D. W. Winnocott (1896-1991), the pediatrician, psychoanalyst, and British Object Relations theorist, is often quoted as saying that “There is no such thing as a baby” (1960). This was his way of dramatically emphasizing that a baby cannot survive alone. It is part of a symbiotic unit consisting of a mother and a baby.

Many babies do survive subpar caregiving. However, they often develop a variety of serious psychological issues.

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is one of the problems that can develop if the lack of attuned care occurs at the crucial developmental stage of around 15 to 24 months of age. This time period appears to be very important to the development of the ability to self-soothe and be alone (Mahler, Pine, and Bergman, 1975; Masterson, 1976).

To understand why this is so, a bit of knowledge about the research into how appropriate childhood nurturing, or the lack of it, can create serious problems might be helpful.

Hospitalism Syndrome

Early research on babies in orphanages by Rene Spitz (1887–1974), an Austrian American physician and psychoanalyst, discovered that babies were dying at a surprisingly high rate despite being adequately physically cared for—fed, diaper changes, and a crib in which to sleep. The ones who survived had developmental delays and a host of psychological problems (1946).

Spitz concluded that emotional comfort and soothing touch were as necessary to babies as food and shelter. Spitz’s research was highly publicized and led institutions to change how they cared for babies. The standard protocol now includes picking them up, interacting with them, and cuddling.

Rene Spitz also noted that the prolonged separation of a young child from its caregivers created serious emotional consequences—depression, social withdrawal, loss of appetite, difficulty sleeping, and developmental delays. He called this state “anaclitic depression” and noted that it led to children becoming more dependent on adults and very fearful of rejection and abandonment. He believed that the damage could be healed if the caregiver returned within a few months or sooner.

Rene Spitz’s work opened a new door into how early childhood care (or lack of it) severely impacts adult Mental health. His work influenced modern attachment disorder theorists.

Harlow’s Monkeys

Harry Harlow (1905-1981), an American psychologist, did a famous study in which he tried to discover the essence of mothering (1958). The study was quite cruel by modern standards.

Harlow separated baby monkeys from their mothers. To discover which mattered more, being fed or being soothed by touch, he gave the baby monkeys a choice of two wire mothers. One had a bottle of milk attached without a soft covering and one was covered in soft terry cloth. Later he added the ability to rock to the wire mothers.

Results: Harlow’s results show that baby monkeys went to the soft mother for comfort and only went to the other wire mother to feed. In addition, baby monkeys who had the soft wire monkey were emotionally healthier and more functional than the monkeys who only had the bare wire mothers.

Unfortunately, all the baby monkeys who had wire mothers were unable to fit in with more normally raised monkeys. They were especially disordered in the areas of sex and aggression.

Attempts were made to help them. They found that putting the wire mother monkeys into a group of younger monkeys helped them cope better. Some of them resumed their development and became more normal.

Harlow concluded that “comfort contact” was an essential part of early caregiving and baby monkeys did not thrive without it.

Note: This conclusion supports Rene Spitz’s findings about human babies needing physical touch and emotional comfort to survive and become psychologically normal adults.

It also suggests that some humans who have trouble functioning at a normal adult level because of inadequate parenting might be helped by being in a form of group therapy which is targeted to their developmental needs.

Margaret Mahler—Filming Mothers With Toddlers

Margaret Mahler (1897-1985) and her colleagues wanted to explore how a young child’s stage of development interacted with the mother’s parenting style to create borderline personality disorder and other psychological issues.

She set up a free nursery for mothers with children under the age of three. In return for nursery school, the mothers agreed to be filmed as they interacted with their child.

Hypothesis: In this age group, children are very sensitive to all forms of abandonment trauma and unattuned and inconsistent parenting. She believed that when this occurred between the ages of 15 and 24 months (the stage she called the “rapprochement subphase of separation and individuation’), the child was more likely to develop borderline personality disorder as an adult.

Results: Mahler’s hypothesis was supported by an analysis of the films of mothers and toddlers interacting. Young children needed consistent maternal support to develop normally. The findings were written up in the book: The Psychological Birth of the Human Infant (1975) in which she and her colleagues described the stages believed to be involved in the typical progression from total dependence on the mother to separation and individuation. A film about this project is still shown in many psychology classes that study the childhood history of adult psychological disorders.

In everyday language people often call the rapprochement subphase the “Terrible Two’s.”

Why Is This Phase so Important?

At around two years of age children are starting to feel more independent. They can walk and talk a bit and are able to move away from the mothering figure. They are experimenting with saying “no.”

They may express love one moment and then get angry and express hatred. They may confidently toddle away and then get scared or frustrated and want to run back to mother to be cuddled and reassured.

Not every mother (or primary caregiver) understands that this stage of ambivalence is a normal part of the road to independence. Ideally, caregivers need to tolerate being pushed away and screamed at and then be willing to lovingly take the child back and be soothing when the child indicates that he or she wants love and cuddling.

Stella Chess and Andrew Thomas—The Mismatch Theory

Stella Chess and Andrew Thomas were infant researchers associated with a longitudinal study of infants to adolescents that focused on the temperament variables of the children. They looked at individual differences and how some children were easier to parent than others (1977).

They concluded that many forms of adult psychological disturbances could be traced to a mismatch between the developing child’s emotional and physical needs and the caregiver’s ability and willingness to fulfill these needs.

Why Do People With BPD Often Have Trouble Being Alone?

Based on research, the likeliest reason why many people with BPD cannot be alone without becoming distressed is that something went awry in their first three years, and they did not receive the type of parenting they needed. As a result, they could not internalize an effective and constructive form of self-soothing.

The lack of an internalized “soothing part,” leads them to either rely on other adults to provide that function or on a variety of sometimes dangerous substitutes, such as drugs, indiscriminate sex, impulsive relationships, and overindulging in food or alcohol.

Summary

Successfully being able to self-soothe when alone appears to be traceable back to being appropriately and consistently soothed at an early age. It is likely that people with borderline personality disorder did not get the right sort of attention from their primary caregiver during a critical developmental period. As a result, they never internalized a personality part that can be soothing, reassuring, and reasonable to help them tolerate their negative feelings when they are alone.