The Power of Intentionality in the Psychoanalytic Understanding of Development

The concept of intentionality is currently of interest to psychoanalysts because of its relationship to the development of healthy aggression in the first year of life, as well as to the expression of desire. Developmental psychoanalysts explore intentionality in their clinical work with children who are unable to access healthy aggression or create an internal structure that supports intentional action leading to the capacity to pursue desired goals. This panel, chaired by Phyllis Tyson, explored ways of understanding the meaning of both conscious and unconscious intentionality and its contribution to the development, expression, and pursuit of relationally desired goals leading to the attachment process during the first year of life. Arnold Modell spoke about the musicality of speech and its role in meaning-making between infants and parents, as well as in psychoanalysis. Molly Romer Witten then presented her work with infants and parents and her observations about the development of intentionality within the parent-infant relationship. Alexandra Harrison discussed the two presentations and shared her clinical experience of the role of intentionality and promoting agency in psychoanalytic work.

In her introduction, Tyson encouraged the group to think about the implications of intersubjectivity for psychoanalysis, as well as for issues outside the consulting room. She suggested that intentionality, embedded in an intersubjective perspective, is essential for building a more peaceful world. She asked whether psychoanalytic insights might help us understand war and conflict. Not every child who grows up in a context of war and violence becomes violent. As an intentional mental being, a child comes to understand that not only are actions deliberate, but that there are links between actions and feelings. Consequently, one can have desires without acting on them. An autobiographical self emerges that integrates self states. Tyson considered the implications of such growing awareness for conflict resolution, as when parent and child can think flexibly and compromise creatively. She emphasized the need to think imaginatively, read the emotions of the other, and let metaphor be the interpreter of the unconscious. When children are not treated in this way, they do not think intersubjectively but deal in absolutes: “That’s the way I see it, and that’s the way it is.” This form of thinking is at the root of bullying on the playground, as well as of terrorism and armed conflict around the world.

Modell titled his talk “It Don’t Mean a Thing If It Ain’t Got That Swing.” He carefully showed that intentionality is communicated through the presence or absence of the musical quality of speech and demonstrated its role in the meaning-making that goes on between infant and caregiver, analysand and analyst. He went on to outline the evolutionary evidence for the essential nature of musicality in communication. He emphasized the importance of Daniel Stern’s and Colwyn Trevarthen’s work, specifically Stern’s concept of vitality affects and Trevarthen’s ideas about musical speech. Vitality affects communicate one’s inner state through movement and rhythm, which are intrinsic to musical speech (Stern 1985; Trevarthen 1989).

Modell’s interest in the musicality of speech developed out of his clinical work with schizoid patients and his observation that their speech lacked this quality (Modell 1975). He suggested that their monotonous speech was a sign of nonrelatedness. They had an illusion of omnipotent self-sufficiency, felt they needed nothing from their analyst, and so did not attempt to relate to him in the usual way (Modell 1980). Without the sense of musicality, words are deprived of their emotional significance, and empathic understanding is interrupted. The listener becomes bored and disengages.

While Modell was able to understand and tolerate this as an analyst, he emphasized that for a child, having a parent whose voice signals a state of nonrelatedness can be devastating. Musicality of speech lends a sense of aliveness to the relationship. It is an indication of Stern’s vitality affects. Conversely, the absence of musicality is a signal that the relationship is dead and without meaning. “Motherese,” or infant-directed speech, is universal and contains the same elements regardless of the language spoken by the adult (Trevarthen 1989). Adults the world over spontaneously modify the cadence, pitch, and intonation of their speech when addressing infants. This speech contains longer pauses, shorter utterances, more repetitions, greater modulations of pitch, and enhanced articulation. This unique musicality guides the infant’s subjective engagement.

Given that this musicality of speech is present in all languages (despite other formal differences), and given that this process is not conscious, it would seem we are witnessing a deeply embedded phylogenetic inheritance. Indeed, the relationship between music, language, and bonding to the other was first described by Darwin in The Descent of Man (1871). Darwin believed that musical communication precedes language acquisition. He noted that earlier species of hominids communicated through song long before they acquired language, hypothesizing that song was used in the service of sexual selection. Today many scientists believe that Darwin was too restrictive in attributing the evolutionary function of song solely to sexual selection. The anthropologist Dean Falk (2004) has proposed that musical communication between mother and infant is fundamental to both bonding and the later acquisition of language. She suggested that earlier hominids, who did not have baby slings and were physically separated from their infants, maintained an attachment through song. This shared communication substituted for skin-to-skin contact.

