Parents and Toddlers in Groups

A Psychoanalytic Developmental Approach

Marie Zaphiriou Woods, Inge-Martine Pretorius, Marie Zaphiriou Woods, Inge-Martine Pretorius

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781136886690
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This book explores how psychoanalytic principles can be applied when working with parents and toddlers in groups. Illustrated with lively observations, it discusses how these parent-toddler groups can be an effective medium for early intervention during a period which is critical for the negotiation of a child's central emotional issues.

Parents and Toddlers in Groups demonstrates the particular challenges of the toddler phase and its contribution to an individual's future development and relationships. Focusing on an approach developed by the Anna Freud Centre and comprising chapters from a range of expert contributors, topics include:

• the history, theory and practice of parent-toddler groups at the Anna Freud Centre
• how this approach has been adapted and applied across a wide range of settings and cultures
• the findings of research projects carried out on parent-toddler groups.

This book will be a valuable resource for practitioners wanting to reach parents and young children in community, educational and a variety of other settings. It will also appeal to child psychotherapists and psychologists working in CAMHS teams.

Part I

The Anna Freud Centre parent-toddler groups

Chapter 1

A historical background of the Anna Freud Centre parent-toddler groups and the use of observation to study child development¹

Inge-Martine Pretorius

People no longer remember who led the way in the methods they now use.

August Aichhorn

Introduction

The Anna Freud Centre’s parent-toddler groups embody Anna Freud’s consistent endeavour to link psychoanalytic theory, observation and practice in the field of child development. The history of the groups is rooted in her lifelong interest in the applied field of psychoanalysis and her many attempts to build bridges between different professional disciplines concerned with the wellbeing of children: education, paediatrics and family law.

This chapter offers a historical overview of the work of Anna Freud and her successors with toddlers, from the Jackson Nursery in Vienna to the current parent-toddler groups run at the Anna Freud Centre and in the community. It shows how Anna Freud’s first tentative attempts at direct observation became a crucial component of her “double approach” which integrated observation and psychoanalytic reconstruction, in her quest to build a psychoanalytic theory of normal child development.

Die Kindergruppe (1927–38)

Writing about “Little Hans”, Sigmund Freud (1909) called for use of direct observation of children to complement psychoanalytic investigations:

Surely there must be a possibility of observing in children at first hand and in all the freshness of life the sexual impulses and wishes which we dig out so laboriously in adults from among their own debris.

(1909, p. 6)

Anna Freud’s own interest in direct observation emerged when she gave four lectures on the “Introduction to technique of child analysis” (1926–27), at the newly-founded Vienna Institute of Psychoanalysis. Regular seminars on child analysis followed and became known as “die Kindergruppe” (the children’s group). Held on Wednesday afternoons, these seminars were the forerunner of the Wednesday Meetings at the Anna Freud Centre (Kennedy, 1995). They were attended by Dorothy Burlingham, Erik Erikson, Hedwig and Willi Hoffer, Anny Katan, Margaret Fries, Edith Jackson and others (A. Freud, 1966). While doing analysis with verbal children and observing babies (often their own), these analysts began to think about the importance of the mother–infant relationship for the child’s future development. The longitudinal observations that took place within the context of a training analysis were regularly recorded, in special columns of the psychoanalytic journals of the time (A. Freud, 1967; Young-Bruehl, 2004).

During these early years, the Viennese school of child analysis (led by Anna Freud) explored the adaptations to classical technique required by the child’s developing mind. They believed that the aim of child analysis was to prevent arrests and inhibitions and undo regressions and compromise formations, thereby “setting free the child’s spontaneous energies directed toward the completion of progressive development” (Freud, 1967, p. 9). Anna Freud became convinced of the need for child analysts to build up “a psychoanalytic theory of normal development” (Freud, 1978b, p. 276) in order to recognise and assess psychopathology.

The Jackson Nursery (1937–38)

Anna Freud’s interest in observation and normality, together with her awareness of social deprivation in Vienna, motivated the opening of the Jackson Nursery. As a Jew, she was not allowed to be in charge of an institution, so the nursery was officially run by her American friends, Dorothy Burlingham and Edith Jackson, who also funded the venture (Edgcumbe, 2000). They rented part of the “Haus der Kinder” from the Montessori Society and shared some of their toys. Twenty toddlers aged 1 to 3 years were selected from the poorest section of Vienna. Anna Freud explained her interest in directly observing pre-oedipal children:

Our wish was to gather direct (as opposed to reconstructed) information about the second year of life, which we deemed all important for the child’s essential advance from primary to secondary process functioning; for the establishment of feeding and sleeping habits; for acquiring the rudiments of superego development and impulse control; for the establishment of object ties to peers.

