Session Information
Paper Session
Contribution
In the scope of this paper, the main focus is set on the question, how alterity can be considered in research, namely, regarding a primary intervention programme for socially and economically disadvantaged parents and their toddlers: a psychoanalytical parent-toddler-group (PTG), established at the Child Guidance Clinic in Vienna in January 2021. In cooperation with the working unit Psychoanalysis and Education in Vienna, the research project "The Impact of Parent-Toddler-Groups on the Development of Children in the Context of Family Relations" was initiated with the support of Inge Pretorius (London, former Anna Freud Centre). Within the framework of the research project, the questions of what specific experiences children and their parents have while attending a PTG and what changes on the part of the children, the parents, and the parent-child relationship can be identified over time within the PTG, and also in everyday family life, are in focus.
The overarching aim of the PTG, based on the concept of the "parent-toddler-groups" of the Anna Freud Centre in London, is to promote toddler development, to strengthen the attachment between parents and toddlers, to strengthen their relationship, to enhance separation and individuation, so that toddlers can gain independence (Zaphiriou Woods, 2012). In order to achieve these goals, two psychotherapists lead the therapeutical PTG in Vienna, all the while referring to psychoanalytical theories on early child development. In the context of this analytically orientated group setting, the questions arise of what distinguishes the work with and the working relationship with the parents in this alternative psychoanalytic group setting from therapeutic one-to-one-setting, how the therapists’ work with the parents is shaped, and what kind of working alliances are possible within this alternative psychoanalytically group setting. These questions are all the more significant since some parents are obliged to attend the group on condition of the Youth Welfare Office and, especially at the beginning of the group, several parents dropped out of the group.
Although a review of various psychoanalytic publications suggests that since the works of Freud (1912), Sterba (1934), Zetzel (1956), Greenson (1986) as well as Sandler, Dare and Holder (1973) the psychoanalytic concept of working alliances has been widely discussed and elaborated (not only) in psychoanalytic discourses (Horvath, Luborsky 1993), these discussions are mainly related to psychoanalytical one-to-one settings. Looking for reflections on working alliances in psychoanalytic alternative group therapy services, however, reveals hardly anything with focus on psychoanalytically oriented groups. Therapists who further developed the concept of PTG of the Anna Freud Centre refer in their articles to the (at times difficult) formation of groups, but these considerations do not represent an established research focus (Zaphiriou Woods, Pretorius 2011). Eder-Steiner and Freilinger (2016) note that more than one third of the families frequenting the Child Guidance Clinic are committed to psychotherapy by the youth welfare authorities. In this context, they refer to the question under which conditions it is possible to develop a therapeutic motivation and a stable working alliance with demotivated patients. According to Fraiberg (1980), some developmental potential and processes only occur when external support is provided to the parents. In this regard, she refers primarily to parents who are unable to recognize their children's suffering and distress and thus cannot provide sufficient developmental support for their children. But following these remarks, what kind of working alliances can be developed in psychoanalytical PTG when, in addition, some of the parents are also required to participate, which may have an impact on their level of motivation, and on experiencing doubts and uncertainties? Are early terminations of the group possibly an indication of alteration, repression, negation, splitting or disavowal (Green 1986)?
Method
To address these questions, narrative interviews were conducted with the attending parents and the leading psychotherapists in order to gain insight into their experience of the group. This procedure requires an open and narrative interview that encourages the parents and psychotherapists to reflect on and talk about their own experiences within the framework of the group. This approach gives the interviewed the opportunity to narrate their subjective experience and to share how they individually make sense of their experiences. The course of the interview is orientated towards the interviewees' statements and the interaction between interviewer and interviewee during the interview is seen as an essential part of the research process (Rosenthal 2015). Since the start of the parent-toddler-group in 2021, five group-interviews were conducted with the two leading therapists, and one interview was conducted with each of the attending parents who started the group before December 2022 (also with those parents who dropped out of the group very quickly; till now overall 9 interviews with 8 mothers and one father were carried out). To evaluate the interviews, not only conscious life designs were considered, but following König (2019, 29) also unconsciously suppressed socially objectionable life designs. In this sense, a depth hermeneutic analysis was carried out, which "examines the narrative content of texts and images through their effect on the researcher's experience" (König 2019, 31). With this approach also the pre- and unconscious fantasies, desires and fears can be accessed – diversity as internal to the subject. An ambiguous understanding of the manifest sense on the one hand and the latent sense on the other hand in the text layers should be carried out. Manifest and accepted life concepts can be verbalised, latent and frowned-upon life concepts are usually not conscious or are repressed again due to their incompatibility with social moral concepts. "Under the pressure of a compulsion to repeat" (König 2019, 31-32), however, conflicting life designs seek their way through impulse outbursts, failures, and other irrational behaviours. Initial findings from a depth-hermeneutic individual-case-analysis of Leon and his mother, Stefanie Daller, who attended the parent-toddler group, are presented to illustrate the theoretical considerations with a case study (all personal data were anonymized according to common ethical guidelines).
