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In 1968 I presented a paper built around clinical experiences and infant observations ‘concerned with the primal function of the skin of the baby and of its primal objects in relation to the most primitive binding together of parts of the personality not as yet differentiated from parts of the body’ (Bick 1968). There I described some of the evidence suggesting that in the earliest times the parts of the personality are felt to have no inherent binding force and fall apart unless passively held together, an experience indistinguishable from feeling the body to be held together by the skin. The suggestion was also made that in the event of defective development of this containment function other ‘secondary skin’ devices may arise, in collaboration with particularities of the maternal care, such as muscular or vocal methods. The consequences for personality development were briefly illustrated, with special reference to ego strength, pseudo-independence and tendency to disintegration.
In the present communication I wish to extend those findings and to investigate them in greater depth. The same child, Mary, whose material served originally, will most usefully open the area to investigation if described in somewhat greater detail. She came to me for analysis at the age of three and a half years for reasons of severe general retardation which relentlessly followed on from a difficult birth; the mother had a Caesarean section after a prolonged and futile attempt to deliver her normally. In the very first week she manifested severe clamping on the nipple so that it could hardly be removed from her mouth, and in the second week the mother lost much of her milk. Mary then became a lazy feeder but was always impatient to come to the breast, which she would not surrender until she was eleven months old. She was quite intolerant to separation from the outset, so that mother could never go out in the evenings, all of which was greatly aggravated when she developed eczema at four