Part One: Development: Nurturing and Destroying a Child

Developmental achievements during the first five years of life are described. From birth children are readily able to engage with and respond to their caregivers, whose attunement is crucial to their welfare. The child learns to differentiate objects and people and develops schemata of relating to others. Spatial exploration and the ability to categorise facilitate the attainment of object and other permanence at around eighteen months of age. At this time children begin to understand that others are intentional agents with internal states that are the sources of attitudes and actions. The child's identification with others is salient to the formation of identity and the ability to differentiate from others. Play is vital to understanding the nature of symbols. When attachment is secure requisite transitional space is provided and mentalization is achieved. However, a grasp of beliefs and of the difference between appearance and reality is not yet achieved. Attachment characterised by misattunement and/or overt abuse may result in pathological dissociation resulting in developmental deficits that are most extreme in dissociative identity disorder.