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الرئيسية A Psychoanalytic Theory of Infantile Experience: Conceptual and Clinical Reflections (The New Library..
A Psychoanalytic Theory of Infantile Experience: Conceptual and Clinical Reflections (The New Library of Psychoanalysis, Vol. 16)
Eugenio Gaddini
Eugenio Gaddini, a pioneer within the Italian psychoanalytical movement, devoted a lifetime of research to the organization of infantile mental life. In this edited collection of his papers Dr Adam Limentani introduces Gaddini's key theories showing how they are closely linked to, but different from, the thinking of Phyllis Greenacre, Donald Winnicott and Melanie Klein. These ideas are of great clinical relevance for the treatment of adult patients, particularly in the understanding of psychosomatic disorders. The richness of the clinical evidence with which Gaddini supports his hypothesis, and the originality of his conceptions make this a rewarding and stimulating book for the practicing analyst and psychotherapist.
Categories: Psychology
الصفحات: 240 / 208
psychoanalytic254
freud239
ego192
infantile173
functioning145
psychoanalysis142
imitative122
aggression121
instinctual118
imitation117
gaddini106
psychoanalytic theory104
primal102
analyst96
libido93
infantile experience90
therapeutic88
theory of infantile87
libidinal87
bodily83
clinical74
psychoanalysts74
phenomena71
physiological70
primal scene69
fantasies68
psycho67
transference67
cathexes60
psychophysical58
kleinian55
pathological55
infant54
pathology53
introjection53
winnicott51
discharge51
imitations48
psychic46
klein44
identifications44
omnipotence42
fragmentary40
analysts40
sensory39
detachment39
vicissitudes39
hypothesis39
psychoanalytical38
mental functioning37
sensations36
psychical36
catastrophe35
organism35
perceptions34
defences33
Health and Lifestyles
Mildred Blaxter
A Psychoanalytic Theory of Infantile Experience
Eugenio Gaddini (1916±85) was a pioneer within the Italian psychoanalytical
movement. His research into psychic conflicts in adult patients led him to realize
that most archaic and primitive mental processes were close to body functions.
Focusing his researches on the psychophysical syndromes of early infancy, he
then sought to determine which particular functions contribute to the creation of
the mind.
For this edited collection of Gaddini's papers, Dr Adam Limentani has
selected those covering three main themes: imitation, which Gaddini saw as a
central factor in early development; ego formationÐthe processes of instinctual
drive arousal and the awareness of separateness from the object; and the way the
body becomes meaningful to the mind through the elaboration of primitive
defensive fantasies. In each paper Gaddini supports his hypotheses with ample
clinical material. Dr Limentani's interpretative and explanatory introduction
discusses what Gaddini and Winnicott had in common and where they differed;
the points of contact and difference with Kleinian theories; Gaddini's view of
imitation in the development of the mind; and his approach to psychosomatic
medicine. Above all Limentani stresses Gaddini's originality and independence
of thought.
For analysts unfamiliar with Gaddini's work, this book will open unexpected
vistas on perennial and familiar issues to do with the organization of infantile
mental life. His ideas have wide-ranging implications for the understanding of
child and adult psychopathology and its therapeutic treatment.
Adam Limentani is a training and supervising analyst of the British PsychoAnalytical Society, and a Fellow of the Royal College of Psychiatry, London.
The New Library of Psychoanalysis was launched in 1987 in association with the
Institute of Psycho-Analysis, London. Its purpose is to facilitate a greater and
more widespread appreciation of what psychoanalysis is really about and to
provide a forum for increasing mutual understanding between psychoanalysts
and those working in other disciplines such as history, linguistics, literature,
medicine, philosophy, psychology, and the social sciences. It is intended that the
titles selected for publication in the series should deepen and develop
psychoanalytic thinking and technique, contribute to psychoanalysis from
outside, or contribute to other disciplines from a psychoanalytical perspective.
The Institute, together with the British Psycho-Analytical Society, runs a lowfee psychoanalytic clinic, organizes lectures and scientific events concerned with
psychoanalysis, publishes the International Journal of Psycho-Analysis and the
International Review of Psycho-Analysis, and runs the only training course in the
UK in psychoanalysis leading to membership of the International
Psychoanalytical AssociationÐthe body which preserves internationally agreed
standards of training, of professional entry, and of professional ethics and
practice for psychoanalysis as initiated and developed by Sigmund Freud.
Distinguished members of the Institute have included Michael Balint, Wilfred
Bion, Ronald Fairbairn, Anna Freud, Ernest Jones, Melanie Klein, John Rickman,
and Donald Winnicott.
Volumes 1±11 in the series have been prepared under the general editorship of
David Tuckett, with Ronald Britton and Eglé Laufer as associate editors.
Subsequent volumes are under the general editorship of Elizabeth Bott Spillius,
with Christopher Bollas, David Taylor, and Rosine Jozef Perelberg as associate
editors.
1 Impasse and Interpretation Herbert Rosenfeld
2 Psychoanalysis and Discourse Patrick Mahony
3 The Suppressed Madness of Sane Men Marion Milner
4 The Riddle of Freud Estelle Roith
5 Thinking, Feeling, and Being Ignacio Matte-Blanco
6 The Theatre of the Dream Salomon Resnik
7 Melanie Klein Today: Volume 1, Mainly Theory Edited by Elizabeth Bott
Spillius
8 Melanie Klein Today: Volume 2, Mainly Practice Edited by Elizabeth Bott
9 Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph
Edited by Michael Feldman and Elizabeth Bott Spillius
10 About Children and Children-No-Longer: Collected Papers 1942±80 Paula
Heimann. Edited by Margret Tonnesmann
11 The Freud-Klein Controversies 1941±45 Edited by Pearl King and Riccardo
12 Dream, Phantasy and Art Hanna Segal
13 Psychic Experience and Problems of Technique Harold Stewart
14 Clinical Lectures on Klein and Bion Edited by Robin Anderson
15 From Fetus to Child Alessandra Piontelli
NEW LIBRARY OF PSYCHOANALYSIS
General Editor: Elizabeth Bott Spillius
A Psychoanalytic Theory of
Infantile Experience
Conceptual and Clinical Reflections
E.GADDINI
ADAM LIMENTANI
Foreword by Robert S.Wallerstein
First published in 1992
by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
a division of Routledge, Chapman and Hall Inc.
Brunner-Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2005.
ªTo purchase your own copy of this or any of T aylor & Francis or Routledge's collecti on of
thousands of eBooks please go to www.eBookstore.tandf.co.uk.º
© 1992 Andrea Gaddini and Sylvia Gaddini Morelli
All rights reserved. No part of this book may be reprinted
or reproduced or utilized in any form or by any
electronic, mechanical, or other means, now known or
hereafter invented, including photocopying and
recording, or in any information storage or retrieval
system, without permission in writing from the
British Library Cataloguing in Publication Data
Library of Congress Cataloging in Publication Data
Gaddini, Eugenio.
A psychoanalytic theory of infantile experience: conceptual and
clinical reflections/E.Gaddini; edited by Adam Limentani;
foreword by R.Wallerstein.
p. cm.Ð(New library of psychoanalysis; 16)
1. Cognition in infants. 2. Psychoanalysis. I. Limentani, Adam.
II. Title. III. Series.
BF720.C63G33 1992
155.42 23Ðdc20 92±1035
ISBN 0-203-01377-8 Master e-book ISBN
ISBN 0-415-07434-7 (Print Edition)
0-415-07435-5 (pbk)
by Robert S.Wallerstein
by Adam Limentani
On imitation (1969)
Aggression and the pleasure principle: towards a psychoanalytic
theory of aggression (1972)
Beyond the death instinct: problems of psychoanalytic research
on aggression (1972)
Formation of the father and the primal scene (1974)
On father formation in early child development (1976)
Therapeutic technique in psychoanalysis: research, controversies
and evolution (1975)
The invention of space in psychoanalysis (1976)
Notes on the mind-body question (1980)
Early defensive fantasies and the psychoanalytical process (1981)
Acting out in the psychoanalytic session (1982)
The pre-symbolic activity of the infant mind (1984)
The mask and the circle (1985)
Changes in psychoanalytic patients up to the present day (1984)
ROBERT S.WALLERSTEIN, MD
It has become a psychoanalytic commonplace that the past two decades have
witnessed the true internationalization of psychoanalysis and its literature, with
an increasing worldwide acceptance of, and accommodation to, our
psychoanalytic diversity, or pluralism, as we have come to call itÐa multiple
pluralism, in fact, of theoretical perspectives, of linguistic and thought
conventions, and of distinctive regional, cultural, social, and language emphases.
A major aspect and vehicle of that process of spreading dissemination and
accommodation has been both the increasing discourse across regional (or
national) and theoretical boundaries through personal scientific interchanges and
visits, and also the increasing translation, especially into English, of the work of
prominent psychoanalytic contributors from the other major and official IPA
language areas, French, German, and Spanish.
What has, however, to this point occurred far less, is the dissemination of
conceptions about psychoanalytic theory and praxis from those numerous enough
languages spoken in but one psychoanalytically populated country, of which
Italian and the Italian psychoanalytic literature is of course the most substantial
and vigorous exemplar. Psychoanalysts writing in those single nation languages
who hope to relate to, and to influence, the worldwide psychoanalytic
community, are caught in the dilemma of somehow appropriately dividing their
psychoanalytic contributions into those articles directed to their immediate
colleagues and countrymen in their own national psychoanalytic journal in their
native tongue, and those articles directed to the far larger external psychoanalytic
world, most often written in English and directed to the International Journal
and the International Review of Psycho-Analysis.
