the arrow of time and developmental psychopathology

The Arrow of Time and Developmental PsychopathologyAuthor(s): Sebastiano SantostefanoSource: Psychological Inquiry, Vol. 5, No. 3 (1994), pp. 248-253Published by: Taylor & Francis, Ltd.Stable URL: http://www.jstor.org/stable/1448861 .

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The Arrow of Time and Developmental Psychopathology

Sebastiano Santostefano Wellesley, Massachusetts

Overton comprehensively reviews how the machine and organic paradigms have been engaged for centuries in revolutions and counterrevolutions and proposes that a shift is occurring in favor of organic concepts. With this commentary, I attempt to illustrate that this shift can be seen in the domain of developmental psychopathology and to highlight what investigators and clini- cians see when they peer through the lens of the organic paradigm to understand cognition, personality development, and change.

The reader who is not as familiar as Overton is with historical developments in philosophy and physical sciences may experience, upon reading his account, that he or she is flying the Concorde over a blurred terrain, rapidly shifting altitudes from theory to a single concept and back again, while also (and paradoxically) creeping along in a covered wagon through tangled thickets of "objectivism," "skeptical postmodernism," and "interpretationism." The terrain might become clearer if we remind ourselves that Western thinking has typically divided points of view with boundaries. Wilber (1979) convincingly argued that, although nature is an organized whole, when we attempt to understand and give meaning to human experience, knowingly or unknowingly, we immediately draw mental boundaries that cast the experience as a pair of opposites signifying either pleasure or pain-for example, good versus evil, freedom versus restriction, appearance versus reality. To quote Wilber, "To desire something means to draw a boundary line between pleasurable and painful things and then to move toward the former. To maintain an idea means to draw a boundary line between concepts felt to be true and concepts felt not to be true" (p. 17). Segregating points of view, as Overton discusses, has typified Western philosophy

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when asking the question: What is the basis of knowledge? Objectivism responds by drawing a boundary between events that occur independent of the mind (the objective or real) from those that are dependent on the mind (the subjective or appearance), proposing that knowledge exists independent of the knower and segregating the subjective as unpleasurable. The individual is viewed in terms of "machine" categories-as inherently passive and aroused to action by stimuli. Phenomena are separated into isolated elements that operate in an additive fashion.

Although a boundary serves some conceptual convenience, it limits our understanding of the whole individual. But, there is an even more damaging outcome. Quoting Wilber (1977), "A boundary line, as any mil- itary expert will tell us, marks off the territories of two opposing and potentially warring camps" (p. 10), and, "when the opposites engage in conflict, a typical way of solving the problem is to attempt to dismiss one or reduce it to the other" (p. 20). This strategy, as Overton points out, has characterized skirmishes between objectivism and skeptical postmodernism. The later viewpoint suppresses the real in favor of appearance, divides appearance in terms of constraint versus freedom, and rejects concepts suggesting constraint (e.g., "holism," "coherence").

Boundaries dissolve when the proposition is ac- cepted that what appear to be opposites in fact share a fundamental unity, because nature knows nothing of opposites. To illustrate this point, Overton uses the familiar figure that simultaneously forms a vase and faces. Although the lines divide space so that we per- ceive one or the other, the lines simultaneously unite the figures, as neither exists without the other. The viewpoint of interpretationism does not divide the in-



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dividual into parts, and the individual is not segregated from the environment. Person and environment are viewed as involved in continuous, reciprocal ex- changes, each influencing and influenced by the other, each existing because of the other, and each defined by the other. Here, knowledge is the product of an individual's interpretation of this activity taking place within a relational matrix. In the absence of boundaries, the individual is viewed in terms of organic categories-as an inherently active (dynamic), self-organizing, holistic system, (holism) functioning within a relational matrix (dialectic).

At this point, I turn to the domain of development and psychopathology, which has constructed its share of boundaries-for example, between overt behavior and psychodynamics, conscious and unconscious, normal and pathological. More than a century ago, in perhaps the first published discussion of personality assessment, Francis Galton (1884) seemed to have been aware of psychology's tendency to draw boundaries in order to avoid unpleasantness: "There are two sorts of [psychologists]. Those who habitually dwell on pleasanter circumstance and those who have no eye but for unpleasing ones" (p. 180).