(Freud, 1978a, p. 731)

Considered an “experimental nursery group” (Freud, 1978a, p. 731), it offered an opportunity to learn and to test some of the developing theoretical ideas in a day-care setting. Anna Freud immediately introduced recorded observations when the nursery opened in February 1937. She visited regularly as an observer and attended the once-weekly staff meetings where the individual children were discussed. She also convened monthly seminars to discuss theoretical issues arising from the nursery work. The first meeting took place on 1st March 1937 and was attended by Anna Freud, Dorothy Burlingham, Josefine Stross (the nursery’s paediatrician), Grete Bibring, Berta Bornstein, Edith Buxbaum, Heinz Hartmann, Hedwig and Willi Hoffer, Anny Katan, Ernst Kris, Hans Lampl, Jeanne Lampl-de Groot, Richard Sterba, Robert Wälder, Jenny Wälder-Hall and Wolff Sachs (Kennedy, 1988).

They discussed the methodology of data collection and debated whether they should try to make objective behaviouristic observations or use the “analytic method”: gather material to confirm or contradict impressions gained from their psychoanalytically informed, first impressions (Kennedy, 1988). The possible pathology of the children seemed to be of less interest than establishing a sound methodology. No observations survived when the nursery was closed by the Nazi government in 1938.

The Hampstead War Nurseries (1940–45)

When Sigmund Freud and his family fled to London in June 1939, Anna Freud anticipated the direction of her work in London, by including ten little children’s stretcher beds in her luggage. Most of the furniture and toys from the Jackson Nursery followed soon after (Young-Bruehl, 2008). With the outbreak of war, Anna Freud realised the need for shelters for children and their families who were rendered refugees or homeless by the war. Together with Dorothy Burlingham, she opened the Children’s Rest Centre at 13 Wedderburn Road in North London, January 1941. In the summer of 1941, two additional residential nurseries were opened; the Babies’ Rest Centre at 5 Netherhall Gardens, in North London, and New Barn, an evacuation home in Chelmsford, Essex. Freud and Burlingham were pioneers in establishing the three residential homes that became known as the Hampstead War Nurseries (Hellman, 1983), in that they sought not merely to provide for the physical and educational needs of young children, but also for their psychological and emotional needs.

Anna Freud and Dorothy Burlingham ran the London homes and required a supervisor for the country home. Hearing reports about Alice Goldberger, who had established a nursery school on the Isle of Man, where she was interned as an “enemy alien”, Anna Freud set about enlisting Alice’s expertise. Through her intervention, Alice was released and became the superintendent of the country home, New Barn. After the war, she joined the first cohort of trainees on the Hampstead Child-Therapy Course (Friedmann, 1986, 1988).

Although repairing and preventing physical and psychological damage caused by war conditions were the two most important aims of the nurseries, they also offered a tremendous opportunity for research and teaching. In particular, the work offered an opportunity for longitudinal studies of child development (Burlingham & Freud, 1942). Children aged from 10 days to 6 years were admitted (191 children in total). Approximately one fifth came with their mothers, who remained in the nurseries for periods ranging from several days to several years. This made it possible to observe children, almost from birth, in contact with their mothers or deprived of maternal care, being breast- or bottle-fed, being separated or reunited with their mothers, in contact with mother substitutes and developing relationships with peers (Freud, 1951).

All staff recorded detailed observations as part of in-service training. Apart from six highly qualified people, the staff comprised younger workers – many refugees themselves – who had not been analysed or exposed to psychoanalytic theory. Anna Freud described them as, “young people, eager for an adventure in education and observation, untrained for this type of work, but also untrained in methods hostile to it” (Freud, 1951, p. 20). She described the early observational work and stance:

Emulating the analyst’s attitude when observing his patients during the analytic hour, attention was kept free-floating and the material was followed up wherever it led.

(Freud, 1951, p. 19)

Recorded mostly in English, the observations were classified under English and, occasionally, German headings, like “Einfühlung” – a word that encompasses empathy and insight. Hundreds of observations recorded on index cards remain in the AFC archives. These observations were integrated within the overall theoretical framework, which was continually being modified and developed by information gained from new observations. This process highlighted how important the child’s earliest relationships were for the child’s later development. Anna Freud and her staff began to show that early intervention could mitigate the development of later emotional and behavioural difficulties. This preventative work is central to the parent-toddler groups (Zaphiriou Woods, 2000).