Eugenio Gaddini was an illustrious member of that small group of Italian
psychoanalysts who enthusiastically undertook this challenge. The collection of
thirteen of his papers, about half re-published from a span of over two decades of
the International journal, and the other half, spanning the same time frame, but
newly translated from Italian and now published in English for the first time, all
lovingly brought together and placed into a logical ordering by his long-time
close friend and colleague, Adam Limentani of LondonÐand with a beautifully
interpretative and explanatory long introduction by LimentaniÐattests superbly
to the success with which Gaddini played out his chosen role, as the interpreter
back and forth between the Italian and the worldwide psychoanalytic
What is revealed by Gaddini's papers, brought together in this way from two
languages, and sequenced with a logic expounded clearly by Limentani, is a truly
significant corpus of cumulative contribution to our conceptions of the earliest
phases of infantile mental development and the lifelong reflections of these
formulations in the various arenas of child and adult psychopathology and in the
issues for therapeutic technique that derive from those perspectives. Here
Gaddini poses for the English-speaking, and particularly the American, audience
a variety of conceptions, most of them highly original and interesting, others
perhaps seemingly old-fashioned and maybe even somewhat outdated, in what
has now come to be called the modern post-ego psychological era in
psychoanalysis.
The ideas that may sound anachronistic today are indeed the far fewer in
number, and they stem from Gaddini's firm anchoring in Freud's classical
metapsychology, with his especial continuing adherence to the economicenergic-quantitative metapsychological point of view. Within this framework
Gaddini formulates his own conceptionÐand here, differently from FreudÐof
the temporal primacy of the aggressive drives with their primary orientation
outward, over the libidinal, with their putative original orientation self-directed
and inward, with their various combined vicissitudes then of successful fusion or
not in the maturational and experiential unfolding of a normal or abnormal
developmental process. In describing this interplay, with the libidinal always
subsequent to and leaning upon the aggressive, Gaddini's formulations are novel
and do pique speculative interest, however much we do or no longer subscribe to
the drive-energic framework within which these formulations are cast.
For the restÐand it is indeed the great majorityÐGaddini's conceptions will
strike the reader unfamiliar with his work as inventive and highly original (and
modern-sounding) conceptions, that invite us to fresh vistas upon perennial and
familiar issues. His chosen conceptual domain is that of the organization of
infantile mental life, and he grounds his ideas very clearly in, or at least links
them very closely to, the theorizing of Melanie KleinÐthough he also gives a
detailed and thoughtful critique of the reach but also the limitations, as he sees
them, of Kleinian techniqueÐWinnicott, and, to a very substantial and surprising
degree, Greenacre. There is also clearly discernible a real linkage, though not
made as explicit, to the developmental conceptions of Mahler, including the idea
of the gradual psychic evolution, post-partum and over time, to what Gaddini
calls the `basic mental organization' (BMO) of infancy which marks (his words)
the `psychological birth' of the infant
Within this overall matrix, then, Gaddini develops a whole series of linked
conceptions and formulations, building incrementally one upon another; of
imitation as a primitive process of creating perceptual identity in a first
psychosensory developmental phase, and as antecedent to the next psycho-oral
phase of introjection (incorporation), leading ultimately through processes of
intermingling and fusion of these trends to developmentally mature
identifications; of (more broadly) what he calls the body-mind continuum, with
the evolution of the physiological response state through to mental symbolic
activity (of `needs' evolving to `wishes') and concomitantly of psychophysical
syndromes of a sensorial nature evolving to psychopathological syndromes of an
objectual or object-relational nature (with correlated psychosomatic and
psychological syndrome examples); of the progression in fantasy formation from
fantasies in the body, to fantasies on the body, to fantasies divorced from the
body; of the similar progression from loss-of-self anxiety, through the oscillations
of non-integration and integration anxiety, to, ultimately, the object-related
anxieties of the psychoneurotic state. Most interesting of all perhaps, during the
phase of triangulation leading into the Oedipal process, the issues of what
Gaddini calls `father formation', in which he distinguishes between the initially
`extraneous father' who intrudes upon the mother-infant duo from outside and
evolves, if all proceeds reasonably well, into the `external father' of the Oedipus
complex; distinguishing that psychologically from mother who is gradually
differentiated by the child from the originally undifferentiated unity into the
`external' Oedipal motherÐand the implications of this distinction in origin for
the unfolding developmental dynamic.
And Gaddini by no means leaves all of these provocative (and speculative?)
ideas on the understanding of the developmental process resting in the air for us.
He does essay in several chapters to develop their implications for our
understandings of child and adult psychopathology and its psychoanalytic
therapeutic amelioration. He develops in this the conceptions of what he
considers to be a pre-instinctual `magical imitative transference' or `transference
of need' (as dis tinguished from a transference of wish or of desire) where verbal
interpretations may prove completely ineffective and where recourse to the
`holding' conceptions of Winnicott (with echoes of the `empathic immersions' of
Kohut) is vigorously advocated. And at a number of points throughout the book,
Gaddini further elaborates his ideas of these `imitative transferences' (which
unhappily characterize not only specific kinds of patients, but as well specific
kinds of psycho-analytic candidates who seek to `become' analysts without
having to `be' analysts or `be analysed') as defences against object-related
transferences and as barriers against true internalizations and identifications,
upon which, after all, all analytical processes depend.
This of course is all just a naming of Gaddini's various quite original
conceptions which are laid out for us in this valuable new book. Limentani's
introduction defines and spells them out eloquently and places them then as
cumulative building blocks in a very distinctive view of psychoanalytic theory
and praxis. For the full immersion in Gaddini's creative thinking and in his very
particular contribution to the total worldwide psychoanalytic corpus, the reader
will have to repair to all the chapters in this book. It is a pleasure to help
introduce this, the essence of Gaddini's life oeuvre, in unified form, and reunited
into one language, to the English-speaking psychoanalytic audience.
I am greatly indebted to Professor Renata De Benedetti Gaddini, Dr Andrea
Gaddini, and Ms M.Mascagni for their help in organizing the bibliography, but
particularly for providing me with a great deal of information concerning the
author's thinking and conceptualizations. I can only express my admiration for
the work of Mr Philip Slotkin who translated Chapters 3, 4, 6, 7, 8, 11, 12, and
13. I am very grateful to Mrs E.Spillius for her support, guidance, advice, and
helpful suggestions in preparing this book. Finally, I wish to thank Miss Nancy
Dunlop for her patience as well as her invaluable contribution in preparing the
In the course of an informal discussion with some colleagues in 1985, shortly
before his unexpected death, Eugenio Gaddini was asked what was his special
field of interest in psychoanalysis. His spontaneous reply was as follows:
I must say that when I became deeply involved with psychoanalysis I was
particularly interested in the primitive perceptions as described by
Fenichel. At the time I understood that these were not really perceptions
but rather that they were sensations. The movements from sensations to
perceptions, as I saw it, led me to understand the importance of mental
development in relation to the early primitive body development. I was
also impressed with the extent to which the development of bodily
functions conditions the mind, creating models of functioning which we
later discover at the mental level. This created my interest in the study of
movements from sensations to perceptions on which I am still working on
the basis of the clinical material which I have accumulated. I think there is
still a lot of work to be done.
Here we have a clear statement from a man who throughout his life showed a
combination of scientific intuition and a tendency to put forward a hypothesis
with the determination to explore it, no matter how long that might take, and no
matter where it would lead. The readers of these essays can also safely expect
that clinical evidence in support of such hypotheses will be forthcoming. This is
in keeping with his belief that there could be no research in psychoanalysis
without clinical reference, a point he stressed in his introduction to the Italian
edition of The Work of Melanie Klein by H.Segal. There he wrote: `In
psychoanalysis research work is indistinguishable from therapeutic activity.
Therapy is in itself research, and vice versa.' On another occasion he referred to
psychoanalysis as a process through which, from a subjective knowledge of the
self, one reaches the maximum possible objective knowledge of it.
With a solid medical background behind him, he felt free to criticize those
psychoanalysts who turned to psychiatry in order to find a safe base against their
feelings of insecurity. He did not, however, reject biological findings, as they
have been forthcoming in recent times. On the contrary, those who were close to
2 A PSYCHOANALYTIC THEORY OF INFANTILE EXPERIENCE
him knew that he was trying to explore how these new findings could relate to
his theories and whether and how his theories might need to be modified. To put
it simply, amongst his primary concerns was an interest in the mental sense of
the biological, in the way the mind comes to understand the body.
The Italian edition of his collected papers runs into over 800 pages, covering a
variety of interests from metapsychology in itself, to its application to clinical
work and to critical essays on art and writers. Some 200 pages comprise his
original clinical notes which form the background for his theoretical discussions.
His thought is original, his prose style compacted, and his theorizing is inevitably
speculative, for it concerns a construction of what babies think and feel, a matter
about which we have even less direct evidence than usual since babies cannot
talk. Nevertheless, Gaddini's theories are of great clinical relevance for the
treatment of adult patients, particularly in the understanding of psychosomatic
disorders and in the identification of mechanisms involving fusion and imitation
used as defences against awareness of separateness and dependence.
For this collection I have chosen the most significant papers that cover three
major themes: imitation, which Gaddini considers to be a central factor in early
development; the process of instinctual drive arousal, ego formation, and
awareness of separateness from the object; and the way the body becomes
meaningful to the mind.
Interspersed through the writings there are numerous hypotheses (sometimes
described by Gaddini as `useful fictions' rather than hypotheses) concerning the
working of the infant's mind, and associated with reports of direct observations
of children. Although he was not engaged in the treatment of children it is clear
that he took every opportunity to observe infants. In this respect he took full
advantage of the fact that he worked closely with his wife, Renata De Benedetti,
a paediatrician who subsequently took up psychoanalysis. The rich exchanges
arising from their close interaction have found their way into several papers
written together and separately. An early investigation carried out in
collaboration, `On rumination in infants' (1959), illustrates very clearly
Gaddini's capacit y for combining biology and psychoanalytic theory.
Rumination in infants is a fairly rare condition, also known as merecysm,
which can occur as early as eight weeks. It affects the alimentary system as a
form of regurgitation, when previously swallowed food is re-chewed and reswallowed. The symptom, as revealed by this investigation, shows that the infant
is capable of learning and remembering during this early stage of development.
