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Infant Observation:International Journal ofInfant Observation and ItsApplicationsPublication details, including instructions forauthors and subscription information:http://www.tandfonline.com/loi/riob20

What is psychoanalytic aboutthe tavistock model of studyinginfants? does it contribute topsychoanalytic knowledge?Isca WittenbergPublished online: 04 Feb 2008.

To cite this article: Isca Wittenberg (1999) What is psychoanalytic about the tavistockmodel of studying infants? does it contribute to psychoanalytic knowledge?, InfantObservation: International Journal of Infant Observation and Its Applications, 2:3,4-15, DOI: 10.1080/13698039908405026

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What is psychoanalytic about the Tavistock model of studying infants? Does it contribute to psychoanalytic knowledge? *

I s c x WittPnOvrg

To those of 11s who have been profoundly changed by doing iiilkrit observation and regard it as the basis o l ’ o u r undei-standing of the eniotional devrlopnient o f Iiiiniiiri

Ix~iiigs, i t mines as a shock t o discover that there are still many psychoanalysts w h o r l o i i b t its value and regard its tindings with suspicion. “What have Ixbies to teach iis?” rltey say; and, “Anyway, you have no verbal conlirination for your hypotheses ;ihorii what babies expcriciicc, i t is al l conjecture.” ‘Ihis piper is a i i attempt t ( J deal with iliese queries, to examine to what extent the study ot‘inlknts a s taught ;it the Tavistock Clinic is psychoanalytic and h o w infant ol)sc*rvation contributes i o liirthei. psychomalytic iinderstandirig.

Psychoanalysis and the psychoanalytic study of infants ’Ihe stiidy of the infant psyche might be said to he the “baby” of‘ psychoanalysis. Iiaviiig grown witliiii its womb with seeds sown by Frtvd ( 1 9 2 0 ) aiid Klein (1952) a i i c l haviiig heen given birth and nourished by Rick (1964). We can trace thc lincage t o Freud for i t was his discovery of the Oedipus Complex which led him to becoiiie in tcrested in observing its onset and operation iii children. His discovery 01‘ the phriionienon of the ttxnsfereiice inevitably led to his belicf that nothing of the intlivitliial’s past is ever lost but is either rememhei~ecl conscioiisly o r remains within the iiiicoiiscious. Hence it follows that the ed ie s t experiences in life leave traces ;itid are of significance to the developnierit ofthe structure of the niiiitl. Furtheririore. Freud (ibitl.) understood the play of an 18-inonih old child with a cotton reel to be ;in en;trtment of separating from and regaining his rnotlrer. IHe was laying t h t x

li)iintlations of observing young children’s play atid attacliiiig syiiibolic meaning t o

it. Melanie Kleiti carried this idea further, seeing the child’s play as an enactiiittiit o I his picture of the relationship between others and between those others anti himself. She begail t o treat the free play of the child in the consulting rooi i i as a coiiiiniiriicatioii, o i i it pai- with the tree associations of adult patients in analysis. Ant1

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just as F i -e~td’~ findings of the child within the adult led t o theories about the development of the niind in cliildhood. s o Klein’s discovery of extremely primitive phantasies existing in tlie minds ofveiy youiig childreii resulted in theories concerning the emotional developnient i n the first year of Iik. I can still reineinber Mrs Klein looking at a baby and saying: “I wish yo11 could tell us what you are thinking!”

It was Klein’s analysand, Esther Bick, who believcd that infants could tell IIS what they were thinking and feeling, n o t in so inany words, of course, hut through all the other ways they had of expressing theinselve he thoriglit that observing the behavioui. of babies would help child psychotherapists in training to understand the non-verlxil cornmunications of their yoiingest patients, children who had not yet acquired speech and others who primarily expressed their feelings and tlioughts in this way. Infant observation was thus seen in the first place primarily as ii nieans of learning the baby’s and young child’s “language” rather than as a source of fiirtliering knowledge aborit mental life in infancy. I t soon became evident to MIS Bick that such observations, if carried out regularly and systernatically, provicled a mine of inli)imation, yielding iinsnspectetl riches ahoiit the way infants relate to tlie world. I t opened rip a whole new dimension to understandiiig the niost primitive anxieties and defences against them, the intimate iiiter-corinectiori twtween soma and psyche and the intricate interactive processes between inother and baby. Inlant obseivation also proved to be of enormous value in helping students to learn to contain the powerfully painful emotions aroused in them by witnessing the babies’ states of distress arid to become aware of the operation of transfa-ewe mid coiuiter-ti-ansference; all so vital tbr their work with child and adult patients.

