The Developmental Psychology of Psychopathology

Chapter 4

Chapter 43,881 wordsPublic domain

To assume that the child is born a "tabula rasa" is superstition. Cerebral processes and responses have been observed in utero. Sounds condition the EEG of fetuses. They startle at loud, sudden noises. This means that they can hear and interpret what they hear. Fetuses even remember stories read to them while in the womb. They prefer these stories to others after they are born. This means that they can tell auditory patterns and parameters apart. They tilt their head at the direction sounds are coming from. They do so even in the absence of visual cues (e.g., in a dark room). They can tell the mother's voice apart (perhaps because it is high pitched and thus recalled by them). In general, babies are tuned to human speech and can distinguish sounds better than adults do. Chinese and Japanese babies react differently to "pa" and to "ba", to "ra" and to "la". Adults do not - which is the source of numerous jokes.

The equipment of the newborn is not limited to the auditory. He has clear smell and taste preferences (he likes sweet things a lot). He sees the world in three dimensions with a perspective (a skill which he could not have acquired in the dark womb). Depth perception is well developed by the sixth month of life.

Expectedly, it is vague in the first four months of life. When presented with depth, the baby realizes that something is different - but not what. Babies are born with their eyes open as opposed to most other animal young ones. Moreover, their eyes are immediately fully functional. It is the interpretation mechanism that is lacking and this is why the world looks fuzzy to them. They tend to concentrate on very distant or on very close objects (their own hand getting closer to their face). They see very clearly objects 20-25 cm away.

But visual acuity and focusing improve in a matter of days. By the time the baby is 6 to 8 months old, he sees as well as many adults do, though the visual system - from the neurological point of view - is fully developed only at the age of 3 or 4 years. The neonate discerns some colors in the first few days of his life: yellow, red, green, orange, gray - and all of them by the age of four months. He shows clear preferences regarding visual stimuli: he is bored by repeated stimuli and prefers sharp contours and contrasts, big objects to small ones, black and white to colored (because of the sharper contrast), curved lines to straight ones (this is why babies prefer human faces to abstract paintings). They prefer their mother to strangers. It is not clear how they come to recognize the mother so quickly. To say that they collect mental images which they then arrange into a prototypical scheme is to say nothing (the question is not "what" they do but "how" they do it). This ability is a clue to the complexity of the internal mental world of the neonate, which far exceeds our learned assumptions and theories. It is inconceivable that a human is born with all this exquisite equipment while incapable of experiencing the birth trauma or the even the bigger trauma of his own inflation, mental and physical.

As early as the end of the third month of pregnancy, the fetus moves, his heart beats, his head is enormous relative to his size. His size, though, is less than 3 cm. Ensconced in the placenta, the fetus is fed by substances transmitted through the mother's blood vessels (he has no contact with her blood, though). The waste that he produces is carried away in the same venue.

The composition of the mother's food and drink, what she inhales and injects - all are communicated to the embryo. There is no clear relationship between sensory inputs during pregnancy and later life development. The levels of maternal hormones do effect the baby's subsequent physical development but only to a negligible extent. Far more important is the general state of health of the mother, a trauma, or a disease of the fetus. It seems that the mother is less important to the baby than the romantics would have it - and cleverly so. A too strong attachment between mother and fetus would have adversely affected the baby's chances of survival outside the uterus. Thus, contrary to popular opinion, there is no evidence whatsoever that the mother's emotional, cognitive, or attitudinal state effects the fetus in any way. The baby is effected by viral infections, obstetric complications, by protein malnutrition and by the mother's alcoholism. But these - at least in the West - are rare conditions.

In the first three months of the pregnancy, the central nervous system "explodes" both quantitatively and qualitatively. This process is called metaplasia. It is a delicate chain of events, greatly influenced by malnutrition and other kinds of abuse. But this vulnerability does not disappear until the age of 6 years out of the womb. There is a continuum between womb and world. The newborn is almost a very developed kernel of humanity. He is definitely capable of experiencing substantive dimensions of his own birth and subsequent metamorphoses. Neonates can immediately track colors - therefore, they must be immediately able to tell the striking differences between the dark, liquid placenta and the colorful maternity ward. They go after certain light shapes and ignore others.

Without accumulating any experience, these skills improve in the first few days of life, which proves that they are inherent and not contingent (learned). They seek patterns selectively because they remember which pattern was the cause of satisfaction in their very brief past. Their reactions to visual, auditory and tactile patterns are very predictable. Therefore, they must possess a MEMORY, however primitive.

But - even granted that babies can sense, remember and, perhaps emote - what is the effect of the multiple traumas they are exposed to in the first few months of their lives?

