Psychoanalysis and Infant Research

Joseph D. Lichtenberg

• Publisher: Routledge
• Year: 2014
• Print ISBN: 9781138179905
• eBook ISBN: 9781317758358
• Topic: Psicología
• Subtopic: Psicología del desarrollo

Lichtenberg collates and summarizes recent findings about the first two years of life in order to examine their implications for contemporary psychoanalysis. He explores the implications of these data for the unfolding sense of self, and then draws on these data to reconceptualize the analytic situation and to formulate an experiential account of the therapeutic action of analysis.

Part I:
The Neonate

Chapter One
The Challenge for Psychoanalytic Theory from Neonate Research

The data from neonate research pose an exciting challenge to psychoanalytic theory. Before 1960, except to a few pioneers such as Spitz, Benjamin, Fries, Wolff, and others, research on the neonate seemed as esoteric subject and an unpromising source of information for conceptualizing detailed aspects of human development. Since 1960, publications on neonates have grown from a trickle to a flood. Monographs and books now regularly appear, detailing the latest ingenious experiments. Our view of the newborn human has changed accordingly. Instead of a “blooming, buzzing confusion” (James, 1890), a state of undifferentiation, or a tabula rasa, we see an organism whose internal states and capacities for behavioral regulation are already rather complex. From the findings of the new research, neonates emerge as much closer to the tiny replicas of self that delight their parents than to the not-yet-psychologically meaningful, tension-discharging organisms postulated by classical analytic theory.

Nonetheless, it is still possible to question the direct application of this burgeoning mass of data to psychoanalytic theory. After abandoning his Project for a Scientific Psychology (1895), Freud opted to make his theory a purely psychological one and the existence of psychic representation became the sine qua non for what psychoanalytic theory could encompass. Some might argue that although the neonate’s activity is far more complex than either analytic or nonanalytic theoreticians believed, nothing in these fascinating observations demonstrates an ability to receive or to establish psychic representations: This lack alone might place the neonate research findings outside the realm of psychoanalytic theory proper. In my opinion, however, such an argument for exclusion from psychoanalytic consideration is not convincing. The principal issue, I believe, is whether the data lend themselves to or indeed compel a reexamination of basic psychoanalytic hypotheses.

To begin with, we might look at how the new data from research on the first weeks of life confirm or raise doubts about psychoanalytic drive theory, ego psychology, object relations theory, and affect theory. I should, however, first clarify that some of this research has been conducted by investigators with psychoanalytic training. In distinguishing between “psychoanalysis” and “neonate research, ” I refer not to differences in training but to differences in the data base and methodology. The distinction is between hypotheses derived from the clinical psychoanalytic setting and those stemming from direct observation in an experimental setting.

Some Questions for Drive Theory

The bulk of evidence from neonate research lends support to those who criticize two proposals of psychoanalytic drive theory: (1) the economic view that drive discharge or tension reduction (the pleasure-pain principle) is the primary principle orienting infantile life, and (2) the genetic-dynamic proposal that the infant awakens to the world of objects as a consequence of the need to satisfy instinctual drives.

Is Tension Reduction an Adequate Model?

From the perspective of the pleasure-pain principle, the neonate is pictured as resting contentedly asleep until physiological hunger, psychologically represented as the oral drive, rises above a threshold level. The infant is aroused, cries (as a discharge manifestation), and then receives the feeding needed to quell the cause of the tension. After experiencing the pleasure of tension-diminution, the infant returns to the sleep state—tension-free.

The picture from current research data on the neonate is markedly different. During the awake state, neonates do more than feed, they look. They show an ability to fix their gaze and to pursue an object visually at an earlier time than was previously believed. Infants will interrupt their feeding, whether it is by breast or bottle, to look at what interests them. Moreover, they exhibit preferences among the visual stimuli they perceive (Fantz, 1961). When a favored stimulus is offered, rather than withdrawing into quiescence, the newborn will prolong the alert period. In studying the different methods mothers use to soothe their babies, Korner and Thoman (1970) found that putting the infant to the shoulder is the most effective means of diminishing crying. Compared with other methods, this action by the mother involves the most stimulation for the infant. The neonate receives direct vestibular and proprioceptive stimulation; indirectly, being held at the shoulder is a potent elicitor of visual alertness.

