Welcome to Child Psychopathology Class 10 Dr. Geoff Goodman ext. 4277 ggoodman@liu.edu Course Website: http://myweb.cwpost.liu.edu/ggoodman/home.htm

The Structural Approach To Development Heinz Hartmann’s ego psychology model Concept of “change of function”—behavior originating at one point in development may serve an entirely different function later on Cleanliness might serve a different psychological function in adulthood than in childhood. Secondary autonomy—behavior achieving autonomy from its childhood instinctual origins Genetic fallacy—assumption that adult behaviors serve the same function as in childhood Splitting and identity diffusion might be related to adolescent trauma Apparatuses of primary ego autonomy—ego mechanisms that do not evolve out of id frustration Perception Memory Motility

The Structural Approach To Development Conflict-free sphere—part of the ego that operates independently of the id Frustration of drives contributes to organization of the ego Average expectable environment—importance of actual parents in psychosexual and psychosocial development—adaptation versus maladaptation Adaptation to what kind of environment or culture? Synthetic function of the ego—emerging components and functions come to be linked, forming the ego (coherently functioning organization) Content of intrapsychic conflict (oral, anal, phallic, oedipal) not relevant in comparison with the ego’s relative autonomy from the id

The Structural Approach To Development Symptoms—compromise formations among agencies of the mind (primarily id and ego) Drive derivative—personal childhood wish for gratification Unpleasure in the form of anxiety or depressive affect Fear of object loss Fear of loss of object’s love Castration Defense, which functions to minimize unpleasure Manifestations of superego functioning—guilt, self-punishment, remorse, and atonement Psychic development within the structural model Erikson—eight stages of psychosocial development Trust vs. mistrust (0-18 mos.) Autonomy vs. shame and doubt (18 mos.-3y ears) Initiative vs. guilt (3-5 years) Industry vs. inferiority (5-11 years)

The Structural Approach To Development Identity vs. role confusion (11-18 years) Intimacy vs. isolation (18-40 years) Generativity vs. stagnation (40-65 years) Ego integrity vs. despair (65-death) Shift from drive theory to interpersonal theory with caregiver-child dyad at center Spitz Shifts in psychological organization are marked by the emergence of new behaviors and new forms of affective expression Self-regulation—important function of theory Mother’s emotion expression serves a soothing or containing function Infant then uses the mother’s signaling device to indicate safety Infant later uses the mother’s emotional response and uses his or her own emotional reaction as a signal of safety Noted presence of depression in young children

The Structural Approach To Development Jacobsen Caretaker behavior determines quantity of good and bad valences of self and object representation Maturation and caregiver behavior determine differentiation between self and object representation Superego regulates self-esteem and behavior Loewald Drives are inherently related to and organized with object relations Development of the psyche occurs through disorganization and reorganization at a higher level (e.g., pregnancy, parenthood) All mental activity is relational Internalization (learning) is the basic psychological process that propels development Oedipal conflict reflects the emerging capacity for self-reflection Psychic separateness is the price for reflective self-awareness

Structural Model of Developmental Psychopathology General features of the model Regressions result from interagency conflicts that the ego cannot resolve Ego’s failure results in symptom formation through compromise with other agencies (id and superego) Intensification of guilt Intensification of drive demands Inappropriateness of these demands in relation to the external world Pathogenic sequence Frustration Regression Internal incompatibility Signal anxiety Defense against regression

Structural Model of Developmental Psychopathology Return of the repressed material Compromise and symptom formation Ego restrictions can cripple psychic functioning The structural model of the neurosis Conversion hysteria—compromise achieves dramatic representation in somatic form and reflects an oral or phallic fixation Obsessional neurosis—ego binds anal sadistic and aggressive drive derivatives into forms of secondary process thinking (e.g., rumination, obsessional doubt) Phobias—fear is external but may reflect quite similar unconscious developmental concerns (use of projection as defense) The structural theory of personality disorder Character neurosis—similar to neurosis except that compromise formations are not split off from the ego (ego-syntonic symptoms)

Structural Model of Developmental Psychopathology Evidence suggests real differences between character disorder and character type—underlying processes are different Personality disorder—ego functions are impaired Reality testing impaired Anxiety tolerance impaired Stable defenses impaired Model of borderline personality disorder Ego functions impaired by trauma Integration (synthetic function of ego) Concept formation Judgment Realistic planning Defending against eruption into conscious thinking of id impulses and their fantasy elaborations

Structural Model of Developmental Psychopathology Identity diffusion—deficiency in temporal continuity of self-experience and social group of reference Regressive defense against deeply disturbing oedipal issues Structural theory of antisocial personality disorder Failure of progression from pleasure principle to reality principle Malformation of superego Causes of obstacle to renunciating pleasure principle Deprivation Internalization of poor parental norms Ego keeping superego at a distance and therefore unable to control impulses Superego bribed by the ego Superego lacunae—gaps in moral reasoning because of the parents’ unconscious wish to act out forbidden impulses

Structural Model of Developmental Psychopathology Singer’s tripartite model Drive disturbance (e.g., stealing to undo impotence and castration) Disturbances of ego functions (heightened sensitivity to displeasure, disturbed reality testing, inability to deny action by fantasy) Corruptible, defective superego Structural model of the psychoses Profoundly disturbed early ego development Regression to very early, normal functioning

Criticism and Evaluation Drives no longer viewed as firmly anchored to developmental stages Failure to resolve psychological conflicts in the domain of wishes and ideas causes somatic distress and not vice versa (e.g., sex addiction) Addiction can sensitize the wanting system and create a drive related to craving Dreaming and craving experienced in addictions share the same dopaminergic neural pathway Ventral tegmental area of brain—neural structure that most closely fits Freud’s concept of instinctual drive states