The Vulnerable Child Discussion Group, which in 1992 celebrated its thirtieth anniversary, has announced the publication of the first of six volumes collecting the often seminal papers presented before it.
Theodore Cohen, who has chaired the group since 1973, notes proudly that many issues now in the mainstream of concern, child sexual abuse in particular, were first addressed in its discussions. The volumes, to appear under the imprint of International Universities Press, will make available to readers nearly seventy contributions by such eminent figures as Eleanor Galenson, Judith Kestenberg, Paulina Kernberg, and Sally Provence.
When the group was established, very little was known about the normal or pathological development of children, and even less about issues specific to poor or handicapped children. Although work was proceeding at the Hampstead Center in London, little research was under way in the United States. Indeed, many analysts questioned the very existence of “child analysis,” and the feeling was abroad that culture and the family were not proper objects of analytic concern. The Association for Child Psychoanalysis (ACP), founded in 1965 by Marianne Kris to accommodate nonmedical child analysts, did not yet exist; the Academy of Child Psychiatry numbered barely 200 members; subspecialty board examinations in Child Psychiatry had been established for only four years; and no organizations at all existed for adolescent or infant psychiatry. In short, very few people were then engaged in work with children. There were few certified child psychiatrists, and the views and data of workers without medical degrees were held suspect. Further, it was a time when the theories of Mahler, Stern, Kohut, Emde, and Greenspan, now so familiar to workers in the field, had not yet seen the light of day.
In 1962, at the Saint Louis meeting of The American, the Committee on Social Issues was directed to redress the situation. To that end, a Subcommittee on the Vulnerable Child was created, with Eleanor Pavenstedt as chair. Pavenstedt, who had devoted much of her life to work with poor children, had been working toward such a group for many years. With extensive knowledge of the poor black population
of Boston, of depressed ghetto mothers and infants showing failure to thrive, she was committed to the idea that child analysts needed a deeper understanding of how environment affects the psychological development of children. Under her guidance, and with the help of Sylvia Brody, Jeanne Spurlock, and J. Alexis Burland, the group began to collate all that was then known on the subject and to formulate research objectives. In 1973 Cohen joined Pavenstedt as co-chair, an arrangement that continued when in that same year the subcommittee became known as the Vulnerable Child Discussion Group. Upon Pavenstedt's retirement in 1973, Cohen remained as sole chair.
Unfortunately, an early attempt to collate information from institutes with child programs ended in failure, as many groups simply felt unable to respond—surely a discouraging measure of the lack of data and theory at that time. In fact, even much of the research on poor children ended prematurely because of “burnout” by researchers or lack of funding. Pavenstedt herself eventually gave up her work out of concern for the safety of her staff, and groups in New York, Washington, and Philadelphia met similar fates.
In these early years, the group met whenever child analysts convened in sufficient numbers—at the twice-yearly meetings of The American, the annual meetings of the ACP, meetings of the World Association for Infant Psychiatry (WAIP), and the International Association for Child Psychiatry—as often as five times a year. Interest ran high, and the meetings served to focus participants and cross-pollinate their work. A major effort was the work on vulnerability and high-risk children by E. James Anthony and Albert Solnit, who attempted to identify and define the kinds of childhood experiences that can distort development. “High risk” was defined as describing children who have been subjected to poverty, divorce, war, major trauma, or sexual or physical abuse, while “vulnerability” referred to deficits present from birth—e.g., prematurity, slow neurological development, and genetic disorders. In 1972 the discussion group took its official place on the scientific program at meetings of The American.
Beginning in 1980, the group reduced its meetings to three a year—those held at the national gatherings of The American and the ACP. As child analysts continued to present data from their expanding research, interest grew among the general analytic membership, and research groups proliferated. Today the group's work has expanded well beyond its early emphasis on the socially disadvantaged and the first years of life, while retaining an emphasis on the study of environmental influences on internal structures.
Since 1990 the group has addressed various challenges to psychoanalytic theory and practice. Because many children seen in treatment show evidence of difficulties beyond the neurotic, theoretical and technical innovations that take into account both deficit and conflict are required for their proper treatment, and the group has in consequence served as a lively forum for new approaches. Donald Cohen has presented work on the concomitant use of drugs in the analysis of certain types of children; Robert Emde, who eschews the use of free association with children, has conducted research on the development of the affective core and moral development; and Stanley Greenspan has examined the psychoanalytic treatment of children with pervasive developmental disorders.
In 1991 The American acted to bring the Vulnerable Child Discussion Group further into the fold. With the agreement of the ACP, the group was made a section within The American. In addition, publication of its proceedings was authorized, and a research fund was established for the study of vulnerable and high-risk children. According to Ted Cohen, Anna Freud was always an enthusiastic supporter of the vulnerable child group; the conflicts and developmental arrests of childhood were an ongoing concern throughout her life. In fact, the Hampstead Center has had a special relationship with the group for the entire thirty years of its existence. Hansi Kennedy has presented to the group several times, and many Hampstead graduates regularly attend its meetings.
With publication of its proceedings, the work of the Vulnerable Child Discussion Group will be available to child analytic programs the world over, at a time when child analysts are assuming leadership roles in the most prestigious psychoanalytic organizations—Joseph Sandler as President of the IPA; Bernard Pacella and Judith Schachter as President and President-Elect of The American. In addition, child analysis has extended its influence into previously less analytic areas. The World Association for Infant Psychiatry, for instance, was organized in 1980 by analysts Eleanor Galenson and Justin Call. Cohen served as its first treasurer, and several analysts have served it as president. Just this year, a joint meeting has been planned between Division 39 of the American Psychological Association and the ACP; Bertram Cohler, a new member of the latter, is a past President of Division 39.
All of this would seem to suggest that child analysis has finally come of age, and that its present vitality may be traced, in no small measure, to the efforts of the Vulnerable Child Discussion Group.