Developmental Research

Patrick Luyten, Ph.D. Linda C. Mayes, M.D. Mary Target Ph.D. Peter Fonagy, Ph.D., F.B.A.

While the content of an individual's life history cannot change, it can be told or reconstructed in many differing ways

Mary Main (200DJ

A DEVELOPMENTAL PERSPECTIVE .s at the heart of most psychoanalytic approaches. Indeed, the idea that psychopathology has its roots in recapitulated ontogeny is acknowledged by all genuinely psychoanalytic theories to some degree. From a psychoanalytic developmental perspective, disorders of the mind are thus at least in part understood as involving maladaptive residues of childhood experience and developmentally primitive modes of mental functioning (Fonagy et al. 2006).

This developmental perspective also defines the contours of what makes psychoanalytic approaches dynamic approaches. From a psychoanalytic perspective, both normal and disrupted development involve an ongoing series of attempts of the individual, throughout the life span, to find a balance between biological givens on the one hand and demands of the environment on the other. Hence, psychopathology, and normal and disrupted development more generally, are not seen as be-

ing a static end siaie but as reflecting continuing attempts, however maladaptive, to find a more optimal balance between endowment and experience (Luyten and Blatt 2011). Development, from this perspective, entails that the individual is continually involved in a striving for allostasis; the achievement of stability through continual change (McEwen 2007). This dynamic equilibrium therefore reflects attempts of the individual to COpe with developmental tasks and challenges and/or defend against painful conflictual issues.

Moreover, the psychoanalytic study of development has amply demonstrated that development not only proceeds in a linear fashion hut also involves important nonlinear, qualitative shifts (Mayes 2001}. During development, the individual is faced with the task of negotiating important developmental challenges (e.g., separation and individuation, development of gender identity) that often necessitate a dramatic reorganization of psychic structures and mental functioning that cannot be simply explained by a reliance on linear models. Despite the ''developmental pull" or "forward-looking aspect" of developmental processes (Emde 20051, both research and clinical practice demonstrate how, in this context, the complex interplay between biological, psychological, and environmental factors may lead to developmental disruptions that result in often rigid templates for representations of self and others in the present, thereby also precluding more adaptive developmental pathways in the future.

The inevitable confrontation with adversity dirough-out the life cycle {e.g., experiences of loss, failure, aging, death and dying) may furthermore seriously challenge the individual's apparently stable state of allostasis, leading to a reactivation of hitherto "invisible" vulnerabilities, and render problematic what in the past had not been problematic through the mechanism of deferred action (i.e., that prior events take on a new meaning depending on later experiences).

These long-standing psychoanalytic assumptions concerning continual change against the background of stability are remarkably congruent with life event research that has provided impressive evidence for the role of stress and adversity in the causation of psycho-pathology across the life span (Gunnar and Quevedo 2007), as well as with simulation studies (Fraley and Roberts 2005} showing how important the stability of the environment is in explaining the stability of psychological features.

From a psychoanalytic perspective, it is therefore hard, if not impossible, to imagine an understanding of both normal and disrupted growth without a developmental perspective regarding ontogeny of mind. This theoretical interest is paralleled by an equally strong interest and focus in psychoanalytic treatments on the relationship between the past, present, and future. Indeed, gaining insight into the past to change how one thinks and feels about oneself and others in the present, offering the possibility for a "new beginning" (Balint 1952}r has been considered to be the hallmark of psychoanalytic treatments. Moreover, even in psychody-nannc interventions that have less of a focus on the past, there is always a keen awareness of the importance and role of developmental antecedents of behavior, thoughts, feelings, and attitudes and that in the "here and now," the "there and then" is always present.

Recent longitudinal, epidemiological birth cohort studies (Hofstra ct al. 2002; Kim-Cohen et al. 2003), as well as neurobiological (Gunnar and Quevedo 2007} and genetic (Plomin and Davis 2009; Rutter 2009) studies, have provided dramatic confirmation that psychoanalysts were on the right track when they emphasized the developmental perspective in their understanding both of "normal" development and of the problems they faced with their patients (Luyten et al. 2008]. Indeed, studies suggest that in the vast majority of cases, adult psychopathology is antedated by diagnosable childhood disturbance. For instance, estimates suggest that up to 75% of adults with a mental disorder may have had a diagnosable childhood problem (Kim-Cohen et al. 2003). Moreover, research in both animals and humans suggests, congruent with basic psychoanalytic assumptions, that early adverse experiences may program the developing stress system and associated neurotransmitter systems, the immune system, and systems involved in pain regulation, resulting in an increased vulnerability for a wide array of both psychiatric and (functional) somatic disorders (Gunnar and Quevedo 2007; Lupien et al. 2009). Furthermore, there is a growing body of research indicating that the developing stress system is under substantial environmental control, with early as well as later attachment experiences playing a crucial role in this respect (Champagne and Curley 2009; Gunnar and Quevedo 2007; Lupien et al. 2009; Luyten et al., manuscript submitted for publication). Finally, although still controversial, the growing evidence for so-called gene-environment correlations and interactions | the influence of genes on the exposure to certain environments and vice versa, and the synergistic interaction of genes and environment, respectively), as well as the potential role of cpigenetic mechanisms |Champagne and Curley 2009) involved in the intergenerational transmission of psychopathology, has dramatically changed the nature-nurture debate and has rekindled interest in complex interactions among environmental and genetic plasticity, change, or other critical periods across development.

Psychoanalytic developmental theories typically also have underestimated the enormous complexity of developmental processes by their overemphasis on early experience, although it must be said that several authors attempted to redress this balance. These include the work of Anna Freud (19811, who emphasized the importance of simultaneously considering different developmental lines and their complex interactions; Erik Erikson (1959), who developed an epigenetic theory of human development across the life span; and George Vail Ian t 11977), who was one of the first psychoanalytic investigators to embark on a series of longitudinal studies of adult development. Yet psychoanalytic theories have often been characterized by an unjustified confidence in tracing specific forms of psychopathology to specific (early) phases (examples are the link sometimes made between borderline personality disorder and the rapprochement subphase of separation and individuation, or between oedipal conflict and obsessional neurosis) while neglecting other important factors. Of particular note is the neglect of the often considerable role that genetic factors, as well as chance events and stochastic processes in general, play in explaining developmental trajectories (Fraley and Roberts 2005).

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