Abstract
Lisa Farley, Associate Professor of Education at York University in Toronto, has written an engaging volume from a psychoanalytically infused reconceptualist perspective on child development and psychopathology. A nuanced reading of Childhood beyond Pathology offers much to the psychoanalytically minded reader, especially those unfamiliar with this field of contemporary childhood educational study.
Following a short, thoughtfully written introduction that defines childhood as “neither a natural stage of development, nor a neutral category, but rather a placeholder for political struggles, philosophical ideals, and social anxieties” (p. 1), Childhood beyond Pathology engages in its method: Five disempowered children from the areas of fiction, recent sociopolitical events, and the psychoanalytic literature are tapped chapter by chapter in order “to open new conceptualizations of the child who oversteps or is cast outside of dominant trajectories circumscribing growth, learning, language, and being itself ” (p. 4). In this manner Childhood beyond Pathology studies development through disenfranchised figures in order to subversively reinscribe conceptualizations of the normal, natural, and universal as fabricated constructs that serve primarily as containers of oppressive power relations.
Despite the author’s tendency to uncritically champion this perspective, Childhood beyond Pathology inarguably advances our discourse on child development, as a consideration of its chapters will demonstrate.
Chapter 1 summons the “replacement child,” a child born to a parent after another child has died, through an analysis of Ann-Marie MacDonald’s 2014 novel, Adult Onset. The analysis places Freud’s “Morning and Melancholia” (1917) in the context of a “larger ‘affective turn’ in social and political theory that seeks to de-pathologize historically denigrated affects” (p. 25). The novel’s narrative of Mister, an adult replacement child and lesbian beset by depression and idiopathic symptoms, describes her entry into psychoanalysis in search of healing. The work is read as an allegory of the process through which the fields of childhood studies, education, and psychology may similarly mourn the idealizations of the childhood “myth” and of simple narratives of nation and normative growth. Through the concept of mourning, Farley channels Loewald (1960) in this chapter to suggest that we may convert cultural “ghosts” into “ancestors” of a newly enlightened sociocultural movement and society.
Chapter 2 enlists Winnicott’s “Bob,” a six-year-old boy with a “primary defect” or “infantile schizophrenia” (1965), to explore psychoanalytic conceptualizations of autism and neurodevelopmental disorders. Here Farley champions a move from deficit-based to strength-based theories. Acknowledging that “psychoanalysis remains a highly contested discourse” in this area of childhood pathology, she emphasizes in its exploration “times when analysts admit mistakes and change their minds” (p. 17). A presentation of the writings of Tustin (1994), Alvarez (1997), and Ogden (1997) concerning a child’s means of attaining protection, potency, and privacy, respectively, orients the chapter. Here Farley offers perhaps the book’s most systematic review of the psychoanalytic literature, beginning with psychoanalysts’ efforts to help an expanding array of clinical presentations (Stone 1954), including Anna Freud’s, Melanie Klein’s, and Donald Winnicott’s work with children.
Chapter 3 turns to Ken Corbett’s study of Leticia King, a fifteen-year-old black transgender adolescent murdered by a white classmate (2015), to explore the phenomenon of the “counterfeit child” (Bruhm 2012), a folktale figure “pretending to be [a child] but who clearly [isn’t],” which permits an “unconscious and forbidden hatred of children” (Corbett 2015, p. 66). “Childism” (Young-Bruehl 2012) and other psychoanalytic formulations of projection and projective identification (Klein 1946) are recruited to understand the projected “badness” of black children, the “disproportionate statistics involving criminal incarceration and murder,” and white privilege (p. 70). In this manner, Childhood beyond Pathology demonstrates how discursive practices serve to protect the empowered agents of historical narratives from self-introspection surrounding disavowed affects, and in doing so harm the disenfranchised through manipulation and denigration into objects at the service of the powerful. This mechanism resonates with others that many consider inherent in current political exigencies such as migration and the childhood separation crisis at the American border with Mexico.
Chapter 4 uses The Absolutely True Diary of a Part-Time Indian (Alexie 2007), a National Book Award–winning novel, to discuss the impact of social trauma, colonial legacies, and racism on the narrative of an adolescent quarrel on the Spokane Indian reservation. The adolescent conflict is presented “as symbolizing the work of disagreement to productively unsettle the selfsame aim of assimilation that is the violence of colonialism” (p. 83). This chapter is the exception in Childhood beyond Pathology, in that the book’s engagement with psychoanalytic theory is absent here, inviting Farley to indulge bravely in the reconceptualist perspective without the comforts (or dialectic productivity) of reference to the analytic literature.
