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2. Aspects of supervision: an observation seminar about a ten-month-old triplet

Leite da Costa, Mariza; Melega, Marisa Pelella; Mendes de Almeida, Mariangela Harris Meltzer Trust ePub

Marisa Pelella Mélega

As a supervisor, I have had the opportunity over the years to observe many aspects of the process of how knowledge is acquired through the emotional experiences of both observational visits and supervisions. The following considerations about this process focus on an account of an observation seminar about a ten-month-old triplet, with a group that has worked with me for about a year.

When we began working as a group, each student/observer stated that she expected to learn about the mother-baby relationship and the infant’s development. The students were not fully aware that the group situation might be a source of knowledge in itself. This group developed relatively quickly into a work group (Bion, 1961); conflicts and anxieties were gradually overcome by concentrating on our common task, as most students were able to learn through introjective identification.

What are the tasks faced by a group of people who gather to talk about the emotional experience of mother-baby observation?

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5. Psychoanalytic observation: the Esther Bick method as a clinical tool

Leite da Costa, Mariza; Melega, Marisa Pelella; Mendes de Almeida, Mariangela Harris Meltzer Trust ePub

Magaly Miranda Marconato Callia

Adriana, aged one year and three months, was sent to my practice by her mother’s analyst. She has a narrow face, curly blond, hair, a broad smile, and a facial and physical appearance often described as elfin or gnomish in books and by doctors – a somewhat peculiar face, the kind found in Down’s Syndrome cases. Both parents wanted to explore the difficulties they were having with their daughter. The couple were in their mid-thirties, each was in individual analysis. Both were professionally successful and had wanted to have a child, Adriana was a “planned” baby.

When they sought my help their primary concern was the difficulty Adriana had in feeding, since birth. She was currently highly selective in her choice of food and refused to eat most things outright. The mother felt that Adriana related much more to their nanny than with her; often she did not to respond to her. Despite her young age Adriana already showed signs of language difficulties. She communicated mainly through gestures, facial expressions, smiling, crying, etc. However, the impression I had was that the parents’ main concern, and what motivated them to seek me out, was that they received a diagnosis of Williams’ Syndrome at Adriana’s birth. From what they said and from a few articles they brought with them, I understood this was a genetic disorder that affects the ability to process information sequentially. Other characteristics of the syndrome include the possibility of slight mental retardation, a distinct elfin facial appearance, congenital heart disease and elevated calcium levels. The syndrome was identified in 1961 in New Zealand by cardiologist J. C. P. Williams. When I met the couple, I felt they were anguished and anxious about Adriana’s future. They compared her with other children and feared that she would fail to develop “normally”.

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7. The psychoanalytic observer at the nursery

Leite da Costa, Mariza; Melega, Marisa Pelella; Mendes de Almeida, Mariangela Harris Meltzer Trust ePub

Ana Rosa Campana de Almeida Pernambuco and Maria da Graça Palmigiani

This paper is an account of a study conducted at a child day-care centre between September and December 1989. Following the Baby and Child Observation Course at the Mother-Baby Study Centre, together with our professional experience in dealing with people, made us realize that the first few years of a child’s life are central to the development of its personality. We also know that appropriate care can assist the development of the resources needed for coping with life, and we felt that there was insufficient professional training available in Brazil regarding the emotional aspects of child development in its various stages.

Over the course of this study we noticed that information on its own does not modify the adult-child relationship. It is more important to be receptive and reflective than to simply counsel and inform. In other words, an attitude that reflects what is being communicated – that is self-reflexive rather than demonstrative – is needed. This enables the adult to think about what is happening at any given moment and to find solutions that can help the child’s development.

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12. Infant observation and its developments: working with autistic children

Leite da Costa, Mariza; Melega, Marisa Pelella; Mendes de Almeida, Mariangela Harris Meltzer Trust ePub

Mariângela Mendes de Almeida

The Esther Bick Infant Observation method has for many years played a fundamental role in the training of professionals in the therapeutic and psychoanalytic field. It has enhanced our comprehension of both ordinary development and unintegrated states. According to Bick, training in Infant Observation should “increase the student’s understanding of the child’s non-verbal behaviour and play, as well as the behaviour of the child who neither speaks nor plays” (Bick, 1964, p. 558).

This paper considers some of the developments inspired by the observation of children who neither speak nor play due to severe emotional disturbances. These disturbances fall within the wide spectrum of autistic disorders. Psychoanalytic observation of infantile bonds and early intervention with parents and infants has helped us to comprehend infantile unintegrated states. The use of this method within the clinical and research fields has contributed to important developments in the psychoanalytic technique of working with children in the autistic spectrum. Susan Reid states that “insights gained from infant observation have informed changes in technique, making it possible to work more effectively with patients who are hard to reach or who would previously have been considered unsuitable for psychoanalytical psychotherapy” (Reid, 1997, p. 6).

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8. The psychoanalytic observer in paediatric assessment

Leite da Costa, Mariza; Melega, Marisa Pelella; Mendes de Almeida, Mariangela Harris Meltzer Trust ePub

Marisa Pelella Mélega and Maria da Graça Palmigiani

This paper aims to illustrate the usefulness of observing the paediatric patient both during the paediatric appointment and in the family environment. This may bring to light emotional factors implicit in paediatric pathology. The following example describes an infant seen in both situations, observed by Maria da Graça Palmigiani. The paediatric consultation took place in the São Paulo Hospital children’s ward, and the observations were supervised by Marisa Pelella Mélega in seminars at the São Paulo Mother-Baby Relationship Study Centre. They are part of ongoing research by the Social Psychiatry section of the Department of Psychiatry and Medical Psychology at the Paulista School of Medicine.

The mother being observed is a single parent from a low socio-economic class. She has taken Suzy, her 13-month-old daughter, to the doctor because of a cough and bronchitis, and is surprised to learn that her daughter is suffering from malnutrition. The child’s weight of 7.5 kg placed her in the category of “second degree malnutrition”. The mother is then invited to take part in a study which would mean being observed at her home, and she accepts.

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