As part of the Association of Child Psychotherapists (ACP) 70th Anniversary events, the ACP and the Bridge Foundation (Bristol-based charity providing therapeutic services) hosted an inter-disciplinary conference on Saturday 9th November 2019 at the Watershed, Bristol.
The conference was conceived by Fiona Brodie (child psychotherapist) and Sara Tibbetts (documentary film-maker). Their idea was to examine the commonalities and differences between the psychoanalytic process of reflective observation, and the role of the documentary film-maker. The particular focus was on the relationships formed within both disciplines, and the potential for transformation within the ‘Observing Relationship’. The conference was attended mostly by child psychotherapists/trainees and film-makers, and proved to be a very stimulating day.
- Margaret Rustin, Consultant Child Psychotherapist, Head of Child Psychotherapy at the Tavistock Clinic 1985–2009
- Paddy Wivell, BAFTA and RTS Award winning documentary film-maker
- Gail Walker, Senior Child Psychotherapist, Bridge Foundation
- Hen Otley, Trainee Child Psychotherapist, Marlborough CAMHS
- Sara Tibbetts, Documentary filmmaker
Conference Chair: Rachel Pardoe, Child & Adolescent Psychotherapist, Parent-Infant Psychotherapist, and Video Interaction Guidance Practitioner and Supervisor
Documentary film-making award: since the conference, Paddy Wivell has won the Grierson award for ‘Best Documentary Series’. We are delighted for him.The judges’ appreciation included the comment: ‘The full humanity of people on both sides of the story shone through because of the empathy and thought with which they were filmed.’ Paddy Wivell is currently working on a documentary on women’s prisons.
This article reviews the conference and makes some links between the psychoanalytic process of reflective observation, documentary film-making, and Video Interaction Guidance (VIG). VIG is a strengths-based, effective, brief intervention for parents of children across all ages. VIG aims to promote enhanced sensitivity, and capacity to mentalise, in both client and practitioner.
VIG has a strong theoretical base: attachment, co-operative intersubjectivity, mediated learning, mentalisation, and positive psychology. VIG is client-centred – moving at the clients’ pace, with their goals in mind.
The evidence base for Video Interaction Guidance is an international one. VIG is recommended as an evidence-based intervention in the NICE guidelines.
To start the day, we viewed clips from ‘Observation Observed’: Closely observed infants on film – based on the BBC film series of the work of the Tavistock Clinic, called the ‘Talking Cure’ (1998). An observation seminar was specially convened, it was filmed, and each weekly visit to the two observed children – a baby and a young child – was also filmed. Interviews with leading teachers of Infant Observation provided the theoretical frame.
Gail Walker and Hen Otley then presented an eloquent infant observation, rich in detail, of a baby boy growing up in his family. We subsequently viewed clips from Paddy Wivell’s films, Prison (documenting life in HMP Durham, broadcast 2018-2019), and Boys and Girls (documentary about growing up in poverty in Britain, 2001). Paddy’s discussion of his films was titled Entering, Representing and Leaving the Field.
In the afternoon, Margaret Rustin presented a detailed examination of the Process and Power of Infant Observation, reflecting onthe ‘unconscious aspects of the emotional forcefield we become part of as observers’.
Throughout the day there were questions and lively discussion. We became engaged in a creative ‘translation’ process across disciplines, digesting comments from differing perspectives and backgrounds. The conference touched on emotional material, especially Paddy Wivell’s films. It was important to create a safe space for reflection. Paddy Wivell, in particular, was courageous in acknowledging his own emotional responses to his material (see below for comments on the impact on the film-maker of filming painful situations).
One reason I was invited to chair was my involvement in VIG. In drawing some links between VIG and the theme of the conference, I commented that I am always struck by the power for parents of seeing themselves in attuned moments of interaction: “I would never have believed it..”. “I think it makes you realise you are doing well.. ‘cos you don’t see it normally. I feel like I’m doing something right”.
However, the task for a documentary film-maker is different: to tell a story, to bear witness to both positive and difficult aspects of situations, rather than to provide a therapeutic experience. Through offering a new/different perspective, the documentary film-maker has the potential to change attitudes and the way systems function in society.
Several themes emerged around the ‘observing relationship’, including the following.
