How video can bring to view pathological defensive processes and facilitate the creation of triangular space in perinatal parent–infant psychotherapy

Abstract

This paper explores what it can mean to use video in psychoanalytically informed parent–infant psychotherapy (B. Beebe, 2003, Brief mother–infant treatment: Psychoanalytically informed video feedback. Infant Mental Health Journal, 24(1) 24–52). I use case material to show how the use of video helped illuminate previously unseen transference dynamics between a mother and her baby; and also the defensive processes roused in the mother since her baby's birth. I discuss the purpose of filming and describe how to work with the material that emerges whilst watching the film. I suggest a parent's super-ego is likely to be roused in the context of filming and watching (S. Freud,1923, The Ego and the Id. S.E. 19: 3–66. J. Sandler and A. M. Sandler, 1998, Internal Objects Revisited, London: Karnac). If used sensitively working with video can introduce a helpful observer position (R. Britton, 1989, The missing link: parental sexuality in the Oedipus complex. In: R. Britton, M. Feldman and E. O'Shaughnessy (eds) The Oedipus Complex Today: Clinicall Implications, London: Karnac. D. Birksted-Breen, 1996, Phallus, Penis and Mental Space, International Journal of Psycho-Analysis, 77, 649–657), a different triangular perspective from which new thoughts can emerge that, in time, might help to modify a parent's defensive responses and soften his or her punishing super-ego (J. Strachey, 1934, On the therapeutic effect of psycho-analysis, International Journal of Psycho-Analysis, 15, 127–129). For the baby, this can bring relief: for as the projected aspects of the parent are reclaimed, the baby becomes freer to be noticed as a separate being with thoughts and feelings of its own. In this way the use of video can enhance a parent's reflective functioning and mentalizing capacities (P. Fonagy, M. Steele, H. Steele, T. Leigh, R. Kennedy & G. Mattoon, 1995 Attachment, the reflective self, and borderline states: The predictive specificity of the Adult Attachment Interview and pathological emotional development, In S. Goldberg, R. Muir and J. Kerr (eds), Attachment theory: Social, developmental and clinical perspectives, pp. 233–279 (Hillsdale, NJ: Analytic Press). A. Slade, 2002, Keeping the Baby in Mind: A Critical Factor in Perinatal Mental Health, Zero to three Press, June/ July, l0–16).

Keywords:

• Defensive processes
• narrative construction
• parent–infant psychotherapy
• projective identification
• self-observation
• super-ego
• triangular space
• video

Notes

¹There are many ways of working with parents and infants (some of which also make use of video). See for example, Aquarone (2004), Baradon et al. 2005, Bakermans-Kranenburg et al. (2005), Juffer et al. (1997, 2005), Puckering (2004) and Sameroff et al. (2004).

²I looked at this in detail in my doctoral research which was on the process of parent–infant psychotherapy (see Jones 2005).

³Consent forms are signed at an appropriate moment and parents can take the VHS tape or DVD home at the end of treatment or, if requested, at different points during treatment. Each clinician would need to follow Trust procedures and policies about such matters.

⁴The CARE-Index training by Patricia M. Crittenden (2001). I also find useful the Atypical Maternal Behaviour Instrument for Assessment and Classification (AMBIANCE) Manual for coding disrupted affective communication (Bronfman et al. (version May 2004)) although I have not undergone formal training in the use of the method.

⁵Although names and details of the case are anonymous I have this mother's permission to share aspects of the therapy for the purpose of teaching about parent–infant psychotherapy.

⁶One way of understanding this would be to see Sofe as lessening her defensive use of projective identification. See Klein (1946), Bion (1959, 1961, 1962), Sandler (1987), Jones (2005, 2006), Likierman (2005). For a contemporary description of projective identification see Cimino and Correale (2005, pp. 51–61). It is a defensive process that involves minute splitting of the ego (Green 2005, p. 217).

⁷For a clear description of how an infant comes to distinguish self from other see Bateman and Fonagy (2004, pp. 55–109).

⁸See Sandler and Sandler (1998, pp. 121–140) and Green (2005, pp. 106–109).