WHAT IS INFANT MENTAL HEALTH?

Selma Fraiberg and her colleagues in Michigan coined the phrase infant mental health in the late 1960s.It is de?ned as the social,emo-
tional,and cognitive well-being ofa baby who is under three years of age,within the context ofa caregiving relationship (Fraiberg,1980).
Fraiberg understood that early deprivation affected both development and behavior in infancy and reminded us that an infantis capacity for
love and for learning begins in those early years. She had been trained in a psychodynamic approach to mental health treatment for adults
and children,which she adapted for work with parents and young children from birth to three.
Fraiberg was attuned to the power and importance ofrelationships and understood that how a parent cares for a very young child has a
significant impact on the emotional health ofthat child. She also understood that parental history and past relationship experiences
in?uence the development ofrelationships between parents and young children. Fraiberg referred to this new knowledge and understanding
about infants and parents as ia treasure that should be returned tobabies and their families as a gift from sciencei(1980,p.3).She
spent the remainder ofher career returning that gift through training and a carefully crafted approach called infant mental health service
(Weatherston,2000).
Four questions are ofgreat signi?cance to the scope ofinfant mental health practice and to the training needs ofinfant mental health
specialists: What about the baby? What about the parents who care forthe baby? What about their early developing relationship and the context for early care? What about the practitioner? These questions shape the framework for infant mental health practice and training (Weatherston,2001).

Returning the Treasure to Babies

Imagine that you are an infant mental health practitioner and that
you are sitting in a familyis kitchen. The young mother,her infant,and her toddler
were referred to you by a nurse practitioner who had some concerns about the babyis
care and development following the babyis discharge from the newborn intensive care
unit. It is about 2 P.M. Dishes are piled high in the sink; food from several meals sits
on the counter. It is hot. The windows are shut tight,and although the sun is shining,
the shades are drawn as if to protect against the intrusion of daylight. The baby,three
months old,cries in the back room. The information that you were given tells you that
the baby was premature and had been separated from her motheris care for three weeks
before hospital discharge. The twenty-two-month-old toddler,a boy,brings you toys
and indicates with a grunt that he wants to climb up on your lapoyou,the stranger.
His face is smudged with traces of chocolate. He is pale and unsmiling. There are sig-
ni?cant developmental questions about both small children. Their mother,a single
parent,twenty-four years old,is alone in caring for her children and isolated from fam-
ily or friends. She seems agitated and surprised that you have come,although you
spoke to her yesterday on the phone. She,too,is unsmiling,unable to pay attention
to the toddler or to hear the babyis continuing cries. She lights a cigarette,pours a cup
of coffee for herself and asks you,iSo . . . why are you here?

This vignette marks the beginning ofan infant mental health intervention in which the focus is on early development and relationships
between a parent and her two young children.The scene is a familiar
one in the world ofinfant mental health,challenging and complex.
What is it that you,in the role ofan infant mental health practitioner,
will do? What core beliefs, skills,and strategies will guide you to work
effectively from an infant mental health perspective? Finally,what
training experiences will you need to have in order to offer this family
meaningful service support? The intent ofthis chapter is to introduce
the reader to the practice ofinfant mental health and the experiences
that contribute to the growth and awakening ofan infant mental health therapist.