INFANT OBSERVATION AND ETHICS
Infant observation in clinical training
Esther Bick PhD, wrote that, ‘Infant observation was introduced into the curriculum of the Institute of Psychoanalysis in London in 1960 as part of a course of first-year students… (It was)’Part of a training course of the child psychotherapists at the Tavistock clinic since 1948 when the course began (1963). Piontelli commented that, ‘Detailed observation and reporting to the discussion group of each student’s weekly observation helped to keep interpretive impulses at bay so that the language of observation naturally remained unburdened by jargon, but rather tended towards the poetic.’
Structure of infant observation
It is an arrangement consisting of a weekly one-hour observation of an infant in the first year of life (and subsequently) and her family, in their own home, reported to and discussed with a confidential small group seminar. It allows for systematic and thoughtful reflection, in particular about how to enter the inner world of the baby. It is usually provided as a training experience to develop an understanding of the infant’s world and development to allow improved clinical work with children. The use of the observer’s own feelings are critical to this understanding (both transference and countertransference). It has also been used as a therapeutic intervention, eg, by Didier Houzel in France.
Infant observation research has been reported in a number of publications of which the most widely known are Closely observed infants, Lisa Miller et al. (1989), Developments in infant observation: The Tavistock model, Susan Reid (1997) and Backwards in time, the study in infant observation by the method of Esther Bick, Alessandra Piontelli (1986).
Applications of infant observation include shorter observations of infants as well as those of older children. There have been systematic observations in different settings (early childhood daycare, orphanages, hospitals, neonatal intensive care and other settings). There have been observations before birth using ultrasound (Piontelli), serial videotaping of observations (Lynn Barnett), and infant observation has also been used in other training programs of psychoanalysts and child psychiatrists.
Infant observatio: Some ethical issues
First we must do no harm. We can then ask whether we provide a positive intervention, what are the ethical questions, and whether our presence is therapeutic?
Infant observation dilemma : “Should I say something?”
An infant observation dilemma involved an anxious young first time mother, an older father with other children and na observer who was an experienced clinician. The baby seemed to have an un-held experience in the family and was quiet, undemanding and sad. At 4 weeks the observer began to wonder whether the baby could see, and this was discussed in the seminar group. What should she say? At 6 weeks the parents reported that their anxiety had been discussed with the maternal and child health nurse and the baby was referred to the GP, to the paediatrician
and to the ophthalmologist.
Com a colaboração: Australian Association for Infant Mental Health Inc.