My approach to this vast subject must derive from the area of my especial experience. The remarks that I may make must be cast in the mould of the psychotherapeutic attitude. As a psychotherapist I naturally find myself thinking in terms of
the emotional development of the individual;
the role of the mother and of the parents;
the family as a natural development in terms of childhood needs;
the role of schools and other groupings seen as extensions of the family idea, and relief from set family patterns;
the special role of the family in its relation to the needs of adolescents;
the immaturity of the adolescent;
the gradual attainment of maturity in the life of the adolescent;
the individual’s attainment of an identification with social groupings and with society, without too great a loss of personal spontaneity;
the structure of society, the word being used as a collective noun, society being composed of individual units, whether mature or immature;
the abstractions of politics and economics and philosophy and culture seen as the culmination of natural growing processes;
the world as a superimposition of a thousand million individual patterns, the one upon the other.
1 Part of a symposium given at the 21st Annual Meeting of the British Student Health Association at Newcastle upon Tyne, 18 July 1968.
The dynamic is the growth process, this being inherited by each individual. Taken for granted, here, is the good-enough facilitating environment, which at the start of each individual’s growth and development is a sine qua non. There are genes which determine patterns and an inherited tendency to grow and to achieve maturity, and yet nothing takes place in emotional growth except in relation to the environmental provision, which must be good enough. It will be noticed that the word perfect does not enter into this statement – perfection belongs to machines, and the imperfections that are characteristic of human adaptation to need are an essential quality in the environment that facilitates.
Basic to all this is the idea of individual dependence, dependence being at first near-absolute and changing gradually and in an ordered way to relative dependenceand towards independence. Independence does not become absolute, and the individual seen as an autonomous unit is in fact never independent of environment, though there are ways by which in maturity the individual may feel free and independent, as much as makes for happiness and for a sense of having a personal identity. By means of cross-identifications the sharp line between the me and the not-me is blurred.
All I have done so far is to enumerate various sections of an encyclopaedia of human society in terms of a perpetual ebullition on the surface of the cauldron of individual growth seen collectively and recognized as dynamic. The bit that I can deal with here is necessarily limited in size, and it is important therefore for me to place what I shall say against the vast back-screen of humanity, humanity that can be viewed in many different ways and that can be looked at with the eye at the one or the other end of the telescope.
Illness or Health?
As soon as I leave generalities and start to become specific I must choose to include this and to reject that. For instance, there is the matter of personal psychiatricillness. Society includes all its individual members. The structure of society is built up and maintained by its members who are psychiatrically healthy. Nevertheless it must needs contain those who are ill – for instance, society contains:
the immature (immature in age);
the psychopathic (end-product of deprivation – persons who, when hopeful, must make society acknowledge the fact of their deprivation,
whether of a good or loved object or of a satisfactory structure that could be relied on to stand the strains that arise out of spontaneous movement);
the neurotic (bedevilled by unconscious motivation and ambivalence);
the moody (hovering between suicide and some alternative, which may include the highest achievements in terms of contribution);
the schizoid (who have a life-work already set out for them, namely the establishment of themselves, each one as an individual with a sense of identityand of feeling real);
the schizophrenic (who cannot, at least in ill phases, feel real, who may (at best) achieve something on a basis of living by proxy).
To these we must add the most awkward category – one that includes many persons who get themselves into positions of authority or responsibility – namely: the paranoid, those who are dominated by a system of thought. This system must be constantly shown to explain everything, the alternative (for the individual ill that way) being acute confusion of ideas, a sense of chaos, and a loss of all predictability.
In any description of psychiatric illness there is overlapping. People do not group themselves nicely into illness groupings. It is this that makes psychiatry so difficult for physicians and surgeons to understand. They say: ‘You have the disease and we have (or will have in a year or two) the cure.’ No psychiatric label exactly meets the case, and least of all the label ‘normal’ or ‘healthy’.
