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Geleerd, E.R. (1946). A Contribution to the Problem of Psychoses in Childhood. Psychoanal. St. Child, 2:271-291.

(1946). Psychoanalytic Study of the Child, 2:271-291

A Contribution to the Problem of Psychoses in Childhood

Elisabeth R. Geleerd, M.D.

SUMMARY

This paper has described cases of children whose overt symptomatology was that met in children with extreme behavior disorders. Close observation showed that the emotional development of the children was retarded and that their behavior could be understood when it was compared with the feelings and reactions of very young children. Three cases were described whose earlier symptomatology had been similar to that of the previous cases, and who in adolescence developed schizophrenia. It is possible that the difference between the

cases described and those which have the classical diagnosis of schizophrenia in childhood is only one of degree.

It is suggested that the difference between normal or neurotic development and that of the child who will become psychotic lies in an early disturbance of the ego development. The normal child is able to erect an image of his mother within his ego which enables him to be contented in her absence and which seems to be the core of his development to a mature and independent individual. The psychotic child functions only in the presence of a mother-substitute (seldom his own mother). Disappointment in her or her absence suffices to throw him into a state of withdrawal or incites a temper outburst in which he breaks away from reality and develops paranoid ideas.

The therapy of individual attention and modified psychoanalysis has been successful in a few cases. However, the duration of observation is too short and the number of cases treated too small to make any definite statements as to prognosis or to recommend any definite treatment. But for these children, as well as for the normal and neurotic children with whom they mingle and who suffer through them, early recognition of the underlying disorder is essential.

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