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Emotional development, from a Winnicottian psychoanalytic perspective, must be understood through the relationships established between the individual and the environment. Internal resources are initially developed through the physical and emotional support of the maternal environment, which promotes the necessary adaptation for the infant’s survival and, later, through family support, which provides the conditions for the child to successfully integrate and adapt to new environments in society, such as school, work, and cultural life in general (Winnicott, 1957/2022). Thus, environmental influence persists throughout the individual’s life, and their ability to cope with frustrations and environmental failures will depend on the accumulation of introjections and memories of care provided by the environment, as well as projections of the need for such care, sustained by a reliable environment (Fulgêncio, 2020).
The infant develops ways of experiencing the world without direct care, relying on introjected memories of care and projected personal needs, supported by trust in the environment (here, we must also consider the element of intellectual understanding, with its complex implications). This process occurs in potential space, an intermediate area of experience where transitional objects are used.
Transitional objects carry subjective emotional meaning and are therefore chosen by the child rather than given, supporting the self in safely fantasizing and navigating between the internal world and external reality as needed (Morais, Amparo, & Brasil, 2017). As such, these objects are considered paradoxical: they belong to neither internal nor external reality but connect the two, contributing to both instinctual (intrapsychic) and relational (environmental) experiences (Winnicott, 1971/2019).
This interplay enables the creative and spontaneous transformation of experiences, which is both a hallmark of emotional maturation and a foundation for psychic elaboration. Play, broadly understood, functions as a transitional phenomenon rooted in creativity, through which individuals select external resources to project their entire personality and connect with their true self (Winnicott, 1971/2019). This symbolic capacity is essential for emotional growth and maturation, as it fosters an experiential space that supports self-integration and the construction of shared reality (Sousa, Pedroza, & Maciel, 2020).
If creative resources are insufficient for conflict elaboration, adapting to the environment becomes difficult, resulting in submission through disorganized, stereotypical, and non-spontaneous defensive structures (Winnicott, 1958/1993).
In times of emotional distress-particularly in overwhelming situations such as the COVID-19 pandemic-reality was drastically altered, and its unpredictability could be experienced as a traumatic disruption that hindered children’s individual experiences and the expression of the creativity and spontaneity necessary for their psychic health. The inability to cope with social isolation may reflect a limited internalization of adaptive resources in response to an environment that was not “good enough,” driving a stereotyped search for external objects rather than relying on available internal resources to process suffering (Macedo, Fernandes, & Freitas, 2021).
Since the pandemic restricted access to the adaptive elements of children’s social environment-such as school attendance, cultural activities, and peer relationships-it is necessary to investigate how their psychic organization responded to the distressing situations brought about by the pandemic. Although two years have passed since the peak of the pandemic, the emotional and psychological aspects still warrant investigation, as its impact may have disrupted children’s emotional and psychological development. This investigation must be grounded in children’s own perceptions, based on their worldview and their internal capacity to cope with resulting conflicts.
During the period of social distancing imposed to mitigate virus transmission, few studies focused on children’s emotional well-being. It is believed that, because the virus had milder effects on children and higher lethality among adults and older adults, research efforts were primarily directed at populations deemed at higher risk.
However, studies have shown that the emotional, psychological, and social consequences observed during previous epidemics-such as H1N1, AIDS, and Ebola-mirror the potential traumatic impacts of the COVID-19 pandemic. COVID-19, therefore, presents multiple risk factors to healthy child development, including heightened parental stress, school closures, social isolation, nutritional vulnerabilities, exposure to toxic stress (especially in already dysfunctional households), and reduced opportunities for physical activity (Araújo et al., 2021).
The closure of schools deprived children of social interactions and outdoor activities, resulting in increased idle time, greater screen exposure, and excessive worry about family and friends. These stressors have been linked to increased psychological distress in children, including depression, irritability, insomnia, aggression, and emotional exhaustion (Zhang, 2023).
A study conducted with parents in Brazil found that only 15% of children exhibited no behavioral changes. The remaining children experienced shifts in peer relationships, increased aggression, sadness, and anxiety. The study also identified a significant increase in screen time and changes in habits such as eating, sleep patterns, mental well-being, and emotional recognition. On a positive note, most children did not show learning difficulties and continued engaging in physical activities (Ramos et al., 2024).
Despite these findings, there is a noticeable gap in research conducted directly with children in Brazil. Although the family is a crucial environmental factor for children’s emotional health, it is essential to understand children’s experiences directly and participatively, recognizing them as authors of their own stories.
