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S unrest grosvs in our social scene, as in-stitutions undergo change, as innova-tions revolutionize everyday living, there is

among many a longing to return to affirma-tions of older and simpler virtues. Their dis-content often is expressed in a

condemna-tion of youthful rebellion and, by extension, of youth and child care practices. It tends to focus upon “permissiveness” as the main

cause of youthful lawlessness and laxity of


In American society the elaboration of methods of child rearing to besvildered par-ents by specialists in behavior, medical and

nonmedical, is not new. In the early txven-ties character formation, according to the behavioristic psychology of Watson, was thought to l)e best achieved by a firm and rigid schedule, early developed, rigorously

obeyed, and meticulously followed. L. E. Holt, Senior, warned in the tenth edition of the then standard text in pediatrics, “the practice of playing with infants and

excit-ing them by sights, sounds and motions un-til they shriek with apparent delight is of-ten harmful and should be condemned (p.

4) . . . it is surprising to see what can be

accomplished by intelligent efforts at

train-ing in these particulars. An infant can often be trained at 3 months to have his move-ments from the bowels when placed upon a

small chamber (p. 3) . . . regularity of

nurs-ing is of great importance. . . after nursing

he should then be returned to his crib and not disturbed for some time” (p. 137).1

Such prescriptions were freely given by the child specialists of that day. Loving

parents tried diligently to follow such “good” advice.

In the thirties, a counter-movement

slowly gained momentum. The work of

Freud and Sullivan began to emphasize the importance of childhood experiences in the developmental process, presaging a more

liberal approach. American society began to recognize the rights of children, child labor was abolished, and National Youth

Admin-istration and Social Security legislation (aid to dependent children) were enacted. In

this climate, interrupted by World War II, Dr. Spock’s volume imploring the parent first to enjoy the child became the “bible”

for many bewildered parents who reflected on the rigidities of their own upbringing.

They wished something better for them-selves and their offspring. As prosperity and affluence grew, they were able to give more time and consideration to the needs of their children. Of course there were parents who, because of their own difficulties contributed to distortions in the rearing of their chil-dren by confusing permissiveness with

li-cense. Nevertheless, many raised their children effectively to allow for personality development that emphasized respon-sibility and concern.

We have come to realize that child care

is a process between at least two people, one of whom is an adult bound by his own personality and culture and the other a




child whose survival and well-being are in the hands of the adult during a long period of dependency. This transaction is some-times influenced by the family physician

who may help one or the other to conduct

his side of the transaction more efficiently

through advice or counsel, medication, or

other intervention.

We know that parents seeking counsel are best helped when they can choose be-tween alternatives with little ambivalence and anxiety. If anxiety lessens, decision-making is simplified. Action undertaken with ambivalence rarely produces the de-sired effect but only generates further

anxi-ety when repeated failures occur. The ob-jective is for the parent to have the freedom to choose what fits him best. If he can feel secure in what he is doing, his baby will de-velop similar freedom to utilize his own rhythm to achieve the end result of “good” habits. More important, the child will grow with the security of feeling that he can find pleasure in every developmental stage

un-encumbered by doubt and indecision when trying something new.

The concept of permissiveness as ex-pressed in the current social climate has led

to confusion. To consider permissiveness as

a determinant for the turmoil in our rapidly changing society is a gross oversimplifica-tion. The period of the thirties was marked by great unrest, violence, and disorder, with unprecedented poverty, depression, labor disruption, strike breaking, “red scares,” and riots. At the same time, the

pre-vailing mode of child rearing was rigid and

restrictive. Apparently rigid views of

paren-tal behavior toward their children are no guarantee of social peace.

In order to evolve, science or social insti-tutions need exploratory questioning in a climate that emphasizes constant inquiry

into society’s outmoded instruments. Ques-tioning that has led to change often has

stimulated a violent response. To a closed mind, the threat of change engenders anxiety

and fear that intensify resistance. There is effort to maintain the status quo by propa-gandizing current practice as embodying

the good society and the forces of change as a nefarious evil that confronts us. The atti-tude that emphasizes “what is right with America” carries the danger of blinding us to justified questions that emanate from


persons of all ageS.

It is traditional for young people to ques-tion, and today they seek confrontation with

what they see as the prevailing hypocrisy

around them. They see inconsistencies



their families and in their culture-decaying cities and black rebellion in con-trast to the good life manufactured on screen and tube; war and poverty in the midst of unprecedented affluence; the

world “shooting for the moon” but unable to solve problems at home; the preaching of

honesty and trust but the practice of a free enterprise system that urges, “get yours while the getting is good;” tax advantages

for corporations but the cutting of health budgets in our larger and richer states;

fidelity is praised but the frequency of

di-vorce and illegitimacy rises precipitously. The good life is represented as coming

through material acquisitions of new

prod-ucts, vividly portrayed by advertising and the communications media. The schools

in-doctrinate the young with “America the

Beautiful” while they helplessly observe the

increasing pollution of air and stream. There is little question that there are those who distort these concerns for

per-sonal advantage or questionable motiva-tion. Those who confuse permission with

li-cense will tend to abuse drugs, sex, or the law. But the social concerns so dramatized

by youthful dissent are in fact shared by


thoughtful adults.

