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Mittelmann, B. (1960). Intrauterine and Early Infantile Motility. Psychoanal. St. Child, 15:104-127.

(1960). Psychoanalytic Study of the Child, 15:104-127

Intrauterine and Early Infantile Motility

Bela Mittelmann, M.D.

SUMMARY

Dynamically, we may differentiate between motility (1) as an urge, a factor in object relations, and a source of pleasure (id aspects); (2) as a form of reality testing, mastery, communication, and integration (ego); and (3) as relating to the ultimate formation of conscience and ideals (superego aspects).

From the point of view of maturation and relation to the environment, we may differentiate between movement and action. The former predominates in the intrauterine or pregravitational period as well as in the first six months of the postnatal or gravitational period.

The study of motility suggests that later motor and related psychological phenomena have successive precursors in intrauterine and early infantile motility. The time of the appearance and the quality of the pattern vary with environmental circumstances, and immediate or later pathology may arise because of trauma to motility proper, e.g., being hurt while crawling, or through motility being involved in other traumatic situations, e.g., affect starvation.

Passive motility, i.e., intrauterine posture and being moved rhythmically, reinforced by the similar postnatal experiences and by being cared for, stand for unlimited care and protection. Later horizontality may also mean helplessness and death.

Active motility involves, at first non-adaptive varieties. Reflex grasping is the antecedent of later voluntary grasping, of clinging, of grasping for manipulation, and therefore of later adaptation and reality testing. It is antecedent to the manifestations of dependent longings, anxious dependency, affection, adult love-making, particularly dependent love-making. Random movements, with the antecedent "quickening" in utero, are the first manifestations of the motor urge, and are precursors of regressive diffuse discharge via motility. Affectomotor

patterns are antecedents of interpersonal communication, and adaptive handling of objects; together with autoerotic rhythmic patterns, they are the precursors of adult intercourse movements, of excess discharge through hypermotility, and via kinesthetic sensation of foot fetishism. They are retained and narcissistically elaborated in blind and schizophrenic children.

Adaptive motility (manipulative, postural, and locomotor) is one of the main avenues of the development of mastery, reality testing, motor urge, object relations, and later, aggression, self-esteem (with possible later self-depreciation) and of the concept of the self and not-self. Fear of falling and of failure of motor function now appear. Restriction arouses anxiety and rage which in excessive amounts raise the possibility of later neurosis or psychosis.

Sensory motility (visual), together with tactile motor exploration of the body, contributes to reality testing and mastery, differentiation of part self, self, and not-self, and displacement from the genitals to the extremities.

Generalized inactivation when looking at the faces, combined later with inactivation and staring during anxiety while being looked at, is the precursor of voyeurism and exhibitionism, a paralyzing fear, e.g., in the Wolf Man's nightmare, or in hysterical paralysis.

Oral motility, i.e., hand-to-mouth movement and support of mouth activity by posture and locomotion, is an element in self-differentiation, reality testing, passive or active aggressive devouring fantasies, and use of the mouth as a manipulative and aggressive organ.

Excretory motility combined with "freezing" in anxiety and restrained aggression contributes to the general muscle tension in obsessive-compulsive states.

Genital motility, as manual handling or grasping, results in incorporation of the male genitals in the body image, and in the relief of anxiety. Rhythmic pelvic thrusts are the precursor of adult intercourse. The ease of occurrence of erection, often combined with general motor responses, is the precursor of the symbolic use of the body as a phallus.

The early motor crying pattern, reinforced later by slamming of the thighs and head banging, is the antecedent of aggression directed outward and toward the self, and therefore of masochism

and conscience. Combined later with the general motor-rage response to restriction, it is the prototype of diffuse outburst of hostility.

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