Infant Observations
Over a period of 3 months, I had the privilege of undertaking weekly observations of an infant in my local community. The observations were required for my attendance on the ‘Infant observation in the perinatal period’ course via the Tavistock and Portman Centre. The aim of attending the course was to expand on my observational skills, and to enhance my knowledge of ‘ordinary’ emotional development of parent-infant relationships.
Although the sessions initially created feelings of anxiety due to my limited availability and work commitments, I quickly became fond of attending the sessions. Apart from looking forward to seeing the subtle changes with the infant’s development, I loved watching the evolving and blossoming relationship between the infant and their mother.
One requirement for the observations was that I was not to take notes; rather, I was directed to pay full attention to the infant and their interaction. To be honest, this felt a little awkward at first as although I have observed a copious number of parents during family time within a child protection context, I was mindful of how note-taking can help break the intense awkwardness that I can at times feel. I’m not sure whether other practitioners experience similar feelings, but I know from speaking to parents, the feeling of being closely observed can certainly be overwhelming (I wonder whether the parents’ anxiety of being watched influences my own feelings of awkwardness and this being a result of emotional transference?).
After I contained my own feelings, I increasingly became more focused on trying to make sense of the micro interactions between the infant and their mother. Apart from trying to understand the reasoning for the infant’s fluctuating state of arousal and their strategies for eliciting responses from their mother, it was interesting to reflect on how the mother was continuously trying to make sense of her infant’s interaction. The mother was very good at identifying and responding to her infant’s cues, with this making me reflect on how her interaction was different to some of the parents I have observed during family time sessions.
Most notably, the mother continuously narrated what she and the infant were doing, including her frequently making comments about how she interpreted her infant’s experiences. While reflecting on these observations at the end of one of our sessions, the mother advised that she wasn’t aware of what she was doing, or the possible reason for her interaction. I found this interesting as without intentionality, I believe the mother evidenced the capacity to mentalise for her infant (mentalisation including the capacity to reflect on the experiences and mental states of others). Without such intentionality, this raised the question of how the mother had learnt to mentalise for her infant, and why she appeared to subconsciously believe that such interaction was important for their relationship (the infant is the mother’s only child, with her having no significant prior experience of parenting)?
Having a keen interest in Attachment Theory, I was always trying to make sense of the infant’s strategies when the mother was absent for brief periods, and what the infant did when wanting to seek comfort from her mother. One of the most insightful moments was when the mother left the room, with this resulting in the infant initially smiling at me, and then redirecting her focus to her toys and appearing inwardly focused when she didn’t receive what I assumed to be an anticipated response (I was asked to interact with the infant as little as possible, meaning I didn’t reciprocate the infant’s smile or vocally engage). As soon as the mother re-entered the room, the infant appeared to seek instant connection with her mother by smiling and by vocalising what sounded like an expression of excitement. As soon as the mother responded and reconnected with her infant, the infant’s demeanour instantly changed and all indicators of distress disappeared (for example, the infant no longer presented as internally focused). This brief moment of separation for the infant, and the mother’s capacity for reconnection, made me reflect on the reciprocal dance between the infant and their mother and how their interaction was similar to what I have seen referred to as secure attachment behaviour.
Apart from trying to make sense of the infant’s strategies for connection, the mother shared comments which highlighted an interesting insight into her experiences of being a parent. For example, the mother made comments about her historically finding the process of winding frustrating, but as her infant became older and no longer needed to be winded, she expressed that she had started to miss that experience. The mother also commented on how her infant no longer looked like a young baby; subsequently kissing and gently blowing a raspberry on her infant’s cheek.
The mother’s comments suggested a dichotomy of feelings, whereby she appeared to be relishing in her experiences of being a parent, while also experiencing feelings of loss (loss of her infant’s changing physical appearance, and her infant’s fast-changing habits and behaviours). The mother’s apparent feelings of loss also made me reflect on the parents I have worked with and assessed within the context of child protection; with me considering the additional layer of loss that some parents had to manage when their child was removed from their care due to risks surrounding the child’s safety and wellbeing.
Apart from all the interesting reflective discussions I engaged in with the other participants, and the fascinating literary reviews that we undertook, my favourite moment of the whole course was one moment of connection between the mother and infant. While cradling her infant in her arms and reflecting on her experiences of being a parent, the mother commented on how she always knew that parenting brought people joy, but until she became a mother, she didn’t realise that such joy could be experienced. Not being a parent myself, I found this moment very moving and thought provoking. Most importantly however, it made me feel more motivated to help parents who need support to enable them to experience the feelings of joy that this mother was clearly experiencing on her journey of being a parent.
I would like to express a huge thank you to the mother, infant, and the Tavistock Centre for enabling me to have such a wonderful learning experience…
Reflective Functioning
The importance of Reflective Functioning
Over the past 12 months, I have undertaken a countless number of parenting assessments where the parent(s) had additional needs with their cognitive capacity (cognitive capacity meaning someone’s general ability to process information). Although the parent’s cognitive capacity was an important consideration when undertaking the assessment sessions (this resulted me needing to use visual aids and being mindful of how I structured questions to help support the parent’s engagement), I often found that the parent’s understanding of what needed to change was not a reflection of their cognitive capacity. Instead, I found parents very often lacked reflective functioning, whereby they were not able to understand their own mental states, or how their mental states influenced their parenting strategies. Of most significance, it was also evident that the parent’s lack of reflective functioning was having an adverse impact on their capacity to understand their child’s experiences, including the child’s experiences of being parented.