We could look at society in terms of illness, and how its ill members one way and another compel attention, and how society becomes coloured by the illnessgroupings that start in the individuals; or indeed we could examine the way in which families and social units may produce individuals who are psychiatrically healthy except that the social unit that happens to be theirs at any one time distorts them or renders them ineffectual.
I have not chosen to look at society in this way. I have chosen to look at society in terms of its healthiness, that is, in its growth or perpetual rejuvenation naturally out of the health of its psychiatrically healthy members. I say this even though I do know that at times the proportion of psychiatrically unhealthy members in a groupmay be too high, so that the healthy elements even in their aggregate of health cannot carry them. Then the social unit becomes itself a psychiatric casualty.
I therefore intend to look at society as if it were composed of psychiatrically
healthy persons. Even so, society will be found to have problems enough! Enough indeed!
It will be noted that I have not used the word normal. This word is too well tied up with facile thinking. But I do believe that there is such a thing as psychiatric health, and this means that I feel justified in studying society (as others have done) in terms of its being the statement in collective terms of individual growth towards personal fulfilment. The axiom is that since there is no society except as a structure brought about and maintained and constantly reconstructed by individuals, there is no personal fulfilment without society, and no society apart from the collective growth processes of the individuals that compose it. And we must learn to cease looking for the world-citizen, and be contented to find here and there persons whose social unit extends beyond the local version of society, or beyond nationalism, or beyond the boundaries of a religious sect. In effect we need to accept the fact that psychiatrically healthy persons depend for their health and for their personal fulfilment onloyalty to a delimited area of society, perhaps the local bowls club. And why not? It is only if we look for Gilbert Murray everywhere that we come to grief.
The Main Thesis
A positive statement of my thesis brings me immediately to the tremendous changes that have taken place in the last fifty years in regard to the importance of good-enough mothering. This includes fathers, but fathers must allow me to use the term maternal to describe the total attitude to babies and their care. The term paternal must necessarily come a little later than maternal. Gradually the father as male becomes a significant factor. And then follows the family, the basis of which is the union of fathers and mothers, in a sharing of responsibility for this that they have done together, that which we call a new human being – a baby.
Let me refer to the maternal provision. We now know that it does matter how a baby is held and handled, that it matters who it is that is caring for the baby, and whether this is in fact the mother, or someone else. In our theory of child care, continuity of care has become a central feature of the concept of the facilitatingenvironment, and we see that by this continuity of environmental provision, and only by this, the new baby in dependence may have a continuity in the line of his or her life, not a pattern of reacting to the unpredictable and for ever starting again (cf. Milner, 1934).
I can refer here to Bowlby’s (1969) work: the two-year-old child’s reaction to loss of mother‘s person (even temporary), if beyond the time-stretch of the baby’s capacity to keep alive her image, has found general acceptance though it has yet to be fully exploited; but the idea behind this extends to the whole subject of continuity of care and dates from the beginning of the baby’s personal life, that is, before the baby objectively perceives the whole mother as the person she is.
Another new feature: as child psychiatrists we are not just concerned with health. I wish this were true of psychiatry in general. We are concerned with the richness of the happiness that builds up in health and does not build up in psychiatric ill health, even when the genes could take the child towards fulfilment.
We now look at slums and poverty not only with horror, but also with an eye open to the possibility that for a baby or a small child a slum family may be more secure and ‘good’ as a facilitating environment than a family in a lovely house where there is an absence of the common persecutions.1 Also, we can feel it is worth while to consider the essential differences that exist between social groups in terms of accepted customs. Take swaddling, as opposed to the infant’s permission to explore and to kick that obtains almost universally in society as we know it in Britain. What is the local attitude to pacifiers, to thumb-sucking, to auto-erotic exercises in general? How do people react to the natural incontinences of early life and their relation to continence? And so on. The phase of Truby King is still in process of being lived down by adults trying to give their babies the right to discover a personal morality, and we can see this in a reaction to indoctrination that goes to the extreme of extreme permissiveness. It might turn out that the difference between the white citizen of the United States and the black-skinned citizen of that country is not so much a matter of skin colour as of breast-feeding. Incalculable is the envy of the white bottle-fed population of the black people who are mostly, I believe, breast-fed.
