Enveloppes psychiques précoces : la difficulté d’être contenant auprès d’un bébé en retrait relationnel

Abstract

Context

Autism spectrum disorder (ASD) results from a complex interaction between innate factors of the infant and their environment. Many risk factors have been identified. The difficulties in physical organization of at-risk children can allow us to identify the most fragile infants at birth. The baby in relational withdrawal can teach us about the part played by the infant in the weaving of early psychic envelopes. Research on babies who have become autistic children demonstrates disturbances in their motor skills, from their general movements to difficulties with body organization. The infant's sensorimotor difficulties hinder the expression of subjectivity. They also have an impact on the parents’ ability to interpret the signs coming from the baby. It is difficult for a parent to be the receptacle of the intentions of a baby who does not seem to be addressing its parent. An accompaniment of the parents supports them in their capacity to provide a secure “container” for their baby. A transdisciplinary team ensuring the continuity of the group psychic envelope may be necessary to establish harmony between the baby and their environment.

Objectives

The goal of early post-natal care is to support parents so that they feel they are the receptacle to the baby's intentions. We want the baby to be able to actively engage in the relationship with its parent from the first months of its life, despite any sensorimotor difficulties that may be present.

Method

In this theoretical reflection on the difficulties of containment with a baby in relational withdrawal, we develop the theoretical-clinical bases which underlie our work as care providers. We focus here mainly on supporting parents in the containing function they occupy as the organizing center of their baby's instinctual life.

Results

The result targeted by this treatment is the entry of the baby into goal-directed movement towards the other from 4 months, as evaluated by the Préaut grid, within the framework of a pleasant relationship of shared pleasure. We promote the establishment of a relationship in which the parent can both perceive the signs emitted by their baby while being attentive to their own internal experience. Particular attention is paid to joint listening. From this theoretical-clinical base stems the current practice of a transdisciplinary team and two ongoing research projects.