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There is Something Comforting about the word developmental when it is used in psychoanalysis. It promises to accomplish, as well as to explain, change by using principles that apply to everyone as they grow older. These are the kinds of changes that seem to occur spontaneously, as well as through interaction with others, including an analyst.
A close look at the disparate ways development is used in psychoanalysis dispels this sense of certainty. There are many aspects of development, some measured and others inferred. Only a few of these concepts become prominent within any general analytic theory. Because a developmental event is likely to be understood through an observer's theoretical orientation and personal prejudices, clinical judgment about a patient's developmental status and needs becomes highly personalized. As individuals evolve from childhood, they acquire knowledge, prejudices, anxieties, and a style of being. Experience is processed in ever more complex ways, forcing development and creating conflict simultaneously. People are seldom free from such conflict (Greenberg, 1991; Mitchell, 1993): there is intrapsychic conflict, conflict among semiautonomous states of mind (Frankel, 1995), and conflict between an individual's wishes and capabilities and the world's expectations. More complexity is added by the influence of partners on each other, the intersubjectivity of the analytic couple. Also, the subject's needs and conflicts change constantly. Developmental pathology, arrested development, and developmentally acquired distortions in need and perception are similarly shaped by personal attributes and conflicts and through interaction with others. Any effort to effect change developmentally, including through psychoanalysis, has analogous personal and interpersonal determinants.
How, then, can principles of normal development help us understand the clinical requirements for recognizing and addressing our patients' developmental needs? Inasmuch as developm