It may be noticed that I am concerned with unconscious motivation, something that is not altogether a popular concept. The data I need are not to be culled from a form-filling questionnaire. A computer cannot be programmed to give motives that are unconscious in the individuals who are the guinea-pigs of an investigation. This is where those who have spent their lives doing psychoanalysis must scream out for sanity against the insane belief in surface phenomena that characterizes computerized investigations of human beings.
1 Overcrowding, starvation, infestation, the constant threat from physical disease and disaster and from the laws promulgated by a benevolent society.
Another source of confusion is the glib assumption that if mothers and fathers bring up their babies and children well there will be less trouble. Far from it! This is very germane to my main theme, because I wish to imply that when we look at adolescence, where the successes and failures of baby and child care come home to roost, some of the present-day troubles belong to the positive elements in modern upbringing and in modern attitudes to the rights of the individual.
If you do all you can to promote personal growth in your offspring, you will need to be able to deal with startling results. If your children find themselves at all they will not be contented to find anything but the whole of themselves, and that will include the aggression and destructive elements in themselves as well as the elements that can be labelled loving. There will be this long tussle which you will need to survive.
With some of your children you will be lucky if your ministrations quickly enable them to use symbols, to play, to dream, to be creative in satisfying ways, but even so the road to this point may be rocky. And in any case you will make mistakes and these mistakes will be seen and felt to be disastrous, and your children will try to make you feel responsible for setbacks even when you are not in fact responsible. Your children simply say: I never asked to be born.
Your rewards come in the richness that may gradually appear in the personal potential of this or that boy or girl. And if you succeed you must be prepared to be jealous of your children who are getting better opportunities for personal development than you had yourselves. You will feel rewarded if one day your daughter asks you to do some baby-sitting for her, indicating thereby that she thinks you may be able to do this satisfactorily; or if your son wants to be like you in some way, or falls in love with a girl you would have liked yourself, had you been younger. Rewards come indirectly. And of course you know you will not be thanked.
Death and Murder in the Adolescent Process1
I now jump to the re-enactment of these matters as they affect the task of parents when their children are at puberty, or in the throes of adolescence.
1 Published under the title ‘Adolescent Process and the Need for Personal Confrontation’ in Pediatrics, Vol. 44, No. 5, Part 1 (1969).
Although a great deal is being published concerning the individual and social problems that appear in this decade, wherever adolescents are free to express themselves, there may be room for a further personal comment on the content of adolescent fantasy.
In the time of adolescent growth boys and girls awkwardly and erratically emerge out of childhood and away from dependence, and grope towards adult status. Growth is not just a matter of inherited tendency, it is also a matter of a highly complex interweaving with the facilitating environment. If the family is still there to be used it is used in a big way; and if the family is no longer there to be used, or to be set aside (negative use), then small social units need to be provided to contain the adolescent growth process. The same problems loom at puberty that were present in the early stages when these same children were relatively harmless toddlers or infants. It is worth noting that, if you have done well at the early stages and are still doing well, you cannot count on a smooth running of the machine. In fact you can expect troubles. Certain troubles are inherent at these later stages.
It is valuable to compare adolescent ideas with those of childhood. If, in the fantasy of early growth, there is contained death, then at adolescence there is containedmurder. Even when growth at the period of puberty goes ahead without major crises, one may need to deal with acute problems of management because growing up means taking the parent’s place. It really does. In the unconscious fantasy, growing up is inherently an aggressive act. And the child is now no longer child-size.
It is legitimate, I believe, as well as useful, to look at the game ‘I’m the King of the castle’. This game belongs to the male element in boys and girls. (The theme could also be stated in terms of the female element in girls and boys, but I cannot do this here.) This is a game of early latency, and at puberty it becomes changed into a life-situation.
