One December evening, nine dedicated analysts, candidates, and early childhood specialists assembled to create what would become a thriving Parent-Infant Program (PIP) at Columbia University Center for Psychoanalytic Training and Research. Led by Karen Gilmore and Susan Coates, the initial meeting also included Beatrice Beebe, Patricia Nachman, Pamela Meersand, Ilene Lefcourt, Michael Feldman (a former APsaA Fellow), Laurence Saul, and myself as program administrator. By February, our ranks had grown to 25 faculty members, including Arietta Slade, who became our research coordinator. By that time, we had a working model for the PIP, as well as a mother-baby group that was off and running as part of our Parent-Infant Education Service (PIES), led by program supervisor Ilene Lefcourt, research associate Cassandra Cook, and me.
The PIP's gestation had not been so brief. Roger MacKinnon, former director of the Columbia Center for Psychoanalytic Training and Research, set the stage for the PIP's development in 1996, in conjunction with the Sackler Foundation. The foundation arranged to make a generous donation to Columbia University, with provisions that would allow for the birth of a clinically oriented program. This program would be dedicated to the treatment of parents and infants, the training of clinicians interested in treating this population, and research furthering treatment and training.
Robert Glick, the current director of the Columbia Center, has been a potent force in restoring the center's prominence within the university's Department of Psychiatry by spotlighting such areas as early child development and the cognitive sciences. Thus, the PIP is his baby. He has made it one of his primary goals to energize and recast the Division of Child Psychoanalysis within the Columbia Center.
Glick appointed Karen Gilmore as new chair of the Division of Child Psychoanalysis in September 1997. At the same time, Gilmore became the director of the PIP and asked Susan Coates to be co-director. Coates' work on the development of the Zero to Three Diagnostic Classification System and on the synthesis of object relations and attachment theories through her studies of gender identity disorder has been at the forefront of early childhood applications of psychoanalytic thought.
Gilmore and Coates assembled a stellar advisory board: Myron Hofer, Clarice Kestenbaum, Alicia Lieberman, Donald Meyers, Daniel Stern, Charles Zeanah, and Alan Zients. Stern, a pioneer in infant psychiatry, gave three talks at Columbia in January to kick off the program. His inaugural lecture was on transference in mother-infant psychotherapy.
The Columbia PIP sees its role within the Columbia Center, the Department of Psychiatry, and the university itself as a catalyst for ongoing dialogue in human development, psychology, and psychoanalysis. The PIP has three aims represented by its three component programs, which are envisioned as mutually enriching.
The first is clinical service. This has already begun with PIES, which consists of mother-baby groups that focus on normal development. We also are offering brief and long-term analytically oriented psychotherapy for mothers and infants or toddlers. This includes a comprehensive consultation service (including developmental testing and the option for video-assisted evaluation) staffed by child psychiatrists and psychologists specializing in early childhood.
The current PIES group consists of six dyads, screened by our staff, with infants whose were four to seven months old at the start of the group in February. The group is offered for two years and is staffed by two group leaders and a child-focused assistant. The groups are psychoeducational and psychodynamically supportive to dyads. Mothers join the group for many reasons: to supplement their knowledge of development, to understand important themes in their lives that affect their infants' development, to understand their babies better, and to augment their social support network. Two new groups will be forming in September, one on the Upper East Side and one at the Columbia Center. We are also accepting referrals for consultations and parent-infant psychotherapy.
The second aim of the PIP is training, represented primarily by the Parent-Infant Psychotherapy Training Program. The PIPTP will teach clinicians to work with parents and infants in a variety of settings over a two-year period. The program embraces an eclectic theoretical orientation but remains rooted in the psychoanalytic tradition. We have already assembled a diverse curriculum; an advanced special topics segment addresses such areas of interest as the theory of intergenerational transmission of trauma, the treatment of the neurologically compromised infant, and issues related to gay and lesbian parents. Course directors are Gilmore, Coates, Beebe, Paulina Kernberg, Elsa First, Laura Whitman, and Debbie Hamm. Application for the PIPTP is open to any interested clinical psychologists (Ph.D. or Psy.D.), psychiatrists, or other physicians, including pediatricians and family practitioners. Scholarships are available.
The third aim of the PIP is research, which will involve ongoing evaluation of the effectiveness of both the training and service aspects of the program. The PIP Research Committee, headed by Arietta Slade, is working on developing longitudinal protocols to investigate (among other issues) changes in mothers' mental representations as they are affected by therapeutic intervention. Toward this end, Slade and Coates have been working with Peter Fonagy and Mary Target to develop a coding system of Slade and Aber's Parent Development Interview that would take into account a mother's reflective functioning. This important concept was developed by Fonagy and Target and addresses one's theory of mind in relation to another.
Meanwhile, I attended the IPA Summer Research Program in London to work with Peter Fonagy and Robert Emde on the development of potential future PIP studies of maternal trauma, attachment, and psychopathology in mother and infant using the Zero to Three Classification.
Over the last 10 years, infant psychiatry and psychoanalysis have burgeoned, integrating a wide variety of disciplines spanning psychiatry, psychology, and psychoanalysis with areas as diverse as neurobiology and speech-language pathology. Particularly exciting at this point in the history of psychoanalysis is the convergence of attachment theory, developmental psychobiology, and cognitive sciences with mainstream psychoanalysis. The work of Fonagy, Target, Bowlby, Ainsworth, Main, Slade, Beebe, Hofer, Kandel, Solms, Olds, Reiser, and Donald J. Cohen, to name just a few contributors to this body of work, extends our thinking as analysts by extending and applying ideas that are central to our clinical practice.
The PIP finds itself at this convergence point, on the cutting edge of the field of applied psychoanalysis. Our hope is that over time the PIP will enrich psychoanalytic practice and theory, along with developmental psychiatry and psychology, through an ongoing collaboration of dedicated individuals who share the desire to see our fields grow.
Daniel S. Schechter, M.D., is a former APsaA Fellow and a current affiliate member of The American. He is a 1998–99 Presidential Scholar of the American Academy of Child and Adolescent Psychiatry and is in private practice.