Cruelty begins at home

Cruelty begins at home

pp. Child Abuse & Neglect, Vol. Il. 33 l-338, Printed in the U.S.A. All rights reserved. 1987 Copyright 0145~2134/87 $3.00 + .oo Q 1987 Pergamon Jo...

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pp.

Child Abuse & Neglect, Vol. Il. 33 l-338, Printed in the U.S.A. All rights reserved.

1987 Copyright

0145~2134/87 $3.00 + .oo Q 1987 Pergamon Journals Ltd.

CRUELTY BEGINS AT HOME HENRI

PARENS,

M.D.

Director, Infant Psychiatry Section, Research Professor in Psychiatry, The Medical College of Pennsylvania Eastern Pennsylvania Psychiatric Institute, 3200 Henry Ave., Philadelphia, PA 19129

at

Abstract-The abuse of children is presumed by most mental health professionals to occur at the hands of parents who were themselves harshly traumatized by abuse or neglect. A 14-month-old child is presented who was well treated by his family and developed well until 6.5 months of age, after which, due to traumatization of his mother, the child became neglected and physically abused. In a therapeutic-observational environment, as the child recovered from his massive depression, much explosive destructive behavior not seen in him before was observed. From his past studies and those of other psychoanalysts, the author presents the collectively advanced hypothesis that excessive unpleasure mobilizes hostility in humans and suggests that this hypothesis may be fruitfully applied to explain why the abused become abusers. The hypothesis may also serve to guide the treatment of abused children so as to prevent their becoming tomorrow’s abusers. Furthermore, the hypothesis suggests that strategies can be proposed toward preventing child abuse. RCsumC-Un grand nombre des personnes impliqukes par leurs professions dans la santC publique croient que les s&ices exercts sur des enfants le sont par des parents qui eux-m&mes ont CtC tres cruellement traumatises dans I’enfance soit physiquement soit moralement. L’auteur prksente I’histoire d’un nourrisson de 14 mois qui Ctait bien trait6 par sa famille et s’est bien dCveloppC jusqu’g I’ige de 6 mois et demi aprks quoi B cause de s&ices subis par sa m&re I’enfant fut lui-m&me victime de violence physique et de ntgligence. Pendant que I’enfant se remettait d’une dkpression massive dans un environnement thkrapeutique et d’observation il manifesta de faGon explosive un comportement destructeur qui ne s’ktait pas manifest6 auparavant. A partir de son experience ainsi que celle d’autres psychanalystes, I’auteur soutient I’hypothtse qu’une experience dCsagrCable excessive mobilise I’hostilite chez I’&tre humain et il suggkre que cette idte est un modtile qui pourrait &tre applique avec profit pour expliquer pourquoi les gens qui ont CtC maltraitks deviennent des maltraitants [email protected] L’hypothkse peut Cgalement Ctre utile pour la conduite du traitement d’enfants victimes de s&ices avec I’idCe que cela les empkherait de devenir eux-m&mes des personnes maltraitantes. En plus cette hypothkse suggkre qu’on peut mettre sur pied des stratkgies pour la prtvention de la maltraitance.

CHILD ABUSE is now at the forefront of our concerns. In the early 197Os, well before it became a topic of interest to the mental health field in general, Brandt Steele was among the first psychoanalysts to call our attention to the hostile abuses of children and push to put it on our agenda of mental health concern. Steele was also early among those who recognized the converse, namely, the abuses and destruction of parents by their children. How can we account for such noxious behaviors? In this communication, we cannot review the literature on child abuse which has rapidly multiplied during the late 1970s and early 1980s. Suffice to say, many contributors propose that the interplay of biologic dispositions and experience forges the characterology that leads to hostile behaviors [l-3].

