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Interpersonality in early childhood: Possibilities of an encounter with the other Interpessoalidade na primeira infância: as possibilidades do encontro com o outro

In this article, a theoretical proposition is formulated about the development of interpersonality in the first two years of life. Drawing on Jean Piaget’s accurate observations on this period of development, and adopting the theoretical framework of structural phenomenological psychopathology, a conception of structure in the early stages of formation will be expounded, centering on the experience of interpersonality. Also discussed are the differences between child and adult (the latter as a paradigm of the mature structure), as well as the manner whereby the recognition of the specificities of childhood experiences broadens the possibilities of perceiving pathological processes at this stage of life.


Introduction
Jean Piaget drew on the concept of structure for his analysis of cognitive development. His concept of structure is that all phenomena originate from an organizing totality. As defined for structural phenomenological psychopathology, the concept of structure shares the central axis of Piagetian thought-i.e., structure is conceived as an aprioristic totality that can be apprehended from the manner it shapes psychic phenomena (Barthélémy, 2012;Messas, 2010a). Every phenomenon observed alludes to this totality, pointing to a common internal consistency. Structure is the manner in which individuals plant themselves in the world. Underlying these two epistemological approaches is an understanding that the entire psychic process is subjected to a structural totality that governs the interaction between any elements.
The concept of structure comprises two aspects: essence (which characterizes the individual as a unit throughout existence) and mobility (yet one that preserves stability) (Messas, 2012). This dyad allows us to recognize our ultimate constitutive material (our own essence) and the most productive channels and opportunities that our constitution can provide for our personality to emerge and reach apogee. From an inner sphere, we choose which native elements can oppose optimal resistance to help promote our own development. A structural totality is therefore what allows individuals to remain the same, while modifying themselves throughout their development process.
This transformative process, however, ensues differently in adults and children-and, as regards the concept of structure, so does the process of expansion. In the healthy adult, as a paradigm of a mature structure, the fundamental structural categories (spatiality, temporality, interpersonality, corporeality) are assumed to be organized in a balanced, harmonious fashion (Blankenburg, 1982;Messas, 2010b).
In the child, by contrast, the structure is still in a state of immaturity, thus yielding a qualitatively dissimilar world experience. The child's perception of the world, as we shall see below, is shaped from a structure based on the experience of corporeality, since it is the body in the world that determines experiences (Fuchs, 2009;Tamelini and Messas, 2019). Spatial immaturity promotes a borderless experience between the self and its surroundings, causing the world to be experienced as a single unit. In this experiential format, the self is experienced as a diffusing center, albeit a center in a state of undifferentiation with the surrounding world. As spatiality and temporality evolve throughout the maturation of structure during the first two years of life, the child gradually comes to experience a stable surrounding universe, which affords spaces of separation between elements. In the sections that follow, the particularities of interpersonality will be analyzed in the setting of this experience of the world-an experience that begins in a state of merging between the self and its surroundings.

