Frances Thomson-Salo

Perinatal mental health: Fathers – the (mostly) forgotten parent

The importance of parental mental health as a determinant of infant and child outcomes is increasingly acknowledged. Yet, there is limited information regarding paternal mental health during the perinatal period. The aim of this review is to summarize existing clinical research regarding paternal mental health in the perinatal period in various contexts, and its possible impact on infant development.

Understanding the Sexuality of Infants Within Caregiving Relationships in the First Year

Infants’ innate joyful sexuality in the 1st year, as well as parental sexuality, are relatively neglected in models of clinical work with infants. We offer a developmental perspective that pays close attention to the body of the infant, in contrast to some psychoanalytic theories that view infantile sexuality as phantasy. With greater awareness of the infant’s body as sexual, therapists could develop a more resonant countertransference and become more aware of the experiences of the infant as subject. Some symptomatic difficulties are described, and the relevance for psychotherapeutic intervention with adults is indicated.

Consultation-liaison psychiatry in a maternity hospital

Objective: The aim of the study was to describe referral patterns of maternity inpatients to the consultation-liaison psychiatry (CLP) service at a large womens hospital in metropolitan Melbourne, Australia. Method: Clinicians recorded socio-demographic data, referring unit, consultees reason for referral, psychiatric diagnosis made, and treatment provided for all maternity inpatients referred from 2004 to 2008. Results: Main reasons for referral were detection of depression, past psychiatric history, and concern regarding a womans coping. Most common diagnoses were depression, substance use disorders and anxiety disorders. Many women referred for assessment while inpatients were initially seen in the antenatal period. Conclusions: Pregnant women referred to a CLP service present with a range of mental health problems, most often depression, anxiety and substance use disorders. Many of these problems are evident in and require intervention during the antenatal period as well as at the time of confinement. CLP services to maternity hospitals should be provided in the antenatal as well as the inpatient setting.

Response to Lombardi

We address some of the individual points that Lombardi makes, some that we agree with and some that as infant mental health clinicians we do not agree with—for example, that at the beginning of life the mind is still not there—and try to show why we think that is.

Out of the Night Kitchen and Into Clinical Practice: Response to Commentaries

In reply to the commentaries by Susan C. Vaughan, Teresa Russo, and Dimitra Bekos on “Understanding the Sexuality of Infants” we concur with Vaughan’s noting, in her playfully creative response, a relative absence from the psychoanalytic literature of sexuality, even now, of the bodily realities of infants and parents in the 1st year of life. Teresa Russo and Dimitra Bekos in exploring the relevance of our paper for the work of an infant therapist challenge us to think further why the bodily sexuality of infants is also relatively absent in accounts of infant observation, and in clinical work, both in a transference/countertransference dimension and in descriptions of technique.

The world is looking east: Growth and development of psychoanalysis in the Asian region†

are still unclear, but we should not lose sight of how it is only in recent times that detailed correlations across these levels have been possible at all. Before, such correlations were based even more on faith alone. Coincidentally, this presentation demonstrated one of the other values of research enterprises to psychoanalysis: an entry route for talented younger people with a feel for analysis to find places in which they can further their development. The Tavistock Adult Depression Study and its Treatment Manual was the topic of the third presentation. It began its project of assessing the value of 18 months of weekly psychoanalytic psychotherapy for patients with long-term, so-called treatment ‘resistant’ or ‘refractory’ depression in 2000 and it is now in its final stages. It has 129 participants. The final participant in the two-year follow-up period will be rated by December; by then a total of almost 600 years of trial patient data will have been collected. The primary outcome findings will be reported in the course of the next year. The Tavistock Study, like the LACS, has aimed to develop an in-depth understanding of these difficult-to-treat forms of depression. It has combined three methodologies: randomized control trial, qualitative research and clinical investigation, in order that each complements the findings of the others. This author describes how key to the co-operation between researchers and clinicians is the constant attention to maintaining a culture of mutual respect. The approach taken in the Treatment Manual is key to this; it does not set out to teach qualified, well-trained analysts how to do their job. It is permissive and not prescriptive. It does not impose a focus but authorizes the analyst to follow the patient. For Taylor, on the basis of clinical impression, at least some of the seriously ill patients receiving the treatment under test in this trial show themselves able to use and benefit from psychoanalytic therapy. However, the ending of the treatment is often a severe crisis. A brief but moving clinical case illustrated this. In conclusion, this rich, well-stocked Panel, ably time managed by its Chair, Heinz B€ oker, presented three very serious research enterprises. As is proper, the outcome findings are as yet unknown, including to those doing the study. Their attitude is best captured by Samuel Johnson in his letter to Bennet Langton: Let us endeavour to see things as they are, and then enquire whether we ought to complain. Whether to see life as it is, will give us much consolation, I know not; but the consolation which is drawn from truth if any there be, is solid and durable: that which may be derived from errour, must be, like its original, fallacious and fugitive. [Note: The IJP is planning a special issue on psychoanalytic research. We welcome submissions of quantitative and/or qualitative research that explore the grounds for psychoanalytic ideas and conclusions. Guidelines for Research Papers can be found online at: wileyonlinelibrary.com/journal/ijpa. All submissions should be sent in the usual way and will be peer reviewed. Deadline for submission: 1 July 2014.]