CASE OBSERVATION A number of writers, including Steele [4], hold that abusive parents or caregivers themselves experienced significant emotional and/or physical abuse as children. Much clinical experience supports this hypothesis. One case of abuse we observed near the time of traumatization allows a glimpse into one young child’s reactions. We found his behavior 331

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to add support to the thesis that being abused mobilizes hostility and rage which, as they stabilize in the psyche, in turn, lay the foundation for hostile behavior (abuse) toward others and self. Case History: Richie We first saw Richie when he was 14 months, 11 days of age. He appeared

depressed, hyperalert, with a disHe looked about 8 months old. He was subdued: just sat, barely stretched to reach for toys accessible to him, his movements sluggish. Although we inferred that he probably experienced some stranger responsiveness, his initial reactions to us seemed dominated by depressive withdrawal and distrust. Richie was brought to our parent-infant group by a member, Mrs. V. Our parenting educational group met twice weekly for two-hour sessions, and, in time, we had ample opportunity to observe Richie. We have previously described in detail our method [5, 61. We learned that Richie lived with his mother and mother’s aunt until he was about 6.5 month of age. Mother was the principal caregiver although her aunt had a say about caregiving matters. Photographs of him at 4 and 5 months of age showed him smiling widely, bright-eyed. The photographs showed a well-fed, attractive, smiling, in fact, charming and expressive infant. Evidence from the many photographs as well as from information elicited indicated that prior to Richie’s 65th month he had been well cared for, and he related well to those around him, developing normally, and giving evidence of both good somatic disposition and experience. At 6.5 months, at his father’s insistence, he and his mother moved away from the mother’s aunt. Two weeks after the move, the father left the family. The mother. then alone with the baby, became more and more upset and soon could not tolerate his complaining, whining and not eating. According to Mrs V., who had known him before, at 9 months Richie had changed dramatically and seemed withdrawn. Mother would put him out in the hall alone to cry out his whining and refusal to eat. Mother reported that during a fight with her husband a hot iron fell on 9.5-month-old Richie’s back and burned him. Mother’s aunt, Mrs. V., as well as the hospital staff where Richie was taken, did not believe the mother’s report. As a result Richie was placed in a city shelter where he stayed until the age of 14 months when mother’s elderly aunt took him back into her home in foster care. When mother visited Richie at the aunt’s, Richie avoided contact with her. ignoring her. trustful

look and sad eyes.

A sample of the observational notes entered on Richie as we tried to help Mrs. V. and his aunt understand him and thereby facilitate his recovery and rearing follow: Case Notes At 1 (year)-2 (months)-25 (days) of age, depression continues, so do affective and motor retardation. There is a notable dampening of sensorimotor exploratory activity (of nondestructive aggression-see below) although hyperalertness to people continues. Occasionally smiles, bounces on his knees; on the other hand, several times seemingly spontaneously, he threw toys harshly, his affect strained, the pressure of his aggressiveness (of hostile destructiveness-see below) eliciting immediate limit setting. Object relatedness is restricted, but he turns to Mrs. V. to lean against her, depressed. At 1-3-1 of age, affect is unstable, shifting quickly; depression dominates. But he also beams at Doris who engaged him by rolling a ball to him, which he then rolled back to her. When Doris (2.5 years) playfully hid the ball between her legs where we thought she wanted him to pursue it, he appeared confused, suddenly unbearably frustrated, cried and banged his head on the floor to the dismay of Doris. Mrs. V. intervened. Soon thereafter he went into a rage reaction when he could not get a toy he wanted. At l-3-8 of age, depression dominates, but is lifting; he is much less morose; indeed, smiles more at people. Motor activity (fueled by nondestructive aggression) is much expanded: scurried, crawling, across the infant area, reaching out to PB, Freddie and Doris. Much more involved exploring things as well as people; used a number of toys. Today again, affect sober. he threw toys down harshly, one by one out of the toy cart; he did so too harshly and elicited the need to contain him. We felt that the load of rage he was experiencing “invaded” his motoric activity, that it became too harsh and destructive. Richie seems to have moved in object relatedness from “People can’t be trusted, they only hurt you” to a tentative attitude “OK, I’ll take a chance; you can make me feel better; I’ll try you again.” He is especially attentive to Mrs. V., engaging her with toys, but also leaning against her chest when suddenly depressed. He now wakens during the night, screaming; can be comforted by aunt in a few minutes, suggesting he is having bad dreams (perhaps nightmares). At l-6-7 of age, affect is labile, but Richie does not look profoundly depressed as one month before; occasionally smiles. He now is walking, wobbly but upright, without support.

