Infant Previewing: Predicting and Sharing Interpersonal Outcome

293 Pages·1990·7.211 MB·English

by  Paul V. Trad (auth.)

Infant Previewing
Paul V. Trad
Infant Previewing
Predicting and Sharing
Interpersonal Outcome
Springer-V eriag
New York Berlin Heidelberg
London Paris Tokyo Hong Kong
Paul V. Trad
Department of Psychiatry
The New York Hospital
Cornell Medical Center
White Plains, NY 10605
USA
Library of Congress Cataloging-in-Publication Data
Trad, Paul V.
Infant previewing: predicting and sharing interpersonal outcome /
Paul V. Trad.
p. cm.
Includes bibliographical references.
ISBN-I3:978·1-4612-7979· 2
I. Infants-Mental health. 2. Mental illness-Diagnosis.
3. Mother and infant. 4. Infant psychiatry. I. Title.
RJ502.5.T73 1990
I 55.42'2-dc20 89-26237
Printed on acid-free paper.
© 1990 Springer-Verlag New York Inc.
Sof tcover reprint of the hardcover 1st edition 1990
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ISBN-13:978·1-4612-7979· 2 e-ISBN-13:978-1-4612-3358-9
001: 10.1007/978-1-4612-3358-9
Preface
Although a good deal of recent research in the area of infant and early
childhood development has probed the nature of the interaction between
the caregiver and the infant, few researchers have articulated a compre
hensive thesis that captures the full impact of the normative develop
mental processes of the mother-child relationship. In the past several
years, I have devoted myself to articulating a theory of early infant psy
chopathology. The etiology of such psychopathology appears to lie in def
icits that plague the dyadic relationship. These deficits can often be·recti
fied when adaptive behaviors are reintroduced into the primary
interaction between mother and child and when the overwhelming
potency of the trends of imminent development are appreciated, acknowl
edged and responded to. Thus, from my work with caregivers and infants
who suffer interactional failures, I began to understand that the dyad must
align itself with the rhythms of adaptive development if the infant is to
mature in a psychologically healthy fashion.
My work in this area also led to the notion of previewing. As will be
discussed more fully in the following chapters, previewing refers to a
unique quality, manifested in varying degrees by virtually every care
giver, which helps propel development forward by introducing the infant
to imminent maturational trends. Previewing requires that the caregiver
represent or envision the direction of incipient development, convert
these representations into behavioral manifestations which may be en
acted during interaction with the infant and then, in a supportive fashion,
ease the infant slowly back to his previous developmental state. Not only
did I discover that adaptive previewing was an integral part of the dyadic
relationship between mothers and infants who were interacting in an opti
mal fashion, but it also became apparent that previewing techniques could
be used as an interventive tool by therapists to help realign relationships
that had gone awry and to help stimulate infants who had been deprived
of adaptive interaction.
Moreover, a review of the recent clinical and experimental literature
revealed that certain caregivers appeared highly competent at stimulating
vi Preface
their infants appropriately and encouraging the manifestation of matura
tional skill. The infants of such caregivers tended to be extraordinarily
motivated in the sense that they communicated, through gestures and fa
cial expressions, a desire to perpetuate the interaction with the caregiver.
Investigators have labeled caregivers who display these characteristics as
"intuitive," "empathic," and "responsive." Despite the label, however,
on closer examination these caregivers appear to be exhibiting a cluster
of behaviors which, taken together, comprise previewing manifestations.
Although the overarching concept of previewing has not been introduced
before, the normative components of this phenomenon have been associ
ated with adaptive caregivers. Thus, clinical and experimental studies
have already provided some substantiation for the concept of previewing.
This book, then, serves to launch the theory of previewing by providing
an explanation of the concept, by describing how previewing heightens
the maturational processes of the infant, and by offering guidelines for
using previewing behaviors in the treatment of caregiver-infant dyads.
Because this concept has proven to be such a potent instrument for effect
ing change within the mother-infant relationship, several other volumes
that explore various clinical implications of this phenomenon are in prep
aration. The fundamental notion of previewing as an aU-encompassing
concept and its dramatic effect on the early infancy years is described in
the foUowing pages.
My understanding of previewing required a good deal of thought and
analysis. During this process, I was deeply fortunate to be able to discuss
my ideas with Wendy Luftig, whose keen intelligence and encouragement
were given consistently and without reservation. My warm thanks also
go to Richard H. White for his unflagging support. My appreciation is
also extended to Craig C. Berggren who was always willing to discuss my
ideas and share his insights. I am grateful to Sharon Yamamoto, James
Wtorkowski, Stephanie Hill, and Vernon Bruette who assisted in prepar
ing the manuscl'ipt. My warm acknowledgement is extended to Paulina
F. Kernberg, M.D. whose critical insight and compassion have guided
my career.
FinaUy, this book is dedicated to Jorge, Pilar, Emilio, Emily, Roberto,
Ligia, Alex and Lorena-my brothers and sisters-in-law. They have al
ways made me feel special.
