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The earliest phase of infant development is called by the author 'the holding phase'. By this is meant not only physical holding but also the protection of the infant from physiological insult. This is the stage of primary process, primary identification, auto-eroticism, and primary narcissism. Beginning with gestation, the normal mother focuses her attention on the developing child and through a process of projective identification responds to the child's needs on a twenty-four-hour basis. When the child reaches the next stage of differentiation from mother, she responds to the child's need for separateness by relinquishing her involvement. This maternal care complements the infant's weak ego, permitting him to grow powerful and stable. The infant develops means for going beyond this stage through the accumulation of memories of care, the projection of personal needs, and the introjection of care details, accompanied by the development of confidence in the environment. Anxiety at this period is experienced as annihilation. Without proper maternal care, the ego is distorted or destroyed.
This earliest stage is not recoverable as memory in psychoanalysis. In working with borderline cases, where there has been a disturbance in this period the psychoanalyst, like the mother, has to be sensitive both to the patient's need for symbiosis and for separateness. The study of the transference-countertransference relationship can furnish us with valuable information about this earliest period of ego development.