Neurodivergence in Childhood Psychopathology: Integrating Constitutional Factors with a Dynamic Approach

This paper is concerned with children whose subtle central nervous system differences interact with environmental factors to lead to difficulties that cannot be fully explained by either traditional psychodynamic formulations or reductionistic organic formulations. We present a descriptive analysis that integrates neurocognitive descriptions of idiosyncratic processing styles with psychodynamic accounts of disorders in the affective, symbolic and interpersonal domains. In so doing, we are attempting to bridge a gap between mental health professionals and those in related disciplines: Mental health professionals often underestimate the importance of children’s constitutional difficulties, while educational specialists, occupational therapists, speech and language pathologists and pediatricians frequently overlook the transaction of these difficulties with emotional and interpersonal functioning. This paper integrates current knowledge of constitutional and environmental factors in a single model that looks at children’s personalities and relationships as a unified experience that cannot be reduced or explained with reference to a single set of factors, however important. Our approach is non-linear and applies developmental systems paradigms, such as the “transactional” model, and is especially influenced by infant development research. Specific problems in child psychotherapy are discussed and technical suggestions are offered. Interdisciplinary assessment, intervention and treatment planning are stressed.