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Ed Tronick achieved an impossible mission by integrating theoretical abstract notions and empirical data in a manner that resulted in the emergence of a new language of understanding infants. Tronick’s central goal was to present his Mutual Regulation Model (MRM) of infant-adult interaction. Whilst MRM did not overshadow all that was presented in this scholarly book, it provided a solid footing to appreciate complex and abstract concepts such as dyadic states of consciousness. The author never omitted an opportunity to translate the empirical/ theoretical aspects into clinical utilisable concepts. That to me was the epitome of this scholarly writing.
How did Tronick achieve this? He gave a lot of credit to his collaborators, and colleagues. This 5 part volume resonated his deep commitment to understanding infant’s inner world.
Part 1, “Neurobehavior”, described some well- known and some entirely new concepts. The author stated that he was trying to “broaden the definition of what is considered a teratogenic effect” (Page 21). He then outlined the newborn behavioral capacities, and the use of the Neonatal Behavioural Assessment Scale. The description of the NNNS (NICU Network Neurobehavioral Scale) that was specifically developed to assess neurological and behavioral capacities of at risk infant, such as substance exposed, was detailed. These chapters were supported by a DVD that provided visual understanding of infant states, and actual execution of some of the tests.
Part 2 described the role of culture in child development, brain organization and parenting. True to the theme of this book, this discussion was supported by empirical observations. The caregiver-child strategy model is explained emphasizing the impact of parenting practices embedded in the sociocultural and ecological environment of the infant. Tronick’s work with the Efe exemplified this strategy model. For example, availability of multiple nurses to the newborn was seen as a culturally adaptive procedure that safeguarded against threats of dehydration and introduced the infant to a gregarious way of living. This part also included discussion about the continuous care and contact required by human infants and the benefits from such a dynamic system seen from a cultural and evolutionary viewpoint. By using early mother infant interactions in the Efe and the Guissi dyads, one theme was clearly stated, that infants learn about their culture from very early stages; “It is our feeling that the interaction does not simply reflect the developmental process but rather forms the basis of that process” (Page 152).
Somehow the next two parts regarding the “Infant social-emotional interaction” and “Perturbations: Natural and Experimental” did not capture the almost poetic flow of the first two chapters. These two parts compiled seminal research on the infants’ social emotional interactions. Seven chapters in Part III and ten chapters in Part IV is basically a compilation of published papers and book chapters by Tronick and other well known researchers. This is truly a primer for anyone who wanted to learn the basics of infant’s social emotional development and the caregivers’ role in this process. The MRM and normal stress manipulations by infants will no doubt appeal to most early childhood clinicians. The discussion emphasized reparatory processes that infants employed in coping with daily routine stressful messiness of life, and mini coping episodes that contributed towards infant’s resilience.
Tronic asked and answered an important question, “Why do humans so strongly seek states of emotional connectedness and intersubjectivity and why the failure to achieve connectedness does have such a damaging effect on the mental health of the infant?” (Page 402). He answered this question by outlining a hypothesis of the dyadic expansion. This hypothesis rested more on the process of interaction rather than the structure of the nodal event. It was suggested that the dyadic expansion model provided scaffolding required in the therapeutic process. I liked the suggestion that scaffolding has two sides, the one that allowed patients to move toward more complexity and deeper meaning making, and the second side of the scaffolding process that led to the co-creation of a dyadic state of consciousness. Although this concept can be applied to any therapeutic situation, the mother-infant dyad’s co creation of dyadic states of consciousness seemed particularly appealing.
This book will easily find a comfortable place on the shelves of psychotherapists, psychiatrists, psychologists, infant researchers and ethnographers. It is definitely a must for subspecialty trainees in Infant Mental Health.