Interpersonality
Interpersonality is the aprioristic category that allows the formation of a shared anchoring in the dual encounter, providing a basis for stability, which in turn can promote an invigoration of the self, opening it up to expansion (Fuchs, 2005;Messas, 2004). This experience of synchronic, harmonic, psychic penetration creates a third space, a third experience, shaping the world as it is experienced from mutual understanding.
As adults, we are conscious of being in the world, with no need for ascertaining that we are the ones who think and experience (Parnas, 2013). This experience, termed ipseity, constitutes the basis for living an existence in which the self is present, incarnated, spatially demarcated in relation to others, conscious of itself along a timeline, within a stable, shared world.
On the other hand, early childhood experiences contrast with the adult's pre-reflective possibilities. The child's spatiality does not allow demarcation between self and other, but shapes a world made up of merged elements (Ceron-Litvoc, 2016). Such embryonic spatiality cannot promote separation between bodies, creating an experience of undifferentiation with the surroundings and preventing the child from self-perceiving as a unit amid other units. Immature temporality, on the other hand, determines a history-less world restricted to present-time events, devoid of the stability provided by a biographical timeline-one that allows me to know myself in a world that I recognize from my life history (Ceron-Litvoc, 2019). In temporal terms, the child begins extrauterine life tied to a temporality circumscribed to the present, devoid of oneness between times, which determines an experience of reality fragmented as fleeting moments, with no synthesis between them. (Ceron-Litvoc, Messas, 2016).
Corporeality is the category that makes possible experiencing some degree of familiarity and does so through bodily habituation from a reiteration of actions. The body recognizes a given situation because it has "acclimated" to a range of repeated events (e.g., breastfeeding position).
The more accustomed the body becomes, the greater the deftness and likelihood of successful movement-bodily experience generates a budding outline of stability laws for the child's surrounding world. The body is a core of meanings, one that promotes stability of contact with the world. In other words, corporeality plays a unique role at this point of development: it accounts for ballast, retention, as well as for the recognition of familiarity in the contact with the world (Ceron-Litvoc, 2017).
With this initial description, we have paved the way for a crucial question concerning this developmental period: How does the dual encounter take place in early childhood in a world of merged elements?

Dual encounter in the first two years of life: proto-interpersonality
The shared experience of the world lived by the adult enables the self to transcend an egocentered perspective by sharing the perspective of the other, without suppressing, however, the primary perspective of the individual (Fuchs, 2015). However, in the child's experience, the self is unable to transcend its ego-centered perspective, since as yet there is no ego to be transcended. Therefore, the aprioristic state of undifferentiation with the surrounding world that the child experiences does not allow reciprocity to take place-reciprocity as communion of two autonomous beings, synchronous in a shared space and time. The earliest moments of interpersonality evolve from a state of undifferentiation between inner and outer spheres-a sui generis situation, if compared with the remainder of human existence, and this is why we shall term proto-interpersonality the interpersonality taking place during this phase.
Unable to differentiate between objects, the child merges stimuli, sensations, and elements into a single experience. Doubtless, a human being can be regarded as a special object among all others-as illustrated by the fact that infants, from birth, tend to imitate other humans, but not other elements (Meltzoff, 1977;Gallese, 2003). Although unable to recognize a caregiver as a separate entity in a dual relationship, the newborn is able to react, and in a singular manner, to a situation in which the caregiver is one among other elements (Piaget, 2013). In this setting, the other is perceived as an element that can fulfill the child's basic needs and foster feelings of wellbeing, but which is not recognized as separate from other elements in the situation. Here, no contact is established between two independent beings-i.e., there is no interpersonality, as in a relationship between adults. Piaget (2013, p. 4) remarks that "as far as the boundaries between the self and external world are concerned, a universe without objects is such that the self, lacking knowledge of itself, is absorbed in an external picture for want of knowing itself".
In this sense, the aprioristic need for contact felt by an undifferentiated being (the child) and the human tendency to attach to sensitive, responsive adults constitute the embryo of interpersonality: proto-interpersonality. Unlike a dual contact established between adults-a horizontal relationship, with a balanced exchange of forces-the interpersonality that takes shape from birth onwards is vertically oriented: an adult (the caregiver) who donates and a child who needs this donation and receives it.
The interpersonality matrix is non-symbolic, unintentional, non-verbal, non-reflective for consciousness and, most markedly, procedural. Interpersonal contact exhibits on a unique outline.
Holder of a mature pre-reflective structure, the adult self-perceives as distinct from the child. One of the features promoting the intuition of this structural dissonance between adult and child involves comparing how these two structures react to the environment. While adults resonate with, yet are not determined by, the environment (e.g., an adult may feel upset at a noisy place, but the annoyance will not suffice to overtake consciousness to the point of making volition impossible), an annoyed infant tends to be overtaken by the disturbance, an experience that will markedly determine subsequent reactions to the world (e.g., a baby who cries inconsolably when experiencing a noisy environment). Since the manners of experiencing the world and oneself are different, adults are not always able to track which elements will dominate the mind of young children whose wellbeing they are in charge of. It can thus be said that, from the adult's point of view, the child is a territory of unsteadiness and surprise.
A child fails to recognize two distinct, autonomous spheres placed in contact. A merging of distinct elements is the experience possible at this stage of life, entailing recognition of a single, denser center: the child's center of activity. Piaget calls this specific structure "egocentrism," but the term must be taken with a caveat: this is an egocentrism devoid of ego, since the incipient structure is still incapable of recognizing the self as a unit. Egocentrism, thus defined, will abate during the course of the maturation process, as interpersonality evolves from the encounter between two units (Gruber and Voneche, 1977).
This fusional aspect is what confers distinctiveness to this relationship of proximity between child and caregiver. Both elements constitute a single entity floating over the vicissitudes of a world devoid of rules (as regards the infant's consciousness). The only rule assimilated is the coziness and security provided by body contact. A practical example of the relevance of this merging is the likely decrease in sudden death events among newborns who share a bed with their parents (Mckenna and Mcdade, 2005).

