Unit of Perinatal Health, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
Int J Psychoanal. 2021 Dec;102(6):1138-1157. doi: 10.1080/00207578.2021.1953384. Epub 2021 Nov 15.
Infants express emotional distress through whining, crying, flailing, silence, etc., which can be viewed as communications that also afflict the caregiver(s). One expressive mode, subtle and often unnoticed except by the parents, is . It often elicits parental feelings of rejection, shame and despair, and may be a reason for seeking parent-infant psychotherapy. In therapy, the symptom often discloses a disturbance in the dyad's emotional interaction. Therapy can bring about relief in the symptom and the relational disorder. Sometimes, the therapist discovers that the infant is avoiding the therapist's, rather than the parents', eyes. This challenges the therapist's expertise in establishing contact with the baby and in perceiving and processing emotional reactions to what may be experienced as the baby's dismissal. Gaze avoidance elicits theoretical questions approached in a previous publication: what does the child seem to avoid in the adult's eyes, and how can we conceptualize the psychodynamics behind the symptom? It also evokes technical questions: how can the therapist make contact with an infant who avoids the mother's or the therapist's eyes? How can the clinician exploit their emotional reactions, the countertransference, to understand and further the dyad's emotional communication? Two case vignettes are provided.
婴儿通过哼哼、哭泣、挥舞、沉默等方式表达情绪困扰，这些可以被视为与照顾者有关的交流。一种表达模式，微妙且常常被父母忽视，是眼神回避。它常常引起父母的拒绝、羞耻和绝望感，可能是寻求母婴心理治疗的原因。在治疗中，症状常常揭示了二元情感互动的障碍。治疗可以缓解症状和关系障碍。有时，治疗师会发现婴儿在回避治疗师的目光，而不是父母的目光。这对治疗师与婴儿建立联系以及感知和处理可能被视为婴儿拒绝的情绪反应的专业知识提出了挑战。眼神回避引发了之前一篇出版物中探讨的理论问题：孩子似乎在成年人的眼中回避什么，我们如何将症状背后的心理动力学概念化？它还引发了技术问题：治疗师如何与回避母亲或治疗师目光的婴儿建立联系？临床医生如何利用他们的情绪反应，即反移情，来理解和促进二元情感交流？提供了两个案例片段。
