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Norman, H.F. (1954). The British Journal of Medical Psychology. XXVI, 1953: Psychoses and Child Care. D. W. Winnicott. Pp. 68-74.. Psychoanal Q., 23:619-620.
Psychoanalytic Electronic Publishing: The British Journal of Medical Psychology. XXVI, 1953: Psychoses and Child Care. D. W. Winnicott. Pp. 68-74.

(1954). Psychoanalytic Quarterly, 23:619-620

The British Journal of Medical Psychology. XXVI, 1953: Psychoses and Child Care. D. W. Winnicott. Pp. 68-74.

Haskell F. Norman

This paper is addressed to pediatricians to acquaint them with their responsibility for the prevention of psychosis. Some degree of psychosis in childhood is common, but can only be diagnosed when the child 'organizes along a certain defensive line which becomes recognizable as a disease entity'.

The mental health of an individual is determined during the earliest phase of development. It depends on the mother's 'devotion', 'her sensitive and active adaptation to the infant's needs which at the beginning are absolute'. Psychosis occurs when the mothering has been defective from the beginning and has produced in the child distortions in emotional development before the child has become 'a whole person capable of total relationships with whole persons'. Klein and others have developed this theory for depressive and paranoid psychoses; Winnicott attempts to do so for schizoid states and schizophrenia.

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The author refers to the earliest, most primitive stages, when the infant is being introduced gradually to external reality and is not yet a unit but rather an 'environment-individual setup'. With good mothering the child creates 'a personal environment' which comes to resemble the external perceived environment sufficiently to enable it to pass from dependence to independence. The infant develops the ability to use illusion, without which no contact is possible between the psyche and environment. If the infant's needs are not met, illusion is impossible for it. In extreme cases a basic splitting of the personality occurs. There then develops a 'secret inner life' but little derived from external reality and truly incommunicable. The individual also may be 'seduced' by the environment into showing a compliant 'false self' which may appear outwardly satisfactory but which cannot mature. Schizophrenia is then latent. Later as the ego becomes integrated the paranoid tendency cannot be overcome, because of the deficiency in the mother's love. Defenses must then be organized against confusion and disintegration, and a schizoid or autistic state develops.

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Article Citation

Norman, H.F. (1954). The British Journal of Medical Psychology. XXVI, 1953. Psychoanal. Q., 23:619-620

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