In the presence of maternal failure in nurturing, the infant learns to stimulate the
hard palate with one or two fingers to bring back into the mouth the milk he has
just ingested. In the course of extensive observations, backed by photographic
records, it was apparent that the infant was in a state of continuous tension which
found temporary relief in the bodily experience of rumination, as shown by its
ecstatic smile the moment the milk appeared in the mouth. The assumption is
that this activity is accompanied by a fantasy in which the baby imitates the milkgiving activity which the mother had withdrawn from him. The regurgitation has
all the characteristics of being self-protective and it occurs as a response to
inadequate mothering, in itself due to emotional factors in the mother. The result
of the investigation, linked with work with the mothers on the provision of
adequate mothering, greatly reduced the mortality which was quite prevalent in
these cases.
I have dwelt on this aspect of the author's researc hes at length because readers
will find frequent references to it, such was the impact of these observations on his
subsequent work on somatic disorders and the body-mind question. But first I
shall briefly state his position vis-à-vis the infant who, he feels, cannot
distinguish between self and non-self after nine months inside mother. For
several months the infant will be unable to notice the difference between self and
environment. A part of what the infant believes is his body is in reality mother's
body. If a baby is hungry a breast appears, but he does not know it is not his. In
fact, all that is around is a product of magical omnipotence. If all is well the
present experience is not unlike intra-uterine life. The difference, though, is that
learning capacity begins at birth, whereas in intra-uterine life, the development
of the foetus and its behaviour are biologically pre-ordained. It follows that
memory in utero is not necessary, so it is unlikely that we remember that time of
our life.
Gaddini believed that it was pathology which was most enlightening. The
appearance of skin disorders, asthma, and so on in childhood may appear to be
casual, but he believed that they are pre-determined through the mental meanings
assigned to physical sensations and their role in preserving the integrity of the
self. Before the perception of the external world gains mental significance,
external stimuli are assimilated through the physical sensations they produce,
resulting in changes in the body which are noted and remembered. The
earliest mental organization is still fragmentary, primarily taken up with bodily
sensations and needs, especially the need to keep the fragments together by
keeping them assembled within a boundary. Survival is the peremptory aim, and
the non-self is appraised in the light of the subject's first experiences of being
rudimentarily aware of being separate. Atopical dermatitis is likely to develop at
about four to six months of age (at the time when some awareness of separation
is developmentally appropriate) if the subject cannot face awareness of such
separateness. The skin disturbance proclaims awareness, through contact, of the
skin as the limit of the self, and expresses the feeling of mental break-up of the
self through the break-up in that boundary part of the body.
His researches on the function of the skin in early development were close to
those of the Kleinian analyst Esther Bick, who wrote about the disturbance in the
primal skin function leading to the development of a second skin formation.
There were essential differences, though, as in her conceptualization; the
dependence on the object is replaced by pseudo-independence through the
inappropriate use of certain mental functions for the purpose of creating a
substitute for the skin container function (Bick 1968).
Gaddini's work `On imitation' (1969), which brought him considerable
acclaim, is much more comprehensive than Bick's, showing considerable
perspicacity in insisting on the importance of distinguishing between imitation
and identification. He thought that imitation was a basic defence and, like all
defences, part of ordinary development, normally leading to identification
through the integration of imitation with introjections which is essentially an oral
mechanism. Frustrations, especially at the oral level, can lead to pathology like
rumination, in which, as we have seen, the baby imitates the feeding function of
the frustrating mother. Precocious conditions of oral frustrations cause
disturbances in the psycho-oral area and, more precisely, in the introjective
mechanisms. This results in the activity of imitating introjections which can
substitute for true introjection. By imitating one magically becomes the external
object but unhappily this will not lead to internalization. To be is not to have.
What is lost can therefore be spuriously maintained, a fact that should not be
ignored when analysing separation.
It should be understood that although imitation is an essential element of the
structure of identification (as is introjection), it expresses a basic disposition
towards the object. The avoidance of introjection by using imitation as a defence
may be a way of defending oneself against the anxiety provoked by introjective
conflicts. Finally, in the process of identification, imitations and introjections are
fused and integrated in the service of the aims of adaptation and of the reality
principle. `Being' and `having' are integrated, which leads to `identity'; that is, to
a true sense of being `oneself, separate from but related to the `other'.
The suggestion that the pathology of imitation will show us how in some
instances, perceiving the object is experienced as being the object, has farreaching implications. Some of these ideas will allow us to modify our
conceptualization in the case of many sexual disorders where we often speak of
`faulty identification', disturbances of identity, and so onÐwhereas we should
consider the presence of imitations.
This is the first chapter in this collection. In the last one, `Changes in
psychoanalytic patients', written in 1984, Gaddini extends some of his
conclusions in the area of imitation to the training of psychoanalysts. There he
expresses concern about the possibility that training can lead to the creation of a
host of imitators rather than true psychoanalysts with their own sense of identity,
a concern shared by the majority of those involved in psychoanalytic education.
This chapter begins with the challenging statement that the potential
relationships of patients with their therapists are mediated by the culture of the
society in which they live. Patients, having been involved in psychoanalysis,
soon begin to spread what they have grasped of it. Before long many people
become something of an analyst. In some instances the imitation goes so far as to
lead these people to call themselves `psychoanalysts' as a result of a variety of
training experiences when the only title that could be bestowed upon them would
be that of impostors. As a result of the spreading of psychotherapy, the task of
selection committees across the world has become very hard, and in some
instances it has led to the motto, `Everyone can be a psychoanalyst'. This is the
wisdom of unwisdom in selection, but we are warned, `Look at what happened to
Lacan's followers', who were in due course rejected by the master. The chapter
contains some interesting critiques of developments by Hartmann, Winnicott,
and Klein when views are presented clearly without bias or animosity.
In his own metapsychological thinking, Gaddini's early papers are in some
respects close to Klein, though always with his own highly original construction.
Thus, for example, in the first three chapters of the present collection, published
between 1969 and 1972, he regards imitation (`to be') and introjection (`to
have') as simultaneous processes which gradually develop and become
integrated into `identification' . (This process of `identification' is similar to
Klein's idea of the `depressive position', though this is not a conception that
Gaddini uses, and he certainly does not conceive of the earlier unintegrated
period of development in terms of Klein's `paranoid-schizoid' position.) The
`introjection' side of Gaddini's idea of dual development into `identification' is
consistent with Klein's view of there being an early rudimentary ego and early
fantasies of introjection, projection, and so on. Gradually, however, Gaddini came
to view imitation and `imitative identity' as characteristic of an early phase from
birth to six months (see Chapter 11) of `non-integration' in whch sensations of
contact are used magically to induce a sense of self and in which there is at first
no perception, no instinctual drive, no ego, and no awareness of objects or of
dependence on them. Such awareness comes about gradually through a process of
`detachment', from the fourth to the sixth month (see especially Chapter 11).
This formulation owes much to Winnicott, though its delineation, especially the
emphasis on imitation and on sensations of sensual contact, are Gaddini's own.
Quite apart from changes in those who practise psychoanalysis, Gaddini draws
our attention to the fact that besides the innovation of treating children, as
introduced by Anna Freud and Melanie Klein, there has been a readier
acceptance of characterological problems and disorders of personality in our
patients. Further innovations have also been brought about by renewed interest in
enquiries into early infancy by Winnicott, Greenacre, and the author himself, as
well as into aggression, especially by Kleinian writers.
The issues around a psychoanalytic theory of aggression were at the centre of
Gaddini's interest in the early 1970s. In `Aggression and the pleasure principle'
(1972a) and in the intriguingly titled `Beyond the death instinct' (1972b)
(Chapters 2 and 3) he reviews the concept of energy. His hypothesis at this time
is that aggressive energy is present and operating in the infant from birth,
qualitatively different from the libidinal energy and by nature primarily directed
towards the external world. Indeed there are many points in Gaddini's writing
where he uses the word `instinctual' to mean aggressive energy primarily
directed outwards on to objects. I should stress here that he thinks of libido as
inward-directed. The aggressive energy can be discharged outwards by the infant
organism through the striated muscular apparatus, whereas inward discharge
takes place through smooth muscles, vessels, and mucous membranes. Here
Gaddini reveals his disagreement with the majority of analysts on two points.
First, he challenges the view that relief from tension is equal to pleasure, as some
states of tension can be pleasurable, suggesting a different quality of energy at
work. Second, he disagrees with the general view that aggressivity follows the
libido outward. His contention here is that aggressive energy must be discharged
outwardly immediately, otherwise the internal structures would suffer. Having
noted some contradictions in the pleasure principle theory, he reminds us of a
little-known letter written by Freud to Marie Bonaparte in which Freud expressed
the opinion that it was the aggression that was object-related in the first instance,
and not the libido. As a consequence, the libido, which Gaddini insists is
basically internally orientated, is dragged out by the aggression which has been
directed at an external object and is fused with it. This suggestion, quickly
doubted by Freud himself, provides support for Gaddini's claim that our views
concerning the early relationship between aggression and libido need to be
reconsidered. In the present writer's view, there is a great deal to be commended
for this novel conceptualization which would provide us with a fresh contribution
to the understanding of some cases of sexual deviations associated with violence.
Gaddini is critical of the majority of psychoanalysts for not studying
aggression, especially in its economic aspects, and for their frequent assumption
that aggression is aroused only in response to frustration. But he is equally
critical of those, especially Klein, who `without discussion' have adopted the
idea of the death instinct but who use the term `death instinct' as if it meant
`instinct of aggression', thus in Gaddini's view confusing description with
metapsychological explanation. To Gaddini, aggression is a primary instinct in
its own right.
I should add that these two chapters offer interesting suggestions regarding the
relationship between aggressive and libidinal energy. If the outward discharge of
aggressive energy is blocked, it will be discharged internally, which would cause
an immediate disruption of internal equilibrium. This disruption is halted,
Gaddini assumes, by a `compensation mechanism'; namely, by an immediate
arousal of libidinal energy which counters and contains the disturbance. The
compensation mechanism leads to fusion of the two instincts and to the
mastering of the aggressive instinct by the evolving capacities and vicissitudes of
the libidinal energy in the interests of the subject's survival. In somewhat later
papers Gaddini puts forward the view that the most basic anxiety of the
individual concerns anxiety about the loss of the self, a catastrophic event which
tends to promote staying in a state of non-integration as a defence, a view which
is of far-reaching importance to the technique of analysing adults and to ways of
dealing with the negative therapeutic reaction.