I think it is important to distinguish infant obseivation froin the psychoanalytic understanding that we derive from it. I Iwlieve we only confuse the issue ifwc speak of psychoanalytic obseivation of infants. For surely observation means taking in whatever our senses are able to perceive. Ftirtherniore, neither the niethod nor the focus is psychoanalytic: tlie primary focus in psychoanalysis is the internal world as it manifests itself i n the transference and interpretation plays a central role in testing the correctness of the analyst’s understanding as well as in effecting change. In obseiving inparits, we are studying object relations and an internal world in the making. What also makes it very diffei-cnt is that we stiitly the relationships which develop between third parties, betweeii baby and otliers, ones that happen in the inter-woven mental and physical activities. It is this detailed hi-focal attention to body and mind, intra-psychic and inter-psychic events which gives the study of infants its specific character.

So to what extent is the study of in fh ts analogous to, though different fi-om, the gathering of evidence and understanding of the unconscioiis as it occurs in psychoanalysis? Entering the home, speaking with parent5 and to some extent, however limited, responding to the Imby is a Far ciy from tlie setting of the consulting room and the way we act in it. Yet there are important similarities. They lie partly in tlie regularity and time-boundary of the obsewations Imt primarily in the “mind-setting”, as one might call it, of the observer. The observer waits to see what unfolds rather than initiating action. He does not proffer advice nor does he voicc opinions. In this way, he t,iies to provide the conditions in which the mother and baby’s communications and interactions are as free as possible from his interference. The observer’s primary

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task is to pay attention to every detail of behaviour and to be sensitively aware of the emotional content of what is communicated.

The aniount of data available, the fact that the ohserver is privy to activities in a quickly changing situation make it almost impossible to find space for thinking. The ohserver may have strong emotional reactions to what he sees and hears hut needs to store such feelings within his mind - and later add these to his descriptive notes. His impressions will he checked against the evidence of what has been observed and the response to it o f other members ofthe infant observation seminar. It is in the seminar that thinking about the plethora of data and attaching meaning to it takes place. The correctness of our interpretation of the material presented cannot, unlike in clinical work, he tested by direct interchanges with the person to whom they apply. Instead, o u r hypotheses are confirmed or shown to be unfounded by examining the development of patterns of hehaviour in the context of the same or subsequent ohsrrvations. The fact that we are largely dealing with non-verhal data does not, to

my mind, make the evidence any less convincing. Words, as we know, can br used to hide o r distort the truth and actions often speak louder and clearer than words. The seminar in which the thinking and discussion o f data takes place corresponds to some extent to the supervision of clinical work and here, as there, a psychoanalytic kame of reference will he turned to in discussing the material.

Preparing to be an observer: a psychoanalytic approach Unlike students who pursue a clinical training, those doing an Infant Observation (:ourse are not required to he, and seldom are, undergoing a personal analy ’ Seminars therefore need to serve as a training ground for learning to become an ol)server, aware and receptive to anxieties and phantasies within oneself and others ;ind [lie way they may be communicated. For only such an observer can gather the data required to allow us to analysc the mental-emotional interchanges between the baby and his world and engage in the psychoanalytic study of development. I therelore see it as my primary task as the seminar leader, right from the beginning, to encourage a psychoanalytic approach within the context of the seminar. Lookcd a t from this point o f view, i t is inappropriate to give a straight answer to the inevitable question stirdcnt~ ask: “What should I say to the parents of the baby at our first meeting?” Iiistrad, this and similar queries can lead us to reflect on how we feel about entering ;I firnily and asking to he an observer. Students often express their lear of intruding into the intimate relationship between mother and haby. They voice other anxieties; that, having met with the parents, they will not be allowed to observe their baby; thr fear that the way the mother handles the baby will not he as one should like it to he clone and how upsetting that will be; that in discussing observations, one might discover one’s own failures as a mother or father. In encouraging thinking about anxieties and doing so before one finds oneself in a situation where one has to act, I could he said to be adopting something of a psychoanalytic stance. It does, of course, not mean that the group hecomes a therapeutic group. Anxieties are not aiialysed, they are merely allowed expression, seen to he permissible and sharrd by other meinhers of the group. Being aware of and thinking ahout one’s feelings is consequently

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experienced as hopefully preventing them from undermining the task. Such self- observation usually leads students to wonder how the parents might feel about allowing themselves and their baby to be observed and what kind of observer they might find tolerable. Role-playing the initial interview, with different members of the seminar acting as mother, father and potential observer, can be very useful in learning to empathise with parents, seeing what it might feel like to be in their position. It also brings with it a realisation that our wishes and fears affect the way we behave, what we say and how we say i t and the effect this might have o n the couple’s decision to allow the observer into the family.