The monthly reports on the war nurseries gave examples and summaries of observations on various themes (Freud & Burlingham, 1940–45). The first major summary was published as “Infants without families” in 1944 (Freud & Burlingham, 1944). Although in Anna Freud’s opinion these early observations were unsystematic, they were nonetheless the immediate forerunners of her subsequent advocacy of direct observation, a method that continued to be frowned on by many analysts (Solnit & Newman, 1984).

Anna Freud revealed her initial scepticism about the direct observation of children, writing that “the observations of manifest, overt behaviour mark a step which is not undertaken without misgivings” (Freud, 1951, p. 18). Anna Freud hoped – but was doubtful – that observations would prove useful in validating or refuting psychoanalytic reconstruction, thinking in 1951 that “it will not break new ground” (Freud, 1958, p. 93). However, by 1958, she realised that she had been overly pessimistic about the value and power of observation. She noted that – as she had hoped – direct observations confirmed some psychoanalytic assumptions, such as the overlapping of libidinal phases. She highlighted the value of direct observation for children subjected to trauma; these children often showed regressive and repetitive behaviours that were easily recognised during observations (Freud, 1958).

Anna Freud eventually came to value the “double approach” to gathering data – observation and reconstruction – and the way in which direct observation and psychoanalytic insight could reciprocally enrich each other to create a psychoanalytic child psychology (Freud, 1958). Such became her appreciation of this approach that she wrote:

While observing the coming and going of the manifestations of pregenitality in their inexorable sequence, the observer cannot help feeling that every student of psychoanalysis should be given the opportunity to watch these phenomena at the time when they occur so as to acquire a picture against which he can check his later analytic reconstructions.

(Freud, 1951, p. 21)

Anna Freud’s concept of developmental lines epitomises the synthesis of data gathered from observation and analytic reconstruction, as does the Provisional Diagnostic Profile (Freud, 1965). While the developmental lines give an external picture of the child from which psychic development is inferred, the Diagnostic Profile includes the child’s subjective, inner world. Essentially a developmental assessment instrument, the Profile drew on and reinforced Anna Freud’s quest for a greater understanding of normality and pathology. Her written work during the last 20 years of her life showed her preoccupation with both, as well as her awareness of how much remained to be learned about how to treat disturbance (Freud, 1983; Solnit & Newman, 1984).

The Hampstead Nursery School (1957–99)

When the War Nurseries were closed at the end of the war, Kate Friedlander and Barbara Lantos encouraged Anna Freud to organise a formal course to train “child experts” (Freud, 1965, p. 9). The Hampstead Child Therapy Course began in 1947 with seminars held at the teachers’ homes and at 20 Maresfield Gardens (Kennedy, 1995). Friedlander and Lantos served as teachers and training analysts (Young-Bruehl, 2008). With the acquisition of 12 Maresfield Gardens, The Hampstead Clinic opened in 1952 and the organisation became known as the Hampstead Child Therapy Course and Clinic.

The nursery school was founded to provide the students training at the clinic with an opportunity to observe and study normal development, to bring the two disciplines of education and psychoanalysis together and to offer a nursery service for children. Anna Freud chose Manna Friedmann to run the nursery school that opened in May 1957. The two women had met in 1946 when Manna was Alice Goldberger’s co-worker at Weir Courtney in Surrey: the residential home for the youngest survivors of the concentration camps (24 children aged 4–16 years) (Friedmann, 1986, 1988). The nursery school rapidly became Anna Freud’s favourite project and many delightful anecdotes survive from her playful interactions with the children. Friedmann recounts one little boy asking Anna Freud where she lived. Anna Freud replied “I live in Coco’s house” (Coco was Anna Freud’s dog) to which the boy replied with much sympathy, “You don’t have a house of your own!” (reported by Friedman, in Tewkesbury, 2006).

Housed in the basement of 12 Maresfield Gardens, the nursery school was attended by 8–13 children aged 3–5 years. In addition to normal children, the group included some children with special needs and some receiving or awaiting individual psychotherapy (Sandler, 1965). The nursery school provided intensive psychoanalytic cases for students training at the clinic. Initially the school offered a half-day programme, but in 1966 the Headstart Program in the USA stimulated the nursery to extend to a fullday programme that included disadvantaged families. Two consultants were assigned to the Nursery staff: Agi Bene and Anne-Marie Sandler, who were succeeded by Rose Edgcumbe and Peter Wilson.

