PTIP) aims to relieve emotional disturbances within the parent(s), the baby, and/or their interaction, for example, postnatal depression and anxiety, infant distress with breastfeeding and sleep, and attachment disorders.
Donald Winnicott, a pediatrician and analyst, focused on the mother-baby interplay in his theorizing and his brief parent-child consultations,[4] but he did not work with PTIP.
A related method was developed by Esther Bick [8] at the Tavistock Clinic in London, psychoanalytic infant observation, aiming to enhance therapy students' skills and to train clinicians who work with babies.
A psychodynamic perspective sees humans as struggling with unconscious urges that impact on their character, relationships, interests, passions, conscious attitudes, and cognitive capacities.
Psychoanalytic theory often regards the mother as the baby's primary object, especially, her body parts or functions that stimulate the infant's fantasy life.
The PTIP therapist is prone to a "massive identification with the child… it is not always easy to control one's reactions to [the baby's] positive or negative provocations".
Also, the notion of psychoanalysis as a "talking cure" led to the idea that the primary therapy data are words, rather than all the "representations or signifiers of process".
A final reason for the late development of PTIP might be that the high prevalence of postnatal depression [22] and infant emotional disturbances,[23][24] was demonstrated only recently.
The infant's symptoms might express "a repressed tendency in the parent",[38] which enters into a "core conflictual relationship" with the baby and will be enacted in therapy.
Whereas Fraiberg suggested the mother's trauma might build up to forming the "ghost", Lebovici focused more on how her unconscious infantile sexuality colored her relationship with the baby.
[47] Like Dolto, the Swedish psychoanalyst Johan Norman sought to establish a relationship with the infant, who he thought possessed a primordial subjectivity and an intersubjectivity.
He also thought the baby sought for containment from the therapist, and that she had a "unique flexibility in changing representations of itself and others that comes to an end as the ego develops".
Questions about the baby's role in PTIP become less puzzling once we clarify that human communication takes place at various levels, among which the verbal is only one.
Many analysts today use concepts by the American philosopher of Semiotics, Charles Sanders Peirce to describe the therapeutic process.
[58] Parent-Infant Psychotherapy (PIP) at the Anna Freud Centre in London [59] integrates Freudian metapsychology with infant research, attachment theory and developmental psychology.
The authors use a psychoanalytic framework and wish to promote "the parent-infant relationship in order to facilitate infant development" (p. 25), support the baby's "attachment needs" towards his caregivers (p. 8), and scaffold him to help in his "emotional regulation" (p. 26).
Most authors worked in public health clinics, whereas Norman's cases were drawn mainly from his private practice and were long, high-frequency treatments with what seemed well-motivated parents.
Such factors will influence the parents' trust in the clinician, motivation for therapeutic work, and economic and practical means of taking part in treatment.
This may explain why a recent Cochrane review [75] only found some evidence of improved infant attachment but none concerning parental mental health.
There are courses, for example, at the [Columbia University Center for Psychoanalytic Training and Research] and the Anni Bergman Parent Infant Training Program in New York, the Anna Freud Centre and the Tavistock and Portman NHS Foundation Trust and the School of Infant Mental Health in London, [International Psychoanalytic University Berlin], the University Sackler School of Medicine in Tel Aviv, the "Säuglings-Kleinkind-Eltern-Psychotherapie" or SKEPT in München, Centro Studi Martha Harris in Italy, the Eriksson Infant Mental Health Certificate Program in Chicago, the Infant-Parent Program at the University of California, San Francisco, training programs in Barcelona organized by the Spanish Psychoanalytical Society,[77] and in Buenos Aires at the Hospital Italiano.