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Book Forum: Childhood and Adolescence Issues   |    
The First Idea: How Symbols, Language, and Intelligence Evolved From Our Primate Ancestors to Modern Humans
JUDITH R. DEUTSCH, M.S.W.; JAMES W. DEUTSCH, M.D., Ph.D.
Am J Psychiatry 2005;162:1232-a-1233. doi:10.1176/appi.ajp.162.6.1232-a
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Toronto, Ont., Canada

By Stanley I. Greenspan, M.D., and Stuart G. Shanker, D.Phil. Cambridge, Mass., Da Capo Press, 2004, 504 pp., $25.00.

Psychoanalyst/child psychiatrist Greenspan and philosopher Shanker marshall paleoanthropology, neuroscience, clinical work with children diagnosed as autistic, and primate, infant, and attachment research to show how two million years of accumulated cultural progress are packed into several months of early life. Maturational potentials for language and thinking rely on the sensitivity and timing of the "good enough mother"; cognition emerges from a rich emotional matrix of mutual emotional attunement, which makes possible an idea, not any one universal first idea. The authors criticize genetic determinists within psychiatry (see Kendler [1] for a more complete discussion) and the social sciences, and they place Damasio’s dualism and Chomsky’s genetic theory of language in a more comprehensive context. They remind us that brain structure changes with experience (it would have been helpful to have some examples with illustrations).

One wishes that the authors had made more use of the rich contributions of child psychoanalysts like Winnicott, Fraiberg, Spitz, and E. Furman, who so carefully observed and captured the emotional quality of both mother and infant. The authors seem comparatively behavioral and mechanistic. It is puzzling that their comprehensive program for autistic children (Table 12.2, p. 316) makes no mention of emotion per se. Further, one misses the greater complexity and depth with which these earlier clinicians described and conceptualized the emotional field. Early on, Spitz (2, 3) showed that failures in the maternal environment can lead to mental and physical retardation and even death. Fraiberg (4) demonstrated how one emotion can ward off an infant’s accurate perception of both his own inner world and of his mother’s emotional intent: a mother repeatedly taunts her 5-month-old baby with the offer of food and then snatches it away; the baby comes to respond with laughter and motor excitement, engaging in a sadomasochistic game. Even in such young children, emotions can be reversed or transformed. The picture is not so straightforward as Greenspan and Shanker imply.

Perhaps the most questionable part of the study is the lengthy section on group psychology, which offers a developmental view of the capacity of groups to function "democratically." Despite their claims of not offering a simplistic linear view of history, and of not being ethnocentric, the authors’ conclusions seem to us uncritical and highly ethnocentric. For example, they state that "nations without large numbers of logical, reflective individuals who can learn and master new challenges generally do not progress economically in the same way as nations with large numbers of individuals who have these capacities." This sounds like the Protestant ethic revisited. One wishes they had looked at Chomsky’s other work (5) showing how the word, symbol, and idea of "democracy" are used to represent what it is not, and how this usage functions to rationalize the most atrocious acts. More than seven million people, mainly civilians, have been killed in Korea, Vietnam, and in the first Gulf War, in places that many "literate" people cannot locate on a map. Time is getting short for figuring out how people can be "logical, reflective individuals," and Greenspan and Shanker provide only partial answers.

Kendler KS: Toward a philosophical structure for psychiatry. Am J Psychiatry  2005; 162:433–440
[PubMed]
[CrossRef]
 
Spitz RA: Hospitalism, in The Psychoanalytic Study of the Child, vol 1. Edited by Eissler RS. New York, International Universities Press, 1945
 
Spitz RA: Hospitalism: a follow-up report, in The Psychoanalytic Study of the Child, vol 2. Edited by Eissler RS. New York, International Universities Press, 1946
 
Fraiberg S: Pathological defenses in infancy. Psychoanal Q  1982; 51:612–635
[PubMed]
 
Chomsky N: Deterring Democracy. New York, Verso, 1991
 
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References

Kendler KS: Toward a philosophical structure for psychiatry. Am J Psychiatry  2005; 162:433–440
[PubMed]
[CrossRef]
 
Spitz RA: Hospitalism, in The Psychoanalytic Study of the Child, vol 1. Edited by Eissler RS. New York, International Universities Press, 1945
 
Spitz RA: Hospitalism: a follow-up report, in The Psychoanalytic Study of the Child, vol 2. Edited by Eissler RS. New York, International Universities Press, 1946
 
Fraiberg S: Pathological defenses in infancy. Psychoanal Q  1982; 51:612–635
[PubMed]
 
Chomsky N: Deterring Democracy. New York, Verso, 1991
 
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