Parent-Infant Psychotherapy: A Review Article

The relatively new field of parent-infant psychotherapy, while largely dominated by the paradigms provided by psychoanalysis and attachment theory, also encompasses considerable diversity. Stern's latest book, The Motherhood Constellation, attempts to offer an overview of these different approaches and he accordingly subtitles his work ‘A Unified View of Parent-Infant Psychotherapy’ (Stern, 1995).

According to Stern, and here he is developing a thesis previously adumbrated in an article in the Infant Mental Health Journal (Stern-Bruschweiler and Stern, 1989), all the different therapeutic modalities, competently practised, are equally effective. He accounts for this by arguing that the ‘Clinical System’, as he terms it, is interactive in nature so that a change in one area of the system will necessarily lead to changes in other areas. For example, a change in the mother's representation of the infant (the privileged target of a more psychoanalytic approach) would lead to a change in the mother's behaviour towards the infant and hence a change in the infant's response, but equally a change made to the mother's behaviour towards the infant (as in a more behavioural approach) would lead to a corresponding change in the infant's response and hence to a change in the mother's representation of the infant. In consequence it matters little which ‘port of entry’ into the system is used since the effect will pervade the whole system.

Bertrand Cramer, a colleague of Stern in Geneva, is in no doubt which ‘port of entry’ he prefers and his recent (1993) book on The Practice of Mother-Infant Psychotherapy, co-authored with Francisco Palacio-Espasa, gives a vivid account of his avowedly psychoanalytic approach. It is a book I would warmly recommend to all those interested in this area of work, though regrettably it seems unlikely that it will be translated into English. However, a highly condensed account