The author proposes a general developmental frame that integrates the psychoanalytic theory of development, rooted in psychoanalytic object relations theory, with neurobiological aspects of the development of social cognition, the theory of mind, and the complex issue of empathy. It represents the next step in the integration of the author's earlier work on the developmental hierarchy of motivational systems with recent findings on affective neuroscience. A general conclusion relates to the parallel and mutually influential development of neurobiological affective and cognitive systems, ultimately controlled by genetic determinants, and psychodynamic systems, ultimately corresponding to both reality and motivated distortions of the internal and external relations with significant others. From the point of view of the psychoanalytic treatment of severe psychopathology, with fixation at the level of identity diffusion, the concepts of interpretation and mentalization as well as structural change are reformulated.