Furthermore, sleep does not prove to be a state of absence of tension. On close examination, the newborn reveals an extensive repertoire of well-organized sleep behaviors. The amount of activity present during the neonate’s sleep can even exceed that observed during noncrying wakefulness (Emde et al., 1976). There are of course periods of quiescent sleep (non-rapid-eye-movement [NREM] sleep), alternating with REM sleep. Yet the active REM sleep periods are longer in the newborn than in the older infant. One group of researchers speculates that the young organism is programmed not to shut out stimulation, but rather to seek it because it is needed for neural growth (Roffwarg et al., 1966).

Other research suggests that prolonged “quiescence” in the neonate, rather than representing the normal end-point of drive discharge, is an indication of pathological reaction to stress. Prolonged quiet (NREM) sleep has been reported to follow circumcision done with a ligature technique that produced an ischemic necrosis (Emde et al., 1971). This dramatic response has been interpreted to be an adaptive altering of the threshold as a response to continuing pain. A similar explanation of an altered threshold has been offered to explain infantile responses to both over- and understimulation involving tactile-proprioceptive-kinesthetic excitation (Shevrin and Tousseing, 1965). The researchers regard the seeming quiescence in these situations as a pathological loss of the appropriate level of excitation needed for normal development. The import of these findings is that a theory stating that tension reduction is the governing principle of the neonatal period (or later) requires revision. Stimulation and the tension it produces as needed for the newborn’s homeostatic balance and ongoing development as any other nutrient. This of course does not eliminate the significance of tension reduction. As I will describe, the infant has a variety of means to turn off in response to stimuli—whether distressing (as the circumcision finding) or simply overly repetitive (habituation experiments). What is suggested by the research is that rather than a stimulus barrier and simple reduction mechanism, the newborn is innately equipped to regulate stimuli and tension within optimal threshold limits.

Is Need Satisfaction the Sole Basis of Object Relations?

Traditionally, it has been believed that the infant gradually awakes to the world of objects because of the need to satisfy instinctual urges—built principally around oral needs. The original hunger-centered view of the oral phase was extended to include many aspects of mouth-skin proprioceptive-thermal needs, but the central idea was still that the infant remained in a stage of “primary narcissism, ” like a chick in its shell, until forced by hunger to attend to the mother as a need-satisfying object. Neonate research raises serious doubts about this simple causal chain. Instead, the neonate emerges as an organism whose responsiveness is centered on and geared to a perceptual-motor-affective dialogue with the mother.

Study after study documents the neonate’s preadapted potential for direct interaction—human to human—with the mother. Newborns respond selectively and actively to sound frequencies within the range of the human voice. The focus of their gaze is most accurate for objects about eight inches away—the exact distance from the mother’s eyes when an infant is held in the normal breast- or bottle-feeding position (Stern, 1977). Neonates will look for longer periods of time at line drawings of a face than at dots. By two weeks, they will look at the mother’s face longer than at a stranger’s and will also look at the mother’s face longer if she is talking to them (Carpenter, 1974). Films have documented that neonates react in a specifically responsive manner to the mother’s chattering at them—in a way that suggests participation in a dialogue (by eight weeks, infants add to their repertoire of responses what appear to be definable pre-speech activities). Presented with a toy suspended in front of them within eight inches gaze focus react actively, but differently—they seem to try to reach and grasp the object (Trevarthen, 1974, 1977). All this suggests that the neonate begins life with different patterns of response to human and inanimate sources of stimulation.

