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It is my pleasure to comply with the request of the Programme Committee by making a few comments about Dr Lipton's methodical and lucid lecture (this issue). Since there are no points with which I fundamentally disagree I would like to formulate a few thoughts which arose while reading his discourse, particularly with reference to points 1 and 2.
The subject of maternal deprivation remains an important one. By and large there seems to be an increasing tendency for neurotic tension to be discharged either in addiction or in that which we commonly refer to as psychopathic behaviour; destructive aggression to be specific. People tend to take two directions when trying to escape inner conflicts and the corresponding painful emotions: acting out of tensions and addiction, one of the greatest and most difficult problems in modern clinical psychiatry.
Two personality traits visible in all individuals with a predisposition to these forms of escape are: low frustration-tolerance and poor impulse-regulation. We do know that a warm relationship between a mother and child is a necessary condition for the development of effective impulse-regulation and frustration-tolerance, although it is, of course, more complicated.
A lack of security and impossibility to identify with parents who have a more or less structured superego and ego ideal make it impossible for many children to learn to cope with disappointments, to bear the grief inherent in each frustration and what is probably more essential, to conquer the grandiose fantasies that so often serve as a solution to frustration yet simultaneously increase the child's vulnerability. Of course we are aware of social factors which can also play a role in this respect.
No discussion about the relationship between child development and general psychiatry would be complete without mentioning Dr Mahler's research, so aptly summed up by Dr Lipton.
Insight into these stages of development and their disturbances brings us closer to an ans