Contents
Preface ............................................................................... v
The Concept of Previewing: Introduction.................................. I
Previewing as a Parental Manifestation............................................ 2
Previewing as a Dyadic Manifestation............................................. 4
Previewing as a Therapeutic Goal................................................... 7
Chapter I Prelude to Previewing: The Effects of Prenatal
Representations....................................... ............................. 10
Introduction................................................................................ 10
Prenatal Representations of the Infant:
The Physiologic Repercussions of Pregnancy.................................... 15
Prenatal Representations of the Infant:
The Psychological Fantasies of Pregnancy ....................................... 25
The Representations of the Expectant Father................................... 37
Conclusion................................................................................. 41
Chapter 2 Previewing: A Means of Fostering the Infant's
Predictive Abilities................................................................ 42
Introduction................................................................................ 42
Maternal Intuitive Behaviors That Foster
Infant Predictive Capacities............................................. .............. 46
Visual Cuing............................................................................... 47
Vocal Communication.................................................................. 51
Holding Behavior........................................................................ 55
Feeding Behavior........................................................................ 56
Maternal Stimulation That Enhances
Predictive Capacities.................................................................... 58
Support of Infant Integrative Processes ........................................... 61
Playas the Arena for Creativity and Experimentation........................ 64
Maternal Empathy....................................................................... 65
Meaning Attribution by the Caregiver.................................. ........... 67
Conclusion................................................................................. 68
viii Contents
Chapter 3 Previewing: A Catalyst for Differentiating
Developmental Function........................................................ 71
Introduction................................................................................ 71
The Emergence of Fundamental Representational Skills..................... 73
The Consolidation of Representational Skills.................................... 85
The Effect of Representation on the Quality of Previewing ................. 89
Conclusion. ........ .. . .. ... . . ...... .. . ... ... . ... .. .. ... .. ... ... .. ... .... .. .. .. . .. . .. .. . ... . 93
Chapter 4 Previewing: A Catalyst for Coordinating
Developmental Functions....................................................... 94
Introduction................................................................................ 94
The Development of Multimodal Integration..................................... 100
The Contribution of Previewing to Multimodal Capacities................... 107
Conclusion ................................................................................. 114
Chapter 5 Play: A Paradigm for Tracing Previewing Behaviors ... 115
Introduction................................................................................ 115
Defining Play.............................................................................. 117
Developmental Changes in Play and Play-Related Behaviors ............... 120
Factors Contributing to Developmental Transitions ........................... 121
The Contribution of Mood States ................................................ 121
The Contribution of Socialization ................................................ 129
The Contribution of Cognitive Processing..................................... 135
Symbolic Play .......................................................................... 139
Role-Playing ..... ... ..... ... ..... ......... ........ ... ..... ................ ... ..... ...... 142
Conclusion ................................................................................. 144
Chapter 6 Language: A Paradigm for Tracing Previewing
Behaviors............................................................................ 145
Introduction.. ....... ....... ..... ..... ........... ............. ........ ... ......... ... ... .... 145
The Relation of Dyadic Regulation to
Language Expression ................................................................... 146
Antenatal Regulation ................................................................. 146
Postnatal Regulation.................................................................. 149
The Relation of Affect and Cognition to Intentional Behavior .............. 157
The Relationship Between Infant Predictive Abilities and Caregiver
Interaction.................................................................................. 169
Conclusion. . ....... ..... ... . .. .. .. ... . .... .. . . .. .. .. ..... . .. ..... ... . ... .. ... .. .. ... .... ... 171
Chapter 7 Previewing as a Principle for Motivating Interpersonal
Communication.................................................................... 173
Introduction................................................................................ 173
Previewing as a Dynamic Process................................................ 177
What is Previewing................................................................... 177
The Psychological Residue of Previewing....... ......... ... ..... .... .... ...... 185
Previewing Facilitates the Infant's Predictive Abilities .................... 185
Previewing Enhances the Infant's Ability to Integrate Multi-Modal
Perceptions.. .... .... ..... ... ..... ... ......... ...... ....... ........... ..... ........ ...... 186
Contents ix
Previewing Objectifies Present and Future Reality.... ... ... ...... .......... 187
Previewing Supports the Infant's Emerging Sense of Control and
Mastery Over the Interaction...................................................... 189
Previewing Provides the Infant with the Ability to Compensate for
Developmental Deficits.............................................................. 189
Conclusion................................................................................. 191
Chapter 8 Previewing as a Principle for Intervention................. 192
Introduction................................................................................ 192
The Adaptive Caregiver ............................................................. 193
The Maladaptive Caregiver......................................................... 199
Previewing and the Adaptive Caregiver........................................ 202
Previewing and the Maladaptive Caregiver.................................... 203
Previewing During Treatment ..................................................... 205
