THE CHIEF focus in child psychiatry at the present time is on family relationships. It is of considerable interest that the concept of family relations did not really come into being until about the turn of the century and since then has come to occupy a position of increasingly greater emphasis in our thinking. This change in thinking took place mainly because of the efforts of Freud in Europe and Meyer in this country. It was in the first decade of the Twentieth Century that psychiatric history taking came to include a biography. However, even at that time, little attention was paid to children's behavior difficulties. It is of considerable interest that Freud's theories on infantile sexuality were published before Freud had ever seen a child professionally.
The greatest impetus came in the Twenties with the establishment of child guidance clinics at various places throughout the country and these began to study family attitudes and the relationships between various members of the family.
When we introduce the subject to medical students, we like to tell them that they have learned in medical school about various sets of agents which may be normally necessary for the proper body economy, may, on some occasions, be pathogenic, and may, under different circumstances, be remedial. Chemical substances, for example, are vitally important as foodstuffs, detrimental as toxins, and remedial as drugs. We have come to recognize that there is one other set of agents that is just as important and can have similar effects. These agents we choose to refer to as attitudes. In general, a person's feeling about himself and about the world in general will depend on the attitudes of the people who constitute his world. Certain attitudes provide an emotional climate that is ideal for the growing child and likely to provide for emotional stability. In summarizing the various attitudes that are necessary, we like to think of them in terms of the three A's: Affection, Acceptance, and Approval. It is certainly true that any child has a better chance of developing emotional security if he is surrounded by this attitudinal constellation.
- Copyright © 1957 by the American Academy of Pediatrics