The paleontologist Steven Mithen has placed music at the center of his theory of language acquisition. He reasoned that early hominids, who walked upright and could travel great distances, needed to coordinate their hunting activities. They had a need for a form of language more complex than that of contemporary primates. He believed that variations of pitch (i.e., musical sounds) provided that language. Neanderthals, who populated Europe for 200,000 years, relied solely on musical communication and did not possess a verbal language (Mithen 2007). While vitality affects function unconsciously, higher-order consciousness is defined as being conscious that one is conscious. It is a mental faculty that is probably limited to our own species. Modell suggested that the mother’s expression of vitality affects through her musical speech enables the child to develop the capacity for secondary higher-order consciousness. For example, if the child is angry or anxious, the musical qualities of the mother’s speech will mirror the inner state of the child, and through this process the child learns to recognize what he is feeling. This mirroring process is fundamental to the affective communication that takes place within psychoanalysis. Although ours is a talking cure, words themselves are not necessarily the carriers of intentionality. The meanings carried by tone and rhythm have a long evolutionary history that is embedded in our genes. In many instances this musical meaning will override the apparent meaning of the words that are spoken.

After Modell outlined the history of intentional intersubjective relating from an evolutionary perspective, Molly Witten looked at the concept from the perspective of psychoanalytic developmental theories. She spoke of how object relations and attachment theory inform our understanding of intentionality and intersubjectivity, as well as of what these theories do not explain. She proposed that intentionality can be fully expressed only after an individual achieves integration of motor, sensory, and relating functions. By intersubjectivity she meant that we understand how we feel about ourselves through the subtle, often unconscious, flow of emotions between ourselves and important others who care for us. Intersubjective relating organizes our experience of ourselves.

First Witten provided some context for the integration of object relations theory, attachment theory, and the interpersonal origins of self development. Melanie Klein was one of the pioneers who described how from the beginning of life babies are agents in constructing internal psychic structures based on relationships. She identified the presence of an ego from birth and a punitive superego from just a few months. In Klein’s theory, the development of psychic structures followed upon the characteristics of relating between mother and baby (Klein 1958). The further development of object relations theory by Donald Winnicott (1965) suggested that the infant achieves the capacity to hold his mother in mind through integrating enjoyable, successful interactions with his experiences of relational deprivation. Both Winnicott and Klein observed that the baby becomes an initiator of relationships as soon as this integration is achieved.

Thus, object relations theory attributed intentionality and intersubjective relating to babies from birth and provided an explanation for how character develops. Forty years after the development of object relations theory, attachment theory and ensuing empirical research began to create links between a parent’s style of managing affect and the baby’s style of learning and capacity for sociability. Babies develop a variety of relational styles, influenced by the relational style of one or both parents or other essential caregivers.

A major thrust of empirical research has elucidated how the parents’ style of managing affect influences the development of the baby’s attachment style (Beebe and Lachmann 2014). We know that when the parents’ conscious demeanor and unconscious communication of affect differ, the baby has to make active choices about how to understand their communication of affect (Lyons-Ruth 2003). This research orientation focuses mainly on the parents’ behavior and how it contributes to relationship development within the baby. Witten distinguished between observable behavior and what is in the infant’s mind, suggesting that a focus on attachment behavior has obscured the importance of relatedness happening earlier. She emphasized the infant’s more primary capacity to relate in a coordinated, intersubjective way, including exploration, seeking, anxiety modulation, and risk assessment using affective processes.

Witten approached her further exploration of intentionality from the perspective of earlier developmental capacities. These include incorporating issues of motor function, sensory/ perceptual integration, and styles of relatedness. The sensory system becomes integrated between three to five months of age. By seven to twelve months, babies begin to develop consistent styles of relating with their essential others, as seen in Mary Ainsworth’s strange situation (Ainsworth and Bell 1970). As for motor development, empirical research has demonstrated motor intentionality from seven weeks of conception, when a fetus will move away from a tactile stimulus (Delafield-Butt and Gangopadhyay 2013). Neonates perform intentional motor actions (Meltzoff and Decety 2003). If a parent makes a face at a two-hour-old baby, he will imitate the facial expression (Tomkins 1982). This capacity to imitate eventually leads the baby to experience affect expressed by his relating partner.

