Book Review

Father Hunger: Explorations with Adults and Children

N Engl J Med 2002; 347:1538-1539November 7, 2002

Article

Father Hunger: Explorations with Adults and Children
By James M. Herzog. 324 pp., illustrated. Hillsdale, N.J., Analytic Press, 2001. $49.95. ISBN: 0-88163-259-7

Riveting page turners are more the exception than the rule in psychoanalytic explorations, and James Herzog has written a fine one in his Father Hunger. Right from the preface, we know that this will be a passionate and revelatory book about the “other” crucial human intimate in the child's universe, as seen through the eye, ear, mind, and heart of an able clinician. He sets himself the following task: “to accompany, even in terror; to refuse to extract myself, even at a cost; and to try to help so that a person who requests my assistance, and with whom I have forged an alliance, need not do it alone.” Such forceful language, it seems, is well suited to the rigorous exploration of the complex internal domain of children's longings and appetites for their fathers.

Dr. Herzog knows well that he will have to make his case regarding the universal relevance of the father to healthy child development from a variety of perspectives. Like a disciplined surveyor suspicious of his measurements, he skillfully fixes his, and subsequently our, understanding of father hunger in time and space from several vantage points: the analytic couch and environs, the medical consulting room (with 103 men who fathered premature infants), the community consulting room (where 40 teenage boys spent 30 weeks participating in small-group discussions of sexuality and intimacy), and the wider perspective of clinical-research settings.

Comfortable and literate in these diverse cultures, the author argues a series of theses throughout the book: all children need their fathers, a thesis that is supported by the majority of clinical evidence (despite the relative frequency with which that need remains unmet); fathers are indispensable in helping children manage their separation from their mothers and their autonomy, as well as their aggressive drives and fantasies; much can be learned about father–child transactions through the study of trauma and repair, play, and intrapsychic development; fatherhood is inexorably related to the conjugal relationship; the meaning of prospective fatherhood is assimilated into the individual man's life history to a greater degree than the meaning of prospective motherhood is for individual women; and finally — Herzog's most creative and provocative contribution — all men (and boys) need to participate in relationships with a male parent who is himself loved by a female parent.

The author actively engages the reader's curiosity and knowledge base with the authenticity and compassion of his own clinical work. One is struck and moved from the outset by the high, nonjudgmental regard in which Herzog holds his coinvestigating adult and child patients and their families. By implication and example, he reiterates that the way one is as an analyst is at least as important as what one does as an analyst. I was reminded frequently of Jeree Pawl's admonition to “do unto others as you would have others do unto others.” Were the analytic presence considered in terms of optimal dosage, Herzog's touch could serve as a useful standard.

In his use of an analytic vocabulary, Herzog is respectful of his broader readership, relying only rarely on guild language. Even then, as in his discussion of the “caretaking line of development in boys and men,” he widens the clinical application of the theoretical concept so that it may be easily understood and integrated into the next level of discussion. His ideas, in fact, seem to him to require more than one language in order to be understood, and he uses Romance languages and poetic references throughout the book to freshen the eye, mind, and palate. This touch is aesthetically pleasing without diminishing the warmth, humor, and accessibility of Dr. Herzog's narrative. He is equally circumspect in his use of clinical concepts and new language. Much analytic writing may be justly criticized for relying on an idiosyncratic use of language, but Herzog is wisely sparing in his dependence on esoterica.

Corroboration of Herzog's theses is interwoven with other contemporary scholarship on fatherhood and child development. In Chapter 15 (“Expectant Fatherhood”), he organizes his observations of paternal behavior into various stages, from getting ready through conception, the turn toward father and fathering, and delivery. The mosaic of mood and behavioral changes, in which fantasies are nurtured and aggression is avoided, was recently validated in two Canadian investigations that tracked hormonal changes in men during the period when they are anticipating fatherhood. An increase in estrogen and prolactin levels and a reduction in the level of circulating testosterone may be the biologic mediators of the psychological experience Herzog describes.

Further corroboration of his clinical observations regarding father hunger in boys whose parents are divorcing is also accumulating in the prospective Collaborative Divorce Project in Connecticut that is investigating developmental sequelae in 160 families with divorcing parents and children under six years of age. The project's methodology calls for multiple empirical investigations of the children and their families, including play interviews with experienced clinicians to inquire into the child's experience of and imaginings about divorce. Sleep difficulties and troubled dreams are frequently reported in the preschool children as their time with their father diminishes.

One closes this book reluctantly, feeling inspired, challenged, and enriched by its unflinching exploration of the domain of the father's relationship with his child in the presence of the mother. We are inspired to listen more carefully to our patients, challenged to risk more of ourselves on their behalf in order to understand this unique appetite, and enriched by the time spent with this creative clinician who understands the internal experiences of children and the relationships that humanize them so incredibly well.

Kyle D. Pruett, M.D.
Yale Child Study Center, New Haven, CT 06437
kyle.pruett@yale.edu