Developments in Infant Observation

The Tavistock Model

Susan Reid, Susan Reid

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781317835547
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Infant observation carried out within the family is a compelling approach to the study of early human development, vividly revealing the impact of intergenerational patterns of child-rearing and the complex relationship between nature and nurture. It provides unique insights into the early origins of emotional disturbance and suggests ways in which healthy development can be promoted by both professional and parent, often resulting in changes to clinical practice.
Developments in Infant Observation: The Tavistock Model is a collection of twelve key papers from international contributors. It offers an overview of current practice, explores the new concepts that have arisen from direct observation, and shows how the findings from observation are being applied in the research setting. An essential text for child psychotherapists in training and practice, this is a book that brings alive the academic theories of child development through thought-provoking and stimulating case-studies which will be of interest to any professional working with children.

Chapter 1

Introduction

Psychoanalytic infant observation

Susan Reid

What is Infant Observation?

This chapter is intended primarily for the reader who is not familiar with the practice of infant observation. A fuller discussion of the functions and theory of infant observation is to be found in Closely Observed Infants (Miller et al. 1989).

The psychoanalyst, Esther Bick, pioneered the practice of psychoanalytic infant observation in 1948. It became part of the training programme for those students studying to become psychoanalytic child psychotherapists (Bick 1964). Later, in the 1970’s infant observation became part of a course of wider observational studies for many other professionals.

Each observation takes place in the baby’s home; ideally the observer meets the parents before the baby is born, and then visits the family for an hour each week until the second birthday. As far as is possible, these hourly visits are at the same time of day each week. A parallel is made with psychoanalytic clinical work itself in that the observer is instructed not to take notes during the observation, but instead to record, in as much detail as can be recalled, all the events that took place during that hour. The emphasis in this method of observation is on what is seen and felt during the observation, and premature attempts to explain and make formulations are actively discouraged.

What is the impact then, of this open-minded, naturalistic observation? The student is encouraged and supported to see what is there to be seen and not to look for what they think should be there. Initially this may be an alarming experience since it strips the observer of the usual competences which protect each of us from being taken unawares; the observer has no idea what he or she will see and therefore is exposed to a whole new level of perception of human relationships. This is both disturbing and exciting.

Mrs Bick realised the training potential of this naturalistic method of infant observation. It has steadily spread so that most psychodynamic psychotherapy trainings in Great Britain include it as a central requirement. This very distinctive approach to studying the development of babies within the family has also rapidly spread to the training of others in the helping professions, such as social workers, clinical psychologists and doctors, not only in this country but around the world. The last twenty years have seen an enormous increase in the academic study of infant development and the work of researchers such as Brazelton (Brazelton et al. 1974), Stern (1985), Trevarthen (1976) and Main and Hesse (1992) can be seen to complement the findings of this method.

Becoming an Observer

The start of an observation is difficult and disquieting for every observer. Each individual will have varying degrees and types of knowledge of how infants develop. Some will have a thorough grounding in theories of child development, some will already be parents themselves and thus will have had intimate contact with infants. Others will be experienced child care professionals. Each observer will of course, long ago, have been an infant, and although for most people conscious memories of the first two years of life are lost, these memories lie in waiting in the unconscious of each of us, ready to be evoked by intimate contact with the infantile experiences of another human being. It is well documented that parents find themselves deeply stirred by the experience of contact with their own infants. In most cases this can deepen their empathy with both the helplessness and the capacities of their own child – providing, that is, that they are not too emotionally overwhelmed by the experience and also have sufficient support in their own adult lives.

However experienced the new observer, beginning an observation is a great equaliser. It strips away much of what we thought we knew and exposes the ignorance and prejudices in each of us. To observe well, the observer has to relinquish their current professional identity. We discover how easy it is for activity in professional situations to mask anxiety and uncertainty, and even interfere with the best interest of our clients. We may also discover the liberation in thinking which follows upon the close attention to detail. It is likely to have a lasting influence on our subsequent professional lives when we discover how much an infant (and any other family member) responds positively to the experience of having our close attention upon them. We discover the real meaning of containment (Bion 1962), one of the most useful theoretical concepts ever developed to aid us in our understanding of what it is human beings need throughout life, in order to be able to function effectively. By adulthood, much of this capacity has been internalised – if we were fortunate in our caregivers in infancy. However, we continue to need containment by others at times of stress. We are always aware when someone is really attending to us, not merely going through the motions.

Containing another is a generous act, natural to the mother of the infant, unless she is emotionally overwhelmed herself. It means suspending temporarily our own needs and wishes in favour of those of another. It means putting our own mind at the disposal of another and, therefore, what we will be required to do for them may disturb our own equilibrium. Experiencing containment is to feel loved and cared for and may result in a responsive feeling of gratitude which initiates a loving or caring act in return. Sometimes gratitude is not felt because it is overwhelmed by envy; an envy of the capacity to do what we are unable to do ourselves. Where gratitude follows upon containment, then a benign cycle is set in place, supportive of healthy emotional development. Where containment is absent, or worse, the mother burdens the infant with her own unmet infantile emotional needs, then a pathological defensive system may be set up which arrests, or may pervert, healthy development.

