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III RESEARCH IN INFANT OBSERVATION

INTRODUCTION TO RESEARCH IN INFANT OBSERVATION

While Bick (1964) emphasised that the aim of infant observation is to help a candidate in their training as a psychoanalyst or psychotherapist, and it is not initially meant as research many of the chapters indicate that it can be adapted for study; Bick had, after all, started out in child psychology research before becoming an analyst. Research was, however, highlighted by Bick (Chapter Two): "some aspects of the baby observation as training for scientific data collection and thought", giving the example of Baby Charles's use of his hands, the way they related to each other "at times as mouth to breast", and the implications of this for the way his object relations were experienced and represented in bodily terms. This line of thought entered psychoanalytic theory in the work of the French psychoanalyst, Genevieve Haag (2000), on early identifications and the body image: infant observation may be particularly suited to generating knowledge about bodily experiences. Research in infant observation is now outlined.

Michael Rustin published several justifications of infant observation as a research tool in its own right that generates further clinical hypotheses and has argued for a more systematic research agenda (1989, 1997, 2002, 2006). Green's vehement criticism that infant research is of such a different order from psychoanalysis that it is irrelevant to consider a possible contribution from the research applies, as with Wolff's (1997) critique, more to empirical research than to the material derived from psychoanalytic infant observation (Sandler et al., 2000).

Qualitative research projects studying infant observation have recently proliferated not without some tension as to nature of the findings, current debate centring around infant observation as a form of qualitative research (Rustin, M. J., 2011) or as generating knowledge (Groarke, 2011), as applied psychoanalysis (Hollway, 2012). The strength and limitations of infant observation as a research methodology are explored by Urwin and Sternberg (2012). Observers' notes are regarded as part of the triangulation and validation required in qualitative research; observers presenting to what is effectively a peer group over an extended time provides a basis for trying to assess their projections, and acts as a form of triangulation and validation. Themes in the notes can be analysed in a grounded thematic analysis (Urwin, 2007).

Hopkins' chapter has shown how infant observation can provide a powerful model for research in child development. Other examples of the research yield of infant observation include Jackson's (1996) paper on empirical work in South Africa inspired by Winnicott's (1941) spatula game described in The Observation of Infants in a Set Situation. This has indirect links with Freud's (1920) observation of his grandson's cotton-reel game, and his theorisation of it as symbolically mastering anxiety about hostility and separation from the mother. Houzel's work (Chapter Seven) has had considerable impact outside France. A pilot study was conducted in Britain by Rhode (2007), and Gretton (2006) described becoming an active participant in the observation through the use of her countertransference in her account of a year's work with a mother and her eighteen-month-old son who was at risk of being on the autistic spectrum. Clinical research has included studying the experience of infants in out-of-home care (Jackson et al., 2008; Wakelyn, 2011). Comparing the observational material of an infant with material when he was in psychotherapy showed that strong themes about his primary experience were in the transference, so that data from infant observation can show good predictive validity (Lubbe & Joffe, 2009).

Since the 1990s there have been an increasing number of qualitative research studies of infant observation, its effects and outcomes, particularly as part of writing for a doctorate or Masters course. A few studies are outlined here, beginning with those of the effectiveness of the method for observers. Sternberg (2005) researched specific learning outcomes from infant observation which she described as "the heart of training". She interviewed students from four psychoanalytic and psychotherapy trainings in London before they began their observations about what they hoped to gain, and after they had finished about what they thought they had gained. The data was analysed and some themes that emerged included looking without preoccupation, waiting for meaning to emerge, the pain of abstinence, understanding early stages of development, awareness of non-verbal and infantile communication, learning about relationships, and awareness of multiple perspectives. Sternberg showed that the experience of infant observation played a demonstrable part in developing particular skills and capacities necessary for an analytic attitude. A recent study followed a small number of trainees for two years: the trainees found the infant observation course enlightening, feeling that they gained in knowledge and skills and became more reflective professionals (Trowell et al., 2008). The Reflective Functioning interviews of the trainees had revealed considerable personal vulnerability on their part but most of them were more reflective and thoughtful at the end of training, to which their infant observation was thought to have contributed.

