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The case of a four-year-old boy is described with a view to assessing the contribution made by maternal deprivation to his severe ego disturbances. Both parents were withdrawn and the area of traumatic handling embraced all the early milestones. Restriction of movement and enforced loneliness were features. Symptoms of echolalia, awkwardness, confusion of pronouns, and inability to establish relationship fitted into the picture of schizophrenia, but there were significant symptomatic omissions.
The introjection of the vague withdrawn mother seems to have been a factor in producing a reality-shy ego. In the child's almost objectless world, an increase in primary narcissism with primary aggression partly turned against the self were inevitable features. The author offers the speculation that internalized aggression may have taken as its object the non-autonomous ego functions and handicapped the process of synthesis.
The retarded speech, still at an imitative level at four years, contained suppressed oral and anal elements beyond which the child had not progressed. An anal regression, activated during treatment, revealed an early fear of abandonment. A secondary aggression (anal spite), superimposed on these