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What Can The Matter Be? is part of the rich harvest that springs from the union of Kleinian theory and the infant observation work pioneered by Mrs Bick, which has been the inspiration of the child psychotherapy training at the Tavistock Clinic for over 50 years. The book chronicles the work with under 5s that emerged in the late 1970s and was given form in the Under Fives Service, and was one of the many specialities that grew under the umbrella of that training. What marks the book is the close attention to detail which all the clinicians display, together with their capacity to hold onto their observations in the face of their own uncertainty, until they can use them to elucidate the child's behaviour and the dynamics within the family. This is very much done in the service of the child and of helping the family to find its way forward freed from some unconscious issue by which they have been held up. This often involves helping parents to be in contact with their knowledge of their own infantile experience which then enables them to receive and accept their baby's experience. The book is a breath of fresh air in a culture that has become obsessed with ‘how to do’ books, which hand out advice with little attention to the impact on the child's internal life or the ensuing development of the family.
It is fitting that such a book opens with a paper by Isca Wittenberg who has taught generations of child psychotherapists, both at the Tavistock Clinic and indeed throughout the world. Her baby observation seminars were, as I can vouchsafe, and I imagine still are, an eye-opening experience. One was encouraged to learn to observe in detail, to retain and write this up, to notice when observation became difficult and one's mind left the scene and to face the difficult and often unwelcome aspects of infantile experience both internally and externally. The clinical work in her chapter is based on observation which allows us to understand more about the needs of infants and