So by now, we are trying to put ourselves into the skin of others, observing our own and other people’s actions and noting the inter-active nature of relationships. We are beginning to ask: how does each separate partner o f a relationship feel? How are emotions and phantasies conveyed through words, facial expression, bodily posture and behaviour? In which way do these affect another person’s mind and actions; how do two or more people interact and influence each other? We find ourselves in the realm of object relations, the notion olthe internal world affecting external relationships and vice versa, not in any theoretical way but from the experience within the seminar, having through role-playing observed minds and bodies at work and thinking about the processes of communication they demon

Reflections in the seminar also make it clear that although we share ce:-tain human reactions, there are any number o f individual differences. Ifwe want to find out how other persons feel, all we can do is to observe and he emotionally receptive in the hope of learning to understand them. And so, whalever professional training we have undergone previously, whatever amount of experience gained from having children of one’s own, we can lcarn from each systematic infant observation both how mental life develops and how particular character patterns come to be formed.

As a seminar leader, I have a responsibility not only for the stiidents but also to the families which are going to be observed and therefore have to exercise judgement as to a student’s readiness for the tafk. This may mean asking a student who appears to bc intrusive, judgmental or over-assertive to delay looking for a family. Other attitudes may interfere with being an observer, sucli as wanting to become friends or a part of the family. Preliminary discussions will allow students to air their concerns and help us decide when it is appropriate for them to l o o k for a baby and begin observing.

Improving observational skills The following is a report of the first obseiwtion undertaken by a student:

Mother opened the door 10 tile and 1 followrd her to thr sitting- t-oot11 wherr the baby was lying in his crib. Mother picked up thr Ixtby and opcried her bloiise and the baby fed for about tivr minutes on each side. Motlicr thrn hcld the baby over hri- shoulder and burped it. The baby started crying whrn piit clown atitl niothri. rocked the crib until the baby quietened and eventually fell asleep.

It is an unusually sparse account. Encouraged by questions from meriibers of the seminar, the observer was, however, able t o add quite a number of factrral details about the way the mother picked up the baby, how shc held him, t h e way baby sucked.

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Other qticstions could not be answered at thcl tinir tiecause the observer had not iioted w h a t had occurred. We wanted to know, for inscatice, aboitt the I ~ b y ’ s hoclv tnovetnents, his facial expression at every stage of‘ the interaction, the qidity, intcnsity mid tliiration of liis crying. Did the mother piit the nipple in his ti iotith or did he go tow;irtls it? Did tic let go of the nipple o r did niotlier rcwiove i t and how did lie react to this? Did the iiiother look at the babywhile feeding. did she talk to liinil By raising qtttwions, wanting to know more precisely what occurrrd, the seiiiinar group helps observers to look riiorc closely and become more ;irciiratr in their descriptiolis. I t is, for instaricr, not enough to team that a baby moved or played witlioitt knowing exxtly what lie was doitig. For i t is the detail, the noting of the minutiae of‘hehavioiir aud tlie clianges that occitr f‘rom moment t o monient which enable (IS to get in toiic.li

witli ail itifatit’s sensuous-inental-eniotional experience. As one stitdent said after ;I

ywr’s ohsetvation: “I used to find it dilficult to write a ftill page. now my observations lil l m a n y pages. I feel I have a responsibility to the baby to be aware ofand rciiiem1,ei- rvcry drcail.”

