INTRODUCTION AND HISTORICAL REVIEW

    As early as 1949, Mahler first adumbrated her theory that schizophrenia-like infantile psychosis syndromes were either autistic or symbiotic in origin, or both. In 1955, with Gosliner, she introduced her hypothesis of the universality of the symbiotic origin of the human condition, as well as the hypothesis of an obligatory separation-individuation process in normal development.

    These hypotheses led to a research project on “The Natural History of Symbiotic Child Psychosis,” carried out at the Masters Children’s Center in New York, under the direction of Mahler and Dr. Manuel Furer (co-principal investigators). The project was sponsored by the National Institute of Mental Health, USPHS. It was designed to study the gravest deviations of the assumed normal symbiotic phase and the complete failure of the obligatory intrapsychic separation-individuation process. The yield of this research is described in On Human Symbiosis and the Vicissitudes of Individuation: Volume Ⅰ, Infantile Psychosis.

    In its earliest stages, the research was limited to the study of symbiotic psychotic children and their mothers. However, the necessity of further validation of the above hypotheses in normal human development became more and more apparent to the two principal investigators of the project. A comparative parallel study was needed with normal babies and their mothers to substantiate the universality of the hypotheses. Hence in 1959, investigation of a control group of “average mothers and their normal babies” was begun at the Masters Children’s Center. A pilot study, “The Development of Self-Identity and Its Disturbances,” was made possible by grants from the Field Foundation and the Taconic Foundation. Its aim was to learn how healthy children attain their sense of “individual entity” and identity. Anni Bergman, and later Edith Atkin worked with Mahler and Furer on this pilot study.

    When in the very beginning of the 1960s, the National Association of Mental Health expressed its interest in a comparative investigation within our framework of “The Development of Intelligence in Schizophrenic Children and a Control Group of Normal Toddlers,” the complementariness of the two research projects became more apparent. Dr. David L. Mayer was added to our research stuff, and many of the workers who hitherto had been exclusively engaged in the symbiotic psychosis study now joined the work of the normative study as research psychiatrists or participant observers.

    The complementariness of the two research projects called for a sophisticated innovative methodology, which was initiated in 1961 by Dr. Fred Pine. (The 1963 paper by Pine and Furer, “Studies of the Separation-Individuation Phase: A Methodological Overview,” is relevant for the understanding of that stage of our overall work.)

    As the methodology envolved and led to more systematic, psychoanalytically oriented observations, the joint efforts of Mahler, Furer, Pine, additional hypothesis of four subphases of the normal or near-normal separation-individuation process was formulated. After the formulation of this additional hypothesis, it became apparent that its validity had to be checked by repeating and extending the study to another group of average mothers and their normal babies.

    In February 1963, Mahler applied to the National Institute of Mental Health for a research grant. In her application she stated that on the basis of her previous work, she and her co-workers found that the roots of infantile psychosis are to be sought in the second half of the first year and in the second year of life. This time span came to be recgnized as the “separation-individuation phase” of development. Mahler stated that the purpose of the proposed study was to verify the occurrence of the four subphasesof the separation-individuation process by longitudinal study of another group of mother-child pairs——and to delineate both the patterns of mother-child interaction typical of each subphase and the developmental patterns of the child occuring at each subphase. It was felt that added systematic knowledge about this little-known period of development could be applicable in the prevention of severe emotional disturbance. Funds for such a study were granted by the National Institute of Mental Health for five years (later extended). The results of this research are described in the present volume.

    Dr. John B. McDevitt became our associatein 1965 and since that time has invaluably enhanced the systematization, as well as the scope and precision, of our work. However, rather than participating in the writing of this volume, he preferred to devote his time to important aspects of the study that are of special interest to him and to the ongoing follow-up study.

    The Psychological Birth of the Human Infant: Symbiosis and Individuation is divided into four parts. The authors thought it would be salutary first to present a background against which the formulations explicated in Parts Ⅱ and Ⅲ could be viewed. In Part Ⅰ， Chapter 1 (written by Pine and Mahler), we therefore integrate the ideas contained in 20 or more widely scattered relevant papers by Mahler and her co-workers, past and present. This opening chapter was greatly influenced by our joint discussions. (The minutes of our staff conferences are utilized in this as well as in other chapters.)

    Part Ⅰ，Chapter 2, as well as the Appendices (written by Pine), describes the evolution and the functioning of the research setting from a methodological point of view. We believe the correlation of Pine’s work with that of Mahler and Bergman becomes evident in Parts Ⅱ and Ⅲ.

    In Part Ⅱ, Chapters 3 through 6, Bergman and Mahler describe their clinical study of the first three subphases of the separation-individuation process and provide illustrative vignettes. Chapter 7 deals with the fourth subphase and with object constancy in its psychoanalytic (emotional) sense.

    In Part Ⅲ, contributed by Mahler and Bergman, the “subphase histories” of five representative children in interaction with their mothers are presented. Thus, in this section we attempt to document the implications of the broad middle range of “variations of normalcy” contained in Part Ⅱ. From our observational study, as well as our clinical work, the subphase developmental histories of the representative cases seem to prove quite dramatically the conceptualizations of McDevitt and Pine, on which the seventh chapter of the book essentially is based.

    In the concluding Part Ⅳ, Mahler summarizes the results of the observational study and offers some amplifications and changes in the focusing of hitherto accepted metapsychological concepts. She also points to a few (by no means all) specific areas that she and her co-workers found to be in particular need of further psychoanalytic research.

