Bridging the Chasm Between Developmental Theory and Clinical Theory: Part I. The Chasm

The problem of the relationship between childhood events and the reconstruction of those events made in the clinical setting is one among the many thorny theoretical problems with which psychoanalysis has been faced in recent years. This problem underlies the following questions: (1) Does the transference replicate the actual childhood events or the experience of those events, and if the latter, what is the relationship between the recollections and the historical occurrences? (2) Can the developmental sequence itself be reconstructed from the regressed states that patients manifest in the transference, and if so, what is the relationship between the transference and normal development? (3) Conversely, what is the relevance of formulations derived from naturalistic observations of infants and children to the understanding of the phenomena observed in the clinical setting? (4) What is the relationship between the therapeutic interventions made by a therapist and the nurturing activities of a caregiver to a child? All of these questions may be subsumed under the broader rubric of the question of the relationship between clinical theory and developmental theory Freud, 1914, 1937; Fine, Joseph, and Waldhom, 1971 Basch, 1973; Spence, 1982; Barglow, Jaffe, and Vaughn, 1989; Cohler's discussion in E. V. Demos, 1989).

There is now widespread agreement that the sequence of developmental phases cannot be inferred from the observations made in the clinical setting (Lichtenberg, 1983, 1989; Stern, 1985). We may only speculate as to what might have occurred. We have no way of identifying the events that actually caused the pathological outcome (Emde, 1981, 1984; Zeanah et al., 1989). Serious questions may, therefore, be raised