I t is in part curiosity, in part experience, which bring ahout siich an iinprovenieiit in ohs tw&mal skills. h i t i t is also a matter of being able to tolrwte what there is to see, hear ;ind [eel. Having idealised atid ovcr-sitiipliliecl infaiicy and mothcrhootl, it collies

a s ;i shock to most adults to discover the reality of the diffictilties arid coiriplcxity of it all. When we asked the observer whose report I have quoted h o w she felt during the olxervation, slic said i t tiad been awful: she had lieen i n a state o f panic, alrairl thv tnotlier would drop tlie baby, that the baby might not leecl nor stop ctying. It became clew that these anxieties had been so overwhelming that they had almost blotted out

hcr capacity to observc. Although her description of tilother atid baby did ~ i o t soiititl

wot-lying, we were, in tlie absence of more detiiled evidence. iiiiable to discern wlietlier the obscver’s disturbed state of mind stemmed from her owti anxieties, were clue t o Iier picking tip the mother’s unconscious fears or the baby’s, or ;i inixture of all three. What we were ahlr to do, however, was to raise these questions atid difrereiit ways of looking at what might have Iiappened and, in this way, encourage the o1xervt.r t o t l i i i ik about the location and possible transmission ofanxieties. I n acltlitiori we w e i t able, based 011 observation and our own in-toticliness with fears of being dropped atid l’dlitig, to considcr what kitid of physical 1ieh;ivioitr ii Imhy might exhi bit w h o is afraid of‘ being dropped. Equally, what posture woiild indicate that a mother was ft.arf’iil ofdropping tlie baby or tiarbouririg a wish to c lo s o ? Stich exploIations convey to the beginner the kind of evidence needed t o niakc sense ol pliysio-psychic states. The s tdent ’ s report also let1 us to coiisider how o u r o w n fears and wishes can easily coloitr perception aiid the interpretatiou we put upon what we see. Some stticleiits ;ire iit tirst reliictatit to coiiiineiit on their r:motional reactions to the observation, others flood 11s witli what they feel or believe the parents olthe child to be feeling. By studying the detailed cviclctice over time, the seminar group can, on the one h i d , Iit.111 to correct views 1)ased on the observcr’s projections and on the other hand raise his awarctiess that feelings evoked in him may provide ;I clue t o the baby’s or rlie mot l ids emotional state and the nature of the emotiorial link between them.

Altliotigli observers ask parents to do what they woitld normally do diiring tlie o1)srrv;itioii tiour, having a third person thcre is bound to af‘fect the situation to sotile

extrwt. I n soiiie cases, we gain the impression that thc mother gives more attention

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to the baby when the observer is present than at other times. Some parents wish to demonstrate the baby’s latest achievements. Being watched may, especially to begin with, make a mother inore anxious. Others niay feel the benign presence of another person provicles thein with a sense of security, like one rnother who told the observer that she had been waiting tbr her as she was too mxious to give her tiny baby a bath when she was alone with him. Freqnently, mothers speak about their worries quite openly, using the observer as a container for their anxieties. TI~LIS, in spitc of wishing not to be actively involved, the presence of the observer does affect the relationship between mother and baby. 0bscrvet.s niay also have a inore direct impact on the inFmt, presenting hiin with an oedipal situation. This is especially so i l the mother talks a great deal to the ohserver at the rxpense of paying attention to the baby. On the other hand, thc baby may at times use this third person h r the containment of his angry feelings arid i n this way be able to inaintain his loving attitude towards his mother. Frequetitly, the obsei-wr becomes the repository of feelings which neither mother nor baby can tolerate, such as, for instance, depression aroused by weaning.

Observation of sensations and rtnotions passed f‘rotn baby to mother, mother to baby, mother to observer, baby to observer and the inipact of the to and fro between mother and baby gradually heroine part of the awareness which students acquire. We may nanie them later and liiik them to psychoanalytic concepts like transference, countel-- transference, projection, projective itietitification, splitting, containnient, but I would not wish to do s o until these processes have been ohsrrved, described and have come to form part o f the alive, powerful, felt experience of‘ the observant student.

Learning to contain anxiety

As clinicians we have to bear a great deal olcniotional pain on behalf of, or together with our patients. We are, Iiowevrr, alde to nanie and communicate to our patients what we intuit. Out- stuclents have a harder time since their contract is limited to being observers. Being in the presetice of the baby’s terror or despair or niisery naturally makes them want to act in one way o r another - or get the mother to do s o

- to relieve such frightening and painlitl states. Yrt all they can do is stand by, bear it and try to understand it. “I could not.stand his scrcarning”; “I wanted to pick hiin LIP and comfort him “I wished she would not keep him waiting for his feed”, they tell us. They find i t hard t o witness the baby’s upset ;ind desire motheis to relieve i t right away or preferably not allow it t o arise in the tirst place. When parents do not live up to theses expectations, observers readily become judgmental and criticise them. When parents are i n Fact insensitive to the inPatit’s distress or at limes actually nrgligent or cruel, it hecomes very hard to go on obset-ving. The serninar needs to help students to stay with their own and the baby’s pain rather than siniply blaming parents who themselves niay not have been helped ill their childhood to deal with their powerful emotions. While expericnce has shown that parents who are nnaware of something going wrong in the drvclopment of their child, harclly ever wish to have it pointed out to them, we do have to weigh up in wliicli v t y rxceptional rircumstanccs the observer might be thought to he colluding if hc remains passive. €le will also I J ~ looking for any sign which indicates that the parrnts are concrrt~ed and i n that instance suggest where they might turn to for help.

