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On-going physical trauma in an infant observation

Frances Thomson-Salo

Three painful and confusing times are described from an infant observation that I carried out which involved containing unusual intuitions and psychotic-like anxieties through projective identification in the countertransference. The fine-grained detail that infant observation provides can alert the observer to the intense feelings and anxieties in the world of an infant, and his or her mother in the first year in difficult circumstances. When an observer is attuned in this way to the infant, they may sense things about the infant that might easily be overlooked and come to have a conviction about their intuition that becomes available for clinical work. As therapists became more aware of how they changed in doing a psychoanalytic infant observation, they came to view it as essential to extend the capacity for contained observation to enable them to work when exposed to uncertainty, confusion and anxiety in an intense emotional experience with patients (Harris, 1976/1987); to fulfil the most fundamental requirement for working with extreme emotional states, the ability to sit with another's distress without feeling that one has to, or can, immediately alleviate that pain and without denying how that pain relates to one's own feelings and experiences. I then describe working in a psychiatric mother-baby unit as an application of some of this learning.

 
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