We mentioned the traumas of birth and of self-inflation (mental and physical). These are the first links in a chain of traumas, which continues throughout the first two years of the baby's life. Perhaps the most threatening and destabilizing is the trauma of separation and individuation.

The baby's mother (or caregiver - rarely the father, sometimes another woman) is his auxiliary ego. She is also the world; a guarantor of livable (as opposed to unbearable) life, a (physiological or gestation) rhythm (=predictability), a physical presence and a social stimulus (an other).

To start with, the delivery disrupts continuous physiological processes not only quantitatively but also qualitatively. The neonate has to breathe, to feed, to eliminate waste, to regulate his body temperature - new functions, which were previously performed by the mother. This physiological catastrophe, this schism increases the baby's dependence on the mother.

It is through this bonding that he learns to interact socially and to trust others. The baby's lack of ability to tell the inside world from the outside only makes matters worse. He "feels" that the upheaval is contained in himself, that the tumult is threatening to tear him apart, he experiences implosion rather than explosion. True, in the absence of evaluative processes, the quality of the baby's experience will be different to ours. But this does not disqualify it as a PSYCHOLOGICAL process and does not extinguish the subjective dimension of the experience. If a psychological process lacks the evaluative or analytic elements, this lack does not question its existence or its nature. Birth and the subsequent few days must be a truly terrifying experience.

Another argument raised against the trauma thesis is that there is no proof that cruelty, neglect, abuse, torture, or discomfort retard, in any way, the development of the child. A child - it is claimed - takes everything in stride and reacts "naturally" to his environment, however depraved and deprived.

This may be true - but it is irrelevant. It is not the child's development that we are dealing with here. It is its reactions to a series of existential traumas. That a process or an event has no influence later - does not mean that it has no effect at the moment of occurrence. That it has no influence at the moment of occurrence - does not prove that it has not been fully and accurately registered. That it has not been interpreted at all or that it has been interpreted in a way different from ours - does not imply that it had no effect. In short: there is no connection between experience, interpretation and effect. There can exist an interpreted experience that has no effect. An interpretation can result in an effect without any experience involved.

And an experience can effect the subject without any (conscious) interpretation. This means that the baby can experience traumas, cruelty, neglect, abuse and even interpret them as such (i.e., as bad things) and still not be effected by them. Otherwise, how can we explain that a baby cries when confronted by a sudden noise, a sudden light, wet diapers, or hunger? Isn't this proof that he reacts properly to "bad" things and that there is such a class of things ("bad things") in his mind?

Moreover, we must attach some epigenetic importance to some of the stimuli. If we do, in effect we recognize the effect of early stimuli upon later life development.

At their beginning, neonates are only vaguely aware, in a binary sort of way.

l."Comfortable/uncomfortable", "cold/warm", "wet/dry", "color/absence of color", "light/dark", "face/no face" and so on. There are grounds to believe that the distinction between the outer world and the inner one is vague at best. Natal fixed action patterns (rooting, sucking, postural adjustment, looking, listening, grasping, and crying) invariably provoke the caregiver to respond. The newborn, as we said earlier, is able to relate to physical patterns but his ability seems to extend to the mental as well. He sees a pattern: fixed action followed by the appearance of the caregiver followed by a satisfying action on the part of the caregiver. This seems to him to be an inviolable causal chain (though precious few babies would put it in these words). Because he is unable to distinguish his inside from the outside - the newborn "believes" that his action evoked the caregiver from the inside (in which the caregiver is contained). This is the kernel of both magical thinking and Narcissism.

The baby attributes to himself magical powers of omnipotence and of omnipresence (action-appearance). It also loves itself very much because it is able to thus satisfy himself and his needs. He loves himself because he has the means to make himself happy. The tension-relieving and pleasurable world comes to life through the baby and then he swallows it back through his mouth. This incorporation of the world through the sensory modalities is the basis for the "oral stage" in the psychodynamic theories.

This self-containment and self-sufficiency, this lack of recognition of the environment are why children until their third year of life are such a homogeneous group (allowing for some variance). Infants show a characteristic style of behaviour (one is almost tempted to say, a universal character) in as early as the first few weeks of their lives. The first two years of life witness the crystallization of consistent behavioral patterns, common to all children. It is true that even newborns have an innate temperament but not until an interaction with the outside environment is established - do the traits of individual diversity appear.

