Who do I love when I love my mother? Who do I love when I love my baby?

Separation and Attachment Themes in Parent-Infant Groups.

 

Authors: Norma Tracey, Vera Auerbach, Mary Cameron, Helen Kvelde, Maria Kourt, Maggie Newlyn, Sylvia Enfield, Lorraine Rose, Beulah Warren.

“I start to be impatient. There is a confidence in me emerging now, that life might be even more beautiful with you at my side, instead of inside me. I will find the patience to deal with noisy out-of-control children, I will find the strength to make them breakfast on hardly any sleep and I will ring for help when I need it. And you will be there, making it all worthwhile, enjoyable and beautiful. Together we will embrace chaos, enjoy it and eventually defy it – everybody will find their place, we will negotiate, rotate until we will find an equilibrium acceptable for all five of us – until one of us starts moving again. The order will collapse like a house of cards and we will keep on building and building. We will make a good team.” (A group mother two days before her infant’s birth)
Background: This paper is the result of discussions by ten psychotherapists, all of whom are members of the Parent Infant Foundation of Australia (PIFA) and facilitators of parent infant groups. The groups are for pregnant couples, mothers with newborn infants, mothers and/or fathers with babies up to four years of age, mothers with infants and toddlers and mothers with special needs infants. There are six groups in all and an average of 6 to 8 mothers attend each group. The groups are available on a weekly basis and continue from a year to several years. Each group has two facilitators who are trained psychotherapists. Some of our mothers and fathers with infants are from the local community seeking friendships and support in the ordinary everyday process of parenting, in some cases they are ‘at home’ fathers, others are referred by professionals with some problem either with their infants or themselves, e.g. postnatal depression, sleep problem, serious illness in the infant, loss of partner, etc.
Some of the groups are open and new people are added as mothers go back to work (or children go to kindergarten). The group can support a mother through from the first pregnancy until the third child is well established in kindergarten. Each group varies according to the needs and desires of the mothers as well as the learning and skill of the facilitators. Every group is different. Differences are encouraged and respected. These differences may range from intensely psychotherapeutic groups to groups modeled on a “Therapeutic Community”. The groups are not publicly defined as therapy groups, but group interpretations are part of the group work to assist the facilitation of the group and support members of the group. The infants and toddlers are always present, playing or feeding, sleeping or interacting with their parents and others as an integral part of the group.
Each new group has a support person as it is becoming established. All facilitators attend fortnightly supervision with a group specialist (trained in the Tavistock Group tradition). Further consultation with an organizational specialist (also trained in the Tavistock Organisation model) is called on as needed to help us define the organization’s identity. The professionals are a loose group of individual therapists contracted to run parent infant groups in a formal legal structure we called PIFA. The Foundation is privately funded and all professionals are paid.
The groups are the beginning project of the Foundation, and home-visiting of mothers with special difficulties who are in the groups is part of the program. A counseling service is being added. The main author of this paper is the coordinator of the study, research and education section of the organization. Her role is to create a space where thinking can occur on the work we do. This paper is the result of that thinking.

Group Philosophy: The group philosophy stresses that the groups belong to the mothers and/or fathers and each group is defined according to its members’ needs. Facilitators create a waiting space where this can happen. In that space we are the receptors and the holders of the mothers’ and fathers’ feelings. The counter-transference feelings projected are quite different from those in ordinary therapy, as these mothers are “really” occupants of a special internal space, through being pregnant and having a baby. The chaos and depth of emotions the mothers bring to the groups can surprise us and its effect on us is enormous. Sometimes we have thought nothing much had occurred, but the emotions took days to process. Some groups are extremely intense, others are not; some are more social and more community-based but carry a depth of material able to be brought to the group and thought about.

Our Work in the Groups

Our work in groups to date is a story of ambiguity and paradox. It is also a story of confusion and chaos. This is the space mothers and babies occupy normally, so our experiences seem to correlate all too closely with theirs. Here within our groups there seems to be a virtual pregnancy in the making, with all the precariousness and questioning that the pregnant mothers in the group might themselves be having with their pregnancy. The sense of clumsy, struggling uncertainty that we experienced is not very different from that of the mothers with their infants. The groups became our “infants”, formulating very slowly over time, with us never sure that each group would make it at all and never sure what form it would take. We felt as powerless as the mothers did to direct how the group would go and even whether it would go. Faith was a necessary state of mind, as indeed it is for every mother.

Carrying the Projections: Into the group came the emotions of being a mother and having a baby, losing the old identity, in-laws, the parents, the children, sibling rivalry, sleep, and feeding. We did not advise, since we were not equipped to do that; our task was to carry the projections, in the sense of being the holders of the emotions, pain and frustrations the mothers brought to us. But more than dealing with individual mothers, we held the centre of the group experience. Often the groups appeared ordered superficially, but projected feelings of chaos seemed unconsciously to create a sense of disorder in our minds, especially when the little ones were at the toddler stage.

Life – Death

In this section of the paper our focus is on the mother’s and infant’s terror of death or annihilation before the birth process and certainly as a result of it. We focus on the interaction of the mother with her infant and how it is affected by the mother’s fear of death and the infant’s fear of death. These link in our minds with attachment and separation. We concentrate our attention on this fear, while remaining aware of the myriads of other factors that affect the nature of attachment and separation.

In the normal mother-infant interaction the mother holds the infant in her mind (and arms) to procure his or her sense of safety. She is aware in the separating out of a “thinking through” process, in which the dose, the timing, the fit for herself and her baby is an ever-present interactive concern. She shares in and is part of the separation, the sense of loss and sense of liberation. In our groups there were many mothers at one extreme who could not separate, because to separate (even to help their baby feel safe to sleep), would in their minds be akin to allowing death. There were other mothers who were so “switched off” from terror of any kind that they separated from their babies with no thinking to either planning or directing the dose or the timing of the separation, sometimes creating a similar trauma in their infant to one they themselves had previously suffered, either in infancy, childhood or adolescence.

