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Not having at our disposal as yet any systematic study of infant development from birth, we are choosing an example from the case histories of our children with atypical development and hope to be able with these data to offer a contribution to the understanding of the formation of psychic structure; namely, how the ego ("a substructure of personality defined by its functions," H. Hartmann) is molded under the impact of reality on the one hand, and of the instinctual drives on the other. With the same material, we shall highlight the vicissitudes of libido and aggression and their forms of expression. This approach, which stresses the significance of the early object relationship (emotional climate) for the understanding of child development, does not question the existence of preparatory autonomous stages of the ego, although for reasons mentioned above it does not include a discussion of individual differences in infants at birth.
A few words to justify our procedure: from the study of this group of atypical children, we have learned that their personality structure represents fragments of various stages of development, showing high achievements of some of the executant functions of the ego, while other manifestations of the ego or instinctual drives remain crippled or on a much lower level (18). These children show manifold individual differences but have in common a disturbance in their relationship to people, manifested in different forms of isolation or withdrawal. However, it has been our experience that with the gradual establishment of confidence in the person of the therapist, a breach in the isolation can be made which leads to a progressive building-up of relationship to people and the outside world.
We can follow in such cases the unfolding of the capacity to recognize the existence of other people than themselves (i.e., object finding) and observe by what means the developing ego deals with the demands of instincts (sexual or aggressive) and reality