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This is a sensitive piece of work with a very young and vulnerable mother and her very young baby. Reading the background, the list of risk factors for the mother is long – she
is a teenage parent, rejected by her parents, with a history of attachment problems, for whom the conception of this child was a shocking mystery. The risk factors for the eight-week-old baby are also mounting – an immature and depressed mother, two losses of caregivers (mother and youth club leader) and at least some indications of possible emotional neglect (for example, mother is used to leaving her in her car seat).
Yet it is already evident that this young mother and baby have considerable strengths too. They are a responsive dyad – to each other and to the therapist’s holding. They are also capable of facing the pain entailed in the work that is to be done. This is a critical element in our psychoanalytic work and in work with mothers and infants; the mother’s wish to give positive life forces to her infant can be a strong ally for the therapist. The therapist, here, captures this beautifully: “your mummy loves you very much but is so little herself she finds it hard to know how to be a mummy.” The tone of the session indicates that the therapist – in only the third session – is already positively engaged with them.
The therapeutic process that unfolds follows an inner logic so that the development of trust, insight and tentative behavioural change takes place. The therapist conveys in words and in her manner a deep empathy and understanding of the mother’s predicament and how it may impact on the baby. This provides the holding framework within which emotional work can take place. Part of the psychological work is to transform confusion and inchoate pain into a narrative of meaning, a story of their intergenerational togetherness. Persecutory rage also finds its place in the construction of meaning through understanding of the transference. Following the therapist’s containment, mothe