Psychoanalytic infant observation

Psychoanalytic infant observation is a distinctive experiential approach to training that was developed at the Tavistock Clinic in London by Child psychoanalyst Esther Bick. In 1948 she collaborated with Dr John Bowlby to develop the approach to training psychotherapy students in conducting an infant observation. It has since become an essential feature of pre-clinical training in child and adult psychotherapy, psychoanalysis and related fields throughout the world.

The practice of psychoanalytic infant observation usually involves a weekly observation over a two year period of an infant from soon after birth and until their second birthday. This naturalistic form of enquiry provides a unique opportunity to enrich and extend observation skills. Students learn at first-hand how a relationship begins between babies and their families and enables them think about how babies grow physically, mentally and emotionally. This experience of observing ordinary family life is valuable for professionals who work with difficult, complex and disturbing presentations.

Early Development

Psychoanalytic Infant Observation is a distinctive approach that was the inspired initiative of Esther Bick. As a Child Psychoanalyst she pioneered a particular technique of studying babies in the ordinary life of their family environment. In 1948, she began teaching at the Tavistock Clinic and in collaboration with Dr John Bowlby she initiated the method of psychotherapy trainees conducting an infant observation. This involved visiting a family to observe their infant from birth to two years. These weekly observations in the natural environment of the baby’s home offered a very vivid learning experience of development. The observers came to appreciate the mutual influence of the developing relationship between mother and baby, and father and siblings. Importantly, the observer also considered how the feelings aroused in them during the observation and how their presence influenced events.

Esther Bick’s 1964 paper ‘Notes on infant observation in psycho-analytic training’ set out the model of infant observation and her view of how much can be learned from it — how to observe, the nature of early infantile anxiety, especially the baby’s fear of ‘falling to bits’, the impact of maternal anxiety and postnatal depression, and the significance of good observational capacities for future child analysts. She emphasized the gathering of data over time, the need to wait for meaning to emerge, and the observer’s responsibility to respect their role as learner and to behave with tact and reliability.

Bick’s ideas took shape at the same time as Wilfred Bion’s work on ‘A theory of thinking’, and these two explorations of the emotional and cognitive dimensions of the early mother-child relationship are profoundly complementary. Both build on the work of Melanie Klein and her pioneering analysis of children.

Later Development

Over the last fifty years courses for professionals working with children and families have made increasing use of infant and child observation as a central aspect of training. It has proved very valuable in increasing professional skills and in sensitising workers to the range of anxieties, difficulties and creative possibilities in each family.

From 1960 to 1980 Martha Harris was head of the Child Psychotherapy service at the Tavistock Clinic. She was responsible for the expansion in the number of English and international trainees at the Tavistock and for developing the training into what became known as the Tavistock Model. This model, in which infant observation continues to play a pre-eminent role, has been adopted with modifications across the UK and internationally: for example, GERPEN in France and the Martha Harris Study Centres in Italy.

Beginning in the 1980’s, and initially supported by visiting staff from the Tavistock Clinic, courses in infant observation were developed to support the training of a wide range of professionals across the UK and worldwide. Over time other components and seminars were added to develop a comprehensive programme leading to post-graduate qualification. The post-graduate programme known as Psychoanalytic Observational Studies that is run under the auspices of the Tavistock Clinic is currently delivered in the UK in Belfast, Birmingham, Bristol, Devon, Oxford and Liverpool and in Italy in Florence, Genoa and Milan. In the UK equivalent post-graduate programmes exist at the Anna Freud Centre and British Psychotherapy Foundation in London, the Northern School of Child and Adolescent Psychotherapy with University of Leeds in Leeds, University of Northumbria in Newcastle and Human Development Scotland with University of Strathclyde in Glasgow. In the US the programs are run at the Washington School of Psychiatry Washington DC since 2004 and at Columbia University.

The Process of Observation

Psychoanalytic infant observation usually involves a weekly observation over a two year period of an infant soon after birth and until their second birthday. Students normally undertake the observation in the home setting for one hour per week. Students are responsible for finding a baby to observe under the guidance of their tutor. New observers attend seminars to discuss the practicalities of setting up an observation and to learn about the process of finding a baby.