From Oblivion to Catastrophe to Psychic Being: What processes take place as the infant moves from oblivion to becoming, as we traverse from nothing to something? How do these processes create, impede or destroy psychic birth? Until we are psychically alive we cannot know the terror of annihilation, and yet the central core of being alive has to do with surviving the terror of annihilation. Beginning becomes like making a massive effort to pass through a force field, an anti-life field, where the “big bang” that destroys all is also the big bang out of which life is born. Hopefully the result is the triumph of Freud’s eros over thanos (Eigen, 1996). But this is not always the case; sometimes mothers, fathers and infants suffer terribly from past losses, awakened now to impinge on them.

In the latest scientific theorizing, the “big bang” was followed by an immediate, incredibly speedy and massive movement of parts gathering together to survive. Eigen (1993), in thinking through Bion’s work, sees this early time as filled with “primordial terror”. He says, “for Bion there is something terrifying in the very birth of self and the latter’s inextricable tie to oblivion that is part of it and that it is part of.” It is that sense of catastrophe that links aspects of the personality. “Cataclysm is a formative part of our being,” Eigen says. “The first thoughts were non-thoughts. They are catastrophic hallucinatory bits and pieces which seem to function chaotically, that is without reference to one another … feelings of depression, persecution and guilt, aspects of the personality linked by a sense of catastrophe” (1993, p. 216). “In optimal growth, this dispersed state culminates in the emergence of genuine coherence. The transmuting of such primordial emotions to emotions that can be thought about and thought through heralds the advent and the evolution of self (alpha elements)”. Eigen (1993, pp. 114–119). In Bion’s (1977) terms, without a sense of catastrophe there would be no self and without self no sense of catastrophe. The capacity to experience and sustain the experience of catastrophe is everything.

With these theories to inform our work, we wanted to observe and document (and think) about how mothers and infants traversed the area of separating out, which is an inevitable part of becoming. It explains the depth of feelings the groups exposed, such as emotional conflicts in areas of our unconscious that we may not normally have had access to.

Parent–Infant Love: Who Do I Love When I Love My Baby? We might ask this of the mother. And likewise, “‘Why’ and ‘how’ do I love when I love my baby?” Frances Tustin (1983) wrote about holding the baby in “the womb of the mother’s mind”. She wrote also of the catastrophe when the baby was prematurely separated and the sense of “at-one-ness” was ruptured. This is a well-accepted phenomenon in our thinking. “The bough breaks, the cradle falls”, and there is catastrophe. Does the mother’s love protect from the crash? In primary maternal preoccupation we think about the mother’s love protecting the baby not only from the dangers without – cold, hunger and illness, but also from the dangers within – her own hate, anger, murder and rage at the loss of the baby from her womb. Her love forgives the baby for being separate, for being. But her love also protects the baby from his or her own internal overflowing emotions, linked with a terror of death and annihilation. Does it mean when a mother loves her baby, that she is loving life more than death?

Who Do I Love When I Love My Mother? Likewise for the baby we might ask: “How do I love when I love my mother? or “Why do I love when I love my mother?” Does the baby love the mother to save him or herself from annihilation? Is the baby’s natural life urge so real and rich that it overcomes so much to find the mother as his or her total source of survival? One of our members, from her experiences of supervising infant observations and her work in the pregnancy couples group, spoke of the massive strength of the thrust for life and health, both in the couple before the baby is born and in the infant to find that person whom he loves and who loves him with all her heart, soul, mind and strength. This is how the infant loves his or her mother. From this comes the survival of “the catastrophe in becoming” (Eigen, 1993, p. 216). We are touched in our work by the incredible efforts mothers go through to bond with their babies and the incredible efforts babies go through to have their mother’s attachment. Such attachment protects from the terror of death. When the mother and infant cannot negotiate the dread, they cannot enter into or face it, and paradoxically then they cannot leave it.

Mothers in Our Groups

With this kind of thinking in our minds we had the chance through our groups to observe ordinary everyday mothers in the interacting with their babies. These mothers joined our groups for the company of other mothers, or because their own mothers were in other cities, or because they had built up friendships in their workplaces and therefore did not know other women who were mothers. It was these observations in the group and in infant observation that led us to ask, “What is the norm?” In the “good enough” relationship, does the holding in the mothers mind bring the baby through the catastrophe? If so, then the holding we were giving in the groups, the space we were creating for the mothers to hold each other, was central to everything we did. While there were some “good enough” mothers, we were also the observers and holders of some very disturbed women. Nevertheless, we never stopped being surprised at how often our predictions were inaccurate and how many problems the mother and infant faced and were able to overcome. This was in part the extraordinary motivation of mother and infant to get it right for each other. We developed a respect for the role of the father in holding the mother–infant couple, as we saw the difference such a presence made compared to our mothers who were without partners. A pathological past uncovered by the pregnancy and birth processes can sometimes, in such an optimum environment, be repaired. There is something about the organism’s desire for survival and the mother’s protectiveness that we lose in viewing pathology only, so we felt privileged to observe and interact with “good enough” mothers, as well as with the many mothers whose past was not as easily overcome, or who had a dreadful present with illness either in the infant or themselves.

Holding the Faith

We began to think how central the mother’s and father’s faith is to life itself. Without someone holding the faith one could wonder how anything ever comes into being. This is largely an unconscious process but it probably becomes more conscious when things go wrong. We think it is one of the mother’s most important functions to hold onto some kind of faith, unspoken and often even unknown to the mother, but all the same a faith that life itself is worth having and experiencing, for however long or short a time, and however much risk there is of pain or damage. Without this capacity, how does any pregnancy even hold, as there is always risk of death or damage in pregnancy. Fathers help to hold this faith, but the mother literally holds it in a physical sense as well during pregnancy. And mothers are also prepared to risk harm and damage and even death themselves in order to bring forth new life. This has to be a strong faith that life is worth creating.

