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Reading back over this account of the relationship brings home to me what a great chunk of communication is missing from it, namely the whole world of body language which adds flavour to the spoken words. All the subtle signs, like a glance, the way the head is held, movement of hands, pitch, and volume of voice—the how something is said—give to the spoken word its essence and value, its mood, and create the possibility of grasping meaning at an unconscious level. Within the total sphere of behaviour I understood who I was to Carla and what might have been expected of me, namely to stand in for her mother who was absent and could not offer any holding.

I understand my relationship with Carla to have been a transference relationship wherein lies the answer to the first question posed at the beginning of this paper: "What exactly is the relationship between mother and observer?" It is a relationship, which operates with the ingredients of transference and countertransference as in any other relationship. The degree and quality of these will vary, depending not only on the family and their circumstances but also on the observer and her circumstances. For example, an absent but much longed-for mother of the mother-to-be or the existence of unconscious conflicts with her mother might prompt analogue transference to a female observer, as seemed to be the case in my situation. The development of the transference was also fostered by the attitude prescribed for the observer, that is, to be detached and unobtrusive, like the therapist's attitude in a therapeutic relationship.

Having identified the relationship between mother and observer as a transference relationship opens the question of whether the way the mother relates to and treats her baby is again a form of communication to the observer within this relationship, bearing in mind that the observer is a transference figure. Dinora Pines (1982) wrote that pregnancies revive early infantile experiences of the pregnant woman with her own mother. Boundaries become blurred, primitive anxieties and conflicts based on the experience of being mothered may be reactivated. "The physically symbiotic state of pregnancy is paralleled by an emotional symbiotic state in the future mother where identifications with her own mother and with herself as the foetus may reactivate intense ambivalent feelings" (Pines, 1982, p. 311). In identifying with her mother the woman begins to relate to her own baby, in the process of which she experiences herself as mother's baby. In short she relates to her own baby the way her mother once related to her. Again this is a communication to her baby and to her own mother.

I do not know how Carla had acquired her epilepsy. My feeling is that she believed she had been falling out of her mother's arms as Anna fell out of hers. Even if this was not so, her emotional reality would have been one of falling, that somebody, something, somewhere in the dim past did not hold her the way she should have been held. This was then repeated with me as her proxy mother watching both of them falling. "Epilepsy can be acquired," she reminded me, and recalled that her "father put padding around the sharp edges of the furniture to protect us". This time there was no protection, either for her or for her baby. She made her point by dropping me the same way she herself felt dropped and in turn dropped Anna. She became distant. I had to find her. She was sometimes not there or she had difficulties in keeping the usual time of my visits. There was no more tea served.

So the stage for the drama was unconsciously set, each role allocated to the players, and it unravelled itself as if by an inner force. I felt I was at the same time both an actor in the drama and a half-knowing but helpless spectator. My role allocated through her transference was the one of her mother whom she missed and who had left when I came on the scene. My countertransference confirmed my role. I felt motherly, very protective, concerned. I was in touch with what was due to happen, hence my dream of the baby with the open skull. However, I had another role to play at the same time, the one of the observer. Although "concerned", "alarmed" and "very worried" I kept silent—and maybe contributed to the outcome. That I may have done so is a very troublesome thought, which has never left me and has prompted me to write this account of my experience.

If I view the relationship between mother and observer as a transference relationship and the way the mother treats her baby as a communication to the observer as a transference figure (in my case her mother), then it becomes doubtful whether the observer can or even should stick to the role of being distant and unobtrusive. Perhaps the observer sometimes has to make a delicate and undoubtedly difficult decision as to when and how to interpret or else when to make herself available to be made use of as the appropriate transference figure. In my case this seemed to require being a good enough and possibly an intervening mother. This could, of course, be difficult because it could severely interfere with the other relationships of the mother. For example, at the beginning of this paper I mentioned the attitude of Carla's husband towards me. His attitude also showed that there were preconceived ideas of who I was and what I was up to. Almost certainly he would not have welcomed any interference on my part.

It remains unknown what would have happened had I not tried to follow Esther Bick's guidelines that the observer "must attain ... a position that will introduce as little distortion as possible into what is going on in the family. He has to allow some things to happen and to resist others" (Bick, 1964, p. 241). If I had said what I thought at the time, that it was dangerous to use the sling with Carla's proneness to epileptic fits (in other words: don't do it!) would I then have been acting out my countertransference and giving advice or would I have been acting as an "ordinary human being" in an "ordinary human relationship" (Brafman, 1988, p. 49).

This brings me to my second question concerning the influence of the relationship on what was observed. I am left with the uncomfortable feeling that either way, distant and nonintrusive or transference mother, the relationship would have influenced what I was observing. In other words the very fact that I was there and necessarily engaged in a relationship influenced the outcome.

This is inherent in the role of the participant observer, which immediately poses the epistemological problem involving the interference of the observer with the observed. This is nicely analogous to the situation faced by physicists dealing with subatomic particles. One cannot ask, for example, what would be the velocity and position of a particle if it were not being observed because the laws of physics deal with the results of observations. Yet the very act of observation disturbs such particles because they are so small that light affects them. This is embodied in the Heisenberg Uncertainty Principle, which expresses mathematically the necessary extent of doubt in one item, say position, for a given amount of doubt in the other, say velocity (Bransden & Joachain, 1983). In human relationships we deal with a more tangled web and lack the benefit of a quantified principle to tell us the extent of our ignorance.

 
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