Thus, the general objective of this study was to understand the psychic organization of school-aged children in response to the emotional impact of the COVID-19 pandemic through the use of the Procedimento Desenhos-Estórias com Tema (PDE-T, Themed Story-Drawing Procedure). Specifically, it sought to investigate children’s reactions to conflict and the ways in which they drew upon internal resources to cope with the pandemic situation.
Method
Study Design
This is a clinical-qualitative study (Turato, 2018) based on a multiple case study design utilizing projective methods (Husain, 1991).
Participants
The study involved four children-two girls and two boys-aged 8 to 10, enrolled in the 2nd to 5th grades of elementary school, with no prior psychopathological diagnoses and residing in the city of Manaus, state of Amazonas (AM), Brazil. The girls were 9 and 10 years old, and the boys were 8 and 9 years old. Inclusion criteria included availability for in-person sessions; age between 7 and 10; current enrollment in early elementary school grades; no history of psychopathological diagnosis; and a parent or guardian who could provide proof, via updated vaccination records, that the child had received at least two doses of the COVID-19 vaccine.
Instruments
The instruments used for data collection included a parental anamnesis interview, a diagnostic play session, and the PDE-T.
Anamnesis Interview
Conducted with parents and/or guardians to obtain detailed information about the child’s life history, including experiences and behaviors during the new daily routine imposed by the COVID-19 pandemic and the child’s environmental (family) relationships.
Diagnostic Play Session
Used as an initial contact with the child to establish therapeutic alliance and build trust between the child and the researcher. This projective technique enables interpretation of the child’s internal and external content, allowing for the projection of conflicts, fantasies, and object relations into the play environment (Affonso, 2012).
PDE-T
Developed by Aiello-Vaisberg in 1999, this technique is derived from Walter Trinca’s original Story-Drawing Procedure. It allows for the exploration of a specific topic of interest to the examiner and seeks to understand the participant’s emotional logic regarding a particular social object (Aiello-Vaisberg, 2020). The instruction given to participants was: “Draw a child at school during the pandemic.” Materials included a sheet of A4 paper, a graphite pencil, and a set of 12 colored pencils.
Data Collection Procedures
Data were collected during May and June of 2022, with all necessary COVID-19 safety protocols observed, including physical distancing and personal protective equipment. The sample was recruited by convenience sampling via a Google Forms questionnaire shared on social media platforms (Instagram, Facebook, and WhatsApp) during March and April of 2022. The form contained general information about the study (objectives and methodology) and included screening questions for participant selection, along with contact information for scheduling appointments.
After the initial screening and based on the inclusion criteria, guardians were contacted by phone to schedule sessions. Although the original plan was to conduct the sessions at the University’s Psychology Clinic, it was closed due to pandemic restrictions. Consequently, a partnership was established with a private psychology clinic in Manaus for data collection.
The assessment protocol consisted of three sessions per participant and was conducted by two trained researchers. In the first session, informed consent was obtained from the parent or guardian, followed by the anamnesis interview. The second session involved obtaining the child’s assent and administering both the Diagnostic Play Session and the PDE-T. The third session was dedicated to providing feedback to participants.
Data Analysis Procedures
Data interpretation followed a Winnicottian psychoanalytic framework, with analysis procedures tailored to each instrument and subsequently integrated into a comprehensive synthesis.
Anamnesis
Data were analyzed to understand the child’s environmental context, from early infancy to behaviors and emotions experienced during the pandemic, with attention to relational dynamics (Silva & Bandeira, 2016).
Diagnostic Play Session
Analyzed using the diagnostic play interview protocol grounded in psychoanalytic theory as outlined by Efron, Fainberg, Kleiner, Sigal, and Woscoboinik (2009).
Themed Story-Drawing Procedure (PDE-T)
It was decided to adapt the analysis grid model created by Adaptation of Tardivo’s 1985 grid to the Winnicottian reference model. This method involves a comprehensive psychoanalytic interpretation of the participant’s productions-drawings, narratives, and responses to inquiry-through a Kleinian perspective (Tardivo, 2020). The material was organized into seven major domains and 33 subdomains, addressing elements such as instinctual impulses, object relations, unconscious fantasies, predominant anxieties and conflicts, significant relational bonds, and defense mechanisms.
