Parent-child therapy and maternal projections: Tripartite psychotherapy--A new look.

Abstract

Tripartite psychotherapy--where the mother and child are treated together by the therapist--is underutilized as a valuable form of child psychotherapy. Here, a preliminary discussion is based on clinical observations within a brief historical context. Illustrative case examples are offered to exemplify what actually occurs between the mother, child, and therapist in session. This treatment approach is traditionally applied to work with babies and very young children. A basic premise of classical tripartite therapy holds that the presence of the infant in treatment evokes strong transference phenomena in the parent, thus offering direct and immediate intervention within the mother-child relationship. Here, the author stretches the boundaries to extend the age range to older, latency-age children who, within the attachment relationship, may be enacting negative maternal projections.

Risk Factors for Poor Self-Rated Health in Women at 2 Months and 1 Year after Childbirth

“…Many of the infant variables were based on the mothers' assessment, and the answers may therefore reflect their own feelings projected to the baby. 41 All these infant factors could be interpreted as mediators of stress. 18,19 Perceived stress, 42 as well as stress measured by biological data, 43 has been shown previously to increase the risk of poor SRH.…”

Tripartite therapy with older children: mutuality in the relationship of a parent–child attachment

“…My adaptation of the tripartite model for older children facilitates the reorganisation of relational templates within the context of new experiences (Berlin, 2002(Berlin, , 2005. In the therapy situation, past expectations can be replaced with new expectations based on reliable new experiences, and dysfunctional representations transformed into healthier ones.…”

“…Her negative attitudes of being rejected and fantasies of having a close mother-daughter relationship, consciously or unconsciously, powerfully affected how she responded to her child, and compromised her ability to respond sensitively to her child's attachment needs. At times, she projected her own unconscious anger toward her mother onto Emma, and feeling bad herself, perceived Emma as bad (Berlin, 2002), further complicating Emma's reaction to her.…”

“…It diverges from the conventional individual model of intervention in child disorders in its reliance on attachment theory for its conceptual framework, in its attention to the attachment dynamics between parent and child, and in its interpretive attention to those dynamics. I have discussed the history, theory and practice of tripartite psychotherapy in earlier publications (Berlin, 2002(Berlin, , 2005. The purpose of this third paper is to demonstrate in more detail the clinical applications of this treatment approach.…”

Treating a High-Risk Mother–child Relationship

“…It excludes only those children who were recently traumatized or too fragile to tolerate playful, exuberant interactions. Berlin (2002) extended Mahler's model of Tripartite Therapy to work with latency-aged children whose difficulties stem from a conflicted mother-child relationship. She argued that children's attachment needs do not diminish as they grow but continue to influence their development.…”