In 1998, Eric Kandel called for a rapprochement between psychoanalysis and the biological sciences, suggesting that this would provide a new intellectual basis for psychiatry and enrich both disciplines. His call has been resoundingly answered in this work by Fonagy & Target. They have summarised the theories of the most important British and American psychoanalytic thinkers over the past 100 years, providing the empirical evidence for the underlying model of development of each theory, drawing on the neurosciences and infant and child development research in particular to do so.
The coverage of psychoanalytic theories is brief, yet comprehensive, and theorists who have been too little acknowledged for their contribution, Joseph Sandler for example, are given due credit. The strengths and weaknesses of each theory are delineated in succinct fashion and without apparent bias – no mean feat in a field where views may be held with quasi-religious fervour, and workers within the field invariably have their own favourites.
Most importantly, theories that have suffered because some aspect of the theory has been regarded as disproven by research findings are re-examined in the light of current knowledge. The example that stands out in my mind concerns the work of Margaret Mahler. Her concept of the phases of separation–individuation in infancy and early childhood has been useful both clinically and theoretically. However, her conceptualisation of the initial stage of infant life as commencing with a phase of ‘normal autism’ followed by a symbiotic period has been seen as incorrect, according to the findings of infant development researchers over the past 20 years. In an exploration drawing on findings from studies involving several fields of research, Fonagy & Target raise the possibility that Mahler's developmental framework may be appropriate to the truly psychological world of the human infant, an important possibility that must now face rigorous examination.
Fonagy & Target complete their tour of British and American psychoanalytic theories viewed from the perspective of developmental psychology and psychopathology with an account of Bowlby's attachment theory model, suitably updated by current attachment concepts and research, followed by accounts of systems theory models of development and, lastly, their own concept of ‘mentalisation’. This refers to the process by which the concept of the self as a mental agent grows out of interpersonal experience with the primary caregivers.
The final chapter offers thoughts about future directions for psychoanalysis, enjoining workers in the clinical field to engage with researchers from the biological sciences to examine psychoanalytic theories using the rigorous means increasingly available.
I recommend this book both to students and to experienced practitioners in the fields of psychoanalysis, psychiatry and psychology. Anyone who desires a deeper understanding of the development of the human mind, its psychology and psychopathology, has much to gain from this work. It is of particular importance because psychoanalytic theory stands now at an exciting threshold. If its theorists join with biological researchers in ongoing exploration of the development of the mind, we can gain a truly integrated understanding of the mind and brain, surely the challenge of the 21st century.
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