Of the boundaries drawn, those between cognition and emotion and between body and mind have been prominent. The stage was set when orthodox behavior- ism, with its taboos against mentalism, drew a boundary between mind and overt behavior, renouncing the former in order to preserve thought as right and rational and to protect it from passion and the irrational (Bruner, 1990). Then along came the work of Jean Piaget, pro- viding one way of understanding the forbidden mind. Psychologists embraced this viewpoint, cast aside the boundary between mind and behavior, and produced a very sophisticated cognitive science (Gardner, 1985). But as this science grew, a boundary was constructed within the mind between cognition and emotion. Some psychologists located themselves on the side of emotion, peered over the boundary, and protested that emotions were being neglected by those on the cognitive side. And skirmishes between cognition and emotion were launched, resulting in a series of conferences (e.g., Clark & Fiske, 1982; Read, 1984; Shapiro & Weber, 1981). In these discussions, the boundary between cognition and emotion was experienced as real, rather than a conceptual convenience, resulting in a complex tan- gle of questions. For example, is a feeling state a special type of cognitive process? What is the difference between cognition about emotion and cognition that is a component of emotion? Is cognition the result of emotion or the cause of emotion? Regardless of the theoretical interpretations investigators followed, they tended to define and measure emotional variables and cognitive variables separately (Izard, Kagan, & Zajonc, 1984, pp. 3-6).

As for body and mind, in spite of attempts by neu- rology and psychoanalysis to integrate these domains, the topic received isolated attention within mainstream psychology, except for the work that entered through the doorway of cognitive research (e.g. Wapner & Werner, 1965). In recent years, body-image research has surfaced, focusing mostly on eating disorders and the effects of plastic surgery (Cash & Pruzinsky, 1990). But, this work shows psychology's proclivity to draw a boundary between body and mind and, within the latter, segregating cognition and emotion. For example, currently popular methods used to assess body image do not ask the body itself to speak but ask a person to choose between statements such as "I like my looks" and "I am physically unattractive." In another widely used method, an individual is asked to rate satisfaction in each of a series of silhouettes that vary in body size/weight guided by instructions to distinguish "how you think each [figure] looks and how you feel each looks." Reviewers Thompson, Penner, and Altabe (1990) noted that, "[even with alternating instructions] it is difficult to determine if the measure is tapping into an affective or cognitive component of body image" (p. 33).

In support of Overton's proposal, a shift is occurring. More voices are suggesting that boundaries be dis- solved and the person studied and conceptualized from the organic perspective. For example, reviewing their work with Down syndrome infants, Cicchetti and Schneider-Rosen (1984) concluded, "efforts should be made not towards cataloging specific capacities in the cognitive and affective domains, but rather toward at- taining a more holistic picture of the infant in which changing integration and organization of competencies becomes a central objective" (p. 397). Izard et al. (1984) proposed, "... there may be one ultimate integrating system that ... may fruitfully conceptualize human activities as a function of the integration of perceptual, cognitive, motor, and emotional processes" (p. 8). And Decarie (1978) noted, "... if we ever hope to be able to describe the ... child as a whole, and not 'enpieces detachees,' we have to work toward an ap- parent contradictory goal by studying simultaneously the perceptual, mental and affective components of ... phenomena" (pp. 199-200).

But, if cognition, emotion, and body are studied simultaneously, what fundamental unity do they share? An increasing number of investigators, guided by interpretationism and its embodiment theory, have proposed that conscious and unconscious meanings, experienced and expressed by an individual, unite these domains as one (Bruner, 1990; Santostefano, in press; Wozniak, 1986; Zajonc & Markus, 1984). Embodiment theory, Overton tells us, proposes that "mind emerges out of embodied practices" and that changes in the mind are viewed as an Arrow of Time spiraling in the direction

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of increasing complexity. Peering through this lens, researchers have observed that, during the first 18 months of life, the infant is an active, self-organizing system interacting with persons and things and experiencing patterns of sensations, perceptions, actions, cognitions, and emotions. These repeated patterns give rise to nonverbal meanings conceptualized, for example, as "sensorimotor schemas" (Piaget) "representations of interactions that generalize" (Stern, 1985), and "embodied image schema" (Johnson, 1987). As meanings are constructed, the infant evolves a sense of self, of others, and of intersubjective relatedness. For example, having again observed mother putting on her hat and leaving, an 18-month-old places a napkin on her head, transferring the properties of a hat to the napkin (de- ferred imitation). At the turn of the second year and beyond, nonverbal meanings are translated into symbols (metaphors) now including words as well as actions/images/emotions. For example, upon seeing father jogging, a 30-month-old leaned forward and, with each exuberant "Choo! Choo!" vigorously thrust his arm forward and back, experiencing and symbolizing the father in terms of a powerful train engine. What the child knows, does, and feels is what the child represents, and, from infancy throughout the life span, representations lead to actions and actions result in representations (Forman, 1982).

