23rd November 2023

Historical Models of Development, Maturational Tasks and Stage Theories

Why bother learning these psychodynamic models of development, you may ask?

Well, a central diagnostic task of a clinical interview is assessing what developmental level a person is characterologically organised. Are the main issues with which the person repeatedly struggles those of the earliest phase of life, the one Freud called oral, and Mahler called symbiotic? If so, the interviewer will hear themes such as the Eriksonian conflict between basic trust and mistrust, the Sullivanian confusion of ‘me versus not me’, and other derivatives of the infant’s struggle to define a sense of existence and personhood.

Or is the person preoccupied with the themes and conflicts of the phase Freud called anal and Mahler called separation–individuation? If so, the clinician will feel a sense of dyadic struggle, of Erikson’s (1950) ‘autonomy versus shame and doubt’ and of Sullivan’s (1947) ‘good me versus bad me’, see how these theories come together. Maturational challenges will categorise the former patient as neurotic and the latter patient as borderline and inform us of how their reality testing and affect regulation will be in each case.

This chapter will just briefly overview these theoretical models in understanding development. I hope these theories indirectly influence a sensibility that informs your day-to-day interactions with your patients – not just for the RCPsych exams! By discussing their problems through a developmental lens, patients can learn to see themselves as grappling with maturational challenges rather than as stymied by unrelenting, static realities.

According to Jean Piaget, development occurs in hierarchical stages; each stage is qualitatively different; and the stages consist of invariant functions, and all children undergo these sequentially. Let’s start from the very beginning with Freud.

Freudian stages of psychosexual development

In this section, I oversimplify Freudian theory for didactic purposes, omitting many interesting problems and complications in it.

Sigmund Freud’s original development theory stressed three ‘infantile’ (i.e., preschool) stages, the oral, anal, and oedipal, each of which had predictable issues and conflicts, mastered differently depending on the child’s constitution and the caretakers’ interventions. These were typically resolved by about age 6 into the main outlines of someone’s permanent personality structure. (Freud also talked about minor transitional phases in the infantile era that applied differentially to the two sexes, including a urethral phase, a phallic phase, and a reverse or ‘negative’ oedipal phase, but these have been less emphasised in the literature and include too many idiosyncratic issues to go into here.)

Oral phase – 0-18 months

According to Freud, in the oral phase, the child’s sensory experience is organised around the mouth, the chief organ for expression, exploration, and enjoyment, and the means of connection with the nursing mother from whom the child is not yet psychologically differentiated.

Anal phase – 18-36 months

From about eighteen months to three years, the child’s preoccupation shifts to anal concerns, partly because of the maturation of the anal sphincter muscle and partly because the toilet training scenario typically represents the first conflict between the child’s natural proclivities and the demands of civilisation, represented by the child’s caretakers. Associated infantile concerns involve struggles between compliance and rebellion, cleanliness and mess, giving and withholding, promptness and lateness, autonomy and shame, sadism and masochism – all very dyadic issues. The dramas of this phase all seem to involve the question of agency. Colloquially, the Freudian ‘anal’ phase has been nicknamed the ‘terrible twos’ because of the intense pitting of the toddler’s will against that of the parents at this time.

Oedipal phase – 3-6 years

With the inception of the oedipal phase at about age three, the child has become cognitively capable of understanding that two other people can have a relationship in which he or she is not a player. The child’s preoccupations shift to a fascination with issues about power, relationships, and identity. He or she gets very interested in sex differences, generating imagery about castration, mutilation, and other infantile theories about the distinctions between males and females. Children this age are raptly curious about the origins of babies, and they construct elaborate fantasies and experience associated jealousies about their parents’ sexual lives. By somewhere around age three or four, normally developing children also have an awareness of personal agency that is not defined by dyadic power struggles as in the previous phase.

They also come to an awareness of the reality of death, which, because of their unfinished sense of the independence of idea from action, makes them frightened by their natural wishes to get one parent out of the way and possess the other. Guilt and projected guilt, as in bedtime anxieties about hidden attackers, are typical. Fears of retribution for hostile wishes are eventually resolved by identification with primary caregivers, especially the parent with whom the child feels most competitive (‘I can be like daddy and have someone like mommy when I grow up’). Children at this age need to idealise their caregivers, who, as self-psychologists have noted (e.g., Kohut, 1977), must be attuned enough to be idealised in the first place and non-defensive enough to tolerate the child’s de-idealisation. This normal, expectable dethroning of the parents starts around the end of the oedipal phase (when the kindergarten teacher starts knowing more than mommy). A cardinal achievement of this developmental era is attaining a complex and well-internalised sense of conscience that is the natural consequence of complex identifications with childhood authorities. In analytic lingo, a mature superego replaces the primitive all-good and all-bad images of the previous stage.

