Developmental Aspects of Psychoses

The concept of developmental lines provides an additional perspective from which to view childhood psychopathology (A. Freud, 1965). Development along a particular line will be impaired by quantitative or qualitative changes in instinctual drive endowment, by some fault in the maturation of the ego functions of motility and perception, by temporal factors which induce a too rapid or too slow development of the ego vis-à-vis the drives and by the effect of errors of omission and commission on the part of the parents. These 'developmental sources of disturbance' (A. Freud, 1963) lead to disharmony and to conflict. This conflict is to be distinguished from the internalized conflict which prepares the ground for the neuroses of childhood and adult life. Symptoms in childhood can be a consequence of these psychical disharmonies and as such their origin lies in developmental sources rather than in those of conflict.

The suggestion that there can be a non-conflictual source of pathology in children (A. Freud, 1963) has important implications for the psychoanalytic study of the functional psychoses. The phenomena which characterize these states are not satisfactorily explained by a psychopathology which looks to conflict as the principal source of the morbid process despite claims to the contrary. The fact that identical danger situations and identical conflicts are to be found in neuroses and psychoses has always led to the thought that some additional factor must be present to account for the differences in the symptomatology. Freud (1911) must have had such an idea in mind when he said:

We can no more dismiss the possibility that disturbances of the libido may react upon the ego-cathexes than we can overlook the converse possibility—namely, that a secondary or induced disturbance of the libidinal processes may result from abnormal changes in the ego. Indeed, it is probable that processes of this kind constitute the distinctive characteristic of psychoses (p. 75).