Proto-self
In early life experiences, the child is an element undifferentiated from others and devoid of boundaries. At the same time, the child is able to self-experience as a center of activity, an element of higher density than others. This center will constitute a germ of recognition of the self: a protoself. At the outset of this journey, however, this center is still far from being recognized as a unit; it is merely a diffuser of actions, unseparated from its surroundings. It would, therefore, be unwise to attribute self-consciousness to a child at this age, given that the self can only constitute itself in comparison with and in opposition to other selves and the external environment. "The child is therefore still very far from being able to attribute his intentions and his powers to a 'self' conceived as different from a 'non-self' and opposed to the external world" (Piaget, 2013, p. 233).
Post-Piagetian literature, however, has objected to the term "egocentrism", coined by Piaget to describe the interpersonal relationship taking place at this phase, as debatable. Primary, or embryonic, interpersonality still lacks a self capable of promoting an ego-centered view of the world as in an adult perspective (Wilfred, 1944;Rochat, 2012). "Egocentrism" thus might refer to the child's conception of a world that revolves around a single diffusing center of activity, fused with the outside-i.e., ignoring the reality of the other, both by the power of that diffusing center and by the impossibility of recognizing the other as separate from self. The term, however, does not lend itself to fully describing the actual situation of undifferentiation that the child experiences, and can stoke misunderstanding-that a self exists which is conceived as different from other selves-thus missing the crucial role played by the dual relationship in the child's development.
Merleau-Ponty (2010) refers to this state of undifferentiation as "syncretic sociability"-a total absence of ego or self-identity-and illustrates it with the contamination of crying observed among three-month-olds: as soon as a baby begins to cry, all others will follow suit, even if experiencing a comfortable situation (Dillon, 1997). Development of the self and the possibility of ipseity unfold during the first two years. In Table 1, we highlight the main stages of this process. From the child's perspective, experiencing reciprocity, interconsciousness, and resonance is not possible.
Vertical contact: adult gives; child receives.
Contact shaped by corporeality (synchrony and rhythm).

1-3 months Recognition of situations, but no distinction between elements.
Recognition and specific reactions to positive situations.
Competent caregivers are fused with the positive situation.

4-8 months
Earliest recognition of density poles in the experience, but still devoid of boundaries.
Children experience themselves as the center of the universe-the sole diffusing center.
Humans recognized as special objects, subordinate to child and devoid of autonomy.
Reciprocity not possible.

9-11 months
Earliest consciousness of duality in relationships. Perception of two separate beings.
Child conceives the other as a second center of activity, but still subordinated to child's will.
Child incapable of transcending toward the perspective of other.

months
Child's expectation that actions of other are a mere prolongation of own actions begins to abate.
Earliest reciprocal recognition of two distinct, equal-value poles.
18th months Beginning of a relationship in which the child can conceive that own mental state differs from other's.
Earliest reciprocity and possibility of interconsciousness (encounter between two equal-strength powers, generating a third entity).

