Psychotherapy with Children

Frederick H. Allen

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9780415209199
• eBook ISBN: 9781136296284
• Topic: Medicine
• Subtopic: Health Care Delivery

This is Volume I of nineteen in a collection of Abnormal and Clinical Psychology. Originally published in 1942, the theme of this book is that children with personality and behavior difficulties can be helped to help themselves.

1

THE NORMAL PSYCHOLOGICAL GROWTH PROCESS

THE COMMON characteristic of all living matter is a capacity to perpetuate itself by the formation of new functioning units. In human growth we observe the emergence of a new individual maintaining the characteristics of its species, yet acquiring, through the orderly process of development, qualities unique for the particular individual. Biological and social factors are, of necessity, interwoven in this process. No life can exist apart from life.

It is my purpose first to study this process of individuation as a living and dynamic phenomenon in order to formulate positive principles that will give a functional understanding of some basic facts of human nature. My second purpose will be to apply these principles to an understanding of the therapeutic experience, which can be one of growth and differentiation for the individual who participates in it.

The growth process begins as a purely biological phenomenon, yet back of that we have a different factor of two adults giving a start to life by their own volition. Their own feelings and attitudes are a part of this life process that, once initiated, becomes a biological phenomenon. Two cells, in uniting, form a whole having potentialities for newness and uniqueness which in turn divide and reunite in new wholes. In this process we see operating the principle of differentiation and the separating out of groups of cells with functional differences all related and interdependent. There is orderly purpose in this process. It is not simply cell division and reunion, a constant proliferation of cells without difference. This is the characteristic of cancer cell growth, where no cell differentiation occurs but only cell proliferation. The resultant mass has no function and becomes a foreign body. Normal growth, on the contrary, leads to the formation of functioning interrelated units which make possible an integrated whole that at birth takes the form of a living person capable of independent physiological existence.

In the original cell division a cell gives up a part of itself in order to go on growing. The principle of separation, as basic in growth and development, is manifest in that original biological phenomenon. The same principle of separation is operative in the birth process. Physiological differentiation and integration have proceeded to a point which allows the infant to function as a new living unity, and separation from the mother is necessary if the new functioning aggregate of cells which we call a baby is to go on living. Just as the original cell would die if it did not undergo division, so the infant would die if it were not divided from the mother. This is the end of one phase of growth with its more exclusive biological characteristics, and the beginning of a different phase that brings into operation new factors and new influences, and new functions emerge in both the infant and in the adults concerned with his birth.

Coghill has made important contributions to the study of the nature of biological behavior. Drawing his facts from animal experimentation, he observes that “the organism is first integrated as a total pattern without part-functions.” Even early reflexes emerging as local reactions are under dominance of the total pattern and become partial or “individuated with a progressive restriction of the zone of stimulation to the amount needed for response.” He states further that “inhibition first begins as a total reaction and dominates the whole organism.” This gives way to local excitation and allows local or partial and appropriate reactions to take place. He concludes that “behavior develops in man, as it does in the amblystoma [salamander], by the expansion of a total pattern that is integrated as a whole from the beginning, and by individuation of partial patterns within the unitary whole.”¹ Partial patterns of response, however, are made possible as the original whole gives up some of its original functions to a part as the new whole acquires its own different functions. This is not displacement of function but a basic phenomenon in cell differentiation with the growth and change of function as new cell aggregates reach the necessary stage of development.

In biological progression one can study the gradual emergence of these appropriate and partial functions of the parts of the larger whole from which they originate and for which they now work. The first reactions of the total organism thus made possible are significant. In keeping with Coghill’s conclusions, it responds as a totality without the capacity, later acquired, for partial and more purposeful responses. When a young infant grasps for an object, the whole body is involved with the hand movement. In contrast is the later capacity to make fine and controlled movements with that hand. When a baby smiles he smiles all over; hand and foot movements are as noticeable as the play of facial muscles in this response. Biological differentiation proceeds from this integrated whole. Through this process, physical development brings about the ability to restrict movement to the particular parts needed for a response, allowing the others to proceed to the performance of their proper activities.

