Infantile Neurosis

views updated

INFANTILE NEUROSIS

A psychogenic mental disorder, infantile neurosis manifests expresses a psychic conflict that has been symbolically noted in the subject's early childhood. The term is used to designate either a disorder characterized by neurotic pathology, with variable prognostications, or a transference neurosis, constituting the prolegomenon of adult mental problems. Infantile neurosis is organized in terms of a dependency model. This results in counter-transference reactions on the part of the adult, which can be dangerous for the future development of the child, especially if the adult concerned remains oblivious to such a possibility.

"Little Hans" was treated by his father, who was in turn "supervised" by Freud. Freud himself only saw this five-year-old boy twice. Hans suffered from a phobia that prevented him from any activity, a fear that arose from having seen a horse fall on the ramp at the Vienna railroad station. When Freud saw Hans again as an adult, his parents had separated and he had drawn closer to his father. He did not recognize Freud, and he did not appear to be very healthy mentally. The son of a musician, by the end of his professional life he was director of the Geneva Opera, but his career left few traces. About all that is known about him is that he was interested in Wagner's Ring Cycle, that he staged the story of Brunhilde and Wotan, and that he was particularly taken with Siegfried's search for a mother in Brunhilde.

One might therefore agree with Jean Bergeret, who argued that this boy had a phobia linked to the his father's relations with his wife, who had been analyzed by Freud. Freud perhaps knew too much about this family's secrets. Despite the appearance of having been cured of his phobia through Freud's work of interpretation, Hans suffered from a neurosis that certainly inhibited his creativity.

The cases of the "Wolf Man" and the "Rat Man" published by Freud have been the object of extensive commentary. The Wolf Man, Sergei Pankejeff, suffered from an infantile neurosis. Freud concentrated on describing the key fantasy of observing the coitus of the parents, especially in the context of the dream of wolves. In this nightmare, the patient saw immobile wolves, sitting on the branches of a tree and staring at him. Eventually the Wolf Man was declared to be psychotic. He died at the psychiatric hospital of Vienna after a number of psychotic episodes, which were treated by students of Freud. At the end of his life the Wolf Man said terrible things about Freud to a Viennese journalist. However, he had been supported by psychoanalysts, who purchased paintings in which he depicted his dream.

In fact, it was on the basis of this dream that Freud had decided to study the primal scene. He wanted to determine if the wolves that observed Pankejeff were placed in a situation opposite to the real one, when, as a child, he witnessed his parents making love. It seems probable that the coitus a tergo of animals had been attributed by the child to humans.

It is known that the Wolf Man had made the rounds of psychiatric services in Germany, ending up with Freud after seeing many other doctors. After he was financially ruined during the Russian Revolution, he married one of his nurses in Vienna. She was somewhat able to contain his madness. It is understandable that this man, who had paranoid tendencies, but was also persecuted in reality, would try to protect himself through various fantasies. But he needed to renounce them in order to find some peace and be able to return to a more normal life.

The Rat Man, who died during World War I, was traumatized in his childhood by his relations with the nurses who raised him and who had pathological sexual experiences with him. As an adult he suffered from an obsessional neurosis; many notes about Freud were found with him; and once in the course of a transference he attempted to transform Anna Freud into one of his nurses, insulting her constantly.

Neurotic symptoms in childhood do not necessarily lead to adult neuroses. In the adult, the existence of neurotic symptoms can mask an underlying psychotic structure. Furthermore, the study of the evolution of certain cases of autism treated by psychoanalysis demonstrates frequent obsessional masking of psychoses, as is also the case in serious obsessional neuroses in children.

In Serge Lebovici's report on the relation between infantile neurosis and transference neurosis presented to the Congrès des psychoanalystes de langue française des pays romans, he recalled Anna Freud's theory that normal neurotic symptoms were a sign of good psychic health in a child during the oedipal phase: the repression of the drive is generally insufficient at that time, and thus transitory neurotic symptoms will arise. It has been demonstrated that the absence normal infantile neurosis is a sign of a predisposition to psychoses. However, subsequently Lebovici considered that his exposé should have been slightly rectified: normal infantile neurosis is also a sign of a solid narcissism, linked to a narcissistic cathexis with "His Majesty the Baby" on the part of his parents, who structure the ego of the child. The organization of intersubjectivity demonstrates the importance of family relations to the psychic life of the child. The kinship system accords a huge place to the imagined child, that is to say, to the imaginary and phantasmic child of the mother. This is contemporaneous with the child's proto-representations. This ensemble communicates the presence of phantasmic interactions and also shows the importance of the role of the child in the psychic lives of the parents.

When this double process is satisfactory, the inter-generational transmission results in a solid and flexible ego. However, when there are "ghosts in the nursery" (Selma Fraiberg), this double process fails and the cultural constitution of filiation becomes impossible, illustrating the importance of studying the early interactive stage. But this work comes up against various obstacles that are not oedipal.

The triangulation process starts relatively early. It is preceded by a triadic arrangement, in the course of which the father and mother, in present-day society, play a specific role, allowing one to predict of the possible outcomes of triangulation. In the dull repetition of interactions, certain events are fundamental to the reconstitution of the interaction: they are "spoken backwards"—that is to say, they become truly significant events.

This perspective give understanding of the specific incidents in upbringing that demonstrate the modalities of the transmission of attachment, asJohn Bowlby anticipated them. Mary Ainsworth has described this kind of attachment as the "strange situation," transmitted according to genetic rules. The mechanisms of transmission in the adult follow the principle of a genetic transmission (Mary Main). Peter Fonagy has built on this idea, considering that children forced to deal with insecure transmission would benefit from a psychotherapeutic approach, which can modify the givens of this genetic transmission, as can be observed in thirty percent of cases. Studies on narration seem to confirm that episodic memory inscribes these givens, emphasizing the importance of the "proto-narrative envelopes" described by Daniel Stern.

Serge Lebovici

See also: "Analysis of a Phobia in a Five-Year-Old Boy (Little Hans)"; "From the History of an Infantile Neurosis (Wolf Man)"; Infantile, the; Neurosis; Phobias in children; Prepsychosis; Psychoanalytical Treatment of Children ; Transference neurosis.

Bibliography

Freud, Sigmund. (1909b). Analysis of a phobia in a five-year-old boy. SE, 10: 1-149.

——. (1914c). On narcissism: An introduction. SE, 14: 67-102.

——. (1918b [1914]). From the history of an infantile neurosis. SE, 17: 1-122.

Lebovici, Serge. (1980). L'expérience du psychanalyste chez l'enfant et chez l'adulte devant le modèle de la névrose infantile et de la névrose de transfert. Revue Française de Psychanalyse, 64, 5-6, 733-857.