The first meanings undergo change as the child en- acts them in a spiraling series of play rituals that negotiate key developmental issues-for example, attachment-separation-individuation, controlling- being controlled, identification/deference-dominance, and aggression-assertion. As one illustration, consider the following observations made in the home. Begin- ning at 18 months, a child repeated a play ritual for many weeks in which he sat on father's lap and gestured that father button father's shirt around the boy's body and then unbutton the shirt. At this point, the toddler slipped off father's lap and scampered away, and father looked for him. With this play ritual, enacted at the dawn of symbolic functioning, the first edition of a meaning is constructed and negotiated-attachment (at one with father's body) and separation/individuation (running off with father looking for him). A few months later, the child initiated another play ritual that differentiated this meaning to include allegiance and identification. The child insisted he sit immediately next to father at mealtimes, gradually extending this seating arrangement to the car, restaurants, and homes of rela- tives. At the end of his third year, the child introduced still another edition, now including elements of compe- tition/assertion while retaining a positive identification with father. The child requested that, during mealtimes, he use a glass identical to father's and that the liquid poured into each be exactly the same height. After drinking, they placed the glasses side by side and care-

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fully judged which glass contained "bigger" or "smaller" amounts.

This anecdote illustrates several aspects of the Arrow of Time discussed by Overton: Each cycle of activity does not return to the original starting point but spirals, moving the system toward greater complexity and resulting in new patterns exhibiting novel properties (viewed as increased differentiation, integration, and flexibility rather than as the addition of acquired elements). In our example, the series of cycles forms a spiral of interpersonal activity, initially negotiating separation-individuation and gradually negotiating other interpersonal issues, each negotiation building upon the previous one and differentiating the activity matrix into a progressive, integrated series of self-other relations (from "I am in you and separate from you," to "I am by your side," to "Who is bigger/smaller?").

There is another aspect of embodiment theory, with its Arrow of Time, noted by Overton, that directs our attention to other phenomena. The child's activity with others also results in the child's mind differentiating into modalities of subjective experiences. Applied to the issue of constructing meanings, the vehicles the child uses to construct meanings (to code experiences,) differentiate into a hierarchy of modes. Research findings support the view that young children tend to sym- bolize and express meaning with actions/gestures. With age, fantasies (imagination) dominate, assimilating actions; still later, language (linguistic metaphors) domi- nates, assimilating imagination and action, representing an ontogenetic shift from concrete processes (direct/immediate) to abstract ones (indirect/de- layed) (Santostefano, 1978). The original action (embodied) meaning is not replaced but is metaphorically projected into, and assimilated and elaborated by, meanings constructed at higher (abstract) levels of fantasy and language.

To illustrate, consider the following Arrow of Time, formed by spiraling cycles of activity, observed during psychotherapy with a 5-year-old boy. Harry was expelled from preschool because he hit, bit, and spit at children and teachers. At the start of treatment, he displayed impulsive, restless behavior for several sessions.

The First Cycle

Soon he ritualistically repeated a particular action that the therapist viewed as an embodied meaning. With a flick of the wrist, Harry toppled toys one by one from shelves to the floor, expressing anxiety/tension. The therapist enacted this meaning, initially pushing items (e.g., paper clips) to the floor and, on occasion, falling to the floor whenever Harry toppled some item. Soon Harry imitated the therapist, throwing himself to the



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floor, calling himself and the therapist "Mr. Fall." The therapist struggled to prevent each of them from falling by surrounding himself, or Harry, with objects (e.g., chairs, wastebaskets)-actions symbolizing the search for sources of body stability.