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Threw things suddenly, again too harshly. threateningly, in a wide trajectory. Was soon restricted and scolded by aunt with an edge of harshness. Interacts with adults with much reserve but is reaching out; interacts more easily with peers, although even there he is suspicious. At l-7-15 of age, he looks much better; depression is there but often interrupted by smiling. glee and play. As at l-6-7. he manifests sudden bursts of explosive aggression (hostile destructiveness): suddenly. too forcefully thrown items alarm the mothers. At l-7-23 of age, affect is much improved. Sudden. too aggressive outbursts with toys continue: we have not seen him attack people: he at times rouses anxiety when he approaches a baby but his affect is then not threatening; indeed. he seems low-keyed, and he has never lashed out at one. Regarding object relatedness, much pleasurable interaction with certain objects: some widening of objectal horizon with preference for Mrs. V. At l-8-23 of age, enormous strides in development: improved affect stabilizing, control of aggression, ego functioning at more advanced level. object relatedness more positive. Although affect is fluid, there is more stability in his pleasant. smiling feeling. Smile is softer, not so much a grimace now. Aggression (hostile destructiveness) is in better control; no throwing today. no manifest harshness or explosiveness. Now folds hands on chest as if to prevent them from grabbing or reaching for something he things he should not touch; also shakes head “no” at such moments. Continues to have bad dreams/nightmares, three per night. With regard to object relatedness. smiling, he entertains aunt and Mrs. V. by repeating something at which they laugh. The pictures of him at 4 and 5 months suggested his tendency to be quite responsive and entertaining. A dramatic episode suggested to us a nuclear element of the traumatizing abuse he experienced. On this day he approached baby Karen (0-4-O) whom he had taken note of before, sat by her. stayed there several minutes. head down, softly subdued. low-keyed. He gently reached (aggression well modulated here) for the baby’s pacifier, toyed with it. His aunt, uneasy. distracted him as did Mrs. G. (Karen’s mother). After about three minutes he devised a game of bringing blocks to his aunt. while he glanced at Mrs. G. playfully interacting with Karen. He then brought a block to Karen (again modulating aggression nicely), smiling. He handled a wooden turtle toy near the baby, and his aunt became alarmed. When his foot neared Karen‘s head. his aunt pulled him away. He then became quietly upset, head down. No reaction of anger or rage (hostile destructiveness) was evident. He cleared up, moved away and went to play briefly with Laurie. Again, gently insistent tnondestructive aggression at play), he brought a block to Karen, ending up sitting on the baby’s blanket. He then brought dolls to his aunt. wanting Karen’s

rattle

Karen’s

mother

Several minutes. painful

her to hold them (we explained

(the taming

allowed

times

of hostile destructiveness,

this) which

he climbed

he wanted

into his aunt’s

to aunt these were proxies

we thought,

aunt to shake

arms and just

seemed

conveyed

for the doll-proxies, lay there,

looking

for him) 171. He brought to his aunt,

and she and

smiling when she did so.

painfully

depressed

for several

(We inferred that seeing Karen and her mother interact warmly and playfully might have aroused in him experiences

before his mother

of yearning

for such nurturance

and relatedness

which,

we believe

he had experienced

moved away from the aunt when he was 6.5 months old.)

We point to the fact that cruelty for this child, as for all abused children, began in the context of his relationship with his painfully hurt mother; it began at home. We have seen ample evidence-both in direct observation and in clinical work-of parents becoming exceedingly angry with infants and young children they deeply value emotionally. In sum, Richie’s mother, an emotionally troubled and inhibited 17 year old became pregnant by a young man who could not sustain the commitment he tried to make to her. He demanded that she move out of her aunt’s home so that they could live together, but soon was compelled to leave her alone with her 7-month-old baby. Neglected and maltreated herself as a child, she had been pressured by her promising (and threatening) mate to leave the relatively secure home provided by her aunt, only to find herself soon abandoned by him. She then experienced her less-than-one-year infant’s crying as intolerable and would move his crib into the hall outside her apartment door when he cried. We came to assume that she not only rejected her crying and progressively more pained baby by doing this, but that she also was protecting him from her own rage toward him-which eventually did erupt-and toward those who in the past had neglected and abused her. The interplay of a number of factors prevails in what will make for an individual’s becoming an abusive parent. Given the variable contributions to it of constitutional givens, vulnerabilities and invulnerabilities [g-l I], experience seems to be a major contributor. Several major psychoanalytic studies of the past 15 years further support the

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assumption that early life experiences contribute critically toward setting down the personality factors that yield the behaviors of abusive parents. These studies shed further light on some basic mechanisms underlying hostile behaviors in relationships.

