"In a black hole": the (negative) space between longing and dread: Home-based psychotherapy with a traumatized mother and her infant son
Abstract
This paper offers fragments from the first year of a home-based mother-baby psychotherapy, in which I attempted to help a traumatized and dissociated mother to emotionally engage with her infant son. The treatment was organized in part around certain developmental objectives common to both attachment and psychoanalytic theory. These include: The ability to name and metabolize feelings, to evoke a soothing maternal introject, and to relate to the partner's mind as a separate, understandable center of initiative and intention. In addition, attachment theory, with its emphasis on the critical psychobiological role of containing fear and distress in infancy, was a useful guide in formulating the treatment. The paper reviews research findings on mother-infant pairs described as frightened-disorganized, discusses some of the challenges encountered in home-based mother-infant psychotherapy and then discusses the case of Mary and John. The case illustrates how mother-infant psychotherapy may interrupt the intergenerational transmission of disorganized attachment by working within the couple to name, metabolize and flexibly respond to painful, dissociated or frightening experiences.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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