Bruch, discussing the interaction between the infant and mother necessary for the infant's normal emotional development, calls attention to the prerequisite need of the infant to identify correctly sensations indicating biological urges. Only then can the child begin to differentiate himself from external objects. This leads to the development of body concept, self-awareness, and self-effectiveness. If the infant fails in this task in a major way, the author feels that all stimuli coming from within the infant, whether they be bodily sensations, thoughts, or feelings, are experienced as originating in the external world. This causes a predisposition to schizophrenia.

An interesting side comment is the explanation of the poor development of Harlow's monkeys; reared by synthetic terry cloth mother surrogates, they were deprived of the responses of live animal mothers who initiate behavior in their young. Thus, the infant monkey was also deprived of the type of learning essential for the organization of adaptive behavior.