On Child Psychosis and Schizophrenia—Autistic and Symbiotic Infantile Psychoses1

It seems that psychosis is the sad prerogative of the human species. It is not confined to adults alone. Animals are born with well-developed instincts which guarantee their independent individual survival soon after birth. In the human young, however, these animal instincts (in terms of sense of track) have atrophied and became unreliable and, as Freud stated, the ego had to take over the role of adaptation to reality which the id neglects. The somatic corollary of ego development is the central nervous system, which is in a very immature state at birth. The neonate appears to be an almost purely biological organism with instinctual responses to stimuli not on a cortical but essentially on a reflex and thalamic level. There exist only somatic defense mechanisms, which consist of overflow and discharge reactions, whereby cortical inhibition is undeveloped. Thus, we may say, that at birth there exists only a rudimentary ego, incapable of retaining stimuli in any degree of tension, or else, that prevalence of the undifferentiated phase of personality development persists for a comparatively long period of extrauterine existence (Hartmann, Kris, Loewenstein, 1947). Yet the psychobiological rapport between the nursing mother and the baby complements the infant's undifferentiated ego. This normal empathy on the part of the mother is the human substitute for the instinct on which the animal can rely for survival. In a quasi-closed system or unit, the mother executes vitally important ministrations without which the human young would be unable to survive. The intrauterine, parasite-host relationship within the mother organism (Deutsch, 1945) must be replaced in the postnatal period by the infant's being enveloped, as it were, in the extrauterine matrix of the mother's nursing care, a kind of social symbiosis.

The young infant is readily thrown into affectomotor storm-rage reactions which, if not relieved by the mother's ministrations, may result in