family therapy Archives | Brighton and Hove Psychotherapy

Babies are not born with the neurological capacity to understand distress, or even to differentiate between discomfort and mortal danger. To ensure their survival therefore, babies are biologically programmed to communicate all forms of distress to their primary caregivers through very primitive means (e.g. crying, screaming and reaching out).

Under ideal circumstances, these ‘signals’ from the baby will elicit a sensitive (‘attuned’) response from their caregiver, whereby their caregiver will utilise their more developed brain in order to empathise with the infant’s distress, to soothe them and overtime, to give them words to better understand and communicate their distress. Repetition of this pattern over time, coupled with a deepening joy of the relationship, is not only the foundation for a secure attachment relationship, but the building blocks for other important skills such as developing empathy and emotional regulation.

When working well, attunement enables a child to feel truly understood, accepted and ‘felt’ by their caregiver. Inevitably however, “getting it right” all the time is not possible and sometimes signals will be missed or responded to incorrectly (‘mis-attunement’) – also known as a ‘relationship rupture’. Ruptures are normal and actually present opportunities for a child-carer relationship if the carer is able to repair the relationship appropriately. Indeed, it is estimated that for a secure attachment to develop, carers need to attune correctly around one third of the time (Hoghughi & Speight, 1998), which is reassuring!

Over the years, researchers have examined the importance of attunement on an infant’s mental health. This includes Ed Tronick’s (2007), ‘still face experiment’, which illustrates the distressing disintegration of a young child, whose parent temporarily stops responding to their cues (Youtube link). It also includes the work of Lynne Murray, who demonstrated that even warm responses to infants are not regulating unless they are exactly timed with their cues. This is important as for some parent-infant dyads, ruptures can be severe and chronically prevent the carer from being able to sensitively attune to their infant – ‘toxic mis-attunement’. This might occur when factors specific to the child get in the way of them being able to communicate their needs effectively (e.g. speech and language difficulties or neurodevelopmental difficulties), or when factors specific to the parent stop them being able to receive and process the child’s distress signals appropriately (e.g. mental health difficulties or substance misuse problems). There may also be external stressors impacting on the relationship (e.g. domestic violence or poverty). In these cases, it is imperative that mental health and social support services are proactively mobilised to offer early support to both the child and the carer.

Hoghughi, M. & Speight, A. (1998). Good enough parenting for all children – A strategy for a healthier society. Archives of Disease in Childhood, 78, 4, 293-296.

Murray, L. & Trevarthen, C. (1985). Emotional regulations of interactions between two-month-olds and their mothers. In T. M. Field & N. A. Fox (Eds.),Social perception in infants (pp. 177-197). Norwood,NJ: Ablex.

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes practice.

There has been much talk of how Brexit has divided our country, and indeed, in my own extended family I have members on both sides of the debate.

In this blog I want to write a little bit about how we as humans are divided and how Psychotherapy can ease some of the conflict contained in that. This divide, or split, can happen when we think or do things that don’t accord with what we believe to be our own beliefs. Beliefs about ourselves as doers of good, thinkers of pure thoughts etc.

Freud describes how these splits can be repressed, by quoting Nietzsche’s phrase: –

“’I did that’ says my memory; ‘I cannot have done that’, says my pride and refuses to yield. Finally – memory gives way.’”

Splitting is not necessarily a bad thing, it is often a way to manage something that cannot be managed at the time, so, cleverly, the psyche represses it. However, this repression is never total so the thing that wasn’t able to be managed, perhaps due to it being too overwhelming at that time, seeks to come out in some other way.

The outpouring of grief at Princess Diana’s funeral, for instance, was not only about the sad and untimely death of Diana but also presented a triggering of an outpouring repressed and split off grief in so many people and perhaps goes to show how much grief so many of us carry around.

Another way splits can occur is when we have, as we almost always do, conflicting feelings of love and hate to those we are close to. This can sometimes create a terrible conflict, where the anger or disappointment or hurt, feels like it can’t be expressed for fear of hurting the one that is also loved and therefore potentially causing us to lose that person.

However, the feelings are still there, so find other ways to come out; – road rage, shouting at the TV, getting into arguments at work, etc. Most of us want to be good and can find these parts of ourselves distasteful and best not thought about. However, that has side effects, sometimes serious ones and that is when a person will sometimes seek psychotherapy.

The psychotherapist will work to facilitate the unearthing of these conflicts in a way that is sensitive, non-shaming and understanding, in order to allow their expression and lessen their negative effects on the client’s life.

To start with this can seem strange and almost feel like the therapist is only interested in their ‘bad bits’. However, it is not that the therapist wants to humiliate the client, but rather to do the opposite of colluding with the sometimes-long history and input of well-meaning friends and family who have tried to make them feel better by joining in the game of pretending to look the other way.

As Carl Jung said :-

“One does not become enlightened by imagining figures of light, but by making the darkness conscious.”

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

The role of ‘attunement’ in relationships with babies and young children

A Nation divided

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