The dangers and deprivations of too-good mothering

The paper explores Winnicott's ideas on the detrimental effects of mothering which is too well adapted to infant needs. Winnicott claimed that such too-good mothering, when pursued beyond the baby's earliest months, led to two possible outcomes: the child would either reject the mother or would remain in a state of arrested development, merged with her. The paper follows the development of a baby girl, observed by the Bick method, and illustrates how her mother's devoted and sensitive care effectively deprived her of the development of some aspects of the sense of self and of possibilities for negotiation, concern and reparation. The baby developed a paranoid orientation and later rejected her mother after the birth of her sister. The paper also mentions the alternative outcome of a persisting state of passive merger with the mother and ends by hoping for further exploration of the means by which some sensitive, responsive parents may inadvertently ‘worse than castrate’ their children by depriving them of an autonomous sense of agency.     

Anxiety across the transition to parenthood: change trajectories among low-risk parents

Background and Objectives: A number of sources suggest changes in anxiety across the transition to parenthood may be experienced by parents in different ways, yet no studies have examined whether new parents experience changes in anxiety in distinct subgroups. Design: We conducted a longitudinal study of 208 first-time parents (104 couples) from a low-risk population. Parents were interviewed from the third trimester of pregnancy to nine-months postpartum. Methods: The current study utilized latent class growth analysis to explore subgroups of change in symptoms of anxiety. Based on stress and coping theory, we also examined a number of personal and social prenatal predictors of subgroup membership. Results: We identified two distinct change trajectories: (1) moderate and stable and (2) low and declining. We also found prenatal depression, expected parenting efficacy, and relationship satisfaction were significantly associated with subgroup membership. Conclusions: Our results suggest a majority of new parents adjust well to parenthood in terms of anxiety, while a smaller subgroup of parents experience continually higher levels of anxiety months after the baby is born.     

The role of a parent's illness in the emotional experience of a child evidence from Klein's Narrative of a child analysis

Abstract

The analysis of Richard, described by Melanie Klein in Narrative of a Child Analysis, gives us some insight into the effect on a child of threats to the health of his parents. His mother was involved in a road accident when Richard was 2; his father collapsed during the time of the analysis when he was 10. This paper links these events with disturbances in Richard's relation to his father and to his mother, as well as with threats to his own integrity, as demonstrated in the analysis. Richard's reversal of roles with his father and mother is discussed, as are Klein's reaction to Richard's report of finding his father ‘ill and nearly fainting’ and Richard's response to her behaviour. The paper draws attention to the way in which a child's reaction to the ill health of one parent can affect relations with both parents, as well as disturbing his sense of himself.     

Mother as Messenger of Love and Death

For mothers, the act of giving birth also brings them close to death as well as other human experiences. The mother represents the dual structure of life and death in the mind. It was this unconscious convergence that stirred the interest in reconsidering the subject of the loss of children and its effect on individual development. This article demonstrates what happens when death triumphs over life chronologically close to birth. The author presents a clinical report on a six-year-old girl, Dinah, who suffered the effects of the mother's mourning. She illustrates the therapeutic approach to mourning over time, at moments in which the shadow of pain is more clearly present. These are moments when the loss must be brought to consciousness, because of the unconscious effects it has on the survivors. Dinah's problems were not caused by the loss itself, but rather the fact that the loss occurred in a phase of her emotional development when she was only a baby an unable to react in a mature manner.     

How New Knowledge About Parenting Reveals the Neurobiological Implications of Intersubjectivity: A Conceptual Synthesis of Recent Research

