What does the Meaning of the Child Interview Assess?

The Meaning of the Child classified parenting interviews for the level of risk, and also the nature of the parent-child relationship; the degree to which it is:

 

Sensitive: mutually pleasurable to parent and child, and supportive of the child’s development

 

Unresponsive: psychologically distant from the child, leading to neglect in extreme cases

 

Controlling: psychologically intrusive towards the child, leading to, in more serious cases, hostile and/or enmeshed relationships

 

The MotC is based upon Attachment theory, and the classifications are linked to their effects upon the child’s developing attachment pattern, and the potential risks or strengths in the child’s development arising out of this (Grey and Farnfield, 2017a, 2017b).  Particular use has been made of the developing understanding of ‘mentalisation’, the way in which both adults and children learn to understand the mind of themselves and others, and the impact of this on parent-child relationships (Fonagy et al. 2004, see also below).

 

“One of the key changes to my practice is thinking about who the driving force of change within any intervention should be, whether this be the child or parent or both. I would certainly recommend the training to those who wish to understand risk in areas of parent and child work.”

Dr Satbinder Kaur Bhogal, Clinical Psychologist, Birmingham

 

A Dyadic, ‘Inter-subjective’ understanding of Parenting Representations

The focus of the Meaning of the Child is the parent-child relationship, rather than primarily a capacity, or attribute, of the parent.  The MotC classifications are drawn from Crittenden’s CARE-Index (Crittenden 2007), where the parent’s behaviour is seen dyadically, from the perspective of the child (and vice-versa).  The meaning of the child to the parent is not seen simply as an outworking of the parent’s self-protective strategy in childhood (attachment pattern) but as the result of a developing and ongoing ‘collaborative conversation’ between parent and child (Beebe 2012a&b, Lyons-Ruth 1999).

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Sensitive parents enable the development, protection and nurture of the child through facilitating a collaborative ‘inter-subjectivity’ between them. Each party offers something of themselves, whilst listening and eagerly attending to both the responses and initiatives of the other.  Different perspectives are entertained, considered and valued.  Such ‘dialogues’ are a pleasure to listen to, as there is ebb and flow, the ability to think creatively about the relationship with the child, as well as obvious enjoyment of it.

 

Controlling parents need to dominate the meaning making process. The intrusive parent perceives the child’s autonomy and ability to make meaning of the relationship as a threat, and so ‘moves into’ the space that is otherwise jointly constructed in healthy relationships. The controlling parent deals with the threat they perceive from the child by attempting to make the relationship what they want it or need it to be, rather than feeling secure enough to allow the relationship to develop in a way that respects the child’s subjectivity and personality.  Only one version of ‘reality’ can be thought about, dominated unwittingly by the parent’s internal experience, which is ‘imposed’ on the external world in general, and the child in particular.

 

Unresponsive parents seek to withdraw from the dialogue, usually out of fear. The unresponsive parent constructs a meaning of the child that justifies their own lack of genuine participation in the conversation. Usually the child is idealised, such as to underestimate the parental involvement the child needs, and facilitate the parent’s absence.  The parent’s consideration of their relationship is ‘disconnected’ from their own lived and felt experience, which is largely avoided.  For this reason it is a kind of unwitting ‘pretence’, a way of feeling safe and protected from inner reality, or borrowed from the outside world (e.g. professional opinions or cultural stereotypes) as a means of avoiding emotions that are too frightening to be expressed or thought about. The parent’s psychological absence leaves a vacuum that the child has to fill for his or her own survival. The child becomes the driving force in the dialogue and the relationship.

 

These general patterns are of course simplifications; few, if any, parents are entirely ‘one’ thing. Ultimately, the MotC uses these patterns to help understand what is going on in a particular relationship rather than just seeking to classify parents.

 

The Particular Contribution of the Meaning of the Child

1. The MotC offers a systemic, inter-subjective approach to classifying parenting representations

As such, the MotC is alive to the way in which outside relationships, such as couple, family and wider social relationships help shape the meaning of the relationship for both parent and child, in addition to the influence of the parent’s childhood attachment experiences.