While the original framework was based on the Kleinian theory, modifications were made for this study to align the tool with Winnicottian concepts. The aim was to investigate environmental conditions critical for the child’s emotional maturation and adaptation to new realities, emphasizing the role of a facilitating environment in healthy development. This shift reflected an understanding that challenges related to social isolation extended beyond individual psychic structures and involved the deprivation of essential psychic, social, and cultural experiences, particularly those offered by the school setting and changing family dynamics.
By adopting a Winnicottian perspective, the analysis emphasized the traumatic potential of environmental failures over internal instinctual drives (Silva & Junior, 2023). According to Winnicott (1945/2021c), the individual depends on the environment for physical and psychological existence, highlighting the relevance of environmental provisions in maintaining health during the physical and psychological challenges caused by the pandemic.
Consequently, terminology and conceptual adaptations were made to focus on the child’s attitudes, perceptions, and needs in relation to the environment. The first group was renamed Basic Attitudes Toward the Environment, referring to adaptive or oppositional tendencies depending on the child’s acceptance of and response to reality. These attitudes are shaped by processes of positive or negative identification.
The second group was restructured with the aim of prioritizing the perception of the environment, seeking to understand the subjective reality that the evaluated person attributes to their concrete reality. In this context, the meaning given to the experienced reality takes on greater relevance than the objective reality itself.
The feelings expressed in the next group in Tardivo’s grid investigate the instincts of life and death, concepts that do not exist in Winnicott’s theory. The correlation with conflict was then analyzed, which can present itself in a healthy (adaptable) or dysfunctional (anxiety-inducing, aggressive, passive) way, thus aiming to understand the maturity of the individual’s development.
The group originally referred to as Tendencies was adapted to Egoic and Bodily Needs, exploring: (1) creative and constructive tendencies, indicating psychosomatic integration and emotional maturity; (2) antisocial tendencies, representing an inability to integrate or establish social contact; and (3) the need for holding, reflecting the subject’s dependence on others to manage conflicts beyond their developmental capacity.
The Destructive Impulses subcategory was renamed Aggressive Impulses, as Winnicott viewed aggression not as destructive but as a response to the thwarted development of the true self - an important reality-testing mechanism and source of creativity and vitality (Dias, 2000; Winnicott, 1950/2021b).
In the penultimate group, referring to anxieties, the nomenclature used by Tardivo (1985) distinguishes between primitive anxieties and depressive anxiety. Primitive anxieties are characterized by splitting and persecution, reflecting a primary and initial process. On the other hand, depressive anxiety demonstrates more mature characteristics in the individual’s emotional development, where a more integrative ego structure is perceptible, aligning with Klein’s theory.
For Winnicott, the most primitive anxieties are conceptualized as “unthinkable agonies,” describing a process of intense and traumatic mobilization. As a defense mechanism, the subject regresses to the dependency phase, characterized by the splitting of the ego, the true self, toward a false self. In contrast, Winnicott understands depressive anxiety as the capacity for concern, through which the individual advances toward healthy development, with an integrated and conscious ego, and an adequate capacity to experience a true self.
Results
For the discussion of results, the four cases assessed were presented based on a synthesis of the anamnesis and the qualitative analyses of both the play session and the PDE-T, following the assessment protocols for each instrument. After presenting the individual cases, a comprehensive synthesis was conducted in light of Winnicottian psychoanalytic theory. To ensure participant confidentiality, superhero pseudonyms were assigned.
Participant 1 - Batman, 8 Years Old - 4 Months of School Isolation
Anamnesis
Batman is an only child of married parents who are both teachers. His mother reported developmental delays (e.g., in language acquisition until the age of two), childhood health issues (such as a hernia at age two), and sleep-related difficulties, including frequent nightmares. The mother perceives the father as permissive, whereas the mother assumes the role of the figure who imposes limits and is perceived as someone to be feared:
He’s very attached to his father - his best buddy - while I’m the “witch” who sets the rules. His father tends to give in to whatever he wants, but I’m the one who enforces boundaries. Still, overall, he gets along well with both of us, and we always include him in everything we do. Since I work two shifts, he stays mostly with his father. I’ve noticed, though, that he seems afraid of me, afraid of being scolded. [Batman´s mother]
Additionally, the mother-child relationship is marked by limited in-person interaction, as she dedicates most of her time to work-related activities. Despite having his own bedroom, Batman still sleeps with his parents.
