Beebe presented her dyadic systems approach to face to face interactions – key domains of interaction – facial mirroring, vocal rhythm coordination, distress regulation. Dyadic systems view of face to face interaction informs nonverbal communication across the lifetime. These patterns of communication become organized into predictable, contingent interaction sequences that that generate expectations of each other’s behavior in the relationship. All this occurs in the realm of procedural knowledge. Heller and Haynal study.
Study of mother-infant (M-I) face to face interaction with split screen videotaping, videotape with one camera on each partner, second by second coding. Code orientation, touch, vocalization, facial expression, etc. Studying mothers and infants focuses on what goes on in the interaction outside of language.
Dyadic systems model proposes that all face to face interactions are simultaneous product of self and interactive regulation. DS view is that the way you co-construct relatedness is unique for the dyad; it respects the uniqueness of the individual and also of the dyad. How the mother responds to the baby partly is a function of how she regulates herself and how the baby responds to the mother is partly a function of how the baby regulates himself. The degree of the stability of the moment to moment behavior is a measure of an individual’s self-contingency [rhythm of regulation]. How does the rhythm of one partner affect the rhythm of the other? Mothers who over-stabilize themselves are less able to track their babies because they are so involved in regulating, out of awareness,[attentive to] their own state, whereas mothers who are more flexible in degree of self-predictability are better able to track their babies. The organization of the dyad is within and between. The key point is that the rhythm within your body that you think of as your own is partly organized by how you are related to your partner. This idea of the emergence of the “self” from the experience of being in a relationship is an organizing principle of the course and was repeated in the presentation by Peter Fonagy later in the weekend.
Infants are able to detect regularity and perceive contingencies. They predict when events will occur. This results in expectancies. These contingencies can be in facial expression, gaze, every communication modality [many things]. They occur in a split second time frame. It is usually the baby who breaks the gaze in gaze contingency. The degree of self and interactive procedural contingencies in an infant-mother pair is affected by the mother’s anxiety, self criticism, dependency, and depression post-partum; and these contingencies are correlated with attachment. Mothers with post partum depression may vigilantly coordinate with [look at] the baby’s face , through corresponding facial changes of her own, while not attending to the baby’s focus of attention [intention, what the baby is doing.]
The commonest mother-infant therapy situation is one in which the mother cannot tolerate the normal interruptions of gaze aversion the baby initiates to self regulate. If the mother pursues, calls, chases, this stresses the baby and makes it harder for the baby to look back at the mother. Mothers often feel rejected when this happens. One way to deal with this therapeutically is to explain to the mother, “This is the way babies work” and explain the baby’s need to gaze away to regulate himself before he looks back. Beebe says that “the baby’s agency is in the co-construction of relatedness”. She describes what she calls the “chase and dodge” situation in which the baby tries to turn away momentarily to self regulate and the mother follows him, stressing him further.
Beebe showed us ways of regulating a baby’s distress: (1) join the rhythm of the baby’s distress but in a milder intensity [version]; (2) join increments of facial distress; (3) join vocal distress, join the cry rhythm; (4) wait, join the dampened state; (5) disruption and repair.
The caregiver can give the distressed child a structuring rhythm, keeping the volume low but a predictable pattern with a little variation, and put her hand on his belly or make her hand available so that the baby can use it for self-soothing.
Problems occur when there is (1) teasing of the baby by the caregiver, such as when the mother repetitively puts her finger or the nipple in and then takes it out, without any connection to the baby’s cues; (2) mutually escalating over-arousal; and (3) when mother denies the baby’s distress and smiles or looks surprised. (4) mothers look away more from the baby’s face, pays less attention to the infant who is distress; (5) mothers “loom” into the baby’s space.
When Beebe works with a mother and videotape, she asks “what the baby feels” at a particular point in the tape, and if the mother’s response is incorrect, she will say something like, “Well, actually, I think what he is feeling is X.”
Beebe showed us many fascinating films of mothers and infants. She said that in her clinical work with mother-infant pairs she “tries to link three stories – the story of the complaint, the story of the nonverbal, and the story of the parents’ histories.
Two excellent references for Beatrice Beebe are:
-Beebe B, Cohen P, Sossin K, & Markese S (Eds). (2012). Mothers, Infants, and Young Children of September 11, 2001, New York, Routledge Press.
– Beebe et al. (2010). The origins of 12-month attachment: A microanalysis of 4-month mother infant interaction, Attachment and Human Development, New York, Routledge, 12 (1-2): 3-143.
Claudia Gold, a recent graduate of our program and now the author of the blog, http://claudiamgoldmd.com/, and the celebrated book, Keeping Your Child in Mind: Overcoming Defiance, Tantrums, and Other Everyday Behavior Problems by Seeing the World Through Your Child’s Eyes, 1st Da Capo Press, ed. 2011, was our last speaker of the weekend. She talked to us about how the study of psychoanalysis, the mentorship of Peter Fonagy and the research group at Yale, and her participation in the UMB IPMHC Course helped her move from a career as a primary care pediatrician to a career as a behavioral pediatrician with a specialty in mentalization.
Reminding us that primary care clinicians have the largest professional interface with young children and their families and have relationships with these children and families over time that involve implicit trust. Yet, whereas 30% of their practice involves emotional or behavioral concerns, these pediatricians have limited knowledge or tools – behavior management, parent training, and medication – to deal with them. Considering this challenge, Claudia made a paradigm shift in her own practice and now in the wider world of parents and children, by identifying her primary task as promoting reflective functioning. By “holding a child in mind”, Claudia attempts to teach parents to be curious about the meaning of their child’s behavior, to have empathy for them, to contain and regulate their child’s behavior and also to better regulate themselves. In addition to her practice in Western Mass., Claudia is beginning to work on an Early Childhood Social Emotional Health Program at the Newton-Wellesley Hospital.