Table 1

Comparison of Mahler's Stages of Separation‐Individuation with Pinals' Developmental Stages of Forensic Psychiatry Fellows

Mahler's Stages of Separation‐Individuation*Pinals' Forensic Fellows Stages of Development
Differentiation (5–10 months)Transformation
    Infant begins to hatch from autistic shell, develops cognitively, 
 and begins to compare what is and is not “mother.” Anxiety 
 toward strangers (the unknown) involves both curiosity and fear.    Fellow has limited knowledge and may have a sense of loss 
 emerge as he or she moves from the known and comfortable 
 clinical treatment role. Trainee may have a sense of anxiety 
 regarding the unknown and his or her ability to manage time 
 and to acquire basic forensic skills.
Practicing (10–16 months)Growth of Confidence and Adaptation
    Infant begins to gain a new perspective, a mood of elation at times. 
 Exhibits characteristic separation anxiety when the mother is not 
 around.    Fellow gains new perspective and comfort level with role as 
 forensic psychiatrist. Confidence begins to develop in newly 
 acquired skills. Sense of identify is “just beginning to 
 blossom.” Fellow has increasing curiosity 
 and begins to focus on the future.
Rapprochement (16–24 months)
    Toddler has more awareness of physical separation, brings objects 
 to mother, desires to be soothed by mother but may not be able 
 to accept help. Resolution of crises occurs as child is able to 
 obtain gratification from his/her own accomplishments.
Object Constancy (24–36 months)Identification and Realization
    Child becomes comfortable with mother's absence, has gradual 
 internalization of mother, and can tolerate delay and endure 
 separations.    Fellow begins to believe he or she has mastered certain skills 
 and “realize [his or her] self‐identification as forensic 
  • * Adapted, with permission, from Mahler MS: On the first three phases of the separation‐individuation process. Int J Psychoanalysis 53:333–8, 1968.

  • Adapted, with permission, from Pinals DA: Forensic psychiatry fellowship training: developmental stages as an educational framework. J Am Acad Psychiatry Law 33:317–23, 2005.