Regarding the pandemic, the mother reported that the participant showed significant fear and concern, which led her to consider whether he might need psychological help. However, she described him as being somewhat dramatic about it:
My son is quite dramatic; everything feels like a big deal to him. When we began explaining the pandemic, he understood it very well. He’s a very perceptive child-he even reminded us to follow hygiene procedures. He was really scared, especially when we were contaminated. He even asked me if I was going to die when I got sick. He has always been very afraid of losing someone close to him.[Batman´s mother]
After a month of isolation, Batman missed his friends. When he returned to in-person activities, his mother noticed that he was more withdrawn. His parents tried to reestablish their previous routine and organized games with him. For the family, the period of isolation was challenging, as his parents, who are teachers, returned to work after four months, and the participant began to accompany them in this new routine.
Play Session
On the first day, the participant was expected to stay alone with the researcher. His grandmother, who had accompanied him, appeared visibly apprehensive about leaving him. She projected intense persecutory fears onto the situation, instructing him to “scream if anything happens.”.
Initially, the participant exhibited introverted behavior and required guidance and explanations to engage in the activities. Most of his play involved building structures with construction toys and then destroying them. This pattern of building and then demolishing may indicate an excessive need for control, anxiety, and the expression of aggressive impulses. At the same time, it could reflect an omnipotent attempt to control the constructed object (“I can create, but I can also destroy”), which is connected to creativity as he seeks new ways to deal with reality. Batman displayed good contact with reality and developed a satisfactory bond with the researcher, feeling comfortable in the setting.
Note: Drawing title: Green Coronavirus
Figure 1 Story-Drawing Procedure with a Theme - Participant 1
“This is the ‘Green Coronavirus’ that is outside the school trying to catch those who are inside.”[Batman]
The participant discarded his first drawing and asked to create a new one (again, the theme of destroying and creating). In the second drawing, Batman depicted an oversized child with wide, fearful eyes, painted green-the same color as the virus drawn beside the figure.
The participant expressed emotional distress related to the virus (fear, anxiety, persecutory feelings, and depressive themes), needing help and seemingly without adequate emotional support to cope with the pandemic. The child figure is disproportionately large, and despite the presence of a school wall, the child appears overwhelmed by the green color of the coronavirus, as if the virus has reached him. The wide, alarmed eyes convey an intense fear of infection.
Participant 2 - BatGirl, 9 years old - Two years of school isolation
Anamnesis
The family dynamics described by the mother reveal some maternal insecurity in her emotional relationship with her daughter. However, she depends on her support network to help care for the child, despite having reservations about the quality of this care-especially from her own mother, the child’s maternal grandmother.
The relationship is good, but I don’t consider it healthy because I lack patience. As for her, I’m not sure whether it’s good or bad; I think she demands more attention now. I believe she gets along better with her father but feels safer with me. [...] We live in a house behind my mother’s house, which I don’t think it’s positive because my mother spoils her. I wouldn’t recommend anyone live with the grandmother. [Batgirl´s mother]
The mother reported spending a significant amount of time traveling to the rural areas of the state of Amazonas to work on the frontlines of the pandemic. Consequently, the child was primarily cared for by her father and maternal grandmother during that period.
During the pandemic, the mother stated that the participant exhibited anxious behavior and gained weight due to the lack of physical activity. The child also faced an excessive demand for schoolwork and expressed fear that her mother might contract the virus, given her frontline work (the mother did contract COVID-19 but experienced only mild symptoms). In 2021, the participant lost weight, which, according to the mother, was due to a growth spurt and the fact that she was given a scooter to help her exercise.
Play Session
BatGirl showed emotional distancing both from the researcher and the play environment. She avoided conversation and did not try to engage the researcher in her activities, focusing instead on completing the tasks she chose. She displayed little interest in the play, favoring concrete activities like arranging building blocks in monochromatic patterns and handling slime just to spend time-suggesting a limited capacity for fantasy. When she did speak, her tone was rigid, and her speech unusually formal and elaborate.
I made a drawing of a child studying. During the pandemic, I wasn’t going to school because of the virus, so I studied at home using my tablet or my mom’s computer. We took tests, did assignments, and attended classes - all online. Later, when classes resumed, some days were in person and others online. On online days, we had to study at home using the school’s device to keep learning. It felt like time passed so quickly that I couldn’t fully experience it like I am this year. This year, I started studying from the beginning, but last year, I only began later. Now, I’ve been able to do many other things, too. [Batgirl]
Despite the instruction to draw a child at school during the pandemic - and her verbal statement that she drew one - the participant did not draw a human figure in the PDT-E. Instead, she drew a very small house filled with bars, which may indicate personality inhibition, maladjustment to the environment, repression of aggression, and feelings of inferiority (Campos, 1993).