In this stage of the human growth process important breaking up and shifting of functions take place as the parts begin to assume their appropriate activity in their relation to each other. As the living individual emerges and begins to function as the integrated whole which is the new-born infant, he is brought into relation with his environment and becomes more than a biological entity. The term “psychobiological” best describes this new phase of growth and living.

The moment an individual begins to live, unsupported by the physiological connection to the mother, new and significant influences and factors become operative. Consciousness of a separate self is awakened, and the infant gains a first awareness that while he is, in himself, an individual he is also closely associated with and related to others. This feeling is at first of an undifferentiated nature, in keeping with the status of infancy,² where the boundaries between what is self and not-self have not yet been clearly defined. With the opportunity to use his own muscles and do his own breathing and sucking and crying, the first steps are taken toward breaking up the totality of the infant’s conception of self which is bound up in a larger whole, the mother.

The infant is more than a physical unity influenced by reflex, chemical, and other physical stimuli. When he can respond as a separate biological integrate, he comes into relation with people and events, and is influenced by and in turn influences them. He becomes a social as well as a biological entity, capable of feeling. “Feeling,” as I use it here to describe a quality in the infant, refers to an “organismic”³ reaction that brings the individual into a state of awareness of his relationship with others. In its early manifestations, feeling is as undifferentiated as is the impression created by the use of the word. It is the sense of being alive, of being able to react to a stimulus with a pleasant or unpleasant overtone.

Mead speaks of feeling as “the lowest form of consciousness ascribed to a living thing.”⁴ What is implied is that when living forms enter into such a systematic process that they react purposingly, and as wholes to their own conditions, consciousness as feeling arises within life. Mead adds further: “Feeling is the term we use for this added element in life when the animal enters in some degree into its own environment.” The infant does exactly this in the earliest reactions to stimuli. In responding as an integrated whole, the feeling of aliveness emerges in him. He and his environment no longer exist as a totality, one and indivisible. The first step in the final phase of differentiation between self and not-self emerges with this capacity to feel.

The capacity to have and to show feeling is a function taken over by the total organism. But its earliest expressions occur, of necessity, through the only medium available, the organic. Probably the organism in utero experiences feeling but responds only reflexly and with physical expressions, that is, as far as we know, without consciousness in any usually accepted meaning of that word. Biological living involves solely physical expression. This undergoes great modification as growth proceeds and the individual, as an integrated whole, is able to experience and express feeling without involving the physical parts in such degree as to interfere or replace their necessary and proper functions. They have given up to the total organism the function of feeling and of channeling the expressions of feeling without interfering with the functions of any part of the organism. Only by this progression can growth as orderly sequence take place. The infant and young child must use the mouth not merely for nutritive purposes. This organ is also used for yelling and screaming and is utilized, too, for vomiting and breath-holding as feeling is roused. If a ten-year-old child vomits under the stress of anger, we have an instance in which a part of the organism that should have acquired, long since, its appropriate function, still serves as the medium for expressing feeling. When this happens, the physical and emotional expressions acquire the distortions often found clinically. Feeling is not expressed as feeling nor is the gastrointestinal tract able to perform its appropriate task of ingestion, digestion, and elimination.

In the evolution of appropriate channels for expressing feeling, considerable emphasis has been laid on specific organic areas. Psychoanalytical literature has stressed the significance of oral and anal activity and particular significance is attributed to behavior activating unusual responses from these zones of stimulation. These are important media for expressions of feeling in early life. They are most involved in the differentiating shifts of function discernible as the integrated whole emerges. In the normal transfer of functions with the emergence of an integrated whole, these physical parts even more than others give up to this new functioning whole the capacity to express feeling while at the same time their own specific and appropriate physical functions are developed and carried on.^{5 6}

In a sense the discussion of change from biological to psychobiological behavior would remain purely descriptive if we could not understand the essential dynamics in this movement. The more descriptive formulation has been presented first in order to gain better perspective for the discussion of psychological growth as an essentially dynamic process and not a series of shifts and steps that just “happen.” It is a living process, and the essential element in growth lies in the differentiation between live people. A self gets its start and direction from another self. A new entity emerges from a whole that includes another self, and psychological growth becomes the separation of these selves and the gradual experiencing of individual difference as well as of likeness and relatedness to others.