‘I’m the King of the castle’ is a statement of personal being. It is an achievement of individual emotional growth. It is a position that implies the death of all rivals or the establishment of dominance. The expected attack is shown in the next words: ‘And you’re the dirty rascal’ (or ‘Get down you dirty rascal’). Name your rival and you know where you are. Soon the dirty rascal knocks the King over and in turn becomes King. The Opies (1951) refer to this rhyme. They say that the game is exceedingly old, and that Horace (20 B.C.) gives the children’s words as:
Rex erit qui recte faciet;
Qui non faciet, non erit.
We need not think that human nature has altered. What we need to do is to look for the everlasting in the ephemeral. We need to translate this childhood game into the language of the unconscious motivation of adolescence and society. If the child is to become adult, then this move is achieved over the dead body of an adult. (I must take it for granted that the reader knows that I am referring to unconscious fantasy, the material that underlies playing.) I know, of course, that boys and girls may manage to go through this stage of growth in a continued setting of accord with actual parents, and without necessarily manifesting rebellion at home. But it is wise to remember that rebellion belongs to the freedom you have given your child by bringing him or her up in such a way that he or she exists in his or her own right. In some instances it could be said: ‘You sowed a baby and you reaped a bomb.’ In fact, this is always true, but it does not always look like it.
In the total unconscious fantasy belonging to growth at puberty and in adolescence, there is the death of someone. A great deal can be managed in play and by displacements, and on the basis of cross-identifications; but, in the psychotherapy of the individual adolescent (and I speak as a psychotherapist), there is to be found death and personal triumph as something inherent in the process of maturation and in the acquisition of adult status. This makes it difficult enough for parents and guardians. Be sure it makes it difficult also for the individual adolescents themselves who come with shyness to the murder and the triumph that belong to maturation at this crucial stage. The unconscious theme may become manifest as the experience of a suicidal impulse, or as actual suicide. Parents can help only a little; the best they can do is to survive, to survive intact, and without changing colour, without relinquishment of any important principle. This is not to say they may not themselves grow.
A proportion at adolescence will become casualties or will attain to a kind of maturity in terms of sex and marriage, perhaps becoming parents like the parents themselves. This may do. But somewhere in the background is a life-and-death struggle. The situation lacks its full richness if there is a too easy and successful avoidance of the clash of arms.
This brings me to my main point, the difficult one of the immaturity of the adolescent. Mature adults must know about this and must believe in their own maturity as never before or after.
It will be appreciated that it is difficult to state this without being misunderstood, since it so easily sounds like a down-grading to talk of immaturity. But this is not intended.
A child of any age (say six years) may suddenly need to become responsible, perhaps because of the death of a parent or because of the break-up of a family. Such a child must be prematurely old and must lose spontaneity and play and carefree creative impulse. More frequently, an adolescent may be in this position, suddenly finding himself or herself with the vote or with the responsibility for running a college. Of course, if circumstances alter (if, for instance, you become ill or die, or you are in financial straits) then you cannot avoid inviting the boy or girl to become a responsible agent before the time is ripe; perhaps younger children have to be cared for or educated, and there may be an absolute need for money to live. However, it is different when, as a matter of deliberate policy, the adults hand over responsibility; indeed, to do this can be a kind of letting your children down at a critical moment. In terms of the game, or the life-game, you abdicate just as they come to killing you. Is anyone happy? Certainly not the adolescent, who now becomes the establishment. Lost is all the imaginative activity and striving of immaturity. Rebellion no longer makes sense, and the adolescent who wins too early is caught in his own trap, must turn dictator, and must stand up waiting to be killed – to be killed not by a new generation of his own children, but by siblings. Naturally, he seeks to control them.
Here is one of the many places where society ignores unconscious motivation at its peril. Surely the everyday material of the psychotherapist’s work could be used a little by sociologists and by politicians, as well as by ordinary people who are adults – that is to say, adult in their own limited spheres of influence, even if not always in their private lives.
