For over 20 years members of Four association have been studying the psychological development of children burdened by poverty, by mental and physical illness, and by discrimination on the basis of race, ethnic background, and sex. In 1969, the Committee on Social Problems, under the chairmanship of Robert Dorn, created a subcommittee to study such children. Eleanor Pavenstedt of Boston was appointed the first chair.
It was natural that this quiet but determined woman be selected; Pavenstedt and her group of Boston co-workers had been urging for some years the establishment of a group within The American to “study the first few years of life of with the goal of preventing mental disease.” Pavenstedt firmly believed that child analysts needed to broaden their understanding of how the environment could affect the psychological development of children. For years she had urged young clinicians with whom she worked to do assessments of children in the homes, housing projects, and neighborhoods in which they lived. She was in favor of family work and of creating mental neighborhood health clinics where people would be not only treated but educated in caretaking techiques that might promote better mental health.
Under the aegis of The American and with the help of Sylvia Brody, Jeanne Spurlock, Alex Burland, and others, Pavenstedt brought together clinicians and researchers to study aspects of child development that were to remain timely topics for the next 20 years. She urged her newly formed subcommittee to study 1) the development of the sense of self and of reality orientation in children, 2) the regulation and organizing function of the primary caretaker in fostering a child's ego development, and 3) the manifestation and modification of aggression in children.
In 1972, the first Vulnerable-Child Discussion Group was held as part of the offical scientific program of The American. It has continued to meet ever since. Theodore Cohen, who became its chairman in 1973, has led the group for the past 18 years. This discussion group is the most enduring and best-attended discussion group in the history of The American. Between 60 and 100 participants attend each meeting. Many of them, like Jo Ann Fineman and Stanley Cath, have been there since its inception. Fineman attends regularly because “it is the one study group on The American that has continually focused on early devolpmental issues from a psychoanalytic point of view.” Cath finds in it the important interface between child and adult analytic work where new ideas are welcome. For Eleanor Galenson, who has presented her work there many times, it is a “most interesting group of innovative researchers who venture outside the borders of usual psychoanalytic thought.” The group has helped spawn countless publications and helped many young, as well as more experienced, researchers develop their work through presentation and discussion.
The secret of the group's success is largely attributable to Dr. Cohen, who carefully orchestrates each meeting, in collaboration with the Committee on Social Issues. He selects the topic for dicussion, chooses the researchers who present their work, and selects the discussant. Written material on the topic to be discussed is precirculated to group members. Minutes of each meeting are available to anyone interested.
Reading the minutes, which M. Hossein Etezady has kept over the last 14 years, is itself an education in child development. In them one finds that such researchers and theorists as Judith Wallerstein, Erna Furman, Sally Provence, Anne-Marie Sandler, Gerald Stechler, and Sam Ritvo, to name but a few, have presented their work on a variety of topics violence in children, the effect of divorce, vulnerabilities in reconstituted families, the efficacy of early intervention with infants, body image and internalization, issues in termination, and, most recently, the effects of sexual and physical abuse. While the discussions of the group have broadened to include more than the socially disadvantaged and now include development well beyond the first few years of life,
Dr. Cohen's selection of topics remains designed to study the outside influences on internal structures. “We try,” he says, “to integrate classical psychoanalytic principles with newer research.”
In conjunction with his duties as chairman of the Vulnerable-Child Discussion Group for The American, Dr. Cohen also chairs each year a similar discussion group at the meetings of the Association for Child Analysis. Thus, as The American's president, George Allison, noted, Dr. Cohen's work “is an important link between the two organizations” and helps forge stronger bonds between child and adult analysis. A man of boundless energy and consummate organizational skiils, Dr. Cohen plans his programs a year or two in advance.
At the winter meetings of The American in 1991, the topic will be “Affective Development in Vulnerable and High-Risk Children.” Drs. Emde and Osofsky will present their work. Jules Glenn will be the discussant. Stanley Greenspan will present his research on early ego development at the dicussion group to be held as part of The American's program in the spring of 1992 in Washington, D.C. At the Association for Child Analysis meetings in Atlanta next spring, the topic will be “Nursery Research from the Hampstead Clinic.”
Two decades have not diminished Dr. Cohen's enthusiasm for his work. Nor has the interest of those who attend his group slackened. In fact, members are full of suggestions for future meetings. Jo Ann Fineman would like to see more emphasis placed on research into the analytic treatment of children. Eleanor Galenson favors further study of the psychopathologies of infancy, such as sleep disorders and early problems of gender identity. She is also interested in discussing the effect of surgical procedures on chidren and its sequelae in both mother and child. Clearly, there is no dearth of ideas or of energy as the Vulnerable-Child Discussion Group enters its third decade.