Watching, waiting, and wondering: Applying psychoanalytic principals to mother-infant intervention

Abstract

There is general acceptance that the intergenerational repetition of relational patterns is transmitted within the interactions between mother and infant. The highly invested nature of the mother‐infant relationship makes it a prime arena for the playing out of unresolved relational conflicts of the mother. This occurs through the mother's responses to her infant in which she projects into the infant certain disavowed but highly invested positive or negative attributes. This leads to the interactional re‐creation of a whole relational system reflecting the mother's current and past relationship experiences. When a mother's conflictual past is unresolved and unmitigated by current relationships, her interactions with her infant are more driven by such perceptions than by real appraisal of the infant's actual attributes. The sleeping, eating, and behavioral management problems of infancy are often manifestations of such situations. A deceptively simple set of instructions to the mother, to become a nonintrusive observer of her infant and only interact at the infant's initiative, allows a role for the infant's initiative in changing interactions and thus potentially changing a relational system.

Termination as a therapeutic intervention when treating children who have experienced multiple losses

“…Our role is to observe and interpret their interactions and support the caregiver through modeling, reflection, and instruction. This method draws on several complementary techniques, including Parent-Child Psychotherapy (Liebermann et al, 1999), Watching, Waiting and Wondering (Muir, 1992), and Speaking for the Baby (Carter et al, 1991).…”

“…There have been many studies of the effects of single and multiple stressors on populations, including school-aged children, adolescents, and adults (Gisalson & Call, 1982;Kaufman, 2000;Osofsky, 1999;Pfefferbaum et al, 2001;Pynoos, 1996;Pynoos & Eth, 1984;Terr, 1988), and many worthwhile explorations of working with traumatized children (Carter, Osofsky, & Hann, 1991;Chaffin & Hanson, 2000;Gaensbauer, 1996;Gaensbauer, Chatoor, Drell, Siegel, & Zeanah, 1995;Lieberman, Silverman, & Pawl, 1999;Muir, 1992). Although there are writings that specifically discuss the effects of multiple losses on very young, traumatized children and how this impacts and should inform their treatment, as well as writings on termination of psychotherapy with older children, we could find no literature specifically addressing the importance of termination with multiply traumatized infants and toddlers and their families.…”

The Practice and Roles of the Psychotherapies: A Discussion Paper

“…Therapy manuals exist for psychoanalytically oriented treatments (91), family therapy (92), cognitive therapy (93), parent training (94), social-skills training (95), mother-infant interventions (96), and briefpsychotherapy ofvaried modalities (97), to name but a few.…”

Predictors of outcome in infant and toddlers functional or behavioral disorders after a brief parent–infant psychotherapy

“…The behavior-oriented therapies, such as interactional guidance, aim to directly modify mother-infant interactions, without any reference to the mother's past history [35]: videotaped interactions of mother and infant are used by the therapist to help the mother recognize positive interactions and to develop appropriate responsiveness and confidence in her parenting role. The infant-led psychotherapies, such as the program called watch, wait, and wonder (WWW), focus on the infant and work both at representational and at behavioral level [9,38]: the mother is asked to observe and follow her infant's initiations during a first part of the session, then with the therapist to discuss her observations and experiences of the infant-led play, trying to understand the themes and relational issues that occurred.…”