Expected Outcomes
To conclude, diversity and alterity in the context of working alliances within a parent-toddler-group are discussed under two intertwined perspectives. On the one hand, with reference to psychoanalytical theories. Greenson (2008) understands working alliances as the patient's ability to cooperate in an analytic situation (cf. 2008, 83). According to Bordin (1979), “various modes of psychotherapy can be meaningfully differentiated in terms of the kinds of working alliances embedded in them” (Bordin 1979, 252). Furthermore, he states that working alliances are one of the keys to the change process n therapy and that “the strength, rather than the kind of working alliance, will prove to be the major factor in change achieved through psychotherapy” (cf.). Deserno (1990, 146–150) criticized, however, that the concept of the working alliance is mostly discussed uncritically as a normative concept and is treated as a rational and non-neurotic aspect of the psychoanalytical alliance. Although the question of how a lasting working alliance with the analyst can be established or maintained is considered in several psychoanalytical publications, as exemplarily pointed out here, these discussions are mainly related to psychoanalytical one-to-one settings. Also, the question of what unconscious factors are important in forming a working alliance on the part of parents who have to attend a parent-toddler group has not been addressed significantly. According to this research gap, diversity and alterity in the context of working alliances within a parent-toddler-group are, on the other hand, discussed by the depth-hermeneutically analysis of an interview with a mother who was required to attend the PTG by the Youth Welfare Office and ended her participation short time after the interview.
References
Bordin, E. S. (1979): The generalizability of the psychoanalytic concept of the working alliance. In: Psychotherapy: Theory, Research & Practice, 16, 3, 252–260 Deserno, H. (1990): Die Analyse und das Arbeitsbündnis. Eine Kritik des Arbeitsbündniskonzepts. München, Wien: Internationale Psychoanalyse Eder-Steiner, S., Freilinger, S. (2016): Zwischen Macht und Ohnmacht. Psychotherapie im Auftrag der Jugendhilfe. In: Zeitschrift für Individualpsychologie, 41, 207–219 Fraiberg, S. (1980): Clinical Studies in Infant Mental Health: The First Year of Life. London: Tavistock Freud, S. (1912): Zur Dynamik der Übertragung. Ges. Werke, Bd. 8 Green, A. (1999): The Work of the Negative. London: Free Association Books Greenson, R. R . (1986): Technique and Practice of Psychoanalysis. Stuttgart: Klett-Cotta Greenson, R. R. (2008): The working alliance and the transference neurosis. The Psychoanalytic Quarterly, 77, 1, 77–102 Horvath, A. O., Luborsky, L. (1993): The Role of the Therapeutic Alliance in Psychotherapy. In: Journal of Consulting and Clinical Psychology, 61, 4, 561-573 König, H-D. (2000): Tiefenhermeneutik; in: Flick, U.; von Kardorff, E.; Steinke, I. (Hrsg.): Qualitative Forschung. Ein Handbuch. Verlag Rowohlt: Reinbeck, 556–569 König, J. et al. (Hrsg.) (2019): Dichte Interpretation. Tiefenhermeneutik als Methode qualitativer Forschung. Springer VS: Wiesbaden 2018 Rosenthal, G. (2015): Interpretative Sozialforschung. Eine Einführung. Beltz: Weinheim und München Sandler, J., Dare, C, Holder, A. (1973): The Patient and the Analyst: The Basis of the Psychoanalytic Process. London: Allen and Unwin Sterba, R . (1934): The Fate of the Ego in Analytic Therapy. In: International Journal of Psychoanalysis, 15, 117—126 Zaphiriou Woods, M., Pretorius, I.-M. (2012): Parents and Toddlers in Groups: A Psychoanalytic Developmental Approach. London: Routledge Zetzel, E. R. (1956): Current Concept of Transference. In: International Journal of Psychoanalysis, 37, 369-376
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