In two remarkable and original papers of the mid-1970s (1974, Chapter 4, and
1976, Chapter 5) Gaddini turned his attention to a much neglected area of
psychoanalytic investigation, that of the role of the father and the primal scene in
the early development of the infant and child. In these papers, too, we see him
moving away from the conception of the simultaneity of the `imitative' (and also
called `psychosensory') and the `introjective' (also called `psycho-oral', `oral
instinctual', or sometimes just `instinctual') modes of experiencing in early
infancy, towards conceiving of them as successive phases. The father, and what
Gaddini so aptly calls the `primal scene process' are in part the means by which
the infant moves out of his illusory world of imitative identity into the troubled
world of instinctual conflicts, desire, object recognition, awareness of the
parents' relationship, development of identification, and acceptance of external
reality. But recognition of the father and having to recognize the parents'
relationship are not only the means by which these developmental advances are
achieved; they are also the product of the very advances that they help to bring
about. (Gaddini's researches on the primal scene paving the way to the
insurgence of Oedipal feelings heralds some of the recent work of Kleinian
analysts on similar topics (see Britton et al. 1989).
Gaddini thinks that the child has a series of experiences of the parents'
relationship and that they are elaborated in fantasy and then condensed into a
special defensive construction which may make it appear as if the child had
witnessed the intercourse of the parents only once. He compares the denial and
condensation of the primal scene to the repression of the Oedipus complex. The
mother of the primal scene is experienced as utterly different from the familiar
mother of imitative identity; she is `extraneous' [`alien' might be a better wordÐ
Editor], a monster, sometimes with many arms and legs like a spider. The father,
when he is perceived, is likely to be conceived as if he were the `extraneous'
motherÐthe horrible monster who attacks the child's mother of imitative
identity. (Gaddini recalls Klein's descriptions of the `combined parent figure'.)
Gradually, in normal development, the mother comes to be conceived as
`external' rather than `extraneous', and the father is accepted as a `second
object'. These developments continue into the second and third year, and Gaddini
describes the later phases of them as `the triangular phase' .
Derivatives related to this series of perceptions and experiences are found in
dreams, screen memories, behavioural symptoms, masturbation fantasies, and so
on. It could be thought that the views so far presented are rather close to those
proposed by Mahler about the separation-individuation phase; in reality they
cover the same period but suggest a very different systematization of the first
three years of life from that proposed by the American analyst.
Both these papers on the father and the primal scene (Chapters 4 and 5) are
full of telling clinical examplesÐthe case of a patient, for example, who
projected on to his father not the `extraneous' mother of the primal scene process
but the idealized mother of the phase of imitative identity (Chapter 4). And there
is a particularly useful description (Chapter 5) of the `imitative transference';
that is, of patients who appear to be engaged in an object relationship with the
analyst but who are actually using the relationship to establish a symbolic form of
sensory contact which is meant to establish a state of imitative identity between
analyst and patient which will block development towards true object
relationship.
In the author's contention, which I find highly acceptable, the infant is
overwhelmed by the primal scene experience, which is that of an attack on his
imitative identity leading to a sense of self-mutilation. There is an experience of
loss, abandonment, and disintegration due to his aggressive drives being aroused
and re-directed inwardly, affecting the psychosensory area. (In this
conceptualization auditory, tactile, and all other sensory stimuli are all-important
during the first few months of life.) The libido, on the other hand, comes to the
rescue by being stimulated and mobilized to counteract the aggressive drives.
It will be appreciated that here we are offered a new conceptualization which
is helpful in understanding not only the pathology of women who regard their
male partners as nothing more than a split-off aspect of mother, or men who
prefer distinctly masculine women, but also the pathology met in perversions
when physical contacts are sought in a casual way. The physical contact is a way
of realizing an imitative identity of a primitive kind, which is helpful in evading
the conflicts and anxieties involved in accepting the separateness of both oneself
and the other.
I have already hinted at some areas where Gaddini stands out from the
mainstream of psychoanalytic writers. It is therefore interesting to follow him on
an exploration of `Therapeutic technique in psychoanalysis: research,
controversy and evolution' (1975) (Chapter 6). Here he points out how, in the
case of Jung, a split seemed inevitable from quite early on in view of the
personal difficulties between him and Freud. The introduction of the concept of
the self has also presented psychoanalysis with a diversity of opinions which
could become a threat to the unity of the movement. Similarly, the addition of
child analysis could have been expected to cause severe dissensions. As Anna
Freud embraced the structural theory as a legacy from Freud, she became
engaged in a course of investigation and technical innovations which led to a
clash with the views of Melanie Klein who had also accepted a part of Freudian
doctrine, the death instinct, as a central part of her legacy. But as they both
worked well within the Freudian framework, no split occurred. On the other
hand, Gaddini dwells on the controversy which had been a source of profound
disturbance within the British Society and goes on to show how fruitful Klein's
research has been in adding to our current knowledge of the dynamics of
aggressive drives and the origins of the instinctual relationship with the object.
Although he believes that Kleinian conceptualization, being predominantly
dynamic, renders it metapsychologically incomplete, he feels that this in no way
detracts from the richness and validity of the research. He also suggests that
indirectly Kleinian exploration has made a substantial contribution to the
structural level too, adding to our knowledge of the early development of the ego,
superego, and the earliest defence mechanisms.
Gaddini also admired the rigour and consistency of Klein's technique, though
he felt that this very rigour was also a limitation. He thought that it is difficult to
talk in words, difficult to make effective interpretations, especially transference
interpretations, about the inchoate and sometimes terrifying experiences dating
from the unintegrated period of earliest infancy. And if pathology in the
development from the `whole self' to the `individual self' has interfered with the
development of the instinctual relationshipÐthat is, with the relationship to
objects and recognition of their separatenessÐGaddini thinks that
the analytic relationship must be able to operate on very deep levels remote
from language, and barely if at all instinctual. Verbal interpretations at
instinctual levels may in these cases have no meaning, whereas silence and
participation may assume an important therapeutic function.
He thought that Kleinian analysts would modify their technique to take account
of the fact that the therapeutic relationship `extends beyond the instinctual
transference', and, as he notes in a postscript, was surprised to find a few months
later at the 1975 Congress of the International Psychoanalytical Association in
London that several Kleinian analysts had, he thought, done just that.
In `The invention of space in psychoanalysis' (1976) (Chapter 7) Gaddini makes
a first clear attempt at formulating some personal views on the formation and
definition of the self vis-à-vis the mental structure (ego and superego) as well as
the relation between the two. By using the term `space' Gaddini points out that
Freud was able to introduce into metapsychology a topographical, structural
description of the mental apparatus. Thus, the space is a concept and is not real in
the sense of external space. Early mental activity is fed by bodily experiences
derived from primarily auditory, tactile, and other sensory stimuli, included under
the term `psychosensory area'. In due course, the sense of self is built on needs,
at first without boundaries and timeless; Gaddini calls it the `total self'. Slowly
we reach the dramatic birth of the self, to be called the `individual self. This is
catastrophic and mutilating to the organization of the `total self', especially
because the non-self now becomes a threat; hence the urge to survive comes into
being. This urge can be dominating and capable of affecting the sense of
identity, separation, and so on, if needs are not adequately met. The survival urge
mobilizes the instinctual cathexes; the peripheral location of the aggressive
cathexes outwards and that of the libidinal cathexes, turned inwards, contribute
to the forming of a boundary for the individual self. The paper is notable for the
introduction of the concepts of the `instinctuality' of the self, `the instinctual
activity of the infantile ego' in which aggression is fused with libido and turned
towards an object in the outside world, which is more related to the reality
principle. With the developing ego we shall now encounter manifestations of
`instinctual anxiety' which has to be distinguished from `loss-of-Self anxiety'
which is paralysing to the ego.
Many of the experiences related to the growth of the individual self and the
early activities of the ego lead to experiences oft-repeated in analysis. At first there
is only anxiety related to loss of total self as it moves into becoming the
individual self. Later, with the appraisal of time, another kind of anxiety linked
with loss-of-self makes its appearance. I should stress here that the loss of total
10 A PSYCHOANALYTIC THEORY OF INFANTILE EXPERIENCE
self is catastrophic and is seen in patients who cannot relate and who are also
prone to resisting transference interpretations, giving the impression of
uninvolvement. The loss-of-self anxiety, instead, is frequently seen as part of
well-organized defensive structures and seems to contain a memory of something
which must not be repeated. Needless to say, instinctual anxiety arises in the ego
when the object is already distinct from the self. In analysis it will make its
appearance through missed sessions, lateness, and so on, thus showing that
patients know only too well how to withdraw into the self and away from
instinctual experiences and stimuli. With the delineation of the individual self
and the mobilization of instincts, loss-of-self anxiety decreases and a first mental
image of the self, a circle, a circumscribed enclosed space begins to form. This is
the first symbol representing the self (see Chapter 12).
In `Notes on the mind-body question' (1980) (Chapter 8) Gaddini traces the
origins of the mind-body continuum in utero, up to the formation of a separate self.
Having established the principle that the mind is extended throughout the body,
rather than being localized in the brain, he follows the path of differentiation of
physiological learning from mental learning: that is, the physical model is
converted into a parallel mental one (for instance, incorporation is parallel to
introjection). As recent work has shown that learning in foetal life begins at about
three months, it seems safe to assume that an unborn baby develops a bodily self
which is in a circumscribed space. After the shock of birth, physiological
functions develop. However, only memory can transform the physical models of
breathing, feeding, excretion, and so forth into mental ones. In the first phase of
development the individual's knowledge is based on experiences which occur
alongside fantasies associated with the involvement of tactile, auditory, and to a
lesser extent visual, sensations and emotions. On the other hand, for Gaddini all
that is related to `touch' constitutes a new boundary for the baby's developing
self, a view well supported by his investigations into skin diseases in all ages, as
I have already noted.
An important aspect of the arguments put forward here is that the first mental
formation consists of fragmentary sensory experiences (the psychosensory area)
related to functions which are endlessly repeated. The recognition of the body by
the mind suggests acknowledgement of one's own separateness and vulnerability.
