Studying the process of psychoanalytic parent–infant psychotherapy: Embodied and discursive aspects

Abstract

This paper presents findings from an intensive, mixed methods case study of one session of psychoanalytic parent-infant psychotherapy (PPIP) addressing early relational trauma, and aims to shed light on the multimodal interactive processes that take place in the moment-to-moment exchanges comprising the therapeutic encounter. Different research methods were used on video material from PPIP sessions, including microanalysis of adult-infant interactions, discourse analysis of talk, and coding systems developed to study parent-infant interaction. These different perspectives were brought together with the clinical narrative to illuminate the complex, dynamic processes of parent-infanttherapist interaction. More specifically, the detailed analysis of one interactive episode revealed brief behavioral manifestations of fearful and disoriented states of mind, reflecting dysregulated interaction between mother and infant, which also powerfully affected the therapist. The processes through which the therapist gradually resolves this rupture are also described in detail. Through this pilot study, we were able to show that it is possible to systematically study the process of PPIP. The study contributes to the growing psychotherapy research literature that takes into account both the verbal domain and implicit, interactional processes in therapeutic practice, and underscores the therapist's comprehensive engagement in the therapeutic process.

Exploring Conversational and Physiological Aspects of Psychotherapy Talk

“…There is an extensive research literature on infant-parent interaction using multimodal microanalysis to examine live embodied interaction (Beebe, 2014(Beebe, , 2017, and it has recently been suggested that this could be extended to the study of implicit processes in psychotherapy (Beebe, 2017). Indeed, some recent studies have applied microanalysis to psychotherapy with interesting results (e.g., Harrison and Beebe, 2018;Avdi and Seikkula, 2019;Avdi et al, 2020;Graver, 2020). Drawing upon the literature on infant-parent interaction may provide conversation analysts with both concepts and analytic tools that can help include the implicit domain when studying the process of therapy.…”

“…Our aim is to explore ways to expand our understanding of the interactional processes underpinning psychotherapy by studying the therapeutic conversation in conjunction with nonverbal displays (primarily of affiliation and disaffiliation) and psychophysiological measures of participants' autonomic arousal during the session. Our methodological approach can be described as a 'layered analysis' (Avdi et al, 2020), as we examine the same interactional events on different levels and using different methods, and combine findings in an attempt to generate a multi-layered, clinically-informed description of therapy process. In line with the focus of this special issue, our broader aim is to better describe 'what takes place' in psychotherapy.…”

Observing and interpreting clinical process: Methods and findings from ‘Layered analysis’ of parent–infant psychotherapy

“…The method of Layered Analysis (LA) was applied to brief segments of video‐recorded psychoanalytic parent–infant psychotherapy sessions with four therapist–parent–infant triads. Layered Analysis (Amiran et al., 2019; Avdi et al., 2020) is a group‐based analytic method that integrates a range of approaches to study therapeutic process. Analysis takes into account the clip's cinematic qualities, in the sense of movement, timing, rhythm, affective tone, and narrative.…”

“…We have drawn upon this method of observing parent–infant interaction and the application of the microanalytic approach in different clinical situations, and brought the therapist's countertransference into dialogue with it. The method of Layered Analysis we have developed (Amiran et al., 2019; Avdi et al., 2020) studies clinical process in psychoanalytic parent infant psychotherapy (PPIP). PPIP treatments are of particular interest because the embodied, nonverbal communications between babies and their parents are of primary importance and are a central focus within the sessions (Baradon with Biseo, Broughton, James, & Joyce, 2016; Lieberman, 2004).…”

The imprint of systems theory upon psychotherapeutic process.

“…Parallels exist across effective therapeutic methods and applications, as in parent-infant psychotherapy (Avdi et al, 2020;Stern, 1995) and mentalization therapy (Asen & Fonagy, 2020;Bateman & Fonagy, 2013). Just as systems of all sorts can encounter redundancy and stasis, so can therapy.…”