1. Receiving a “dose” of the subject’s feelings
Extracts from Observation Observed included commentary from Margaret Rustin and Hamish Canham (Child Psychotherapist, and organising tutor of the Tavistock’s child psychotherapy training, before his untimely death in 2003). Rustin spoke about the observer of the young child receiving a “dose” of what the child feels (for example, helplessness or feeling unwanted); Canham talked about using our own feelings as a “clue” to what the child may be feeling.
In Hen Otley’s observation, we heard about an 11 month old boy who enjoyed an intimate and affectionate secure attachment to his mother. During one visit he was observed to be “freezing out” Grandma, and behaving towards her in a rather disdainful way. The observer recorded feeling uncomfortable in the face of this; later she recorded feeling protective towards his mother when, aged 13 months, he grabbed her breast roughly, scratching her chest, during a particularly painful period around separation when he was starting with a childminder. The observer’s detailed observation, and self-reflection, helped us to think about the painful feelings the infant was struggling with, and how he was communicating these to his carers.
In Paddy Wivell’s film, Boys and Girls, we saw Jordan, aged 10, struggling with a chaotic home life including a preoccupied mother, an absent father, and domestic violence by mother’s partner. Paddy experienced at times feelings of vulnerability and helplessness, which it seems reflected Jordan’s feelings, often hidden behind a mask of ‘being in control’ and laughing at others’ vulnerability. Paddy felt intense concern for Jordan and the impact of his home life, which so clearly affected his emotional wellbeing and his ability to access education: school was Jordan’s main source of support, but he became increasingly absent as the chaos of homelife escalated. In the final scene, Paddy is encouraging Jordan to go to school, but Jordan is conflicted – with some insight he comments that he knows he will hit them [his peers] today… Jordan runs away and Paddy runs after him, but Jordan ends up at some distance; he seems to be isolated and adrift, with Paddy unable to reach him.
Similarly, we see Troi, in Prisons, entering and leaving prison, at both times experiencing difficult feelings: on entering he seems anxious and uncertain, masking this by laughter; on leaving he is fighting back his tears as he is taken through the routine of prison leaving procedures, devoid of any sensitivity to his state. We feel his upset.
Paddy Wivell commented that in the world of documentary film-making, these personal emotional responses are not attended to in detail, nor is it perhaps adequately recognised that film-makers may need support to process and digest their experiences. The conference was an unusual and safe place where such things could be thought about and powerful emotions rekindled.
With reference to VIG, being aware of our own responses, and managing emotions in the shared review (where we view with the client the edited ‘attuned moments’ of interaction) is central. The Video Interaction Guidance Skills Development Scale (VIG-SDS) includes a specific skill: Item 8 – Naming and managing emotions in shared review, which focuses on receiving and attuning to the emotional content of the shared review, and appropriate containment of the client’s emotion. This requires us to not only be aware of the client’s emotion when viewing the clips, but our own. VIG-SDS Item 12: Naming and receiving the process highlights, also, the necessity of being sensitive to the impact of our own responses on the client.
2. A relationship of trust
Paddy Wivell’s documentary work does not shy away from the painful struggles of vulnerable people in very difficult circumstances – his films are brutally honest, and can both shock and move us. Paddy’s empathy and compassion for his subjects shone through, in the films and in his commentary.
His biography included the comment:
“..they all shared something – a desire to speak and be heard, a glint in the eye and a spirit for adventure. There’s always a moment after we’ve first met when, despite the risks, they decide to throw in their lot and choose to conspire with me to make a film together. It’s a heady moment, a rush and a thrill and a little bit like falling in love. I’ll always be grateful to them for it.”
This rather extraordinary experience of being given access to another person’s life, can be as Paddy Wivell says a ‘heady moment’. We discussed how for many infant observers (and child psychotherapists too), we can ‘fall in love’ with our ‘subjects’ – infants, children, parents, grandparents; we can also experience very uncomfortable feelings. We share across our disciplines of infant observation and film-making, the joy and pain of this very personal engagement.
Margaret Rustin later spoke of the relationship of trust that film-makers and infant observers build with their subjects, and the common experience of being in an outsider/insider position: an outsider observing a passionate intimate relationship with the difficulties that arise – potential feelings of being intensely involved, and also peripheral or unwanted.
This, of course, links with one of the core VIG Values: Trust, which is essential to an effective therapeutic relationship.
