Grief and Loss Across the Lifespan, Second Edition

3 Infancy, Toddlerhood, and Preschool 77

or resolved. Depressed mothers show lower levels of maternal sensitivity and
emotional availability and are more likely to display negative mood states.
They are also less available to support the infant’s developing capacity to mod-
ulate negative states of arousal. Depressed mothers are more likely to be slow
to respond to infant bids for interaction, make negative attributions about the
infant, provide fewer developmentally appropriate experiences for stimula-
tion and learning, and have difficulty setting limits (Embry & Dawson, 2002).

Discussion of Vignettes: Application of Research to Assessment
and Practice

Vignette One

Jennie’s mother, although connected to her infant, has very little energy for inter-
action and does not engage in positive, mutually reinforcing interactions with her
baby. Research on early brain development and on the development of attach-
ment security, has emphasized the importance of affectively attuned, mutually
regulated, and positively charged parent-child interaction that helps the infant
to augment positive affective states and to effectively mediate states of negative
psychophysiological arousal. Jennie’s mom reads the baby’s withdrawal as a sign
of “being a good baby,” yet an alternative conceptualization is that Jennie has
come to experience bids for interaction with her depressed mom as anxiety pro-
voking. Instead, Jennie withdraws, which leaves her alone; the consequences of
this lack of “serve and return” interaction may affect Jennie for her lifetime as her
opportunities for attachment, exploration, and learning are so limited.

Vignette Two

The case of Eddie has a very different etiology and pattern of maternal depres-
sion. Eddie has developed dysregulated affect and an inability to self-soothe
or to be calmed. This is a serious impairment as a primary developmental
achievement of the first year is to form relationships that support the infants’
developing capacity for affect regulation within the context of sensitive rela-
tional care. Eddie’s vigilance in monitoring his mother’s face for clues to how
she is feeling can be understood as a type of hypervigilance representing a cop-
ing strategy for managing unpredictable parental interaction and responses.
Eddie has learned that changes in expression of maternal affect may lead to
temporal “loss” of his mother, and thus these changes are now associated with
anxiety because they signal a prelude of what is to come. Eddie’s needs for self-
soothing and management of his anxiety overtake his capacity to stay engaged
in the more developmentally normative activities of engagement and play.

Infant Mental Health: An Important Field of Practice

Infant mental health is a multidisciplinary field of clinical work, research,
policy development, and advocacy that emphasizes the importance of early
caregiving relationships in supporting the health and development of young
children and their families. Broadly speaking, infant mental health seeks to
understand and support the ways the developing child builds the capacity to
experience and regulate affect in the context of attachment relationships and