Early reflections on online video infant observation during a pandemic

The Covid-19 pandemic has affected the entire world. Most governments have imposed a degree of ‘lockdown’ as the virus spread from the Far East in Winter and spring 1920. The pandemic has affected travel, work, leisure, social life and family life, university teaching and learning, and, of course, it has affected clinical training of all kinds, including psychoanalytic psychotherapy and related pre-clinical courses. In the case of psychoanalytic observation, a central interest of this Journal, weekly ‘live’ infant and young child observation, and related seminar groups where observations are discussed have all been affected. In the example of a relatively newly established infant observation group in Tehran, the group of observation students working in one of the universities, and attending seminars led by a very experienced teacher, Jeanne Magagna, have gathered their reflections into a paper published in this issue.

In Tehran, a rapidly organised and swiftly deployed plan for the group of six student observers who were eager to continue their observations online- following individual discussions with mothers (fathers are not mentioned). This led to ‘tele-observation’ in which mothers would use video call on their phones in order that the observers could keep in touch with them and their babies. This group, like quite a number across the world to my personal knowledge, in many cities of China, Taiwan, Russia, Ukraine, Turkey) was already taught by video link, using the Zoom teaching platform, and the members of the group in Tehran gathered in one room in the university for their weekly seminars. Interestingly they had ‘live’ seminars with the head of their Psychotherapy Department, alternating with online observation seminars with Jeanne Magagna, who is based in London. Three observers were in their first year of observation, and three were in their second. The group was already experienced in the difficulties of Zoom, partly because of ‘internet restrictions’ and always prey to the question of broadband signal strength and whether or not vision and sound would both work or not! All the observers were eager, as soon as home visiting was not possible, to move into using mobile phone video calling, so that observation could continue.

It seems that the idea of infant observation using video technology spread quickly and thoughtfully to many places. Infant observation seminars on Zoom, along with most other teaching and supervision created an opportunity for continuity and remaining in touch which was enthusiastically welcomed. It meant that seminars themselves were not much interrupted, and that observers could be reassuringly in touch personally with teachers and course leads as well as with other members of their seminar groups.

At the Tavistock Clinic, where the largest number of seminars is offered in a single organisation, Tavistock course organisers met rapidly in order to offer support and guidance and to set clear boundaries around the video observation opportunity. This support of everyone involved at a time when loss (of ordinary life and social contact in particular) affected so many made it clear in written communication that stress, anxiety pain and distress were expected, and were likely to be significant.

Young child observation seminars, many of which were set up in nursery school and children's centre settings were ended. The institutions were closed for the main part and the children were at home. Their thoughtful and supportive approach to setting up baby observation online also recognised the feeling of loss, stress, pain and distress which observation families, observers, seminar leaders and they themselves were feeling. In a very similar way to the very rapid setting up of ‘tele-observation’ in the Tehran group, the course organisers wrote protocols and clarified such things as the necessity of students attending seminars before they tried to set up video-based observations. Each set-up needed to authorised in order to ensure everyone was protected and supported.

Everyone seemed to start the new endeavour with energy, enthusiasm and determination. And the complexities emerged over the subsequent weeks and months. While the Iranian group moved quite quickly into using mobile phone video-calls with WhatsApp, others, including the Tavistock observers, hoped that the observed families, where possible might use a laptop or tablet, so that the device could be placed in a vantage point from which the observer could see the family and the baby in a more similar context to the position of the observer in the usual way. Some mothers did use their mobile phones, which was restricting. The mother of a baby of five months in one of my seminars claimed her baby who tried to grab the phone ‘ … thinks he is already a grown man with it.’ It seemed rather more likely that she used the phone a lot, including night-time video calls with father, who was away from home, and that this had stimulated the baby's interest in it as something which held his mother's attention. His mother herself stated that she could not see the point of an observation while he slept and wanted then to change the observation time. The mother insisted that she had to hold both baby and phone in order to make the observation work, and as ‘camera woman’ she tried very hard to update the observer and was much more talkative and involved while also focusing in close-up on the baby's face. The observer did not feel she could easily have a conversation about what would be helpful to her. It became rather clear in my seminar that this mother had not really grasped the idea of the observer being present for whatever happened in the course of ordinary family life. This meant, for example, that the observer could often hear the baby's siblings squabbling or the friendly greetings of maternal grandmother and her two older sons, but only rarely could she observe what happened when one uncle in particular, picked up the baby and played with him. The situation in this example, did, in fact settle over time, and the baby was often placed in a soft padded ‘nest’ with attached toys and mother did then place the phone in a position so the observer could see her and the baby playing together and others coming into the picture again.

Renegotiation of the observation, or, as the Iranian authors put it, ‘ … . how to present the idea to each mother,’ was the task for everyone; they describe their anxiety about the repositioning of mother and observer and the space they shared. They felt that what controlled the situation for them was neither observer nor mother, but ‘the space created by the technology with its strengths and weaknesses.’ Those observers who were in their second year of observation were concerned about this. A toddler was not likely to remain in one place if he was moving around or had begun to walk. Mothers were without freedom for the hour, ‘to continue as you normally would’. They had to follow the moving baby to keep him or her in view, which was an additional burden to an already busy and possibly preoccupied mother. Some of the second-year observation mothers in UK groups had returned to work and were now working from home. They were much more responsible for maintaining the observation while having work to do, older children to care for, along with cooking and housework. Some needed to be in touch with their own ‘locked-down’ parents on the phone or on Zoom and were doing shopping and delivering groceries if their parents were elderly and shielding themselves Grandparental support was reduced or no longer available unless they were already living in the same home.

