Infantile perspectives on the replacement child

ABSTRACT

This paper tells the story of the work of a parent-infant psychoanalytic psychotherapist with an infant girl and her mother, from the age of four to 19 months old. It became clear, very quickly, that she was a replacement child. She was born four years after the death of her profoundly disabled brother and before her mother had begun the process of mourning her dead son. The mother was struggling to see the infant as a person in her own right and felt that she wanted her daughter to be a reincarnation of her dead brother. Although the infant was always dressed as a girl, there was also something boyish about her presentation. The work centred around us playing together and helping her mother to see her as a person in her own right, as well as observing and trying to make sense of the infant’s play. The therapist used her metaphoric function to hypothesise what the infant might be trying to understand in her play, especially with two identical plastic oranges that were the same and yet different. What emerged was that the mother was herself an identical twin, who never felt fully separated from her twin sister, and always felt that she was two people. An interpretation to the infant that perhaps she also thought that she needed to be two people, herself but also her dead brother, was met with a confirmatory response from the infant; it felt pivotal in elucidating for both mother and infant their respective challenges in the wake of the death of their son/sibling. The paper illustrates the importance of early intervention, of both observing and playing with infants and young children; and the importance of the therapist’s use of metaphor, which could be viewed as an inductive statement, summarising a guess about inner reality expressed in a skewed or displaced way.

KEYWORDS:

• Parent-infant psychoanalytic psychotherapy
• early intervention
• replacement child
• play
• mourning
• metaphoric function

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Consent to publish this clinical material was given by the family and I reflect on the experience of seeking consent at the end of the paper.

Additional information

Notes on contributors

Mary Short

Mary Short works as a consultant child and adolescent psychiatrist in child and adolescent mental health services (CAMHS), and as a parent-infant psychotherapist in a perinatal service, both within the Belfast Trust in Northern Ireland. She also works with children, adolescents and adults in private practice. She qualified as a child psychotherapist at the Tavistock Clinic in 2012 and as a parent-infant psychoanalytic psychotherapist at the Anna Freud Centre in 2020. She is an adult and child analyst and a member of the Northern Ireland and the British Psychoanalytic Societies.