David M. Levy, “Primary Affect Hunger,” 1937

David M. Levy, “Primary Affect Hunger,” American Journal of Psychiatry 94 (November 1937):643-52.

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David Levy was a leading psychiatrist and advocate of the Rorschach test who was affiliated with the New York Institute for Child Guidance, the Columbia University Psychoanalytic Clinic for Training and Research, and the New York State Psychiatric Institute. Known primarily for his theory of maternal overprotection, he wrote in this article about its opposite: the maternal rejection that deprived some infants of critical emotional nurture and left them with an “emotional hunger for maternal love.” That hunger, according to Levy, produced severe behavioral and developmental problems that could not be therapeutically resolved. The four cases described here all involved ill-timed separations of young children from birth mothers, followed by adoptive placements. Levy’s work utilized insights from the literature on hospitalism, bolstered the theory of psychogenesis, and anticipated the attachment paradigm that would triumph among developmentalists after World War II. In closing, Levy suggests that milder forms of affect hunger in childhood may well be responsible for the anxiety and depression experienced by many “normal” adults.

The term, affect hunger, is used to mean an emotional hunger for maternal love and those other feelings of protection and care implied in the mother-child relationship. The term has been utilized to indicate a state of privation due primarily to a lack of maternal affection, with a resulting need, as of food in a state of starvation….

I am using the term to apply only to individuals who have suffered lack of maternal love in the early years of life. Assuming for the moment the value of maternal love as an essential component in the development of the emotional life, what happens when this element is left out of the primary social relationship? Is it possible that there results a deficiency disease of the emotional life, comparable to a deficiency of vital nutritional elements within the developing organism?….

My first example is an eight-year-old girl who was adopted a year and a half before referral. After an illegitimate birth, the child was shifted about from one relative to another, finally brought to a child placing agency, and then placed in a foster home for two months before she came to the referring foster parents. The complaints were lying and stealing. The parents described the child’s reaction to the adoption as very casual…she showed apparently no emotional response….

An unmarried women, aged forty, adopted a child aged two years and eight months, through private arrangement. The child was the illegitimate son of a woman of high economic and social status. The family history was negative. The child was turned over to an agency very soon after birth, placed in an orphanage from age 12 to 27 months and then transferred to a boarding home, where he remained until the period of adoption. After a year, the mother gave up the possibility of getting any emotional relationship with the child. She had never been able to get any sign of affection from him….

The third example is that of a boy adopted at the age of three. The previous history was unknown, except that he was illegitimate and had been shifted around from place to place…. He was referred because he had been twice suspended from school for poor work, and the fact that he made a general nuisance of himself. The mother had given up hope of making any relationship with him. He showed no affectionate response.

The fourth case is another example of an adopted child, a girl aged nine years and ten months at the time of referral to the Institute for Child Guidance. She was referred for general incorrigibility. She was adopted at the age of seven months into a home in which the foster mother could give little affection, but demanded highly conventional behavior….

These case illustrations are given as examples of emotional pathology caused by primary affect hunger of a severe degree. The symptom-complaints are of various types. They include, frequently, aggressive sexual behavior in early life, stealing, lying, often of the fantastic type, and, essentially, complaints, variously expressed, that indicate some lack of emotional response in the child…. As an instrument in modifying behavior, the power of maternal love may be seen most clearly in life histories where it is absent—a kind of ablation experiment in social life….

No doubt there are a number of children who feel a distinct lack that is related to an original privation, who, nevertheless, are in a state of externally good adjustment. Such children are naturally not referred for treatment, since it is rare that a child is not brought to treatment through an adult. There are, certainly, numerous examples of adults, well adjusted according to the criteria of overt behavior, with complaints of various dissatisfactions, chiefly in the form of futility, or depression, that have their origin primarily in affect hunger.

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