Observations of early mother–infant interactions have shown that intersubjectivity is a primary motivation and have underscored the importance of maternal competencies in this development. In our paper we propose a conceptual overview of the different perspectives according to which parental caregiving has been formulated. Psychoanalytical theory has fundamentally promoted the exploration of maternal and paternal intrapsychic constellation, by stressing the role of unconscious processes in parental attitude as well as in infant development. In contrast with psychoanalytical theory, the conceptual framework of attachment has mostly considered real interactions between parents and infant, underlining parental abilities in providing the infant with a secure base. Finally, infant research has explored the complexity of communicative system between parents and infants, which appears already active from the birth of the baby. Recently, these different viewpoints have been broadened by neurobiological research, which has begun to explore maternal brain functioning and structure, by means of new scientific instruments such as fMRI techniques. From these perspectives, we provide an overview of motherhood, underlining both neurobiological and psychological transformations, which begin from pregnancy and run through the first year of the infant, when the mother–infant intersubjective matrix is built. This matrix influences the construction of the infant's Self and support the development of the sense of “we,” a sort of connective net, which ties the baby to parents, letting him feel as a part of the familiar world.     

Maternal intrusion: Its roots and consequences

Abstract

Behind an intrusive mother’s view of her actual child lies a disproportionate, hidden desire to revive an ideal relationship with a perfect mother. The resulting image of an idealized child then becomes a strategic aspect of the mother’s own identity, representing an idealized figure from her own past. As the mother’s idealization is disturbed by the reality of the child, the mother experiences the situation between herself and the baby as “pathological,” that is, disruptive to her. She then attempts to repair the idealization by resisting any change in the status of her relationship to her child, even as the child grows older. Her rigidity in this regard necessarily excludes a paternal presence that could challenge or change the mother–infant idealized dyad. The mother’s orientation is also contradictory to, and acts as a resistance to, psychoanalytic therapeutic interventions, which aim at any “change.”     

The Moro reaction: More than a reflex,a ritualized behavior of nonverbal communication

ObjectiveTo propose a phylogenetic significance to the Moro reflex which remains unexplained since its publication in 1918 because both hands are free at the end of the gesture.MethodAmong the 75 videos of healthy term newborns we have filmed in a research project on antenatal education to parenthood, we describe a sequence that clearly showed the successive movements of the Moro reflex and we report the occurrence of this reflex in the videos that were recorded from Time 0 of birth defined as the moment that lies between the birth of the thorax and the pelvis of the infant.ResultsThe selected sequence showed the following succession of the newborn’s actions: quick extension-adduction of both arms, the orientation of the body, head and eyes towards a human person, and full extension-abduction of both arms with spreading of the fingers, crying and a distressed face. There were 13 Moro reflexes between 2 and 14 s from Time 0 of birth. We found a significant association between the occurrence of the Moro reflex and the placement of the newborn at birth in supine position on the mother’s abdomen (p = 0.002).DiscussionThe quick extension-adduction of both arms which started the sequence may be considered as a startle reflex controlled by the neural fear system and the arm extension-adduction which followed as a Moro reflex. The characteristics of all Moro reflexes were those of ritualization: amplitude, duration, stereotype of the gestures. This evolutionary process turns a physiological behavior, grasping in this case, to a non-verbal communicative behavior whose meaning is a request to be picked up in the arms. The gestures associated with the Moro reflex: crying and orientation of the body, head, and eyes towards a human person, are gestures of intention to communicate which support our hypothesis. The neural mechanism of the Moro reaction probably involves both the fear and the separation-distress systems.ConclusionThis paper proposes for the first time a phylogenetic significance to the Moro reflex: a ritualized behavior of nonverbal communication. Professionals should avoid stimulating the newborns’ fear system by unnecessarily triggering Moro reflexes. Antenatal education should teach parents to respond to the Moro reflexes of their newborn infant by picking her up in their arms with mother talk.     

Sander’s Life Work,on Mother-Infant Vitality and the Emerging Person

ABSTRACT

In the 1960s, partly a result of the availability of television for micro-analysis of life in spontaneous communication with infants, there was a revolution in the scientific understanding of how the human mind grows. The inquisitive and responsive way a healthy baby moves shows that humans are born for intimate sharing of interests and feelings that are essential for acquiring cultural habits and understanding, including language. A newborn infant was found able to provoke and imitate emotional expressions and responses of another person, and an affectionate mother is ready to make her special contribution to joyful episodes of dialogue with rhythms and emotions that confirm the baby’s interest and eagerness to participate. A leader in this work was the psychoanalyst and neonatologist Louis Sander. His sensitive support and observation of how mothers with different personalities and degrees of self-confidence respond to a young baby’s expressions of need for companionship proved their health is adapted to share and support the expression and growth of impulses for human living.     

