Abstract
The Early Years of Life, originally published in German in 2007, was translated and published in English in 2011. Its author, Gertraud Diem-Wille, is a Viennese psychoanalyst who studied infant observation and psychoanalysis with Kleinian/Bionian psychoanalysts and child psychotherapists in London. Her book is a rich and convincing demonstration of what this approach has to contribute both to the training of adult and child psychoanalysts and to our understanding of early development. In illustrating infant/mother/father connections in exquisite detail, it adds richness to our ways of conceptualizing what goes right when family life contributes to healthy development, and what can go wrong when something in the child and/or the family pushes development off the rails. And thus, in the parallel universe we construct as one aspect of our analytic treatment, it can help us formulate our methods and goals as we try to facilitate development in our patients of whatever age.
Diem-Wille constructs her story about the early years of life from three sources. First, and probably of most interest to an American audience because least familiar, is her use of detailed infant observation material from her own experience, from that of colleagues, and from documentary films made by child psychotherapists trained at the Tavistock Clinic in London. She also uses transcripts of videotapes made by other infant researchers, primarily those of Daniel Stern and his group. Second, she illustrates her conceptualizations with detailed reports of clinical interventions with young families and psychoanalytic sessions with young children. Third, she reviews empirical studies in child development, as well as findings of contemporary neuroscience.
For those who have studied Klein and Bion, the central developmental path Diem-Wille seeks to illustrate will be familiar: the growth of the capacity for thought and symbolization as the baby, with the help of caretakers, navigates the emotional struggles of the paranoid-schizoid and depressive positions. It is the illustration of these constructs in real time with real babies and real parents and real struggles within and between them that brings these concepts to life. The book is a gold mine of detailed illustrations for conveying the value of infant observation to training in child and adult psychoanalysis and for the teaching of Kleinian/Bionian theory.
Probably the most interesting chapters in the book for American psychoanalysts are “The Emergence of the Body-Ego—Individuation through the Experience of Separation and Closeness,” “Emotional Development in the First Years,” and “Development of Thinking and the Capacity to Symbolize.” The introduction and the first and last chapters of the book, on the nature vs. nurture controversy and the psychosexual development of the child, would be valuable for teaching newcomers to the field but are of less interest to the experienced analyst.
Diem-Wille gives due credit to Winnicott, Mahler, Stern, and others who have postulated the essential parental supports and major developmental accomplishments of the early months of life. Diem-Wille, from the perspective of the Kleinian/Bionian tradition, asks the question, “How does the newborn child become a reflective person who can engage in love relations and shape its own life?” The emphasis on the capacity for reflection is what distinguishes this perspective. Diem-Wille uses detailed infant observations to illustrate how positive experiences of being held are relevant to both physical and emotional development. In doing so, she expands on Freud’s concept of the body ego, a concept heretofore not well-developed within psychoanalytic theory. Following on the earlier work of Esther Bick, Diem-Wille demonstrates the significance of the skin and of touch for psychological contact and for the emergence of the body ego, which she defines as a cathexis of the body self with its own internal world, separate from but in relation to caregivers.
“Emotional Development in the First Years” begins with a description of the struggles within parents during the phases of pre-conception and pregnancy. She notes the inevitable anxieties and ambivalence and the importance of the parents’ capacities to integrate positive and negative states of mind. She then uses detailed observations of several infants to illustrate the relevance of concepts such as the paranoid-schizoid and depressive positions, splitting, and projective identification. For example, she cites Felix, who had been video-recorded for research and teaching purposes. The first reported observation occurs at twelve days of age, then at four and a half months, and again at nine and a half months. She also uses videotapes from Daniel Stern’s research. The focus on the tiniest shifts in position and mood is impressive. We get the observations and then interpretations. Working within the Kleinian perspective, Diem-Wille focuses on the balance between archaic and mature states of mind, as mother and child have to integrate aggression and hate with their love for each other. In particular, the child “can be overwhelmed by both its hatred and the fantasized retaliatory hatred of the mother” (p. 117).
“Development of Thinking and the Capacity to Symbolize” does much to illustrate the central contribution of Bion to the Kleinian perspective on human development. Hanna Segal is the main proponent of the line of thinking illustrated here. Segal’s articulation of the movement from concrete thinking and symbolic equations to abstract thinking and symbol formation is illustrated in an observation of Felix, now sixteen months old, as he learns his first words and as he comes to know the difference between a towel roll as a material object for holding towels and the towel roll as a trumpet. He seems very pleased as he makes “music” with his new discovery. Diem-Wille then gives us an extended case study of three years of analysis of Ferdinand, eight years old when he began treatment. Again, her attention to detail in her reporting is impressive, and is extremely helpful for teaching purposes. Ferdinand was rigid, withdrawn, friendless, and pseudo-independent when he began treatment. Diem-Wille gives us the “he said/she said” report in the kind of detail that brings the story to life. And the commentary helps the reader see how useful Diem-Wille’s theoretical perspective is for furthering the child’s emotional and cognitive development. Ferdinand becomes more relaxed, playful, engaged, and genuinely friendly with his younger sisters and other children. Diem-Wille ends her chapter on thinking with this: “Observations have provided ample evidence for the close connection between the development of a normal capacity to think and the ability to establish an emotional relation of love and hate, fear and joy with a person (the mother)” (p. 183).
The Early Years of Life is a vivid illustration of the value of infant observation to training in the psychoanalytic method and to conceptualizing treatment and personality development and structure. The book demonstrates why the theoretical trajectory Diem-Wille represents is deserving of as much attention in American psychoanalysis as it currently receives in Europe and South America.