Neglecting neglect: some thoughts about children who have lacked good input, and are 'undrawn' and 'unenjoyed'

摘要

This paper looks at emotional neglect in the early years of life, and postulates some probable long-term sequelae of such neglect. It argues that there is a continuum of neglect; ranging from the severest form, as seen in institutional orphanages, to milder variations. A range of theoretical and research traditions, including developmental psychology, attachment theory and neuroscience are used, alongside psychoanalytic ideas, to attempt to delineate some of the key features and patterns that arise. A question is raised as to whether we have sufficient diagnostic categories or theoretical ideas to make sense of neglected children. Thought is given to the very specific clinical challenges of working with children who are neglected, and how the clinical task might differ from working with children who have suffered other forms of early damage, such as physical abuse. It is argued that these children suffer a multiple, overdetermined form of neglect; their initial neglect because of the form of caretaking they did (or did not) receive being compounded by their inability to use help and then also the tendency of professionals to similarly neglect these children, who can be difficult to relate to and hard to 'warm' to.