Sleeping on the Couch: Interpretation-in-Action in Infant-Parent Psychotherapy

Abstract

Various types of action are prevalent in infant mental health work, not only in the practice of infant-parent psychotherapy as originally conceived by Selma Fraiberg (Fraiberg & Fraiberg, 1980), but also as a matter of course in the action-oriented work carried out by social service providers, early intervention specialists, nurse practitioners, and child protective service workers in the field. As a result, the clinician practicing infant-parent psychotherapy often faces a variety of situations involving (and provoking) concrete action. As the gap between those with access to social and financial resources and those who live in poverty widens, both in the United States and abroad, the need for affordable mental health services will continue to increase. Psychoanalysts, who have suffered criticism in the past as elitist and out of touch with the needs of the impoverished, must find innovative ways to stay relevant as advocates of an important mode of psychological and emotional change. This paper extends the psychoanalytic concept of interpretation-in-action (Ogden, 1994) as it pertains to the work of infant-parent psychotherapy in community mental health. Interpretation-in-action is viewed as a theoretical concept that facilitates socially-minded, psychoanalytic practice through action. It is proposed as a bridging concept between those in the field of psychoanalysis who still view such action with suspicion and those who now call for psychoanalytically oriented clinicians to increase their involvement in impoverished and under-served communities around the world.