In fact, during the first eighteen months of life psychophysical illnesses which
translate mental disturbance into bodily terms are scheduled or dated.
Rumination does not occur before eight weeks. Atopical dermatitis, as noted
above, is likely to occur from four to six months, when the `detachment' process
is under way. Psychoanalytic treatment itself may be able to supply what the
individual's environment did not provide during the actual period of infancy.
Readers will recall, too, how some cases of dermatitis may occur in the course of
an analysis when things are not going too well. Initial attachment to a
transitional object tends to arise between seven and twelve months, when the
process of `detachment' and the primal scene process are, or should be, well
launched. We are also reminded in this chapter of how further developments in
detachment and separation occur at the same time as learning to walk, talk, and
so forth, and that disturbances during this time may lead to psychophysical
disturbances such as asthma, stuttering, or agoraphobia.
In the face of stress, the first mental function of non-integration may be
restored and promoted as a defence, reflecting the space occupied by the
fragmentary experiences of the self in relationship to the environment. No doubt
psychotherapists will recognize the sense of frustration when attempting to deal
with a patient who enacts the original need for self-survival and treats the analyst
as a means to that end. Here the stress is on the sensorial use of the oral function,
but Gaddini draws our attention to the fact that the patient regards the analyst not
so much as a separate object as a source of nourishing, sensory contact, a subtle
but basic distinction in terms of understanding and interpreting the transference.
We all know how disturbing it is to have a patient who is unwilling to recognize
the separate existence of the analyst or any external object or the external world.
This is, in fact, a major factor in the presenting picture of bulimia and anorexia.
It is in this chapter that we really come to appreciate the writer's value as a
research worker, teacher, and therapist. A careful reading will provide us with a
wealth of useful information about many patients' behaviour in psychotherapy
and analysis.
A similar richness of clinical material is also to be found in the next chapter on
`Early defensive fantasies and the psychoanalytical process' (1981) (Chapter 9).
A distinction is made between two kinds of fantasy. There are fantasies in the
body which are rudimentary and proceed from body experiences in the service of
defence. They lack images and are revealed through a functioning of the body
activated by the mind. The psychic events associated with the rumination
syndrome fall within this category. These fantasies are usually enclosed in the
primitive and exclusive body-mind-body circuit and are not available for further
mental elaboration. A purpose of the chapter is to show how, in the infant's mind,
fantasies in the body are followed by fantasies on the body which are based on
the idea of space in the developmental process and are associated with imagery.
Unlike the earlier ones, these fantasies are visual and in fact they represent the
first mental image of the separated self. They are usually represented in dreams,
or graphically as round shapes (see Chapter 12).
A study of the fantasies in the body can contribute to a better understanding of
some normal and pathological aspects of functioning of the first year of life.
When they are transitory and linked with the psychophysical syndromes, they
may be an expression of a fragmentary, non-integrated early organization of the
self and be related to fear that this organization might go to pieces or get lost in
space. This anxiety of non-integration is one of two main expressions of anxiety
of loss-of-self, the other one being `anxiety of integration', which is a fear that
whatever change occurs in the non-integration state will lead to a final
catastrophe. All therapists are very familiar with this latter type of anxiety which
slows down progress. Clinically, it is essential that we should distinguish
between non-integration and splitting, for splitting in Gaddini's view occurs only
after an integrated state has been achieved.
The clinical examples in support of these theoretical arguments are well
matched by those included in the chapter `Acting out in the psychoanalytic
session' (1982) (Chapter 10), where this troublesome symptom is regarded as a
defence, usually self-oriented, magic, and omnipotent. The main aim of acting
out is to regulate tensions and at times to dispose of them.
Before summarizing the contents of the next two essays, I think I should pause
to examine some of the conceptual differences which separate those
psychoanalysts who have been concerned with early mental developments. It
will be easily recognized that a dominant feature of Gaddini's work could be
described as a prelude to more advanced ego functioning. According to Klein,
the breast is invested from the outset with instinctual charges. This presupposes
an ego, no matter how primitive, as well as conflicts. In Gaddini's theoretical
formulation, however, there is no ego immediately after birth. This has important
implications as it means a postponement of phenomena attributable to
introjection and projective identification, as the latter are impossible without an
ego. This should not be construed as a wholesale rejection of Kleinian
psychology, for Gaddini regarded it as indispensable in clinical work. He greatly
admired its contribution to the study of counter-transference, aggression, and
object relations, as well as for its adherence to the stringency of the setting.
Winnicott, in his seminal study on primitive and elementary activity preceding
the functioning of the ego and other psychic agencies, referred to this first
expression of life as self. His aim, of course, was to distinguish it from the ego.
Greenacre and Gaddini, quite independently, proceeded in the same direction,
which lends cogency to their findings. Gaddini's own observations soon led him
to conceptualize the existence of a psychosensory area which has mental priority
over perceptions, for perceptions are associated with structures: that is, with the
existence of the ego. Imitation, which I have shown as being central to the
author's thinking, is associated with sensations, whilst introjection is linked to
perception. Here we notice an overlap of his conclusions with those reached by
Winnicott, who claimed that there was an absence of instinctuality and conflicts
in early life.
Some, if not all, of these ideas are ventilated in the chapter on `The
presymbolic activity of the infant mind' (1984) (Chapter 11), perhaps the most
complete statement by Gaddini of his history of infant development. Here we are
confronted by the introduction of a `basic mental organization' (BMO), which is
said to cover the period from biological to psychological birth (separateness). It
is contended that the onset of mental activity is necessitated by the urge to
survive. During this phase the inevitable physiological disruption acquires
mental sense. The BMO serves the self as it is the result of sensory activities
which dispense with unwelcome perceptions. All sense organs at first function as
contact organs (visual and auditory sensations can magically abolish distance by
transforming them into contact). In adult life and in analysis, as we know, sight
and hearing can indeed be experienced as continuous contact and, as all
therapists know, many patients will make full use of it to redefine object
awareness into sensory contact. It follows that sensory experiences relating to
specific functions of the body will concur to the formation of the self. The early
BMO is fragmentary in nature. However, with separation some integration will
occur but the self feels mutilated. The fragments that survive the mental
catastrophe, as produced by recognition of separateness and as described by
Bion, are kept together by the BMO. The loss-of-self anxiety described in
previous chapters may oppose integration or favour it. In severe pathological
states, true integration does not occur, and this accounts for the stillness
sometimes found in the psychoanalytic process. This is a chapter in which we
share with the author his experiences of patients who suffer from fear of
integration and/or disintegration, opposing any change because of an
unconscious fear that it will annihilate them, hence their preference for
remaining in a non-integrated state. This state is vividly expressed by the sort of
patient who is perpetually afflicted by the problem of `I can't live with youÐI
can't live without you' type of anxiety. To sum up, this is what we can expect in
states which precede full symbolization, the role of the BMO being in essence
that of forming the first image of the bodily self.
The chapter, therefore, should be considered together with `The mask and the
circle' (1985) (Chapter 12), in which Gaddini recalls how Freud regarded the
manifest dream as the mask of the latent dream content, going on to compare
dream consciousness with that of waking life. The discontinuity between the two
states is comparable to that of the body-mind-body continuum. Dream
consciousness acts as a bridge to allow manifest access to deeper levels of
fantasy life. Gaddini shows us how mental images of the body self and its
primitive pathology are to be found in dreams in advanced stages of analysis.
Round images appear in highly diversified forms, and patients acknowledge that
the images are representations of themselves.
To justify this challenging conclusion the author points out how, in relation to
the first mental learning, the circle is to be regarded as the actual origin of
creative expression of the self in consciousness. This seems to happen during the
second year of life when the sense of self is equal to consciousness in the ego.
The circle is then a symbol invented by the child as a further expression of
inventiveness already expressed in the creation of the transitional object. As he
continues to grow up, the child goes on adding to the circle what he perceives of
himself, mouth, eyes, limbs, and so on. The filling of the circle, of course, is
done with the help of the developing ego acting between self and object. For the
author the circle represents the conclusion of the dramatic process through which
the individual, under the impact of anxiety of self loss, moves from the stage of
the magical and omnipotent organization of non-integration to the
acknowledgement of separateness and the dividing boundary between self and
external environment. In keeping with this view we are once more reminded of
the psychological events related to separation and recognition of vulnerability
and of the psychophysical syndromes that may result from difficulties in
negotiating these maturational tasks.
Before ending the chapter, however, Gaddini seizes on this opportunity to
stress the fact that psychoanalysis works at the confines of the biological and that
it does not oppose or invade the territory of neurophysiology; on the contrary, it
proposes to extract from it what can be understood of the neurophysiological
function which is at the basis of mental functions. On the other hand, he rightly
insists that it does not make sense for the biologist to say that the origin of dreams
is in the basic physiological processes and not in masked desires. This means
that there is no structure behind the origin of dreams and its formation. Somehow
I believe that Gaddini would have been delighted with current researches which
show that the foetus responds to different sounds in the womb and that in the
first week of life the infant can distinguish between mother's voice and that of
others. One wonders too what he would have thought of the findings of Daniel
Stern (1985) and others which suggest that processes of fusion and processes of
self-object differentiation evolve from birth onward in tandem, rather than a
phase of fusion being followed by a phase of self-object differentiation.
All psychoanalysts have in some ways been influenced by one or more
teachers or colleagues whom they held in high esteem. Gaddini's deep respect
and gratitude for Freud's contribution to the understanding of human nature is
apparent throughout the writings presented in this volume. It is indeed a pleasure
to re-read Freud under his guidance because he can be both critical and
objective.
There will also be no difficulty in noticing the deep admiration for the
theoretical contributions of Phyllis Greenacre, derived mainly from her writings
in the field of physical determinants in the development of the sense of identity.
