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We review research of the last 30 years on the emergence and development of active “self-and-other” awareness in infancy, and examine the importance to mental health practice with children of the motives and emotions of the infant that have been found. There has been an historic bias in favour of reductive accounts of infant communication and cognition that portray the newborn as a “biological organism” lacking true psychological powers, such as intentions and emotions – an organism that acquires “self-consciousness” from learning guided by adult intelligence. Though a mechanistic cognitive bias is still dominant in psychology, and specifically in the psychology of childhood, an alternative perspective exists. In our examination of scientific evidence on the nature and activity of human motives, and especially their “initial state” at birth, we focus on the concept of “innate intersubjectivity,” and outline the history of its acceptance in developmental research.The normal development of the individual child’s movement, emotions, perception, selective attention, thinking, learning and memory, as well as all social understanding between persons in the community, depends upon mutual awareness between human minds. Both an infant’s biologically-grounded self-regulation of internal state and his or her self-conscious purposefulness in dealing with a changing cultural world are sustained and increased through active engagement with sympathetic others. The impulses of the newborn infant’s coherent intentional and conscious “Core self” (Stern, 2000) are supported in communication. Self-other-consciousness in communication mediates the heart and mind of cooperative and imitative intelligence for cultural learning and language. The infant makes an essential contribution in this growth of experience and how it changes at different ages.The relevance of infants’ inherent intersubjectivity to major child mental health issues is highlighted by examining selected areas of clinical concern. There is increasing evidence concerning how growth of a child’s brain and his or her mental health are dependent on how effectively the infant seeks and responds to intimate and sympathetic human care from birth. We review recent findings on the effects of maternal postnatal depression, infant prematurity, autism, ADHD, specific language impairments and central auditory processing deficits, and neurodevelopmental disorders in general, and comment on the efficacy of interventions that aim to support intrinsic motives for intersubjective communication when these are not developing normally.