In contrast, chapter 5 is significantly relevant to psychoanalyst readers in its tackling of transgender health and its relation to their field. Arguably, psychoanalysis remains an even more “highly contested discourse” in relation to autism and neurodevelopmental disorders, and the chapter succeeds in moving this discussion forward. Placing the contemporary psychoanalytic literature alongside Winnicott’s discussion of transitional phenomena (1953), it discusses the care of a five-year-old transgender child named Jenny (Saketopoulou 2014). Avgi Saketopoulou’s work, which recognizes the trauma of misgendering and advances psychoanalytic approaches to varied gendered experiences, is cited as a notable exception to a trend in psychoanalysis that Childhood beyond Pathology finds alarming regarding the treatment of transgender individuals. Ayelet Barkai’s review of psychoanalytic treatments of patients with gender dysphoria / gender identity disorder (2017) is used to show that many of these treatments should in fact not be characterized as psychoanalytic at all, insofar as the case reports fail to show the analyst working in a truly neutral stance; providers are shown from the outset to set a goal of returning the children’s conception of their gender to match their biological sex. The chapter cites work from allied mental health fields that either perpetuates (Zucker et al. 2014) or challenges (Saketopoulou 2014) this therapeutic stance. Saketopoulou considers transgenderism “not as a symptom but as a viable subjective reality,” (2014, p. 776) as formulated through an interpersonal developmental model, where pain and suffering derive from “feeling unseen and unknown” (2014 p. 779). The chapter concludes with a return to Winnicott—“it is a joy to be hidden but a disaster not to be found” (1963, p. 186)—giving psychoanalyst readers a thoughtful perspective on which to reflect.
What can psychoanalysts say of this work and receive from it? A restatement of the understanding of development and psychopathology put forward by Childhood beyond Pathology can help us answer this question. In the book’s introduction, aptly titled “Why Study the Child after a ‘Century of the Child’?”—in reference to an early-twentieth-century pedagogical text (Key 1909) that is identified as a precipitant of the “invention” of childhood as a modern concept—childhood is critiqued as a construct, a container of idealizations, and an affirmation of adulthood as an age of reason. The developmental stage of childhood is viewed as created in response to sociopolitical currents that introduced rapid changes in society. The post-historical twenty-first century (Fukuyama 1992) and its studies of psychopathology and development are presented as poised to revisit these constructions in the service of the child.
Childhood beyond Pathology sees the suffering of these children as an opportunity to challenge the falsities of normative developmental discourses and, thereby, not only to restore the humanity of disempowered groups, but also to generate a more textured and accurate theory of childhood development. Childhood beyond Pathology invites psychoanalysts to participate in this process. Unconditionally, this invitation is appreciated and valuable: the book demonstrates how normative conceptualizations of childhood service sociopolitical arguments in a dehumanizing manner.
Yet this vision and its model of childhood at times feels limited and restricted. This feeling may be a reaction to a rhetorical strategy employed at various points throughout the book. Too often, alternative perspectives are presented in an undeveloped or mischaracterized form, which allows their wholesale rejection. Given Farley’s thoughtful narrative voice in other areas, its absence at these points is notable. Examining this process might help us develop a reconceptualist perspective of greater use to the clinical psychoanalyst, one more easily integrated into the canon of developmental theories.
For example, nuanced depictions of genetic, epigenetic, and neurobiological determinants of development are absent from Childhood beyond Pathology. When these factors are presented in an underdeveloped way, their mere mention is viewed as an oppressive manifestation of essentialism, and as such they are immediately warded off. But this wholesale rejection ignores empirical data in various areas under consideration in Childhood beyond Pathology. One such area is autism spectrum disorders, where neurobiological findings have been used thoughtfully in psychoanalytically informed studies (e.g., Singletary 2015). Not only may Farley’s reconceptualist frame deprive patients with such problems of helpful biological interventions and the benefits of future research; it also prevents the employment of her perspective alongside other developmental models. Lost are the moments of pluralistic creativity arising from the intersection of reconceptualism and viewpoints that continue to understand childhood as a natural and intricate developmental stage with objective biological determinants. As the reconceptualist perspective offers much, this is a loss for psychoanalysis that could be recovered in part, without stoking fears of essentialism, through a more developed and nuanced integration with neurobiological materialism. Absent this engagement, however, the ideological charge of Childhood beyond Pathology seems decidedly pronounced.
