Early Human Development, 30 (1992) 261-262

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Elsevier Scientific Publishers Ireland Ltd. EHD 01344

Book Review

From Fetus to Child -

An Observational and Psychoanalytic Study

New Library of Psychoanalysis No. 15 Alessandra Piontelli TavistocWRoutledge, London/NY, 1992. Modern imaging and recording technology has given psychoanalysis an opportunity to transform itself from the hermetic discipline which it has become into the science which its founder Freud believed that it should be. With its emphasis on the influence of early experience on character formation, it will then be in the footsteps of vegetative physiology which Professor David Barker has shown to undergo permanent modifications in relation to vicissitudes around the time of birth. Dr Piontelli s book falls into two rather distinct parts, the first dealing with the observation of fetal and infant behaviour, the second describing a number of child analyses in which the material, when collated with information about pregnancy and birth, appears to suggest that events before and at birth influence the Weltanschaung of the developing child. A tenuous link between the two parts is provided by the case of a child who was both under observation as a fetus and infant and later underwent analysis as a toddler. For those interested in child development, the first part of the book is necessarily the more illuminating; providing a kind of natural history out of which on reflection testable hypotheses may be born. Using ultrasonographic films in the manner of Prechtl, Dr Piontelli was able to observe what to her seemed a remarkable continuity in the general comportment of a baby before and after birth, active babies remaining active, sluggish babies sluggish - a continuity well illustrated by the contrasting activity of the several pairs of twins whom she was able to study. It was perhaps unfortunate that she was unable for practical and ethical reasons to have the two phases of development - before and after birth - observed independently; but what she thus lost in objectivity she gained in access as a trusted friend of the families concerned and there is much to be said for completing diachronic studies before attempting to make sense of cross-sectional data in the manner of Rutter. Her material incidentally casts doubt on the real value of studies of twins separated at birth in resolving the question whether nature or nurture exerts the predominant influence on human behaviour since - albeit of her twins only one pair was identical - it seemed as if the lower birth weight twin is usually the more active and that twins tend to undergo quite different vicissitudes before and during birth as well as afterwards.

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From Fetus to Child is not a long book - some two-hundred fifty pages in all including preface, introduction, a tentative statement of conclusions, an adequate index and a fairly comprehensive bibliography. The author s introduction makes it clear that she is well aware of the limitations imposed by her training and the circumstances in which her studies were conducted on the validity of her findings, but they represent a brave attempt to explore what the French charmingly call la vie clandestine in the womb and they raise important questions which, in time, one hopes that she or others following in her footsteps will be able to answer. Her book is recommended to everyone interested in early human development in the unexplored area between the mythologies of psychoanalysis and the mechanistic certainties of physiology - leaving to one side pseudo-science based on the activities of maze-running rats, tethered dogs, computers or on crude statistics. It is worth reading if only for the beautifully drawn vignettes of the families into which the author s subjects were born. John A. Davis