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On the other hand, watching a very intimate relationship between a devoted mother, wlio cierivesjoy fromi her baby, and a beautiful and lively baby, can stir up jealousy and envy in the observer and he will have to struggle to contain these feelings within himself. Seeing a mother and baby absorbed in each other may arouse strong longings fix the oceanic experience of being in such an intimate relationship with beauty and goodness. I t is the witnessing of extreme states of bliss as well as intense emotional pain which drives some observers to seek analysis for themselves. It also not infrequently happens that some students who are already mothers become “broody”, hoping that on the basis of their increased understanding, having another baby will provide them and the baby with a much enriched experience. Some students take a long time to get into their stride but develop a far greater in-touchtiess during the second year ofobserving. Those who remain detached and unaffected or overwhelmed by infant obseivation will lie found not to be suitable, or at least not yet ready, if they apply to undertake a clinical training in psychoanalytic work with patients. Many of our students do not intend to pursue such clinical training, but hope, tlirortgh observational studies, to increase their understanding of clients in their own professional settings. The ability to learn to be in toitch with the emotional experience of mothers and babies will give an indication of their capacity to be receptive to and able to think at depth ahout the interactions with their child ;ind adult clients.

The body-mind link I t is prirnarily through studying body language and seeing it iIssociiited with psychic stales that we learn t o understand what babies in the first year or two of life arc con~in~ulicating, getting rid of, taking in, feeling and thinking. Just get into the skin of the characters they portray, i t is often helpful for us to enact the tnovenients o f the observed baby and so attempt to get some sense of what that feels like. We are helped by the fact that we have all been babies, and have stored within 11s some “memory in feeling”, as Klein called it (Klein, 1957). A particular sensation may be evoked by finding ourselves in circumstances which i l l some way resembles twlier experiences. We have all experienced feeling cold when we are shocked and mortally afraid, gripped by pain and panic, soothed or irritated by being touched, f d t safely supported, hoping for a helper to come to ow aid when we felt helpless 01-

terrilkcl, startled by the sensation of falling endlessly as we drift off to sleep, sick with anxiety, kept moving to avoid going to pieces. When we are ‘frightened to death’, w e may keep still to avoid danger or we may figlit or ‘hang on for dear life’.

Uick’s study o f new-horns enabled her LO describe how catastrophic anxieties which she found to precede the paranoid-schizoid and depressive position manifest themselves in infant behaviour and the manoeuvres the baby adopts in liis strugglc for survival (Personal communications in seminars; compare also Rick, 1968). She thus added a whole layer to our understanding of’ primitive anxieties arid tlie dcfences against them. I t has enormously enriched psychoanalytic knowledge of the most primitive level of functioning, the psycho-somatic, or soma-psychotic ( a s Bion used to call it) experience. Rick’s concept of the skin (1968) as a holder for the parts of tlie young baby’s tinintegrated self, linked to the experience of being physically and emotionally held by mother, gives depth to the holding fiinction which Winnicott (1C160) considered sc) important as well as adding a somatic component to Bion’s

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concept of container-contained ( 1962). The notion of adhesive identification and Meltzer’s further exploration of one, two and three-dimensionality ( 1975) are intimately linked to Bick’s discoveries. Getting in touch with the most primitive anxieties, through our own observations of infants, sensitises us to their presence in all our patients. Equally, watching babies not only makes u s more aware of non-verbal manifestations of unconscious phantasy but brings home to us that enlotioils at the most primitive level are embodied in bodily states and processes, located in particular parts of the body. Psychoanalysts have theoretical knowledge of this but with few exceptions, only those who have had a grounding in infant observation integrate this knowledge into their day to day work with patients. 1 remember Mrs Bick remarking that we tend to talk to our patients about their feelings when it would be more accurate to describe their emotional experiences in concrete, physical terms. I personally think that it is important to bear in mind the different levels of experience. A patient moving about restlessly on the couch may have the experience that there is no safe lap to hold him, and/or niay be afraid that we are unable to contain his terror, aggression, depression or any mental pain.