Vignette 1: A Baby with a Chromosome Disorder

A Facilitator Reports: A mother in our group has a baby boy with a chromosome disorder. She has no idea how damaged her baby will be, she has no idea if he is going to be mentally retarded, and he is possibly blind. This mother just gives and gives. Sometimes she is in a lot of pain and anguish. She struggles with their life as a unit, maintaining an amazing constancy towards the baby, always trying to do things the way he prefers. She looks often sad and tries to maintain a lively expression and voice for the baby. I think it helped her initially to have the group to hold her to some extent in her pain. She certainly never talked about issues like faith and if anything tried to be very practical, always trying to do what she could to maximise her baby’s potential for growth. Yet we felt there was an unspoken faith in this woman about the meaning of life – or something similar which sustained her through the most enormous difficulties. It is not a glib thing, this faith, because it is faith in the face of all darkness and hopelessness, yet still going on and not giving up. My feeling is that this mother is struggling with pain and loss, and while at times it seemed as if she could distance herself from the baby, we were not sure that she would. For us she was holding the faith without condition, even if the baby did die or was damaged. It was an act of love, an act of love regardless. It seemed she was enacting that it is worth doing, even if he did die. Is it better to have loved and lost than never to have loved at all, we may wonder? It may also have to do with the spiritual survival.

Vignette 2: A Baby with a Heart Defect

A father had held the faith for his own infant son at birth when he was discovered to have a heart defect. The mother was unable initially to attach because of her fear of losing this baby. The father would go in and hold the infant on his bare chest. He was also afraid of the baby dying but despite this held the baby next to his body and allowed attachment with full awareness of the pain this would bring.

These examples are extreme, because there was risk of damage and death, but it brought home to us that just to be alive means to be at risk of death. Yet we don’t usually think about it.

If the mother loses the faith, then she does not hold her infant in a way that allows the infant to remain in the suffering of the catastrophe, for true faith sustains the holding regardless; it is blind faith. This may be the earliest idea of a container, “an infinite container” as described by Eigen (1993, p. 217). We began as a group to think about how the role of the mother in protecting and holding creates the first paradigm of how catastrophe can be faced with faith. Is this the beginning of a psychic self, we asked? Her capacity to sustain her infant through the no-faith area of catastrophe means she will not have to avoid pain but can take her infant through it. In our groups this played a very important part for us, as we simply held the group regardless. The victory through survival strengthens mother, father and infant.

The group’s continuity and its meaning to the mothers never stopped surprising and delighting us. We began to think how initially a mother is emotionally present for her baby because she has an emotional meaning for herself as mother and she has faith in that meaning. But we also saw in our groups mothers for whom faith is lost. Tracey wrote: “The problem of the depressed mother is that she has no faith that if she falls apart she will come together again. We were thinking that in some early stage in the depressed mother’s life, the “holder of the faith”, her mother, has failed her and has failed to hold her through the catastrophe” (Tracey, 2000, p. 188). Here with her new baby, with her partner’s support, with the group’s support, even as we hold the group, maybe another chance to get it right presents itself to restore faith.

Vignette 3: A young mother with a six-year-old came to the group before her second child was born. She had had a previous baby die after her first child and did not think she would be able to conceive again. She attends the group every single week. Her six-year-old son attends a special school for “emotionally challenged children” as a result of his high levels of aggression and attention deficit disorder. Mother said she went back to full time work too quickly after her son was born (4 months) and this time she wanted to do it differently.

This mother then proceeded to do everything slowly with her daughter. She didn’t want her to crawl too quickly and discouraged movement, and her daughter did not craw until she was 11 months old. She did not want to introduce solids too soon, so that by 10 months her daughter refused all solids and continued to only take breast milk. This mother was not in favour of her baby being immunized until the last possible moment. For the whole group session the baby would either be asleep or nursed on the mother’s lap. A crisis came for her when her baby was 12 months old and she had to return to work for four days a week following her husband’s retrenchment. Her husband at present continues to attend the group each week in her place and is willing to share his emotional experience of fatherhood with the other group members. At 12 months the baby is moving about more and appears more interested in objects around her.

Discussion: This is a mother who, because of all her past trauma, not only could not separate out from her baby, but at the same time could never find her baby, or be with it in the true sense. Lost in her own terror, what she did was for herself and past babies, not for this baby. We thought of how she was using this baby to undo and enact a different relationship to the one she had had with her first baby. We thought she was trying to find the all-giving internal mother opposite to the cruel, killing mother who has had ascendancy in her mind with the trauma of the death of the last little girl.

Symbiosis is a defence against death but there is no security in such an attachment – it is a highly anxious attachment. The anxiety whether she as mother could hold this one in life was tremendous. It made us question whether one could work through the loss of a miscarriage without some lasting effect. She seemed oblivious to the actual needs of her baby, as if caught in a continuum of unconditional holding and attention.

This led us to think about what it may mean for a mother who gives birth to an infant that dies. Facing that there is no all-providing support for life, that death is ever present regardless of her protection, was terrifying for this mother. Perhaps the real sickness for such mothers is that they cannot, like the “good enough” mothers in our groups, dare to go into the emotional chaos, dare to let go and therefore dare to be with the baby. Such a mother has inside her a betraying mother (often a betraying god) who has abandoned her in her moment of need, or else she clings to a belief and is unable to move beyond it to the area of non-belief, where all true belief is held. She has to be the “good mother” and as such cannot face being frustrating in any way. As she is unable to move beyond symbiosis she loses empathy with her infant. While caught up in the baby’s death she is unable to see the living baby who needs her.

