Why Infant Mental Health?

Three Reasons:1) Fetal Programming

2) Attachment

3) Therapy

Reason 3: Therapy

Neil W. Boris, MDTulane Institute of Infant and Early Childhood Mental Health

A Cool Study!

• Ask college aged students to give the namesof three types of people in their lives:

– An attachment figure (security prime)

– An adult with whom their were close as a child but who didn’t serve to protect or comfort (close person prime)

– An adult that was an acquaintance in childhood (acquaintance prime)

Later…

• Watch a series of slides on a neutral topic but within those slides, one of the 3 primes is presented:

– But only for milliseconds!

• As the subject is leaving, they encounter an actor who is actively distressed

Subliminal Priming Effect

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Security primeClose-person primeAcquaintance prime

Proportion of participants who were willing to help a distressed person as a function of priming condition

(Mikulincer, Shaver,

Gillath, & Nitzberg, 2004)

Subliminal Priming Effect

Proportion of participants who were willing to help a distressed person as a function of priming condition

• Susan McDonough’s Interaction Guidance

– One of the earliest parent-infant therapies that used videotape to build relationship

– Therapy focused relentlessly on positive moments of connection

Innovations in Therapy

http://www.cebc4cw.org/program/interaction-guidance/

The You Tube Generation?

Video has become woven into the fabric of contemporary life

– For those of child-bearing age, life without video is unknown

– With web-based streaming and associated advances, its likely that use of video will only increase

The Use of Videotape

• Psychoanalytic therapies

– Beatrice Beebe and others in work with parents and infants

• Attachment-based therapies

– Videofeedback Intervention for Positive Parenting (VIPP; the Netherlands)

– Circle of Security (USA)

• Transactional/Family systems therapies

– Interaction Guidance (USA/Switzerland)

Advantages

• Video allows distance from the child and yet is visually concrete

• Use of slow motion or repeating segments allows therapist to emphasize particular moments or issues

– Observation on screen is controlled

– Skills can be built quickly!

Rusconi-Serpa et al. (2009) Video feedback in parent-infant treatments. Child Adolesc Psychiatric Clin N Am, 18:735-51.

Advances

• Editing allows you to tell a story

• A very powerful way to reframe parents’ perceptions and even overwrite internal working models

– Really can be dynamic in “joining” with families

• Security Priming on steroids!

A Favorite Co-Therapist

Why All The Fuss?1. Selection of neuronal

pathways

2. Emotions – development

and regulation

3. Shaping of Internal Working

Models/Representations

Schore, 1999

Therapy Expert?Genesis of The Expert

Thank you for your attention!

Neil W. Boris, MDTulane Institute of Infant and Early Childhood Mental Health