Chapter XIII. Paediatrics and Psychiatry1 [1948]

I HAVE CHOSEN the subject ‘Paediatrics and Psychiatry’ for my address because of the nature of my work. I am a paediatrician who has swung to psychiatry, and a psychiatrist who has clung to paediatrics. In an address from the Chair it is excusable, even usual, for the speaker to draw on experience that is peculiar to himself. My position, as I am a worker in two fields, ought to qualify me to communicate something that has interest for the children's doctor and also for the doctor whose work is concerned with the insane. It is, of course, inevitable that one who works in two subjects must sacrifice some degree of expertness in each.

The researches that more or less started with the pioneer work of Freud have established the fact that in the analysis of psychoneurosis the patient's childhood turns out to have harboured the intolerable conflicts which led to repression, and to the setting up of defences, and to the interruption in the emotional development of the individual, with formation of symptoms. Naturally, therefore, research became directed towards the emotional life of children. It was soon found that the reconstruction which adult patients gave of their childhood conflicts—conflicts associated with their instinctual ideas and experiences—could be seen in children, and seen clearly in the analytic treatment of children. It was not long before it began to be wondered whether the more psychotic illness of adults might not relate to the experiences of infants. Gradually a highly complex theory of the emotional development of the human being has been worked out, so that with all our terrible and at the same time exciting ignorance, we now have useful working hypotheses, hypotheses, that is to say, that really work. There is now sufficient material available for attempts to be made to formulate things about infants which