The Origins and Fates of Psychopathology
in Infancy: A Panel Discussion
Robert L. Tyson, M.D.
Robert N. Emde, M.D.
Eleanor Galenson, M.D
Joy D. Osofsky, Ph.D.
The purposes of the panel were defined by the Chairman in his introduction as follows: (1) to ask more precise questions about the origins of emotional disturbances in infancy; (2) to assess the adequacy of the currently available answers to these questions; and (3) to evaluate the capacity of our present theories of development to describe and to predict the origins and fates of psychopathology in the earliest months and years of life.
The ambiguities in these areas—for example, in the use of the term psychopathology—derive from different underlying assumptions, from different interpretations of observational data, and from different conceptual frameworks. Because there can be no such thing as psychopathology without a psyche (to paraphrase Winnicott, 1960), some would prefer the term deviancy to psychopathology, or even behavior, so as to by-pass the question of pathology. But the study of the beginnings of mental life can no longer be so easily restricted simply to observable behavior, any more than behavior can be ignored by those who study mental processes.
Winnicott's (1960) dictum—that there is no such thing as a baby because of the vital reciprocity between mother and infant—has been widely accepted. But as we learn more about the fluctuating and ever-evolving dynamic interaction between mother and infant, we find many more points of developmental vulnerability than were originally considered. We are forced to re-evaluate our criteria for disturbance and to reassess the implications of observed disturbance at various points of development. We want to know if what seems to be a disturbance now means that a continuing disruption of development will result, or whether subsequent development will be skewed so as to amplify vulnerability, or whether developmental plasticity will be sufficiently supple to allow an average expectable development.
The quality of plasticity in development was recognized by psychoanalysts quite early, exemplified by the principle of multiple function (Waelder, 1936), followed by the concepts of secondary autonomy (Hartmann, 1939) and persistence (Sandler and Joffe, 1967). The characteristics, dimensions, and limits of this plasticity are now very much the subjects of investigation. Somewhat parallel changes have taken place in the thinking of psychologists, so that today, more than ever before, psychologists and psychoanalysts think about development in many of the same ways. The similarities in ways of thinking may in turn serve as a basis for further distinctions to be made in our