Some technical implications of Klein's concept of 'premature ego development'

In this paper, the author revisits the problem of 'premature ego development' first introduced by Melanie Klein in 1930. She also highlights several developments in post-Kleinian thinking since the publication of that paper, which can be seen as offshoots of or complements to Klein's work. The author proposes a link between this category of precocious development and the absence of the experience of what Bion termed the 'containing object.' She puts forward several technical considerations relevant to analytic work with patients who suffer as a result of early developmental failures and presents various clinical vignettes in order to demonstrate the ways in which these considerations take shape in the analytic setting.     

The influence of infant irritability on maternal sensitivity in a sample of very premature infants

The relationship between maternal sensitivity and infant irritability was investigated in a short‐term longitudinal study of 29 very preterm infants. Infant irritability was assessed at term with the Brazelton NBAS, the Mother and Baby Scales (MABS) and the Crying Pattern Questionnaire (CPQ). Maternal sensitivity was assessed by nurses' ratings in the neonatal care unit and at three months during mother–infant interaction observation. Cross‐lagged panel analysis indicated that neonatal irritability did not influence sensitivity at 3 months nor did maternal sensitivity in the newborn period lead to reduced irritability at 3 months. Both irritability and maternal sensitivity showed moderate stability over time (r = 0.55 and r = 0.60, respectively). It is concluded that in early infancy maternal sensitivity shows little influence on infant irritability in very preterm infants. Copyright © 2003 John Wiley & Sons, Ltd.     

Maternal verbal interaction in different situations with infants born prematurely or at term

The present study investigates whether maternal verbal behaviour, in terms of the use of declaratives, interrogatives and imperatives, can be accounted for by gestational age of the infant, or the situation in which mother–infant pairs were observed. Thirteen mothers and their premature and term babies were observed twice in three situations, namely playing with, feeding and changing their infants. The first observation took place at a mean gestational age of 40 weeks and the second observation took place approximately 7 weeks later. All mothers used more imperatives during play than during changing or feeding situations. Mothers used more interrogatives during play than during changing or feeding, and they used more declaratives during both changing and playing than during feeding. In contrast, gestational age influenced only the complexity of maternal interrogatives. It is concluded that situational factors are significant and hence that the mother's role has to be judged relative to the context in which mothers and infants are observed. Copyright © 1999 John Wiley & Sons, Ltd.     

Predicting preschool motor and cognitive performance in appropriate-for-gestational-age children born at ≤ 32 weeks gestation

Although many follow-up studies have been performed on preterm infants, little attention has been devoted to prediction of motor skills in the preschool or school years. We studied the relationship of performance on the Bayley Scales of Infant Development at a mean corrected age of 21 months to performance on the McCarthy Scales of Children's Abilities at a mean corrected age of 44.7 months for 43 appropriate-for-gestational-age (AGA) children born at ≤ 32 weeks gestation. Motor scores were stable over time with a significant correlation between the Bayley Psychomotor Developmental Index (PDI) and the McCarthy Motor subscale (r = 0.60; p = 0.0001). Scores of cognitive abilities also showed a significant correlation between the Bayley Mental Developmental Index (MDI) and the McCarthy General Cognitive Index (r = 0.42; p = 0.009). Small-for-gestational-age (SGA), very low-birthweight (≤ 1500 grams) children scored lower on the McCarthy General Cognitive Index (p = 0.01) and on the Motor subscale (p = 0.047) than the AGA children. We concluded that motor performance of AGA children born at ≤ 32 weeks gestation is stable from toddlerhood to preschool age. We suggest that SGA children be excluded from studies of motor performance of prematurely born children.     

Evaluations of pairs of experiences: A preference for happy endings

Experiences often consist of a number of temporally separated events or outcomes, events which might be positive or negative. Building on previous research, the present paper proposes that the chronological order of the component events influences overall evaluations of these experiences. In particular, a preference for happy endings is hypothesized such that an experience consisting of a positive and a negative event is evaluated as more satisfactory if the positive event occurs last. This preference is examined in three studies in a variety of contexts. A preference for happy endings is shown to influence people's preferences, even to the extent of influencing preferences for segregated versus integrated events (Thaler, 1985). The implications of a preference for happy endings for decision researchers are also explored.     

AFFECT,SYMPTOM, FANTASY,DREAM: CLINICAL AND THEORETICAL CONSIDERATIONS

A symptom being studied in the process of analysis can be seen as not unlike the unconscious affect it sprang from. The author presents a case in which a symptom, premature ejaculation, was analogous to the unconscious affect of guilt, which itself seemed to be a premature defensive transformation of a deeper current of anger. Guilt was interpreted as if it were a psychic premature ejaculation, a defensive derailment of anger. Fantasy and dream seemed to be engaged in similar transformations, with a fantasy of “premature incarceration” not unlike the symptom itself in its analogous functioning. Analysis of affect, symptom, fantasy, and dream in complex, integrative analytic process led not only to resolution of the symptom itself, but also to a deeper understanding of the mind's complex functioning in general.     

What does it take to let go? An investigation into the facilitating and obstructing factors of forgiveness–the therapist's perspective

The phenomenon of forgiveness, initially neglected by psychotherapists due to its religious connotation, is finding increasing recognition as a transformative process involving the injured party in a profound way. This thesis is based on therapists’ experiences with clients who have been emotionally wounded. However, its content may be of relevance also for those who are struggling to forgive as well as those who are in a position to help others undergoing this process. Fifteen practitioners, most of them highly experienced, from eleven different countries on four different continents, have shared their observations and experiences by filling in an e-mail administered in-depth questionnaire. The topic has been approached with the following study objectives: the nature of forgiveness, intrapersonal and interpersonal factors affecting forgiveness, and the role of the therapist in the client's process of letting go. A qualitative research design has been applied for the data analysis, to identify the major themes of each research question, representing the facilitating and obstructing conditions relevant for forgiveness. Since the danger of premature forgiveness emerged as a recurrent concern, a “forgiveness chart” has been developed, assigning the analysed data to relevant categories: A reference tool designed to support a genuine process of letting go.     

Boarding school: the trauma of the 'privileged' child

Sending young children to boarding school may be considered a particularly British form of child abuse and social control. The trauma of the rupture with home may be followed by other ordeals such as emotional deprivation and, in extreme cases, physical and sexual abuse. The taboo on expressing emotion, which is common in such institutions, may lead to an encapsulation of the self. Consequently, the needs of the distressed child/self remain active, but unconscious, within the adult. This maybe disguised by an armoured, and very often socially successful, persona. The psychological interplay, between these two facets of the personality, may be detrimental to intimate relationships. In clinical practice the emotional conflict between a desire for intimacy and anticipated exile comes to the fore. Three examples demonstrate how within the transference this may lead to a dependent and erotic atmosphere, which abruptly changes to sever all connection. Changes in the frame, breaks in analysis, and confessions of emotional need are all points at which vigilance is required if such disturbance in analysis is not to end in its abrupt termination.