3. The power of human connection: being ‘seen’ and understood
Paddy Wivell named his work as a “playground to explore how lives are lived”. He hopes to portray stories that are not just about the individual, but which speak to a “universal experience”.
In Boys and Girls, Jordan had sought out Paddy, after a period of Paddy being present in the school with no set agenda. Paddy felt that Jordan was “checking him out”, seeing whether he could be trusted. When Jordan presented himself, Paddy knew immediately that there was something about this engaging child – a potential for human connection, and the “love affair” began, with much shared humour along the way. Margaret Rustin commented on how Jordan had “chosen” Paddy, because he needed to communicate his anxieties and feelings to someone who would listen and hear his story. This emotionally containing experience would in turn, hopefully, allow Jordan to know and understand his story a little better.
The final filming was a difficult experience for Paddy Wivell, leaving him with unresolved questions about the impact of the relationship on Jordan? We discussed the importance of endings being managed with care, and the contrast between what can be potentially managed in a safe therapeutic relationship vs the context of documentary film-making where the film-maker also ‘enters and leaves the field’, and may have little control over what happens next (in both contexts, endings can happen suddenly with little opportunity to process emotions).
We thought about the longer-term positive impact on Jordan of this very powerful human connection. Paddy, and Jordan’s much-loved, sensitive teacher, are likely to have helped him to internalise a new model of human relationships: one in which there can be trust, warmth and safety. Margaret Rustin later spoke of the experience of containment which may be provided by the observer/film-maker: “being given house room in the mind of another person across time.. such a relationship provides a basis for development in the individual based on identification with the enquiring, holding, meaning-giving function of the observer or film maker”.
Hopefully, Jordan might be able to draw on this new model of relationships, given meaning through the emotional containment provided by both Paddy Wivell and Jordan’s teacher, to help him to form supportive relationships later in his life. However, as we all know, the impact of childhood trauma (particularly where family relationships remain conflictual and unresolved) can be significant and long-lasting, and therapeutic help hard to access. I think many of us at the conference feared that Jordan might go in the same direction as Troi, the subject of Paddy Wivell’s film on violence in prisons.
Troi, in Prisons, also suffered trauma in childhood. In the safe context of a prison rehabilitation group, Troi is asked to write about his childhood. This is an emotionally powerful scene, both for Troi, and us as observers. In a few moments, Troi moves from being ‘hard man’, using violence to stay ‘strong’, and be what others expect (having to “be someone”), to a state of vulnerability, wanting something different for himself in his life. The prison mentor is himself moved almost to tears. This is the beginning of hope for Troi.
Although the shift in Troi did not come about as a result of seeing himself on film, it came as a result of being ‘seen’ in the group, and being encouraged by the emotionally containing group leader and mentor to take on the ‘observer position’ in relation to himself by reflecting on his childhood. However, for Troi, despite the sense of hope in his mentor, and in us as we see him beginning to explore his vulnerability and another way of being, the therapeutic intervention was perhaps too little, too late. We see him being released from prison after serving his sentence, and his evident distress on leaving the community of relationships he has built during his stay. Prison has been a safe place for him – both physically and emotionally – but there has been insufficient support for the benefits to be sustained.
Practitioners of VIG are very familiar with the power of human connection, and the extraordinary power of being ‘seen and understood’ through using the video as ‘witness’. VIG clients make reflective comments that are profoundly moving: “I think it makes you realise you are doing well.. ‘cos you don’t see it normally. I feel like I’m doing something right” (mother of a 4-year-old boy who, prior to VIG, had been stuck in a negative narrative around both her son, and herself as a mother). Being seen, in the context of an emotionally containing relationship, is a force for change.
4. How are we looking, and what are we looking at?
Margaret Rustin raised this question at the start of her paper. She gave some in-depth analysis of infant observations where the observer and/or the parent’s feelings were powerfully influenced by their own life experiences, i.e. what they were bringing with them to the situation of being an observer or a parent being observed (with reference to Selma Freiberg’s seminal work on the ‘ghosts in the nursery’, 1952).
At times, observers may find themselves impulsively acting, and moving out of role – these may be opportunities to think about the emotional pressures which have led to this act, both within and outside the observer themselves.
She described how in infant observation seminars “members often feel drawn to identify with one person present during the observation” (this can include the baby, or, as above, when the observer found herself feeling protective towards the grandmother and the mother), “or they may feel their sympathies moving from one person to another sometimes at bewildering speed”. The range of responses in the group may reveal the ‘emotional currents’ present in the family life (as well as our own particular lens).
