The Consequences of Severe Early Deprivation as They Emerged in the Psychotherapy of a Girl in Foster Care

This paper sets out to demonstrate the effects of grossly inadequate care during the first three months of life on a little girl's later emotional development.

In describing early infant-mother interaction Wilfred Bion (1962) writes of the importance of the mother's capacity to take in the infant's projections of unbearably distressing emotions, to contain and work them over in her reverie and pass them back to the infant in modified and more manageable form. Bion talks of the infant who has had repeated experiences of this kind of mental containment introjecting the experience of a containing mother and learning progressively to contain himself. Esther Bick has found that the infant who can identify with a mother capable of containing his anxieties in this way, by introjecting that capacity, perceives the containing function in bodily terms as a skin which holds him together. In her paper “The Experience of the Skin in Early ‘Object Relations” (1968) Bick describes examples where lack of such containment in infancy led to disturbances and defects in the experience of the skin as a container and substitute means of engendering the illusion of containment were resorted to. Bick named these secondary attempts at self containment “second skin” phenomena. However, the second skin container does not achieve integration of the personality which is felt to remain in unintegrated bits in danger of falling apart if not continuously held together by these contrived means. This is always a precarious and fragile state.

It seems then that the infant does not start life feeling all of a piece inside his own skin. Normally, the experiences of early empathic containment by the mother, stressed by Bion and Bick as essential for the infant's healthy mental development, would be accompanied by repeated experiences of being picked up and held physically giving rise to tactile sensations in the infant's skin while he was held and handled. I would envisage this as a process in