Attachment and Separation – How Individuation Can be Enacted in Organisational Processes

Even as we write this paper we are very much in the process of individuation as an organization. Some of this creates great suffering; all of it requires faith. We continue to be amazed how much we, as a new infant organization, are experiencing parallel processes. Our group facilitator highlights these for us in fortnightly work discussion groups.

The founder of the organization had to let go and found this “fascinating, confusing and painful.” The organization’s members were confused, “Was she holding on too much?”, “Was she letting go in a way that will confirm life independently lived, or in a hostile way that determines a failure for the separating out?”, “Was she being pushed out into oblivion or was she simply making room for the organization to realize its own self as a functioning entity?” Sorting out the ambivalences in this process and tolerating them, realising how often we descended into the primitive and the ensuing fights in the sorting out and sorting through, gave us a first hand view of what was happening for the mothers as they struggled with separating out. Each mother and each baby struggled to satisfactorily find a rhythmic movement of alone and together, alone and together, a dynamic that goes on with increasing freeing for both, or in non-resolution an entrapment for both. In our own organization, relief and a sense of satisfaction each time we survived was short-lived, as we moved into another situation that would threaten us all with irrelevance or loss of meaning to our value in the organization. We wonder if this was what was happening to our mothers?

Beginning each new group: We are speaking here not only of attachment and separation between the mothers and babies, but of how the mothers attach and separate between themselves and the groups, and how the organization attaches and separates in parallel processes to these. Beginning a group for us was always wrought with anxiety as to whether the group would “take off”, hold as a group, or whether the mothers who came would judge it worthwhile and continue to come. When mothers came and then returned, we were left feeling confused and with many unanswered questions in us. We often felt like failures. We got no feedback, no one telephoned even to say “not coming” or “thank you!” We wondered if mothers at this time mirror the parasitic phase of their baby when it comes and takes and has no sense of acknowledgement or owing. We felt the important thing was for the mother to make her choice as to whether she wanted to return or not, and it was really hard for us to hold the neutral space and allow her that choice. Often a mother felt the group “was not for her”. We saw our role in the group as holding the mothers so that out of this experience they could hold and not foreclose or preempt their separation from their child and/or avoid the “reverie” or “thinking around it”. But how could we control their use of us and their preempting in leaving the group either after some sessions or from the beginning after one session. Not only was the beginning hard but the end also. Sometimes the mention of a group having an end to it was enough to create massive panic among the mothers, who would hear the mention as immediate and final, when it was just being brought up for thinking.

Vignette 4: A mother who we thought would cling for dear life to the group, since her husband had traumatically abandoned her right when the baby was born, just up and left the group in the same way he had just up and left her. The group was left in a state of shock, carrying her trauma and unable to process it as she had left, just as his way of leaving had made it impossible for her to process.

Discussion: We wondered about what makes it possible for some mothers to stay in the group, to wait, to fit, to find a place, while others cannot wait but reenact their worst trauma on/in the group. Was it something to do with “good enough”, to do maybe with some faith from within that holds in the uncertainty until she has a sense of belonging? It is not that mothers who leave do not make a connection. They do! The facilitators were often left with a sense of sadness and resentment, feelings of inadequacy for not holding the mother and even of failing by not keeping her coming to the group. Sometimes we can understand in depth what has happened but have no opportunity to share our understanding with the lost mother. Were these our group miscarriages, or did these mothers use us in an important way, or even the only way they could, and moved on? Vignette 5: One mother came with a dreadful story of a storm at her home. The house actually fell on the baby, and the baby fell in the swimming pool. They had survived it all. She came and shared all this and was never seen again. Yet she had connected in a very real way with the facilitators. If she had continued, would they have to face the trauma? For many of our mothers the trauma was too much to face. Vignette 6: A mother of a three-week-old baby came to the group enthusiastically. She led the group in a way, saying she would never leave her baby until she went to school. “Mothers owe it to their babies to be with them”, she declared, and she had strong feelings about mothers leaving their babies to go to work. She was in a way the centre of the group for that session. She did not return to the next session and her absence was marked and was described as “leaving this big black hole in the centre of the room in the centre of the group”. The mothers in the group seemed stunned by her absence. The group facilitator rang to find out what had happened to her. She had returned to work. Discussion: The paradox here was surprising. Some years previously this mother had a brother and father who had suicided. Had she transposed the grief of their loss and the emptiness it left in her life onto the group, creating in us the empty space where life should be and was no more? More alarming was the fear that her first girl baby was being abandoned, also to carry the “empty hole”, by her mother returning to work. She said she left because the group stirred up too many powerful feelings – it triggered the unprocessed trauma, she ran away enacting it on the group and on her baby. What makes a mother who truly loves her baby impervious to her meaning and value for that baby? Is this what happens in trauma when there is an autistic core created by the trauma? A numbness, a no-feeling space. One sees it clearly in separation processes where the going is not processed or thought through, and is often immediate and contradictory to conscious plans and decisions.

Vignette 7: There were four mothers in this group; two of them coming for their first time. They formed an instantaneous and intense attachment with each other and excluded the facilitator. They exchanged stories about professionals who had failed them, expressing intense anger and bragging about their own assertive or aggressive responses, and how they had put the professionals in their place. The facilitator was ignored, her function reduced to that of serving tea. This session, however, seemed to be a turning point in their growth toward managing their own lives, but neither of the two newcomers continued in the group.

Discussion: We wondered if mothers sometimes need a place to go and get rid of painful stuff, so they come and leave it here with us. This is complex, as it requires therapists to have faith (as in holding the faith) that even a one-off contact may have served some useful purpose. Yet we also had to be able to look at the possibility that the service was not fulfilling its function. A difficult task.

In this section we move now to issues of attachment and separation.

