PSYCHIATRIC ASPECTS OF CHANGES IN INFANT AND CHILD CARE

Abstract

DURING the last 2 or 3 decades child care has concerned itself with the question of how to raise children who would be emotionally secure and well-adjusted as well as physically healthy. A flood of advice has been directed toward parents as to the "best" psychologic methods of handling children. I wish to draw attention to the problems involved in deliberately changing child-rearing customs, particularly when the advice goes from one extreme to the other. In contrast to the relative ease of teaching better physical care, parent education in the field of psychologic care has often resulted in dismal confusion. Such failure of the wonderful promise of better mental health due to better psychologic insight seems to be related to the contradictions inherent in different psychologic theories, their simultaneous and often mechanical application, and the neglect of some of the underlying problems. Deliberately oversimplifying, I shall sketch the background of the various recommendations. Two main schools of thought can be recognized. According to one, children are more or less like blank pieces of paper and it is up to the parents to make the correct entries, or to "condition" a child to the correct way of life. The academic source is the psychologic teaching of behaviorism. Translated into practice it implies child care in which everything is prescribed in exact terms. This trend was congenial to the thinking of scientific pediatrics. The combination resulted in a system of child care characterized by rigid schedules for feeding, toilet training and every other activity, that is, an over-all atmosphere of emotional sterility. This rigid school was the vogue from 20 to 30 years ago. The opposed psychologic approach has its main source in psychoanalytic theories. It starts with the assumption that an infant is a bundle of intense emotions and instincts and that he "knows" in a mysterious way everything that is good for his future development. Hence the chief task is to satisfy to the fullest the child's instinctual demands and not to interfere with the unfolding of his drives.