At birth, the newborn shows no attachment but simple dependence. It is easy to prove: the child indiscriminately reacts to human signals, scans for patterns and motions, enjoys soft, high pitched voices and cooing, soothing sounds. Attachment starts physiologically in the fourth week. The child turns clearly towards his mother's voice, ignoring others. He begins to develop a social smile, which is easily distinguishable from his usual grimace. A virtuous circle is set in motion by the child's smiles, gurgles and coos. These powerful signals release social behaviour, elicit attention, loving responses.

This, in turn, drives the child to increase the dose of his signaling activity. These signals are, of course, reflexes (fixed action responses, exactly like the palmar grasp). Actually, until the 18th week of his life, the child continues to react to strangers favorably. Only then does the child begin to develop a budding social-behavioral system based on the high correlation between the presence of his caregiver and gratifying experiences. By the third month there is a clear preference of the mother and by the sixth month, the child wants to venture into the world. At first, the child grasps things (as long as he can see his hand). Then he sits up and watches things in motion (if not too fast or noisy). Then the child clings to the mother, climbs all over her and explores her body. There is still no object permanence and the child gets perplexed and loses interest if a toy disappears under a blanket, for instance. The child still associates objects with satisfaction/non-satisfaction. His world is still very much binary.

As the child grows, his attention narrows and is dedicated first to the mother and to a few other human figures and, by the age of 9 months, only to the mother. The tendency to seek others virtually disappears (which is reminiscent of imprinting in animals). The infant tends to equate his movements and gestures with their results - that is, he is still in the phase of magical thinking.

The separation from the mother, the formation of an individual, the separation from the world (the "spewing out" of the outside world) - are all tremendously traumatic.

The infant is afraid to lose his mother physically (no "mother permanence") as well as emotionally (will she be angry at this new found autonomy?). He goes away a step or two and runs back to receive the mother's reassurance that she still loves him and that she is still there. The tearing up of one's self into my SELF and the OUTSIDE WORLD is an unimaginable feat. It is equivalent to discovering irrefutable proof that the universe is an illusion created by the brain or that our brain belongs to a universal pool and not to us, or that we are God (the child discovers that he is not God, it is a discovery of the same magnitude). The child's mind is shredded to pieces: some pieces are still HE and others are NOT HE (=the outside world). This is an absolutely psychedelic experience (and the root of all psychoses, probably).

If not managed properly, if disturbed in some way (mainly emotionally), if the separation - individuation process goes awry, it could result in serious psychopathologies. There are grounds to believe that several personality disorders (Narcissistic and Borderline) can be traced to a disturbance in this process in early childhood.

Then, of course, there is the on-going traumatic process that we call "life".

Parenting - The Irrational Vocation

By: Dr. Sam Vaknin

There are some grounds to assume that a cognitive dissonance is involved in feeling that children are more a satisfaction than a nuisance. Why do people bother with parenting? It is time consuming, exhausting, strains otherwise pleasurable and tranquil relationships to their limits. Still, humanity keeps at it: breeding.

It is the easiest to resort to Nature. After all, all living species breed and most of them parent. We are, all taken into consideration, animals and, therefore, subject to the same instinctive behaviour patterns. There is no point in looking for a reason: survival itself (whether of the gene pool or, on a higher level, of the species) is at stake. Breeding is a transport mechanism: handing the precious cargo of genetics down generations of "organic containers".

But this is a reductionist view, which both ignores epistemological and emotional realities - and is tautological, thereby explaining something in terms of itself. Calling something by a different name or describing the mechanisms involved in minute detail does not an explanation make.

First hypothesis: we bring children to the world in order to "circumvent" death. We attain immortality (genetically and psychologically - though in both cases it is imaginary) by propagating our genetic material through the medium of our offspring.

This is a highly dubious claim. Any analysis, however shallow, will reveal its weaknesses. Our genetic material gets diluted beyond reconstruction with time. It constitutes 50% of the first generation, 25% of the second and so on. If this were the paramount concern - incest should have been the norm, being a behaviour better able to preserve a specific set of genes (especially today, when genetic screening can effectively guard against the birth of defective babies). Moreover, progeny is a dubious way of perpetuating one's self. No one remembers one's great great grandfathers. One's memory is better preserved by intellectual feats or architectural monuments. The latter are much better conduits than children and grandchildren.

Still, this indoctrinated misconception is so strong that a baby boom characterizes post war periods. Having been existentially threatened, people multiply in the vain belief that they thus best protect their genetic heritage and fixate their memory.

In the better-educated, higher income, low infant mortality part of the world - the number of children has decreased dramatically - but those who still bring them to the world do so partly because they believe in these factually erroneous assumptions.

