The Journey of Child Development

Selected Papers of Joseph D. Noshpitz

Bruce Sklarew, Myra Sklarew, Bruce Sklarew, Myra Sklarew

• Publisher: Routledge
• Year: 2011
• eBook ISBN: 9781135152994
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

As founder and past president of the American Academy of Child and Adolescent Psychiatry and president of the American Association of Children's Residential Centers, Joseph Noshpitz was at the forefront of psychodynamic treatment and research with children and adolescents for more than forty years. He was the editor-in-chief of the six volume Handbook of Child Psychiatry, co-author of the two volume Pathways of Growth: Essentials of Child Psychiatry, and co-editor of Stressors and the Adjustment Disorders. His breadth of knowledge and wisdom ranged well beyond the traditional areas of diagnosis and therapeutic interventions, envisioning the child as an individual within the family and the wider culture. Based on psychoanalytic ideas and without jargon, Noshpitz's innovative ideas are grounded in the developmental theories of Freud, Mahler, and Kernberg.

These previously unpublished papers demonstrate Noshpitz's scope and the depth to which he conceived the psychic life of the child. Each paper is introduced by experts who contemporize and contextualize the work for the modern reader. The wide-ranging papers include ethics in child development, narcissism in the grade school years, tomboyism, idealization, negative ego ideals, and self-destructiveness in adolescence. More applied papers delve into the formative appeal of literature for adolescent girls, the developmental lessons of the Ninja Turtles, and the creative early motivations behind art, music, dance, mime, and poetry. The papers present an unyielding advocacy for the progressive development of the child interacting with the society at large, most evidenced in the extraordinarily far-reaching proposal for wider preventive family interventions.

As poignant now as the time when they were written, Noshpitz's thoughtful commentaries and analyses repeatedly demonstrate his intrinsic curiosity, joy of learning, generosity and sensitivity to the myriad struggles of youth. His psychodynamic sensibility is a contrast to this era of quick psychopharmalogical fixes, cognitive-behavioral approaches, and managed care.

To learn more about the life and work of Joseph Noshpitz, and to access more of his unpublished work, please visit http://josephnoshpitz.com.

Chapter 1
Ethics in child development

INTRODUCTION

Lawrence Stone

In his paper “Ethics in Child Development,” Noshpitz examines the intense and dynamic issues associated with parenting, schooling, socialization, and the growth and development of our youth. He offers meaningful elaborations and analysis of many of the central problems and challenges faced by our current and future generations. He emphasizes the importance of the development of common sense, popularly supported, and fundamentally sound regimens and structures developed by the current and future creators and caretakers of the forthcoming generations.

In the past, unfortunately, many of those who care for children have reacted as if they were reading a weather report. You want to believe it, but you wonder about it. You may rely on its details and therefore make some constructive plans for your immediate and future circumstances, or you may doubt its accuracy and therefore make nonprecautionary plans, or you may pay it no attention and make no preparatory responses. Thus, primarily through all of our societal history, we have the age-old hit, miss, or do-nothing responses to the devastating issues and concerns of children’s development. “Based on the expectation of a significantly more diverse child population by 2020, and the large number of children living in poverty, greater attention is needed on vulnerable children and their potential for a healthy and productive adulthood” (Cheng & Jenkins, 2009, p. 2491).

Committing to children is a wise investment for the future of the United States in the global community. Much research has documented persistent or increasing child health disparities by population, disease, affluence (Koplewicz, Gurian, & Williams, 2009), violence (Helander, 2008), maternal health (Feldman, Granat, Pariente, Kanety, Kuint, & Gilboa-Schechtman, 2009), geography, and other risk factors, but there is a paucity of research on successful interventions. As seen in this paper, the issues Noshpitz addresses are essentially issues of today and tomorrow.

He presents a review of child development concepts with an analysis of many of the central issues along with a brief examination of common ineffective actions and goals. Noshpitz follows this with his conclusions for reforms, new pathways, and predictable outcomes. He examines the roles of the mother, father, and other family members, neighbors, schools, teachers, and society. They are falling short of the goals of healthy biological, psychological, and social development for children. While spelling out the details, he maintains that we cannot rely on the past for our solutions for tomorrow but rather for guides to avoid development’s stagnation and to devise new and creative methodologies for healthy child development. He clearly expresses the preeminent role that “society” must create for the protection and healthy development of our future, namely, our children.

