Margaret Rustin

The social baby

is immensely attractive volume is intended as an intervention in the Th field of mother, father and baby relationships. Lynne Murray, director of the Winnicott Research Unit, whose work is well-known to the readers of this journal, has teamed up with a research health visitor, Liz Andrews. Together they have written a lavishly illustrated book, primarily intended for parents, about how to understand babies’ communications. From this starting point flow many observations on the care of young babies. The tone is very carefully judged: the aim is to facilitate parental curiosity, intuition and reflectiveness, and to this end a very calm, straightforward, informative and sympathetic text accompanies the stunning photographs. The pictures will delight anyone interested in babies, and are remarkable. The idea the writers wish to convey is that if we watch babies carefully we can understand the meaning of their behaviour, which is not random but communicative, and that this enables us to provide the sensitive care which is optimal for infant development. There is a consistent stress on the individuality of babies and the great differences between them statistical norms about babies’ behaviour are nothing more than averages. Hours of sleep, preferences about forms of comfort, amounts of crying vary across a wide spectrum. The concept of the specially ‘sensitive’ baby is used to describe a range of problems parents may encounter the baby

Dialogues with parents

This paper offers an overview of current clinical approaches to psychoanalytically informed work with parents by child psychotherapists. The analysis is based on practice at the Tavistock Clinic and on broader knowledge of trends in work with children and families within the National Health Service. A brief history sets the scene. Four varieties of approach are described, with clinical examples. The particular sensitivity of child psychotherapists to infantile features in the personality is highlighted, and it is argued that this, together with their broad clinical experience, provides a proper basis for psychoanalytic psychotherapy with parents. Such work significantly extends and enriches the clinical contribution of child psychotherapists and has involved a shift in professional identity. It also raises ethical issues which are discussed.

The therapist with her back against the wall

This clinical paper describes once weekly psychotherapy with two boys with traumatic histories. The way in which the trauma enters the consulting room and the relationship with the therapist is explored. Technical issues are discussed, particularly the understanding of the countertransference and its modulation in communication with the patient. The therapists intense personal anxiety about failure and about management of the difficulties that arise is linked to the impact of trauma.

Multiple Families in Mind

This article addresses the particular nature of the internal worlds of adopted children and their families, and the ways in which ongoing relationships are affected by these internal factors. The complexity of family life lived in the shadow of often multiple painful prior experiences of families is described. Clinical examples are used to explore issues of ‘contact’, the placement of siblings, the impact of parental trauma on a child’s development as seen in psychotherapy, and the opportunities for ‘working through’ afforded by adoption. The article suggests the potential helpfulness of individual psychoanalytic psychotherapy for adopted children and their parents in coping with psychic pain.

Esther Bick's legacy of infant observation at the Tavistock—some reflections 60 years on

Abstract This paper reviews the development of Infant Observation from its inception in 1948. It revisits Bicks original 1964 paper and explores current divergences from her original practice in the context of contemporary theories of psychoanalysis and adjacent disciplines and of relevant changes in society. It draws on the personal recollections of Bicks early students as well as the expanding published literature. It discusses seminar technique, the training of seminar leaders, and clinical and research applications of the observational method.

Taking account of siblings. A view from child psychotherapy

Abstract This paper argues that siblinghood has had an important place in child psychotherapy thinking for many decades. Both psychoanalytic observation of young children and clinical experience have contributed to this. It discusses some reasons for the renewed interest in siblings in the wider psychoanalytic field and emphasises the existential threat to identity posed by the birth of a new baby to the displaced child in the family. The role of siblings as friends as well as rivals is explored and a link is proposed between the development of symbolic thinking and the capacity to give space to siblings in the inner world.

Looking into later life: psychodynamic observation and old age

Psychodynamic observation has been used successfully as a core component of training for child and adult psychotherapists within the NHS. This paper will describe the use of the psychodynamic observational method in the multidisciplinary training of health professionals working with older adults. In taking on the role of receptive observer within the framework provided by the psychodynamic observational method, it is hoped that the observer will come closer to the older persons experience and develop an attuned capacity to see and retain detail. In becoming aware of the emotional impact the interplay between the individual and their environment may produce, participants will learn from their own experience about factors, conscious and unconscious, which can support or impede development and adjustment to transitions in the later part of life. It allows thinking in depth to take place about the experience of the older person as well as the difficulties encountered in the caring role. The first half of the paper will describe the ‘how to’ of setting up a psychodynamic observation. The second half will describe two observations, one in a more normative setting of an outpatient health clinic for older people, and the other in a nursing home where the older person and staff are confronted with a greater degree of physical and mental deterioration.

Observation, understanding and interpretation: The story of a supervision

This paper describes the supervision of the early stages of the psychoanalytic treatment of a 4-year-old boy. The supervision took an unusual form, as most of it was conducted in writing, using fax transmission. The supervisors role in relation to the treatment dyad is linked to pre-Oedipal and Oedipal preoccupations with the parental couple, which are vividly expressed in the childs play. The therapists link to the supervisor enabled her to preside over the childs discovery of three-dimensionality and growth in his thinking space and the creative use of his imagination.

Struggles in becoming a mother: Reflections from a clinical and observational standpoint

Introduction This paper raises two related questions. How can we make use of our experience in infant observation and in brief early intervention to extend our understanding of the internal factors which underlie the development of a capacity for maternal responsiveness? Furthermore, can we conceptualise maternal resilience in the face of the infantile anxieties evoked by the care of a baby? A brief clinical intervention with a teenage mother and some material from the observation of a mother of a toddler are discussed in exploring these questions.

Young child observation: A development in the theory and method of Infant Observation

Observing young children at play is an everyday and often fascinating and pleasurable experience for many of us. It also has a great pedigree in the development of psychoanalysis from Freud’s observation of his grandson’s game with the cotton-reel onwards. This book describes the practice of observing young children in home and nursery settings in a systematic and non-intrusive way to expand our understanding of their emotional, cognitive, and social development. It uses a psychoanalytic lens to enrich the meaning of what is seen. How do minds and personalities take shape? How can we train people to see what is most relevant in helping children to develop? The chapters range from classic papers by famous practitioners of an older generation to observations completed in recent years in the UK, Europe, and the US. Observation of this sort has also spread to Latin America, India, Australia, Africa, and the far East. The differences and continuities with Infant Observation are the starting point. What happens when a child starts nursery? How active a playmate should an observer be? How do we balance the close attention given to the observed child with the wider group of children in a nursery? How do we make sense of the marked cultural differences we see between families, nurseries, and indeed national cultures? How can we use observation as a baseline for early intervention and how can we research what we are doing? The book is written for the many students and professionals concerned with the care and education of under fives, and for parents, grandparents, and all who are interested in the mind of the young child. The meeting of inner and outer worlds, which characterizes life in these crucial years, is vividly depicted. Readers will delight in the children’s capacity for imaginative thought and also find themselves pondering what makes a nursery a good-enough place for staff and children.