TEMPERAMENTAL ADAPTABILITY,PERSISTENCE, AND REGULARITY: PARENTAL RATINGS OF NORWEGIAN INFANTS AGED 6 TO 12 MONTHS,WITH SOME IMPLICATIONS FOR PREVENTIVE PRACTICE

There is a need for standardized measures of infant temperament to strengthen current practices in prevention and early intervention. The present study provides Norwegian data on the Cameron‐Rice Infant Temperament Questionnaire (CRITQ; J.R. Cameron & D.C. Rice, 1986a), which comprises 46 items and is used within a U.S. health maintenance organization. The CRITQ was filled out by mothers and fathers at 6 and again at 12 months as part of a longitudinal study of mental health during the first years of life (the “Little in Norway” study, N = 1,041 families enrolled; V. Moe & L. Smith, 2010). Results showed that internal consistencies were comparable with U.S. data. The temperament dimensions of persistence, adaptability, and regularity had acceptable or close‐to‐acceptable reliabilities in the U.S. study as well as in this study, and also were unifactorial in confirmatory factor analysis. These dimensions are the focus in this article. Findings concerning parents’ differential ratings of their infants on the three dimensions are reported, as is the stability of parents’ ratings of temperament from 6 to 12 months. In addition, results on the relation between temperament and parenting stress are presented. The study suggests that temperamental adaptability, persistence, and regularity may be relevant when assessing infant behavior, and may be applied in systematic prevention trials for families with infants. The inclusion of concepts related to individual differences in response tendencies and regulatory efforts may broaden the understanding of parent—infant transactions, and thus enrich prevention and sensitizing interventions with the aim of assisting infants’ development.     

IMPLEMENTATION OF AN EVIDENCED‐BASED PARENTING PROGRAM IN A COMMUNITY MENTAL HEALTH SETTING

The process of mental health intervention implementation with vulnerable populations is not well‐described in the literature. The authors worked as a community‐partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low‐income community. We used qualitative ethnographic methods to document the adaption of an evidence‐based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic. Seventeen mothers and their identified 0‐ to 84‐month‐old children were enrolled in the study. Key lessons from this implementation include (a) the importance of formative work to build community relationships and effectively adapt the intervention to meet the needs of the therapists and their clients, (b) the importance of designing plans for training and reflective supervision that fit within the flow of the clinic and can tolerate disruptions, and (c) that use of an interdisciplinary approach is feasible with the development of a plan for communication and the support of a trained reflective clinical supervisor. These key lessons advance the scientific knowledge available to healthcare managers and researchers who are looking to adapt mental health clinical interventions previously tested in clinical trials to implementation in community settings.     

FOOD NEGLECT AND INFANT DEVELOPMENT

The impact of food insecurity on child development in the general U.S. population is well‐established, yet little is known about the harm of food neglect relative to other types of maltreatment. Due to the harmful physiological impact of inadequate nutrients and the social impact of food‐related stress, it was hypothesized that food neglect would be more likely to impair infant cognitive and language development than physical abuse, sexual abuse, and other forms of neglect. Families of infants (N = 1,951) investigated by Child Protective Services were studied using the second cohort of the National Survey of Child and Adolescent Well‐Being (NSCAW II; NSCAW Research Group, 2002). Results from multivariable logistic regression models that controlled for likely confounding variables showed that the odds of impairment in cognition and language were significantly greater when food neglect was the most serious form of maltreatment. Considering that both food insecurity and child neglect are associated with poverty and parental mental health problems, it will be important for child welfare and mental health professionals to work collaboratively to better the health of these vulnerable children.     

The agony of integration and the blessings of finitude – facing ‘extinction points’ and moments of madness

This paper explores the inevitable pain that integration requires in our individuation process. The unspeakable agony we defended against in order to survive we now experience consciously, including moments of going out of existence at the core of our madness. Clinical examples are given of these ‘extinction points’ and the abject helplessness analysand and analyst suffer in the face of this destructiveness. The first and second witness to this process (usually the analyst and the psyche itself) and the primordial creative life force are recognized in the process of recovery, a recovery that recoups the blessings of our finite human living.     

Analytic attitude – focus or embodiment? Subtle communications in the transference/countertransference relationship

The paper considers a ‘befallment’ that occurred in the course of analysis at a time when the focus of work was too much at a conscious level, dissociated from the patient’s embodied and visceral depths. A rigidly held attitude of focal attention is considered as potentially a defence against embodied experiences of overwhelm and vulnerability that may haunt shadowy realms which remain unlit by the narrow beam of conscious awareness. Rather as a dream drifts in from the unconscious, an enactment by the analyst brought neglected aspects of the transference and countertransference relationship into the room. Later, the patient’s own dreaming mind offered images that suggested an underlying dynamic. These subtle communications, alongside the patient’s attitude toward the analyst’s lapse, are considered as factors in the achievement of greater embodied integration. The analyst’s difficulty in arriving at a formulation of such events is discussed, along with the necessity of holding such ‘befallments’ in mind over long periods of time before any explanation can be adumbrated.     

Moving towards Soul – an alchemical journey. Rehabilitation of women suffering from ‘chronic pain’ in a clinical and Jungian context

The aim of this paper is to explore the connection between symptom and symbol in the body of women suffering from chronic pain, diagnosed as fibromyalgia. The working hypothesis has been that the symbol that emerges from the symptom in the body can bridge the gap to a deeper meaning of pain and suffering, thereby becoming the agent of change for healing of the bodymind and the experience of pain in the physical body. To explore this subject I will introduce some recent research from the field of fibromyalgia, and the concepts of agency and affect systems in the body, which are important cornerstones in my work. I will briefly present my clinical concept of ‘Form and Freedom’. From this theoretical base I give some clinical examples of what I see as an alchemical journey towards soul, presented through vignettes, images and the words of three women – Maria, Riba and Ishtar. I conclude with how I see analytical psychology taking its rightful place alongside, informing or in conjunction with, as in my case, other psychotherapeutic modalities, working in creative ways that enhance healing in patients who suffer from chronic pain.