On Human Symbiosis and the Vicissitudes of Individuation: Volume I, Infantile Psychosis: By Margaret S. Mahler, M.D., In Collaboration with Manuel Furer, M.D. New York: International Universities Press, Inc., 1968. 271 pp.

This volume holds much more than the title promises. It is not only an investigation of infantile psychosis but also of normal human development, illuminated through pathological deviations. The concepts, derived from the study of childhood psychosis, help us to understand severe neurotic and borderline conditions in adults and schizophrenic regression in the adolescent and adult.

The book is the outcome of observations made over a period of more than thirty years. As it combines material previously published with new findings, it is occasionally repetitious. But it allows the reader to watch the process of sharpening concepts through the accumulation of experience and increasingly subtle differentiating observations. A lively presence of ongoing thought provides a critical survey of the literature, especially of ego psychology.

In considering the etiology of infantile psychosis, Dr. Mahler regards the old controversy of constitutional versus experiential causation a moot issue. She believes the essential etiologic factor to be a predispositional deficiency which does not allow the infant to utilize his mother for homeostasis. In less vulnerable infants, chronic or recurring traumatization through organismic distress may make it impossible to experience the mother as the source for relief of discomfort. Mahler's studies do not bear out theories that implicate a 'schizophrenogenic' mother. She has found variations in types of parents and home climate, ranging from the 'average expectable' to the 'frigidaire' atmosphere (Kanner) and the psychotically violent. It is the type of interaction rather than the pathology of the mother that interferes with the essence of mothering. The infant's constitutional deficiency leads to the vicious circle of a pathogenic mother-child relationship. When psychosis has become manifest, the mother, of whatever type, has to give up her normal mothering function. Often the mother of an autistic child shows a withdrawal similar t