2. The MotC coding system integrates Crittenden’s DMM understanding of self-protective information processing (Crittenden & Landini 2011) with a dyadic approach to the ‘co-construction’ of attachment

The MotC makes use of current understanding of how adult discourse about relationships is shaped by the adult’s history of danger and loss, but unlike the Adult Attachment Interview, its focus how the relationship between the parent and child operates.  In particular, the MotC draws upon the method of discourse analysis and understanding of conscious and unconscious defensive processes developed by Crittenden, but seeks to illuminate the parent-child relationship rather than the adult’s self protective strategy (Grey and Farnfield, 2016).

3. The MotC system integrates developments in the understanding of reflective functioning into its understanding of the different ways in which parents misconstrue meaning in ‘at risk’ relationships

The Reflective Functioning (RF) Scale (Fonagy et al. 1998) and the Parental RF scale (Slade et al. 2005) represented a critical breakthrough in both understanding and measuring how parents think about their children and experience of parenting.  Its development paved the way for significant research and theoretical development, particularly around pathological or unhealthy mentalising.  However, the benefits of this later work are are not fully incorporated into the RF scale itself, which focusses  upon the parents’ controlled (conscious) reflective functioning, and works primarily by scoring the presence of adequate or healthy RF. Although unhealthy and inaccurate mentalising affects the score, it does not examine how different forms of impaired reflective functioning can lead to different kinds of ‘at risk’ parent-child relationships.

 

The MotC makes use of the suggestion that family trauma results in a retreat to earlier stages of the development of mentalisation, or a retreat from it altogether, and incorporates this into its understanding of ‘at risk’ relationships.  In particular, use is made of the contrast between ‘psychic equivalence‘, where mental states are thought to be naively ‘real’ (to replicate reality accurately, rather than be just an ‘idea’ of it, based on just one perspective), and the parent confuses their inner experience with outer reality (seen in the MotC Controlling pattern); and ‘pretend‘ mentalising, where the parents’ understanding of their and others mental states is theoretical, borrowed from others, and even imaginary, ‘decoupled’ and disconnected from the parents’s own inner experience (seen in the MotC Unresponsive pattern), as it is too threatening to actively process (Fonagy et al. 2004).  In addition, the MotC’s use of Crittenden’s work on memory systems (Crittenden and Landini 2011) allows evaluation of the automatic (or ‘unconscious’) dimension of mentalising (Fonagy and Luyten 2014, Grey and Farnfield 2017a, 2017b).

4. As a result, the MotC is able to differentiate between differently functioning ‘at risk’ relationships

Approaches to Parenting Interviews that are simply scored, as well as those which identify just one ‘at risk’ category are for this reason unable to help understand the complexity of different kinds of endangered relationships. The clinical and forensic usefulness of the MotC is enhanced by the way it is able to make relevant distinctions within relationships at risk, rather than simply identify them. For this reason it is especially well suited to inform both decision making and intervention with endangered and struggling families.

5. The Meaning of the Child has been developed to assess fathers as well as mothers

Most of the research around how parents perceive their children has been carried out only with mothers, even though these tools are commonly used with both genders.  The MotC does not depend upon culturally specific or gendered norms of parenting and can be used with both mothers and fathers.  Both mothers and fathers were included in the validation study, and the tool was as valid with each.

6. The Meaning of the Child can be used with parents who have a Learning Difficulty

Parents, including those who have had dangerous and unresolved childhood experiences, frequently distort the meaning of their own and their child’s experience. This ties in with the findings of Professor Sue McGaw and her colleagues (2010) that it is commonly childhood trauma, rather than possessing a learning difficulty for example, that results in dangerous parenting.  The Meaning of the Child specifically looks at the effects of trauma on the interview in a variety of ways. In addition, the careful examination of interview transcripts allows for misunderstandings to be recognised, and the use of different sorts of information ensures that difficulties arising out of a cognitive impairment and not allowed to inappropriate influence the classification.  The MotC has been used extensively with parents with learning difficulties, who were included in the validation study, which compared interviews with face-to-face observation.