The Theory

John Bowlby was one of the first to recognise that a baby enters the world predisposed to participate in social interaction. Much of his work formed the basis of attachment theory. He insisted that the infant needed an unbroken (secure) early attachment to the mother. Winnicott (1962) recognised the importance of the caregiver’s psychological understanding of the infant for the emergence of the true self. He saw that the psychological self develops through perception of oneself in another person’s mind as thinking and feeling. Parents who cannot reflect with understanding on their children’s inner experiences, and respond, accordingly deprive their children of a core psychological structure which they need to build a viable self on. In the 1970s, Mary Ainsworth further developed the concept of attachment. She proposed that it was the infant’s appraisal of the mother’s absence that accounted for the infant’s response, and she proposed the first three major attachment classifications.

The infant’s response to the Strange Situation procedure (Ainsworth et al., 1978) showed that the majority of middle class 12-month-old children responded to the mother with proximity-seeking and relief at reunion (balanced/securely attached: B infants). About 25% responded with subtle signs of indifference (avoidantly attached: A infants). A further 15% responded with proximity-seeking but little relief at reunion (ambivalent/coercive attachment: C infants).

Attachment may be secure or insecure. Secure (balanced: B) attachment implies an internal working model where the attachment figure is seen as accessible and responsive when needed. Insecure attachment implies a representational system where the responsiveness of the caregiver is not assumed and the infant adopts strategies for circumventing the perceived unresponsiveness of the attachment figure. Securely attached individuals have internalised the capacity for self-regulation, in contrast to those who precociously either down-regulate (avoidant) or up-regulate (ambivalent) in affect. Thus the work of Ainsworth and colleagues showed that maternal sensitivity is the primary determinant of quality of attachment (at 12 months); sensitive mothers have secure children, inconsistent mothers have ambivalent children, and interfering/rejecting mothers have avoidant children.

During the 1980s attachment research came to be increasingly concerned with child maltreatment. The disorganised (D) classification was proposed and linked to maltreated children or to unresolved trauma in the parent; behaviour in this child was marked by fear, freezing and disorientation (Main & Solomon, 1986).

Patricia McKinsey-Crittendon developed a dynamic–maturational model of attachment, defining attachment as a pattern or strategy of identifying and responding to danger. Infants who become avoidant by 12 months typically experience maternal rejection when they display affective signals indicative of a desire for closeness to their mothers (Main, 1981). If infants protest at this unpleasant outcome, they often experience maternal anger. Inhibition of affective signals both has the predictable effect of reducing maternal rejection and anger, and teaches infants that expression of affect is counterproductive. If, furthermore, the caregiver’s own affective behaviour is misleading, the infant’s task of learning the meaning of affect becomes even more difficult. Thus infants cannot learn the meaning of affective signals and learn to inhibit their own signals of desire and anger.

Other children have mothers who are clear in their affective communication but inconsistently responsive to infant signals, and these infants find it difficult to learn to communicate effectively. When infants cannot predict their caregiver’s response, they become anxious or angry. Because infants of inconsistent mothers are unable to make predictions, they are unable to organise their behaviour on the basis of predictions; cognition fails them.

Secure infants have learned the predictive and communicative value of many interpersonal signals; they have made meaning of both cognition and affect (MacKinsey-Crittenden, 19??). Avoidant infants have learned to organise their behaviour without being able to interpret or use affective signals; they have the use of cognition but not affect. Ambivalent infants have been reinforced for affective behaviour but have not learned a cognitive organisation that reduces the inconsistency of their mother’s behaviour.

Two contrasting vignettes showing different feeding relationships of two mother/baby couples

Here are contrasting examples of two mothers and infants, one who is very much in touch with her baby and the other struggling and not very well in touch a lot of the time. The babies are the same age. The first vignette shows the difficult nature of the attachment process for this mother and baby couple.

Vignette 7: Prue began to feed Polly, 3 months old, having moved herself a little to the outside of the group. Polly fed contentedly on one side then on the other. Polly and Prue seemed immersed in each other for about three quarters of an hour and after this they rejoined the group, both looking dreamy and content. They seemed to have been present but not really listening to the group conversation.

A month later Prue arrived with Polly who was sucking vigorously on her dummy. Prue said she had fed Polly on one side before coming and that she still needed the other side. She had never done this before but wanted to get to the group in time. Polly seemed to be tolerating the wait in a way she could not have done before now, and we felt the way Prue had managed this feed reflected how in touch with her baby she was. She felt that Polly could manage this break in her feed. We felt Polly’s vigorous sucking on her dummy was a soothing defence against the anxiety produced by this change in her feeding routine and that she was secure enough and integrated enough to cope with this. She felt held together enough in her mother’s mind.

However, when Prue fed Polly the second side it was difficult. Polly kept looking around and being distracted. Prue said, “She does this at home now even when there is no one else around”. The experience had rattled Polly and she seemed unable to focus on the feed. Prue commented about Polly taking her time “whilst I sit here exposed, which I don’t like”, laughing as she said this. We commented, “She’s making you wait, like she had to wait before”. There was a sense of trust and ease between Prue and Polly, with Polly trusting her mother would wait for her to feed, despite Prue’s irritation at Polly’s distracted feeding behaviour.

Discussion: This healthy mother is already preparing her baby for separation, leaving the room and so on. She is not only tuned in to her baby but tunes everyone in as well.

Vignette 8: Rosa was 3 months old. Rachel, her mother, was talking. Rosa woke from a sleep and, seeing a stranger’s face, burst into tears, turning her head away. Rachel picked her up, saying it was time for her feed, not in tune with her Rosa’s tears and fright at seeing a strange face. Rosa did not feed well. She cried a lot, perhaps because her mother was talking to the group. Rachel did not seem to notice and continued with her complicated talk. It was alarming for us to feel how out of touch she seemed and unaware of her baby’s emotions and needs. The clash of reds between Rosa’s magenta outfit and her mother’s scarlet lipstick seemed to emphasise this.