The link between internal and external events As Winnicott (1941) pointed out, it is impossible to conceive of a baby in isolation. It is what mother and baby bring to the relationship and how they (as well as other members of the family) interact which determines the infant’s mental-emotional as well as physical development. Our observers try to visit parents well before the bahy is due in order to get what one might call their pre-transference to the baby; their phantasies ofwhat kind of baby they are hoping or fearing to have and feel him/her to be, as well as how they want him t o develop. We may gather from such information some idea as to the kind of parenting envisaged, like the couple who told the observer that they wanted a baby who would be “no trouble”. and would “not change the way we have been living”. These ideas may, of course, be altered radically by the actuality of the birth and the baby. It is much easier for observers, especially at the beginning, to comment on what the parents are saying and doing than 10 describe the baby’s activity. But through the questions raised by members of the seminar, they are also enabled to think about the baby’s contribution, his inborn characteristics and constitution. How inert or lively is he, how out-going or turned into himself? How weak, strong or greedy in sucking, how responsive to being comforted; how peaceful or irritated and restless; does he scream i f the breast is not immediately available or can he bear waiting if mother holds him and speaks to him? How sensitive is he to noise, light, touch, pain? Does he communicate his distress by crying or is it held within? Some babies we observe squirm and seem to be in pain but do not cry out. It suggests an inability to project and, in some cases, the absence of hope in an object receptive to and able to bear pain. From these factors we may gather what the infant is bringing to the relationship with the external world. One little girl looked around the room within minutes of being born, seeming to observe her surroundings with great interest. She screamed if not fed immediately and turned away from the breast if not of‘fered at the right time or in her preferred way. She continued to show both great curiosity and intelligence as well as grcat deterinination to get what she wanted, steadfastly refused what she disliked and, by the age of 18 months, “mine” was a

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Iavourite word, miployed with vigour whenever she fancied what sotnrotie else possessed. In thinkitig about the genetic factors we will, o f course, hear in mind in which ways tlie baby’s relationship to the world may already liave been affected positively or negatively by intra-uterine experiences as well b y the circitiiistaiices of‘ ihc birth and post-birth interventions.

(:ompariiig the babies presented in the seminar shows us how different thry are from the very beginning as well as how differently they are afleactcd by the impact ofdifferent experiences o f the external world. We are impressed by the inter-dependence 01‘ inother ;ind baby, the sensitivity with which they respond to each othei: For instance, when mother removed the nipple from nineday old Mark, his hancls Iluitet~ecl; tiiotliet.

rrtnarked, “He looks mad” and pushed him slightly away from her body. At liftecn days when she called him “Greedy nioiise” becaiise he was hanging 011 l o hcr breast withoiii sucking, he shuddered. By the tinic he was live weeks old, Mark woiilcl I’requently interrupt his feed to look up at mother’s l ice hefbre continuing to slick. Wlicti lie had finished f t d i n g , he would give her a smile, wheretipon shc hugged him i~tid showered hiin with endearments. We felt that Mark was a Iiighly sensitive I,aby w h o , from early on was not only aware of what mother could and coiild t i o t

tolerate and adjusted t o this, hut responded by being sparing otthc Iireast and showing gratitude; a very loving little boy who had the capacity to reassure tiiotlier m d evoke 1 ovc .

A tiiothcr conveys to her baby by the way she handles him, holcls him, looks at hiin 01.

(toes not, and by the way she spc:ab to him whether lie evokes love, hatred, persecution, eiivy, gratitirdta, despei-ation or rinderstanding, whether she sees him a s a ‘thing’ or ;I

person. It is throiigli studying the constant 10 and fro, the [lux of the interaction hrtwerti baby and mother that we can see some of the ways that ndadjustment and itthihitions come about, how drep-seated fears, destructiveness, depression and despair take t x w t , h o w the b is laid in infancy for specific viilnerab es and difliculties i i i

