Psyche, 22, Nos. 9–11, 1968: GERD BIERMANN (Psychosomatic Clinic for Children, University Child Hospital, Munich 15, Pettenkoferstr. 8a, Germany). Symbiotische Mutter-Kind-Beziehungen (Symbiotic mother–child relations)

Apart from the rare mother–child symbiosis described by M. Mahler, there are many other simpler and more frequent forms of symbiotic relations between mother and child. They develop in cases where the solution of the normal dependency of the first year of life has failed; manifestations are over-long breast feeding, many forms of sleeping disturbances (mother and child sharing the bed or at least the bedroom) and later on various forms of school phobias. Absence of the father (because of illegitimate birth of the child, divorce, death) tend to reinforce the original symbiosis of mother and child, particularly in the oedipal phase. Psychosomatic diseases will lead to regressive behaviour and help to fixate or re-establish the symbiotic relationship. Secondary symbiosis is the frequent outcome in cases of severe anomalies like cerebral disturbances, heart diseases and malformations of the child. During puberty and adolescence the tendencies for individuation are often associated with very ambivalent feelings of love and hatred in both mother and child. Indications of symbiotic relationships may be obtained by means of projective testing procedures like the 'Scenotest' and the 'Draw a Man' and 'Draw a Family' tests, taken from both the child and the mother. Simultaneous psychotherapy is the best method of dealing with this syndrome. In case of some psychosomatic illness of the child, the mother should not be trusted with the nursing; these are also the cases when rooming-in of mother and child is contraindicated.