Attachment and Infant Mental Health

The young girl was listless, her body limp, eyes hollow and unseeing. Passive and unresponsive, she looked like she just wasn’t part of the social world. There was no feeling of exploration, joie de vivre, energy or reaching out.

She seemed above all, without hope.

It was hard to watch. The image of that young child’s face and limp, unresponsive body stayed with me, long after the film finished.

I had worked hard to be a part of a class that was meant to be for people undertaking a Masters in Infant Mental Health. I was in my final year of a social work degree and none of the electives offered by the faculty interested me. So I waded through the paperwork, meetings and phone calls involved in taking a class outside my department.

There were other social workers there, OTs, physiotherapists, psychologists, trainee psychiatrists and GPs. Some were from interstate and had sacrificed a lot to be there. Most were in full-time work in communities, hospitals and clinics.

Together we watched some pretty confronting, mysterious and haunting films. Some were well-thumbed clinical mainstays: films that everyone training to be a psychotherapist should see and usually does, others were from our lecturer’s own private practice. But of all these fascinating insights into our social beginnings, the one that stood out to me was this moment in the life of an infant who was, for want of a better word, depressed.

Depressed? I can see that many would be sceptical – how could anyone under the age of 14 really be depressed? Certainly I would hesitate to diagnose a depressive illness in a 2 year old. But I wasn't talking about diagnosis as a discreet activity. That was my gut feeling about this heartbreakingly neglected child on watching the film, and it is still my feeling on remembering it all those years ago.

It was a shocking and visceral reminder of just how important our first relationship is.

I had always been interested in attachment and how it influences our social world, but through this class and through my own reading, I came into contact with theorists such as Peter Fonagy, Daniel Stern, Edward Tronick, Margaret Mahler and, of course, Winnicott and John Bowlby. I became fascinated by what they had to say and by how the seed planted by Bowlby had grown into a mighty oak with many branches and deep roots, influencing not just other theorists, but clinical practice with adults and filtering down into the public consciousness through journalism and parenting advice columns.

We learn about who we are through our relationships. And our most important relationship is the first one we have – usually with our mother.

It is within the crucible of the mother infant bond that our sense of self and of the world develops.

Infants are hardwired for attachment – without this relationship they just wouldn't survive. Without recognising or really understanding what they are doing, most parents naturally respond and interact with their child in a “good enough” way. They aren’t perfect, but they are sensitive to their baby’s needs, most of the time.

But sometimes, unfortunately, this isn’t the case.

Parents who are stressed, those who are victims of family violence, those who are financially stretched or experiencing other stressors such as job loss or the loss of a significant relationship are unable to focus on the needs of their child. Parents whose own childhoods were difficult or who experienced adverse events during this time are also going to find it hard to be emotionally present for their child. It's a challenging time for all parents and can confront us unexpectedly with what we never received when we were infants.

Most people aren’t prepared for the intense emotional challenges that accompany new parenthood.

That's OK, we know that it can be a struggle, but its when these emotional struggles provide an ongoing barrier to connecting with our child that we can get into trouble. Even the most well-supported and balanced adult can find this time exhausting and confusing.

As Allan Schore has pointed out in his research, our early life and the attachment relationship are dominated by the right brain – in other words, in early infancy we communicate, learn and grow through non-verbal, sensory input such as images, gestures, touch, rhythm, sound and smell. The sound of our mother’s voice, the scent of her body, the soothing pulse of a nursery rhyme hummed as we drift to sleep, heartbeats and breath, the feeling of being held sensitively and caringly, the touch of warm skin and the smell of milk, all contribute to our early relationship and our early memories.

If a parent is depressed, for example, then the communication between infant and parent will reflect the subdued and blunted affect that usually accompanies depression. Tronick's famous "still face" experiment provides an unsettling demonstration of this possibility.

But its not just about appearance or "smiling at your baby" - it's about awareness and understanding your own feelings - accepting that you might not be super-parent all the time - no-one is. I think for women, the pressure to perform as a mother is particularly high. So the niggling feeling that one isn't doing the right thing can leach into a feeling of resentment.

Children are extremely sensitive to the emotional underpinnings of gestures and facial expressions. That doesn't mean that you should be afraid of your child - or of the demands of parenting. Just that you need to do the best you can, get help if you need it and try to understand that your baby will respond emotionally to your feeling states. Its important to make sure that most other things are taken care of during this time - if you have to run around looking after others, trying to earn a living, or juggling a range of different responsibilities, then you might not have the resources to be there in the way you need to be for your baby.

The mother of the little girl in the film I saw in my class was depressed and unable to deal with her daughter's needs. She had no support or emotional back-up, no partner or close family. Luckily, though, parent and child got to work with a team of therapists who helped them transform their relationship. The subdued young girl in the film changed into a toddler both more outward looking and full of empathy for her playmates. It was a truly remarkable journey.

Because infants are hardwired for attachment, they will still seek closeness, soothing and comfort from their primary caregiver, even when this person might be unable to deal with their own needs, let alone those of a demanding infant. We need to understand that putting our own needs aside just for a little while and being emotionally present for our child are the two things we must do to parent well in this early period.

If you would like help with your parenting, need advice or just want to talk, please visit https://www.amandarobinspsychotherapy.com.au/

MORE POSTS

Death of a Thousand Cuts: Young People and Trauma

Running on Empty: What Personality Disorders like BPD can tell us about Identity

Taking it to the Limit: Anorexia and the Scourge of Perfectionism

The First Mirror

Trapped in the Mirror

What I learnt from Leaving Neverland

What your Doctor won’t Tell you about Mental Health Treatment

Attachment and Infant Mental Health

The young girl was listless, her body limp, eyes hollow and unseeing. Passive and unresponsive, she looked like she just wasn’t part of the social world. There was no feeling of exploration, joie de vivre, energy or reaching out.

