The Perpetuation of an Error

August 18, 1993

I wish to respond to Dr. Eric Gillett's letter of January 8th, 1992, in this Journal in which he pointed out "a neglect in the major journals of the work of Daniel Stern (1983), (1985), and others refuting the dual unity hypothesis of Mahler (1968)." He cites various American writers such as Klein (1981), Peterfreund (1978) and Silverman (1981) who have challenged the "dual unity" hypothesis and who, in various ways, have met with prejudice or have been ignored. Quite late in the day, Mahler herself found Stern's challenge, based on his observations of young babies, very persuasive, so that in her eighties, with scientific integrity, in a lecture in Paris delivered just before she died, she renounced the concept of normal primary autism as a stage in early infancy. But she had no time to write about it.

This notion of pathological autism being a regression to a stage of normal primary autism (to which I myself had subscribed), has caused such difficulties in communication between those who held this view and those who did not subscribe to it that I wrote papers, using Dr. Gillett's information, to clarify the situation. One paper was in the International Journal of Psychoanalysis(1991), and the other one will be in the Journal of Child Psychotherapy (1994).

As I have now abandoned this erroneous notion, I felt that it was incumbent upon me to work at suggesting an alternative hypothesis that better fitted the clinical and observational facts. After a careful review of my own nonorganic autistic cases and those of other workers, I realized that the mothers of such autistic children had all reported being very depressed before or after the birth of their baby. But not all babies whose mothers are depressed become autistic. I came to the conclusion that there must have been something in the children that predisposed them to be so sensitive to the mother's depression. It seemed possible that they were extra vulnerable children with a predisposition