Every observation is written down in detail as soon after the observation as possible. This can often take about an hour to complete. Students discuss their observations in small group seminars which take place on a weekly basis over two academic years. Each student has the opportunity to present their detailed observations to the groups. The presentations are anonymised and no identifying features are used.

The unique experience of psychoanalytic observation allows the student to observe a mother and baby, living through and resolving routine and difficult situations in their own ways. With the help of the seminar, the observer learns to process the inclination for judgmental and blaming thoughts which arise when anxiety is stirred. Along with developing sensitivity and precision in observation, the course teaches how to think freshly and inductively from observation, including trying to understand how the developing infant is making sense of his world.

Young Child and Brief Observations

Some courses and trainings, including those at the Tavistock Clinic, The Birmingham Trust for Psychoanalytic Psychotherapy and the Northern School of Child and Adolescent Psychotherapy also offer the chance to undertake an observation of a pre-school child (approximately two to four years old) in their family or in a nursery setting for an hour a week for one academic year. This offers an additional understanding of development through the experience of observation as the child starts to communicate verbally and non-verbally with other children and with adults outside the immediate family and takes a range of steps towards the world outside the family.

Several courses provide the opportunity to undertake a brief infant or young child observation as a less intensive but still valuable training experience. See for example Infant Mental Health and Early Intervention with Under Threes and their Parents.

Infant Observation: International Journal of Infant Observation and Its Applications

Infant Observation is published by Taylor and Francis and the current Editor is Trudy Klauber. The international journal publishes the best of the varied and original writing emerging from this field. It comprises case studies on infant and young child observation, research papers, and articles focusing on wider applications of the psychoanalytic observational method, including its relevance to reflective professional practice in fields such as social work, teaching and nursing. Papers are peer-reviewed. There is a developing body of research knowledge that draws upon the infant observation approach

Bibliography

• Bick, Esther. (1964) ‘Notes on infant observation in psycho-analytic training’. Reprinted in Collected Papers of Martha Harris and Esther Bick. Clunie Press, 1987.
• Harris, Martha. (1976). ‘The contribution of observation of mother-infant interaction and development to the equipment of a psychoanalyst’ Reprinted in M. H. Williams (ed.) (2011), pp. 117–132.
• Harris, Martha. (1977) ‘The Tavistock training and philosophy’. Reprinted in The Tavistock Model: Papers on Child Development and Psychoanalytic Training by Martha Harris and Esther Bick, ed. M. H. Williams (London: Harris Meltzer Trust/ Karnac, 2011), pp. 1–24.
• Reid, Susan. (Ed.) (1997) Developments in Infant Observation: The Tavistock Model. Hove: Routledge
• Rustin, Margaret. (2009). 'Esther Bick's legacy of infant observation at the Tavistock – some reflections 60 years on',Infant Observation: International Journal of Infant Observation and Its Applications, 12(1), p. 32.
• Rustin, Michael. (2006). ‘Infant observation research: What have we learned so far?’ Infant Observation: International Journal of Infant Observation and Its Applications, 9 (1), pp. 35–52.
• Sternberg, Janine. (2005). Infant Observation at the Heart of Training. London: Karnac.
• Waddell, Margot. (2013). ‘Infant observation in Britain: a Tavistock approach’. Infant Observation: International Journal of Infant Observation and Its Applications, 16(1), pp. 4–22.

External links

• Videos of NSCAP students talking about the experience of undertaking Psychoanalytic Infant Observation
• Tavistock Clinic
• International Journal of Infant Observation and Its Applications
• Esther Bick
• British Psychotherapy Foundation
• Birmingham Trust for Psychoanalytic Psychotherapy
• Northern School of Child and Adolescent Psychotherapy
• Human Development Scotland
• Anna Freud Centre
• Association of Child Psychotherapists
• Washington School of Psychiatry