The psychoanalytic view of phobias. Part II: Infantile phobias

The psychoanalytic literature on infantile phobias, despite disclaimers by several of its prominent authors, seems to demonstrate a growth in knowledge of these conditions and an increasing respect for methodology. It is also noteworthy in its close adherence to the presentation of clinical material. Looking at phobia from this developmental viewpoint has caused us to modify our definition of phobia, adding independence from immediate, fear-provoking stimuli and requiring an inference on the part of the observer because of some integral mental process which is nontransparent. These additions are further specifications of the meaning of the term in general; they are not intended to be limited to infantile phobias. Phobic syndromes can certainly arise well before age four, well before there is any evidence of a child's having entered the oedipal phase of development. Nevertheless, because of the early genital phase, castration reactions, albeit with a somewhat different meaning, usually appear to be involved in the symptom formation. There is also a suggestion that all infantile phobias may begin to arise at this period of development. The symptom pictures in the cases of the children reported in the psychoanalytic literature are very similar. We seem to have described a disorder which, we can hypothesize, has its beginnings in the early genital phase, may emerge as a psychopathological condition at that time, or may reach proportions sufficient to interfere with function or development only several years later. The disorder appears to make use of inherited reflex-like patterns of response to certain stimuli as dangers. On the basis of the reported psychoanalytic experience, we cannot really generalize much about psychogenetics or psychodynamics. Psychoanalysts have applied their ideas about neurotic symptom formation in general to these cases. Just why the illnesses assume these particular forms in these particular children is unclear. The only steps toward specification have been hypotheses introduced by Anna Freud and Owen Renik. Anna Freud hypothesized that a major condensation occurs to focus infantile anxieties on a single symbol, thus causing sharply focused, rather than generalized, anxiety. Renik related self-object differentiation and cognitive development to such "symbolization" in infancy, explaining phobic object formation in terms of primary and secondary process representations and their interaction. Although we have descriptively defined a syndrome "phobia," it is not yet clear whether the disorders of infancy and childhood which fit that definition have significant similarities--descriptively or psychodynamically--with conditions which develop later in life and also appear to fit the descriptive parameters.(ABSTRACT TRUNCATED AT 400 WORDS)