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Foremost, the work reported by Provence and Naylor enlarges the field of infant psychiatry, proposes an interventional strategy, and makes recommendations for the implementation of services to disadvantaged infants and their families, both of which we know to be greatly needed and to be sound. In addition, it is important for psychoanalysis.
It is noteworthy that a number of leaders in the field of infant psychiatry, which includes the senior author, are child psychoanalysts. We have to ascribe this to two factors at least: (1) the clinical finding by practitioners and clinical infant observers that many infants show evidence of emotional strain, symptoms, and disordered development; (2) discontinuity theory notwithstanding, Freud's genetic point of view, Erikson's epigenetic theory, and the more recently evolved developmental point of view, strongly corroborated by clinical work, all state the relevance of emotional development during the first three years of life—infancy—for all subsequent psychological development. In his last work, An Outline of Psychoanalysis, Freud noted that "the earliest cathexes are indelible." Both factors, complemented by much recent exciting psychoanalysis-relevant infancy research, have compelled clinicians to focus on and establish a sector of our field, infant psychiatry. For two decades now, Provence has been at the forefront of this field.
In this book Provence and Naylor detail a service strategy for infants at risk of maldevelopment and parents at risk for parenting difficulties. They report their five-year effort in working with seventeen disadvantaged families, each with a subject infant. They detail the types of service they rendered these families, namely, pediatric care, developmental evaluations, social services, and providing day care and preschool facilities. Although some examples are given of all services rendered, specific interventional strategies are given only sketchily, one of the major regrets I experienc