One month later Rosa seemed safer in the group. Although she had grown she still looked small and as though she hadn’t quite been put together psychically. She made eye contact with each of the group leaders. It was a long look, as if wanting to hold on. When it was time for a feed Rachel told us Rosa has been crying at her feeds. When she began to cry Rachel looked up at us as if to say, “You see”. Again she talked while Rosa cried. She moved Rosa around from breast to breast in a restless way and then placed her over her shoulder, not really in touch with her baby. When Rachel did stop talking Rosa fed quietly.

At 5 months of age Rachel vigorously rocked a crying Rosa. She sat next to one of the group leaders and said, “She’s usually not like this, crying with her eyes closed.” The leader said she guessed there weren’t usually other people around and maybe she doesn’t want Rachel to talk to other people. Rachel looked down at her baby then, who stopped crying. Rachel spoke more softly, still to the group, while looking at Rosa who went to sleep.

Discussion: Often we noticed a lack of connectedness between Rachel and Rosa, who seemed unable to find a place for herself in her mother’s mind. We were aware that Rosa not only could not cope with separation but could not cope with attachment, crying during her feeds. Coming together for this baby is as hard as separating. Rachel is emotionally absent even when she is present. We later heard she had been adopted at the age of three after many experiences of neglect. Her baby cannot cope with the togetherness and cries during an actual feed.

How do babies respond to trauma of a separation that is too quick, too much and too soon?

Thingifying: What babies do in the absence of the good enough caretaker is go into their motor development prematurely. They move into an area where there can be life. It is like an inbuilt mechanism to help the baby survive. We were trying to think about what these babies might experience. Would they actually experience a fear of dying or of annihilation? We saw a baby that had closed down, whose mother wouldn’t hold her gaze. The baby always needed to hang onto the mother’s chain, touch it and feel it, in the absence of the gaze. A physical object became substituted to hold herself together. These babies also create actions with their bodies that hold them together. The loss is about the loss of a sense of self – perhaps the idea of the death of a personality is a better way of putting it. It is the death of relating; relating is now different, it becomes about objects. The babies have to hang on to something. That something becomes an object, not emotionally saturated as it would be under ordinary circumstances where the mother-object is emotionally available for the baby. Vignette 9: Julie had come to our group from birth. Her mother returned to work when Julie was three months old, but Julie continued to come with her nanny. Her behaviour was tragic for us to observe. One day, Julie was counting to 100 at the request of her nanny. It had a mechanical and almost uninterested sound to it, but she liked that the nanny congratulated and praised her. A few minutes later the nanny got up to leave the room and almost sadistically laughingly said, “Watch this!” As she left the room Julie lay on the floor and began to scream in something between rage and terror. She sobbed uncontrollably as if her world had ended and the nanny was almost triumphant in her saying, “See how attached to me she is? Her mother is worried about it so we are going to send her to kindergarten next term” We were horrified. There was much discussion about should we or should we not approach the mother. Finally we did and did not even get an interview. We were virtually laughed at and Julie did not attend again.

We were devastated by this experience. We knew that whatever we did would be wrong. It was painful for us to observe such behaviour and have no control over it. These were our hardest times. Nothing we did would be good enough.

There were mothers, however, who could use our “good enough” holding. Although we were conscious of a desire to fix and make things right, we knew we could not and must not. We realised this was how a mother felt with her infant, always wanting to get it right and knowing often she could not. Through this we remained aware of our central role to the group, not only to the individual mother in the group. In fact it seemed that our attention moved constantly from mothers to individuals to mothers. We could see our role to hold a group so that the group could hold the mother through her pain, so she could hold her baby through her pain. How much the discussion group played a role for us became more and more evident. It held us through the processing of pain, linked in not only to our individual processing, but to how that processing affected the group of mothers, our group and the organization.

Infant’s Response to Pain of Absence or an Absent Presence

One of the things we observed often in our groups was an infant’s response to the presence of an emotionally absent mother. The infant might cling to a thing (like the mother’s chain), a safe arena where the absence is not felt. It seemed actually as if there was an inbuilt mechanism to help the baby survive. In trying to think about what the baby might experience, we wondered if would it be a fear of dying or of annihilation, if not held in the mothers arms, mind or with the mothers attention? How relevant was our holding of a group, our allowing true pain to be present? Sometimes the babies created with their bodies that experience of trying to hold themselves together. The loss seemed about the loss of a sense of self – perhaps the idea of the death of a personality, death of a relating. The relating is different, it becomes about past objects. It is an area where there can be “life”, but it is also devoid of life in that it does not have the symbolism and the emotional saturation of real life. This is quite different to when a physical object is being held as a symbol or as a transition from the mother. This is being held instead of the mother.

Mother’s Response to Pain

This is central to our paper, as not only do babies flee the pain of absence but mothers also do this in relation to their babies. It worried us how many mothers have to go to work, have to return to work so that they will not lose their career, have to focus on material good rather than on their baby. Some women who have babies open up areas of distress and disturbance in themselves which are too much to handle on their own, so they race back to work to escape. Often we saw the groups as opening the way for them not to have to run back, but to stay and process things. We were very conscious that in all our groups almost every case of return to work was delayed or put off, or thought about and planned for, and discussed more. Mothers who at first felt they should go back to work began to feel it was safe to let go, not to hold on to material things, and to have faith they would find work again at the right time. We gave them permission and they gave themselves permission to keep the space where they could mother without being driven. Is this one of the most important things the group did, we wondered? Did many of the mothers who lacked human contact go back to work as an avoidance of the pain of loneliness and aloneness? A lot of the mothers’ conversation centred on the fathers working very hard and being absent for long hours.

Here is a facilitator’s story of one mother’s return to work that expresses much of what we are speaking about.

