“There is no hope of joy except in human relations.” Review of Relational Trauma in Infancy

This review highlights the need for ‘touching’ in our life, and how that need is therapeutic – in our relationships and in our sense of self.  

Baradon, Tessa (Ed) (2010) Relational Trauma in Infancy: Psychoanalytic, Attachment and Neuropsychological Contributions to Parent-Infant Psychotherapy. Routledge: Taylor & Francis Group. London and New York. 

            As I read this book, my associations kept returning to the thoughts of a scientist that I had read thirty plus years ago during a psychology class.  The professor introduced the class to the work of Jacob Bronowski. The professor continued my introduction to Freud, to the stages of child development from the various schools or orientations, and highlighted each stage remarkable for its place in the mid-1970s period.  He also focused our understanding of what the goals of psychotherapy were, as he was also a practicing clinician. 

            It was this professor’s insistence on our reading this short book of essays by Bronowski (Science and Human Values) that is most memorable.  Bronowski’s underlying theme throughout this work – and undoubtedly my professor’s motivation – was “we must touch others.”  Jacob Bronowski was a scientist and a humanist – but ‘touching others’ in the relational sense was a thread that ran through much of his work. 

            The parallel in this review is on the change possible within relationships. This excellent collection of work brought together by Tessa Baradon aptly demonstrates, especially through the clinical illustrations, the need to touch others – to help those that have been so afflicted by trauma and traumatic circumstances that the relationship between a mother and an infant is so deeply affected and in need of professional understanding and aid. 

            The researcher’s contributions in this collection present their attempts to assess, to integrate, and to document the diagnostic criteria that will be useful in furthering the clinical endeavor.  The data also illustrates the efficacy of the clinician’s work with these traumatized parents and infants.  The focus is on the relationship – touching each other – and, as was underscored by Baradon and Bronfman, the capacity to increase our sensitivity to and understanding of the infant and parent in trouble – and enhancing our therapeutic efforts.  Linda Mayes also highlights this constant thread in all the psychotherapeutic work discussed in the  clinical and the research-oriented chapters, that is, the parent’s ability to reflect on the emotional needs of the infant and, importantly, to the understanding of how the parent’s needs, wishes and behavior “directly impact [the] infant’s feelings and needs.” 

            The essays in this collection cover an extraordinary range of work with parents and their infants, and in their fascinating and encompassing manner, each essay depicts a unique clinical setting.  The parent-infant programs that are established at the Anna Freud Centre are detailed, as are those centered in community locations, such as Sure Start – a governmental enterprise aimed toward preventative intervention. ‘Containment’ is offered as a contextual approach for therapeutic work that is being done with traumatized mothers and their infants.  This work is done by psychotherapy consultants in the community, and their endeavor to contain the anxiety consequent to the impact of poverty and social isolation that frequently attend these relational pairs. Several approaches are offered with richly evocative descriptions of the clinical work with the homeless population – living in hostels – and these attempts utilize health visitors, infant-parent psychotherapists, and a research psychologist. Further therapeutic efforts include the Mother Baby Units (MBU) in a prison, work with immigrants – with particular attention to the trauma visited upon them in their homeland prior to coming to the UK, and last, the enormously unsettling work with very disturbed mothers.  This last category includes vivid vignettes with a woman that could avail herself of the support offered – and those that could not, i.e., ones that could not escape their disturbance enough to progress into a closer relationship with their child. 

            Developmental scientists find their mark in this collection by demonstrating the significant strides that are made in epigenetics, with attention to the gene-environment interaction – and the advances made in molecular genetics in relation to that interaction. The need to integrate the findings of these studies with psychoanalytic theory is addressed, with a very comfortable perspective on understanding the role of environment, the psychological, and genetics in relation to traumatic experiences. The impact of these experiences and their consequences for the individual are discussed.  The ultimate benefit of much of the work presented in this volume will be in early intervention efforts with parents and infants – efforts that have shown dramatic therapeutic results.  Further work in this area of genetics revisits the concept of resilience.  Though not new to the field, the concept is attracting attention once again in light of recent research and findings, and the complex role of resilience in counterbalancing or moderating the effects of adversity is understood more comprehensively in relation to trauma. 

            Similarly, the role of attachment research is featured with respect to neurobiology, as well as the assessment work with the Adult Attachment Interview (AAI), both in relation to preventative work with infants and trauma.  The Parent-Infant Relational Assessment Tool (PIRAT), developed at the Anna Freud Centre, has been shown to be valuable in the effort to identify risk in the relationship between parents and their infants. 

            The “therapeutic endeavor for change,” to use Baradon’s term from this volume, may be thought of as the particular focal point in each of the contributions made in this collection. More directly to the point, the therapeutic work being done by all participants is exceptionally well illustrated by the metaphoric use of ‘ghosts’ and ‘angels’ in the nursery – ghosts or angels that aid or hinder the transformation of a healthy, forward-moving relationship between a parent and their infant.  I am also reminded of a phrase from The Little Prince, “There is no hope of joy except in human relations.”  This is the sine qua non of our therapeutic work.     

Rudy Oldeschulte

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