Emde (1983) has asserted that “the self is a process and refers to a vital set of synthetic functions which increase in complexity and depth as development proceeds throughout the life-span” (p. 168). Expanding on this conception of self-as-process, Stern’s research (1985) indicates that during the first four months a baby develops four core invariant ways of experiencing his body, which interact with each other to create a sense of self. These four ways of organizing perceptual motor experience are self-agency, self-coherence, self-affectivity, and self-history.

As the infant develops a sense of self-agency (i.e., the capacity to act in accordance with impulses, ideas, and fantasies), he develops the capacity to experience his internal sensations of physical movement in response to something outside of himself. As the baby develops consciousness of his motor system, he becomes aware of himself as the author of his physical movements.

Initially the baby will be easily overwhelmed by essentially any change in the intensity, frequency, or duration of affect. Stern observed that over the first four months the baby learns to maintain perceptual capacity in the face of the rise and fall of affect from all sources. This capacity to maintain the perception-action-execution link reflects the baby’s capacity to maintain a cohesive sense of self and not become fragmented by change in affective qualities. Between repeated experiences of interoceptive affect and the partner’s expression of affect, the opportunity arises for the baby to develop a sense of self-coherence by becoming aware of self and others while experiencing waves of affect.

As the baby gathers experience with expanded states of being, moving from a state of sleep to wakefulness, from hunger to satiety, from discomfort to satisfaction, from moments of being solitary to moments of relating, he develops a sense that he exists in multiple states of affect and experience, in a constant flow. When a young infant falls asleep during a noisy family gathering, for example, we see a moment when the baby stops the flow. The capacity for maintaining perception through a wide range of affective experiences constitutes the development of self-affectivity. That is, the baby develops a sense of riding on the waves of affect without drowning in them and without stopping the flow.

Finally, as the baby reaches the fourth month of life, the patterns of internal rise and fall of affect, as well as those induced through moments of relatedness, become recognizable as repeated patterns. Stern describes the development of self-history as the beginning of memory. Witten noted that it is the beginning of the capacity to recognize repeatable affect and motor patterns. This awareness of patterns of affect affords the baby the practice necessary to learn to recognize and modulate tension. The baby begins to develop a vocabulary of cries to signal his needs to caregivers, distinguishing between hunger, discomfort, and the need for touch and holding. It is after the baby can juggle the conscious acknowledgment of Stern’s four sources of self-invariance that he develops relatedness.

Witten suggested that the first form of an observable, intentionally related response is the infant’s capacity to smile in response to the presence of another person. If the baby gets the motor support necessary to organize perception, he may attempt to smile any time after three weeks. The baby’s behavior is intentional only in his responsiveness to stimulation by others. The smile back at the parent constitutes the first expression of healthy aggression for the infant. He uses his motor system in an organized response to an external prompt from the partner’s actions. Witten showed a video clip of a baby with his father to illustrate this. If the baby has the motor development and sensory integration necessary to organize perception, he may attempt to smile any time after three weeks. Intentional, self-initiated relating seems to consolidate in months four to six, along with the consolidation of sensory integration, motor control, and relational awareness (Thelen et al. 1993). Ammaniti and Gallese (2014) hypothesize that the goal of sensory integration is intentional attunement. As intentional attunement consolidates, the baby develops a preference for repeatable patterns of shared emotion with the relating partner.

It is only when a baby has firmly established the desire to relate, the capacity to initiate reaching out aggressively or assertively to further promote relatedness, and the sensory integration to support relatedness that the attachment processes can unfold in healthy ways. These three factors affect the quality and style of the attachment process as it emerges. To the extent that any of these factors are compromised due to functional or neurological delay, the infant’s capacity for intersubjective sharing of affect and intentional attunement to the affect of another will be impacted negatively, as will the later intentional actions that constitute attachment.

Witten suggested that intentional intersubjective relating is itself a critical component of development, rather than something that appears only in its lack, as a mere symptom of an attachment problem. Rather than just wait to treat an attachment problem, then, she sought to understand the development of intentional intersubjective relating in a way that would allow her to influence and support a child’s development by intervening before any emergence of an organized insecure attachment style.

In her discussion, Alexandra Harrison emphasized the importance of intersubjective relating in infant development and the connection with the primary caregiver. She also spoke about intentionality and its connection to the development of agency as a child grows up. She presented several clinical examples.

