Commentary: All at Sea: A Case Discussion

By Deborah Weatherston, PhD, IMH-E®

Jan Proudfoot has given us a great gift – the affirmation of the power of relationship to affect growth and change through the story of a new mother struggling to respond to her baby who she described as strong willed, inconsolable, difficult to feed and unresponsive to people or playthings. Jan’s initial response to the referral was meaningful. She explained, “These problems are so big and I’m so little,” giving us an immediate window into her own feeling of vulnerability as she wondered if she would “know what to do.” She drew on experiences with mentors who had guided her so thoughtfully over many years. She was quietly present, watched and listened carefully, deeply affected by the stories she heard. Her capacity to be emotionally available to Mom and Baby, to witness their interactions and hold their relationship, were strategies that form the bedrock of an infant mental health service. Although in the “assessment and information gathering” phase, Jan’s presence provided a carefully crafted and powerful intervention. After listening intensely to Mom’s stories, she shifted ever so slightly to observe with Mom and wonder aloud about the baby’s experience. This was a carefully paced shift that fueled Mom’s capacity to begin to have empathy for her baby’s difficult entry into the world. Quiet, confident, and very seasoned, Jan worked without hurry, countering the press she felt to teach or to tell Mom what she should do.

Mum's little boyAs I fell under the spell of the story, gently carried by Jan’s words, I wondered about parallel process, so beautifully illustrated here. Jan, worried about the complexity of the task and if she would know what to do; a new mother, worried about the tasks of motherhood and wondering if she knew how to care for her Baby. Similarly, Jan, observing and listening to Mom so that Mom would observe and listen to her Baby’s cues. Jan, guided in relating to Mom and Baby by the maps her mentors had given her over many years; a new mother, finding a map to guide her in relating to her Baby through her relationship with Jan. Jan nurturing and understanding Mom; Mom nurturing and understanding her Baby.

Finally, I was enchanted by the use of metaphor. The “ship was off course;” Mom and Baby were “at sea.” Jan’s presence and relationship provided “a map” as Mom and Baby “sailed to sunnier climes.” Simple, yet enormously complex work. Thank you indeed for this great gift.