Reference to the work of Winnicott has been so frequent in this introduction
that it is hardly necessary for me to stress the closeness that existed between
these two creative thinkers regarding the intricacy of the infant's mind in areas
which had been largely unexplored. It was Winnicott the paediatrician whose
experiences with children could be added to the information gathered from
Gaddini's collaboration with his wife, Renata De Benedetti. In this introduction I
have tried to show the considerable affinity in their understanding of nonintegration and integration. Gaddini's personal contribution in this area was in
stressing the role of loss-of-self anxiety in individuals who cannot face
separation. Here he brought together the fear of integration with the fear of
autonomy and individuation. The basic overlap, though, with Winnicott's view is
in the concept of non-integration as a fragmentary functional organization of the
self. On the other hand, they differ in so far as Gaddini stresses the fact
that disintegration presupposes some degree of integration. In my opinion there are
some considerable divergences in their views on the role of illusion in early life.
Winnicott believed that the self-creative process occurs in the early stages of life
with an illusory quality of dependency fostered by the mother. Gaddini agrees
with this but also argues that the early imitative experiences, as described in his
work on imitation, are defensive in providing the baby with the opportunity of
slipping back to his self-omnipotence, or, better still, giving him the means to reestablish the experience of the illusion of being at one with the object.
Another major difference concerns their ways of understanding the image of
the circle which often recurs in Winnicott's writing, when he tends to use it as a
potential diagram for the representation of the self since birth. If there is a break
in continuity the circle divides into two circles, the psyche seduced by the
intellect interrupts its relation with the soma, and we have the elements which
lead to the formation of the false self, a concept which Gaddini did not use.
It is difficult to know exactly to what extent the author was influenced by
Bion, although his admiration was evident in `Paths through the creativity of
Bion' (1981) and `Ultimate Bion' (1984), not included in this collection.
Undoubtedly in the last few years of his life he was more interested in the fact
that Bion had worked with the earliest traces of mental life, principally derived
from work with psychotics, which allowed him some comparison with his work
on children. He certainly shared his fascination with the protomental, learning
from experience and the analytical encounter, quite apart from seeing a close
connection between Bion's views on `the inner group' and his basic mental
organization with its fragmentary multiple character and magical functioning.
In this Introduction I have attempted to stress Gaddini's independence as a
psychoanalytic thinker and writer. Yet he did not believe that independence was
a concept that made much sense, except in a historical and social context. He
firmly believed that absolute independence is what the baby imagines the
omnipotent mother has to offer at the moment of separation, as any analyst knows
when the time comes to let a patient go. But growing up for this gifted analyst
meant to move from total but unrecognized dependence to real dependence. In
other words, it meant coming to terms with reality, particularly psychic reality.
so central to his contribution. However, with that dry sense of humour so wellknown to his colleagues and friends, Gaddini would also say that luckily the
world is not made of reality only.
On imitation
This paper was first published in the Rivista di Psicoanalisi (1968), XIV, 3 under
the title `Sulla imitazione'. An amplified version appeared in the International
Journal of Psycho-Analysis (1969) 50:475±84.
This paper is a first attempt to organize some thoughts of mine on imitation,
elaborated during the last ten years. What I propose to do, in the first place, is to
distinguish on the metapsychological plane imitation from introjection and
identification, and to show how the latter usually presupposes not only
introjections but also imitations. Second, I shall try to show how certain infantile
psychopathological pictures (taken from personal experience and from
psychoanalytical literature) become more comprehensible if one takes into
account the use of imitations in relation to the regime of gratifications and
frustrations in the first period of life. Finally, I shall attempt to indicate how, in
adulthood, pathological imitations may be found even in easily encountered
clinical examples. I have purposely avoided developing this last part, as I intend
to do so in a later paper.
When Freud (1900) introduced the concept of identification, with reference to
the hysterical phenomena of psychic contagion, he stressed above all its
distinction from imitation: `Thus, identification is not simple imitation, but
assimilation on the basis of a similar aetiological pretension; it expresses a
resemblance and is derived from a common element which remains in the
unconscious' (p. 145). This distinction did not imply that identification was the
opposite of imitation but rather that it was a more complex phenomenon.
However, the later development of the concept of identification has not been
very much concerned with imitation, but has been amplified with other
complementary concepts, such as incorporation and introjection (Ferenczi 1909),
probably arising from the need to underline the genetic and the dynamic aspects
respectively. Unfortunately, these partial aspects have often been confused with
each other, and with the concept of identification itself, giving rise to no little
confusion.
Federn (1952) has objected to the concept of introjection followed by Edoardo
Weiss (1960). Federn intended to clarify the confusion by eliminating the concept
of introjection and substituting for it that of internalization.
A PSYCHOANALYTIC THEORY OF INFANTILE EXPERIENCE 17
Naturally, all those (even though they are not many) who have detected the
presence of imitative phenomena have found themselves forced to distinguish
them from what could seem, at the first glance, to be identifications. Among
these few, Fenichel (1937), Ferenczi (1932a,b), Deutsch (1942), Greenacre
(1958a), Greenson (1966), Stoller (1966), Ritvo and Provence (1953) and
Eidelberg (1948) may be mentioned. Owing to the terminological confusions
which still exist, one can still find the term `identification' used in the place of
`imitation', and this indicates the sufficient elaboration of the concept of
imitation. However, it is fairly widely agreed that imitation reveals itself as a
disturbance of identification, and with the characteristics of a primitive
phenomenon, which probably precedes identification in development. In this
sense imitation has been recently set by Jacobson (1964) in a more decidedly
metapsychological frame.
As far as the original meaning of identifications is concerned, Jacobson
prefers to speak of `early identifications' rather than of `primary identifications'.
These early identifications permit the internalization of a reality, at first
fragmentary and selective, in the sense of part-objects, and later of whole
objects, towards which partial and selective identifications correspond to the
interests of the ego; the development of identifications permits the development
of other essential functions of the ego, such as reality testing, and the formation
of a sense of identity and gender identity.
What precedes these `early identifications' should, in my opinion, be indicated
as `early imitations'. The term used in this respect by Jacobson, `primitive
identifications', is in fact also used by others, but it seems to me a misleading
term, since it is used to indicate phenomena which are of an imitative nature. To
distinguish them from `early identifications' may perhaps allow not only a
greater clarification of both the concepts at the beginning, but perhaps also the
distinction of imitation from identification in terms of processes.
Early identifications can be distinguished from imitations by the important
fact that a reality, even though fragmentary, becomes introjected and assimilated.
In this sense Jacobson uses the term `realistic identifications'. I would like to
suggest that this realistic element represents, right from the beginning, something
which permits us to speak of identification proper. Early imitations, on the other
hand, represent and are concerned only with unconscious fantasy. Further-more
they seem to follow a process of their own, which apparently has a distinct role
in the development of the ego.
Because imitations precede identifications in the individual development, we
should expect, clinically, the possibility of regressions from identification to
imitation. Since imitations are concerned with unconscious omnipotent fantasies
we should expect a similar regression to involve an object relationship of a more
primitive type. In fact, clinical experience offers notable examples of this sort of
regression with disturbances of identification of an imitative type, accompanied
by fantasies of omnipotence. In my experience it is practically constant in
18 ON IMITATION
character disturbances in general, and it may be found very frequently in male
and female homosexuality, and also in fetishism and transvestism.
As far as the process of development of imitations is concerned, it seems to be
distinct from, even though gradually integrated with, that of identifications. On
the other hand, it seems evident that imitative activity is placed, in the course of
its development, at the service of the ego functions and processes of adaptation.
In this connection we should expect, besides a regression to imitation, a
regression within the imitationÐthat is, from a more integrated imitation to one
which is less integrated, or not integrated at all, in the structure of the ego; that is
to say, pathological disturbances of imitation itself.
Imitation seems to be connected, originally, with perception, in the sense that
primitive perception is physically imitative. At first the infant perceives by
modifying his own body in relation to the stimulus. In this way, the infant does
not perceive the real stimulus, but the modification of his own body. Perhaps the
differentiation of the systems of perception and systems of memory has its
beginning in this community of physical perception and imitation.
As we shall see, the regime of gratification and frustration to which the infant
is subjected has a determining influence on the further destiny of these `imitative
perceptions' and their mnemonic traces, in the sense of their normal or
pathogenic evolution. In general, a prevailingly frustrating regime tends to
reinforce and make them last more than they might. The phenomenon, however,
which seems to constitute the first step forward seems to take place under the
sign of frustration, and is known by the term `hallucinatory image'. Using this
term we refer to the fact that, in the absence of the gratifying objects, and in the
attempt to end the painful sensations which derive from its separation, the infant
has a hallucination; that is, represents some image as reality. In order to
understand the meaning of separation from the object and of the subsequent
representation, it should be kept in mind that, at this stage, the object is not
perceived as such but as a part or an extension of the body self.
Rapaport (1951) has justly defined the hallucinatory image as `the prototype
of thought'. I would like to suggest that it can also be considered as the psychic
prototype of imitation. If one bears in mind that (in the words of Freud)
`originally the mere existence of a presentation was a guarantee of the reality of
what was presented (1925: 237), one can understand the meaning of this primordial
psychic imitation. From now on, the biological model, `imitating in order to
perceive', changes into the parallel psychic model, in which to perceive becomes
`to be'. `Imitating in order to perceive' becomes, that is, `imitating in order to
be'. Or rather, perceiving is still, as before, `being', but whereas this occurred
previously on a prevailingly physical level, it now does so on one which tends
towards the psychic.
We do not know in what way the functional model becomes converted into a
parallel psychic model, even though we can argue the economic advantage of
such a conversion, but primitive psychic activity offers us more than one
example of this sort. Introjection, for example, with which we shall deal shortly,
is today defined as the psychic model parallel to the physical one of `putting into
the mouth', of `incorporating' orally (Greenson 1954). We shall shortly see how
some early affects may be correlated with bodily functional models. As Federn
has written apropos of this,
It will be a further task of psychoanalysis and biology to find out to what
extent and detail the mental processes parallel the bodily ones, and how
many somatic phenomena may and must be transposed to the mental level.