Harrison agreed with Witten’s assertion that little is understood about the relationship between attachment processes and the development of mind. Expressing caution, however, she questioned the usefulness of preventing the emergence of an organized insecure attachment as a clinical goal, since evidence that an insecure attachment style has lasting effects on the child’s development is modest to moderate. While the strange situation has come to constitute what is generally accepted to be the “gold standard” measure of security in early life, it is noteworthy that in ordinary situations a substantial proportion of infants (about a third) do not display a secure attachment to their caregiver (Rutter 2009). Accordingly, insecurity in itself is not an indication of disorder or even maladjustment. Also, whereas insecure attachment has been widely found to be associated with an increased likelihood of psychopathology in childhood, the association is weak and well below the level at which it might be clinically useful. Instead, Harrison identified helping the child develop intentionality as a worthwhile clinical goal.

She also pointed out that while the strange situation has demonstrated that infants experience a stable preference for their attachment figure beginning at about seven months, newborns actually show a marked preference for their mother, for the smell of their mother’s milk, and for the sound of their mother’s voice, even in utero. She agreed with Witten, though, that what is most important about the infant’s preference for the mother is less about attachment style and more the baby’s availability for intersubjective relatedness. However, she cited Beebe’s work as a good example of how attachment theory can be relevant to the understanding of intersubjective relatedness and its development. In Beebe’s studies of four-month-olds and their mothers, she was able to predict attachment status at one year from the quality of infant-mother vocal rhythm coordination, a measure of intersubjective relatedness, at four months. The mother-infant pairs who showed mid-range coordination were for the most part securely attached at one year. One could imagine that these infants and their mothers were attuned enough to create intersubjective states but not so tightly synchronized that there was no freedom to innovate or to “be alone in the presence of the other” (Beebe et al. 2012).

Although there are many ways of thinking about intentionality, Harrison explained that in her clinical work she conceptualizes it in terms of supporting her patients’ agency. She does this by becoming attuned enough with them in affect and intention that together they can metaphorically take a step in the direction the patients have indicated they want to go. She cited Trevarthen’s work as useful in illustrating the importance of intentionality in relating. Trevarthen explains that “consciousness and intentionality of the self are re-defined, if they are known as founded, not in perception of the difference of contents between the body and the outside world, but . . . in an inner awareness of the self-as-agent coherent in movement. . . . Human intersubjectivity emotionally evaluates both the rhythmic grace and the affective sympathy of intentions in movement. . . . The expressive body movements determine the degree of cooperation that may be achieved with them in intersynchrony and with affect attunement of the rhythms of intention” (Trevarthen in press).

Harrison also spoke about the importance of rhythmicity, not only in parent-child communication, but also in clinical work. She presented two video clips to illustrate intersynchrony in the rhythms of intention. The length of vocalizations and pauses were matched between Harrison and her patient, and volume and pitch were also mirrored. A disruption occurred in the session when Harrison used a little girl’s voice in the play. The patient then asked how much time was left in the session, and she told him they had only about five minutes. “Goodies,” was his response. “Baddies for me because I like playing with you,” Harrison commented. She made an interpretation that he was suddenly eager to leave because the voice she used had unsettled him. Ultimately, his response to her was, “You might be wrong, you might be right, but you can never know for sure.” She agreed that she could not know for sure because she could not see inside his mind. She explained that they were creating a way of exploring his mind together without taking away his agency, and they were doing this not only by the content of their language but by the coordination of their vocal rhythms and the vitality affects in their speech.

A rich discussion followed the panelists’ presentations, with thoughtful questions and comments from the audience. It was noted that a child is born with the potential and inclination to connect with a responsive other in a positive, contained, and pleasant way, but that that is only half the story. Winnicott (1969) emphasized that from the very beginning a baby needs to create a mother and evoke a response from her in order to be alive, and also to be able to destroy her and for her to survive it. Aggression is therefore essential to intentionality. Harrison described how Berry Brazelton gets a newborn to stick out its tongue by relating and encouraging. She postulated that neonates are making meaning, though not on the cognitive level. The importance of disruption was also addressed, and the opportunity it creates for the infant to experience rupture and repair. By tolerating disruption and making meaning from it, children develop a sense of agency, as when Harrison’s patient said “goodies” and she said “baddies.” Harrison noted that repair of ruptures generates hope and empowerment to take further risks by trying again to continue relating.

While Modell spoke about intention and musicality, Witten and Harrison further elaborated the technical considerations relevant to supporting children in the development of intentional intersubjective relating. Overall, the panel highlighted the importance of relational development from birth, if not earlier, months before the period that has been the focus of attachment research.