PSYCHOANALYTIC

STUDIES

There is much stirring regarding the psychoanalytic theory of aggression, and there is general consensus about the need for revision of critical issues pertaining to it. Striking is the fact that a number of psychoanalysts [S, 12-191 separately, i.e., without cross-reference to their respective work, and using different psychoanalytic avenues of approach as well as conceptual contexts, came to the similar critical conclusion: that hostile destructiveness (extending from anger through hostility, hate, and rage) is not an inborn given. Rather, it is provoked in the self by experiential events. Many psychoanalysts assert that hostile destructiveness, as we speak of that trend in aggression [5], is not an innate component of a psychobiological or instinctual drive. Among the many psychoanalysts who out of their clinical and direct observational work in the past 15 years have called for and contributed to a reformulation of the psychoanalytic theory of aggression, Rochlin, Kohut, and Parens have independently proposed models explicatory of the production of hostility in humans; others have made contributions to this question [5]. Rochlin’s [14, 151 extensive work on aggression highlights the hypothesis that there is an intimate relationship between injury to one’s narcissism, “this love of self through which preserving the self is assured” [14:1], and aggression. Rochlin asserts that “narcissism and aggression together govern human emotional experience with a multiple authority” which is only dimly perceived [14:vii]. He holds that “when narcissism. . . is threatened, we are humiliated, our self-esteem is injured and aggression appears” [14: 11. Rochlin suggests that it is “to restore our self-esteem, assert our value. . . (that) the defensive functions of aggression are invoked. The aggression generated by the need for restitution may be enormous” [ 14: I]. Rochlin holds that narcissism and aggression are linked from our earliest years on, and so linked they develop over time. Consider well-cared-for 6-month-old and traumatized, troubled 9.5-month-old Richie’s experiences in light of Rochlin’s asserting the well-established psychogenetic view that “we. . . associate needs and wishes from our earliest years, with the significance of a state of want. What remains with us is no mere collection or residue of experiences. . . but rather the conflicts into which our needs have taken us and the failures of gratification drawn into. . , the unconscious. They provide the limitless SOUYC~Sfrom which aggression muy issue” (italics added) [14:84]. Also consider Richie and his mother in light of Rochlin’s salient hypothesis that many clinical cases in which excessive acts of sadism (hostile destructiveness) and cruelty are part of symptomatic behavior, that such acts are compelled by injured narcissism which allows no compromise [ 14:95-961. There is significant consensus between the conclusion of Rochlin and Kohut-despite their conceptual differences-on the question of the origins of human hostility. Having already hinted at the following in 1972, in 1977 Kohut asserted “that man’s destructiveness as a psychological phenomenon is secondary; that it arises originally as the result of the failure of the self-object environment to meet the child’s need for optimal. . . empathic responses. Aggression, . . . as a psychological phenomenon, is not elemental. . . . From the beginning, (aggression, i.e., hostile destructiveness, is) a constituent of the child’s assertiveness” [ 17: 1161. Like Rochlin, Kohut holds that “destructive rage. . . is always motivated by an injury

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to the self.” It’s “bedrock” is “a serious narcissistic injury, an injury that threatened the cohesion of the self, especially a narcissistic injury inflicted by the (caregiver) of childhood” [17:116-1171. Kohut proposes: The primary psychological conliguration (of aggression) does not contain destructive rage but unalloyed assertiveness. . If however the phase-appropriate need for omnipotent control over the self-object (caregiver) has been chronically and traumatically frustrated in childhood, then chronic narcissistic rage, with all its deleterious consequences, will be established. Destructiveness (rage). (does) not therefore constitute the emergence of elemental, primary psychological givens, but despite the fact that they may, throughout a lifetime, influence an individual’s mode of perceiving the world and determine his behavior, they are. . reactions to failures of traumatic degree in the empathic responsiveness of the self-object vis-a-vis a self the child is beginning to experience (italics added) [17: 118-1211.

