[The "bad mother" to the vulnerability of the parent child relationship]

This paper summarizes the results of a longitudinal study on young asthmatic children and particularly on the mother-child relationship in this illness: At both observation times--14 to 30 months and 4 to 6 years--the majority of the children appeaed to be developing in a very adequate manner, both in the area of autonomy and opposition. Similarly, in most situations, the mothers appeared quite adequate in the face of their child's illness, and mother-child relationships, generally, seemed harmonious. However, a certain vulnerability in the area of opposition was more marked in a few cases, more frequently between 4-6 years than between 14-30 months. The author attempts a brief history of the development of the concept of the "bad mother" who has become a scapegoat not only in childhood asthma but also in many illnesses encountered in child psychiatry. In questioning the role which may have been played by dynamic theories in this evolution, psychoanalytic writings are reviewed (for example, S. Freud, M. Klein, Spitz, Brody) and it is hypothesized that psychoanalytic theory has had more of a catalytic than a causal influence in relation with a strong tendency in our culture to the eclosion of negative attitudes toward the mother in her relationship with her child. The emphasis placed by North American culture on the nuclear family, the hypertrophy of the maternal function coupled with a paternal role much reduced in time, as well as the almost complete disappearance of maternal substitutes, have all probably greatly influenced the development of this concept of the "bad mother". The author notes however, that happily, in recent years some child development theories insist on the concept of mother-child interaction and on the mutual role that mother and child have on one another in their exchanges. A review is made of the work of Sander, Bowlby, Schaffer, Lewis and Rosenblum which demonstrates this new trend. The author also studies the question of vulnerability within parent-child relationships, leading to the appearance of child psychopathology, and discusses the development of methods which could help in its early detection. Recent attempts in this direction are reviewed, particularly those of Broussard, Gray et al., Lézine. The importance of Thomas and Chess' work is particularly underlined, which emphasizes the specific interaction between the temperamental characteristics of the child and the parents' specific responses to them, at all levels of development. More recent studies by Brazelton et al. and by Korner are also reviewed, suggesting a very early interaction between mother and child. The author concludes by briefly developing the preventive implications of these works and stressing the importance of closely following the efforts made at pre- and post-natal levels which may have much influence in the early prevention of psychopathology in parent-child relationships.