devrlolment then and later on in life. Often mother’s unworked-throtigti i t i f in t i le - desires a s well as anxieties are re-awakened by having a baby, resulting in rejection, harsh treatiiient, distancing o r over indulgeticc. An example ol’thc Iattcrwas shown by Kay’s niotlier w h o let the hahy sleep next to her for the first few months so that she could feed arid play with the breast whenever she wanted. When, a t the Health Visitor’s suggestion, Kay eventii;illy slept in her cot, inother would hang her Ix-rast over the sidc of it, dangling it into t h e , baby’s mouth as soon as she wakened. We waLched this little girl becoming ever inore greedy, indiscriminately pushing objects right to the back of her n i o t t t h in ;I way that felt quite disgusting. We were afraid that Kay was developing into ii cliiltl i l l a t had 110 regard for the quality of whai she incorporated, no care tor or even a notion of a mother behind thr breast. Having had very little opportiitiity t o develop her own resources to cope with trustra~ioti. she encountered great difficulty at the time of weaning and becariie a little tyrant .

Although w e mainly see mother and baby, we always hope io hear aboiit tlic relatiotiship between father and mother and fhther and baby and io ohserve it in ;icticin. We Iicar in mind also tlie support or interference that is corning froni others who play a part in the household. Siblings and grandparen&, for instance, may provide relationships which coinplement or coiuiter-bal;ince wliiit the baby is able to get froin h i s niother.

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The influence of the observation and imdei nding of these early anxieties and interactive processes on clinical work are veiy consiclerable. Firstly, students will have learnt to be inore observant, paying attention to and trying to understand in detail what is conveyed non-verlially by, for example, the child’s posture, his every movement, facial expression, tone ofvoice and the ch;uiging nature of these. I n assessing children for analysis or psychoanalytic psychotherapy we will, iis well as evaluating how the child uses the exploratory sessions, want to get as fill1 a picture as possible of the pregnancy, birth and the first year of life, what the baby WAS like and how the parents felt at that time and feel now. I n addition, we will be seiisitive t o the wny the parents relate and respond to us and thris get some feeling ahout what it is like to be that child in that family. We will he more liopefiil al~otit being able to help ;I child or adult therapeutically who conies from a disturbed hackground than a veiy disturbed child or adult fi-om a far less rlisturhed one. I n the analytic work with our patients, one will be attuned to thc infantile anxieties underlying the emotional disturbances our patients bring to 11s. Having witnessed the moment to moment emotional changes in iiifants and toddlers, we would hope t o be more aware of subtle shifts in the transference. Having leaint from our observations how sensitivity to the other person is part of being in a dependent relationship, we are painfully conscious that what patients bring to u s is not all due to what is transferred but that our psychic and physical state impact on our patients to a liir greater extent than we likc to admit and that this initst be takcn into iiccoiint.

The psychoanalytic bias and psychoanalytic knowledge gained from infant observation We have known through the work o f Bion how important it is for the development of the mind that parents, like analysts, provide containment for the infant’s pi-ojected anxieties, are ahlc to hcar them, think about them, modulating them by naming them 01- acting in a way that conveys tinderstanding, thus enabling the infnnt to iiitiwject a mind capable of containing mental pain. But, although infant observation has shown us and we have known aboiit i t for a long time, we did not put forward in any theoretical foi-miilation what happens when parents project into their offspring. I t is only i n the last few years that Williams (1997) and Reid (1997) have published applications of their learning from itifant observation to a theoretical exposition of clinical cases. They show the very serious iund at tinies devastating effects on physical and emotional developinent if parents frcquently, or worse still, consistently, project their anxieties aiid unwanted aspects o l their personalities into their offspring. Although a persoiial analysis is ;in essential part of training, i t does not guarantee that clinicians too might not at times pi-ojcct unwanted aspects, for instance dependency needs, into their patients. Aitd, like parents, they may have t o acknowledge that they find theniselves more capable tlcding with some disturbances than with others and realise that i t is important to match patient and therapist rather than assume that they c;in all deal eqmlly well with cvcry kind of prohlcm.

We have also gone along with the psychoanalysts’ silence about the positive prqjections which take place. In recent years Keid (1987) and I~ikierman (1988) have each written movingly about the role that love plays in psychoanalytic work with children, inspired,

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110 doubt, by having become aware that the love parents project into their babies is an essential element in their development. Alvarez (1992) has emphasised the importancc of the therapist maintaining hope and taking a more active part at times when treating very disturbed children. Yet we have not shown the depth nor the significance ofniothers conveying hope in the face ofthe baby and child’s frustration, depression aiid despair.