In a personal communication, Emilio Dominguez, a Spanish friend and colleague and expert on the family, wrote in response to Noshpitz’s paper:

The consequences of our failure to meet our collective responsibility to assure our children’s complex developmental needs are in the news every day: serious child abuse cases all over the world, child exploitation, children made into soldiers to fight wars, used for sexual objects, and so many other atrocities. And we have the less reported cases of neglect and abuse, all with serious consequences for all children and later for all of society. It is one thing to raise children to be puppets or ideologues; it is another to seek to enhance each child’s capacity for altruism, cognitive achievement, emotional maturity, aesthetic self-realization, and warm interpersonal relations.

In a recent article in Journal of the American Medical Association (JAMA; Mercy & Saul, 2009), many of the points Noshpitz makes about the importance of early interventions in childhood experiences and development are highlighted. Of particular note, this issue of JAMA had 11 articles pertaining to some aspect of children’s mental health and emotional growth. What a change from earlier times when Noshpitz supported me in a quest to bring “current issues” forward as prime content for a major series of medical textbooks in 1979 and 1987. I personally felt at the time his urging and encouragement to examine, analyze, and elaborate all aspects of life that impacted the mental and emotional growth and development of our children and adolescents. The goal was to bring forward, evaluate, and present the unique emotional and behavioral impacts of new and developing phenomena. Out of this was to come greater awareness, sharper insights, and productive interventions in the quest for diminished mental morbidity and improved emotional growth and stability in our young people.

It is hard to tell whether we are gaining in these areas. We currently see more and more electronic addiction and microinvasions of our human systems and functions, our privacy, our uniqueness, our behavior, and even our ambitions. There is debate and conflict over the values and the boundaries of our individuality. Among all of these dynamic challenges, Dr. Noshpitz, we miss your wisdom and thank you again for this paper and your forever timely forethoughts. My recommendation to a new reader is to read the conclusions first; if you find that you have little disagreement, then read from the beginning to learn more about “how to”; if you found large disagreements, then read from the beginning to learn more about “why to.”

To review, synthesize, and comment on but a few parts of the works and information left behind by Joseph D. Noshpitz, MD, is personally challenging and gratifying. What responsibility. What an honor. What a privilege. What a pleasure.

References

Cheng, T. L., & Jenkins, R. R. (2009). Health disparities across the lifespan. Journal of the American Medical Association, 301(23), 2491–2492.

Feldman, R., Granat, A., Pariente, C., Kanety, H., Kuint, J., & Gilboa-Schechtman, E. (2009). Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation, and stress reactivity. Journal of the American Academy of Child and Adolescent Psychiatry, 48(9), 919–926.

Helander, E. (2008). Children and violence: The world of the defenseless. London: Palgrave MacMillan.

Koplewicz, H., Gurian, A., & Williams, K. (2009). The era of affluence and its discontents. Journal of the American Academy of Child and Adolescent Psychiatry, 48(11), 1053–1055.

Mercy, J. A., & Saul, J. (2009). Creating a healthier future through early interventions for children. Journal of the American Medical Association, 301(21), 2262–2264.

ETHICS IN CHILD DEVELOPMENT

Joseph D. Noshpitz

Traditionally, child development has been a family matter. Every child grows within a human context; there is always a surrounding milieu of one or more adults whose efforts and activity are essential to the child’s survival. The complex interplay between infant and caregiver, their mutual regulation and interaction, and the meaningful consequences of this exchange to both child and milieu have been documented many times. Nor does this interplay stop with infancy. It persists lifelong, with a highly varied evolution of duties, roles, and responsibilities as the years progress.

What ethical principles apply to this universal human pattern? At the outset, it is evident that we are concerned with the interactions between a presumably adult-rearing person and a relatively helpless and dependent individual in need of rearing. The act of rearing an infant implies mandatory access to such biological necessities as caring, nurturing, and protecting. It would be unprincipled to allow a helpless child to go unfed, untended, unprotected from avoidable danger, or deprived of necessary medical care. But these are the easy positions.

In our day, child development has been studied as never before in history. As we have continued to observe babies, a host of needs have come to be identified, needs that are a great deal more subtle and complex than the short list of biologic necessities previously set forth. This added array includes needs for appropriate stimulation, needs for responsive attention, needs for acquiring solace, needs for playful interaction, needs for emotional nurturing, needs for identifying the specifics of temperament, and needs for making the necessary adaptations to that profile.

