Psychosomatic Medicine 10:134-144 (1948)
© 1948 American Psychosomatic Society

The Infantile Personality

The Core Problem of Psychosomatic Medicine

¹ Division of Psychiatry, University of California Medical School, and the Langley Porter Clinic San Francisco, California

Personality structure, interpersonal relations, and rehabilitation of the infantile person have been described as encountered in clinical medicine in a variety of psychosomatic conditions.

Mature persons differ from the infantile personalities by having at their disposal suitable techniques for interpersonal relations and by having mastered problems of communication in terms of self-expression and self-extension, thus availing themselves of expressive signs which are derived from the somatic sphere, from action, and from verbal symbolization. In contrast, the infantile person does not possess the necessary techniques for social interaction and communication; hence life experiences cannot be integrated. In the absence of satisfactory. interpersonal relations communication is limited; signs used for self-expression originate in the somatic sphere or are related to action, and interpersonal relations on the level of verbal symbolization are rudimentary or nonexistent.

Personality disorganization and specific disability for interpersonal relations are factors which tend to expose the immature personality repeatedly to frustrating situations, the management of which is attempted by means of control rather than through mastery and adaptation. Inasmuch as operation through control is not likely to be successful in the long run, the infantile person is frequently confronted with emergencies. Although both mature and immature persons tend to handle emergency situations by means of physical symptoms, the mature person reverts only temporarily to somatic expression, while in the immature personality this type of expression persists.

Inasmuch as the infantile personality is incapable of removing sources of frustration through goal-directed behavior and, in addition, is unable to express excess tension in interpersonal relations, tension must be expressed either through action or through organs. If tension is managed through actions which are intended to alleviate tension, pathology can develop incidental to activities, as one can see in obesity through overeating, in accidents through overexposure to danger, or in venereal disease through promiscuity. If tension is expressed in somatic terms it is related to vascular, respiratory, intestinal or skeletal pathology. It is this peculiar coincidence of emergency management by means of somatic expression with the habitual expression of tension through organs or action which makes infantile personalities so liable to psychosomatic conditions.

Since the psychotherapeutic methods employed in the treatment of psychoneuroses were derived from study of more mature and organized persons, the rehabilitation methods used with psychosomatic patients and immature persons had to be modified. In such cases, the therapeutic situation constitutes really the first experience in consistent human interaction. The whole approach can be summarized by stating that the procedure is really child psychotherapy with chronologically adult patients.

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