What is reflective functioning?
Reflective Functioning (RF), also known as mentalization, refers to the psychological processes underlying the capacity to understand oneself and others in terms of mental states such as feelings, beliefs, intentions, and desires. It involves both self-reflection and an interpersonal component, enabling individuals to distinguish between inner and outer reality, pretend and real modes of functioning, and intrapersonal and interpersonal processes. This developmental skill allows individuals to interpret behaviour in terms of underlying mental states, making actions meaningful and predictable (Fonagy et al, 1998).
While rooted in early interpersonal experiences, particularly with caregivers, RF is considered a skill that continues to evolve and may vary across different situations and relationships (Fonagy et al, 1998).
There are significant benefits for a child when a parent is able to mentalize. This includes mentalization helping a parent’s capacity to understand their child’s behaviour in terms of underlying mental states like thoughts, feelings, beliefs, and intentions, as well as playing a crucial role in the child’s emotional and social development (Rossouw et al, 2021).
Some of the key benefits for a parent being able to mentalize for their child may include:
Development of the Child’s Own Mentalizing Abilities: Children learn to identify and mentally represent their own affects through their parents’ interest in their subjective experiences and the parents’ emotional displays that focus on the child’s mind and feelings. Reflective parents teach children to adopt a mentalizing stance themselves in everyday activities, and by being curious about the child’s behaviour, listening, and trying to understand their perspective, parents model mentalizing for their children (Midgely et al, 2023).
Enhanced Affect Regulation and Self-Control: When parents can imagine their infant’s or young child’s subjective experience, it facilitates the development of the child’s affect regulation and self-control. Through processes like attention-shifting strategies and communicating about affects (“I could see you trying to be brave, even though it hurt a little…”), parents help children to start thinking of themselves as having a mind and helps them to develop self-regulation skills (Midgely et al, 2023).
RF makes a child’s behaviour more predictable and meaningful to a parent: By attributing thoughts and feelings (mental states) to the child, the parent can understand the underlying reasons for their actions. This allows the parent to respond more sensitively and appropriately, reducing the need for constant explicit explanations and fostering greater autonomy for both parent and child (Fonagy et al, 1998).
Secure Attachment: A parent’s mentalizing capacity underlies sensitive parenting, which is crucial for the development of secure attachment. Parents who are reflective can mentally put themselves in the place of the infant and imagine the infant’s experience, leading to sensitive and responsive caregiving. Secure attachment, in turn, provides optimal conditions for the development of mentalization in children. Children who develop secure attachment strategies tend to see themselves and their relationships in terms of mental states more than those with insecure attachment strategies (Midgely et al, 2023).
Epistemic Trust and Social Learning: When parents communicate an interest in their child’s mind and feelings, it helps the child to develop the capacity to recognize their feelings and regulate emotions. This also communicates that the information shared by the parent is valuable and that the parent is trustworthy – this fosters epistemic trust, which is the willingness to consider new knowledge from another person as trustworthy and relevant to the self. Epistemic trust is a precondition for the transmission of all culturally transmitted knowledge and helps children open themselves to learn from those around them (Midgely et al, 2023).
Development of a Coherent Sense of Self: A parent’s ability to mentalize contributes to the child’s developing sense of self. Children with reflective parents who help them understand their feelings and behaviours are more likely to develop basic self-knowledge (Midgely et al, 2023).
Facilitating Communication and Connection: A parent who can consider the child’s perspective and mental state will communicate more effectively, ensuring the child feels understood. This aligns with the general principle of collaboration in communication, where understanding the other’s point of view is crucial (Fonagy et al, 1998).
Improved Social Understanding and Relationships: Children of mentalizing parents are more likely to accurately read the intentions of others and show empathy and emotional attunement. They are often better at resolving conflict situations because they can use perspective-taking skills and regulate their own affects (Midgely et al, 2023).
Buffer Against Stress and Trauma: Parental reflective functioning has been shown to be a protective factor in the context of trauma. Even when children experience difficult situations or negative emotions, a parent who can mentalize can help them make sense of their experiences and regulate their emotional responses (Midgely et al, 2023).
Effective Management of Difficult Behaviours: By looking past the child’s behaviour to understand their underlying experience and mind, parents can respond in ways that help the child feel understood rather than simply reacting to the behaviour itself (Midgely et al, 2023). This can prevent the escalation of negative interactions and vicious cycles of non-mentalizing.
In essence, a parent’s ability to mentalize creates a secure and understanding environment where the child can develop a strong sense of self, learn to regulate their emotions, build trusting relationships, and develop their own capacity to understand the complexities of human behaviour.
References:
Fonagy, P., Target, M., Steele, H., & Steele, M. (1998) Reflective Functioning Manual (Version 5)
Midgley, N., Ensink, K., Lindquist, K., Malberg, M., & Muller, N. (2023) Mentalization-Based Treatment for Children: A time-limited approach. American Psychological Association
Rossouw, T., Wiwe, M, & Vrouva, I. (2021) Mentalization-Based Treatment for Adolescents: A practical Treatment Guide. Routledge, Oxon