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'Maturation' (the processes of growth to some extent independent of the environment) refers to the intrinsic and prospective aspects of ontogenetic patterning. 'Development'
indicates those aspects of growth in which the effects of environment and maturation are intimately fused. Clinically they can hardly be differentiated and are used interchangeably. Personality has a reciprocal relation to growth and development. When maturation occurs at the proper rate and sequence, personality grows in a way partly understood. Factors that impair the drive for normality or frustrate the maturational sequence may create a basic primary stress which is biologically determined. This primary stress alone or with secondary environmental stresses may seriously weaken the ego. These primary disturbances may so strain the child's environment that they further aggravate the basic defect because of the anxiety induced in the organism. Thus a vicious cycle of reverberating anxieties is set up, often very early in childhood. Primary tensions are constantly fed by secondary ones and the latter may be perpetuated long after the primary maturational defect has been overcome.
Deviant growth in body image or ego boundaries, language, motility, and gestalt perception are important. The body schema (biological and psychic ego) penetrates to the depths of identification and introjection within the ego and expands to the outer limits of all projective boundaries of the organism and is in relation to space and time. Defects in integration of body image can become manifest very early in life. Organization in space, language, motility, and gestalt perception are related. As lying, sitting, and crawling give way to walking and running, there occurs a change in forces of the ego, and conflict over the child's dependence and independence begins. Delayed or precipitous motility results in anxiety in the child and parents. Deviation in development of speech causes in the organism a stress