What I am stating (dogmatically in order to be brief) is that the adolescent is immature. Immaturity is an essential element of health at adolescence. There is only one cure for immaturity and that is the passage of time and the growth into maturity that time may bring.
Immaturity is a precious part of the adolescent scene. In this is contained the most exciting features of creative thought, new and fresh feeling, ideas for new living.Society needs to be shaken by the aspirations of those who are not responsible. If the adults abdicate, the adolescent becomes prematurely, and by false process, adult. Advice to society could be: for the sake of adolescents, and of their immaturity, do not allow them to step up and attain a false maturity by handing over to them responsibility that is not yet theirs, even though they may fight for it.
With the proviso that the adult does not abdicate, we may surely
think of the strivings of adolescents to find themselves and to determine their own destiny as the most exciting thing that we can see in life around us. The adolescent’s idea of an ideal society is exciting and stimulating, but the point about adolescence is its immaturity and the fact of not being responsible. This, its most sacred element, lasts only a few years, and it is a property that must be lost to each individual as maturity is reached.
I constantly remind myself that it is the state of adolescence that society perpetually carries, not the adolescent boy or girl who, alas, in a few years becomes an adult, and becomes only too soon identified with some kind of frame in which new babies, new children, and new adolescents may be free to have vision and dreams and new plans for the world.
Triumph belongs to this attainment of maturity by growth process. Triumph does not belong to the false maturity based on a facile impersonation of an adult. Terrible facts are locked up in this statement.
Nature of Immaturity
It is necessary to look for a moment into the nature of immaturity. We must not expect the adolescent to be aware of his or her immaturity, or to know what the features of immaturity are. Nor do we need to understand at all. What counts is that the adolescents’ challenge be met. Met by whom?
I confess that I feel I am insulting this subject by talking about it. The more easily we verbalize, the less are we effectual. Imagine someone talking down to adolescents and saying to them: ‘The exciting part of you is your immaturity!’ This would be a gross example of failure to meet the adolescent challenge. Perhaps this phrase ‘a meeting of the challenge’ represents a return to sanity, because understanding has become replaced by confrontation. The word confrontation is used here to mean that a grown-up person stands up and claims the right to have a personal point of view, one that may have the backing of other grown-up people.
Potential at Adolescence
Let us look and see what sorts of things adolescents have not reached.
The changes of puberty take place at varying ages, even in healthy children. Boys and girls can do nothing but wait for these changes. This waiting around puts a considerable strain on all, but especially on the late developers; so, the late ones can be found imitating those
who have developed early, and this leads to false maturities based on identifications rather than on the innate growth process. In any case, the sexual change is not the only one. There is a change towards physical growth and the acquisition of real strength; therefore, real danger arrives which gives violence a new meaning. Along with strength come cunning and know-how.
Only with the passage of time and the experience of living can a boy or girl gradually accept responsibility for all that is happening in the world of personal fantasy. Meanwhile there is a strong liability for aggression to become manifest in suicidal form; alternatively, aggression turns up in the form of a search for persecution, which is an attempt to get out of the madness of a persecutory delusional system. Where persecution is delusionally expected, there is a liability for it to be provoked in an attempt to get away from madness and delusion. One psychiatrically ill boy (or girl) with a well-formed delusional system can spark off a group system of thought and lead to episodes based on provoked persecution. Logic holds no sway once the delicious simplification of a persecutory position has been achieved.
But most difficult of all is the strain felt in the individual belonging to the unconscious fantasy of sex and the rivalry that is associated with sexual object-choice.
The adolescent, or the boy and girl who are still in process of growing, cannot yet take responsibility for the cruelty and the suffering, for the killing and the being killed, that the world scene offers. This saves the individual at this stage from the extreme reaction against personal latent aggression, namely suicide (a pathological acceptance of responsibility for all the evil that is, or that can be thought of). It seems that the latent sense of guilt of the adolescent is terrific, and it takes years for thedevelopment in an individual of a capacity to discover in the self the balance of the good and the bad, the hate and the destruction that go with love, within the self. In this sense, maturity belongs to later life, and the adolescent cannot be expected to see beyond the next stage, which belongs to the early twenties.
