Parent-infant psychotherapy with a child showing early signs of autism: Is improvement in the nature of internal parental representations a key factor in therapeutic change? An in-depth qualitative study of a single case

It has been claimed that parent-infant psychotherapy improves the parent-infant relationship (Barlow et al, 2015). However, little research has been done to explore how the internal parental representations of the main caregiver is connected to improvement in a child’s early signs of autism. Such symptoms can be considered in a relational context, since disturbances in the parent child relationship are known to be risk factors for infant social and emotional disorders. As early research confirms that the primary carer plays a significant role in regulating the infant’s mental states, this study will draw on concepts of intergenerational transmission and investigate a possible link between the nature of the parents’ internal representations and the symptoms of their child. This study will look at a single case where a child’s early signs of autism have improved after a twenty session treatment of parent infant psychotherapy and concurrently explore the changes in the internal representations of her main caregivers. Based on a qualitative narrative analysis of three sets of data; from parents’ interviews, process recorded notes of clinical sessions and parent infant video material, the hypothesis will be tested that improvement in internal representations is a key factor in the modification of symptoms in the child. Keywords: parent-infant psychotherapy, early signs of autism, autism, parent-infant relationship, intergenerational transmission, internal parental representations, autistic symptoms, ghosts in the nursery, angels in the nursery, family relationships.