She seemed above all, without hope.

It was hard to watch. The image of that young child’s face and limp, unresponsive body stayed with me, long after the film finished.

I had worked hard to be a part of a class that was meant to be for people undertaking a Masters in Infant Mental Health. I was in my final year of a social work degree and none of the electives offered by the faculty interested me. So I waded through the paperwork, meetings and phone calls involved in taking a class outside my department.

There were other social workers there, OTs, physiotherapists, psychologists, trainee psychiatrists and GPs. Some were from interstate and had sacrificed a lot to be there. Most were in full-time work in communities, hospitals and clinics.

Together we watched some pretty confronting, mysterious and haunting films. Some were well-thumbed clinical mainstays: films that everyone training to be a psychotherapist should see and usually does, others were from our lecturer’s own private practice. But of all these fascinating insights into our social beginnings, the one that stood out to me was this moment in the life of an infant who was, for want of a better word, depressed.

Depressed? I can see that many would be sceptical – how could anyone under the age of 14 really be depressed? Certainly I would hesitate to diagnose a depressive illness in a 2 year old. But I wasn't talking about diagnosis as a discreet activity. That was my gut feeling about this heartbreakingly neglected child on watching the film, and it is still my feeling on remembering it all those years ago.

It was a shocking and visceral reminder of just how important our first relationship is.

I had always been interested in attachment and how it influences our social world, but through this class and through my own reading, I came into contact with theorists such as Peter Fonagy, Daniel Stern, Edward Tronick, Margaret Mahler and, of course, Winnicott and John Bowlby. I became fascinated by what they had to say and by how the seed planted by Bowlby had grown into a mighty oak with many branches and deep roots, influencing not just other theorists, but clinical practice with adults and filtering down into the public consciousness through journalism and parenting advice columns.

We learn about who we are through our relationships. And our most important relationship is the first one we have – usually with our mother.

It is within the crucible of the mother infant bond that our sense of self and of the world develops.

Infants are hardwired for attachment – without this relationship they just wouldn't survive. Without recognising or really understanding what they are doing, most parents naturally respond and interact with their child in a “good enough” way. They aren’t perfect, but they are sensitive to their baby’s needs, most of the time.

But sometimes, unfortunately, this isn’t the case.

Parents who are stressed, those who are victims of family violence, those who are financially stretched or experiencing other stressors such as job loss or the loss of a significant relationship are unable to focus on the needs of their child. Parents whose own childhoods were difficult or who experienced adverse events during this time are also going to find it hard to be emotionally present for their child. It's a challenging time for all parents and can confront us unexpectedly with what we never received when we were infants.

Most people aren’t prepared for the intense emotional challenges that accompany new parenthood.

That's OK, we know that it can be a struggle, but its when these emotional struggles provide an ongoing barrier to connecting with our child that we can get into trouble. Even the most well-supported and balanced adult can find this time exhausting and confusing.

As Allan Schore has pointed out in his research, our early life and the attachment relationship are dominated by the right brain – in other words, in early infancy we communicate, learn and grow through non-verbal, sensory input such as images, gestures, touch, rhythm, sound and smell. The sound of our mother’s voice, the scent of her body, the soothing pulse of a nursery rhyme hummed as we drift to sleep, heartbeats and breath, the feeling of being held sensitively and caringly, the touch of warm skin and the smell of milk, all contribute to our early relationship and our early memories.

If a parent is depressed, for example, then the communication between infant and parent will reflect the subdued and blunted affect that usually accompanies depression. Tronick's famous "still face" experiment provides an unsettling demonstration of this possibility.

But its not just about appearance or "smiling at your baby" - it's about awareness and understanding your own feelings - accepting that you might not be super-parent all the time - no-one is. I think for women, the pressure to perform as a mother is particularly high. So the niggling feeling that one isn't doing the right thing can leach into a feeling of resentment.

Children are extremely sensitive to the emotional underpinnings of gestures and facial expressions. That doesn't mean that you should be afraid of your child - or of the demands of parenting. Just that you need to do the best you can, get help if you need it and try to understand that your baby will respond emotionally to your feeling states. Its important to make sure that most other things are taken care of during this time - if you have to run around looking after others, trying to earn a living, or juggling a range of different responsibilities, then you might not have the resources to be there in the way you need to be for your baby.

The mother of the little girl in the film I saw in my class was depressed and unable to deal with her daughter's needs. She had no support or emotional back-up, no partner or close family. Luckily, though, parent and child got to work with a team of therapists who helped them transform their relationship. The subdued young girl in the film changed into a toddler both more outward looking and full of empathy for her playmates. It was a truly remarkable journey.

Because infants are hardwired for attachment, they will still seek closeness, soothing and comfort from their primary caregiver, even when this person might be unable to deal with their own needs, let alone those of a demanding infant. We need to understand that putting our own needs aside just for a little while and being emotionally present for our child are the two things we must do to parent well in this early period.

If you would like help with your parenting, need advice or just want to talk, please visit https://www.amandarobinspsychotherapy.com.au/

MORE POSTS

Death of a Thousand Cuts: Young People and Trauma

Running on Empty: What Personality Disorders like BPD can tell us about Identity

Taking it to the Limit: Anorexia and the Scourge of Perfectionism

The First Mirror

Trapped in the Mirror

What I learnt from Leaving Neverland

What your Doctor won’t Tell you about Mental Health Treatment