Alice Colonna was amongst the first-year students who began observing the children. The student observers mingled with the children in the nursery school, adopting a neutral role (Wilson, 1980). Students and staff discussed their observations at weekly meetings. Observations in the nursery sometimes drew on observations made in the War Nurseries and were combined with the assessment and psychoanalytic treatment of nursery children (Zaphiriou Woods & Gedulter-Trieman, 1998).

Manna Friedmann was initially daunted by the task of recoding observations. She recalled Anna Freud’s characteristically simple response:

Make a note of anything you would feel inclined to tell a friend, either because it charmed you, or because it was funny and amused you, or it was irritating and angered you; make a note of anything which would confirm some psychoanalytic theory or which would contradict it; and make a note of any behaviour which would seem to you precocious or the opposite.

(Friedmann, 1988, p. 280)

Parents first visiting the nursery showed pleasure, but also suspicion about the low cost of the extensive service provided. Staff explained that the Clinic was a training and research centre and that their children were needed to teach the students and workers about “normal” children. According to Manna Friedmann, “the word ‘normal’ was all-important and reassuring” (Friedmann, 1988, p. 285).

When Manna decided to retire after running the nursery for 21 years (1957–78), Anna Freud initially thought of closing the nursery. However, a young American, Nancy Brenner, succeeded Manna and “urged her (Anna Freud’s) favourite project into renewed life” (Brenner, 1988; Young-Bruehl, 2008, p. 419). Nancy Brenner highlighted the somewhat unexpected advantages that recording observations brought for observer and child:

Originally, I believed that I was recording the observations primarily to have a report for students and colleagues. I soon realised that the importance of the observations was really for myself and the children. Recording observations helped me to get to know each child uniquely and intimately. They provided me with the material to think about and assess the child’s personal strengths and needs and to reflect on my relationship to, and handling of each child. Non-nursery time used in this way was additional time given to the children, as its influence on the following day was always felt. It was as if the child and I had a private “visit” which enabled our ongoing relationship to deepen.

(Brenner, 1992, p. 89)

Nancy Brenner ran the nursery until 1990 when she was succeeded by Myriam Senez. Marie Zaphiriou Woods was the psychoanalytic consultant from 1986 to 1997. The nursery was closed in 1999.

The Well-baby clinic (1950s–97)

Established by Joyce Robertson in the 1950s, the Well-baby clinic aimed at helping and advising young mothers about how to handle their infant’s physical and emotional needs. It provided a means for making long-term observations, beginning shortly after birth and, sometimes, continuing through nursery school. The focus was on preventative work. The staff tried to determine the extent to which guidance and support could relieve tensions arising between mother and infant, supporting mothers to cope with difficulties arising from the infant’s sleeping, feeding and weaning and the repercussions of these bodily experiences on the infant’s mind (Sandler, 1965). Over the years, staff included Ernst and Irene Freud, Nicky Model and Josefine ...

Table of contents

• Cover Page
• Half-Title Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of contributors
• Foreword
• Acknowledgements
• Introduction
• Part I The Anna Freud Centre parent-toddler groups
• 1 A historical background of the Anna Freud Centre parent-toddler groups and the use of observation to study child development
• 2 Normal toddler development: Excursions and returns
• 3 A psychoanalytic developmental approach to running a parent-toddler group
• 4 The role of play
• 5 Normally diffcult and diffcult normality: A toddler observation paper
• 6 Being seen to be able: The relationship between a partially sighted father and his daughters born with foppy baby syndrome
• PART II Adaptations and applications of the Anna Freud Centre approach
• 7 Difference and disability: Experiences in a specialist toddler group
• 8 Running a toddler group on a council housing estate: Invisibility, intrusion, dislocation and the importance of boundaries
• 9 Building a toddler group in a hostel for homeless families: An iterative technique
• 10 Reaching out to vulnerable parents and toddlers: Establishing a parent-toddler group in a deprived area of South London
• 11 Integrating parents and toddlers with special needs: Parent-toddler groups in St. Petersburg
• 12 Integration, sharing and separation: Introducing the concept of toddlers and toddler groups in Greece
• 13 Finding our own path: Engaging working parents in a toddler group in Peru
• Part III Research and evaluation
• Introduction
• 14 A qualitative study of the experience of parents attending a psychoanalytic parent-toddler group
• 15 Thinking about my toddler: Can a psychoanalytic toddler group enhance refective functioning capacities in parents?
• 16 Snack time at an Anna Freud Centre parent-toddler group: Microanalysis of social eating in toddlerhood
• 17 Conclusion
• Appendix
• Notes
• References
• Index