(1952:352)
Concerning the psychic protomodel of imitationÐ`imitating in order to be'Ðit
may be helpful to repeat that it installs itself not in the presence of the object but
in its absence, and that precisely because of this, its aim seems to be that of reestablishing in a magical and omnipotent way the fusion of the self with the
The period immediately following consists in the active development of
fantasies in which these two characteristicsÐno objective reference to reality
and a magical restoration of the omnipotent fusion with the objectÐcontinue to
constitute the essential fact. This belongs to the `symbiotic phase' (second-fifthsixth month) of Mahler and La Perriere (1965). These fantasies of fusion,
however, can last for a long time, even beyond the pre-Oedipal period (Jacobson
As far as the early introjections are concerned, according to Fenichel (1945:
37) in this period `in the unconscious all sense organs are conceived as mouthlike'. That is, the introjections also aim at the fusion of the self with the object
which may come to be lacking: and this seems to be what Fenichel intends in saying
that, originally, ª`putting into the mouthº and ªimitat ion for perception's sakeº
are one and the same' (1945).
However, these two functional models seem to determine in a distinct way,
right from the beginning, that two-fold attitude taken towards an object which
Freud has detected and defined: `what one would like to be' and `what one
would like to possess'. The fact that these can be lived as one and the same thing
does not mean that they are. The primitive imitative perception seems to lead to
the hallucinatory image, to the fantasies of fusion through modification of one's
own body, and to imitations, in the direction of the wish to be the object. Oral
incorporation seems to lead to the fantasies of fusion through incorporation and
to introjections, in the direction of having, of possessing, the object. In the
narcissistic cathexis these two basic dispositions coexist, providing the reason
for the fact, indicated by Freud, that in the identifications called by him primary,
the relationship is both one and the other.
The early affects seem, in turn, to be modelled on the same original physical
paradigms, and this seems to determine the sense of early conflicts. The early
appearance of envy and rivalry (Klein 1957; Jacobson 1964) becomes in fact
more comprehensible if one takes into account how near rivalry is to the
imitative-perceptive model (the object as what one would like to be) and envy to
the incorporating-introjective model (the object as what one would like to have).
According to Jacobson, still in the first year of life, affectomotor imitations
between mother and child would follow the fantasies of fusion, and in turn would
be followed by imitations of the parents' emotional expressions `induced' by
them (1964).
The following step in development, however, seems to be represented by the
first assimilations of imitations or introjections relative to partial or fragmentary
realities. The maturational development of perceptive and mnemonic functions
has certainly a determining role in this step, but other factors also intervene,
connected with the characteristics of the relationship. I shall not enter here into
the metapsychological problems relative to this passage. I shall limit myself to
saying that the internalization of reality involves a quantitative and a qualitative
modification of the object cathexes so that an external reality, gradually
recognized as separate from self, and an internal part of the ego, more stable and
separate from non-ego, correspond to the accumulation of the imitations and the
introjections assimilated in a realistic way. Imitations and introjections converge
therefore in this process, originally fragmentary and gradually more integrated,
for which I would like to reserve the term `identification'.
I should say that the distinction between imitation, introjection and
identification is not found in psychoanalytical literature in the terms now
described, and the reason for this, apart from the general lack of distinction
between imitations and identifications, lies also in the fact that the term
`introjection' has been in turn widely fused and confused with that of
identification, right from the moment when it was introduced by Ferenczi
(1909). Here the confusion was justified by the fact that introjections were
concerned with the oral base of identification, constantly underlined by Freud,
who wrote, `There are¼good reasons why a child sucking at his mother's breast
has become the prototype of every relation of love' (1905:222).
However, what has complicated the development of the concept of
identification seems to be the difficulty of integrating, on the conceptual plane,
the evolution of the developmental area, which seems to be characterized by
psychosensory activity, with that of the area which could be defined as psychooral. Naturally, the oral psychic area is not limited to the oral zone, just as the
sensory psychic area does not exclude the oral zone. That is, if it is true that all
sense organs may unconsciously be conceived as mouth-like, it is also true that
the oral zone and cavity may be experienced as a sensory organ inasmuch as they
are the seat of perceptions with their relative mnemonic traces. Further on, an
extraordinary example will be given of imitative reactivation of the perceptions
of the oral cavity, as the result of serious oral frustrations. I would like to point
out here, however, that certain early conditions of oral frustration may determine
disturbances of the oral psychic areaÐnamely, of introjective mechanismsÐwith
the result that an imitative activity of introjections may partly substitute
introjective activity.
From the dynamic point of view the psycho-oral area seems to be
proportionately much more exposed to the conflicts in the object relationship,
while the sensory area seems to provide a possible withdrawal from the conflicts,
and the exclusion of the external object which promotes them. If we refer to
individual development in terms of object cathexes, identifications may be
considered, in this development, as an intermediate station of crucial importance,
in which the imitative phenomena of the sensory area and the introjective ones of
the oral area become integrated in the service of reality and the ego processes of
adaptation. In this sense, what Freud has described as secondary identification is
perhaps to be considered as the only conceivable one whose appearance is to be
dated right from the moment of `early identifications' (Jacobson), or `realistic
identifications', whose development continues uninterruptedly till adulthood.
What precedes I would designate as `imitations' and `introjections' with
reference to their respective basic bodily models of perception and of oral
incorporation. Imitations and introjections obey the pleasure principle, while
identifications are orientated towards reality and lead, in their gradual
development, to the possibility of mature object relationship, which in turn
functions according to the reality principle. What Freud called `narcissistic
relationship' had originally more to do with the self than with the object, and in
this sense is to be referred to the perceptive-imitative area in which the object is
experienced in the service of the self; while what Freud called the `anaclitic
relationship' has more to do with the object than with the self and is to be
referred to the incorporating-introjective area in which the self experiences its
real dependence on the object.
Deutsch has described the `as if' kind of identifications, which in her opinion
are found in a characteristic way in the pre-Oedipal period, and which are found
clinically in certain schizoid personalities which Deutsch defines as being of the
`as if' type. These patients behave as though they themselves were their love
objects (1942).
There seems to be no doubt, to my mind, that Deutsch intends to refer to a
markedly imitative kind of object relationship, primitive in nature, even though
in the terms used by her imitation is not clearly distinguished from identification
and from introjection. Deutsch seems in fact to maintain that the `as if'
phenomena are a type of `imitative identification' based on fantasies of oral
incorporation. The `imitative identifications' of infancy are, in my opinion,
`imitations' and, compared to identifications, can at the most be considered as
precursors of the latter. Consequently we are not faced, on the clinical plane,
with a particular type of identification but with a regressive defence from the
relationship which would involve identification. The seriousness of these
patients is equal to the entity and to the extension of the imitative phenomena
which substitute identifications, and to their primitive character (regression
within the imitation). They lead to what one could correctly define as an attempt
to gain a vicarious identity, magically acquired through imitation.
In a case of `as if character, a girl of 21, the patient tried to make up, by a
striking use of imitative mechanisms, for the painful emptying of her own
identity, consequent on the necessity of cutting off an essential part of herself
relative to the oral area of her object relationship. Her more serious disturbances
had begun in early adolescence, after her father, whom she loved very much,
had abandoned the family and after a period of several months spent alone in a
school in a foreign country, whose language she did not speak, so that she was
able neither to understand nor to make herself understood. Through the use of
markedly primitive imitative mechanisms, this patient tried to regain magically
an identity, which in reality was vicarious and precarious, but which in fantasy was
magically lived as her own, and which corres-ponded to fusion with idealized
Federn (1952) would have preferred to reject in toto the concept of introjection
because it confused, in his opinion, that of identification, in the sense that it led
one to believe that a mental or bodily representation could be internalized by the
ego, for the sole reason that it was `thrown (ªjectedº ) within' it (introjected). He
would have substituted the term `internalization' for t hat of `introjection'.
Weiss (1960) distinguishes imitation from identification, and points out that he
is not referring to `simple imitation' but to a phenomenon of `reproduction' or
`autoplastic duplication'. The term `autoplastic', he says, was coined by
Ferenczi, to indicate `those processes which enable an organism to acquire and
modify its shape and functional parts'. The reference to the biological model of
imitative perception seems obvious, and the adjective `autoplastic' represents
very closely, in this connection, what in fact is verified. But Weiss, like Federn,
also considers introjection only as a badly chosen term, which confuses the
concept of identification. As Weiss says,
We must realize, however, that the metapsychological phenomenon of the
extension of ego cathexis over the autoplastic duplication of the object has
nothing to do with an act of throwing (or `jecting') something within one's
self. Therefore, we prefer to avoid the term `introjection'.
(1960:35)
Weiss therefore criticizes Anna Freud who, `like her father, does not share
Federn's concept of the ego¼for instance, she equates identification with
imitation, disregarding the phenomenon of egotization, that is, inclusion within
the ego feeling' (p. 35).
One cannot but agree that imitations are to be distinguished from
identifications. Concerning this, the merit of having insisted on the distinction is
to be given to Weiss. However, in rejecting the concept of introjection both
Federn and Weiss have failed to recognize the distinction between the two basic
physical models (`imitating in order to perceive' and `putting into the mouth')
precursors of the parallel psychic models (`imitating in order to be' and
`introjecting in order to put in'), and the consequent two-fold attitude towards the
object. In putting them together, WeissÐalbeit insisting on the distinction
of imitation from identificationÐhas committed the error of assimilating
introjection in imitation. Experience has in fact shown that introjection is not
merely a superfluous term but a concept relative to detectable phenomena of the
psycho-oral area, and it is therefore to be distinguished from imitation.
As I have mentioned above, imitations and introjections are constitutive
elements of the process of identification, which aims at fusing and integrating the
phenomena of the perceptive-imitative (sensory) area with those of the
incorporating-introjecting (oral) area, in the function of the superior processes of
the ego in the relationship with objective reality. We may be able in certain cases
to recognize the various levels of development of these two areas, and also the
interaction of the relative phenomena in their different stages. We should keep in
mind in this respect that early identifications, with their internalization of
fragmentary aspects of reality, represent in fact the first elements of the
secondary process. We should furthermore keep in mind that imitations and
introjections, more or less evolved, remain continuously active, independently of
the fact that they represent the principal constitutive elements of identification.
The latter, that is, cannot take place without the former, but on the contrary
imitations and introjections can occur without leading necessarily to
identification.
