THE scientific study of child development did not begin until the twentieth century, which has been called, among other things, the Century of the Child. If it is to live up to this label, we must make better use of the next forty years than we have of the past sixty. But the revolution in child psychiatry is still relatively young, and I will begin by trying to sketch the somewhat erratic course it has taken so far.
If I dwell on the thought and influence of Freud, it is because I speak as a child psychiatrist; but I do not wish to minimize the contribution which outstanding people in other disciplines have made to our understanding of childhood. Piaget and Sears in the field of psychology, Mead in anthropology, Lorenz in ethology, and the Russian Pavlovians are a few of the people that come readily to mind. Freud, however, was the first to attempt to give us a body of scientific knowledge that would lead to a general psychology of man. The anthropologists, applying this knowledge to the study of culture and society, found that child-rearing processes furnished illuminating clues to an understanding of people and their institutions. The pediatricians learned to connect physical growth with emotional development, and the way was paved for Dr. Spock to write his bible on the subject of infant care. Whichever way we turn, we detect the seminal influence of Freud's discoveries.
Freud's investigations into the neuroses of adults forced him to reconstruct their early childhoods and provided clinical support for the old belief that "The Child is the father of the Man." His findings led him to frame not only a psychology of man but also laws of human development, and his contributions have completely changed our image of childhood. Gone is the sentimental view that childhood is an era of innocence and the belief that an innate process of development continuously unfolds along more or less immutable lines. Freud suggested that, from birth on, the child's development proceeds in a succession of well-defined stages, each with its own distinctive psychic organization, and that at each stage environmental factors can foster health and achievement or bring about lasting retardation and pathology.
This realization has placed new and complex responsibilities on parents, teachers, and community services. Many parents are now well aware how much their presence or absence, their words, their actions, indeed, their whole emotional state affect their children. This is an important gain. Unfortunately, it must be added that Freud's theories have also been widely misunderstood. For one thing, they have often been taken to mean that discipline should be suspended, controls eliminated—in sum, that the child should be continuously gratified. Freud, on the contrary, pointed out that denial and conflict were as essential a part of the process of growth as gratification, and he never minimized the child's need for direction.
There are two main reasons why this aspect of Freudian doctrine has been so seriously misinterpreted. In the first place, his early studies of neurosis, made in the bourgeois culture of the late Victorian era, brought to light the damaging effects of authoritarian parental control, moral overrestriction, and stifling prudery; and it was no doubt inevitable that his emancipatory discoveries should have encouraged a concept of child rearing which went overboard on the side of permissiveness.
A second reason for the confusion which has arisen is to be found in the path followed by Freud's own thought. In the early years, he concentrated on those factors in neurosis which stemmed from abnormal repression of the instinctual drives, the forces of the id. It was not until the nineteen twenties that he shifted the main focus of his investigations from the id to the role of the ego —the managerial aspect of man's psychic structure which seeks to align his instinctual drives and moral imperatives with reality. Now, when Freud's doctrine began to be widely propagated in the nineteen twenties, its publicists and popularizers were, at best, familiar only with his early work. They were the spokesmen of a cultural revolt which sought to discredit the moral prohibitions of the past, and they presented an often garbled version of Freud's early findings as a scientific justification of the cult of uninhibited "self-expression." Even today, few laymen are well acquainted with Freud's ego psychology, which emphasizes the organizing and integrating aspects of the ego. These later theories are very important to our understanding of the child. They show that the ego is not self-formative, and they clearly imply that the answer to the crippling restrictiveness of the past is not its diametric opposite, unqualified license.
In fact, Freudian psychology does not, as some people apparently imagine, provide a set of ready-made prescriptions for the rearing of children. It has forced us to take into account not only what the mother or teacher does to a child, but also how it is done; not only whether the mother nurses the baby and spends much time with him, but also whether she is able to give him gratification and support his strivings for mastery. The complexity of the interactions between mother and child cannot be reduced to rigid formulas. Love and understanding cannot be prescribed, and if they are not genuinely manifested, the most enlightened efforts to do what is best for the child may not be effective.
It is certainly encouraging to see how eager are millions of parents today to learn how they can contribute most to the development of their children; the upsurge of interest in this field is nothing less than extraordinary. But a note of caution must be sounded. It is a mistake to look for clearcut, universal answers on such issues as schedule feeding versus demand feeding, imposed toilet training versus demand training, discipline versus self-regulation. In every case, individual factors are involved, and one needs to know the specific quality of the parent-child relationship before recommendations can safely be made. The newspaper or magazine columnists who impersonally dispense answers to their readers' queries are likely to oversimplify the problems, and their advice could readily be misleading. The whole of Freud's contribution points up the complexity of human nature and the intricacy of the laws which govern the early phases of development. Whoever has understood a single page of Freud knows that he never dealt in facile prescriptions.
IT is only in recent years that child psychiatry—the term was first used in 1935—has become recognized as a specialty in its own right. In the past, children were treated as though they were small adults. Their mental disorders were approached with the same criteria as those clinically applied to adults; it was not realized that the same disorder manifests itself differently in a child than in a grown-up person, because the child's organism is different. Thus, until two decades ago, no one diagnosed schizophrenia in childhood, owing to the fact that the expected symptoms were not encountered. But systematic observation of children from birth on has enlarged our understanding of child development, and one of the consequences of our new knowledge is the discovery of schizophrenia in childhood. Indeed, tremendous progress has been made in helping schizophrenic children, even though the precise cause of the disease remains obscure.