引言与历史回顾

        早在1949年，马勒（Mahler）首次提出了她的理论，即类似精神分裂症的婴儿期精神病综合征的起源可能是自闭型、共生型或两者兼具。1955年，她与戈斯利纳（Gosliner）共同提出了人类状况共生起源普遍性的假说，以及正常发展中必然存在的分离-个体化过程的假说。

        这些假设催生了一项名为“共生性儿童精神病自然史”的研究项目，该项目由马勒和曼努埃尔·富勒博士（Manuel Furer，共同首席研究员）指导，于纽约的马斯特斯儿童中心（the Masters Children’s Center）开展。此项目由美国公共卫生署下属的国家心理健康研究所（the National Institute of Mental Health，USPHS）资助，旨在研究假定的正常共生阶段出现的最严重偏差，以及必要的心理内部分离-个体化过程的彻底失败情况。这项研究的成果在《论人类共生与个体化的变迁：第一卷，婴儿期精神病》一书中有所阐述。

        在研究的最初阶段，其范围仅限于对患有共生性精神病的儿童及其母亲的研究。然而，该项目的两位主要研究人员愈发意识到，有必要在正常人类发展过程中对上述假设作进一步验证。为证实这些假设的普遍性，需要针对正常婴儿及其母亲开展一项对比平行研究。因此，1959年，马斯特斯儿童中心启动了对“普通母亲及其正常婴儿”对照组的调查。在菲尔德基金会（Field Foundation）和塔科尼克基金会（Taconic Foundation）的资助下，一项名为“自我认同的发展及其障碍”的初步研究得以开展。该研究旨在探究健康儿童如何获得“个体存在”感和自我认同感。安妮·伯格曼（Anni Bergman），以及后来的伊迪丝·阿特金（Edith Atkin），与马勒和富勒共同参与了这项初步研究。

        20世纪60年代初，美国心理健康协会（the National Association of Mental Health）表示对在我们“精神分裂症儿童与正常幼儿对照组的智力发展”研究框架内开展一项对比调查感兴趣，此时，这两个研究项目的互补性愈发明显。大卫·L·迈耶博士（David L. Mayer）加入了我们的研究团队，此前一直专门从事共生性精神病研究的许多工作人员，如今作为研究精神科医生或参与式观察员，投身到了规范性研究工作中。

        这两个研究项目的互补性要求采用一种精密的创新方法，该方法由弗雷德·派恩博士（Fred Pine）于1961年开创。（派恩和富勒1963年发表的论文《分离-个体化阶段研究：方法论概述》，有助于理解我们整个研究工作的那个阶段。）

        随着研究方法不断发展并趋于更加系统化、以精神分析为导向的观察，在马勒、富勒、派恩等人的共同努力下，针对正常或接近正常的分离-个体化过程的四个亚阶段提出了额外假设。该额外假设提出后，显然有必要通过在另一组普通母亲及其正常婴儿群体中重复并拓展此项研究，来验证其有效性。

        1963年2月，马勒向美国国家心理健康研究所申请研究资助。在申请书中，她指出，基于自己此前的研究工作，她和同事们发现，婴儿精神病的根源应在婴儿出生后第一年的下半年和第二年中去探寻。这一时间段后来被确认为发展的“分离-个体化阶段”。马勒表示，拟开展的研究旨在通过对另一组母婴对进行纵向研究，验证分离-个体化过程中四个亚阶段的存在情况，同时描绘出每个亚阶段典型的母婴互动模式以及儿童在每个亚阶段的发展模式。人们认为，针对这一鲜为人知的发展阶段获取更多系统知识，有助于预防严重的情绪障碍。美国国家心理健康研究所批准了这项研究为期五年的资助（后又延长）。本书阐述了这项研究的成果。

        约翰·B·麦克德维特博士（John B. McDevitt）于1965年成为我们的合作伙伴，自那时起，他极大地提升了我们工作的系统性、广度和精准度。然而，他并未参与本书的撰写，而是选择将时间投入到他特别感兴趣的研究重要方面以及正在进行的后续研究中。

        《人类婴儿的心理诞生：共生与个体化》一书分为四个部分。作者认为，首先介绍相关背景情况会有所助益，以便读者能更好地理解第二部分和第三部分所阐述的理论。因此，在第一部分第一章（由派恩和马勒撰写）中，我们整合了马勒及其新老同事发表在20余篇分散论文中的相关观点。这一开篇章节深受我们共同讨论的影响（我们还在这一章以及其他章节中参考了员工会议记录）。

        第一部分第二章以及附录（由派恩撰写）从方法论的角度描述了研究环境的演变和运行机制。我们认为，在第二部分和第三部分中，派恩的研究成果与马勒和伯格曼的研究成果之间的关联将清晰显现。

        在第二部分（第3章至第6章）中，伯格曼和马勒阐述了他们针对分离-个体化过程前三个亚阶段所开展的临床研究，并提供了具有说明性的案例。第7章探讨了第四个亚阶段以及精神分析（情感）层面的客体恒常性。

        在第三部分，由马勒和伯格曼撰写，呈现了五名具有代表性的儿童与母亲互动的“亚阶段发展历程”。因此，在这一部分，我们试图记录第二部分所涵盖的广泛的“正常变异”中间范围的意义。从我们的观察研究以及临床工作来看，这些具有代表性案例的亚阶段发展历程似乎极为有力地证实了麦克德维特和派恩的概念，而本书第七章实质上正是基于这些概念撰写的。

        在结论性的第四部分，马勒总结了观察性研究的结果，并对迄今已被接受的元心理学概念的侧重点提出了一些补充和修正。她还指出了几个（绝非全部）特定领域，她和她的同事们认为这些领域尤其需要进一步开展精神分析研究。