Making use of psychoanalytic young child observation as a response to referrals of young children in a multidisciplinary medical, mental health and education Centre in Brittany

Abstract

This paper describes a response by a psychologist, a psychomotor specialist (psychomotricians) and a child psychotherapist to referrals of young children under 4 years whose developmental difficulties do not have an obvious physical origin or a clear diagnostic label. The approach they developed was in response to medical requests for observations of the children who had been referred to the multidisciplinary assessment Centre in Brittany. All three had been trained in psychoanalytic observation and offered a four-week assessment involving separate family observations by the psychologist and psychomotor therapist, discussion for detailed observation notes, and feedback discussions with the referring doctor in order to discuss the findings and to consider what was understood and whether and which ongoing treatment might be offered. One detailed case example is presented which underlines the tension and anxiety in the parental couple which prevented them for thinking together about their son. The parents' anxiety about what was wrong with their son, who had delayed motor development, as well as their need to keep an eye on him because of his constant movement and lack of sense of danger, had led to their exhaustion and overload and to their son's anxiety about any separation, day and night. The observations and their careful discussion brought about a change of feeling and of behaviour in parents and child. The parents felt they could relax and reflect and their son, in response relaxed and seemed much less driven and more ready to separate from them, providing more space all round. There is a hypothesis that psychoanalytic observation (rooted in the practice of baby observation) allows the observer to take in with the sense and to be receptive to projections from each member of the family. The ability to reflect on both kinds of communication is considered as important in the development of alpha function, the capacity to think with feeling in a way which is experienced as containing to many parents and children, and which permits the return of hope and the promotion of psychic and physical development.

Keywords:

• child development centre
• psychoanalytic observation
• multidisciplinary assessment
• reflectiveness
• anxious attachment

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. A psychomotrician is part of the health professions. He is trained in various technical approaches and methods that aim to engage with the patient through his body and set up a therapeutic relationship with him. A psychomotrician may deal with infants, children, adults and the elderly. His specificity lies in the listening and particular attention given to bodily expressions and their significance. He addresses the whole person.

2. Literally ‘autonomy house’, the means, in France, by which parents are able to obtain funded additional learning support of special treatment for their children so they can have equal access to education.