It is very interesting to note how many parents simply and readily agreed to the video observation, sometimes at exactly the same time on the same day as before. Perhaps it offered some continuity, a link with pre-lockdown life and offering reassurance that normality, face to face visits, indeed ordinary life, would return. Some parents did not want to refuse the continuation of observation online. They did not want to interrupt the observers’ progress through the course nor their chance of completing the observation or the academic assignment if the course was part of a university validated programme. which parents would know about as part of giving their consent to the observation. Their generosity was and is remarkable in the face of the continuing difficulty in reverting to face to face observation. I imagine that everywhere in the world, no-one expected the whole situation of social isolation to go on for so long, neither, teachers, observers or observed families.

Presenting the idea of video observation to parents or mothers was anxiety provoking for everyone. It seems that, as one might have expected, less anxious observers, and well established observations, made it easier to negotiate the new situation and, in the case of the Tavistock, requesting that parents would sign a new agreement. This was largely to offer reassurance that observers would not record observations, would ensure that no one other than the observer would be present and that use of video observation would end as soon as face-to-face observations could resume.

In Tehran the writers’ concern about losing their tie to the family, was entirely understandable and echoed elsewhere. In fact, well-established observations, stood a better chance of translating into video observations, and, in my own experience, more thoughtful planning between observer and parents led to sensitive placing of a tablet or laptop so that the family could be free to continue ‘ as usual’. Relatively less anxious observers and mothers or fathers also stood a better chance of continuing because they could plan and think ahead without making each other agitated. All the observers in my own seminar and others, like the Tehran group were worried about losing the opportunity to continue. Some momentarily lost touch with the reality of previous contact and conversation, and most people on both sides of the relationship were under much greater strain. One observer in a colleague's group, who was a single parent attending a Tavistock seminar,had to end her observation very quickly. Her three, young children simply could not bear that she was asking them to play nicely by themselves for an hour, when they knew she was watching another child on her computer. Ending until normal life could return was a painful fact for this observer, who continued to ‘attend’ the Zoom seminars and to hear how others had succeeded in continuing their observations. She did receive video clips, which many parents were eager to supply, even when video observation hours had been established. The observer was grateful that she could, as mother said, could at least see important developments.

Observations which had been recently established, or in a few cases had scarcely begun, were at greater risk of not continuing, as were those such as one example in the Tehran paper, … ‘where the mother could not handle the children's excitement, their intense competition to get hold of the phone. The mother requested that the observer should continue in person- despite the risk of spreading infection. Sadly, that observation had to be suspended and I find myself wondering whether the observer kept in touch with this desperate mother.'

New kinds of acting out emerged and some situations were difficult to manage. Some families found it very difficult to refuse the observer, as I mentioned earlier, but practically it was very difficult to manage a range of demands on mothers in particular. This was obviously especially difficult with the babies’ older siblings; in Iranian examples, mothers absented themselves remaining behind the phone. It seems that some had previously used the observer's presence in order to leave the baby and get on with housework or cooking, and one has the impression that some observations had not been clarified in terms of the observer having the opportunity to see an hour of ordinary family life. This seemed to mean that some mothers seemed to feel persecuted either by observer or by the demands of the baby and the observer and took the opportunity to end the observation.

Other parents were extraordinarily helpful, not only feeling responsible for the observer's successful completion of the task it seems, but because they had formed a strong link with the observer and wanted to keep in touch and to talk about their personal situation, replicating what had previously happened face-to-face. In some examples there was a clearer emphasis on mothers who wanted the observer as a friend; someone to talk to. One mother who had clearly accepted the observation partly because her older son had some social anxiety, and mild autistic features, wanted to continue to talk to the observer. She used the observer very much as a container for her anxieties about everyone's physical health and her concerns about her older son. This [proved difficult for the observer who was spending other parts of her day busily working online in a primary school creating teaching materials and maintaining contact with colleagues and children. She, like so many, was much more tired than she realised.

Exhaustion became a feature. Social isolation persisted for months and continues. Many observers had a lot of responsibilities in addition to observation. The third academic term of the year, at the Tavistock and in its associate Italian centres, involved the requirement for written submissions, with new guidelines for content, from the observer-students. Many seminars leaders had agreed, in addition to their continuing workload, to assess the assignments. The overlay of anxiety permeated everything including the observations. I found that I had more individual video meetings with observers and students for whom I was personal tutor. Perhaps frequency of meeting communicated a longing for the kind of contact which was not really possible on video. The reality of distance, of often feeling ‘at sea’ in the face of such a changed pattern of life, work and social contact had originally been underestimated.

