Infants Having to Face Early Failure
of Parenting: A Workshop Report
Myriam David, M.D.
Catherine D. Isserlis
Françoise Jardin, M.D.
Emanuella Malaguzzi-Valeri, M.D.
Hano Rottman, M.D.
This workshop assembled three teams working for two years in three different settings with mothers who showed serious early failure in their infant's parenting. The teams agreed that both mother and infant suffer and that it is essential to protect both the infant's integrity and potential development as well as the mother's capacities for mothering. This double aim is crucial, though hard to achieve. The main problem is to protect mother and infant against outbursts of violence which the infant's archaic needs may provoke in the mother, and to secure complementary care for the baby when needed, at the same time treating the pathological tie. We attempt either to maintain the continuity and help the maturation of this tie or, if this proves to be impossible, to achieve separation by helping mother with the mourning process and the baby with its archaic feelings of loss and with the development of its attachment to a stable mother substitute. According to the degree and type of the psychopathology of the mother-infant tie, appropriate settings are needed in order to offer the optimal physical distancing between the mother and infant at the onset of the pathological process; such settings should also provide a possibility for modifying the process according to its evolution.
We have been flexible in using these settings, moving the infants and mothers from one to another as circumstances required. The three settings are (1) psychotherapeutic foster‐ home care provided by the Centre Familial d'Action Therapeutique at Soisy sur Seine (referred to here as C.F.A.T.); (2) joint hospitalization of mother and infant provided by the mother-infant unit of the Mental Health District Department of Creteil; and (3) home and day care provided by the Unité de Soins Spécialisés à Domicile pour Jeunes Enfants of the thirteenth district of Paris. Each of these settings is described by a representative of each of the teams.
Foster-home care is used for infants of isolated psychotic mothers who are unable to take care of their babies and may endanger their lives. However, in such cases, separation is a difficult decision. Emanuella Malaguzzi-Valeri explains why the decision can only be made in a crisis situation that is dangerous to both