Once we gain such an improved and more detailed knowledge of children’s emotional, cognitive, and interpersonal needs, we come face to face with a number of pivotal ethical dilemmas, namely, how important is it that these needs be met? More to the point, if we perceive that meeting these needs is a valuable good, even a critical necessity, should not these needs be met, consistently and appropriately? If they really should be met, if this is genuinely important, then, in turn, would it not follow that we have to ponder whose responsibility it is that this be done? The easy answer is that it is the family’s responsibility—as it always has been. End of discussion. But in an era of rapid advances in knowledge, where the average family might well be unaware of what is known about child development, in an era of radical dissolution of extended families, of both parents working, of frequent and rapid family fragmentation—in short, of major changes in the meaning of the word family—is it not reasonable to inquire: In some measure, should this not become society’s responsibility? Should not child rearing become a shared responsibility between family and society? For if we do not face this issue, how else can we be sure that all children are getting what we know they must and should have? That, in particular, is the troublesome question challenging so many of our most cherished principles. For there is no obvious way to ensure the appropriateness of child-rearing practices without some form of monitoring of what goes on in each home where a child is being reared. Once we embark on that line of reasoning, however, we encounter another great good whose tenets would be violated by such monitoring.

One of the most precious and valued usufructs of liberty is the freedom to interact with one’s family in the privacy of the home without officious governmental scrutiny, surveillance, or interference. This is a cherished and protected principle; it is celebrated in the ancient phrase “a man’s home is his castle.” It would take an extraordinary state of affairs to breach such a cordon of values. There is, however, much to suggest that such a condition has indeed arrived. Let us consider this in greater detail.

It has long been assumed that a family is the best rearing environment for any given child, that there are both sacred and sentimental reasons for maintaining a bastion of privacy around the rearing of children, and that the biologically derived, intuitive knowledge and life experience of parents (formerly of mothers, more recently of mothers and fathers)—hopefully backed by the wisdom of grandparents—is the surest ground for healthy individual development of the child. And even where it is not, even where a family fails at its child-rearing mission, the ideal solution is to provide the child with a temporary (foster) or permanent (adoptive) alternative family, one that will offer the necessary sage and intuitive upbringing.

Jecker (1993) makes the point that there are a number of ethical principles underlying the relationship of society to family. Although she is making these observations in connection with spousal abuse, they can readily apply to our topic as well. These principles hold true both in the late stages of pregnancy and beyond. To begin with, there is a principle akin to that celebrated in the Hippocratic Oath: First do no harm. That seems self-evident and needs no discussion. Then there is society’s duty to do those things that support and help enhance the welfare of each family and child. The current concern in America with providing jobs and health care are examples of this principle in action. Finally there is the requirement to allot the goods of that society in a manner that is just.

Jecker (1993) notes that modern ethicists have come to regard the preservation of self-respect within a society as a profoundly important social good (Nozick, 1974; Rawls, 1971; Waltzer, 1983). I would add that fostering individual development is of even greater importance. Such enhancement of growth experiences not only underlies any hope for self-respect (or, as we term it, self-esteem) but also makes possible the maximum realization of the means of maintaining such self-esteem a lifetime through. For it is in furthering of one’s capacities for cognitive competence, emotional self‑regulation, and interpersonal bonding that skilled and discerning developmental support reaches its apogee. It is in realizing these potentials that good child rearing offers its truest contribution to creating and maintaining self-esteem.

One of the products of our cultural history, however, is that the extension of justice has tended to stop at the family door. As a society, we are loath to view events within the boundary of family life as meriting the same application of justice considerations as is true for extrafamilial events. For example, the history of the “discovery” of child abuse speaks volumes for the difficulty we have in allowing ourselves even to think about so distressing an idea as the misuse of children within that center of social sanctity, the family home. The syndrome of recurrent multiple fractures and subdural hematoma in infancy was an x-ray diagnosis that had been known for years (Caffey, 1946). Roentgenologists diagnosed it all the time. It was not until a courageous pediatrician connected that with the voluminous evidence of child abuse that the true diagnosis began to be made (Kempe, Silverman, Steele, Droegmuller, & Silver, 1962). The 16 years it took between the initial x-ray description and the subsequent behavioral diagnosis is a concrete measure of the profound unwillingness our society experienced toward dealing with the associated ethical issues.