Recognition of situations, not elements Child Adult
Note that elements circumscribing the dual relationship gradually lose relevance in the relationship.

Proto-interpersonality: an element to counter the vulnerability of the immature structure
Due to its hegemonic trait, corporeality is the principal mechanism that provides the child with a sense of familiarity and stability. Children grow increasingly successful and skilled in the actions performed, basing these on a recognition of bodily situations, which become more complex in the setting of undifferentiation of elements. Corporeality, however, is not the only element to provide stability in the child's universe; it is, however, the only structural element that the child can count on to experience stability.
Undifferentiated from the caregiver or from every surrounding object, children need some degree of external stability to counteract the instability being experienced, which, owing to structural immaturity, is determined by a presentified time and a fragmented space. Children therefore live in an atmosphere dominated by unsteadiness and uncertainty. Although corporeality can promote a degree of continence in the experiences, it is nonetheless incapable of promoting the experience of stability that only a mature structure can afford. It is the caregiver who, in a rhythmic, synchronous relationship with the baby, will promote the primary stabilizing route for further development. This path is materialized by way of interpersonality in the dual encounter, although in a qualitatively distinct manner compared with the adult: in early life, contact is still verticaldonor above, recipient below. Owing to the insufficiency of parallel structures, interpersonality plays a primordial, irreplaceable role in human existence at this stage of life. Pre-reflective vulnerability is partially mitigated by interpersonal contact. The caregiver-the human being who is responsible for survival-becomes tasked with creating a world of embracement and pleasurable sensations, a crucial ballast of stability required by the embryonic structure to develop.

