Dianna Kenny, author of Bringing up Baby: the Psychoanalytic Infant Comes of Age, presents the evidence against the standard assumption that infants are ‘merged’ with the caregiver at birth.
In this short article, I hope to challenge readers to think about the evidence for the enthusiastic acceptance, if not passionate embrace in psychoanalytic circles, of the notion that early infant experience is undifferentiated, merged, and autistic-contiguous.
A number of psychoanalytic theories have suggested that babies pass through auto-erotic (Nagera, 1964), autistic, symbiotic (Mahler, 1967; 1972; Mahler, Pine, & Bergmann, 1975), autistic-contiguous (Ogden, 1989a,b), or fused or merged (Ogden, 2004) states, before emerging with a differentiated sense of self and other. This view has been constantly invoked over the past 100 years in both infant research and psychoanalysis and has never been put to rest (Alperin, 2001). Note the typical quote below that asserts that this position is taken-for-granted.
It is by now a commonplace of child psychology that in the earliest stage of life an infant and his mother cannot be seen as two separate individuals, but rather as a single unit, or dual unity, as Mahler (1963) calls it (Mohacsy, 1976, p. 501).
The psychoanalytic view that the infant is merged or undifferentiated requires clarification. Two concepts have potentially been conflated in this perception of the infant – those of “absolute dependence” or helplessness at birth, and the state of symbiosis, undifferentiation or merger with mother. It is possible for the infant to be in a state of absolute dependence with respect to physical and emotional survival at birth, while also possessing, as Klein has argued, and as subsequent infant research has demonstrated, rudimentary object relations and skills and capacities that render the infant, from birth, a co-constructing partner in the mother/baby dyad.
Recent scholarship has concluded that newborns are interpersonally competent (Morgan, 1997), and that nonverbal modes of communicating and experiencing form the basis for intersubjectivity in infancy (Beebe et al., 2003). Although sociality per se does not emerge until the second or third months of life, and is not directed specifically at primary caregivers until about five to six months of age, infants actively interact with their caregivers from birth in a process of reciprocal mutual influence. Infants are responsive to social referencing cues and adjust their behaviour accordingly (Carver & Vaccaro, 2007; Repacholi, Meltzoff, & Olsen, 2008).
Neonates also engage in active intermodal mapping (AIM), a process that unites perception with execution of a motor plan, which permits imitation from birth (Meltzoff & Moore, 1994) and beginning of “like me” perceptions, which form the basis for social cognition (Meltzoff, 2007a, b; Meltzoff & Brooks, 2008). By six weeks of age, infants show deferred imitation. When confronted with a non-responsive face, they will reproduce a tongue protrusion they had imitated 24 hours earlier, purportedly in an attempt to ascertain whether the passive face before them is the same as the face of the person whom they had imitated the previous day. Imitation rapidly becomes more complex, with cooing games indicating the presence of social expectations by two to three months of age (Caron, 2009).
Research also shows that infants in the first two months of life actively engage and negotiate with their mothers around their sleep-wake and feeding/eliminating cycles. Infants whose caregiver/infant relationship was disrupted after the first ten days of life showed dysregulation in the organisation of basic biological functions, leading to the conclusion that early regulation of biological functions is the outcome of mutual negotiation between the infant and his caregiver (Sander, 1988).
Thus, far from being fused, merged, undifferentiated or “radically egocentric” (Piaget & Cook, 1954), the infant enters the world with self-other equivalences that are innately specified and experientially elaborated (Meltzoff, 2007a, b). Intersubjectivity is primordial, not developmental. Varga (2011) concluded that “neonatal imitation reveals the equi-primordiality of our own sense of an embodied self and a sense of others…” (p. 631). Neonatal imitation, as embodied perception, is intersubjective (Gallagher, 2001). These abilities would not be present in either of the two conceptions of the psychoanalytic infant – one proposing a “selfless” state, and the other, Winnicottian, position proposing infant omnipotence.
Infants are interdependent and interactive with their caregivers from birth and are always already engaged with the intersubjective world. Systems of interaction build psychic structure, that is, internalized objects and representations of interpersonal interactions (see, for example, the work of Beebe and colleagues e.g., Beebe, Knoblauch, Rustin, Sorter, 2003). Bowlby’s (1973) “working model of attachment” and Stern’s (1985) RIGs (representations of interactions that have generalized) are two examples of psychic structure as it is currently conceptualized.
Further, the infant is born with the capacity to experience positive (rewarding) and negative (punishing) affects, which he encodes both neurologically and in memory. The infant is motivated to increase positive affects, decrease or manage negative affects, and minimize affect inhibition. These motivations enhance learning of environmental contingencies that lead to positive and negative affects and to organize behaviour to influence outcomes (Tronick, 2002; Tronick & Beeghly, 2011). Infants appear to be just as attracted to the expectation of a pleasurable outcome that accompanies success as they are motivated to avoid the negative affect experienced with too much incongruence, dissonance, or the inability to discover the contingencies related to outcomes, and adjust their own behaviour accordingly (Papousek, Papousek, & Koester, 1986).