The containment offered by the experience of being attended to closely is something we all know about; perhaps when a friend is able to listen and feel some distress of ours, and is able to bear knowing that they cannot change the external situation for us. What is changed, however, we know from experience, is our internal situation – we feel better. The external situation may well remain exactly the same but we feel differently about it. We are no longer alone and abandoned to distress, but have someone to share it with us. This experience is internalised and reinforces our sense of goodness in others and in ourselves. When the internal world is replenished in this way we, feeling sustained and nourished, may also find new resources to deal with a miserable situation. It may even shift our perspective, allowing us to discover, for ourselves, a new approach to the problem.

This is what underpins the psychoanalytic approach to therapy. Not the giving of advice, but the taking in, by the therapist, of everything that the patient needs to project at one moment in time. The act of thinking about, and feeling for, the patient may modify that projection, returning it in what Bion (1965) called a ‘transformed condition’.

Professionals exposed to the psychoanalytic approach to infant observation can incorporate this understanding into their own professional practice. We learn the true value of attention and considered reflection, and to limit action mostly to moments of crisis where to be inactive would be to expose our clients to risk. It enfranchises the person with whom we are working, supporting that individual in discovering what is best for them.

Exposure to psychoanalytic infant observation also helps in selection and self-selection for psychoanalytic training, helping individuals to see whether the pain of seeing clearly is sufficiently balanced by the pleasure of new insights into human relationships. To observe in this way is like having scales removed from one’s eyes – exciting and terrifying at the same time. It allows the possibility of generating new ideas and hypotheses, rather than looking for evidence to substantiate existing theories. It is an enormous shock for any observer to discover how little we really see, in ordinary situations, of what is going on. We see the surface of things, but not the deeper level of human interactions and communications. This is essential, of course, in the conduct of our daily lives. It is emotionally and intellectually demanding and exhausting to observe in the way I am describing. Indeed one might really say we were never intended to see in this way. Everyday relationships are essential to our survival – they probably cannot bear too close scrutiny – but for any professional working in the caring professions, the capacity for close and detailed observations (called upon in our different professional settings) makes us more effective in the service of our clients, pupils and patients.

The Role of the Infant Observation Seminar

Each observer is supported in this difficult endeavour by the seminar leader and other seminar members. Within an infant observation seminar group the teacher and seminar members are in a position to allow their attention to be free-floating and overarching, to travel back and forth in time. The observer, on the other hand, has been assiduously squirrelling away each nut of information and placing it in a time sequence in order subsequently to record a series of events observed. In this state of mind ‘poetic intuitions’ (see Eric Rhode, Chapter 5) can seem a mere distraction from the primary task. The seminar leader seeks to create a setting which allows space for appreciation of the actual observation, now firmly fixed on paper, and to support the free associations, ruminations and speculations of the observer and seminar members, to see what other dimensions remain to be discovered. This ‘state of mind’ of the seminar group is here analogous to the state of mind of the mother in ‘reverie’ (Bion 1962); making the distinction between a mindful mother and a mother who is only able to look after the baby’s physical needs. The role of the seminar leader is here again analogous to the ‘good mother’ whose task, as I see it, is to provide those conditions which are necessary to allow the baby gradually to discover the world (with due regard to safety), and their place in it, and not just to teach the infant what she knows. This is what Bion calls ‘learning from experience’: not to fill the baby’s mind up with the contents of her own, but rather to allow the infant to develop an original personality. Of course we all know that this is extremely difficult to do. Anxiety often pushes us to ‘inform the seminar’ (see Isca Wittenberg, Chapter 2), just as the mother can feel driven to inform or over-teach her infant, for fear that her child will not learn. Both mother and seminar leader fear that they will be revealed to be lacking. The state of mind necessary to allow the infant and seminar students to learn through the experience of personal discovery is optimistic, generous and hopeful.

There is pleasure to be found in the discovery that someone else will see events unfolding from a brand new perspective. This can engender real creativity; each individual builds up, in interaction with the outside world, their own internal world, unique to that individual. The discovery of another perspective has the potential, providing we are not overwhelmed by envy, to spark a fresh creation for each and everyone. It is the task of the seminar leader, just as it is the task of a mother, to create an environment in which it is possible for discovery to take place and for this to be a source of pleasure to all those concerned. Where mother or seminar leader becomes overwhelmed by anxiety there is a danger that growth may be crushed before it can flower. An example from an infant observation may illustrate this:

Mary enjoys a loving relationship with both parents. By the time she is almost 2 years old she is a confident, competent and creative little girl. Daddy has just arrived home and Mary wants him to play ‘horsey’. Dad is obviously not keen but offers to play later. Mum suggests that she and Mary sit together on the floor to play with Mary’s new plastic stacking cubes. The observer writes:

