Author's Response

The discussants have suggested that the psychoanalyst who presents a paper on a social problem should also direct his attention to the sociocultural and political causes of these problems. Sociocultural and political views on the origins of multiple uncontrolled pregnancies and their results have stressed secondary factors, i.e., the impact of external forces on the life of the individual or group. My research describes the unconscious or internal forces that act on the life of the individual or group. I believe this knowledge

in conjunction with knowledge of the external forces should offer more constructive programs for the individual or group who need and request them.

I agree with Dr. Grier that the characteristics of the mothers described in my paper are observed as well in families of higher or even highest incomes, with similar impacts on the lives of the children. The psychopathology that determines the development of the multiproblem and the hard-core is found in varying degrees within the entire range of sociocultural-economic levels in our society. We find the same fixations on infantile mother-child object relations, with multiple ego and superego defects. These severe disturbances come to the attention of the psychiatrist or psychoanalyst whether he serves as a consultant for social agencies, in hospitals, or in private practice. If he is a child analyst, as is the author, he will observe the psychopathology of the multiproblem in the behavior disturbances, the learning disorders, and the severe problems of adolescence where the thrust to maturity and autonomy is met by the regressive pull to the early motherchild fixations.

As a psychoanalyst I have tried to present the unconscious determinants of these severe problems. Individuals who become the multiproblem and hard-core find themselves on public assistance, develop severe problems with behavior, and become dropouts. What can we do to interrupt these serious consequences in their lives? The multipro