Reference has already been made to two separation steps in the growth process. The cell formed by the union of a male and female cell undergoes division. The cell partially dies in order to live. It gives up a part of itself and a new whole is created. At physical birth the same phenomenon occurs. The child is separated from the mother biologically in order to live. The sense of wholeness with the mother that characterizes the embryonic state is broken up at birth, and then is partially regained in living. Birth ushers in a new and final phase of differentiation.⁷ A new sense of wholeness emerges from the old as the infant lives a separate physiological existence in the framework of a relation with another self. He no longer has that relation in the totality of the intrauterine period. The completeness has a different quality to it in that two separate biological entities, mother and child, now have a living relationship which allows for and requires further differentiation.

Cell division is not considered a destructive biological phenomenon even though a cell is broken up in the process. By the same reasoning, birth cannot be thought of as a necessarily traumatic experience even though it holds the possibility of being traumatic. An experience universally essential for life must, by its very nature, have growth-inducing potentialities. To speak of it as a “traumatic” experience tends to emphasize the dangers rather than the potentialities within the birth experience.

The infant must have a sense of oneness with another in order to grow. The further we go up the scale of animal life, the more this becomes necessary. Unicellular organisms divide and live and the element of unitary difference is reduced to a minimum. However, in higher forms of life, particularly in the human, the sense of individual difference gains in importance, but only as it is balanced with the sense of similarity and of relatedness to others. This balance is acquired by a child through the slower process of living in a setting with others. Thus human growth ceases to be just a biological phenomenon. It now involves a relation with another who has attitudes and expectations and prejudices around which the child responds with his own emerging attitudes and expectations and, in so doing, gradually shapes those attitudes and responses that are characteristically his.

The actual living reality of the child at birth consists of two fused and inseparable realities: the reality with which he is born (genetic and biological), and the reality into which he is born (the social). These two realities can never exist apart from each other but constitute a totality from which growth, as a process of individuation, always proceeds. The infant has a sense of oneness with his outer reality, which is not experienced by him as outer but as a part of the whole. Experience begins to break up this configuration into new sets of wholes bearing a close relation to the old out of which the new is carved. Growth is a continuing process of the formation of new wholes from the elements of preceding ones.⁸ An inseparable and dynamic relation between the inner (biological) and outer (social) realities constitutes the growth picture. The child, emerging through the process, can be understood only as we perceive the constant relation that his inner organization bears to the larger whole (mother or culture) in which he discovers himself. In this discovery, and as he moves toward maturity, the child experiences both his relatedness to others (parents, siblings, friends) and finds at the same time the values of his own individuality and difference.

Whenever child development is studied as a purely biological process or as simply a phenomenon, determined by environment, distortions of necessity inhere in such a study. Much of the discussion about the relative importance of nature and nurture leads to a blind alley because of the attempt to envision these great forces as having separate existence. A clearer and broader conception of heredity and environment will result when we cease trying to allocate to one or the other the prime importance, and study them as inseparable parts of one whole that acquires meaning and value in the emerging self of a child.

This does not mean that these great forces cannot be studied from one standpoint or the other. A child can be observed and studi...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• FOREWORD
• 1. THE NORMAL PSYCHOLOGICAL GROWTH PROCESS
• 2. THE FUNCTION OF THE FAMILY IN THE CHILD’S GROWTH
• 3. THE THERAPEUTIC PROCESS
• 4. THE BEGINNING PHASE OF THERAPY
• 5. THE CHILD’S PARTICIPATION
• 6. A FEARFUL CHILD IN THERAPY: A CASE HISTORY
• 7. PROBLEMS ARISING IN WORKING WITH AGGRESSIVE BEHAVIOR
• 8. FACTORS THAT INTERFERE WITH THERAPY
• 9. THE ENDING PHASE OF THERAPY
• 10. BROADER IMPLICATIONS OF A THERAPEUTIC PHILOSOPHY
• INDEX