Cognitive Development1

As perhaps often happens, I became preoccupied with a problem—in this case the problem of cognitive development—without knowing why it was of such interest to me. I subsequently discovered some of the reasons, and by way of introduction will outline what seems to me the most rational one.

Briefly then, and with a good eal of over-simplification, I think I became preoccupied with cognitive development as the result of reaching the third of three stages in my approach to mental illness—stages which very roughly reflect successive attitude which were fairly common in the psychoanalytic movement as a whole.

In the first stage, 40 or 50 years ago, my dominant assumption would have been that mental illness is the result of sexual inhibitions. This may be profoundly true; but naively understood can lead to very superficial analysis. Moreover, in a subtle way, it can encourage a patient to adhere to the unconscious belief that, instead of giving up his Oedipus complex, he can realize it with the analyst's help and so be master of the world.

In the second stage, 20 to 25 years ago, my dominant assumption would have been that mental illness is the result of unconscious moral conflict. This supplements, rather than contradicts, the earlier view, and implies a better understanding of Freud's concept of the superego with Kleinian additions about the complexity of the early ego-superego relationship. In particular, a harsh superego is thought of as the result, less of a harsh upbringing, than of an "intra-psychic paranoia" (if I may coin the word). The receipt, therefore, is to try to get the patient to reintegrate the projections which distorted his superego—a process which precipitates what Klein called the depressive position, and provides a motive in depressive guilt for curbing attacks on improved internal figures.

In the third and recent stage, my dominant assumption is that the patient, whether clinically ill