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Infant observation: an infant's inner world

The most distinctive feature of infant observation and the most profound reason for its value is learning about the psychic world of the baby as the object of observation. Observers need to develop a sensitivity to possible unconscious processes and the tentative process of hypothesis formation about what is happening, which Bick stressed, carrying over concepts from analysis such as transference and countertransference to describe situations in infant observation. Infant observation develops understanding of subtle projections and aspects of interchange between infant and parent, or infant and parent with observer, and other members of the family, which can be seen in Chapter Six by Cohen and Chapter Four by Blatt.

This chapter has outlined Bick's method and its gains. Chapter Two reproduces her seminal 1964 paper in which she emphasised that the teaching of infant observation is to aid the candidate in their training as psychoanalyst or psychotherapist. After Bick, there were three main directions for infant observation: as preparation for clinical training and understanding of infancy and childhood, as child and family research, and as therapeutic intervention which are explored in Parts I, II, III and V. In Chapter Three and Four Magagna and Blatt describe observations (as with Cohen's and Houzel's chapters), in a method close to that used in psychoanalysis and convey well what is involved for an observer.

Part II traces the evolving practice of infant observation in the last fifty years, indicating significant developments of infant observation as a method within psychoanalytic training as well as its transformational potential. The key themes include the contribution of psychoanalysis to infant observation, the role of infant observation in training, and what infant observation contributes to psychoanalysis and psychotherapy. Hopkins' chapter uses infant observation to extend Winnicott's concept of the too-good mother as an example of the clinical and theoretical relevance of infant observation. In Chapter Six Cohen writes about the use of infant observation to understand the intricate subtleties of the experience and communication of premature infants in a neonatal intensive care unit. Her account, an application of the method that describes the impact of detailed week-by-week observations and the use of the observer's own responses in understanding the material, conveys well what is involved for an observer. The balance between the focus on parents and babies demonstrates that infant observation is a mother-father-and- infant observation. Infant observation as Houzel shows in Chapter Seven has provided a model of treatment of severe problems in childhood.

Part III outlines the yield in infant observation research, and Bekos in Chapter Eight studies mothers' feelings about the observation, in particular about the ending.

Part IV introduces problematic aspects of infant observation in the uses and limits of understanding, including transference/countertransference difficulties, ethical issues, and a critique of some aspects of infant observation. These chapters describe observations that were difficult for different reasons. The first by Thomson-Salo is of an infant who experienced ongoing physical trauma, followed by one in which Coulter recounts a distressing event which occurred in her observation and the questions this raises for the practice of infant observation. In Chapter Eleven, Cantle discusses an observation where a mother seemed powerless to prevent abuse by a sibling to her baby sister.

Part V covers the widening scope of infant observation in terms of the themes of training, teaching models, observers' professional backgrounds, as well as inter-culturally and in observations of wider family structures and settings, and lastly clinical applications. In Chapter Twelve Bharucha describes an observation in an Indian context, in Chapter Thirteen Moskowitz describes the carefully evolving role of a slightly more active observer in a family where the baby was born to a single gay father, and in Chapter Fourteen Music explores issues of culture and beliefs, using anthropological and sociological ideas to discuss cultural bias. An Afterword points to the intersubjective view of the infant in clinical infant mental health and what this might bring into the infant observation field.

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