EDUCATION SECTION: Infant observation in Britain:The Tavistock approach

The author draws attention to something distinctive in the psychoanalytic 'air' from the early 1960s onwards: the strong emphasis upon the very early psychological, emotional and cognitive view of infants and young children. She focuses on the work of two analysts in particular, Esther Bick and Wilfred Bion, and the comparable, though differently expressed, centrality of the observational method in their work. Each explored not only the pathological picture but also the nature and integrative function of psychic containment in earliest mental life. Each also shared a preoccupation with what constituted a psychoanalytic attitude and with the process of becoming a psychoanalyst and, in Bick's case, a child analyst or psychotherapist. The author provides an historical background to the idea of observation, followed by an account, with detailed examples, of the nature of infant observation and the observational method as taught and practised at the Tavistock Clinic, London since the late 1940s, and subsequently in many other training institutions. Here the themes of Bick and Bion are constantly interrelated such that the prototype or model for the creation of emotional meaning and thought can be appreciated and learning from experience can take place.     

Parent Anxiety and Infant Pain During Pediatric Immunizations

Infants’ procedural pain and parents’ treatment room anxiety has been largely ignored in the research and clinical domains. To understand and manage infant procedural pain, it is essential to examine the correlates and potential predictors of this pain. Given that parent anxiety is a strong predictor of preschoolers’ procedural anxiety and pain, it is likely that parents play a role in infants’ distress during medical procedures. The purpose of this study was to thoroughly examine parent anxiety and its effects on infant procedural pain for 37 parent-infant dyads. Results demonstrated that only parent self-report measures were intercorrelated and several measures of parent distress correlated with measures of infant distress. Treatment implications and recommendations for future research are discussed.This article is based on the master's thesis of the first author under the direction of the second, at West Virginia University.     

Stressed parents: a dyadic perspective on perceived infant temperament

The study employed the actor–partner interdependence model (APIM) to test whether one parent's experiences of recent life events as more stressful (the PSS) are associated with the same parent's own (the actor effect) and the other parent's (the partner effect) perceptions of the infant temperament as more negatively and/or less positively tuned (the IBQ; n=584 parents, 292 dyads). The results indicated that the more stress one parent reported the more negatively tuned were the same parent's own, and the other parent's perceptions of the infant. Perceptions of the infant temperament were least positive for members of parent dyads who were more, relative to less, similar in the experienced stress. The associations were independent of the parent gender and the parent‐reported level of trait anxiety. The findings augment prior knowledge on the factors that steer parental perceptions, and suggest that the dyadic perspective may offer valuable insight into the dynamics of interacting within a family consisting of two biological parents and an infant. Copyright © 2006 John Wiley & Sons, Ltd.     

Parent–Infant Synchrony: Biological Foundations and Developmental Outcomes

ABSTRACT— Synchrony—a construct used across multiple fields to denote the temporal relationship between events—has been applied to the study of mother–infant interaction and is suggested here as a framework for the study of interpersonal relationships. Defined as the temporal coordination of micro-level social behavior, parent–infant synchrony is charted in its development across infancy from the initial consolidation of biological rhythms during pregnancy to the emergence of symbolic exchange between parent and child. Synchrony is shown to depend on physiological mechanisms supporting bond formation in mammals—particularly physiological oscillators and neuroendocrine systems such as those involving the hormone oxytocin. Developmental outcomes of the synchrony experience are observed in the domains of self-regulation, symbol use, and the capacity for empathy across childhood and adolescence. Specific disruptions to the parameters of synchrony that may be observed in various pathological conditions, such as prematurity or maternal affective disorder, are detailed. A time-based, micro-analytic behavioral approach to the study of human relationship may offer new insights on intersubjectivity across the lifespan.     

早产儿预防性应用抗生素的临床决策思路

近年来,随着对滥用抗生素所引起的细菌耐药性和二重感染的认识的逐步深入,预防性应用抗生素在临床上越来越受到限制。但由于早产儿感染的临床隐匿性和易并发严重并发症等特点,预防早产儿感染的发生和进一步的发展,就显得尤为重要。通过对早产儿发生感染的易感因素、感染诱因和临床特点的分析研究,来探讨早产儿临床预防应用抗生素的必要性、合理性及临床决策思路。     

'Talk to me baby, tell me what's the matter now': Semiotic and developmental perspectives on communication in psychoanalytic infant treatment