Experience has demonstrated that, in the study of the human mind, it is more
difficult to detect and study directly what is normal, and therefore less evident,
than to study the evidence of psychopathology and to move from this to the norm.
The fields of study which offer us the greatest possibility of detecting and
distinguishing imitations independently of identifications are, in practice, that of
dreams, which represent a sort of rich psychopathology, but innocuous and
circumscribed in the dream state; that of behavioural pathology, as we see it in
character disturbances and perversions; and that of psychosis, a state in which
the psychopathology normally to be met with in dreams has invaded, so to speak,
the waking state.
What I shall now relate is the dream of an adult person, a young married
woman with character disturbances. One can recognize in it a markedly primitive
imitation. This patient dreamed of `seeing' on the back part of her head (in a
zone of the body, therefore, not visible in reality) a large roundish area, completely
bald and more or less covered by the long hair of the front of the head, combed
backwards for this purpose. `Strange', she thought, `they say that only men go
bald, but I've gone bald too; and yet, I am a woman.' (In reality this woman
wore her hair very short, like a man.)
Among the dream associations it came out in an almost casual way and as
though without importance (`I'll tell you because it has come into my mind, but I
don't know whether it's important') that a couple of evenings earlier she had
visited her parents, whom she had not seen for some time, and had noted that her
fatherÐwho was bald at the back of his head as she had been in the dream, but
wore his hair short at the frontÐhadlet it grow, and had combed it back to cover
the baldness. She had only briefly noticed it, and had not even mentioned it to
her father, and certainly it would not have come to her mind if it had not been for
the dream.
Naturally, I shall not enter into the meanings of this dream. What I want to
underline is that it gives us an example of primitive imitations judging from its
characteristics and from the context of the dream. This imitation in fact appeared
on the basis of the memory of a perception; it represents in a hallucinatory form1
something which is lacking in the self; it claims magically `to be', using a part for
the whole (the representation in image that is, as Freud observed, in itself a
guarantee of reality); it is autoplastic in Ferenczi's sense, which is a
characteristic of primitive imitation.
The following is, in contrast, an example of a primitive introjection, as it
appeared in the dream of another patient. In the dream she found herself in a
shop buying clothes when she suddenly discovered that the bezel of her ring was
empty and that she had lost the diamond which filled it. She looked round
anxiously and noticed two little girls in the open lift. One of them was showing
the other a diamond: `Look how lucky,' she was saying happily. `I've just found
it on the ground.' The dreamer intervened immediately, taking back the
diamond. `No, no', she said, `this is mine, I lost it just now,' and as proof, she
showed her empty ring. Once she had regained the stone she was seized by the
worry of not knowing into which pocket to put it in order to be sure of keeping it
with her. She then decided that the only safe way was to swallow it.
In the associations which followed, the dreamer added particulars on the form
of the diamond. It had the form of a champagne cork. She then remembered
having read that the uterus has the form of such a cork. This notion, acquired
intellectually and recently, was only another indication regarding the part-object
dreamt, and which was supposedly found inside the body. In turn, the bezel
without the diamond represented a primitive image of the body self-conceived as
empty; that is, lacking that precious content.
In contrast to the previous dream, and confirming the distinction originally
made by Freud, it can be seen that the object here is not `what one wants to be'
but `what one wants to have', or, if one prefers, `what one wants to be through
having ' with the warning, however, that at this infantile level `to be' and `to
have' are lived in the ambit of the only reality possible: that of one's own body.
In both dreams visual perception is in action while the motor apparatus, which is
implied in the dream of introjection (`putting in the mouth'), does not seem to be
implied in that of imitation. This does not mean that in imitations the motor
apparatus is not implied, but only that this fact is a sign of the particular
primitiveness of the imitation described above.
In fact, the development of the imitative process seems to influence noticeably
in early infancy that of the motor activity, so that an intensification of imitative
activity may enter as a determining factor in the precocity of certain motor
behaviour, or of particular abilities, both motor and of the articulate language.
The intensity of the imitative process is decidedly influenced in turn by the
degree of frustration of oral activities, in the sense that it increases in proportion
to such frustration. With reference to this it seems necessary, however, to
distinguish frustration in an absolute sense (due, that is to a decisive lack of oral
gratifications) from frustrations in a relative sense (due instead to an excessive
sensory stimulation, above all tactile and visual). The lack of oral gratifications
is always followed by more or less serious consequences, but we should expect
that frustrations of an absolute nature will lead to more regressive and damaging
imitative manifestations, compared to the frustrations of a relative type.
Furthermore, the precocity of the affected period of development seems to be in
direct relationship to the seriousness of the consequences. In extreme cases the
modification of the body self-consequent on the intensification of the imitative
process may give illuminating clinical pictures.
One condition very little known to many analysts, and very serious because of
its high mortality rate, but fortunately rare, is that which is known as `merecysm'
or `rumination'. The syndrome arises in the first year of life but, in our
experience, not before the third month. In a study made of six cases (a
considerable number, in view of its rarity) by Gaddini de Benedetti and Gaddini
(1959), in three cases the syndrome arose in the third month, in two cases in the
fourth and in one in the eighth. All these children had been subjected to a regime
of serious frustration of oral activities, added to the effects of traumatic weaning.
In all the cases the relationship of the mother to her own child was decidedly
pathological. Observation showed that rumination occurred at a variable interval
after meals; in some cases immediately after, in others up to an hour and a half later.
Rumination was preceded by visible tension. While, for example, the child was
sucking his thumb he would stop suddenly, grip the sheet, try to put it in his
mouth, then begin sucking his thumb again with feverish, anxious movements.
Rumination began with a rhythmic autostimulation of the oral cavity, obtained
by introducing the thumb into it and pushing it against the back of the hard
palate. The stimulation of this area was accompanied by sucking movements and
by rhythmic contractions of the pharyngeal and epigastric muscles: one had the
impression that the smooth musculature of the oesophagus, the cardias and the
stomach was also involved. In the meantime the tongue was rhythmically
projected forwards, with the central part depressed. During this stage, which
could last from 15 to 20 seconds to a couple of minutes, the child had an
absorbed, intense expression and showed no interest in his surroundings. At a
certain moment small quantities of milk began to appear at the back of the oral
cavity. The rhythm of the movements then accelerated in culminating tension, until
the oral cavity was flooded with milk; this usually took a few seconds.
In these children the peremptoriness of the need to regain the fusion with the
object and the intensity of the relative hallucinatory fantasies succeeded in
producing modifications of the body self such as to procure a physical state of
gratification similar to that which, it should be noted, had already been
experienced in reality, but which had abruptly and prematurely come to an end.
The fact that the syndrome was not manifest before the third month and that it
was first preceded by repeated and incoercible vomiting seems to substantiate
fully the view of Greenacre that
development of defensive measures of the human organism seems to
proceed in an ontogenetic fashion from early direct or reflex reactions of a
purely physical nature, operating against the environment to the complex
structure of psychophysical responses.
(1958a:69)
It should be added that, at least in our cases, the psychophysical answer could
not be considered as casual: it was extraordinarily modelled on the physical
response of vomiting. It is a fact that rumination repeats very closely the
physical phenomena which occur in vomiting, except that they are in the first
place actively self-induced, and not merely undergone; furthermore, they are
psychically controlled and coordinated in the service of fantasy, in such way as
to give rise to a physical experience imitative of that gratifying fusion which is
no longer to be experienced in reality.
The syndrome of infantile rumination should therefore be defined as a
psychophysical complex response (in Greenacre's sense) to a state of oral
frustration of an absolute type. The first response to such a state of frustration is
physical and uncontrolled (repeated vomiting). The later psychophysical
response is, on the contrary, complex and organized even though primitive. It
tends to put under control the physical response of vomiting and to transform it
in such a way that it serves the economic aims of a more efficient defence than
the merely physical one. It tends in practice to obtain a reduction of the tension
aroused by the serious frustrations of the oral area and to such an end aims at
regaining, through a physical, imitative reproduction, the gratification which had
previously been experienced.2
No less extraordinary, even though, as we have said, less serious for
development, are the effects following the oral frustrations which we have called
relativeÐthatis, due to an excessive intensification of the sensory stimuli (above
all tactile and visual), and, in relation to this, a relative insufficiency of oral
stimulations, in the first months of life.
We owe to Greenson (1966) the description of a case of great interest, a child
whom he had the opportunity of treating analytically at the age of 5½ years. This
child, called Lance, behaved exactly like a transvestite adult, except that Lance
had begun this behaviour even before he had reached the age of 1 year. At about
11 months, in fact, Lance already wanted to put on the shoes belonging to his
mother and his sister (who was six years older than he was). `He very quickly
seemed to prefer above all to walk around in his mother's high-heeled shoes and
wept furiously when she tried to remove them.' Since he was so small and
seemed so charming, he was allowed to go on wearing them.
Later on he was able to run up and down stairs in these shoes, to climb trees
in them, ride his bicycle, etc. He gradually put on other items of clothing;
blouse, stockings, purse, hats, etc., until he began to insist on dressing as a
(1966:252±3)
Lance's father was on very bad terms with his wife, and Lance had hardly any
contact with him. In describing the behaviour of Lance in analysis, Greenson
says that Lance was hungry for identification and imitation. From the description
which he gives of the child's behaviour a very intense imitative activity is
evidenced, together with a very slight, not to say non-existent, capacity for
identification. It was enough for Lance to watch what another person was doing
in order to be capable of repeating it immediately, and well, even if he had never
done it before. `For Lance, loving was equated with becoming, with some
primitive form of identification and imitation' (p. 264). Greenson says, of his
relationship with his mother, that `the tactile and visual over-exposure to his
mother's body helped to c onfuse his gender identity' (p. 264).
Lance's mother was analysed by Stoller (1966), who reported on her in a
paper complementary to that of Greenson. Stoller confirms what Greenson says.
The mother allowed Lance to stay with her whenever she was nude, to a degree
unusual in our culture. For the whole of the first year of life he had been seated
or curled up on his mother's body li ke a little kangaroo in its mother's pouch.
As he became