Proto-interpersonality: dependence on the other
Proto-interpersonality operates as a unique aprioristic category during the first two years of life. Only the dual encounter with a stable caregiver can promote the stability that the infant's structure is not ready to provide-i.e., proto-interpersonality is a primordial element for healthy development.
Piaget, Spitz, Bowlby, Erikson, and other classical investigators of child development point out the crucial role of the mother (or any caregiver with the same characteristics) for healthy development of the baby's psychic structure in the first months of life. Erikson, for instance, regards the relationship between infant and primary caregiver as a major factor in the child's ability to understand the outer world as a place that can yield a sense of trust (Waterman, 1988). Unable to experience a relationship of familiarity and steadiness-pre-reflective structures can only experience a fragmented, heterogeneous, unpredictable universe-the child is at the mercy of an environment shaped by the adults around them. By creating a world of stable outcomes, loving caregivers generate self-confident children. Loving caregivers promote stability, and consequently confidence, transmuting an otherwise chaotic universe-if experienced by the child's structure alone-into a secure environment, made possible by the stability experienced through interpersonality.
In the past eight decades, countless observational studies have investigated the quality of dual contact as an element determining the development of lifelong traits. In the post-World War II period, studies on institutionalized children deprived of affectionate, stable caregivers revolutionized the prevailing view on the critical role of affective care in early childhood. Bowlby (1962), René Spitz (1951), and James Robertson (Schwartz, 2003) described situations of maternal deprivation (or of an affectively stable caregiver), emphasizing the importance of parental care in the early years of life and its key role in healthy psychic development. Bowlby, who pioneered this observation, proposed that early emotional ties influence emotional and social development, having lifelong impact (Feldman, 2007) -a theory corroborated by subsequent longitudinal studies (Waters et al, 2000a;Waters et al, 2000b). Spitz (1965) notes that changes in the environment, while of scant importance for an adult, can have a profound influence on the baby, with potential pathological consequences. In the 1950s, Robertson and Bowlby (1953), filming the ordeals of hospitalized children unaccompanied by their caregivers, illustrated the stress that isolation in an unknown (but not necessarily hostile) environment can exert on a structure that depends on the other to experience a universe of security and stability. The theory of attachment, empirically evidenced by Ainsworth (1969;1970) drawing on premises of Bowlby (Ainsworth and Bowlby, 1991;Bowlby, 1951), describes how the quality of the mother-child relationship determines patterns for a child's relationship with the surroundings. Deprivation of care can inflict a series of long-lasting distortions on the personality, impairing the possibility of establishing interpersonal relationships (Spitz e Wolf, 1946;Bowlby, 1952). The manner of seeing the other, including an openness to lifelong exchanges with the other, can be shaped by early patterns of attachment to a caregiver (Belsky, 2006).
The literature corroborates the importance of the dual mother-baby relationship to the regulation of the hypothalamic-pituitary-adrenal axis. Experiences in the early months of life seem to be associated with long-lasting epigenetic changes in this axis (Meaney, 2010;Suomi, 2006).
Early-childhood exposure to adverse situations, such as living in an orphanage for a long period of time (longer than eight months), with scant affective closeness and neglected care, may be linked to lifelong activation of corticoid secretion (Gunnar et al, 2001). Glucocorticoid activation triggered by traumatic events in early childhood is associated with increased vulnerability to lifelong psychopathological phenomena (Heim et al, 1997), as well as with neurobiological changes in brain structure (Nemeroff, 2004). Findings from these studies can also be interpreted based on the premise that proto-interpersonality, when healthily evolved, provides a primary, aprioristic condition for development.
Parents who promptly respond to the needs of babies promote a type of development in which children, from the age of six months, are likely to recognize their primary caregivers as sources of security and relief for stressful situations (Heinicke et al, 2000;Ainsworth e Marvin, 1995). Sensitive parents who provide support since birth tend to raise children who are more secure in terms of attachment quality, having a lasting impact on the quality of subsequent emotional relationships (Fish et al, 1991;Waters, 2000a, Waters, 2000b. For instance, children whose mother experience higher levels of anxious thinking in the early months, to the point of impacting the quality of care, fare worse in socioemotional development at 24 months of age (Kim et al, 2015) and are more likely to exhibit lifelong anxious traits (Meaney, 2010).

Conclusion
During the first two years, immature psychic structure subjects the child to vicissitudes resulting from not experiencing stability. This situation makes children at this age particularly vulnerable to the environment-a situation qualitatively different from that experienced by adults.
As Winicott (2013, p. 54) remarks, "for the little child, life is just a series of terrifically intense experiences".
One way of mitigating instability entails anchoring onto a mature psychism through interpersonality. Interpersonal contact plays a stabilizing role on the pre-reflective vulnerability arising from unsteadiness. With the recognition of vulnerability at this phase of development, and the growing appreciation that care-related dual contact has enjoyed in the past century, the importance of affective care in early childhood has been redefined, transforming behavior patterns throughout Western society. Observational studies conducted since World War II, attesting to the crucial role of quality dual contact in early childhood as a pivotal factor for healthy development, rank among the most significant in 20th-century child psychiatry. These studies have promoted the recognition that mother-baby bonding in the early months of life has long-lasting effects on the child's ability to relate to others, as well as on the regulation of stressful events.
In this article we outlined a theoretical approach on how interpersonal contact takes shape in early childhood. We consider that the pre-reflective conditions operating in this period of life call for the coining of a specific term-namely, proto-interpersonality-to designate the dual encounter in which the child's earliest experiences of undifferentiation with the surroundings unfold. Proto-interpersonality can therefore be defined as the dual encounter in which one party (the child) still fails to recognize any boundaries between self and other. This is a state in which the child merges with the caregiver and absorbs from the external psyche (through the experience of being cared for) the pre-reflective conditions for stability that the child´s own immature psyche is unable to provide-a moment of utmost relevance in the dual contact, where protointerpersonality is responsible for the healthy maturation of the structure.