Mum gently shows Mary the new cubes, telling her ‘The red brick is the biggest, then the blue goes on next’. After a while Mum goes out into the kitchen to make Mary’s supper, telling her what she is doing. Mary carries on building a tower; as she picks up each cube she says to it ‘Is this one big?’ or ‘Is this one small?’ She shows each cube to me (the observer) before putting it in its place. From time to time she experiments, putting a small cube inside a bigger one and leaving it there. When the tower is finished, she knocks it down with a flourish and says It fell down!’ She is very amused by this. She then starts to build the tower again in just the same way, turning to look at me, very spontaneously and openly. At this point Mum comes back to see how Mary is getting on and points out the mistakes Mary has made in putting some small bricks inside big ones in building her tower. This time Mary smashes her tower with a sweep of her arm. She looks angry and confused. Mum looks slightly shocked and tells her off.

Mother unwittingly has crushed the baby’s creativity, an incipient poetic construction, which she has developed upon what mother has shown her to be the ‘properties of towers’ and what, in the past, she has discovered with mother’s support to be the ‘properties of bricks’. On this occasion pleasure, delight, concentration and imagination are destroyed by a careless comment from mother. Such careless comments, of course, are part of everyday life for any infant. No mother can be mindful of the baby’s needs and creative capacities all the time.

For each infant, and for each seminar group, the innate nature of the infant, or group, will determine how soon they ‘risk’ creativity again. Here we can see, illustrated by Mary’s response, the pleasure but risk involved in creativity, versus the pull to conformity. Will she in future only build a tower in the ‘proper’ way? Every new thought, idea or association produced by the seminar also has an element of risk attached to it. Each contribution is open to examination by the other seminar members, and each seminar member therefore needs to feel safe that their contribution will be dealt with respectfully.

Why do Infant Observation?

Infant observation re-exposes each observer to the emotional roller-coaster that constitutes the experience of infancy for each of us when discovering the world and our place in it. It is a pragmatic method of studying child development and differs fundamentally from reading texts on theories of child development.

Observers can learn first, from the experiences of their own observations and second, from the observations of their fellow seminar members, about the impact of sexual identity, family position, social class, race, culture and different child-rearing practices, on infant development. It sensitises the group to the impact of the emotional atmosphere within which a baby lives and grows, no matter which of these factors prevail.

When observing an infant in the family we discover the intimate details of the pleasures and pains of physical, cognitive and emotional growth for a particular child. These experiences can then be compared with the experiences of other infants observed within the same seminar group, and in turn inform a reading of the various theories of child development. It makes the reading of theories more dynamic, more interactive. Each observation is a small research study in its own right: stirring and challenging the observer intellectually and emotionally. Any subsequent readings will therefore be in a more critical, reflective state of mind. Experiences from infant observation may therefore support us in challenging aspects of received wisdom – to change or add to a body of knowledge. Such critical faculties are essential for us all, whatever our professional background, if we are to develop our understanding of human nature. They are essential for psychoanalytic practitioners if we are to extend the range of our work and increase our effectiveness with our patients. Without them we would not have moved on from Freud’s discoveries. Insights gained from infant observation have informed changes in technique, making it possible to work more effectively with patients who are hard to reach or who would previously have been considered unsuitable for psychoanalytical psychotherapy.

Sometimes not being able to see what is really happening is powerfully destructive of the emotional development and mental health of countless individuals. The Robertsons’ observational films, made in the 1950s, have been influential in underlining the ‘blindness’ of society as a whole to the suffering and damage which lengthy, traumatic hospitalisations and separations could do.

The Robertsons’ films reveal something so unbearably painful that there is a collusion not to see what is really there to be seen, unless the pain of seeing clearly can be channelled usefully. It becomes clear, then, that to observe in this way is to bear witness.

What...

Table of contents

• Cover Page
• Half Title page
• Dedication
• Title Page
• Copyright Page
• Contents
• Notes on contributors
• Preface
• Acknowledgements
• Chapter 1 Introduction Psychoanalytic infant observation
• Part I The practice of infant observation
• Chapter 2 Beginnings The family, the observer and the infant observation group
• Chapter 3 Shared unconscious and conscious perceptions in the nanny-parent interaction which affect the emotional development of the infant
• Chapter 4 The meaning of difference Race, culture and context in infant observation
• Part II Theoretical developments
• Chapter 5 First light Knowing the infant as an actuality and as an idea
• Chapter 6 Moments of discovery, times of learning
• Chapter 7 Thoughts on the containing process from the perspective of infant/mother relations
• Chapter 8 Speculations on components in the infant's sense of agency The sense of abundance and the capacity to think in parentheses
• Chapter 9 Psychosomatic integrations Eye and mouth in infant observation
• Chapter 10 Interplay Sound-aspects in mother–infant observation
• Part III Research developments
• Chapter 11 Observed families revisited – two years on A follow-up study
• Chapter 12 Observing when infants are at potential risk Reflections from a study of five infants, concentrating on observations of a Bengali infant
• Endpiece
• Index