 3 year old son in 1991. What first struck me was the typical maladaptive beliefs and cognitive distortions of the different characte...

    Show More

    Dear Madams and Sirs,

    I read with great interest the study by Sarah E. Shea and collegues. However, I am disappointed by some of their conclusions.

    As a general psychiatrist, pediatric psychiatrist and cognitive therapist, I was astounded when I read Winnie the Pooh to my 3 year old son in 1991. What first struck me was the typical maladaptive beliefs and cognitive distortions of the different characters. After a diagnostic study, I have been lecturing on the disorders of Pooh and friends throughout the Eastern United States. Combining elements of cognitive theory, pediatric psychiatry and developmental science, the following represent a more accurate diagnosis of some of the characters:

    Winnie the Pooh clearly suffers from Prader-Willie (not Winnie)syndrome: mental retardation manifested by his concrete and simplistic vocabulary, "I am a bear of no brain", compulsive overeating and insatiability, physical anomalies (typical Prader-Willie facies, small hands and feet, very small chin and hypogonadism: no pants but nothing detectable), overall cheerful mood (except with food related frustrations). Empirical evidence: all medical students and residents rotating through my service receive the task of diagnosing Pooh (only clue given is the fact that it is not a disorder in DSM): over 80% get the diagnosis in less than two weeks and bring in pictures of Prader-Willie patients.

    Tigger fits most criteria for ADHD, combined type, and yes, should be treated with stimulants. A differential diagnosis could be traumatic brain injury (frontal lobes).

    Eeyore has a major depressive disorder: his psychomotor retardation, anhedonia, consistently depressed mood, low energy, and sad affect are features too severe for dysthymic disorder.

    Piglet, indeed, has a generalized anxiety disorder, which is characterized, among other features, by the cognitive distortions of catastrophizing, jumping to conclusions, etc.

    Owl has dyslexia, but also narcissistic traits (he knows it all, or so he thinks).

    Rabbit has OCD and could use SSRI or exposure and response prevention therapy related to being "a cleaner and checker".

    And finally: Kanga and Roo have separation anxiety disorder, manifesting itself through overprotectiveness and some parent - child conflict.

    Respectfully submitted, Leo Bastiaens, MD Clinical Associate Professor of Psychiatry University of Pittsburgh

    Show Less
    Competing Interests: None declared.
  • Posted on: (10 May 2002)
    Page navigation anchor for point well taken!
    point well taken!
    • Yasmin N. Loewe, Social Worker

    Hello,

    I stumbled upon your article quite by accident, and as a both a social worker and Pooh fan, I must say that I was intrigued by your article. Your point is certainly well taken; as a clinician who works with adolescents, I have seen and at times fallen prey myself to a tendency to look for symptomatology suggestive of pathology and mental illness. This is in fact hard to avoid entirely, as it is considered...

    Show More

    Hello,

    I stumbled upon your article quite by accident, and as a both a social worker and Pooh fan, I must say that I was intrigued by your article. Your point is certainly well taken; as a clinician who works with adolescents, I have seen and at times fallen prey myself to a tendency to look for symptomatology suggestive of pathology and mental illness. This is in fact hard to avoid entirely, as it is considered an important feature of assessment. In practice, however, I (as do my colleagues and others) strive more often to find strengths and normalcy in my clients, which I believe all clinicians intend to do and should do.

    I am rather surprised by some of the responses submitted to your article, in that it appears that certain readers have missed the point. Your humourous, tongue-in-cheek approach to this "case" has pointed out the ludicrousness of attempting to apply psychiatric and other labels to everyone we encounter in our professional lives. However, by nature of our work as clinicians, we are exposed to a select portion of the population who in fact tend to present with exceptional difficulties; thus at times, diagnosis is a necessary evil in order to provide a name for those difficulties and to direct treatment. Still, your article serves as a gentle reminder that we as clinicians should never become (for lack of a non-Freudian term) "fixated" on pathology. I will recommend that my colleagues read your article as a light-hearted warning of the pitfalls of hasty diagnosis and pathologization. Well done!

    Show Less
    Competing Interests: None declared.
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Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne
Sarah E. Shea, Kevin Gordon, Ann Hawkins, Janet Kawchuk, Donna Smith
CMAJ Dec 2000, 163 (12) 1557-1559;

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Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne
Sarah E. Shea, Kevin Gordon, Ann Hawkins, Janet Kawchuk, Donna Smith
CMAJ Dec 2000, 163 (12) 1557-1559;
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