Psychoanalytic approach to psychotic disturbances in very young children: a clinical report.

While the psychopathological entity known as early childhood psychosis has been recognized as a clinical disorder for many years, considerable disagreement remains regarding its etiology, the details of its symptomatology, and optimal treatment methods. A body of data is available to us from a 10-year project with 10 psychotic children, ranging in age from 13 months to 3 3/4 years when treatment was begun with them and their parents. Analysis of these data some five years after the termination of the project provides insights into the nature of the illness and effectiveness of treatment methods.

The preoedipal development of the boy.

We have presented an analysis of findings from a ten-year observational study of infants in their second year of life, with a focus on boys. Tracing the sexual development and its relation to development in the object relations and cognitive spheres, we found similarities between boys and girls and sharp differences as well. These latter become evident shortly after the discovery of the anatomical difference. We believe that the differences in reaction to this momentous event account for the greater trouble the girl has in the rapprochement crisis. Our direct observational studies of infants served to clarify many of the preoedipal dynamic currents which in turn affect the form of the oedipal constellation. We have established some sets of conditions which are likely to lead to a negative or positive form or oedipal attachment, and have described the typical and some of the atypical patterns of preoedipal development in both sexes.

Preoedipal determinants of a beating fantasy.

A discussion of "The Psychodynamics of a Beating Fantasy," by Wayne Myers, M.D. This paper emphasizes the role of the parental ambivalence towards the patient in the formation of beating fantasies described by Dr. Myers. It is postulated that excessive maternal ambivalence interfered with the normal resolution of ambitendency during the patient's second year, particularly with the impact of the discovery of sexual differences which takes place at that time. Under such circumstances, a split in both self- and object representations occurs, with a heightening of unbound aggression--the combination of which might well have led to the formation of the maternal aspect of the beating fantasy. Subsequent primal scene expousre, along with the excessively ambivalent paternal attitude toward the patient could only intensify the aggression and the already faltering sense of self and object. Through defensive identification with the aggressor in relation to both parents, the aggression was warded off but also led to confusion in her sense of sexual identity and further problems of self- and object constancy.

Some suggested revisions concerning early female development.

In our view, Freud's original position that sexual drive organization exerts a special and exemplary role during the various psychosexual stages remains a valid one, although drive organization is in turn consistently and extensively influenced by events in the sphere of object relations. Very early genital-zone experiences during the first sixteen months of life contribute to a vague sense of sexual identity, and undoubtedly exert an influence over many ego functions. Some genital sensations probably occur consistently in conjunction with feeding, as well as during many other interactions of the mother and her young infant. With ongoing separation and individuation, the genital zone emerges as a distinct and differentiated source of endogenous pleasure somewhere between sixteen and nineteen months of age, exerting a new and crucial influence upon the sense of sexual identity, object relations, basic mood, and many aspects of ego functioning, such as the elaboration of fantasy and graphic representation in girls and the increased use of the motor apparatus in boys-the latter probably in the service of denial. This era constitutes an early genital phase, preceding that of the oedipal period, and the later oedipal constellation will inevitably be shaped by the preoedipal developments we have described. The discovery of the sexual difference and the new genital sensations of this early genital phase should not be considered merely as several of many variables that influence the growing sense of identity; they are unique, exemplary, and of equal importance to the oral and anal aspects of psychosexual development which have preceded them. Furthermore, the preoedipal castration reaction rapidly reactivates and becomes fused with earlier fears of both object and anal loss, and is therefore particularly threatening to the child's still unstable sense of self and object. In other publications, we have presented data from direct observational research indicating that the little girl's early relation with her mother, as well as her early bodily experiences, are important in determining the effect upon her when she discovers the sexual anatomical difference at about sixteen to eighteen months of age. At this juncture, depending upon the nature of her earlier experiences, as well as the availability of the father, she may either turn more definitively to the father, or she may remain even more ambivalently attached to the mother, a choice having fateful consequences for the oedipal constellation shortly to emerge.(ABSTRACT TRUNCATED AT 400 WORDS)

Some observations on transitional object and infantile fetish.

Observations of a girl's development are presented to demonstrate the role of the transitional object in coping with the normal strains implicit in the separation-individuation thrust and in the anal-urinary and early sexual stages of development. When at eighteen months a separation experience led to a serious preoedipal castration reaction, the transitional object no longer was capable of serving its ordinary function and was replaced by a fetishistic object.