''The Interpersonal World of the Infant'' (1985) is one of the most prominent works of psychoanalyst Daniel N. Stern, in which he describes the

development Development or developing may refer to: Arts *Development hell, when a project is stuck in development *Filmmaking, development phase, including finance and budgeting *Development (music), the process thematic material is reshaped * Photograph ...

of four interrelated senses of self. These senses of self develop over the lifespan, but make significant developmental strides during sensitive periods in the first two years of life. The mother or other primary attachment figure plays a critical role in helping the infant with this developmental process.

Senses of self

Emergent self

At birth, the infant experiences the world as a barrage of seemingly unrelated sensory stimuli, which s/he gradually learns to "yoke" together using cues such as "hedonic tone" (emotional quality), and temporal and intensity patterns shared between stimuli. This process of integrating and organizing experience, called the emergent sense of self, continues until about two months. It serves as "the basis for the child's ability to learn and create," and is what Stern believes is the sense of self that is disrupted in the negative symptoms of

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...

and other

psychotic Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior t ...

disorders.

Core self

Around two months, the child's organization of sensory experience reaches a point where s/he is able to sufficiently organize experience to have integrated

episodic memories Episodic memory is the memory of everyday events (such as times, location geography, associated emotions, and other contextual information) that can be explicitly stated or conjured. It is the collection of past personal experiences that occurred ...

. This enables a higher level of sophistication organizing future experiences, as the child is able to discern discrete invariant objects from cross-modal sensory stimuli and to use these to arrive at generalizations about what s/he can expect in the future from his/her environment. In this process, the infant also becomes aware of its own features ("self-invariants"), which give the child its sense of core self as an entity distinct from other objects in its environment. The child also develops generalized representations of its interactions with its primary caregiver during this time, a concept related to and informed by

attachment theory Attachment theory is a psychological, evolutionary and ethological theory concerning relationships between humans. The most important tenet is that young children need to develop a relationship with at least one primary caregiver for normal ...

. The child learns whether it can depend on its caregiver to provide for its needs and the types of affective and behavioral responses it can expect in specific situations, which serve as the basis for its future attachment style. An important role of the caregiver during this time is to assist the child in regulating its affect . Eventually, if all goes well, the child will internalize these experiences with the primary attachment figure and be able to invoke these memories to help herself self-regulate her affect . Stern believes that ruptures during this phase of development result in borderline pathology .

Subjective self

Around seven months, the child begins to be aware that her thoughts and experiences are distinct from those of other people, that there is a gap between her subjective reality and that of other people. However, with proper attunement by the primary attachment figure, the child also becomes aware that this gap can be bridged through intersubjective experiences, such as sharing affect and focus of attention. A lack of such attunement, as could happen, for example, if the mother suffers from depression, can deprive the child of sufficient intersubjective experiences, leaving the child unable to connect to other people in any meaningful way, which Stern believes may underlie narcissistic personality disorder and antisocial personality disorder.

Verbal self

Around 15 months, the child develops the capacity for symbolic representation and language, and becomes capable of creating complex abstract mental representations of experiences, facilitating intersubjectivity but shifting the child's focus towards those things that can be represented and communicated in language.

Clinical implications

Disturbances (e.g. abuse, trauma) that occur during sensitive periods and thereby interfere with important developmental processes may have more severe consequences than "insults" later in life. According to Stern, these disturbances may become overt any point in time and the nature rather than the time of the insult will determine the resulting conflict. Additionally, later psychopathology will manifest itself in a domain related to the sensitive period in which the insult took place. Regarding

therapy A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different ...

, Stern highlights the importance of "now moments" as a potential for change and growth in the client as well as the therapist, but also in the therapeutic relationship. These can be described as moments of intersubjective emotional relatedness and are, in Stern's opinion, necessary for positive therapeutic outcome.

Criticism

A critic suggested that the nature of insults during the sensitive periods fails to predict the specific clinical issues that subsequently develop, undermining the clinical utility of this theory.Zeanah, C.H. (1986). Book reviews. ''Journal of the American Academy of child psychiatry, 25,'' 582-584.

References

{{DEFAULTSORT:Interpersonal World Of The Infant, The Attachment theory Psychoanalytic books