Studies to predict development were reported from 1997 onwards, when two studies testing the validity and reliability of infant observational data were published. Briggs' (1997) comparative study of five infants at risk in families with extreme conditions of deprivation differentiated different types of containment and their relationship with, and receptivity to, projective identification, and he categorised parents' responsiveness to their infant's communication as receptive, missed or intrusive. Diem-Wille (1997) followed up four infants two years after the end of an infant observation, studying the impact of the observer on infant and family, and also interviewed the mothers when their infants were four years old to learn whether observational detail could provide information for making hypotheses about future development. She suggested that her study supported this for the follow-up period of two years. Bick (1964) stressed that clinicians need to develop sensitivity to possible unconscious processes, and tentatively forming hypotheses about an infant's development; if infant observation suggests a developmental trajectory, a responsibility may exist when observers intuit in the first year that an infant may without intervention have developmental difficulties.

The effect on the observed families and in particular mothers' understanding and experience of the observation are increasingly the subject of research. Watillon-Naveau (2008) has for thirty years conducted semi-structured interviews with mothers about their experience about eighteen months after the end of the observation and feels that these helped the mothers to have some closure of their mourning. In another innovative study six mothers and their observers were separately interviewed in a structured interview two years after the end of the observation to explore the experience of each member of the mother-observer dyad. Findings ranged from the observation experience being enjoyed by both participants, to a mother who was hurt and angry that she had not received more support from her observer. A suggestion arising out of the study was that as women are contacted at a time of increased anxiety towards the end of their pregnancy it might help to reduce anxiety to have more contact between this visit and starting the observation (Lane, 2010).

The application of psychoanalytic observation in qualitative research increasingly widens into assessment and intervention. It has been adapted to explore and research the identities of severely learning-disabled adolescents (Hingley-Jones, 2011), for intervention in system difficulties in a Japanese school (Kanazawa et al., 2009), and in an audit and evaluation of services such as a London child psychotherapy outreach service (Pretorius & Karni-Sharon, 2012). Researching motherhood is the subject of an extensive social science research project in London, "Identities in Process: Becoming Bangladeshi, African, African-Caribbean and White Mothers", which used infant observation to explore changing aspects of identities of six first-time mothers from ethnically and culturally diverse backgrounds (Urwin, 2007). Hollway (2008), the senior researcher, made a strong argument for the reliability of participant observation: she suggested that infant observation, applying the principle of researcher subjectivity as an instrument of knowing, provided a picture that was less dualistic, and took account of emotions, their embodiment, and the effect of past experiences on present identity conflicts and change. Observers noted how often the baby was passed around between family members (as if in common with their displaced mothers) and how many experiences of shock for the observers needed to be processed (Wakelyn, 2007). Urwin (2011) used some of this observation material in seminars with social scientists in Norway and in a kind of ripple effect found it to be effective as a learning tool in a process of "secondary analysis".

Alvarez (1999), while suggesting that few Kleinians since Klein had speculated much in print about the life of the infant, linked the Kleinian view that every external experience is coloured by the baby's state (a view consistent with infant observation, which for example, suggests that a hypersensitive baby suffers more than a calmer one) as consistent with the developmental research finding that an irritable baby is an added risk factor for depression in vulnerable mothers (Murray & Cooper, 1997). Describing the convergences between infant observation, formulations derived from clinical psychoanalytic work, and developmental research is an important area but without the space to consider further here.

References

Alvarez, A. (1999). Widening the bridge. Psychoanalytic Dialogues, 9: 205-217.

Bick, E. (1964). Notes on infant observation in psycho-analytic training. International Journal of PsychoAnalysis, 45: 558-566.

Briggs, S. (1997). Growth and risk in infancy. London & Bristol, Pennsylvania: Jessica Kingsley.

Diem-Wille, G. (1997). Observed families revisited—two years on: a follow-up study. In: S. Reid, (Ed.). Infant Observation. The Tavistock Model. (pp. 182-206). London & New York: Routledge.

Freud, S. (1920). Beyond the pleasure principle. S. E., 18. London: Hogarth.

Gretton, A. (2006). An account of a years' work with a mother and her 18-month-old son at risk of autism. Infant Observation: The International Journal of Infant Observation and its Applications, 9: 21-34.