Latency phase – 6 years to puberty

Freud postulated a latency phase after age 6 or so, in which the child, having developed mature defences, notably repression, that keeps disturbing ideas out of consciousness, is temporarily relieved of the intensity of coping with powerful primal urges and can concentrate on learning and socialisation.

Genital phase – Puberty

The hormonal assault of puberty ushers in adolescence and the final and sometimes stormy consolidation of all the early challenges and resolutions. With sexual maturity, it becomes possible for people to compress all their oral, anal, and oedipal issues into a pleasurable experience of adult genitality, an ideal condition characterised by a person’s capacity to integrate love, aggression, dependency, and sexuality into a relationship with another person. As I have in this account, most of Freud’s clinical writing emphasised the first three phases, as he believed that neurotic problems in adulthood derive from universal ‘childhood neuroses.’

Eriksonian stages of psychosocial development 

Erik Erikson regarded his contribution as an elaboration of Freudian theory rather than replacing it. Each section of the Eriksonian wheel below describes a maturational task, which refers to the psychological challenges that individuals must overcome at different stages of development to achieve psychological maturity. These tasks are thought to be innate, biologically determined, and universal, and are believed to follow a fixed sequence of development that is independent of environmental factors.

Maturity could be defined as a multi-dimensional concept that involves the development of cognitive, emotional, and social skills necessary for functioning effectively and adapting to the demands of life.

Most interesting is that Erikson frequently commented in his last decade (1997) that if he were writing his lifespan theory again, he would not have lumped everything from the sixties into one category. Only by reaching old age himself did he emotionally appreciate the profound difference between the psychology of someone 65 and that of someone 85. Psychoanalytic knowledge of the geriatric stages of life is not well developed.

Klein’s theory of psychological development

Melanie Klein’s influential theory of psychological development posits that infants progress through two major positions in their early development: the paranoid-schizoid position and the depressive position. These positions represent fundamental modes of relating to the world and reflect the infant’s emerging capacity to process their experiences.

Paranoid-schizoid position – Birth to 4-6 months

The infant tends to split their experiences into good and bad, projecting negative feelings onto external objects. This position is marked by primitive anxieties, such as the fear of annihilation and the infant’s need for protection from internal and external dangers.

Depressive position – 6 months onwards

This is the infant’s ability to integrate good and bad experiences and form more complex and realistic views of themselves and the world around them. The infant begins to recognise that the external object has both positive and negative qualities and develops a more nuanced understanding of their relationships with others.

Klein believed that the successful resolution of these positions was crucial for the development of a healthy sense of self and the ability to form satisfying relationships with others. Furthermore, Klein emphasised the role of the mother or primary caregiver in facilitating this development, by providing a secure and supportive environment for the infant’s exploration and growth. Klein’s theory has been influential in shaping contemporary psychoanalytic thinking, particularly in the area of object relations theory, which emphasises the importance of interpersonal relationships in shaping the developing self. The theory also highlights the significance of early experiences in shaping individuals’ psychological development, underscoring the importance of early intervention and prevention efforts in addressing the impact of adverse childhood experiences.

Marcia’s development of adolescent identity 

James Marcia elaborates on Erikson’s proposal of the fifth stage of psychosocial development, by using the identity status interview, a semi-structured interview. You may recall that Erikson had suggested that the normative conflict occurring in adolescence is the opposition between identity achievement and role confusion.

Marcia suggests that this stage consists neither of identity resolution nor identity confusion, as Erikson claimed, but is better understood as the extent to which one has both explored and committed to an identity in a variety of life domains, including politics, occupation, religion, intimate relationships, friendships, and gender roles.

Identity diffusion

At one end of the spectrum is identity diffusion, where the teenager makes no firm commitments for the future, with no identity issues considered with no goals whatsoever. They remain in an amorphous state of identity, with some reporting having little interest in identity crisis or reporting repeated indecision.

Identity achievement

The goal is to ultimately get to the other end of the spectrum called identity achievement. This is where the teen has carefully considered various alternatives and made firm future commitments after experiencing a crisis and working it through.

Identity moratorium

The process to achieve is identity moratorium, where the teen goes through intense exploration in the midst of a crisis, whose commitments are either absent or are only vaguely defined, but who are actively exploring alternatives.