Thus, the house with numerous bars, along with the inclusion of objects mentioned in her narrative but absent from the drawing, seems to reflect emotional difficulties in coping with her environment and challenges in processing these conflicts. Furthermore, her rigid and concrete behavior during the play session reinforces the hypothesis of difficulty in elaborating emotional conflicts, stemming from a limited capacity for fantasy and creativity - both of which are essential elements for emotional processing.
In this sense, it can be hypothesized that the participant presents a significant need for emotional support, affection, and companionship to help her manage and process her emotions.
Participant 3 - Superman, 9 Years Old - 1 Year and 6 Months of School Isolation
Anamnesis
The participant is the youngest of two siblings, with married parents. According to his mother, he has displayed aggressive behaviors since the age of three, particularly when facing changes in his environment. At that age, he exhibited aggressive behavior when starting school (leaving the family environment) and experienced issues such as withholding urine. Although the school repeatedly recommended psychotherapy, he has never received it. During the pandemic, the participant showed aggressive and antisocial behaviors (e.g., destroying objects, drawing on walls, and attempting to run away from home).
He was upset because he lost the chance to be with his friends [...]. After social isolation, he became more aggressive. When I asked him to do something, he would start screaming, having temper tantrums, which he had never done before. Once, he even ran away from home, and I had to go after him to calm him down [...]. When he was bored, he would draw on the walls, on the furniture, and break things. [Superman’s mother]
His mother reports that what he missed most was the social contact with friends and teachers. Being a very energetic child, he struggled greatly with being confined to an environment that limited his ability to release energy. Regarding family dynamics, the pandemic seems to have negatively affected everyone. Although there were no deaths or severe COVID-19 cases in the family, they all began overeating, which may reflect an anxious, maladaptive way of coping with the situation. His mother also noted that he has grown closer to her while simultaneously developing a sense of fear toward his father. She described that when his father scolds him, the participant often seeks her out in tears. Additionally, the pandemic intensified his anxiety, hyperactivity, and mildly oppositional behavior toward imposed rules.
Play Session
The participant demonstrated strong symbolic and creative abilities during the play session and actively involved the researcher in his games. His play included themes of ambivalence toward authority figures, against whom he showed resistance while still complying with their demands. Initially, he displayed some resistance to engaging in the activities with the researcher, questioning the rules, but eventually accepted them. His play also expressed some aggressiveness, with a somewhat restless, distracted, and disengaged attitude at first - as if he felt obligated to be there. However, once he became interested in the activity, he appeared more focused, creative, and spontaneous.
Upon entering the room, he was relaxed, wearing headphones, and sat leaning his head back against the chair. After rapport was established, he became more comfortable participating in the play, taking an approach-oriented attitude. Eventually, he assumed a more proactive stance, inviting the researcher to play with him and often taking the lead in setting the rules. Thus, the participant demonstrated good transitional capacity between external and internal realities, although he showed resistance to accepting rules and limits that were not self-imposed.
He chose activities such as shooting objects to hit targets, solving puzzles, and playing “Guess Who” with the researcher, attempting to lead the game.
Note: Drawing title: Taking Care to Avoid the Virus
Figure 3 Story-Drawing Procedure with a Theme - Participant 3
The father arrived and took the boy to school. The boy went there, sanitized his hands with alcohol to protect himself, and then went to his classroom. When he left school, he sanitized his hands again and went home.[Superman]
The drawing was left uncolored, which the participant quickly justified: “I’m done, I won’t color it because I’m too lazy to do it,” reflecting his attitude toward the authority figure represented by the researcher during the task. The drawing portrays movement, depicting the child being cared for by his father through health safety measures like hand sanitizer and mask-wearing, as also described in his story.
The pandemic is perceived as an intrusive event, but one that the family helped him manage. The drawing conveys ambivalence between the care provided and the care experienced as intrusive. Structurally, the drawing is well-organized, depicting a scene consistent with the proposed theme. However, the narrative shows limited emotional connection to the period of school closure, portraying it primarily as just another rule he had to comply with. The drawing is marked by concreteness and objectivity, yet it displays a good level of creative ability in constructing the scene.
