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Contents:
  1. The International Association for Relational Psychoanalysis and Psychotherapy
  2. Original Research ARTICLE
  3. A Brief Overview of Adult Attachment Theory and Research | R. Chris Fraley
  4. Introduction to R
  5. Beebe, B. & Lachmann, F. (2013) The Origins of Attachment: Infant Research and Adult Treatment
Dr. Allan N. Schore - Modern attachment theory; the enduring impact of early right-brain development

The Origins of Attachment: Infant Research and Adult Treatment addresses the origins of attachment in mother-infant face-to-face communication. New patterns of relational disturbance in infancy are described. These aspects of communication are out of conscious awareness. They provide clinicians with new ways of thinking about infancy, and about nonverbal communication in adult treatment. Utilizing an extraordinarily detailed microanalysis of videotaped mother-infant interactions at 4 months, Beatrice Beebe, Frank Lachmann, and their research collaborators provide a more fine-grained and precise description of the process of attachment transmission.

Second-by-second microanalysis operates like a social microscope and reveals more than can be grasped with the naked eye. She thought a baby may understand some literal meaning of the therapist's words. This is refuted by research, [42]. On the other hand, babies seem to grasp that words indicate something special though they do not understand their literal sense [43]. Dolto claimed that when parents conceal painful or embarrassing facts it may stunt the baby's development, as when a mother wishes to protect her baby and conceal her personal worries. This creates a paradoxical situation for the baby who might sense mother's painful affects beneath her care-taking.

Other Parisian therapists [45] focus on psychosomatic disorders, which they link theoretically to infantile distress [46]. Like Dolto, the Swedish psychoanalyst Johan Norman sought to establish a relationship with the infant, whom he thought possessed a primordial subjectivity and an intersubjectivity. He also thought the baby sought for containment from the therapist, and that she had a "unique flexibility in changing representations of itself and others that comes to an end as the ego develops" [47].

Early therapy was thus recommended.

The International Association for Relational Psychoanalysis and Psychotherapy

He addressed the baby about emotional processes but disagreed that she can understand the lexical meaning of words. Questions about the baby's role in PTIP become less puzzling once we clarify that human communication takes place at various levels, among which the verbal is only one. Many analysts today use concepts by the American philosopher of Semiotics , Charles Sanders Peirce to describe the therapeutic process.

They can help us understand the communicative levels in PTIP treatments [48].

Original Research ARTICLE

A similar perspective is used by infant researchers who micro-analyze the interactive mismatches of certain mother-infant interactions [49] , [50]. Therapists in Melbourne work with babies to "enter treatment through the infant's world rather than primarily through the parents' representations" [51]. They develop a relationship with the baby in presence of the parents, believing that "the infant as subject" needs engagement in his own right.

Its proponents argue that if a mother does not perceive and respond to her baby's signals, a secure attachment will not develop. The therapist asks her to get on the floor, observe the baby, and interact at the baby's initiative.

A Brief Overview of Adult Attachment Theory and Research | R. Chris Fraley

Mother becomes an "observer of her infant's activity, potentially gaining insight into the infant's inner world and relational needs" [55]. The therapist is "watching, waiting, and wondering about the interactions between mother and infant" p. The method also contains supportive elements in providing "a safe, supportive environment…" [56]. See also [57]. The authors use a psychoanalytic framework and wish to promote "the parent-infant relationship in order to facilitate infant development" p.

The baby is seen as a "partner in the therapeutic process" p. The overall goal is to support his "beginning mentalization and emotional regulation" p.

Most authors worked in public health clinics, whereas Norman's cases were drawn mainly from his private practice and were long, high-frequency treatments with what seemed well-motivated parents. Fraiberg often treated mothers with a low educational and economic status [59] , which also applies to the London PIP team. The Melbourne therapists treat severely sick children and their parents. Such factors will influence the parents' trust in the clinician, motivation for therapeutic work, and economic and practical means of taking part in treatment.

PTIP therapists have published clinical studies in various scientific journals. Randomized controlled trials RCT are increasing: [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70]. We focused on the therapist's impact on the patient, but not the patient's impact on the therapist.

