Flexing the frame: contemplating the use of multiple ports of entry in parent-infant psychotherapy.

Abstract

Multirelational interventions are well described in the psychoanalytic parent-infant literature. Daniel Stern (1995) originally suggested and described five "ports of entry" that may be employed to access the multiperson parent-infant clinical system. Other authors have elaborated and extended Stern's original list of ports of entry. The impact of using multiple ports of entry on the psychoanalytic frame, however, is largely neglected in the parent-infant psychotherapy literature. Danielle Quinodoz's (1992) four facets of the psychoanalytic setting are used to structure a discussion of how the multiplicities associated with parent-infant psychotherapy may impact the frame. The article argues strongly for a necessary flexing of the psychoanalytic frame to establish therapeutic alliances. A fifth facet, that of psychoanalytic mindfulness, is offered as a counterbalance to the risks associated with excessive flexing of the frame, particularly in relation to Quinodoz's fourth facet of "refraining from 'doing.'" This article relies on case material to illustrate the issues under discussion. Further engagement and debate are invited.