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Gitelson, M. (1943). Disorganizing Factors of Infant Personality: Margarethe A. Ribble. Amer. J. of Psychiatry, XCVIII, 1941, pp. 459–463.. Psychoanal Q., 12:297-298.
Psychoanalytic Electronic Publishing: Disorganizing Factors of Infant Personality: Margarethe A. Ribble. Amer. J. of Psychiatry, XCVIII, 1941, pp. 459–463.
This is a highly condensed statement of observations from the author's wide experience with infants and young children. One who has worked with young patients and their mothers will be impressed with the psychobiological pertinence of Ribble's findings. It remains for them to be formally integrated into expanding psychoanalytic theory.
The tendency towards 'functional disorganization' is a consistent phenomenon among infants who suffer from deviations in maternal care and handling. Eating, sleeping, and elimination are disturbed, motor and psychic organization may be affected, even life itself may be threatened. There is a potential danger from sudden or premature separation from the mother (or from a poor relationship to her) for a long period of time because of the slow maturation of
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the nervous system. The consequences include disturbances of feeding, assimilation and breathing with resultant 'mounting tension of inner hunger'.
In addition to the child's need for the satiation of its own characteristic degree of oral tension (two hours of sucking as a daily minimum) and anal tension (premature bowel training must be avoided), the most important need is that of a 'long, uninterrupted period of constant and skilful psychological mothering by one individual'. This is necessary until speech is well developed and the child has acquired 'self-security and voluntary control of body equilibrium'. It is a primary form of experience which satisfies what the author calls 'stimulus hunger' and helps bring the nervous system into functional activity.
Three types of sensory experience contribute to this. First there is the tactile experience of feeding and sucking, and of being held and fondled by the mother. Shallow respiration is related to inadequate or weak sucking. Air swallowing, vomiting and colic are seen in children who are not held enough. Second, there is the kinesthetic experience of being moved about, rocked and cradled. The primitive fear of falling is thus overcome and the sense of body position is developed by what the author calls 'stimulus feeding'. Infants deprived of this are likely to develop head rolling, body rolling, or hyperkinesis. Finally, auditory experience in which the soothing effect of the mother's voice, in speech or song, hastens the disappearance of the 'startle reaction' and may even contribute to the developing capacity for intellectual concentration. The mother's voice 'primes' the child for the focusing of his sensory functions on her as object.
In later phases of infancy and in early childhood the mother's presence is necessary at frequent intervals and the child needs to take an active rôle in the inevitable separations rather than simply be subjected to the mother's withdrawals.
There are two general types of reaction to inadequate mothering or to the loss of an adequate mother: a general negativism, characterized by refusal to suck, failure of assimilation, muscular hypertonus, screaming, breathholding, intestinal colic, and depression or regression characterized by stuporousness, pallor, loss of muscle tone, diminished skin turgor, respiratory irregularity, hiccough and yawning, vomiting and diarrhoea. The second reaction is strikingly similar to surgical shock and responds to massage, injections of saline, etc. In older children these reactions may be replaced by outbursts of excitement or by apathy.
The author conservatively states that it would be 'out of place yet to connect these early infantile experiences too definitely with the extensive personality disorders…' The reviewer suggests that this may be a fertile field of investigation for those seeking to solve the dilemmas of psychosomatic medicine.
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Gitelson, M. (1943). Disorganizing Factors of Infant Personality. Psychoanal. Q., 12:297-298