The Prenatal Lausanne Trilogue Play: A New Observational Assessment Tool of the Prenatal Co‐Parenting Alliance

The goal of this study is to present a new observational assessment tool, the prenatal Lausanne Trilogue Play situation (LTP). Expectant parents were asked to role play their first meeting with their baby using a doll, and the videotaped interaction was subsequently coded. Scores were correlated with measures of the couples' marital satisfaction as well as the postnatal family alliance 3 months after the baby's birth. Results showed that the prenatal co‐parenting alliance was positively linked to both fathers' marital satisfaction as well as to the postnatal family alliance at 3 months. Thus, the prenatal LTP allows for assessment of the prenatal co‐parenting alliance at the interactional level. It predicts the place the parents will afford their baby after birth and can contribute to methods of clinical assessment and prevention.     

(Spi)ritual interaction in musical activity for infants in the church space – a qualitative analysis

Abstract

Early mother–infant interaction has been seen as very important for the development of religiosity and spirituality. This case study examines one specific musical activity for infants and mothers from the perspective of human interaction. The studied activity is ‘Babysalmesang’, or baby hymn singing (BHS), within the Evangelical Lutheran Church in Denmark. Meetings are held in church buildings and include singing hymns and other songs, playing in and exploring the church space. The qualitative empirical data on BHS activities were collected through video recording, observing and interviewing. The initial analysis on the data showed that four types of interaction can be found: mother–infant interaction, interaction between the participants, interaction between the participants and instructors and ritual interaction. BHS can be seen as a space for (spi)ritual interaction. In this context, nurturing spirituality combines with religious elements. Together with mother–infant interaction, also other types of interaction might nurture spirituality in early childhood.     

A new look at the vulnerability of puerperal mothers — A clinical study of two inpatient families at the Cassel Hospital

SUMMARY

The paper reviews some previous writings by Dr. Tom Main and Dr. Peter Lomas about the work of the Cassel Hospital with puerperal mothers. It goes on to describe the case histories and treatment of two patients recently treated with their families. The emphasis is on actual material produced in therapy but with reference to other aspects of the much wider treatment structures employed by the Cassel, for example the nursing and the community. Important aspects focussed upon include the essential experience of good mothering in becoming a mother, how closeness to the infantile impulses and urges of a real baby can lead to profound measures of identification and projection, and the effects of motherhood on femininity and sexuality.     

Exploring predictors of change in behavioral problems over a 1-year period in preterm born preschoolers

ObjectiveAlthough predictors of the prevalence of behavioral problems in preterm-born children have been frequently studied, predictors of behavioral change in these children remain unknown. Therefore, in this study we explore predictors of short-term changes in problem behavior in preterm-born preschoolers, an age period characterized by rapid behavioral change.MethodTwo- to 5-year-old children born with a gestational age <32 weeks and/or birth weight <1500 g were eligible, because of their high risk for behavioral problems. Following screening, 59 children with a t-score ≥60 on either the internal, external or total problem scale of the Child Behavior Checklist were included in the study. Linear mixed modeling was used to investigate predictors of change in behavior over a 1-year period.ResultsHigher levels of parenting stress, parent perceived child vulnerability, and parental hostility towards the child and lower educational levels of the mother significantly predicted increases in externalizing behavior. The higher the age of the child, the more internalizing problems decreased.ConclusionsParenting stress, parent perceived child vulnerability and parental hostility towards the child were the only modifiable predictors of increases in externalizing behavior, whilst no modifiable predictors of internalizing behavior were found. There may be a reciprocal interaction between stress in parents and child externalizing problems. Furthermore, stress and worries may directly influence parents’ reports on behavioral measures, because it could cause them to be concerned by behavior otherwise perceived as normal. Therefore, future interventions for parents of preterm-born children should primarily address parental stress and concerns regarding their child.     