Groarke, S. (2011). Understanding babies from the standpoint of experience. Infant Observation: The International Journal of Infant Observation and its Applications, 14: 163-178.

Haag, G. (2000). In the footsteps of Frances Tustin: Further reflections in the construction of the body ego. International Journal of Infant Observation, 3: 7-22.

Hingley-Jones, H. (2011). An exploration of the use of infant observation methods to research the identities of severely learning-disabled adolescents and to enhance relationship-based practice for professional social work. Infant Observation: The International Journal of Infant Observation and its Applications, 14: 317-333.

Hollway, W. (2008). The importance of relational thinking in the practice of psycho-social research: oOntology, epistemology, methodology and ethics. Chapter Seven. In: S. Clarke, P. Hoggett & H. Hahn (Eds.) Object Relations and Social Relations (pp. 137-162). London: Karnac.

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Jackson, J. (1996). An experimental investigation of Winnicott's set situation. Journal of Child Psychotherapy, 22: 343-361.

Jackson, J., Jordan, B. & Thomson-Salo, F. (2008). “Who's looking at me?” Proposed research of infant observation as a therapeutic tool in work with “at risk” babies. Poster presented at AAIMH conference, “Angels in the Nursery”, 5-8 November, Adelaide.

Kanazawa, A., Hirai, S., Ukai, N. & Hubert, M. (2009). The application of infant observation technique as a means of assessment and therapeutic intervention for “classroom breakdown” at a school for Japanese-Koreans. Infant Observation: The International Journal of Infant Observation and its Applications, 12: 335-348.

Lane, N. (2010). Monash University unpublished thesis.

Lubbe, T. & Joffe, A. (2009). The truth of the transference. Reliving infantile experience in the transference: comparing data from an observed infant and the later psychotherapy of the same infant as a young child. Infant Observation: The International Journal of Infant Observation and its Applications, 12: 215-237.

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Pretorius, I. -M. & Karni-Sharon, T. (2012). An audit and evaluation of the Hammersmith and Fulham CAMHS Child Psychotherapy Outreach Service at the Randolph Beresford Early Years Centre. Infant Observation: The International Journal of Infant Observation and its Applications, 2: 165-184.

Rhode, M. (2007). Helping toddlers to communicate: infant observation as an outreach intervention. In: S. Acquarone (Ed.) Signs of Autism in Infants: Detection and Early Intervention (pp. 193-212). London: Karnac.

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Rustin, M. J. (2002). Looking in the right place: Complexity theory, psychoanalysis and infant observation. Infant Observation: International Journal of Infant Observation, 5: 122-144.

Rustin, M. J. (2006). Infant observation research: What have we learned so far? Infant Observation: The International Journal of Infant Observation and its Applications, 9: 35-52.

Rustin, M. J. (2011). Infant observation and research: A reply to Steven Groarke. Infant Observation: The International Journal of Infant Observation and its Applications, 14: 179-190.

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Urwin, C. (2007). Doing infant observation differently? Researching the formation of mothering identities in an inner London borough. Infant Observation: The International Journal of Infant Observation and its Applications, 10: 239-251.

Urwin, C. (2011). Infant observation meets social science. Infant Observation: The International Journal of Infant Observation and its Applications, 14: 341-344.

Urwin, C. & Sternberg, J. (2012). Infant Observation and Research: Emotional Processes in Everyday Lives. London: Routledge.

Wakelyn, J. (2007). A half-day conference: “What do we see when we observe infants and children? Cultural and historical perspectives on Psychoanalytic Observation”. Infant Observation The International Journal of Infant Observation and its Applications, 10: 235-237.

Wakelyn, J. (2011). Therapeutic observation of an infant in foster care. Journal of Child Psychotherapy, 37: 280-310.

Watillon-Naveau, A. (2008). Behind the mirror: interviews with parents whose baby has been observed according to Esther Bick's method. Infant Observation The International Journal of Infant Observation and its Applications, 11: 215-223.

Winnicott, D. W. (1941). The observation of infants in a set situation. In: Collected Papers: Through Paediatrics to Psycho-Analysis, 1958. London: Tavistock Publications.

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