The Transmission of Trauma from Mother to Infant: Radioactive Residues and Counter-Transference in the Case of a Haitian Mother and Her Two-Year-Old Son*

ABSTRACT

Close observation of the interactions between a traumatised mother and her infant son provides information on the modes of transmission of psychic trauma in the mother–infant dyad. Following the presentation of a current literature review on the theme, the subject of “radioactive residue” and counter-transference in the transmission of psychic trauma from mother to infant will be illustrated through a clinical case study that focuses on a Haitian mother and her two-year-old infant son who has been referred to a “transitional care nursery” in urban Paris. The encounter with this mother–infant dyad is analysed through observing the quality of the interactions that take place between the mother and infant in order to determine how a particularly traumatic narrative impacts the mother–infant relationship, in addition to relations with the clinician. Mother and infant respond to one another through the emission and reception of “radioactive residues” as hypothesized by Gampel. This clinical case study shows that there is a need to consider transcultural factors and collective experience and history when analysing traumatic events. Additionally, the case study shows that counter-transference can be an effective clinical tool for gaining access to an infant's experience as the recipient of a traumatic narrative.     

Adaptation des soins et télémédecine en période de confinement et de pandémie de COVID-19 : retour d’expérience d’une Maison des Adolescents

BackgroundThe COVID-19 sanitary crisis has imposed a major reorganization of the health care system in France. Lockdown could be a factor in the emergence or deterioration of psychological disorders; it can be even more fragilizing during the specific period of adolescence. The « Maisons des Adolescents » (Teenagers’ Houses) had to urgently adjust their practices to provide continuity of care for adolescents suffering from physical or mental disorders. The « Maisons des Adolescents » are pluridisciplinary care centres for adolescents and their families that provide assessments and services for medical, psychological, socio-educational, educational and legal needs. How did care continue for adolescents during lockdown? What adjustments occurred in the « Maisons des Adolescents » during the health crisis?MethodsThis article presents the case of an adolescent who suffered a significant deterioration of her anorexia nervosa during confinement. Through this case, we describe the reorganization of care within the different units (consultations - day hospital - hospitalization unit) of a Parisian « Maison des Adolescents » during the COVID-19 pandemic.FindingsIn this service, the rapid implementation of the telemedicine system in the context of the COVID-19 pandemic made possible provision of continuity in care for vulnerable adolescents and families. Based on the existing literature, we discuss the advantages and limitations of telemedicine and the practical issues for the future organization of care for adolescents.PerspectivesIn contrast to pediatric medicine or child psychiatry, there is no protocol describing the application of telemedicine in adolescent medicine and psychiatry. There is an urgent need for further evaluation of the use of telemedicine for this population. This kind of research will improve knowledge about the effectiveness, acceptability and limitations of using a teleconsultation device in adolescent psychiatry in a crisis context. Certain remote care modalities implemented during the sanitary crisis could thus be maintained over time and become routine in the field of adolescent medicine and psychiatry.     

Violences,soins et cultures. Les bébés et les enfants aussi…

The author analyses the empirical and scientific difficulty in recognising the effects that traumatic events have on babies and young children. This is based on work done in situations of both individual and collective violence in foreign lands such as humanitarian situations but also in places both close and familiar. She shows that each culture has its own blind spots but also the ability to help babies and their parents to heal and rebuild. She begs for a philosophy and a trauma clinic for babies that includes all the aspects of caring.     

Passage à la majorité des mineurs non accompagnés : quelles adaptations nécessaires pour la prise en charge psychologique et la clinique transculturelle ?

ObjectivesIn France, unaccompanied immigrant minors are considered to be children unprotected by parents or other legal representatives. Some of them have left their country and their family to study, work and pursue a better life, while others are escaping from war-torn countries. The social workers (and carers) who work with them may cope with a variety of problems. Lack of knowledge about the minor's culture and lack of training about symptoms of trauma may lead to misinterpretation. The teenagers may experience difficulties in trusting any adults, after the loss of their family or other various traumatic events, including being victimized by smugglers. These youngsters confront a multiplicity of difficulties and paradoxes. Since the absence of an adult protection prevails over their “foreignness”, they receive temporary legal protection and social services in France. However, at 18 years old, they can be deported back to the chaotic environment that they fled, often at the risk of their lives. They are also exposed to extremely discordant attitudes among the professionals who deal with them (due to the conflicts between immigration policy and child protection laws). The Pr. Moro team has built multidisciplinary interventions strategies, based on a complementary method resorting to both psychoanalysis and anthropology, in order to respond to the needs observed in recent years, related to different populations. In this article, we focus on the adaptation of the transcultural setting care to the unaccompanied minors. We propose to describe the creation of an original transcultural setting, adapted from the results of an action research and its impact on those teenagers as they age 18.Materials and methodsThis study used a qualitative method that mixed narrative and transcultural approaches. We conducted 47 interviews with 17 different young people and their social worker (2 to 3 interviews per dyad one month apart). The process involved three meetings led by two transcultural careers in the presence of the referring social worker and an interpreter-mediator. We relied on three tools to facilitate the narrative process: objects, the circle test, and cultural mediators. The circle test allows the subjects to represent their perceptions of the past, present and future, as well as the potential correlations between them. The teen is asked to bring three objects or thoughts (for example, music, image, souvenir/memory, sentence…). The three objects shall be associated with the adolescents’ past, present, and future and are required to illustrate some aspects of their inner life, chosen randomly by context, mood, and the investment of the social worker. Interviews were processed using an Interpretative Phenomenological Analysis (IPA) and analyzed in line with a complementary transcultural approach.ResultsThree main themes were identified: reduce the risk of social isolation, psychotraumatism and precariousness, regressive positions and accountability. The effective sub-themes for an action modifying the relationship between the young person and the educator are highlighted: need to get rid of a sense of helplessness; highlight the minor's ability to connect and not being afraid belonging to a group; give meaning to the journey, such as a rite of passage; assume a maternal position for the educator, etc.ConclusionsThis original transcultural setting effectively transmits transcultural skills in three meetings to the professionals accompanying these young people. It is also a relevant framework to re-activate the construction process of identity of these young people, at the delicate period of passage of 18 years. It promotes the emergence of cultural representations and it takes into account pre-migration, migration, and post-migration experiences.