In a way rather like her treatment of constitutional determinants vis-à-vis lived experience, Farley presents classical models of psychoanalysis in a manner that invites their use as straw men. Psychoanalytic readers will recognize that contained in her disclaimer that “the particular brand of psychoanalysis that concerns this book is not, then, the ‘normative side’ that aims to ‘guide patients towards social success’ (Kristeva 1993) or, alternatively, to blame those who somehow fail to follow the course” (p. 8) is a mischaracterization of those classical models. As with Farley’s handling of constitutional determinants, a more nuanced understanding, one that recognizes both the strengths and the weaknesses of these models, would allow us to consider how the various schools of psychoanalysis position us to understand childhood development. Regrettably, this opportunity is missed in Childhood beyond Pathology, even though many psychoanalytic readers recognize that postclassical models of development productively coexist alongside classical models.
Despite these limitations, Childhood beyond Pathology inarguably challenges readers to expand their understanding of contemporary psychoanalytic thought and its applications in our pluralistic era. Accepting emerging models of development need not require the reader to unquestionably accept “postdevelopmentalism” (Blaise 2005) or to abandon the modernist assumptions of truth, universality, and certainty that remain at the center of classical and even many postclassical psychoanalytic developmental models. While it is inarguable that psychoanalysis has an unparalleled history of privileging the “‘divergences, the detours, [and] the idiosyncracies’ (Forrester 2017) of the mind as primary and lived in varying degrees by each one of us” (p. 7), it is inarguable also that psychoanalysis has put forth classical models of development containing truths that extend beyond the idea of childhood as a mere social construction.
These considerations are important in an era when psychoanalysis, while preserving its rich heritage and unique advantages, may have an opportunity to enjoy a productive rapprochement with developmental psychology and the medical sciences, informing and enriching both in the process. Empirical, psychoanalytically informed research, infant observation studies, and neuropsychoanalytic investigations must be brought to bear. To locate psychoanalysis as a tool solely within the realm of critical theory and historicist relativism may risk the extrusion of psychoanalytic interventions and applications from clinical care. This courts the risk of further replacing psychoanalysis as a clinical model with pharmacotherapy or short-term, outcome measure–driven interventions like CBT.
Without updated classical psychoanalysis and techniques and without access to selected contemporary interventions, we may be in danger of medicating a child in need when psychoanalysis may be a superior option for understanding and helping the child. This is not simply a hypothetical in the event psychoanalysis becomes no longer a viable healthcare option: the ability of psychoanalysis today to extend from theory to clinical practice means that these theoretical considerations have real-world consequences that should be carefully weighed in parallel with nuanced debates over theory.
When a child is self-injuring or suicidal, manifesting unviable solutions of an underlying problem, psychoanalysis may offer an avenue toward better understanding and a less self-destructive solution (Levy, Yeomans, and Diamond 2007), in addition to serving as a conduit to merely “depathologizing” certain affects (Farley, p. 25). When a transgendered child may be offered hormones to slow or alter the body’s maturation, with potentially deleterious physiological consequences (Mueller and Gooren 2008; Toorians et al. 2003) and without full consideration of the ethical considerations (Crall and Jackson 2016; Lambrese 2010; Steensma, Wensing-Kruger, and Klink 2017), psychoanalysis may offer more than can be generated through deconstructionist reconceptualist perspectives. Children with neurodevelopmental disorders may be ill served by a reconceptualization of psychoanalytic models purged of neurodevelopmental considerations. These areas considered in Childhood beyond Pathology help us appreciate the consequences of removing psychoanalysis from publicly available healthcare. To prevent this in the contemporary sociopolitical landscape, psychoanalysis must take pride in its empirically validated constructs and create an evidence base. To do this, models that do not reject childhood as a developmental stage and understand psychopathology as merely a social construct have an important role to play.
There is real suffering for these real children who exist in our emergency rooms, consulting offices, clinics, inpatient units, and residential programs. In place of an uncritical acceptance of childhood as solely a sociopolitical construct, psychoanalytic developmental models that have defined the stage of childhood hand in hand with the perspective offered by Childhood beyond Pathology offer greater opportunity for dialogue through which new and more adequate psychoanalytic models may arise. While Childhood beyond Pathology does exceptional work in introducing psychoanalytic readers to a postclassical contemporary reconceptualist perspective, we must consider this view in tension with fully developed classical models in order to retain and develop a truly comprehensive psychoanalytic model of childhood, development, and psychopathology.
