Frontiers of Infant Psychiatry - Vol. 2

By Justin D. Call; Eleanor Galenson et al. | Go to book overview

44
On the Precursors to Psychic Structure:
Notes on the Treatment of
a Two-Year-Old Autistic Toddler

Ruth Codier Resch, Ph.D.

Stanley Grand, Ph.D.

The ego is first and foremost a bodily ego.

SIGMUND FREUD

The body, the body ego, and the ego represent a continuum in the transformation from the biology to the psychology of mental growth. The gradual emergence of thought, fantasy, and symbolization—the evolution of personal meaning and its content—from a biological matrix is a uniquely psychoanalytic concept of human development. The "psychological birth of the human infant" proceeds, in our view, through a complex set of changes in which primarily biological regulations are gradually transformed into structures and functions that are primarily psychological.

Sensory experience—the more or less perceptual aspect of mental representation—persists throughout life and is the moment-by‐ moment contribution of biology to the continuous stream of mental development. Indeed, infant research is increasingly showing the sophistication of the perceptual and social capacities of the neonate (Bower, 1977; Brazelton, 1973a; Carpenter, 1975) and the enormous importance for later development of these capacities in the micromomentary synchronies of very early dyadic relationships (Beebe and Stern, 1977; Condon and Sander, 1974; Stern, 1983; Wolff, 1963).

Mahler (1958), in a paper highlighting the importance of the early relationship between mother and infant, discussed the biological necessity of the "species-characteristic social symbiosis" between infant and mother. Although the importance of this conception of biosocial symbiosis in her early work was overshadowed by the more recent emphasis on the psychological development of the self representation, we think that this earlier concept of biosocial symbiosis is useful for clinical work with patients exhibiting more primitively organized pathology.

In this paper we distinguish two distinct aspects of the symbiosis by presenting the observation and treatment of a two-year-old toddler having a diagnosis of infantile autism. We describe a biosocial and a psychological aspect of the symbiotic bond. In normal babies the two aspects merge with great rapidity very early in development. However, the distinction between the two has particular importance for both the diagnosis and treatment of certain in

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