Our analytic hias extends even further than this. We have often been accused of placing too much emphasis on what is pathological. It is Fair criticism. As the leaders of the infant observation seminars are all practising clinicians, they are inclined t o look out for what might be going wrong: is the baby showing autistic behaviour, is he or his mother severely depressed or being hypermanic or omnipotent? And yet many babies we observe as well as demonstrating deep psychic distress and disturbances in the course o f their development also teach u s to marvel at their strengths, their resilience, their capacity to preserve good experiences and recover from misfortune. I t is this hopefulness in recovery that has given child psychotherapists the courage to treat autistic, abused aiid deeply disturbed children. The awareness of innate strengths has also led to working analytically with patients on a once or twice a week Iyasis where intensive work is not feasible, to engage in brief therapeutic interventions with soiiie 011 an individual basis as well as developing brief work with yoiiiig families.

(hitrary to present psychoaiialytic theory, I believe we have evidence that Lhe infant is not entirely dependent on an adult mind to begin to think but is to some extent capable of discriminating arid making meaningful links. Equally, we have seen a niunber of babies, like Mark whom I described above, who demonstrate a capacity tor concern at a much earlier age than present psychoanalytic theory states. Not enough has been written about the way parents (and analysts) in their day-to-day interactions help the differentiation between healthy aggression arid real destructiveness nor how they not only deal with conflict but confirm and encourage the child’s (or the patient’s) innate sense of wonder, beauty and truth.

I regret that we have not published our findings about the baby’s positive capacities, s o relevant to our analytic understanding of development. We have much to contribute to the understanding of the interactive nature of a growing relationship in all its complexity: the interplay between what each partner brings to the relationship, how they constaiilly influence each other and the cumulative effect of these responses on the psyche and soma of each. For instance, we saw how baby Mark’s capacity to he sparing and show gratitude towards his vulnerable, frightened mother increased his mother’s flow of milk aiid love for him and this in turn enabled liirn to feel loved arid liopefiil about his lovability and creative potential. Yet i t also resulted in constipation, ;IS he held back his aggressive feelings. Some babies have been able to pull mother out of a depressed state by their loving responsiveness. It is the interplay of self and others which creates each individual’s unique history and character structure.

It would appear that we have been so passionately absorbed in the exploration of thr iiifaiit and maternal psyche, s o busy introducing infant observation into a great number of professional trainings that we have until recently neglected to formulate our findings and write about them in a methodical way. Maybe, we have been too identifiedwith the babies we observe, full of deep and rich experiences but fearing that we, like them, will not be able to coinmiinicate theni iii a way that the adult world will understand.

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REFERENCES

Alvarez,A. (1992) Livr Company, London 8c New York: Koutledge.

Bick, E. (1964) ‘Notes on infant observation in psychoanalytic training’. International Journal ?fPsychoannlyrsis.45: 558-566.

Bick, E. (1968) ‘The experience of the skin in early object relations’. International Journal of Psychoanalysis, 49.

Bion, W.R. (1962) Leamingj+oni Expm’enw. London: Heinemann.

Freud, S. (1920) ‘Beyond the pleasure principle’, SE 18: 3-64. London: Hogarth Press.

Klein, M. (1952a) ‘Some theoretical conrlusions regarding the emotional life of the infant’. In 7hr Wn’tings oJMelanir Klrin: 3: 61-93. London: Hogarth (1975).

Klein, M. (1952b) ‘On observing the behaviour of young infants’. I n 7 % ~ Writings of Melanir Kkin: 3: 94121. London: Hogartli Press (1975)

Likierman, M. (1988) ‘Maternal love and positive projective ideritification’.Journal of Child Psyrhothrrrapy u,2: 29-46

Reid, S. (1990) ‘The importance of beauty in the psychoanalytic experieiice’.Journal of Child Psychothrrrapy B, 1 : 29-52

Reid, S. (1997) The generation 01 scientific knowledge: sociological and clinical perspectives. Part Two: projective identilication - the other side of the equation’. British J o U m ~ l ofPsychothrrtlp?r 13, 542-554.

Williams, G. (1997) ‘Reversal of the coiilainer/contained relationship’. I n Inlrrrral Landscapes and Foreign Bodies. London: Duckworth

Winnicott, D.W.( 1941) ‘Observatioiis of infants in a set situation’. I n M.M.R.Khan (ed.) Collected Puprrs, London: Tavistock 1958.

Winnicott, D.W. (1960) The theory of‘ the parent-infant relationship’. In The Maturalio.na1 Process and thr Farilitatirig En=nriironnicnt, London: Hogarth, 1965.

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