The importance of hunger and its satiation is not contradicted by neonate research, but its significance is diminished. It no longer holds the unique, primary position assigned to it in psychoanalytic theory as the “entrepreneur” for the dialogue between the mother and the growing infant. Some studies in fact confirm the great significance of the feeding experience, but they alter the perspective from which to view it. Sander et al. (1976), for instance, studied two groups of newborns. One group was fed on a four-hour, fixed schedule in a lying-in nursery; a matched group was fed on an around-the-clock, demand schedule in a rooming-in arrangement. This first phase of the study lasted for 10 days. Then, for the 11- to 28-day period, both groups of babies were transferred to a setting with a single caretaker in a rooming-in arrangement. (After this, they were transferred to foster homes). In the initial phase, the newborns fed on the fixed schedule cried and were more active at night than during the day. As soon as they were transferred to the surrogate mother (11th day), however, the day-night activity pattern reversed itself—in the first 24 hours. In contrast, with the demand-fed babies (as is true with demand feeding by the infant’s own mother), longer day-activity and longer night-sleep patterns were well established by the 10 days and continued smoothly during the 11- to 28-day period. The abrupt reversal in the patterns of the fixed-schedule babies was followed by “an overcompensation, a precocious advance with greater time awake during the day hours and less sleeping” (p. 185). Surprisingly, this tendency persisted over the whole first month.

In the same study, two surrogate mothers were used. Each of the caretakers was assigned to look after one group of demand-fed babies in the first 10 days and continued with the same babies until the end of the 28th day. These same women were alternatively assigned the care of the fixed-schedule babies after the tenth day. A significant variation was found in the day-night pattern of the infants cared for by each woman, although the experimenters could discern no difference in the women’s overt caretaking procedures. According to Sander et al., these findings “suggest the possibility that we are encountering here some mechanism by which temporal adaptation is being effected between infant and caretaker” (p. 198). They postulate that “regulation of feeding behavior may, already in the first 10 days of life, become dependent upon specific adaptation to the one individual caretaker who regularly feeds” (p. 198).

Observations of infants born with esophageal atresia point to the specific importance of the feeding experience in establishing a normal interest in oral intake and competence in using the mouth (Dowling, 1977). In one group of newborns, formula was fed into a stomach bypass, without simultaneous mouth stimulation. These infants did not develop recognizable hunger-satiation patterns or signals (see Lichtenberg, 1978a, for a discussion of the effects on body-self formation). Moreover, these infants’ attachment to their mothers was tenuous, and their overall functioning lacked motivation, vitality, intentionality, and mastery of the distorting effect these failures produce on the formation of body-self imagery. Other neonates were given sham mouth feedings along with the actual feeding into the bypass. The mothers were encouraged to put up with the inevitable messiness and to give a full and adequate general response to the baby. If sham feedings were begun early, at a time when the sucking response was strong, a normal level of interest in oral intake developed and the infant became competent in mouth functioning. The infants also showed normal vitality and motivation. If, however, sucking and lip-smacking responsiveness were not activated in the early infancy period, it was very difficult to stimulate interest in oral intake later, once the older infant’s esophageal passage had been repaired. Dowling believes these findings confirm the significance psychoanalytic theory has assigned to oral experience as an organizer of motivation.

The research I have cited on different feeding schedules and on neonates with esophageal atresia does link the individual feeding experience of infants to patternings that affect the basic attachment and responsiveness to their mother, as well as to oral interests. Certainly, the findings indicate that the feeding experience is an important factor in the neonate’s development. Yet to say that the feeding experience is important does not mean it is the centerpiece around which all infantile psychological development unfolds. Rather, as Sander et al. explain, it takes its part as one of a number of features of early postnatal development that lead to the establishment and maintenance of “proper phase synchrony within the infant between his various physiological components” (1976, p. 200).

Following this line of thinking, the oral-phase drive, in the psychoanalytic sense, becomes but one aspect of a basic regulatory core (Weil, 1970). In the functioning of this core, neonate research suggests that “extrinsic determinants may have a significant role in modifying both rates of change and the temporal organization of intrinsic infant subsystems, that is, the relationship of the phase characteristics of one function in respect to another” (Sander et al., 1976, p. 195). The intrinsic factor is the potential for response. The abrupt shift in the sleep-activity pattern of the fixed-schedule babies in Sander et al.’s study, in response to a changed environment, suggests a latent, intrinsic regulatory potential taking hold and making an overcompensating advance. Emde (1981a) refers to a biological predisposition “such that there are built-in self-righting tendencies” after a defection due to adverse environmental circumstances (p. 213).

