| Abstract: | This paper has discussed certain ego disturbed children of preschool and school age with infantile personality disorders. Although these children do not form a sharp diagnostic category, it is of clinical importance to differentiate them both from the neuroses and from other more serious ego disorders. These predominantly infantile children suffer chronic ego arrest and deviations as well as some degree of internal conflicts. Reality adaptation is characteristically distorted, ego defenses imbalanced, and social relations aberrant. Unlike some other borderline types, however, these children have no significant potential for psychosis. They are not prone to panicky anxiety attacks, or to psychoticlike ego regressions or withdrawal. Ego disturbed children with infantile personality disorders pose certain typical problems of therapeutic technique. They do not possess the ego strength for classical analysis, nor are they suitable candidates for a purely supportive or nurturing treatment. I have argued that the particular psychopathology of these children requires a form of corrective developmental treatment in which the therapist plays a flexible role and uses a combination of techniques corresponding to the child's progressive ego development. Early in treatment primarily supportive and nurturing techniques are used to promote a corrective identification and strengthen the defenses. As treatment proceeds, however, selected interpretations are introduced to modify the internal conflicts that block personality integration and development. Especially important are the mobilization and interpretation of hostile aggression. In the later treatment phases the therapist becomes increasingly more frustrating to the child's infantile wishes, encouraging reality adaptation and social maturation. The various shifts in therapeutic technique create resistances whose interpretation and working through are integral to the treatment process and cure. |