Margaret Rustin gave a poignant description of a mother, whose own mother had left the family when she was 9 years old, talking to the observer about fears that her baby and older daughter were blaming her as a ‘bad mother’. During the observation, the observer noticed that the baby shifted from being unsettled and crying, to engaging with mother in an animated way, which delighted both mother and baby. Margaret Rustin suggested that the conversation with the observer was containing mother’s misery, leaving a ‘good mother’ who could be attentive to her baby. The presence of an observer, consistently over a period of 1-2 years, can be transformative for the parent-infant relationship.
As with documentary film-making, the observer position is an opportunity to learn about oneself and one’s own responses. In infant observation, the seminar group can provide valuable emotional containment. In Paddy Wivell’s film-making, he tries to ensure that the subject views the film with him. Troi, in Prisons, was moved on too quickly for this to happen. Jordan viewed the film but at a difficult time, and Paddy was not sure what he made of it. We briefly discussed issues of consent and what it means for a child (or their parent on the child’s behalf) to consent to being filmed – and what meaning might the film have for the child as adult, later in life?
By contrast, in VIG, the exploration of the film is carried out within the safe therapeutic context of the shared review. As practitioners, we have the added learning opportunity in a filmed shared review of viewing ourselves and our interactions with our clients. As with infant observation, we have the opportunity to become aware of what we may be bringing to the relationship from our own experience, and where this may not be helpful therapeutically, the onus is on us to seek understanding and support in supervision.
5. Humility and not knowing
Margaret Rustin commented on the importance in infant observation of being aware of what we do not know, and what we do not see. She spoke of the “necessary humility” of the observer position.
In Boys and Girls, Paddy Wivell spent an initial period in the primary school, prior to filming, in a similar position of ‘not knowing’: trying to find his way and not being sure what might emerge, or when… In Prisons, too, Paddy spent time getting to know inmates and staff, waiting for something and a subject to evolve, being led by what happened. This state of not-knowing is often uncomfortable for observers/film-makers. There was agreement that this uncomfortable position is an important element of both infant observation and documentary film-making.
Margaret Rustin later linked the two methods (of infant observation and film-making) “as somewhat like a family relationship in their love of detail and their dependence on the closeness of their own human involvement, however disciplined that needs to be”.
Here, another link with VIG is the importance for the VIG practitioner, when going into a shared review, of being in a state of not-knowing, of humility, not having an ‘agenda’, but being open and curious about what the client sees, and the meaning this has for them. The love of detail is also relevant to VIG, as practitioners know through hours of microanalysis!
During the conference we recalled the seminal films made in the 1950s and ‘60s by James and Joyce Robertson, Young Children in Brief Separation, and also Lynn Barnett’s films Sunday’s Child (1985-2005), recording the development of a boy from infancy to 12 years. A final question arose about whether a current documentary about the parent-infant relationship, with little verbal commentary (as is a feature of observational documentaries), could be interesting for an audience? Are words necessary to convey the meaning, or could the film and soundtrack speak for themselves?
I think, in this era of increasing knowledge and concern about the impact of early experiences, further documentaries about the parent-infant relationship, which speak to the crucial experience for parents and infants of the early years, would be highly beneficial. I hope that a documentary film-maker takes up the challenge.
I have highlighted some of the links between the psychoanalytic process of reflective observation, documentary film-making, andVideo Interaction Guidance, including: the value of building a trusting relationship, the importance of being aware of our own responses and the other’s, of being sensitive to the impact of our own responses on the other, and being open to new meanings co-constructed with the other. Given these links, I hope there will be further collaboration between these disciplines to enrich our understanding.
Thank you to David Hadley and Marie Derome (both Child Psychotherapists on the conference organising committee) and Becky Wylde (Child/Adolescent Parenting Psychotherapist) for their comments on a draft of this article, and to the reviewers of Attuned Interactions.
The Association of Child Psychotherapists (ACP) is the professional body for Psychoanalytic Child and Adolescent Psychotherapists in the UK. See website for details of events, training and publications.
The Bridge Foundation is a Bristol-based charity providing psychodynamic clinical services to a wide range of individuals, professionals and commissioners. See website for details of events and training.
See website for details of events, training and publications.