Participant 4 - Storm, 9 Years Old - 1 Year and 6 Months of School Isolation
Anamnesis
Storm is the middle child among three sisters. Her parents are divorced. The father was absent during the early years of her life and returned when she became ill at the age of one and a half. Driven by guilt over the separation, he now tends to indulge her every wish, which generates conflicts with the mother. Throughout her childhood, the participant has suffered from respiratory issues, including recurring infections. She continues to struggle with coping with adversity and change. During early childhood, she experienced difficulty with sphincter control, and episodes of nighttime enuresis resurfaced during the pandemic. She sleeps with her mother and displays dependency behaviors, marked by fear of losing her parents - especially her mother.
Regarding sibling dynamics, the father reported that she has a closer relationship with her older sister, with whom she shares confidences, but has been more distant from her younger sister due to feelings of jealousy and perceived loss of her status as the “princess” of the family: “With G. (the older sister), she is closer, more of a confidant. But with M. (the younger sister), she was jealous at first because she stopped being the baby of the house. For four years, they barely interacted.”
She began school at the age of two. According to the father, she experiences relational crises with her school friends and tends to form attachments to people who do not reciprocate her affection. In his own words:
She started school at two. She’s always been very sociable, had lots of friends, even attended full-time school, but had issues with eating and sleeping there. Lately, she’s been having friendship crises. She would attach herself to people who didn’t care about her. She’s never repeated a grade and is very concerned about her academic performance. [Storm’s father]
Regarding the pandemic, the participant seems fully aware of the challenges faced. According to her father, she feared losing her parents, particularly since nearly the entire family contracted COVID-19, although there were no fatalities. The father also reported that she missed the social interactions provided by school and extended family. The family worked to maintain her daily routines to prevent her from reversing her sleep cycle; however, he noted that she was developing an addiction to social media.
Play Session
The participant adjusted well to the setting and demonstrated strong imaginative and creative abilities, easily engaging with the researcher. She frequently related the play to her daily life (e.g., when choosing the toy airplane, she commented that she had traveled with her family). She was open and communicative throughout the session, sharing stories about her family members, her interests, and her routines.
She chose games like “Guess Who” to play with the researcher and engaged in making shapes with slime, such as a snake or a heart. She remained cooperative and engaged throughout the play session.
Note: Drawing title: A Happy Girl Because Online Classes Are Over
Figure 4 Story-Drawing Procedure with a Theme - Participant 4
A girl is sitting in the classroom, wearing a mask, but even with the mask on, she is happy because online classes are finally over and she is back to in-person classes. She’s also happy to see her friends again.[Storm]
The drawing uses minimal color-only the sun and the school symbol are colored. She drew a child wearing a mask designed like prison bars, suggesting an appearance of sadness. Yet, paradoxically, she wrote the word “happy” next to it, indicating ambivalence.
In her story, the participant revealed a strong need for in-person social contact, portraying the school as a holding environment (symbolized by the colored sun, indicating warmth and comfort). The drawing also contains regressive elements, as the participant stated the character’s age as younger than her own biological age, along with idealized content. For instance, she shared:
This is Maria. She’s seven years old and an only child. Maria has ten friends-seven from her class and two from another. Her favorite subject is science. I don’t really like science, so I made her different from me.
Discussion
In the productions created by the participants, the need for holding emerged as the most prominent factor. Holding enables the elaboration of psychic conflicts by providing an environment imbued with feelings of trust and predictability, which are essential conditions for adapting to the new reality (Winnicott, 1958/1993).
Despite the high levels of distress experienced during the quarantine, the need to adapt imposed by social isolation led each family unit to reorganize itself and strengthen its bonds. In this sense, confinement can be interpreted as an opportunity for reconnection and mutual rediscovery, since the intensified coexistence led to a redefinition of values and practices. This process enabled the construction of new meanings-both individual and symbolic-that are not predetermined but are continuously built and reworked (Gastaud et al., 2020).
According to the analysis of the anamneses, some families developed creative strategies to cope with the unpredictable pandemic period. These included establishing schedules for daily activities-with the support of the school in organizing class times-which allowed children to experience greater temporal and spatial integration into the new routine. In addition, shared family activities, such as play, games, and meals, provided increased opportunities for meaningful interactions among family members.
Furthermore, some maladaptive behaviors were reported by caregivers, including compulsivity (excessive eating and increased use of social media), impulsivity (aggressiveness, running away from home), greater isolation (even from family members), and regression to dependency. These defensive mechanisms represent reactions to an overly rigid and stereotyped environment, reflecting an inability to adapt, which consequently disrupts emotional maturation and ego strengthening (Winnicott, 1957/2022).