Coming from quite a different vantage point than Rochlin and Kohut, that is to say, not from the clinical consultation room but from longitudinal, psychoanalytically informed, direct observation of children from birth on with their mothers, we propose a model for the production of hostility in humans that is significantly compatible with the propositions made by Rochlin and Kohut. There are some differences and conceptual incompatibilities, but there is agreement on critical issues. Like a number of other child psychoanalysts (Anna Freud, Spitz, Mahler, McDevitt, Settlage, and a growing list of others), we took to observing children from early on in life as a means of complementing clinical psychoanalytic observation. In the course of such research, we came across manifestations of aggression in very young children’s behaviors which challenged the then extant classical psychoanalytic view of aggression and triggered our research in this area [5, 6, 181.

A PSYCHOANALYTIC

THEORY OF AGGRESSION

Our observational findings led to the cataloguing of manifestations of aggressive behavior [5, 61 which generated a set of hypotheses that led to ongoing efforts at reformulating the psychoanalytic theory of aggression 15, 6, 191. In brief, we propose that the aggressive drive is constituted of three discernible trends-nondestructive aggression, nonaffective destructiveness, and hostile destructiveness-which develop interdigitatingly over time. The one of concern to the present discussion is the trend hostile destructiveness. We reported observational evidence of hostile destructiveness (rage, hostility, hate, etc.) manifest in behavior from neonatal life on. We propose that the rage reaction of infancy is illustrative of the most primitive form of the trend hostile destructiveness and underline: (We) do not mean that the wish to inflict pain or destroy an object (i.e., anger, hostility or hate) exists from birth on. (We) assert that hostile destructiveness, as a trend in aggression, emerges prior to the development of such capacity to wish to destroy and before the infant experiences the need to govern it-i.e., before the ego’s capacity to perceive it, implement it, direct, or modify it. This does not occur prior to the second half of the first year of life [19:49].

The same trend has been suggested by others Regarding the trend hostile destructiveness, lowing hypotheses: (a) Hostile destructiveness (b) However, the mechanism and capacity for

[20, 211. observations led us to propose the foldoes not appear or arise spontaneously. its experience and expression is part of

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Parens

every infant’s adaptive make-up and is ready to function at birth. (c) Most important for us is that this mechanism requires a precondition for its activation which is excessive unpleasure, be it in the form of excessive physical or emotional pain or distress [.5, 14, 17, 21-241. This hypothesis explains and accounts for several phenomena: (1) The discharge of hostile destructiveness is not compulsory: it often suffices that the condition of excessive unpleasure (pain or distress) be removed [2 1, 251. (2) It gives to aggression an affective quality which distinguishes it from the other aggression trends, namely, an unpleasure-derived quality best exemplified in rage, hostility and hate. (3) This trend in aggression has an aim, which unlike the other trends in aggression, in due time in the course of development, will contain the wish to inflict pain, harm, and destructiveness for its own sake. As we have detailed elsewhere 15:11I], we have proposed how the precondition of excessive unpleasure changes the basic aim of aggression by giving it a unique negative affective valence. We can assume that the experience and expression of unpleasure has a somatic basis. This basis is the physiological model of “irritability of the protoplasm.” By virtue of the irritability of the protoplasm, the noxious accumulation of tension in the cell (organism) is experienced psychically by the organism as unpleasure. This sensory reactivity of life matter, experienced as unpleasure, serves to protect against the destruction of the organism. From the adaptive point of view, we may say that this experience of pain-unpleasure, of which a human is capable from birth on, leads to the forceful ridding the cell (or organism) of noxious tension. The somatopsychic force in this ridding activity is aggression. The activity is effected even from neonatal life on by built-in adaptive mechanisms. Near birth, of course, neither the noxious agent nor the activation of the aggressive mechanism is cognitively discerned. Nonetheless, not only is the existing mechanism for ridding oneself of whatever causes unpleasure activated, it is furthermore amply inferable from observation that in earliest life this aggressive-ridding activity in due time first attaches to the caregiver. We have spoken so far only of aggressive-ridding activity rather than hostile destructiveness, because a further step has to be elucidated before continuing. By what step does the aggressive-ridding activity become a hostile destructive activity’? The important factor which modifies the aggressive-ridding activity into hostile destructive activity would seem to be the part played by unpleasure itself. From observation we have inferred that: exc~es.siveIv felt unpleasure introduces an all-important qualitative character into (even the most primitive selfprotective) aggression: this painful affective condition changes qualitatively the aim of aggression, the end point of which then becomes a hostile ridding trend, or a hostile destructive trend. Aggression modified by excessively felt unpleasure acquires the qualitative aim of inflicting pain and harm upon and of destroying the object [S: I I I).

