Holding a couple and infant state of mind

Sara Leon is Clinical Lead of the Couple Perinatal Service at Tavistock Relationships. She is a psychoanalytic child and couple psychotherapist and a psychoanalytic parent infant psychotherapist. She worked for many years in the NHS as a child and adolescent psychotherapist, and as a training supervisor. She has much experience as a young child and infant observation seminar leader.

For many couples, having a baby is central to their relationship, and whilst bringing new life into the world can be momentous and joyous, the transition to parenthood can also be fraught with many unforeseen challenges that throw parents into turmoil. Infants are exquisitely sensitive, and often in their raw chaotic emotional states can reflect and highlight problems inherent in the couple relationship. For example, unresolved Oedipal conflicts that have remained dormant in the couple relationship can emerge with the introduction of a third. The parent’s own unprocessed infantile feelings of being parented can be stirred up, leaving them despairing and disorientated. Such challenges often start in pregnancy and, if not addressed, may create complex and disturbing relational patterns that affect family life and continue into the infant’s adult life. The relationship with the unborn starts in utero, for both parents, which is why working with couples from pregnancy up can be important.

The infant’s experience of a parental relationship

Schoppe & Sullivan (2014) claim that the father’s prenatal beliefs about himself as a significant object to his baby contributes to the infant’s higher capacity to relate to two objects at the same time. Von Klitzing (2019) has also shown that the infant’s experience of triadic relationships from the birth strongly influences their development and pre-Oedipal complex, as the father is already known and is therefore less frightening.

Working with a couple and their infant

The following vignette offers a glimpse of how we work with the parents-infant relationship in our work in Couple Perinatal Service at TR and the importance of the role of the infant. Baby was tucked between father’s right arm and his body. She looked very withdrawn. Mother was angry with father, who she claimed left all the childcare to her, and said that baby was a nightmare, not feeding or sleeping, especially at night. Concerned for the infant’s mental state, I spoke to her directly. Father had been gently stroking baby’s head but when I spoke to her, he let out a manic laugh and in a sarcastic tone told me she did not understand me. The above alerted me that it was not just the mother who had post-natal depression (PND), but that the father was also suffering. It was less obvious with him, as he was somewhat cut-off but his angry feelings surfaced when I spoke directly to baby. When both parents have PND they tend to see the infant in a particular way, that is, through the lens of their own early experiences.

Working with the infant and both parents in the room, I was able to observe and experience her as she presented and not just as she was ‘talked about’. This is particularly important if the couple share a picture of an impossible baby. Being able to witness mother’s ‘nightmare baby’ and father’s ‘baby with no mind’, I could observe the projections that had been located in her and from which she was desperately trying to withdraw. This enabled me to gently help the parents separate from their own early and unprocessed infantile feelings and find new dimensions to themselves and to their development as parents (Rustin, 2002).

When working with parents and infants it is important to understand that the infant’s development and mental health takes place within the context of a parental relationship, whether 2 parents are present or not. NCSPIR supervisors can support practitioners who are working in family hubs to hold an infant and couple state of mind.