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In her introductory remarks, Miss Isaacs calls the temper tantrums of children 'manifestations of acute anxiety'. 'The child feels he is up against some force which he cannot control or alter, a person who will defeat all his wishes, rob him of all pleasure, restrict all his movements and reduce him to complete helplessness.' The decisive rôle in this respect is played by 'internal objects' according to Melanie Klein. The child 'is fighting a phantasy mother, rather than the real one with whom he actually struggles'. The analysis shows that this 'phantasy mother' is thought of as being in the child's interior. It is, according to Isaacs, the interest for the dangers inside the body which explains to us that the child in the temper tantrum does not pay attention to outer reality at all.
This conception is illustrated with two case histories, one of a child and one of an adult. The child developed temper tantrums after severe real traumata—loss of a loved nurse and the birth of a sibling—and Miss Isaacs is of the opinion that the tantrums were determined by fantasies of being persecuted by internal objects which fantasies were mobilized by the real events. The adult patient had, as a child, observed epileptic spells of his mother. Unconsciously he not only thought that those spells were due to his own sadism, but they also are said to be felt by him as a proof of the effectiveness of his dreadful fantasies about internal objects.
Miss Isaacs summarizes her standpoint as follows: 'The child's screaming, struggling and rigidity in the tantrum represent his attacking and being attacked by his enemies within and without, against whom he must call up every resource of body and mind, since his life depends upon his getting them once again under his control.'