Identity foreclosure

Identity foreclosure is where the teen adopts the traditional and cultural norms of their parents or surrounding culture rather than exploring or forming their own unique path. They may foreclose on the handed-down identity willingly or under coercion and pressure. As Marcia himself put it, ‘The individual about to become a Methodist, Republican farmer like his Methodist, Republican farmer father, with little or no thought in the matter, certainly cannot be said to have ‘achieved’ an identity, despite his commitment.’\

Sullivan’s model of development 

Harry Stack Sullivan’s model of development posits that human beings are fundamentally social creatures, and that personality development is shaped by interpersonal experiences and relationships. Sullivan emphasised the importance of the individual’s interactions with others, particularly during childhood and adolescence, in shaping their sense of self and their capacity for healthy relationships. Sullivan proposed that individuals progress through several developmental stages:

Infancy

Beginning with the infancy stage, the infant experiences their caregiver as part of themselves.

Good me vs bad me – 5-10 years

In the ‘good me vs bad me’ stage, which typically occurs around age 5 or 6, the child develops an internalised sense of self and begins to differentiate between positive and negative aspects of themselves. This stage is marked by the child’s efforts to incorporate positive aspects of themselves into their self-concept and to disown negative aspects of themselves.

Me vs not me – 10-13 years

In the Juvenile stage, which typically occurs around age 9 or 10, the child begins to develop a sense of ‘me vs not me’ as they increasingly differentiate themselves from others. During this stage, the child’s sense of self is influenced by their interactions with peers and authority figures, and they begin to form more complex relationships with others.

Preadolescence – 13-15 years 

In the preadolescence stage, which typically occurs around age 12 or 13, the individual experiences significant changes in their self-concept and their relationships. Sullivan suggested that this stage is marked by significant interpersonal tension, as individuals struggle to balance their desire for intimacy with their fear of rejection and abandonment.

Adolescence – 15 years onwards

Finally, in the adolescence stage, which typically occurs around age 14 or 15, the individual experiences significant changes in their self-concept and their capacity for relationships. During this stage, the individual faces the challenge of separating from their parents and establishing their own identity. Sullivan believed that the successful resolution of this task is necessary for forming a healthy sense of self and forming mature relationships with others.

Mahler’s separation-individuation stages of child development

Margaret Mahler is a neo-Freudian who dissects Freud’s pre-oedipal stages. The separation-individuation theory is a psychodynamic, developmental theory that outlines the stages of psychological growth that an infant goes through as they move towards separation from their primary caregiver and establish their own independent identity.

Autistic – 0-2 months

A child spends most time in sleep as if the intrauterine aloofness continues.

Symbiotic – 2-5 months

The inner and outer world is studied via senses but perceives mother and self as one unit.

Separation-individuation

Differentiation – 5-10 months

During this stage, the infant develops a sense of self and starts to differentiate themselves from their primary caregiver. This is a critical stage of development, as it is during this time that the infant learns to tolerate being away from their caregiver and to explore the world around them.

Practising – 10-18 months

During this stage, the infant starts to move around and explore their environment more actively but still relies heavily on their primary caregiver for support and comfort.

Rapprochement – 18-24 months 

Alternating drives to be autonomous and dependent; Able to explore alone but requires comfort and reassurance on return.

Object constancy – 2-5 years

Understand that the mother will not be lost if temporarily away; hence, she can function independently.

Piaget’s theory of cognitive development 

Piaget’s theory is a developmental theory that focuses on how children learn and develop their thinking abilities. Piaget identified four stages of cognitive development that occur in a fixed sequence from birth through adolescence. I won’t go through them here as this will be covered in greater detail in other chapters.

References

• Freud, S. (1923). The ego and the id. Standard Edition, 19, 13–59.
• Erikson, E. H. (1950). Childhood and society. New York: Norton. Erikson, E. H. (1968). Identity: Youth and crisis. New York: Norton. Erikson, E. H. (1997). The life cycle is completed. New York: Norton.
• Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psycho-Analysis, 27, 99–110.
• Marcia, J. E., (1966), Development and validation of ego identity status, Journal of Personality and Social Psychology 3, pp. 551-558
• Sullivan, H. S. (1947). Conceptions of modern psychiatry. New York: Norton.
• Sullivan, H. S. (1953). Interpersonal theory of psychiatry. New York: Norton.
• Sullivan, H. S. (1954). The psychiatric interview. New York: Norton.
• Mahler, M. S. (1968). On human symbiosis and the vicissitudes of individuation. New York: International Universities Press.
• Mahler, M. S. (1971). A study of the separation–individuation process and its possible application to borderline phenomena in the psychoanalytic situation. In The selected papers of Margaret S. Mahler (Vol. 2, pp. 169–187). New York: Aronson, 1979.
• Mahler, M. S., Pine, F., & Bergman, A. (1975). The psychological birth of the human infant. New York: Basic Books.