The Milan Approach,History, and Evolution

The two authors intend to underline the continuities and discontinuities that organize the Milan Approach, after the splitting from Selvini Palazzoli and Prata; they intend to tell the teachings of Luigi Boscolo and Gianfranco Cecchin from the beginning of training in 1978 till nowadays. After having spoken of some important stages in the work till the death of the two masters, the article underlines two major new aspects. 1. We speak about the corporeal turn: embodied experience as preconceptual know‐how from which concepts are structured. We speak about the connections between bodies and social issues that enact forms of knowledge and understanding. 2. In this period of war, violence, and tyranny, we speak about epistemology and ontology as complementary stances: the need to let others disclose themselves, by allowing them to speak their own terms of engagement. The therapeutic effort is one of deactivating the dangers of one’s own presuppositions and prejudices that limit one’s capacity to describe and make hypothesis. There are social ontologies, communities with strong moral intensity, historical and social realities that need therapists to take position, since they need to take side and be aware of the categories they utilize. Historical and social ontology deals with the continuous change of symptoms in connection to the continuous change of the social panorama in the context we live in. We live by the bodies we are.     

Reflections on a wounded and bleeding temenos

COVID-19, Black Lives Matter, and financial and political turmoil have uprooted our sense of personal and collective safety and predictability. Analysts are faced with professional and personal challenges, as well as a charge to help make sense of this new normal. This reflective piece focuses on the author’s thoughts on a wounded and bleeding temenos. She grapples with the new reality of analysis carried out via technology (e.g. Zoom or telehealth). The article interweaves personal experiences with theoretical and professional reflections on two Jewish myths that relate to creating temenos or sacred space in the face of ancient disasters. Specifically, she discusses Choni HaMagel, a first-century BCE Jewish scholar and miracle-maker who prays for relief from a drought from inside a sacred circle. She also tells the tale of four Chassidic Rebbes who face crisis from a sacred space in the forest. The author frames this piece with two personal and numinous dreams dreamt during the pandemic; one offering scenes of destruction and one offering hope for a future transformation.     

Archetypes of the pandemic

This paper attempts to read the psychological and emotional impact of the COVID-19 pandemic through the archetypal images contained in patients’ dreams. In these dreams, symbols related to the power of nature and to extreme danger are paired with feelings of detachment that seem to point to a traumatic dissociation, due to the archetypal experience that erupts in familiar surroundings. Through the humanization of the ineffable experience, dissociation, which in the beginning of the pandemic showed in high levels of anxiety, panic attacks and depersonalization, can be transformed into the overview needed for the search for meaning. The container for this process of transformation is the analyst, the real, virtual or imagined one, and his or her ability to relate and feel.     

Clinical experiences during the COVID-19 pandemic

Most of the clinical experiences discussed in this article arose from monthly Zoom meetings at Rome’s Italian Centre of Analytical Psychology (CIPA). We set up a discussion group in April 2020, one month after lockdown began in Italy, and these monthly online meetings continue to this day. All senior analysts and analysts-in-training at Rome’s CIPA, whose backgrounds range from child and adolescent psychotherapy to adult psychotherapy and analysis, to sandplay therapy and medicine and psychiatry, have been participating in these meetings. The group discussions focus on the present time and its impact on us, as well as on our relationships with patients. By further developing these reflections during the lockdown in Italy (9 March - 3 May 2020), it is fair to ask whether a sense of unreality, depersonalization, or derealization has occurred, either in the therapist or patient, and if so, whether it is possible that therapists miss the human contact more than clients. We will mainly refer to clinical and personal experiences as our most precious guidelines.     

Essential anxiety: COVID-19 in analytic practice

This paper explores the impact of the COVID-19 pandemic on my relationship with analysands and my inner world. I reflect on the role of the archetypal Self during times of existential anxiety that may lead to an experience of ‘essential anxiety’. This term refers to a meeting by a fearful ego with an inward recognition of the Self, when faced with threat. The efforts to curb the spread of the pandemic changed our ways of life, while the virus itself threatened our existence in debilitating or outright destructive ways. But what also came into view, in sessions of analysis and supervision, was the creative instinct, and a celebration of life. The soul-to-soul relationship, and the connection with images of the archetypal Self, made the experience of existential anxiety at times an essential experience that facilitated psychological growth. I discuss some advantages of on-line Jungian analysis where, despite distance and partial view, the body still serves as container to hold important psychological material, conferring a sense of wholeness for analyst and analysand. The COVID-19 crisis is terrible and terrifying but it also provides an opportunity for self-regulation and individuation.     

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS

Symptoms of depression negatively impact on mother?infant relationships and child outcomes. We evaluated a novel, 10‐session mother?infant therapeutic playgroup—Community HUGS (CHUGS)—which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother?infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait‐list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self‐Efficacy subscale; J. Gibaud‐Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self‐efficacy, p < .001, all showed improvements, as did observer‐rated mother?infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait‐list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self‐efficacy, depression, anxiety, stress, and mother?infant interactions that supported the program's acceptability and the utility of further rollout.     

ROLE OF FIRST‐YEAR MATERNAL EMPLOYMENT AND PATERNAL INVOLVEMENT IN BEHAVIORAL AND COGNITIVE DEVELOPMENT OF YOUNG CHILDREN

Drawing on economic models of child development and attachment relationship perspectives, this study examined the effect of maternal employment in the first year after childbirth on subsequent behavioral and cognitive development in low‐income children. Analyses of data from the Project on Human Development in Chicago Neighborhoods (N = 411) revealed that despite the accompanying family income gains, maternal employment in the first year after childbirth adversely affected caregiver‐reported internalizing and externalizing behavior problems of Hispanic, Black, and White children at ages 3 and 5 years. This study also examined how paternal participation in childcare might affect children's outcomes. Results indicate that greater paternal participation eased the adverse impacts of maternal employment on internalizing behavior problems. There was no evidence that maternal employment was associated with children's memory cognitive functioning or that paternal involvement moderated children's cognitive development. These findings suggest that when early intervention programs are designed to assist low‐income families, enhancing supports (e.g., paternal involvement or parental leave) for working mothers during their child's first year may be valuable for young children's healthy development.     

IMPACT OF REFLECTIVE SUPERVISION ON EARLY CHILDHOOD INTERVENTIONISTS’ PERCEPTIONS OF SELF‐EFFICACY,JOB SATISFACTION,AND JOB STRESS

Despite widespread recognition of the importance of reflective practice in the field of infant mental health, little quantitative research exists regarding the impact of reflective supervision on professionals’ self‐efficacy, job satisfaction, and work‐related stress. Thirty‐three early childhood interventionists received approximately 9 months of reflective supervision and completed pre‐ and post‐assessments of their job‐related stress and self‐efficacy using a modified version of the Reflective Supervision Self‐Efficacy Scales for Supervisees (S. Shea, S. Goldberg, & D.J. Weatherston, 2012). At the post‐assessment, participants also rated their overall experience of reflective supervision. Reported self‐efficacy increased significantly from pre‐ to post‐assessment, and participants reported a positive overall impact of reflective supervision with respect to a variety of indices, such as job satisfaction, professional development, and the ability to cope with job‐related stress. These results provide necessary quantitative data demonstrating a positive impact of reflective supervision on early childhood professionals and suggest the value of reflective supervision for supporting workforce development.