Drive Theory in Diagnosis and Treatment

A number of writings have been instrumental in providing me with some orientation when working with patients. The article, “Drive Theory in Diagnosis and Treatment” by Dr. Meadow is one of them. It is so much a part of my thinking that I seldom reread it, except when I'm using it in teaching, but rereading it again for this project was a particular pleasure. The paper offers a framework for thinking about patients diagnostically according to very early patterns of handling stimulation and tension states. As she does in many of her writings, Meadow attempts to describe the earliest levels of infantile experience, pre-object and pre-self object, when there is no differentiation between inner and outer, but the infant is beginning to organize representations of sensations as positive or negative, arousing or calming, and the impressions of the other as benign or dangerous, gratifying or frustrating. The balance between positive and negative, arousal of rage versus gratification of need, feelings of fusion versus aloneness with one's arousal states, and managing intrusions, even violence, through discharge or withdrawal—this is what we mean by a focus on drive states, discharge patterns and management of tension.

How can we think about this early time in a way that is useful to us as analysts? How does the infant begin to perceive and filter