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June 9, 1964. INFANTILE TRAUMA. Phyllis Greenacre, M.D.
Dr. Greenacre's further studies of the nature, origin, and sequelae of pregenital disturbances reveal that there is a greater and more frequent incidence of disturbed conditions in the first one or two years of life in psychotic and severely neurotic patients, as compared to cases of anxiety hysteria and compulsion neurosis. In her papers on the predisposition to anxiety (1941), the author indicated that illness, injury, difficult birth process, and conditions in the mother that are passed on to the infant in his early dependent state may intensify narcissism, impair the developing sense of reality, and accentuate and prolong the tendency to primary identification. Clinically, frequency of compulsive masturbation and an unusual display of various habitual autoerotic responses during latency, as well as in the infantile period, were noted.
In contrast to those who define trauma as limited to sexual trauma, perhaps because of Freud's original belief that sexual trauma lay at the core of a neurosis, Greenacre widens her conception to include traumatic conditions which are unfavorable, noxious, or otherwise drastically injurious to the development of the young individual. She feels that in the preoedipal years and later there is a maturational pressure which will generally cause the child to reach out and utilize the slightest opportunities for experience. The child himself may act as the seducer and either get little response and suffer frustration, or attract a response which transcends his specific needs in content and intensity. While the fantasy that accompanies the experience is of primary importance, its later derivatives may be considerably influenced by whether the experience is active or passive, accidental or deliberate.
Dr. Greenacre discusses trauma under three general headings: 1, the significance of actual experience associated with fantasy; 2, the effect of early traumatic experience during the