David A. Freedman

Speech and Psychic Structure: a Reconsideration of their Relation

T IS THE PURPOSE of this essay to re-examine certain propositions concerning the role of speech and language in the ontogenesis I of psychic structure. Edelheit has recently stated (1969) that “The maturation of the physiological speech apparatus, the coordination of vocal-auditory experience, and the organization of that experience in specific linguistic patterns are concomitant with and correlated to the ontogenesis of the ego.” The author goes on to suggest that the I ‘ . . . ego may, in fact, be regarded as a vocal-auditory organization-a language determined and language determining structure which functions as the characteristically human organ of adaptation” (p. 410; italics ours). JVhile we have no doubt concerning the importance of speech and language to the adaptive processes of the ‘’average expectable individual,” this formulation is not congruent with our longitudinal observations of congenitally deaf children. ’SVe believe, in addition, that it is inconsistent both with other empirical data in the literature and with widely held views concerning the relevance of the first two years for later ego development.

Long‐Term Psychological Follow‐up of Patients after Corrective Surgery for Tetralogy of Fallot

We studied long-term psychological consequences of congenital heart disease in which the lesions had been completely repaired in childhood. Forty-eight young adults whose tetralogy of Fallot was corrected by surgery an average of 14 years 2 months earlier completed the Sixteen Personality Factor Questionnaire, the Childrens Report of Parental Behavior Inventory, and a questionnaire. Their parents completed the Parent Attitude Research Instrument and a questionnaire. The data were compared for a group of patients ( N = 22) who had the surgery before the age of 9 years, and a group ( N = 26) who were operated at age 9 years or older. The current ages of the two groups were similar. The older group, whose period of childhood incapacitation lasted on the average 6.5 years longer, showed an internally consistent psychological pattern different from the younger operated group. On the 16PF, the older operated group now appears less venturesome and more insecure, and also reports recall from childhood that mothers had shown less control and discipline. Extended invalidism in childhood appears to result in psychological remnants of the invalid role in adulthood. This result also justifies repair of congenital heart defects as early in life as possible.

Scientific Proceedings-Panel Reports, The Influence of early Deficits on Later Development

A V I D A. FREEDMAN OPENED THE PANEL by quoting \Villiam D Harvey, in 1651, to the effect that nature displays her secret mysteries in cases that are apart from the beaten path, as we have difficulty perceiving many aspects of nature unless we are deprived of them or they are deranged in some way. Freedman indicated that we were not concerned in this panel with the deficits per se, but with the more interesting problems for psychoanalysts in how our study of early deficits can contribute to an understanding of the processes of internalization and psychic structure formation as well as the processes underlying affect, motivation, and the sense of self-object differentiation. Freedman defined early deficit as “any vicissitudes of congenitdl or perinatal life whose effect is to exclude its victim’s development from the range of the average and expectable.” So defined, early deficit encompasses a large range of congenital and perinatal somatic defects as well as adverse environments, e.g., “high-risk” individuals. He went on to develop the rationale for studying such individuals, claiming that “they have relevance to psychoanalytic theorizing because they provide us with the opportunity to make prospective ob-

The Influences of Various Modalities of Sensory Deprivation on the Evolution of Psychic and Communicative Structures

Because I take it to be implicit in the theme of the symposium, I will not dwell on the evidence that the ability to utilize the vocal/auditory system for the purpose of making speech sounds is neither a sufficient, nor even a necessary condition for the process of thinking. Suffice it to say that within the psychoanalytic tradition the necessity to differentiate between thinking and the communication of the products of thought was recognized very early by Freud. It will be recalled that in the course of developing the topographic model, Freud (1895, 1896) assigned the process of attaching word representations to thoughts to the preconscious. Thinking itself he conceived of as an unconscious neural process. In the intervening years, his conclusions have been affirmed by an abundance of empirical evidence. The phenomenon of echolalia in humans, as well as the extraordinary abilities of the mynah bird and parrot, provide proof positive that well articulated speech sounds can be produced by individuals who are entirely lacking in the ability to understand the message their words ostensibily convey. On the other hand, equally persuasive evidence is available from the study of the congenitally deaf (see below), and such comparative studies as those of the Gardeners (1969) to the effect that both the act of creative thinking and the ability to communicate the products of the thought process are entirely possible in the absence of a functioning vocal/auditory system.

The Biological Origins of Psychological Phenomena

The perception, not only of psychoanalysis but of all psychology as occupying a place both within and without the natural sciences is a perpetual source of frustration and fascination for those of us who come to the field as physicians. We share with Freud and other spiritual ancestors of similar background a sense of continuing challenge. How can we reconcile our neurologic and physiologic frame of reference with the clinically inescapable fact that in our day-to-day efforts we seem to be working on an entirely different plane? Our plight—and I use the word advisedly—as psychoanalysts involves dealing with extremely substantial—even quantifiable—physiological processes, while at the same time working in a medium which commits us to the use of explanatory devices which have to do only with relationships. We may detect evidence of what we consider rage, aggression, sensuality, and so forth. What we interpret, however, is the complexities of feelings as they are manifested in the context of human relations. No one has ever profited from being told that he suffers from an excessive aggressive drive. Our patients, however, regularly benefit from becoming aware of covert object-directed impulses and fantasies. Properly timed interpretations can be powerful in affecting not only perception of self and others but physiological processes as well.

Clinical Psycholinguistics. By Theodore Shapiro.

and art-all practices which today are thought to make analysis impossible. Similarly, Silverman is concerned that important aspects in Hans’s treatment, as it would be conceived today, were ignored. But no one speaks to the question of how the results today would be better, and how would we know? T h e integrative summaries which conclude each case section are a disappointment. They do not take up questions raised or struggle with differences posed by various authors’ presentations. Instead they tend to recapitulate and summarize until eventually they imbue the volume with the quality of an elementary text in which basic points are repeatedly stated, often in the very same words as the original presentation. Equally disappointing is the promised concluding integration “New Dimensions in Human Relationships” by Mark Kanzer. It reads as a restatement of what has already been restated and does not unify the book or bring it to a conclusion with which one can be content. Reaching this end, one reluctantly notes that the book as a whole is misleading. T h e integrative portions eschew that task. The book is not about Freud and his patients-and what a wonderful title that is and how full of promise! Rather it is primarily a showcase for contemporary analysts who use Freud’s writings about his patients to explore their own interests. This is a very different proposition. T h e reviewer’s problem with this book is that it is neither so bad that one can condemn it, nor so good that one may praise it. If the editors had taken a cue from Freud himself and worked with a sharp focus and singular purpose rather than being random and pragmatic, perhaps the results would have been a more pleasing Fesibchr

The effects of sensory and other deficits in children on their experience of people.

2, a more rewarding celebration for a well-respected Institute, and a better book.