The Second Cycle

Harry differentiated the meaning of body stability- instability using a hand puppet (also called Mr. Fall), which he repeatedly flipped across the room. Mr. Fall was injured each time he "flipped out." After trying several solutions to stabilize the puppet, the therapist tied one end of a string around the puppet and the other around a doorknob-a solution that prevented the puppet from flipping too far. Harry became fascinated with this solution, experimenting with different lengths of string.

The Third Cycle

Negotiating to this point that the therapist was capa- ble of solutions, Harry regressed, spitting and throwing objects at the therapist-behaviors he had displayed at school. After restraining him numerous times, and during moments of calm, the therapist introduced an embodied symbol of stability/control that Harry and therapist had mutually constructed, experienced, and shared. The therapist tied one end of a string around his head and the other end around Harry's. This body "interpretation" proved successful. For several weeks, Harry and therapist, connected by a string, sat and played form board games (e.g., Candyland).

The Fourth Cycle

Soon, Harry differentiated the embodied meaning of control. He tied a string around his neck, another around his waist, and requested that padlocks be hung from each. He also located a padlock on objects (e.g., pair of scissors, wooden block) and asked the therapist to be a "police station" and decide when each item could be unlocked and how it would be used.

The Fifth Cycle

Next Harry introduced a new ritualized activity that differentiated and extended the embodied meaning of control/aggression into the fantasy level. Fantasizing the area under a table as "a fort" and barricading it with chairs, Harry (and therapist) sat in the fort defending themselves against an imaginary aggressive force, "Mr.

Bad," who repeatedly attacked the fort in an effort to capture them and make them do "bad things" (e.g., throw blocks at the windows). Mr. Bad was eventually defeated.

The Sixth Cycle

At this point, Harry reentered school, successfully regulating his aggression. In treatment, he initiated discussions about his newly developed fear of flushing toilets that reflected a further extension of the meaning of control/aggression into the fantasy level. The flushing toilet reminded him of Mr. Bad's thundering com- mands to do bad things. Harry worked through this fear in two ways. He talked about it, and he repeatedly tied a string to a cup, placed the cup in a flushing toilet, and held onto the string so that the cup would not sink. This symbolic play ritual enabled the therapist to express in language the embodied meaning of string as stability and control, which he and Harry had shared in interactions-that the string prevented the cup from being consumed by Mr. Bad, as it had prevented Harry and Mr. Fall from flipping out and doing bad things.

Harry, and the child who initiated the "shirt game," illustrate how embodiment theory, with its Arrow of Time, serves to organize observations of both normal behavior and developmental psychopathology: Namely, the child is an active, self-organizing system participating in a relational matrix; this activity gener- ates embodied meanings that gradually change (differentiate) through repeated, spiraling cycles of interaction; and the original meaning is reconstructed in progressively higher coding systems of fantasy and language. What research questions and methods are stimulated by embodiment theory? To illustrate, I draw from my own projects, designed to probe two questions: Can methods be devised that ask the body itself to express meanings in some fashion? Are embodied meanings, with their associated emotions and thoughts, metaphorically projected into fantasy and cognitive activity? And, if so, what is the significance for the study and treatment of psychopathology?

One study probed the relation between meanings experienced and expressed when body parts versus Rorschach inkblots serve as stimuli. Youth hospitalized because of conduct disorders assumed body postures and described what the body experience brought to mind. They also completed the Rorschach test. Results suggested a lack of integration between the levels of body and fantasy. For example, they produced a high number of body images representing aggression toward others and body deformities, but these meanings were not expressed at the fantasy level. In a related study, hospitalized aggressive youth tactually examined objects placed under a cloth and described what each could be or brought to mind. They tended to represent

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the objects with concrete symbols (e.g., "something hard, scratchy, round") and to act upon (e.g., tap, roll) and look at the objects (rather than image) in order to avoid experiencing representations of body fear and deformity (suggested by other data). These findings, and others, suggest that, with disorders of action, embodied meanings remain segregated but active in pre- scribing behavior, are not metaphorically extended into fantasy, and therefore are less available for expression in imaginative play and therapeutic discussions. Ac- cordingly, I have recommended that therapists first emphasize symbolic actions as interventions to articu- late and differentiate embodied meanings at the root of the conduct disorder and later emphasize fantasy play and discussions to facilitate extending (spiraling) the meanings into the levels of fantasy and language (illustrated by the treatment of Harry described earlier).

