The debate on day care continued.
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Biomedical subjects
Publications and source records attributed to J S Kestenberg.
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Data from several sources were presented to elucidate the following thesis. The disruptions of rules and regulations in the lives of infants and children, born during the Holocaust, leave as an aftermath a recurring affecto-motor or somatic state of feeling badly which is conceptualized as being bad. The younger the child, the more likely he is, later in life to re-experience trauma as feeling bad, whereas feelings of emotional relief are remembered by things that made the child feel good, such as milk or sugar. The superego that is built to a great extent on feelings of comfort and discomfort, on pain and pleasure, that come and go unaccountably, can become fragmented. In analysis an ego strength is revealed that was masked by a split in the superego. The ego of the child survivor can be quite resilient and flexible. Children and adults suffered from a disintegration of the superego when their values were shattered in the extreme demoralization of a society of persecutors and victims. The parental fragmentation of the superego served survival, but it compounded the lack of integration of the superego-precursors in children. As adults regained a feeling of worth and could re-establish their old values and rebuild their superego, their children were greatly helped in integrating their own. Parenthood raised their aspirations and helped them to heal the rift in the superego.
This is the first in a series of papers about the relevance of infant therapy to the treatment of adults. A description of maternal and infantile movement patterns is used to substantiate our thesis that not only does the mother hold the child, but the child holds the mother. A good-enough holding environment is maintained when the mother's adult patterns of effort and shaping dovetail with the infant's inborn reflexes to make mutual holding possible. Mutual support enables mother and child attune in tension-flow rhythms (used for need satisfaction) and to adjust in shape-flow rhythms (used for intake and output). Attunement is the physical core of empathy, and adjustment is the cradle of trust. Empathy and trust between therapist and patient develop in a good-enough holding environment which is derived from mutual holding in early infancy. Not only does the therapist provide a holding environment for the patient, but the patient does his share to support the therapist in his aims.
This is the second paper in a series of papers concerned with the relevance of infant therapy to the treatment of adults. The detailed presentation of a case of infant therapy illustrates our thesis that (1) early failures in mutual holding lead to a distortion of the body image, to an insufficient development of trust and empathy, and to a difficulty in holding-oneself-up and becoming self-reliant; (2) movement retraining of mother and infant is a method of choice to prevent the sequelae of holding failures; (3) insight gained from infant-therapy through movement retraining helps us understand adult patients whose body attitudes reveal their attempts to hold themselves up by putting strain on their neck, back, or shoulders; (4) the analysis of the defensive use of certain parts of the body for self-support reveals the underlying fear of falling, collapsing or falling apart.
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