Tripartite therapy with older children: mutuality in the relationship of a parent–child attachment

Abstract

This is the last of a series of three papers exploring the use with older children of tripartite psychotherapy – a technique of psychoanalytic psychotherapy of the parent–child relationship with both parent and child in the room together with the therapist. Tripartite psychotherapy merits more attention than it has received. It is a flexible, psychoanalytically oriented approach to parent–child relationship problems, particularly useful when the primary attachment has gone awry. A study is presented of a mother and her 12-year-old (adopted) daughter, who are embroiled in a hostile and rejecting relationship. The mutuality in this case illustrates the complexity in attachment relationships, and also how useful tripartite psychotherapy can be in working with attachment issues that often present as problems of the child alone.

Keywords:

• Mother–child attachment
• parent–child psychotherapy
• tripartite psychotherapy
• attachment therapy
• attachment deficits

Acknowledgements

Dedicated to June Tosca Greenbaum who stimulated the author's commitment to exploring and addressing parent–child relationships.

Notes

1. In all my papers, I refer to the mother as the primary caregiver. Most infants clearly form attachments to both their mothers and their fathers, and we intuitively believe that father–child attachment is just as important. However, paternal attachment is associated with the level of paternal involvement, and although average levels of paternal involvement have increased, even in two-parent families with employed mothers (Lewis and Lamb, 2003), many fathers assume less childcare responsibility than mothers do (Pleck and Masciadrelli, 2004). When fathers are less involved and mothers assume the primary caretaking, infants show a clear preference for the mother (Lamb and Lewis, 2004). At this moment, therefore, the quality of the mother–child attachment has stronger predictive power than the father–child attachment does (Lamb and Lewis, 2004; Sroufe and Fleeson, 1986). Clearly, more research that is sensitive to paternal influences on attachment is indicated. Parental warmth, nurturance and closeness are associated with positive child outcomes with an involved mother or father (Lamb and Tamis-Lemonda, 2004).

2. Being biologically related may help parents adjust to and tolerate a difficult child, thus shared genes may facilitate a better fit between parent and child (Stams et al., 2002). In adoptive families, poor fits are more likely to occur (Brodzinsky et al., 1993).