Previewing as a Means for Accessing Repressed Material................ 207
Previewing as a Means of Obtaining an Unbiased Report................. 209
Previewing as a Means of Predicting Conflict ................................ 210
Previewing as a Means of Facilitating Multimodal Integration........... 212
Previewing as a Means of Instilling Mastery and Control................. 212
Conclusion................................................................................. 213
Chapter 9 U sing Previewing to Stimulate Optimal Development.. 215
Introduction................................................................................ 215
Interpreting Developmental Signals................................................. 219
Previewing Strategies Designed to Achieve Optimal Stimulation of the
Infant ........................................................................................ 230
Conclusion................................................................................. 236
Chapter 10 Strategies for Enhancing Previewing....................... 238
Introduction.. ....... ... ..... .......... ....... ... ............. ... ... .......... ... ..... ...... 238
Treatment Techniques.................................................................. 240
The Developmentally Disabled Child............................................ 240
Post Partum Depression............................................................. 249
Psychotherapeutic Techniques for Treating Depression................... 251
Conclusion................................................................................. 251
Glossary....................................................................................... 253
References.................................................................................... 255
Author Index................................................................................. 273
Subject Index ........................... , ........................... '" ...... ..... ..... ....... 279
The Concept of Previewing:
Introduction
Just as fairy tales of childhood begin with a predictable "once upon a
time" and end with the familiar "they lived happily ever after," so too
does this book suggest that infant development is a tale whose beginning
and end may be predicted.This book is an adventure story. It concerns
two main characters-the mother and the infant, with the father as an
occasional third protagonist. The adventure is about growth and change,
which in the parlance of modem psychiatry is referred to as develop
mental processes. In particular, though, this book highlights both the phe
nomenon of growing up during the first two years of life, a period that
has been labeled infancy, and introduces a new concept-previewing
which facilitates our understanding of how the transformations of matura
tion that occur during this period modify the relationship between mother
and infant.
Unlike other approaches to the study of infant development during the
first two years of life, this book strives to offer the reader a new perspec
tive from which to view maturational phenomena. This new perspective
comes from numerous clinical observations by the author of mother-in
fant interaction, as well as from a critical analysis of research data per
taining to the interactions characteristic of parents and infants. As a result
of these efforts, the concept of previewing was born. Previewing refers
to many aspects of the interpersonal exchange that occurs between care
giver and infant. Distilled to its essence, previewing encompasses all of
the processes, enacted by both members of the dyad, that serve to propel
development of enhanced skill and mastery of the increasingly complex
challenges posed by the interaction between two developing individuals
caregiver and infant. It is the contention of the author that, although mat
urational progression will occur in any event as a result of the infant's
constitutional endowment, this maturation requires an interpersonal com
ponent in order for development to evolve in the most adaptive fashion.
The infant must be exposed to caregiver-initiated behavior that encour
ages adaptive interactions. This form of interactive behavior provides the
dyad with insight into the contours of imminent developmental acquisi-
2 The Concept of Previewing: Introduction
tion and permits the infant to obtain a full awareness of what lies over
the next devt::iopmental horizon, as well as a sense of the implications
that these changes will have on the interaction. Once the infant is exposed
to this form of nurturing response by the caregiver, his own develop
mental skills are heightened. In this manner, previewing perpetuates the
mutually fulfilling relationship. The primary reason why this relationship
is so fulfilling is that it offers to both dyadic members a paradigm for
deriving an enhanced sense of control and mastery over the myriad of
developmental changes.
Previewing as a Parental Manifestation
Given the wealth of knowledge derived from clinical studies, we can be
gin to predict how a specific mother and infant dyad will undergo the
ritual of developmental evolution. But beyond the predictions of the re
searcher-be he or she a therapist, clinical investigator, or bystander
are the predictions of the two crucial characters in the drama of develop
ment-the mother and the infant. From the contours of their representa
tional images, each of these individuals formulates future interactions
which allow them to evolve a unique sense of partnership. This develop
mental pattern will transform two lives, that of the infant and that of the
caregiver. The goals of the following chapters are to provide insight into
the dynamic processes that occur during this interaction and to reveal
how the predictions of both mother and child that emerge in the form of
previewing behavior leave an indelible interpersonal imprint on the lives
of both.
How can we detect this behavior when studying the caregiver-infant
relationship? As discussed in the beginning chapters' of this book, the
caregiver's interactive skills during the early months appear imbued with
intuitive qualities. Caregivers who engage in previewing manifest particu
lar behavior that suggests an awareness of the infant's imminent develop
mental status. These behaviors appear to be spontaneous and yet indicate
an awareness of subtle cues being given by the infant. It is almost as if
the caregiver possesses a comprehensive image or representation of how
the developmental processes will unfold for her individual infant; such
representations guide the dyad in the direction of developmental achieve
ment. As explained in detail in the opening chapters, previewing incorpo
rates that caregiver behavior which offers the infant a prediction or fore
shadowing of the social implications of imminent developmental change
and achievement.
Broken down into its components, previewing consists of a trio of spe
cific behaviors. Fir~t, the caregiver must anticipate the trends of upcom
ing maturational attainment. Once the caregiver has, in a sense, felt the
infant's developmental pulse and envisioned future maturation, she can
begin helping the infant to predict which imminent milestones will occur