Other studies probed whether the body expresses meanings through changes in body tempo and whether these meanings are projected into higher cognitive levels. Youth, diagnosed as having hyperactivity with attention deficit disorders, drew a continuous line over a paper maze at three tempos (regular, slow, fast). They also completed a cognitive task that required them to name pictures of colored fruit as quickly as possible and again when the pictures were surrounded by distractions evoking fantasies/emotions. These children tended to move a pencil slowly, when requested to move fast. They also maintained a slower cognitive tempo while naming colors in the distracting condition. Yet, they made more errors. Moving slowly when requested to move quickly did not serve these children in maintaining cognitive efficiency.

Results from public school children elaborated the relation between body and cognitive tempos when fantasies/emotions are evoked. These children drew a continuous line through a paper maze as slowly as possible and again while the examiner spoke evocative words (e.g., "mother," "spanking," "bad"). Children who slowed their body tempo when evocative words were spoken (vs. the silent condition) also named colors of fruit more slowly when the fruit were surrounded by evocative distractions. However, unlike the hyperactive children, they made fewer errors. Results from both studies suggest that hyperactive, attention-disordered children are characterized by a lack of integration between body and cognitive tempos; in contrast, normals are characterized by an integration of body and cognitive tempos. These findings suggest that, if a child's body and cognitive tempos are not integrated, treatment should first emphasize developing the capacity to differentiate and regulate various body tempos and then extend body regulation into the cognitive domain (see Santostefano, 1985, for techniques).

Another study probed whether the body expresses meaning when a child looks at the examiner through

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binoculars from one end so as to draw the examiner near (hypothesized as symbolizing self-other fusion) or from the other end so as to move the examiner away (hypothesized as self-other differentiation) and whether these meanings are related to actions taken with cognitive tasks. A group of hospitalized youth looked at the examiner through one or the other end of a pair of binoculars and also completed two cognitive tasks. The latter were identical in makeup and proce- dure. Details were omitted from 63 pictures of a scene, displayed in succession, and the child reported any change he or she noticed. One series depicted two cowboys in a shoot-out (aggressive scene); the other two cowboys greeting each other (friendship scene). Subjects were divided into two age groups (young, old) and two binocular groups (children who drew the examiner near, children who moved the examiner far away). No differences were observed in the performance of these groups with the aggressive scene. How- ever, with the friendship scene, young/near subjects produced fewer errors than young/far subjects did, whereas old/near subjects produced more errors than old/far subjects did. Previous studies support the view that producing few errors (cognitive sharpening) indicates a developmentally more mature cognitive organization. Applied to our results, young subjects who drew the examiner near (showing stage-appropriate close bond between self and other) displayed more advanced cognitive functioning with a task representing affiliation, whereas young subjects who moved the examiner far away (showing a premature self-other split) displayed developmentally immature cognitive functioning. Older subjects who drew the examiner near (showing stage-inappropriate self-other fusion) displayed cognitive immaturity, whereas those who moved the examiner far away (showing stage-appropriate self-other separation) displayed cognitive maturity. These results suggested that the binoculars test is effec- tive in assessing embodied meanings concerning relations with others and that these meanings are metaphorically projected into cognition, revealing themselves in actions taken with stimuli representing interpersonal affiliation-an interpretation supported by the observation that binocular-test performance did not relate to cognitive actions taken with stimuli representing interpersonal aggression.

The clinical observations and studies noted here are attempts to illustrate that interpretationism, with its embodiment theory and Arrow of Time, brings into view the whole individual and environment. From this view, modifying a leaf by Mitchell (1988), embodied meanings are the bones, not easily visible to the naked eye but ever active in construing experiences and pre- scribing action; representations of past activity and present interactions are the muscles, transacting with others to negotiate various meanings; the meanings



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(symbols) constructed and shared with others, of one's unique needs and of environmental opportunities and limitations, make up the skin, near consciousness, pro- viding a continuous flow of stimulation; and cognition and the modalities of action, fantasy, and language form neural and vascular networks integrating and coordinating the demands of bones, muscles, and skin. The more we understand the individual and environment as now a face and now a vase, which Overton points out, involved in this process of integrating and coordinating, the more studies of development and psychopathology will achieve a more holistic view of what constitutes good-enough development and guide us in relieving the suffering of those subjected to the tragedies of nature.

Notes

Sebastiano Santostefano, 169 Grove Street, Welles- ley,MA 02181.

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