A somewhat similar state of affairs exists in the realm of spouse battering. Thus, Warshaw (1989) examined medical records where women had been treated by doctors and nurses for injuries highly suggestive of abuse and found “nondetection, nonintervention, and nonreceptiveness to be the norm” (in Jecker, 1993, p. 776). In attempting to understand this state of affairs, Kurz and Stark (1988) suggest that they want to help medical staff members feel comfortable about actually asking probing questions about the source of the injuries because they may regard such an inquiry as “an invasion into ‘personal affairs’” (in Jecker, p. 777). After all, people are likely to find such an inquiry offensive (Sugg & Inui, 1992). As a result, even so conservative a voice as the American Psychiatric Association (AMA) is beginning to assert that to consider domestic violence as a private matter is “a common misconception that should be abandoned” (Council on Ethical and Judicial Affairs, AMA, 1992).

Translated into our own realm of concern, this illustrates an extreme, although unfortunately by no means uncommon, state of affairs where one ethical principle, the right of a family to the privacy of the home, is confronted with another, the right of a child to grow without maltreatment.

One may well argue, however, that since child abuse is in fact an extreme case, it is not something that should be allowed to set the cultural tone for all child rearing. What happens, however, if we find that children have other needs besides the relatively obvious one of protection from physical harm? What if the researchers in child development determine, for example, that each child requires a minimum of interactive stimulation? Some 50 years ago, Rene Spitz (1945) described hospitalism, the syndrome of the under-stimulated child. In our day, this has translated itself into laws that consider “neglect” of a child a grave and actionable offense, one that permits society’s representatives to enter a home and, if necessary, remove a child outright. Here the issue not only is one of physical abuse but also involves the psychological harm to the child as well as the physical dangers an unsupervised child can encounter, which together arouse society’s reaction.

Kaplan (1991) quotes a U.S. Department of Health and Human Services report (1988) as dividing neglect into three categories: physical, educational, and emotional. For the preschooler, physical and psychological neglect are the chief culprits and often go hand in hand. In the wake of such deprivation, serious damage to the child’s developmental processes can ensue. The neglected youngster is often left cognitively handicapped, emotionally stunted or disturbed, and unable to enjoy a full and satisfying interpersonal relationship with anyone. The ethical implications of such a state of affairs seem straightforward enough. Aside from the empirical problems of how much this eventually costs society in terms of compensatory and ameliorative efforts (e.g., social services, investigative services, educational services, special education, the many elements of the penal system), there is the matter of how much children suffer as they yearn for care and closeness—and do not obtain them. How much punishment-seeking behavior follows as the only way to get the much-needed attention, how much travail then ensues on the part of both the child and the family (often extending later on to the community), and how much of a burden of self-hatred and self-devastation becomes yoked to the child as a permanent fixture to carry forward into later years? There is much pain in all this.

The ethical imperative is thus very po...

Table of contents

• COVER PAGE
• TITLE PAGE
• COPYRIGHT PAGE
• EDITORS’ PREFACE
• ACKNOWLEDGMENTS
• CONTRIBUTORS
• INTRODUCTION: JOSEPH NOSHPITZ (1922–1997)
• CHAPTER 1: ETHICS IN CHILD DEVELOPMENT
• CHAPTER 2: IDEALIZATION
• CHAPTER 3: IDEALIZATION AND PSYCHOPATHOLOGY: FORMS OF EXPRESSION OF THE NEGATIVE IDEAL
• CHAPTER 4: MUSIC
• CHAPTER 5: VISUAL ART
• CHAPTER 6: PROSE AND POETRY
• CHAPTER 7: MIME AND DANCE
• CHAPTER 8: INFANTILE NARCISSISM IN THE GRADE SCHOOL YEARS
• CHAPTER 9: TEENAGE MUTANT NINJA TURTLES
• CHAPTER 10: NANCY DREW AND THE BABY-SITTERS CLUB
• CHAPTER 11: GENDER DEVELOPMENT IN LATENCY GIRLS: THE TOMBOY PHENOMENON
• CHAPTER 12: THE TOMBOY, PUBERTY, AND BEYOND
• CHAPTER 13: THE EFFECTS OF TRAUMA ON THE DEVELOPMENT OF SELF-DESTRUCTIVENESS IN ADOLESCENCE
• CHAPTER 14: BEYOND SCHOOL
• CHAPTER 15: THE ETHICS OF RAGE
• AFTERWORD: THE LIFE AND WORK OF JOSEPH NOSHPITZ