Infant Mental Health Awareness Week blog: Observation and Attention

11 June 2020

To mark Infant Mental Health Awareness Week 2020, Jenifer Wakelyn, Watch me play! Programme Lead, speaks on the importance of staying curious and being attentive to infants. 

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Introduction

Freud described attention as a ‘form of observing thought’ which he saw as having two distinct aspects: one active, one more passive or receptive. The active aspect he describes as ‘going out to meet perceptions’, while the passive aspect can be seen in the stance of evenly-suspended, free-floating attention that he recommends to psychoanalysts to allow the most direct contact with instinctual life (1912; 1923).

Freud also described attention as a form of psychic energy that gathers perceptions together and looks for patterns of meaning. This idea of gathering was prominent in the thinking of Esther Bick, the child analyst who developed the Tavistock model of infant observation in the late 1940s. This is what she said in comments reported by Gianna Williams:

“Your attention to everything she does and everything she says acts like a magnet that draws together the fragments of her personality... a magnet drawing together iron filings – that is what a mother’s attention also does for a baby” (personal communication, cited in Williams 1998: 94).

In my view, observational approaches and the gathering functions of attention have an important role: they keep alive and real the needs and experiences of young children and they allow children to experience being held in mind.


Therapeutic observation   

Therapeutic observation as an intervention is rooted in psychoanalytic infant observation, a core aspect of trainings in which observational skills are learned through weekly visits to a baby or young child in their family context for up to two years.

Although the main purpose of an observation, undertaken as part of training, is learning for the student, many families who have chosen to accept the offer of an observation have reported finding it helpful for themselves.  The regular visit of an adult who is interested in every detail of the baby’s life, and the impact of the baby on the whole family, without being intrusive or didactic can be welcome.  Some parents have commented that the observer’s presence encouraged them to observe their own growing infant more closely (Watillon-Naveau, 2008). This recognition has led to the applied use of infant observation for therapeutic purposes (Urwin and Sternberg, 2012).

In the mental health service where I work as a child and adolescent psychotherapist I had the valuable opportunity to carry out clinical research into the acceptability of therapeutic observation. Observation-based interventions are now part of the offer in First Step – a mental health service commissioned to identify psychological needs for children and young people. They are the link between the original model of infant observation developed by Esther Bick and our latest work on Watch Me Play!

 

Watch Me Play!   

Watch Me Play! grows out of the Tavi’s illustrious history of research in child development. It is a simple way for parents and caregivers to support their baby or young child. It was developed in First Step as an intervention to promote child-led play, enhance relationships between children and carers, and create a better understanding of each child’s strengths and needs.

The Watch Me Play! approach grew out of the experience that sharing direct and detailed observations of children and their play can help to bring to life something about the experiences of a baby or young child. It promotes child-led play, individual attention from caregivers, talking with children about their play and talking with caregivers about what it is like to be with the child when they are playing. Caregivers are encouraged to provide children with age-appropriate toys and their undivided attention in a quiet environment for about twenty minutes twice or more often a week. Caregivers are also encouraged to talk with the child about their play, and to reflect later on with another involved adult or professional on their observations of the child’s play and on how it felt to be with the child as they played.

 

Conclusion

Although Watch Me Play! was developed as a first-line intervention for children who have had adverse experiences or have needs that are difficult to understand it has a much wider application. Watch Me Play! offers opportunities for children to gain a sense of personal agency and to explore their world and their relationships with the confidence that their communications can be taken in and taken seriously by the adults caring for them. 

Attention and play are complementary: observing with warmth and interest helps a child play. In turn, as the child’s play becomes more focused, it becomes easier for adults to remember and think about. Holding the child in mind is a fundamental aspect of parenting. Throughout a child’s early years and beyond, play is a hugely important part of developing relationships.  Being in tune, relaxed and playful together helps babies and children to grow up healthy and secure. It’s good for parents and caregivers too: playing together means growing together!

This year Jenifer Wakelyn (Programme Lead WATCH ME PLAY!) and Andrea Katz ( parent-infant psychotherapist and ITSIEY course lead) have revised and updated the original Watch Me Play! manual for parents, taking on board the feedback, comments and considerations that have been received since the first version was published. The new enhanced version of the Watch Me Play! manual has been produced as a beautifully designed book that provides a gateway into the world of child’s play. The project has already generated significant interest worldwide and there are plans to translate the new manual into Russian, Italian, Japanese and Estonian.


To download your copy of the ‘Watch Me Play! Manual for parents visit: tavistockandportman.nhs.uk/watch-me-play

 

 

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