Yvon Gauthier, a Canadian Child Psychiatrist, or more exactly an Infant Psychoanalyst, invites us through the reading of his book on Child Psychiatry, to join him on a exceptionally rich and interesting journey along the development of Child and Infant psychiatry. We are used to read either scientific books that bring new clinical and/or research knowledge, or autobiographies aimed at describing a piece of past or recent history. In his book, Gauthier takes us into the history of Infant Psychiatry through his own professional milestones. This is an account, not only of our own profession, but also of how babies became thought of, in different parts of the world, and more specifically in Canada, with a Québecan flavor in it…
The author starts with the description of his own professional training, that reflects the main milestones in the development of the field of Infant Psychiatry, a field that is at the intersection of Psychiatry, Pediatrics, Obstetrics and Perinatology. This is by positioning at this very intersection that our clinician will find his/her professional identity. The author takes us what I would name “Continuing Education”, meaning traveling from one center to another, searching for the State of the Art in the understanding of the baby’s emotional development.
For instance, the author retraces the history of Psychoanalysis, while focusing on transition points, such as from Adult to Child Psychoanalysis, and later to Infant psychoanalysis. One of the special flavors of this rich and scientifically well-ground book is that one feels along the pages Gauthier’s core identity as a psychoanalyst, even when he writes about the most recent findings in neuro-imaging…
Gauthier shares with us his own life events that have contributed to the conceptualization of his clinical work, and have enriched his teaching. For instance, it is through the fine observation of the complexity of siblings relationship in real life, that Gauthier has been one of the first teachers to emphasize the role taken by siblings conflicts in the development of the child and later, in parental projections clinicians often observe in clinical families.
The author makes us walk along the introduction of the main notion of the dialectics between genetics and environment, between the individual’s and his/her transgenerational intrapsychic processes, between brain and psychoanalysis. This description is based on a concise but precise mentioning of the main thinkers in the field, while each one of them has added a piece to the puzzle of understanding the baby in general, and more specifically the role of his/her first interpersonal experiences in the development of his/her future personality.
Following the description of the history, comes the clinical part, that is so intrinsic to Yvon’s person. Each chapter treats a topic, illustrated by a clinical vignette. This is through these vignettes that the reader discovers Gauthier’s wide clinical wisdom, especially relating to psychosomatics and maltreatment in infancy. This is also through this clinical lens that the author presents his main views about Social psychiatry and community infrastructure networks.
Then, comes the history of the different intervention modalities in infant psychiatry, dyadic as well as triadic, while trying to analyze them in the light of psychoanalytical concepts. This, in itself, throws a different light to the child’s developmental portrait and raises contingent questions related to the treatment approaches.
Yvon Gauthier concludes his discourse on the integration of the old and the new theories of development, by claiming that the child builds him/ her self by and through the Other. By becoming a Self though the Other, he/ she will be able, later, to take care of another One, the same way that his/her parents could empathize with him/her, recognize his/her needs and desires, his/her withdrawing and approaching movements, treat him/her as another Self and not as a part of themselves. This is the history of the development of a true and full Self.
To conclude with a personal note, I would suggest to include this remarkable book in any infant clinician’s professional book arsenal.
by Gauthier, Yvon, M.D.,
Professor Emeritus in Psychiatry, Montreal University Medical School,
Past President of WAIMH,
Reviewed by Tyano, Sam, M.D.,
Professor Emeritus in Psychiatry, Tel Aviv University Medical School,