Invited Commentaries

This contribution by John Bowlby confirms that he was regarded as a contemporary authority in child psychiatry. He had worked in the London Child Guidance Clinic, one of the first child guidance clinics funded by the Commonwealth Fund, which had supported their introduction to the United Kingdom. These clinics introduced the new profession of child psychiatry and a focus on the mental health of children. The child psychiatrist was designated as the leader of the child guidance team, with social workers and psychologists as key members of the clinic. This publication—A Survey of Child Psychiatry (Gordon, 1939)—was part of an approach to generalise the insights gained from the operation of the clinics to help implement them across the country.

The publication date, 1939, was the eve of the Second World War , which marked a turning point when child guidance clinics grew rapidly as a result of the experiences of the stress of evacuation and traumatic effects of the war, and the subsequent founding of the National Health Service. This also marked the phase when John Bowlby was involved in attempts to ameliorate the devastating effects of separation associated with evacuation and awareness of the importance of attachment to the primary caregiver, and to his work with the World Health Organization, which formed the basis of his monumental and influential work on attachment and loss.

This contribution on “Hysteria in children” (Bowlby, 1939) represents an important historical document and provides vivid clinical material. One can see important elements in John Bowlby's thinking with the emphasis on thoroughgoing clinical assessment of the child and his family, and an awareness of the importance of significant stressful events precipitating psychological responses. This emphasis on the reality of such experiences created conflict in his post-war work at the Tavistock Clinic where he argued forcefully against the emphasis on intrapsychic events and object relation