Previewing: a preventive strategy that promotes adaptive development

Article Abstract:

Recently, psychiatric theory has shifted its focus from the importance of unconscious fantasies and the defenses used to keep traumatic memories and forbidden wishes from consciousness, to the importance of actual life experiences - in particular, the early interactions between mothers and infants. This interactional or relational approach has led to the theory that the observed interactions between a mother and her infant can predict psychological patterns that will have an impact on the infant's later life. The phenomenon of 'previewing,' as evidenced from observations of mother-infant interactions, refers to ways in which a mother envisions her infant's future and how these previews influence the way she unconsciously tutors the child. Previewing encompasses all the behaviors of the mother and the interactions between the mother and infant which lead the infant to acquire adaptive or maladaptive developmental strategies. In healthy previewing, the mother conveys to the infant that she will be empathic and available as a guide. Evidence of healthy previewing reflects the infant's exposure to encouraging maternal behavior, and can be seen in the pace and ease of the infant's developmental acquisitions and the rapport between mother and child. Mothers with negative or depressed expectations for their infants often have a history of psychiatric disorder or drug or alcohol abuse. The increasing number of mother-child pairs who demonstrate ineffective previewing points to the need for applying preventive strategies. By observing interactions between a mother and her infant, a psychotherapist can gain insight into the mother's conflict and develop strategies to prevent abnormal development in her child. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infants, Parent and child, Parent-child relations, Infant development, Psychotherapy

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Current prevention concepts in child and adolescent psychiatry

Article Abstract:

In medicine, primary prevention consists of measures carried out to avoid the onset of disease and to promote and maintain health. Most preventive efforts in child and adolescent psychiatry have been secondary (when diagnosis and treatment occur after disorder becomes manifest) or tertiary (promoting maximum functioning in patients with progressive mental disorders). In the US, it is estimated that 7 to 12 million children require psychiatric treatment. Several ideas for approaching mental health from a preventive perspective are discussed. For instance, the early identification of factors that foster learning or emotional problems would allow intervention aimed at reducing or modifying high-risk conditions. A consistent research finding is that a strong psychiatric risk factor for children is a parental mental disorder that distorts and impairs child-rearing practices. A new preventive concept related to parent-child interactions in dysfunctional families is 'previewing.' Previewing entails the fantasies and expectations of the mother, and the ways in which her mental set affects interactions with her infant, her ability to respond correctly to her child's cues, and her ability to prepare and encourage her infant's development. Prevention techniques among therapists trained in observing previewing include redirecting harmful mother-infant interactions. An understanding of previewing can also enable therapists to develop techniques for working with older children. For instance, therapists can take over the mother's previewing role and encourage and guide children through previously missed developmental milestones. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Child development, Child development deviations, Developmental disabilities, Child psychiatry, Adolescent psychiatry

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Whatever became of the schizophrenogenic mother?

Article Abstract:

In the history of psychiatry and psychotherapy, one of the consequences of the ongoing debate referred to as 'nature vs. nurture' has been to blame the early influence of the family, especially the mother, for subsequent mental illness. From the 1940s, when the notions of Harry Stack Sullivan concerning the predominance of anxiety as a psychological force were developed, the role of the mother in inducing schizophrenia was almost unquestioned. A review of the development of psychoanalytic theories concerning the maternal influence upon later psychopathology is presented. Concrete scientific data to support this hypothesis seem to be missing, even though its validity has been frequently assumed. In fact, there seem to be no obvious environmental patterns surrounding the development of schizophrenia. Only in the 1970s, with the rise of feminism, was the idea that schizophrenia was caused by a domineering and rejecting mother successfully challenged. The author speculates that the predominance of the concept of the 'schizophrenogenic mother' actually represents a cultural fear of the female that has taken root in psychological thinking. He warns that the recent trend away from nurture and toward nature (i.e. the influence of neurobiological factors) in the search for the causes of schizophrenia and other psychopathologies may also become reductivist. The simplistic notion of a single causative agent, the 'twisted molecule,' could cause as much damage as the equally simplistic idea of the 'twisted mother.' (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Causes of, Family, Nature and nurture, Schizophrenia, Schizophrenics

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