In seminar groups there were additional technical difficulties- not everyone had the same broadband speed there were breaks in communication, some contributors suddenly ‘froze’, or the sound of a voice was more like a machine gun rattle. Again and again it became evident how different some experiences were from others. While there was evident pleasure at being in contact, and much patience exercised about the difficulties, the strain was great. The quality of electronic equipment and connections showed up differences in location, and in levels of affluence as well as technical ability- between families and observers and in between observers and seminar leaders. On the other hand, in my own and my colleagues’ experience, attendance and punctuality were particularly good. There was a strong sense of personal responsibility for sustaining the project. It is fascinating to discover that, the dedication of some would-be-observers led to ‘meetings’ online with parents and infant observations were actually negotiated and started. This might have been linked with the generosity and good will of parents who are eager to help the observers. This was certainly the case for a number of parents who agreed to in-person observations by postgraduate students at the Anna Freud National Centre/UCL (Perez et al., 2018) The authors asked the question- why do mothers volunteer for infant observation and what do they make of the experience? In that paper mothers spoke of agreeing because they liked the observer on first meeting. Others wanted to help with the endeavour, some stating clearly that they felt they were missing out on their intellectual or working life and saw the observation as a kind of research. There was also a small number of mothers who openly and honestly stated they wanted to get something out of it. It is possible that the parents who agreed to online observation in recent times, consciously or unconsciously wanted to get something out of agreeing. We know that many parents of babies were not able to introduce them to their grandparents at the time of lockdown, nor could they introduce the baby to their friends. Perhaps an observer provided some ‘virtual’ companionship at a lonely and very strange time when the possibility of talking about the baby to someone with a genuine interest who will generally listen quietly is an attractive proposition. The social isolation, without extended family and friends dropping in to visit, was clearly felt by some parents, and at times it became a news item on radio and television. Some couples were at least together, ‘locked-down’ with the baby and getting to know her very well. But it is also known that levels of anxiety increased for many people at that time.

There are concerns about what could happen to the practice of infant and young child observation in the long term. There are thoughts in some organisations that face to face observation, will be replaced by online introductions in the hope of starting an online observation at the start of a new academic year. Perhaps once effective and safe vaccinations are released, it will be possible to return to in-person weekly visits and face to face seminar groups. Nonetheless, continuing to teach online is obviously a tempting thought for organisations seeking to expand recruitment without the limitations of the physical teaching space required for face to face teaching. Running costs would be reduced, course fees could be lower, and more students might be attracted. The ‘market’ becomes wider and more income can be generated. Yet it seems that there is little belief amongst observers or their teachers that an online link can really replace the face to face experience. So much is not in the observer's control and limited in terms of where attention can be focused. The moving toddler cannot be followed all the time on screen and can soon learn to be ‘in’ or ‘out of shot’ shot when the observer cannot follow unless the device-with-camera is moved. The independence of where to look or at whom is severely curtailed in some cases, and, to some degree for everyone.

Much has been noted about babies’ interest in phones and devices with screens. While there is quite a lot of evidence that babies recognise observers on screen and often smile and reach out, we do not actually know what they make of this kind of contact. We know of some babies and small children who want to ‘pull’ the observer into their presence, to reach out and touch, or to get through the screen themselves to make contact. Some observers have expressed the wish that they could do the same in order to ‘be’ there. Internet video technology is extraordinary and widespread and increasingly sophisticated applications have been developed very quickly. But we need to be aware of what is and what is not actually possible in terms of contact, whether for observation, for teaching or, of course for clinical work with patients for which infant observation was originally thought-out, as a preparation for taking in the non-verbal and one's own response to what is observed. This is not always possible on screen and while video contact has been extremely beneficial, it is also limited. There is a risk that observation could become a generalised observation of ‘stages of child development’ and be much more linked with child development research as it grows in sophistication. But this is not the aim of infant observation which is much more focused on being present weekly with mother, baby and other members of the family, who simply try to continue what they would normally be doing. The observer's task in this situation is to be present and to notice whatever can be noticed about the baby in particular and the others who are there. This task, as most observers will attest, is initially very tiring, sometimes upsetting, at others uplifting and mostly, but not always, interesting. Each observer is discovering the story of a unique life (or lives), and simultaneously discovering an expanding capacity to remember what happens and in what order, and so much more. There is inevitably a narrative of self-discovery for the observer, who might discover that his or her quietly attentive presence creates a containing atmosphere in which the observer often learns a lot more than by asking direct questions or by speaking at all. This was part of Esther Bick's intention (Bick, 1964) in encouraging the practice for child psychotherapists and would-be psychoanalysts and, I suggest, the encouragement is less likely when observations do not take place in person.

This is by no means anything like an exhaustive set of reflections and comments. It would be extremely interesting to be able to publish further thoughts, and experiences from observers and observation teachers about the use of video technology for observation and for seminars. There is much to understand and much to learn and the Journal welcomes as many contributions as possible which we hope to publish in subsequent issues.

Notes on contributor

Trudy Klauber is the Editor of Infant Observation and a child and adolescent psychotherapist. She has published several articles for this Journal and for the Journal of Child Psychotherapy. She teaches in the UK, and in Italy, and has spoken at conferences in a number of countries.