The effect of preterm birth on infant negative affect and maternal postpartum depressive symptoms: A preliminary examination in an underrepresented minority sample

ObjectiveTo examine the effect of preterm birth on maternal postpartum depressive symptoms and infant negative affect in an underrepresented minority sample.MethodParticipants were 102 mothers and their 3- to 10-month-old infants. Mothers completed the Edinburgh Postnatal Depression Scale and the Infant Behavior Questionnaire-Revised.ResultsRelative to normative samples, the current underrepresented minority sample of mostly Hispanics and Blacks displayed high rates of preterm birth (30%) and maternal postpartum depressive symptoms (17%). Preterm birth had a significant direct effect on postpartum depressive symptoms and infant negative affect. Additionally, there was an indirect effect of postpartum depressive symptoms on the relation between preterm birth and infant negative affect. Specifically, lower birth weight and gestational age predicted higher levels of depressive symptoms in the mother, and higher levels of depressive symptoms in the mother, in turn, predicted higher levels of infant negative affect.ConclusionFindings emphasize the importance of screening for postpartum depressive symptoms and infant negative affect among mothers and their preterm infants, especially among families from underrepresented minority backgrounds.     

Student volunteer social support and infant intervention: A case study

The emphases in infant mental health have been in the three areas of supporting the mother-infant dyad through education, psychotherapy to help parents resolve emotional conflicts that interfere with the parent-infant interaction, and support during the acute crisis that follows an abnormal birth. The case described herein involves a child with a genetic defect born to competent parents, a chronic stressful situation that does not fit these categories. It became apparent in the first few months after the birth that both the child and parents were in need of some help in coping with the situation. An intervention was designed to help provide both the necessary stimulation for the baby and the needed emotional support for the family, while it acknowledged their skill and competencies as parents. This was done through the help of college student volunteers, who assisted the mother in the home. Developmental data recorded at birth, 7 months, 12 months, and 39 months indicate that the child is severely multiply handicapped. Interview data with the parents at those times document their personal and family difficulties, the eventual resolution as a family in dealing with this problem, and the importance of the volunteer help during that process.     

French translation and validation of the Karitane Parenting Confidence Scale

IntroductionPerceived parental self-efficacy (PSE) is thought to play a crucial role in parental well-being, the parent-infant relationship, and other aspects of infant development, particularly in the early postnatal period. The Karitane Parenting Confidence Scale (KPCS) is a 15-item self-report questionnaire designed for parents with infants aged 0–12 months.ObjectiveTo explore the factor structure of a French translation of the KPCS and assess its psychometric qualities.MethodUsing a French-language translation of the KPCS (KPCS-F), 257 parents of children aged 0–12 months were recruited via childcare structures (e.g. nurseries, community centers, mother and child protection centers). Confirmatory factor analyses (CFA) were conducted to examine 2- and 3-factor solutions for the KPCS-F scale. Internal reliability and convergent validity were evaluated.ResultsThe best model was a two-factor solution (PSE “infant care” and PSE “parental role”) restricted to 12 items. Sound internal consistency was indicated, with a Cronbach's alpha coefficient of 0.80 and a McDonald's omega coefficient of 0.80. Test-retest reliability was good. KPCS-F score was correlated with social support and psychological well-being scores.ConclusionThe KPCS-F showed substantial validity and reliability for this sample. The translated scale should therefore improve assessment and intervention processes for professionals working with parents of young children.     

A Preliminary Investigation of the Assessment and Treatment of Tantrums With Two Post-Institutionalized Romanian Adoptees

A functional analysis of tantrums was carried out with 2 children who were adopted from state-run Romanian orphanages. Tantrums included such behaviours as screaming, property destruction, self-injury and aggression. The functional analysis was conducted in an outpatient treatment unit and consisted of exposing the child and mother to a number of specific social contexts that were designed to identify social consequences maintaining tantrums. These social contexts were alternated rapidly in a multi-element design fashion during the outpatient assessment to demonstrate experimental control. Results indicated that tantrums were maintained by attention from the mother when the mother's attention was diverted away from the child (i.e. when the mother was interacting with another person). A treatment plan, which consisted of the mother delivering frequent but brief attention statements to the child during diverted attention contexts eliminated tantrums during the assessment. Follow-up evaluations for up to 6 months indicated that parents used the treatment plan and that tantrums were no longer a difficulty with these children.     

