Infant Psychiatry in a Changing World:
Optimism and Paradox
The contributions of this volume, like those of its predecessor, give ample evidence that infant psychiatry is an emerging area of vital importance. The topic of infancy captures our imagination, and, increasingly, it also demands our clinical attention. Infants represent our "new beginning," they are inherently attractive to us, and they can be a source of enormous pleasure as they respond to our caregiving, as we play with them, and as we participate in the experience of their growth. But infants are also vulnerable, subject to parental abuse and neglect, to "turning off" and what appears to be depression, as well as to a variety of adaptive difficulties involving feeding, sleeping, and behavioral regulation. Adaptive difficulties are especially apt to involve physically and mentally handicapped infants, infants born prematurely, and infants with particular temperaments. Still other adaptive difficulties occur in infants born to parents with certain diseases, infants born into particular family constellations, and infants in disadvantaged environments. Conditions such as these interfere with the new beginning. Consequently, in this changing world we are becoming more appreciative that infants need our professional help.
Those diverse professionals who identify themselves with the area of infant psychiatry share a concern both with mental health and with the special problems of adaptation in infancy. There is a shared sense of uncertainty, but there is also optimism. Though there are many unanswered questions about development and many puzzles for our clinical science, these papers document new knowledge and an exciting sense that important answers will soon inform our clinical judgments.
In orienting oneself to infant psychiatry, one encounters a number of apparent contradictions or paradoxes. The first has to do with the name itself, both in terms of "infant" and "psychiatry." Clearly, the commitment that joins the professionals in this volume is one involving more than infants. It includes a concern for mother, father, and family, as well. Further, the commitment to infancy goes beyond psychiatry. It involves a variety of other disciplines concerned with understanding and bettering conditions related to problems of adaptation and of psychopathology in infancy. These include health-related disciplines, such as pediatrics, psychoanalysis, clinical psychology, social work, and special education, as well as more basic scientific disciplines, such as developmental psychology, psychobiology, basic education, and family studies. At our first Congress, at which the problems of professional identity were discussed, including the common commitment of those from so many disciplines, Lebovici (1980) aptly commented that