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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
I gratefully acknowledge Karlen Lyons-Ruth, Ph.D., for her invaluable clinical and editorial input, George Ganick Fishman, M.D., for his untiring support, Sarah Birss, M.D., and Ann Epstein, M.D., for teaching me so well, the Center for Early Relationship Support at the Jewish Family and Children's Service of Waltham Massachusetts, for making it possible, and Mary and John for showing me the way.
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.