Case study: Despite a Caesarian section Patricia first attended the group when her baby Chrissy was five days old. She had caught a train and walked to the group. She rarely missed a group – rarely spoke – and was very proud of her little girl, dressing her up every session with different clothes all purchased from St Vincent de Paul second hand shops. I saw her often stuff sandwiches into her backpack at the end of the session, and she told me they were always on the bread line. She seemed to really enjoy being a part of the group, yet she was never really one of the group of mothers. Neither they nor Patricia made much effort to communicate and neither seemed to mind. She just seemed to be happy to be present. She was a large woman. We thought at first that she was a little retarded and probably that explained her lack of involvement. She never missed a group session although she travelled twice as far as any other mother to attend. She was lonely and isolated at home, and told us that on days when not attending the group she would go and sit with the old men at the St Vincent de Paul Centre. They adored the little girl, who was very cute indeed.

One day we were discussing an organizational problem with the mothers. We could not become an organization until we could work out how to have donations made tax deductible. Despite a top firm of solicitors donating their time and energy pro bono for us, we could not resolve this legal problem. We were all astonished to hear Patricia suddenly speak, “Of course you won’t get it accepted under the Charities Act. That was designed for the poor houses of Victorian England, and as such does not consider infants as needing any form of charity or protection. You need to bring yourself under the umbrella of a Church Charity which is more up to date, has a broader base of reference and has its own Act of Parliament.” All this was said as if it was just about going down the street. The legal firm looked into it and our problem was resolved. When the therapist wondered how she knew all of this, Patricia said with some degree of pride that she was a specialist in charities and tax accounting. Even this did not put her on a basis of friendship with any of the other mothers, but during the group they would often now ask her questions to draw her in. Although the other mothers often met and went out together and formed close bonds outside the group, Patricia was never invited. If she was missing, however, all the mothers would comment on her not being there. “Where’s Patricia?”

When Chrissy was 20 months old the following occurred. Chrissy had been unusually irritable in the group and her mother had taken her to a room away from the playing area. The facilitator was with a group of mothers and looked over the fence to see a stroller, with Chrissy in it, standing unattended in the car park. Its back was turned to oncoming cars so that it could not be seen to have a child in it. A large electrician’s van came speeding down the driveway. The facilitator knew he could not see a baby in the stroller and may not even be aware of a stroller there, and in shock she screamed. The driver must have seen the stroller, slammed on the brakes, slowed down and parked in the car park. The facilitator looked across and saw Patricia talking across the fence with another mother about 12 feet away, and blocked from view of her toddler. Totally disconcerted she yelled, “How did you leave Chrissy there like that?” Patricia answered, “I thought he would probably have seen her.” Her voice was slow measured and unexpressive. The facilitator thought, “Is she in a mad space?” Then slowly the lack of emotion seemed to collapse and her face distorted and broke into tears. “I’m going home!” she said, and the facilitator asked, “Is it because I blew up at you?” “No! I have to get her home, she is so grizzly this morning. She is better at home and getting a sleep.” Patricia did not return to the group for the next three weeks and the facilitator became very concerned. When we came to seek her telephone number to ring her, we found no one in the group had it, or even her address. She had moved three months previously and we had not tracked the change. The telephone exchange had no record either, nor did the local church. A month later our other facilitator got an email from Patricia, saying she had started work the Monday following the event and in the ruckus had forgotten to tell us she was not able to come any more. The facilitator who had been involved in the incident sent her an email saying how sorry she was that we had parted like this and was she angry with her? She immediately responded with her telephone number and a message, “How could I be angry with you when you were so right.” The facilitator telephoned her. There was a sense of great relief on both sides. “I knew you didn’t have my number and I knew the telephone was in my maiden name, I was worried you wouldn’t find me”. “Wouldn’t find me?”, the facilitator thought. She could not ring? Did such a concept not enter her mind? What had happened in her separations as a child? Calls and messages came backward and forward each day for about two weeks, and at times they were quite playful, “Chrissie says hullo to you. Well she would if she could, but she is busy on the computer talking to tele-babies at the moment.” Then one night she rang excitedly and said, “Guess what! I told my boss about the group and I have a day off to come.”

Everyone in the group greeted Patricia most enthusiastically and fussed over Chrissy and how she had grown. Patricia told us she had spent the weekend at the St. John Ambulance special training course for mothers to handle emergencies with their babies and toddlers. The mothers were all enquiring about the program. She said she now had a certificate and it was a great experience. The facilitators thought about this emergency training. Was this to protect against a different danger in her mind? Had this mother now become aware of danger? A month later she came again. It was her last session, she told us, as she was returning to full-time work the following week. She had come to say good-bye to us all. At the end of the group, contrasting with the first farewell, the facilitator left with her and carefully walked alongside her, very conscious that this meant something to both of them. They made their way through the car park side by side, talking about how long Patricia had been in the group, when she had first come, and now how it was a move into another stage of her life both for her and Chrissy who she was wheeling in the stroller. As we reached the gate the facilitator said, “This is a good-bye then.” “Well I really left the group when I first went to work.” “Yes! But we didn’t say good-bye that time.” “You know my sister in Victoria whose baby you saw? She fell off a horse and fractured her hip.” “Separating is full of dangers. I hope you and Chrissy will both be safe in this separation”, the facilitator said. Patricia did not look back after the first few steps. The facilitator felt a wrenching pain and a sadness and a satisfaction as she returned alone to the group.

Discussion:
Had that first going back to work been enacted as a total loss too hard to face? She was losing the group, her pleasing role as full-time mother, becoming once more a worker. Did it awaken a previous separation and loss? How did three days a week work, with her child being minded by a much loved grandmother, become for her a situation so fraught with danger that it was enacted or even reenacted in that strange way? We became very aware at this point in the group of the space the mother is in, in her unconscious, and how very black it felt for us as a group as we shared these very difficult cases. We also began to talk of our own ambivalence being reflected and experienced in the group as we were speaking of the seriously ambivalent space the mother occupies. Having a baby may trigger those areas where there has been damage in the past, in many ways.