There is no simple way of reconciling the findings of neonate research with psychoanalytic drive theory and its related theory of motivation. Many of the infant observations suggest an impelling quality to the neonate’s behavior, a general concept that is at least parallel to the psychoanalytic formulation. Sander (1980a) connects the concept of drive with control of the initiation of behavior, a control that must reside with the individual to organize his or her own world. Tomkins (1981) speaks of a drive system, but his definition differs from the psychoanalytic one. In his view, the drive supplies vital information on where and when to do what, but normally affective amplification is needed to make this specific information urgent. As we shall see later, in Chapter 11, this view has special significance for an understanding of how the infant research might be integrated with psychoanalytic thinking on erotogenic zones. Other considerations involving drive theory will be taken up in Chapter 6, in discussing the structural conception of the id and its general property of peremptoriness.

An Amplification of Ego Psychology

Since the advent of ego psychology, the “ego” side of the undifferentiated id-ego matrix has received increasing attention. Neonate, research adds substantial evidence of the existence of autonomous organizing, orienting, and controlling functions. Establishing a longer day-shorter night wakefulness distribution, for instance, would appear to be an internal regulation from the “ego side” of the basic regulatory core. Another type of control is revealed in newborns’ tendency to turn away from unpleasant odors (Bower, 1971), indicating that odors are identified as unpleasant prior to any training. In addition, newborns will turn their eyes correctly toward the source of a sound. They will react with distress if the sound source is experimentally disengaged from their view of the “speaker’s” mouth. These findings suggest that auditory localization and auditory-visual coordinations are autonomous functions (Basch, 1977).

Another type of control is revealed in newborns’ tendency to turn their heads away from the side near which an unpleasant odor has been placed. This indicates that newborns have the capacity to distinguish the direction from which an odor originates prior to any training. Very quickly this preprogrammed capacity to distinguish odors and the direction of their source enters into learned preferential responses. When a breast pad is placed on either side of neonates eight days old, one from the mother and one from another woman, the infants reliably smell the difference and turn toward the mother’s pad (MacFarlane, 1975).

I have already mentioned that infants appear to react selectively to human and nonhuman objects placed before them. Their movements indicate they have inborn precoordinations for each of these exchanges. In response to the mother, the neonate will “open his mouth, circle and purse his lips, and sustain this for several seconds. This is often accompanied by tongue thrusts as well as body quivers and small thrusts of the head forward…. These responses, especially when accompanied by the widening of the eyes, are as compelling as the social smile at 6 weeks” (Bennett, 1976, p. 87). These “greeting responses” contrast with the neonate’s movements in response to a toy, in which visual tracking is combined with precursors of attempts to grasp, kick at, or place the object in the mouth. Stern (1977) suggests that the infant’s differentiated responses to humans and to inanimate objects follow separate paths. The interactions with humans eventually lead to internal representations of people in affectively charged units of experience. The reactions to inanimate objects lead to the formation of sensorimotor schemata, as proposed by Piaget (1936).

As early as the second week, infants will reach for an actual three-dimensional object rather than for a photograph of the same object. What this finding suggests is that, from the earliest days, neonates perceive a three-dimensional world and, with minimal learning, can respond differentially to it and a two-dimensional representation of it (Bower, 1971). Another indication of the infant’s early capacity for organizing experience is the successful mastery of thumb sucking. Murphy (1973) has observed that on the fifth day, numerous trial attempts were made before the thumb entered the mouth. By the tenth day, bringing the thumb to the mouth was a successfully executed pattern.

Newborns show appreciable ear-hand coordination. They will reach out to grasp objects they can hear but not see. This ability normally disappears at age five or six months, when vision takes over as the primary perceptual mode. Bower (1976) has suggested that this innate skill might be exploited with blind children, to provide them with an active way of scanning their world (similar to the active way sighted children use vision). He devised a sonar mechanism that furnished a congenitally blind child with auditory input reflected from objects. “Not only did auditory-manual behavior not decline, but also the infant actually developed some skills comparable to...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Preface
• Acknowledgments
• PART I: THE NEONATE
• PART II: THE FIRST YEAR
• PART III: THE SECOND YEAR
• PART IV: APPLICATIONS
• References
• Author Index
• Subject Index