Infants suffer to a considerable degree from disturbances in nursing, sleep, mood, and attachment. Psychotherapeutic methods are increasingly used to help them. According to case reports, psychoanalytic work with infants and mothers has shown deep‐reaching and often surprisingly rapid results, both in symptom reduction and in improved relations between mother and child. The clinical urgency of the method makes it important to study its results and theoretical underpinnings. Among the theoretical issues often raised in discussions on this modifi ed form of psychoanalysis, those addressing the nature of communication between analyst, baby, and the mother are the most frequent. For example, how and what does an infant understand when the analyst interprets to her? What does the analyst understand of the infant's communication? These issues are addressed by investigating the infant's tools for understanding linguistic and emotional communication, and by providing a semiotic framework for describing the communication between the three participants in the analytic setting. The paper also investigates problems with the traditional ways of using the concept of symbolization within psychoanalytic theory. The theoretical investigation is illustrated by two brief vignettes from psychoanalytic work with an 8 month‐old girl and her mother. demand for the breast. Like the two lovers in the blues, they seemed to be slaves to     

Semiotic transformations in psychoanalysis with infants and adults

The author addresses issues that emerge when we compare psychoanalytic experiences with adults and with infants. Two analyses-one with a 35 year-old woman and one with a 2 week-old boy and his mother-illustrate that infant psychoanalytic experiences help us understand and handle adult transference. However, we cannot extrapolate infant experiences to adult work. Truly, witnessing the baby's communication widens our sensitivity to non-verbal layers of the adult's communication. Infant work also offers a direct encounter with the container and the contained personified by a mother with her baby. But we need to conceptualize carefully the links between clinical experiences with babies and adults. When we call an adult transference pattern 'infantile', we imply that primeval experience has been transformed into present behaviour. However, if we view the analytical situation as one in which infantile invariants have transformed into adult symptoms, we face the impossible task of indicating the roots of the present symptoms. The author rather suggests that what is transformed is not an invariant infantile essence but signs denoting the patient's inner reality. He proposes we define transformation as a semiotic process instead of building it on an essentialist grounding. If we view the analytic situation as a map of signs that we translate during our psychoanalytic work, we can proceed into defining containment as a semiotic process. This idea will be linked with a conceptualization of the mother-infant relation in semiotic terms.     

Infant observation: A range of questions and challenges for contemporary psychoanalysis1

The author attempts to integrate several perspectives within the field of infant observation that reflect the analyst's personal experience as a clinician, as a professor at the analytic institute and as a researcher in the field of psychoanalysis. Can infant observation contribute to analytic technique, theory and training? If so, what would be the nature of such contribution? To answer these questions, the author reviews the literature on infant observation from Freud to the present, highlighting Latin American contributions to this subject. She makes reference to the role of technological innovations, which have allowed videotaping, repeated observations, temporal segmentation and computerized programs, thus giving rise to microanalytic research. This discussion prompts the question about the contributions made by systematic research to clinical practice. To tackle this question, the author presents both a clinical vignette taken from her personal experience, and the current debate on this subject as it appears in the work of Daniel Stern and André Green. Finally, she presents some conclusions that are part of an ongoing debate in the psychoanalytic field.     

婴儿面孔偏好理论模型述评

在婴儿早期的视觉经验中,面孔是最特殊的一类刺激,小婴儿从出生开始就喜欢看面孔,这种现象称为面孔偏好。面孔偏好的发展反映了婴儿知觉能力的发展规律,具有重要的社会化意义。该文系统介绍了线性系统模型、右脑优势模型、CONSPEC理论、视觉模块理论和非特异化识别理论5种最主要的婴儿面孔偏好理论,并对这些理论的区别和联系进行了探讨。最后,对面孔偏好研究的新趋势和未来方向进行了评价和展望     

The relation between 3‐ and 15‐month olds' cry vocalizations and their mothers' affective involvement during inoculation

This study examined if infant immunization distress is related to their mothers' affective involvement prior to the injection. The duration of infant cry vocalizations and the amount of maternal behaviour before and after the syringe injection were observed in 18 mother–infant dyads, of whom nine comprised 3‐month‐old and nine 15‐month‐old infants. The maternal behaviour was scored in terms of various soothing strategies used to calm infants in distress. Infant cry duration, in both the 3‐ and the 15‐month olds, was associated with amount of maternal eye‐gaze before the injection. For the 15‐month olds, also face‐to‐face contact and rocking the infant was associated with more crying. Even though the small scale of the study warrants some caution in the interpretation, the overall findings suggest that young infants have a referential understanding of caregiver affective involvement prior to a stressor. Copyright © 2007 John Wiley & Sons, Ltd.