It is sometimes taken for granted that boys and girls who ‘hop in and out of bed’, as the saying goes, and who achieve intercourse (and perhaps a pregnancy or two), have reached sexual maturity. But they themselves know that this is not true, and they begin to despise sex as such. It’s too easy. Sexual maturity needs to include all the unconscious fantasy of sex, and the individual needs ultimately to be able to reach to an acceptance of all that turns up in the mind along with object-choice,object-constancy, sexual satisfaction, and sexual inter-weaving.
Also, there is the sense of guilt that is appropriate in terms of the total unconscious fantasy.
Construction, Reparation, Restitution
The adolescent cannot yet know what satisfaction there can be attained from participation in a project that needs to include within itself the quality of dependability. It is not possible for the adolescent to know how much the job, because of its social contribution, lessens the personal sense of guilt (that belongs to unconsciousaggressive drives, closely linked with object-relating and with love) and so helps to lessen the fear within, and the degree of suicidal impulse or accident proneness.
One of the exciting things about adolescent boys and girls can be said to be their idealism. They have not yet settled down into disillusionment, and the corollary of this is that they are free to formulate ideal plans. Art students, for instance, can see that art could be taught well, so they clamour for art to be taught well. Why not? What they do not take into account is the fact that there are only a few people who can teach art well. Or students see that physical conditions are cramped and could be improved, so they scream. It is for others to find the money. ‘Well,’ they say, ‘just abandon the defence programme and spend the cash on new university buildings!’ It is not for the adolescent to take a long-term view, which may come more naturally to those who have lived through many decades and begin to grow old.
All of this is absurdly condensed. It omits the prime significance of friendship. It omits a statement of the position of those who make a life without marriage or with marriage postponed. And it leaves out the vital problem of bisexuality, which becomes resolved but never entirely resolved in terms of heterosexual object-choice and ofobject-constancy. Also, a great deal has been taken for granted that has to do with the theory of creative playing. Moreover, there is the cultural heritage; it cannot be expected that, at the age of adolescence, the average boy or girl has more than an inkling of man’s cultural heritage, for one must work hard at this even to know about it. At sixty years old these who are boys and girls now will be breathlessly making up for lost time in the pursuit of the riches that belong to civilization and its accumulated by-products.
The main thing is that adolescence is more than physical puberty, though largely based on it. Adolescence implies growth, and this growth takes time. And, while growing is in progress, responsibility must be
taken by parent-figures. If parent-figures abdicate, then the adolescents must make a jump to a false maturity and lose their greatest asset: freedom to have ideas and to act on impulse.
In brief, it is exciting that adolescence has become vocal and active, but the adolescent striving that makes itself felt over the whole world today needs to be met, needs to be given reality by an act of confrontation. Confrontation must be personal. Adults are needed if adolescents are to have life and liveliness. Confrontationbelongs to containment that is non-retaliatory, without vindictiveness, but having its own strength. It is salutary to remember that the present student unrest and its manifest expression may be in part a product of the attitude we are proud to have attained towards baby care, and child care. Let the young alter society and teach grown-ups how to see the world afresh; but, where there is the challenge of the growing boy or girl, there let an adult meet the challenge. And it will not necessarily be nice.
In the unconscious fantasy these are matters of life and death.
I am proposing that there is a stage in the development of human beings that comes before objectivity and perceptibility. At the theoretical beginning a baby can be said to live in a subjective or conceptual world. The change from the primary state to one in which objective perception is possible is not only a matter of inherent or inherited growth process; it needs in addition an environmental minimum. It belongs to the whole vast theme of the individual travelling from dependence towards independence.
This conception–perception gap provides rich material for study. I postulate an essential paradox, one that we must accept and that is not for resolution. Thisparadox, which is central to the concept, needs to be allowed and allowed for over a period of time in the care of each baby.