Environmental intrusion was perceived by participants as a consequence of the mandatory withdrawal from in-person school, teachers, and peers. For the participant referred to as Batman, this intrusive environment was particularly significant, with persecutory content vividly expressed in his drawing (in which the coronavirus was portrayed as coming to get him). Specifically for this participant, the family environment was perceived as markedly invasive, threatening, and persecutory, as confirmed by the anamnesis and the interaction with his family during data collection.
In this case, the family environment proved insufficient to foster adequate internal resources. The family’s presumably dysfunctional interaction patterns with the participant may have played a significant role in his difficulties managing environmental adversities.
The findings of this study are consistent with those reported by Dutra et al. (2020), who, when interviewing children about the impact of the COVID-19 pandemic on mental health, found that the suspension of in-person classes significantly affected children’s mental health. This impact was primarily due to the loss of the school environment as a space for socialization, learning, and emotional expression. The absence of interaction with peers and teachers, combined with the disruption of routine and the limitation of playful and educational activities, triggered feelings of sadness, frustration, fear, and emotional disorganization. Children expressed missing school and struggling to understand and cope with the imposed changes, revealing heightened emotional vulnerabilities.
The use of regression as a defense mechanism was linked to a return to greater dependence on the environment. This was manifested through more infantilized content and an intensified fear of separation from important parental figures. Although regression represents a temporary interruption in the continuity of emotional development, this return to earlier stages can function as an adaptive resource. It helps establish more appropriate coping patterns that may not have been consolidated previously, aiming to resume the integration process (Winnicott, 1936/2021a).
Regarding impulsive behaviors, such as compulsive eating, aggression, and running away from home, these can be understood as expressions of oral-level content associated with voracity. For Klein, voracity is connected to the death drive, whereas Winnicott conceptualizes it as a phenomenon encompassing both psychic and physical aspects. It involves primitive oral fantasies of internalizing the external world and acts as a secondary defense mechanism against anxiety and depression (Winnicott, 1936/2021a).
In addition, with respect to impulsive behaviors, Winnicott (1950/2021b) explains that these are expressions of id impulses in response to reality constraints - that is, reactions to experiences of failure and frustration. Aggressive behavior may manifest passively, through withdrawal in more introverted individuals, or reactively, through externalized expressions. According to Winnicott, reactive aggression is a positive factor-a creative force that can help construct reality. The process of destruction enables the individual to perceive objects from a more objective perspective, thereby facilitating the possibility of change (Silva & Junior, 2023).
The literature suggests that the behavioral changes in children, perceived by adults as aggressiveness or other forms of challenging behavior during the pandemic, are expressions of their internal worries. Furthermore, the prolonged duration of social isolation is directly associated with the worsening of these symptoms (Imran, Aamer, Sharif, Bodla, & Naveed, 2020).
As for persecutory feelings, these also represent reactions to an environment perceived as invasive (Dias, 2000). This is a more archaic symptom, associated with intense fear resulting from the failure to develop a basic sense of security during early growth (Winnicott, 1957/2022). In this sense, while externalized aggression is considered a sign of health and a creative response, persecutory feelings reflect not only the inability to react but also the individual’s submission to the environment.
It is also important to note the quality of the children’s drawings and stories, which tended to be unimaginative and rigid. This may represent a defensive response to the environment, indicating a retreat from fantasy into concrete reality (Winnicott, 1936/2021a). The confinement brought by social isolation inhibited the freedom necessary for imaginative play, as a reliable and safe environment is essential for free imagination to flourish (Winnicott, 1957/2022). The limited presence of symbolic content and the focus on concrete realities may be related to a shortage of internalized good objects, which are necessary for developing internal resources that help process environmental failures within the potential space (Winnicott, 195/2022).
Additionally, even though the anamnesis indicated that children missed the school environment and experienced behavioral changes, two main thematic differences emerged between boys’ and girls’ drawings. While girls expressed more longing for the social relationships established at school, boys focused more on external aspects, particularly the necessary precautions to avoid contracting the virus. This finding aligns with prior studies conducted with children who experienced quarantines similar to the COVID-19 lockdown (Zhang, 2023).
