Normal Child and Adolescent Development A Psychodynamic Primer This page intentionally left blank Normal Child and Adolescent Development A Psychodynamic Primer by Karen J. Gilmore, M.D. Pamela Meersand, Ph.D. Washington, DC London, England Note: The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors some- times occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family. 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American Psychiatric Publishing A Division of American Psychiatric Association 1000 Wilson Boulevard Arlington, VA 22209-3901 www.appi.org Library of Congress Cataloging-in-Publication Data Gilmore, Karen Normal child and adolescent development : a psychodynamic primer / by Karen Gilmore, Pamela Meersand. — 1st ed. p. ; cm. Includes bibliographical references. ISBN 978-1-58562-436-2 (pbk. : alk. paper) I. Meersand, Pamela. II. American Psychiatric Publishing. III. Title. [DNLM: 1. Adolescent Development. 2. Child Development. 3. Adolescent Psychology. 4. Child Psychology. WS 105] RJ503 618.92(cid:2)8914—dc23 2013010863 British Library Cataloguing in Publication Data A CIP record is available from the British Library. Contents About the Authors. . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii Video Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xv 1 A Psychodynamic Developmental Orientation. . . . . . . . . . . . . . . . . . . . . . . 1 2 Infancy: Parenthood, the Mother-Infant Relationship, and the Mind of the Infant. . . . . . . . . . . . . . . . . . . . . . 21 3 The Toddler: Early Sense of Self and Gender, Rapprochement, Libidinal Object Constancy, and Superego Precursors . . . . . . . . . . . . . . . . . . . . . . . . . . 45 4 The Oedipal Phase and Emerging Capacities: Language, Imagination, Play, Mentalization, and Self-Regulation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 5 The Oedipal Phase: Psychosexual Development, Oedipal Complex and Constellation, and Oedipal Phase Contributions to Mental Life. . . . . . . . . 105 6 The Latency Phase: Cognitive Maturation, Autonomy, Social Development, and Learning . . . . . . . . . . . . . . . 141 7 Preadolescence: Bodily Challenges, Changing Relationships, and the Transition to the Teen Years . . . . . . . . . . . . . . 179 8 Early and Mid-Adolescence: The Importance of the Body, Sexuality, and Individuation, the Role of Action, and the Special Problems of the Teen Years. . . . . . . . . . . . . . . 203 9 Late Adolescence: Identity, Sexuality, Autonomy, and Superego Formation in the Late Teens and Early Twenties. . . . . . . . . . . . . . 249 10 The Odyssey Years: Emerging Adults on the Path to Adulthood . . . . . . . . . 283 11 The Role of Developmental Thinking in Psychodynamic Psychotherapy . . . . . . . . . . . . . . . . 317 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 Video Access: www.appi.org/Gilmore About the Authors Karen J. Gilmore, M.D., is Clinical Professor of Psychiatry, Columbia Uni- versity College of Physicians and Surgeons, and Senior Consultant, Colum- bia University Center for Psychoanalytic Training and Research. She is in private practice in Manhattan. Pamela Meersand, Ph.D., is Assistant Professor of Psychology, Department of Psychiatry, Columbia University College of Physicians and Surgeons, and Director, Child Division, Columbia University Center for Psychoanalytic Training and Research. She is in private practice in Manhattan. Disclosure: The authors affirm that they have no financial interests or affiliations that present or could appear to present a conflict of interest with regard to the content and publication of this book. vii This page intentionally left blank Preface A s teachers of human development to psychiatric residents, psychology doc- toral students, and psychoanalytic candidates for over a decade, we have been faced with the absence of accessible literature that presents a comprehensive picture of mental development, informed by contemporary research and psy- chodynamic thinking. Although there are excellent texts from the 1990s about theory (e.g., Tyson and Tyson 1990) and about the broader psychology of development (Gemelli 1996), these perforce do not offer a twenty-first cen- tury integration of recent findings in the psychodynamic literature and psy- chology research that have introduced new ideas, new data, and even a new developmental phase (see Chapter 10). Moreover, there has always been a dearth of readable literature that presents an overview of development as a dy- namic interaction of the growing mind (including the unconscious mind), the maturing body, and the evolving demands of environment. Observing our stu- dents’ struggle to “pull it all together,” we felt the need for a straightforward primer that gives the reader a picture of how development unfolds as a com- plex transactional process progressing through the first three decades of life, retaining both individuality and universality. As our students labored to envision an organic process of development that was infinitely diverse and yet comprehensible as a coherent set of uni- versal propositions, they educated us as to what was needed to synthesize their thinking while maintaining their receptivity to new ideas. Even as we grapple with current controversies about concepts such as developmental phases and the importance of past experience in present-day functioning, the educational value and usefulness of such a picture for the mental health clinician seem irrefutable to us. For these reasons, we are grateful to the gen- erations of students whose observations, ideas, and challenges helped us realize this project with confidence in its heuristic merit. Our conviction of the project’s value also grows from our belief that understanding development is a building block of clinical thinking. In every encounter with a patient, a clinician with a developmental education can better ix