Second hypothesis: we bring children to the world in order to preserve the cohesiveness of the family nucleus. This claim can more plausibly be reversed: the cohesiveness of the social cell of the family encourages bringing children to the world. In both cases, if true, we would have expected more children to be born into stable families (ante or post facto) than into abnormal or dysfunctional ones. The facts absolutely contradict this expectation: more children are born to single parent families (between one third and one half of them) and to other "abnormal" (non-traditional) families than to the mother-father classic configuration. Dysfunctional families have more children than any other type of family arrangement. Children are an abject failure at preserving family cohesiveness. It would seem that the number of children, or even their very existence, is not correlated to the stability of the family. Under special circumstances, (Narcissistic parents, working mothers) they may even be a destabilizing factor.

Hypothesis number three: children are mostly born unwanted. They are the results of accidents and mishaps, wrong fertility planning, wrong decisions and misguided turns of events. The more sex people engage in and the less preventive measures they adopt - the greater the likelihood of having a child. While this might be factually true (family planning is all but defunct in most parts of the world), it neglects the simple fact that people want children and love them. Children are still economic assets in many parts of the world. They plough fields and do menial jobs very effectively. This still does not begin to explain the attachment between parents and their offspring and the grief experienced by parents when children die or are sick. It seems that people derive enormous emotional fulfilment from being parents.

This is true even when the children were unwanted in the first place or are the results of lacking planning and sexual accidents. That children ARE the results of sexual ignorance, bad timing, the vigorousness of the sexual drive (higher frequency of sexual encounters) - can be proven using birth statistics among teenagers, the less educated and the young (ages 20 to 30).

People derive great happiness, fulfilment and satisfaction from their children. Is not this, in itself, a sufficient explanation? The pleasure principle seems to be at work: people have children because it gives them great pleasure. Children are sources of emotional sustenance. As parents grow old, they become sources of economic support, as well. Unfortunately, these assertions are not sustained by the facts. Increasing mobility breaks families apart at an early stage. Children become ever more dependent on the economic reserves of their parents (during their studies and the formation of a new family). It is not uncommon today for a child to live with and off his parents until the age of 30. Increasing individualism leaves parents to cope with the empty nest syndrome. Communication between parents and children has rarefied in the 20th century.

It is possible to think of children as habit forming (see: "The Habit of Identity"). In this hypothesis, parents - especially mothers - form a habit. Nine months of pregnancy and a host of social reactions condition the parents. They get used to the presence of an "abstract" baby. It is a case of a getting used to a concept. This is not very convincing. Entertaining a notion, a concept, a thought, an idea, a mental image, or a symbol very rarely leads to the formation of a habit.

Moreover, the living baby is very different to its pre-natal image. It cries, it soils, it smells, it severely disrupts the lives of its parents. It is much easier to reject it then to transform it to a habit. Moreover, a child is a bad emotional investment. So many things can and do go wrong with it as it grows. So many expectations and dreams are frustrated. The child leaves home and rarely reciprocates. The emotional "returns" on an investment in a child are rarely commensurate with the magnitude of the investment.

This is not to say that people do NOT derive pleasure and fulfilment from their offspring. This is undeniable. Yet, it is neither in the economic nor in the mature emotional arenas. To have children seems to be a purely Narcissistic drive, a part of the pursuit of Narcissistic supply.

For further elaboration, please refer to: "Malignant Self Love - Narcissism Revisited" and the Frequently Asked Questions (FAQs) sections.

We are all Narcissists, to a greater or lesser degree. A Narcissist is a person who projects a (false) image to the people around him. He then proceeds to define himself by this very image reflected back at him. Thus, he regards people as mere instruments, helpful in his Sisyphean attempt at self-definition. Their attention is crucial because it augments his weak ego and defines its boundaries. The Narcissist feeds off their admiration, adoration and approval and these help him to maintain a grandiose (fantastic and delusional) sense of self. As the personality matures, Narcissism is replaced with the ability to empathize and to love.

The energy (libido) initially directed at loving one's (false) self is redirected at more multidimensional, less idealized "targets": others. This edifice of maturity seems to crumble at the sight of one's offspring. The baby evokes in the parent the most primordial drives, a regression to infancy, protective, animalistic instincts, the desire to merge with the newborn and a sense of terror generated by such a desire (a fear of vanishing and of being assimilated). The parent relives his infancy and childhood through the agency of the baby. The newborn provides the parent with endless, unconditional and unbounded Narcissistic supply. This is euphemistically known as love - but it is really a form of symbiotic dependence, at least in the beginning of the relationship. Such narcissistic supply is addictive even to the more balanced, more mature, more psychodynamically stable of parents.