Social interactions serve as an effective mediating resource to alleviate emotional suffering by fostering the exchange of ideas, emotional support, and reciprocal care. This perspective is widely endorsed within psychoanalytic psychology, which views it as fundamental to both physical and emotional health (Araújo et al., 2021). The gender-based differences observed in the children’s projective content may be linked to the ways in which gender roles are socially constructed and internalized from an early age. These patterns likely reflect broader social learning processes, suggesting the need for further studies that explore how gendered socialization shapes affective and defensive behaviors in children.
Overall, social distancing measures exacerbated feelings of loneliness and isolation. The reduction of children’s social networks is directly associated with increased anxiety and distress (Imran et al., 2020). The rise in excessive use of social media and online games can be seen as a behavioral response to the need to remain socially connected, highlighting the importance of relationships for emotional well-being and psychological development.
Emotional maturation develops through environmental interactions, where the connection with others is vital for survival and, progressively, for achieving a sense of self that is distinct from primary caregivers. Thus, psychic structuring is closely tied to how the child constructs an image of themselves (Bonow, Henn, Gastaud, & Narvaez, 2021). Environmental adversities such as the pandemic can impact children’s psychic development in two main ways: first, by altering the quality of care provided by caregivers - who themselves were dealing with heightened psychological distress - and second, by weakening social bonds due to isolation from peers, teachers, and other significant figures in the child’s life.
Accordingly, the pandemic constituted a privative, chaotic, and disabling environmental failure that restricted the availability of adaptive resources necessary for coping. Childhood, as a developmental period characterized by profound discoveries about the external world - critical for fostering a sense of cultural belonging - was deeply affected. The pandemic had a significant impact on emotional development, primarily due to children’s immaturity in managing social isolation and the insufficient holding provided by families, who themselves were also undergoing considerable psychological and relational strains.
Creativity, a core concept in Winnicottian theory, is essential for facilitating transitional experiences and mediating internal conflicts. In this study, children lacked an adequate and sufficient space to process the adversities experienced during the pandemic. This was not only due to the loss of school as an important transitional environment but also due to limitations within the family environment. These restrictions impaired the development and use of creative resources crucial for maintaining psychological health.
In families that maintained greater proximity to the children’s daily lives and demonstrated the ability to mobilize creative resources to navigate the challenges of social isolation, the children exhibited more functional behaviors, despite experiencing emotional distress. This was observed in the cases of the participants “Superman” and “Storm.”
Conversely, in families where caregivers were frequently absent from home or struggled to provide creative support, the children displayed more concerning defensive behaviors and maladaptive coping mechanisms. This was particularly evident in the cases of “Batgirl” and “Batman.”
This research demonstrated that the unpredictability and psychosocial disruptions caused by COVID-19 significantly impacted family dynamics and had negative consequences for children’s emotional development. Beyond the family context, schools also serve as vital environments for adaptive coping. Through relationships with peers and teachers, as well as opportunities for creative and symbolic expression, schools function as protective spaces. Therefore, it is critical to view the in-person school environment as an essential tool for promoting children’s emotional, physical, and psychological well-being. Furthermore, it is necessary to question how schools are addressing the ongoing consequences of the pandemic.
Despite the well-established understanding of the profound influence of environmental factors on long-term child development, the literature remains scarce regarding the specific impacts of epidemics and pandemics (Araújo et al., 2021). Thus, this study makes a significant contribution to the field of child psychology. However, further research is needed to deepen the understanding of how the pandemic has affected families and schools-both environments that underwent substantial changes and were unable to consistently provide the necessary holding and adaptive resources for children. The analysis of the PDE-T, adapted within Winnicott’s theoretical framework, proved highly relevant for understanding how environmental factors shape children’s psychic organization. Therefore, future studies should continue to investigate the validity of this adapted approach.
Additionally, further research is recommended to explore the gender-based differences observed in the projective content of the children’s drawings. These differences are likely related to socially constructed gender roles and the implications of gendered socialization within society.
This study has some limitations that should be noted: (1) the assessment protocol should have included an additional play session to establish a stronger rapport with the participants; (2) the involvement of two researchers in the study may have led to different perspectives during data collection; and (3) the protocol was limited to school-aged children between 7 and 10 years old.
It is expected that this research contributes to providing technical and scientific support for the development of intervention and prevention strategies in clinical, educational, family, and social contexts for this population. The findings may serve as a foundation not only for professionals working with children but also for guiding public policies, future interventions, social programs, and therapeutic approaches aimed at supporting children who experience negative and maladaptive emotional consequences stemming from the pandemic or future adversities. Ultimately, these efforts aim to promote the development of a healthier and more resilient population in both the short and long term.