Nevertheless, Burton's impact on Beatrice was powerful and palpable in the treatment, and we discussed this in the chapter. Burton clearly knew that he was very important to Beatrice. We also conceptualized the nature of Beatrice's influence solely in terms of interpretation. In the chapter, we do note that in retrospect there was a powerful nonverbal process occurring as well.

The use of nonverbal processes constitutes a continuity in the way we work clinically; although, we now conceptualize these processes more explicitly. Another important continuity in our work, then and now, is the emphases on self-regulation, although we did not use that term as a central organizing construct in the treatment of Burton. In retrospect, we focused intensely on his self-regulation difficulties: drug use, eruptive aggression, and an addictive quality to his relationship with his girlfriend.


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Estelle: As I read your work, you argue for the view that the value of infant research is that it serves, not so much to enhance our understanding of the infantile origins of adult psychopathology, nor that it provides apt metaphors for understanding the relationship between patient and analyst, as that it enhances our understanding of interactive processes between patient and analyst, processes that remain similar across the life span. First, are you merely drawing analogies here between infants and mothers and the two adults in the treatment situation, or are you actually defining how self-and-interactive regulation evolves between individuals of any age?

Second, if the latter is true, which I think it is, does not your innovative, indeed almost revolutionary, perspective on what constitutes the real value of infant research, that it neither describes earlier stages that are recapitulated in adult treatment nor suggests similes for caring relationships, separate your work from most of the thinking that has already been done on the usefulness of infant observation and research for understanding adult treatment?

Estelle: Along this line, when we think of how to understand "normal" development using a nonlinear dynamic systems perspective, it seems to me that the older stage or phase models taking the individual into maturity are cast into severe question.


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How do you now think of development past infancy? Do you think the fruitful ideas brought forward here by you would offer new ways to approach this question? What about "critical periods? Frank: We have not worked on this problem; although, it is clearly very important. Estelle: Contemporary psychoanalytic contributions divide between those that conceptualize room for both the intrapsychic and the interpersonal or intersubjective in their theorizing, and those that focus exclusively on the intersubjective.

With your systems model focusing on self-and-interactive regulation, it would seem that both the intrapsychic and the intersubjective, or interpersonal would pertain. Is that accurate? Estelle: Or how do you think of this issue?

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And how do you think of intersubjectivity? In a developmental, sense, ala Stern, Benjamin, Ogden, or in Stolorow, et al's conceptualization? Beatrice: This is too big of a question to address here.

Introduction to R

Estelle: At the end of the Chapter on "A Dyadic Systems View," you offer an excellent summary pages of the general principles for a theory of interaction at the nonverbal level, one of the many gifts that you provide for the reader of your book. These principles, as you indicate, help us to understand how inner state and interactive process are integrated.

Would you say that this set of principles applies to the adult treatment situation? Or would they have to be modified or selectively applied? Frank: In Chapter 9, we believe the dimensions of our dyadic systems model in relation to its implications for adult treatment.

Most of the points in the summary of Chapter 2 "A Dyadic Systems View" reappear in Chapter 9 where we spell out more directly how these concepts can be used in adult treatment. Estelle: I think that Chapter 7, "Representation and Internalization in Infancy: Three Principles of Salience" is among the best of the chapters in this book, expanding as it does on that most original paper that the two of you wrote, I think in , where I first came to really love your contributions. But now you have included much more, particularly material that enhances our understanding of psychoanalytic treatment.

The three principles are so salient, that perhaps you wouldn't mind recalling them in your own words for the readers of this review? We revisit the subject of presymbolic representation in order to illuminate the origins of internalization. We suggest three organizing principles, three "principles of salience," that determine the salience of events for the infant, organizing what the infant expects from interactive encounters. These three principles are 'ongoing regulations,' 'disruption and repair' of ongoing regulations, and 'heightened affective moments.

Beebe, B. & Lachmann, F. (2013) The Origins of Attachment: Infant Research and Adult Treatment

They constitute hypotheses about how expectancies of social interactions become patterned and salient in the first year. In the next chapter we apply these principles of salience to an adult treatment case, showing how they can further specify modes of therapeutic action. These three principles give us additional ways of drawing analogies between adult treatment and infant research. Disruption and repair captures a specific sequence broken out of the broad pattern.