Critics complain of such dissent as if af-firming a way of life that has simple and di-rect answers; they are not puzzled


life’s unpredictability and complexity.


deci-sions made in society are not polar

oppo-sites generated by questions of good and evil; they have become multifactorial. For example, recent Supreme Court decisions and presidential commissions (on campus

unrest, pornography, and violence) have


can-not be decided with the certainty of right and wrong or good and evil. What will best prepare us to face problems-a method of unquestioning upbringing or one that adopts an experimental attitude toward the self and the world? We need more seekers and

questioners! Permissiveness in child rearing should be fostered, not feared, since it is es-sential for the development of open and

in-quiring minds.

It niay be useful to define what

profes-sionals mean by permissiveness in child de-velopment and how such practices may

fos-ter responsibility and disciplined thought. We find it helpful to define permissiveness not as external license to do as one wishes without restraint but as a complicated devel-opmental process, slowly and painstakingly

pursued over a long period of dependency, that allows the individual the pleasure and freedom to act after thoughtful regard, to

try something new without danger to

him-self or others. Permissiveness thus defined is not instituted by others as a stimulant to

disruption and disorder; it does not repre-sent disregard for the social consequences; it does not lead to behavior projected onto others because of dissatisfaction with self. Far from being a mandate to heedless ac-tion, this permissiveness maintains restraint

when there is need to examine further.

When one has inner permission to feel and to do it is not necessary to project socially one’s own sense of coercion and to condemn the world for demanding conformity. Such

a projection may result in reactive feelings of alienation or rebellion or in destructive

or self-injurious behavior.

How does one acquire such an attitude about oneself, with a sense of pleasure in

learning and freedom to act with regard for self and others? A personal sense of free-dom comes, from infancy onward, from the encouragement and enthusiasm of the par-ent who cares for and helps the child achieve satisfaction and security as the

lat-ter moves from one broadening social

con-text to another, from self, to family, to

soci-ety. As the child successfully accomplishes

a new task, his pleasure in learning

in-creases and he is less frightened and inhib-ited about trying anything new. As his own needs are satisfied, he is able to contem-plate new tasks with less anxiety and he is able to contemplate the needs of others with less ambivalence.

Young people fortunate enough to have had the satisfaction of mastery from each developmental phase express a feeling of

excitement and anticipation about accept-ing an increasing, broader and more re-sponsible role in society. Such feelings have

a quality of eagerness to do and to learn

more and to assume responsibility for one-self and others in an ever-widening social


Pleasure in learning, and satisfaction and security in body and mind lead to an inter-nal permissiveness that allows the individ-ual increasingly to discriminate and to

at-tempt new tasks with less anxiety and greater concern for self and those about

him. The fate of the child, the long period of biological and psychological dependency on the parents, is influenced by the inter-personal transactions of such a relationship. For the child to achieve continued pleasure in learning he must experience reciprocal affects from his parents. The child who tries but is repeatedly and anxiously warned to “Be careful” will try new endeavors only hesitantly. The parent who seeks his own

reward for past failures through vicarious gratification and urges his child to greater

or unachievable ends will stimulate the child to counter-aggression or depression. But the parent who can achieve pleasure from the unique unfolding of the biological

growth and progressive integration of his child’s personality, will encourage his child to respond with greater joy to the attempt to discover what he can and cannot do. The reciprocal affective responsiveness of

par-ent and child in the doing or the negation of doing to prevent injury or hurt, are mir-ror images of each other.




of the manifold results of conflict. Such a child and such a parent at such times have no need beyond the deep content of the

moment of such learning, growth and inte-gration. There is then little or no need to

denigrate oneself or anyone else, nor to equal or surpass some envied competitor, nor to redress some sense of inferiority to

another child in some other respect” (p. 670)

The current attack on permissiveness

may cause doubt in the minds of the mis-guided and fearful, but parents who are

confident in themselves and their children will not be intimidated. Such confidence on the part of parents and their physicians is

not easily shaken. All of us seek a

strength-ening of traditional values-honesty, civil-ity, responsibility, concern-but for this we need, not restrictiveness that stifles growth and experience, but an achieved sense of internal permission to feel and to do.

IRVING Pmups, M.D. Department of Psychiatry

University of California Langley Porter Neuropsychiatric


San Francisco, California 94122


1. Holt, L. E.: Holt’s Diseases of Infancy and

Childhood. New York: Appleton, 1933. 2. Szurek, S. A.: Playfulness, creativity and schisis.

Amer. J. Orthopsych., 29:667, 1959.


Hexachlorophene-containing preparations for skin washing come under scrutiny as this

issue of PEDIATRICS goes to press. Space available allows only a brief summary of the posi-tion of the Academy Committee on the Fetus and Newborn, to be followed by a more detailed statement in a later issue.

As of mid-December 1971, Dr. L. Stanley James, Chairman, reports the Committee’s

conclusion that the safety of daily bathing of infants with hexachlorophene-containing

solutions has not been established, and that the use of hexachiorophene for routine total body bathing of newborn infants in hospital nurseries or at home is contra-indicated.

At present the Committee recommends dry skin care; washing with plain nonmedicated soap and tap water; or washing with tap water alone, for the newborn infant. The two most important factors in transmission of infection from infant to infant: hand-contact and breaks in technique, can be minimized by scrupulous hand washing before entering the nursery and before and after handling each infant. For such hand washing the Committee




Irving Philips



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