Infants develop knowledge about themselves, their world, and their relationships non-verbally, non-symbolically and implicitly and use this knowledge in communicating with primary caregivers. Communicative competence precedes language. Indeed, “prior to language… the origin of mind is dyadic and dialogic; …adult intersubjectivity is built on infant intersubjectivity” (Beebe et al., 2003, p. 746). Many scholars, beginning with Freud (1900a) understood the profound impact of the child’s first emotional ties on subsequent development. Freud argued that “[t]he deepest and eternal nature of man… lies in those impulses of the mind that have their roots in… childhood…” (p. 247).
This implicit, embodied knowledge forms the basis of infant object relationships, which later become accessible in the transference of patients undergoing psychoanalysis (Lecours, 2007; Talvitie & Ihanus, 2002). Transference is understood to be the “process of actualisation of unconscious wishes… infantile prototypes re-emerge and are experienced with a strong sensation of immediacy…” (Laplanche & Pontalis, 1973, p. 455). While transference phenomena are important sources of evidence about infant states, this source must now be balanced against and combined with current empirical literature on infant development in a wide diversity of areas, including infant observation, ethology, behavioural genetics, attachment theory, cognitive development, and developmental neuroscience to formulate an empirically supported and nuanced view of newborn and infant capacities.
Professor of Psychology, The University of Sydney.
Author of Bringing Up Baby: The Psychoanalytic Infant Comes of Age and From Id to Intersubjectivity: Talking about the Talking Cure with Master Clinicians (Karnac Books).
Reviews and Endorsements
‘In this book Dianna Kenny sets out to discover what remains of Freud in contemporary psychoanalytic practice. To do this, she engages us in an intensive dialogue with four eminent practitioners. While no four people can be said to be representative of an entire community of practitioners they are each distinctive and different with respect to their theoretical framework and the cultural milieu within which they operate. After the interviews, she lets them loose on a therapy transcript, which acts as a kind of Rorschach inkblot onto which they project their fantasies about the patient and the therapist. Before we meet the four clinicians, Professor Kenny sets the scene with an unusually lucid exposition of the core ideas of Freud and post-Freudian psychoanalysis. This is an heroic task to accomplish in two chapters but she achieves it with remarkable fluency. Inevitably some detail is missing but the core ideas are so clearly enunciated that these chapters alone will prove to be invaluable to any person seeking to navigate this complex and jargon-infested territory. The four interviews that follow are themselves outstanding exemplars of psychoanalytic enquiry. I cannot put it more clearly than Robert Stolorow, who said at the end of the interview “Your questions were very thoughtful and incisive.” It is clear that Professor Kenny had a plan that she brought to each interview. Her plan was informed by a close reading of the published work of each clinician and curiosity about how their ideas and approaches related to other strands of psychoanalytic thinking. However, she never allowed the plan to get in the way of the conversation and many of the questions were stimulated by the thoughts of the person she was interviewing. Indeed, there were times when the questions were as interesting and informative as the responses.
This is a scholarly work, with all the key ideas assiduously footnoted or referenced. The reader will have no difficulty further exploring any of the many thought-provoking fragments that the conversations weave together. However, it is much more than scholarly. There is an intimacy to the interviews, which enables each clinician to tell a very personal story. We are constantly reminded that an intellectual journey is shaped by life experience and not just by reading and ideas. For clinicians this is in part vicarious life experience through constant engagement with patients. However, through these interviews we also learn about formative personal life experiences such as the death of a spouse, working in an overburdened health system, or the search for a father. When it comes to the transcripts, each of the therapists adopts the position of the “master clinician” or therapy supervisor. Here we encounter something of the superego of each clinician. They are not always in agreement as to what the therapist might do better but they share what might best be described as a clear vision for how the work should proceed. Stolorow put it most graphically when he said in response to one of the therapist’s interventions, “The therapist is still pursuing a cognitive behavioural approach, which is not, at this point, helpful to the patient”. Each of the clinicians felt strongly about both therapist and patient and were emphatic in their advice-giving to the therapist which was motivated by an unwillingness to provide tacit endorsement of interventions that they considered less than ideal from their perspective. However, after the thoughtful and sometimes humble communication in the four interviews, the assumption of the role of expert came as something of a shock. There is a lot we can learn about therapeutic technique from the responses to the transcript. It also reminds us how strongly identified clinicians are with the patient and how little patience they can have with therapists, who struggle with their patients down difficult byways.
Those with a more academic orientation will especially appreciate Professor Kenny’s textual analysis of the responses of the four clinicians to the clinical transcript. She uses a formal text analysis program as well as a conceptual thematic extraction process to identify both the distinctive voices of each clinician and some of the communalities that lie behind these voices. This is an invitation to further research, which I suspect will be both stimulating and challenging for many readers. It is also the means by which Professor Kenny draws together some of the disparate strands that have emerged in the clinical discussions, and in the analyses of the clinical transcripts, to bring her work to a conclusion. I hope you enjoy this book as much as I have. It did not set out to provide you with a complete or fully integrated picture of contemporary psychoanalytic thinking; it does, however, provide you with an excellent overview. Furthermore, it will give you more than a glimpse into the world of the practicing clinician. It may also help you understand something Allan Abbass did not when he said “I don’t know what might be happening in psychoanalytic treatments that take so long . . . I can’t see the added value—the health dollar is so stretched.” Psychoanalysis may not be the most cost effective treatment but the conversations with Spielman, Holmes, and Stolorow do take us to where we might find some of the added value.’
—Robert King, PhD, FAPS, Professor and Coordinator of Clinical Psychology, Training School of Psychology and Counselling, Queensland University of Technology