In this sense we have proposed that excessive unpleasure generates and/or mobilizes hostility. Our impression is that, without elaborating how it occurs, Kohut also held a similar view stating that “the breakup of the larger psychic configuration isolates the assertive component and. . transforms it secondaril~~ into rage” (italics added) [ 17: 119). Gunther proposes that with mounting threat to fragmentation of the self “inevitably, the assertive outpouring undergoes modifications in quulity and quantity. . . . Above all (he stresses) it is regression in the state of the self and its functions that underlies the regression in the quality and quantity of the released aggression (italics added) [24: 1901. Also, elsewhere [26] we propose that this excessive unpleasure-hostility hypothesis subsumes aspects of the frustration-aggression hypothesis of Dollard et al. [27] but, in important ways, also differs from it.

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CONCLUSIONS In conclusion then, where we stand now with regard to the psychoanalytic conceptualizations of the development of hostility in humans, Storr, Rochlin, Kohut, ourselves, and others have come to the similar critical conclusion: namely, that hostile destructiveness (extending from anger through hostility, hate and rage) is not an inborn given; rather, it is provoked in the self by experiential events. Rochlin insists that it is the product of narcissistic injury; Kohut (and Gunther) propose much the same in self-psychology terms; we, like Storr, propose that it is generated or mobilized by experiences of excessive unpleasure, of which narcissistic injury is one kind. Work from related disciplines elucidating genetic dispositions, endocrinologic contributions, and neurochemical as well as neurological factors, searching but still inconclusive [ 1, 21, also proposes different forms of aggression [28-301 and points to the possibility that a biological trait disposing to facilitation of the experience of hostility may exist [3, 311. The interplay of biological dispositions and experiences in the production of hostility in humans is being made more clear [3, 32, 331. That a part is played by experience is acknowledged by all writers on the subject [ 1, 21. Furthermore psychoanalysts [5, 14, 17, 19, 21, 24, 341 propose that aggression develops, that hostility manifests in the development of the self, of human relationships, of modes of adaptation, of intrapsychic conflicts, and more. These authors also suggest a similar process albeit stated in different conceptual frameworks: The hostile destructiveness invested in the earliest object and self-representations (which always occurs in an experiential context) becomes the fountainhead of hostility in the psyche. From this psychic structuralization, hostile destructiveness becomes part of repetitive, automatic, patterned modes of functioning in intrapsychic dynamics and in object relations [5: 1171. This determines the character of a given person’s aggression. Richie’s experiences and resultant behaviors add support to the pool of data that has led to the theorizing described above [5]. This theorizing, in turn, informs clinically compatibly how the abuser (Richie’s mother), having herself been abused in the past and present (being abandoned by her mate and losing the supportive home of her aunt), provoked the generation (production) of excessive hostility in her young infant, evidence of which we saw in direct observation and which, we assume, would increase the chances of his becoming an abusing parent. The implications for interventions in humans like Richie and his mother can be meaningfully informed by our understanding of the production of hostility in them. Furthermore, this view of the production of hostility in humans allows for strategies toward the prevention of child abuse. Based on the hypothesis that excessive unpleasure experiences generate and mobilize hostility, we have developed a strategy being currently researched toward preventing the excessive production of hostility [5, 6, 35, 361. Our impression is that psychodynamic mental health clinicians, when confronted with cases of child abuse, invariably infer the central hypothesis presented here, namely, that harsh and protracted experiences of excessive unpleasure generate excessive hostility in humans, and that those humans at some point become parents who, when sufficiently stressed, enact the product of their too painful pasts in their relationships with their children. REFERENCES 1. SHAFFER. D., MEYER-BAHLBURG, H. F. L. and STOKMAN, C. L. J. The development of aggression. In: Scientijk Foundation ofDe\~elopmentul Psychiatry, M. Rutter (Ed.), pp. 353-368. University Park, Baltimore (1981).

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