Addressing the baby and atypical maternal behaviour in psychoanalytic parent-infant psychotherapy

ABSTRACT

This paper aims to further our understanding of the process of therapy in psychoanalytic parent-infant psychotherapy (PPIP). Using a single-case study methodology, it examines the emergence of atypical maternal behaviours in the sessions and considers direct therapeutic work with the baby. The research material for this study consists of video tapes and verbatim transcripts of two sessions from different time points in one good outcome PPIP treatment. The Atypical Maternal Behaviour Instrument for Assessment and Classification (AMBIANCE) coding system is used as a basis for identifying atypical maternal behaviours, as they manifest in the sessions. In addition, the therapist’s intervention in moments of interactive disruption are analysed discursively, with a focus on the utterances that directly address the infant. Findings suggest that the mother exhibited a high frequency of disruptive behaviours, as coded in the AMBIANCE, in the beginning of therapy. These decreased considerably by the end of treatment. In addition, the therapist was seen to respond consistently and flexibly to maternal disruptive behaviours, employing different interventions. Furthermore, the therapist talked directly to the baby for a significant amount of the session time, especially early on in treatment, addressing several different issues. Disrupted maternal behaviours can be discerned and systematically observed in PPIP sessions; these may be addressed in psychoanalytic parent-infant psychotherapy through the therapist’s verbal and nonverbal interactions with the mother and baby. Using different coding systems to examine patterns of interaction in detail, it is possible to gain insight into the therapeutic process, furthering our understanding of change mechanisms in psychoanalytic work with infants and their parents.

KEYWORDS:

• Parent-infant psychotherapy
• atypical maternal behaviour
• psychoanalytic therapeutic process
• Ambiance coding scheme

Disclosure statement

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

Notes

1. Mother gave consent for the use of this material for research and teaching purposes. For the purposes of confidentiality the participants are referred to as Mother and Baby and identifying features were changed.

2. We would like to thank Dr Michelle Sleed for her support and guidance in the process of analysing sessions with the AMBIANCE.

Additional information

Notes on contributors

Sarah Miltz

Sarah Miltz is an IPCAPA trained Child & Adolescent Psychotherapist with experience working in CAMHS and private practice. Her research interests focus on parent-infant psychotherapy, early infant development and psychotherapy process. She is currently on maternity leave.

Elaine Pennicott-Banks

Elaine Pennicott-Banks has a background in higher education. She is senior Child and Adolescent Psychoanalytic Psychotherapist in Lewisham CAMHS and in private practice. She teaches Infant Observation on the Birkbeck MSc Psychodynamics of Human Development. She is also a member of the ERiC - Trial Steering Committee. Her research and teaching interests focus on parent infant psychotherapy (PPIP) and adolescent mental health.

Evrinomy Avdi

Evrionomy Avdi is Professor of Clinical Psychology at the School of Psychology, Aristotle University of Thessaloniki, Greece, and Research Tutor at the Anna Freud, London. She is director of the Laboratory of Applied Psychology, Aristotle University, where she conducts research, works clinically and provides clinical supervision. She has extensive clinical training in clinical psychology, psychoanalysis and drama therapy, and is secretary of the Scientific Board of the North-Hellenic Psychoanalytic Society. Her main research interests concern psychotherapy research; she uses qualitative approaches to study therapy process, primarily using discursive, dialogical and narrative analytic methods in conjunction with analysing nonverbal interaction and physiological activation. She is member of the editorial board of the European Journal of Psychotherapy and Counselling and the Journal of Contemporary Psychotherapy. She has managed several research projects in the field of psychotherapy research and clinical psychology, and is a member of several scientific societies.

Tessa Baradon

Tessa Baradon came from the field of Public Health to child psychoanalysis and psychotherapy. She initiated the development of a psychoanalytically informed model of parent infant psychotherapy (PPIP) at the Anna Freud Centre, London, and consults internationally on development of parent infant psychotherapy services and trainings. Her teaching and research interests focus on cross-cultural influences on infants and their families in traumatised societies and understanding clinical processes in the PPIP therapies with such families.