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This paper contextualises Bick's contribution historically, particularly in relation to Winnicott's work which challenged the Kleinian tradition to provide a developmental account of psychotic phenomena that would give a role to environmental factors. A difference in emphasis between Bick's early and later account of the functions of the skin in object relations is identified, which to some has suggested a greater distancing from a Kleinian position. A review of contemporary developmental psychology evidence argues for sophisticated coordinations in many perceptual, motor and communication systems in human neonates that apparently disappear within the course of the first few months, to be gradually re-coordinated later in development. The attempt to explain these phenomena has demonstrated that it is necessary to incorporate both integrative and differentiation processes into developmental accounts. While many of Bick's observations and conceptualisations have found confirmation in empirical research, it is argued that the significance of the integrations demonstrated for human neonates is greatly illuminated by Meltzer's (1988) account of the aesthetic conflict. One of Bick's major contributions remains her identification of a range of existential and catastrophic anxieties as universal aspects of human psychic experience, even if these are not always recognised in consciousness.