Difficulties in the Treatment of Depression During Pregnancy and Postpartum Depression

Treatment with women who become depressed during pregnancy or who develop postpartum depression can be challenging. In certain cases where women have a poor parental representation rooted in a negative relationship with their own mothers, a powerful resistance emerges and can take the form of abandoning the treatment. For women who have a history of abandonment by one of the parents, this particular aspect of the relationship may be repeated. In others, where there is a great deal of anger towards the parent, in spite of conscious wishes to be different, there is an identification with this negative parental image; the new mother feels herself to be a bad mother and flees the treatment as a way to protect the baby. Biological as well as psychological factors present during pregnancy and postpartum depression, as well as the impact of the mother’s depression on the developing infant are described and clinical vignettes are provided to illustrate the main points.     

A Child Mourns the Family He Cannot Come From1

ABSTRACT

This article investigates the clinical material from the analysis of a young adolescent who was conceived using artificial reproduction techniques (ART). After reviewing the scant literature regarding how a child is conceived through the use of ART, the use of the term birth other is employed to understand this child’s longstanding sadness and sense of isolation. The material from his analysis demonstrates that the meaning of birth other as Eherensaft suggested (2005, 2007) is not the only meaning that an individual can assign to his experience. This child created a fantasy of a family from which he felt excluded because his parents had birth other families within which they were conceived. The material indicated that his attempt at mourning his lack of a genetically based family in a way that not even adopted children often mourn, occurred only in an unconscious manner, inhibiting him from focusing on more age-appropriate concerns. The psychological issues that he brought to his analysis clearly reflected the complexity of the circumstances of his birth and that he felt he existed outside of a family that he could identify with.     

The welcome baby program: A community-based volunteer prevention model of caring,sharing, and support for new parents

Primary prevention is one of the most important components of any community child abuse and neglect program. Welcome Baby is a community-based, volunteer primary prevention program that offers caring, sharing, and support to parents of newborns through hospital visitation and follow-up contacts during the adjustment period that surrounds the birth of a baby. Program goals include personal support for the new mother, prevention of child abuse and neglect by providing support and information for all parents, reinforcement of strengths and support for quality parenting, improving emotional preparation for parenthood, and early identification and intervention for families with the potential for maltreatment. Program rationale and conclusions agree with research findings that early and consistent support and intervention with high-risk families improve the quality of parent-child interaction and significantly reduce the risk of maltreatment. This article outlines the basic philosophy, goals, and operations of this community prevention program.     

A longitudinal examination of stressors,appraisals, and coping in youth swimming

PurposeInvolvement in sport has the potential to cause athletes, coaches, and parents to experience stress. However, the extent to which experiences of stress are shared within the athletic triad is unknown. The purpose of this study was to examine the individual and shared stress experiences among youth swimmers, their mothers, and coach within the context of training, tapering, and competition.DesignMulti-case study design.MethodFour female swimmers, their mother, and one coach completed daily diaries for six weeks and up to three semi-structured interviews. Data were analyzed through within- and cross-case thematic analysis.ResultsThe study showed evidence of shared stress experiences between all three members of the athletic triad. Participants predominately encountered organizational stressors, which they appraised in relation to movements between squad, interpersonal relationships, and overall progress towards performance goals/outcomes. Numerous coping strategies were employed by participants, with varying degrees of effectiveness, such as seeking social support, distancing, and lift sharing. The coping strategies used by coaches, swimmers, and parents were often interrelated with participants frequently seeking emotional support from one another. The majority of stressors and appraisals cited by parents and swimmers were shared, with both heavily relying on social support to help each other cope with the stressors encountered.ConclusionAthletes, parents, and coaches have the capacity to influence one another's stress experiences and as such their experiences should be considered simultaneously to maximize the impact of interventions.