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Fraiberg, S. (1950). On the Sleep Disturbances of Early Childhood. Psychoanal. St. Child, 5:285-309.
(1950). Psychoanalytic Study of the Child, 5:285-309
On the Sleep Disturbances of Early Childhood
To summarize our findings regarding the sleep disturbance of the second year:
The night waking which is regarded as typical for this age by researchists
in childdevelopment appears in both its moderate and severe forms. In any case its characteristic appearance during the second year may be attributed to those developmental tasks and problems of this age which produce anxiety in the child and hence make heavy demands upon the immature ego which strives toward control of the painful stimuli. Night waking, in the case studied, followed an anxietydream.
It was seen that in each of the cases reviewed, the night waking first appeared in relation to a traumatic event. The dream mechanism in the early stages of such sleep disturbances is likened to that of the traumatic neuroses in which the dreamer is brought back to the scene of the trauma and the dream work supplies the conditions of apprehension and anticipation which had failed in their protective functions at the time of the original event. The character of the dream conforms to the child's tendency at this age to gainmastery through repetition.
The conflicts of the anal period play an important role in symptoms of sleep disturbance as well as the other symptoms so common at this age. When pleasure in soiling must be relinquished for fear of loss of the mother's love, the conflicting tendencies may produce another type of anxietydream which results in interruption of sleep. Here the fear of soiling in sleep breaks through. In two such cases it was seen that the wish to soil was manifest in the dream (from our deductions) but fear of loss of the mother exerted a more potent influence at the critical moment, so that the wish-fulfilling function of the dream failed and anxiety broke through, resulting in the interruption of sleep.
Further, it is noted, that failure to masteranxiety on one developmental level will result in a progressive course of the symptom so that each successive phase of libidinal development comes under the influence of the original trauma and adds its own characteristics to the illness. In one case it was possible to follow the development of the symptom from its origins in a traumatic situation through the anal period and finally the beginnings of a prematurely induced castrationanxiety.
The study suggests that an understanding of the sleep disturbances of early childhood may provide us with further prophylactic measures. The early detection of serious sleep disturbances will still permit simple environmental measures which can secure good results in most cases. The more evolved symptoms require direct therapy. And for the common varieties of night waking during the second year, there is every reason to believe that if we understand the child's activity more fully as well as his devices for mastering the typical traumata, we can improve our nursery techniques and through educational measures reduce the incidence of sleep disturbance. There is great danger that our present techniques of handling the very young child encourage passivity at a time when he
needs all of our help in taking the active position in relation to the dangers which threaten him. By this I do not mean, of course, that we foster a spartan independence, but rather that we understand his behavior and its aims in this critical year and support these tendencies, helping him to abreact through the ancient devices of the nursery.
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