Rapproachment: In Bion’s thinking, an absence is not experienced as absence but as a presence that is persecutory. We began to view this transitional period as one of the most important stages in the dynamic of attachment and separation. Winnicott (1976) described it as the time when the infant is able to be, to be alone, but in the presence of the mother. We saw ourselves as attempting to emulate this in the groups. We were there for the mothers to act and react as they wished, returning to us often to refuel and then going off again, very much as their infants were doing with them during this developmental phase. We knew that those mothers who were racing back to work, who had not planned and prepared the separateness with their infants, were missing a very important stage. They were missing out on the shared pain of separateness which rebinds the mother and infant. It concerned us that the infant in such a situation was left to carry or even feel he or she was carrying all the pain alone. The available mother is described by Mahler, Pines and Bergman (1956) as the mother who again can be present and allow space and time for her infant to be with her. Erma Firman’s (1982) paper, “The mother has to be there to be left”, describes the mother’s pain in just being there while the baby goes to do his own things, play his own games, think his own thoughts, needing her so much less. Often in the groups we had the feeling of being unimportant and unnecessary, something akin to a tea lady. We wondered how much the groups actually helped to hold the mothers in this stage with their infants, to let themselves feel of value at least here, since they were important enough for us to be with them.

Vignette 10: Louise was five months old when Linda arrived with her at the group for the first time. Linda arrived in a flurry of over-excitement. We were shocked to hear that she had just come out of hospital. The reason for her hospitalisation was unclear at first, food poisoning, we thought we were told. She still had her hospital armband on. The second week she told us she had had her appendix taken out. That week she stared vacantly into space a lot of the time and we wondered if she was depressed. This fluctuation in mood continued from week to week. Linda told us that she and her husband had been to a wedding at the weekend and had left Louise with a paternal aunt and uncle whom she did not know. It was only when they picked her up the next morning that they were told she had not taken her bottle and Linda noticed Louise looked stunned and frightened. Linda herself then became alarmed and concerned. She was shocked by how Louise was affected by this experience. On another occasion they had left her with her paternal grandmother whom she knew well and she had been fine. It had not occurred to Linda before that Louise’s familiarity with her carer was important. Perhaps she was letting us know how she felt in a new country, so far away from her own mother, being in a sense left with her in-laws whom she did not know.

Discussion: What makes the difference in a good enough separation? What takes it from good enough to not good enough? The difference, we thought, was that the child was held in the mind of the mother and therefore the pain of not having her present was experienced, not avoided or denied or projected.

CONCLUSION: Motherhood – A Maternal Identity Found or Developed or Strengthened Through the Groups

Motherhood is still terribly denigrated in our society. There is a devaluing of motherhood. You are irrelevant if you are at home; you are valued when in a profession or a full-time job, even by your partner when you are earning. Does our society care if a mother is a good mother or not? Their partners often can’t see the sense or the meaning in it. They think their wife is at home having fun. These are sensitive, supporting men but they still have the fantasy that they are the hard workers, the ones who need their weekend to themselves. Why would we make irrelevant the most relevant (important) task on earth? Often in the groups we questioned our relevance to the mothers, or even if they were speaking anything relevant, and what kept bringing them back when we often felt the groups had no relevance. It must be that the mother carries in her mind the extraordinary tension between the totally relevant, since the baby could not live without her, and having no relevance as a mother. This is a continuum and it is often felt also by the father in the beginning, that in some way his relevance in his wife’s mind comes second to the baby, or even that he has no relevance. There are a lot of women who put themselves down, who consider themselves to be irrelevant, who can’t articulate their usefulness to their partner or even consciously to themselves. They see their needs as mothers as irrelevant in the scheme of things, and see themselves as the ones who must support him in his more relevant job. We felt all our mothers struggled with this. It made sense to us that our groups give them a voice and place where their empowerment could be validated.

In our groups we saw the good enough mother who takes time and space, and allows the emotions for both to begin separating out, carefully, in doses and timing that fits for both, long before the event occurs. This is one end of the spectrum; at the other end we saw mothers for whom death and separation have become confused because the separation is too traumatic, too sudden, too soon. We wondered whether the disturbed mother achieves some sort of deadening of her experience as mother to the baby and some sort of deadening of her baby as an experience to her when she leaves her infant too quickly, too suddenly, without the work of separation occurring for both of them, and the mourning of the loss of the togetherness with each other. We asked, if you deaden your value as a mother then are you irrelevant and unnecessary to your baby?

Our pain: As we were discussing all this we became increasingly aware of a degree of pain and darkness building up in our professional discussion group. Just how much were we carrying for ourselves to do with separations? How much of the mothers’ pain was awakening areas in ourselves that needed diffusing and processing? Birth is the first major separation!

We have tried in this paper to describe how catastrophic is this first psychic and physical movement from together to separate. The good enough mother doesn’t, as paradoxical as it sounds, enter the catastrophe in the same way as the baby. She understands the catastrophe. She knows the baby feels that the world will end and he will go into nothingness. She has faith she and her infant will survive, as they survived birth. She does not enter the catastrophe, but she has knowing; awareness of the infant’s fear and sense of catastrophe. If the mother herself falls into the catastrophe, both she and the infant are overwhelmed by it and faith to survive it is lost. The mother who is unaware of it is the most troubling of all, for she not only leaves her infant in it and cuts off from him, but gives him her terror as well – the infant breaks into a thousands of sharp persecutory pieces. This aware holding, knowing without cutting off from or falling into, is the role we play for our mothers and fathers in our groups. The facilitators hold the group, the mothers hold each other, so that the individual mother better holds her baby.

References
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