Styles of maternal Care

Joan Raphael-Leff (1993)

Raphael-Leff is a well-known psychoanalyst with extensive experience working with pregnant women and mothers.  In her practice and her writings, she has observed a range of approaches to baby care routines.  She has described these different approaches along a spectrum of what she called “facilitator to regulator” and she makes the connection between the approach to infant care and the type and degree of identification that the parent has with the baby.

At one end of the spectrum is the ‘regulator’, Raphael-Leff describes this mother as someone who expects her baby to make a passive adaptation to her lead, to follow and fit in.  Typically, this is because, at some level, the mother fears the baby will greedily take over if not held in line.  At the same time, this woman also identifies with the ‘greedy baby’.  The infant’s expression of need resonates with her own need (often for love or recognition).  Yet, these are the denigrated, unruly aspects of herself, which she feels she needs to contain.

At the other end of the continuum is the ‘facilitator’ mother, who adopts the role of meeting the needs of her idealised baby, in an apparently selfless manner.  Here the mother has an identification with an idealised part of herself, which is represented by the baby.  By meeting all of the needs of the infant, she is in turn satisfying her own unconscious need to feel special, protected and loved.  This mother will often struggle to say no to her baby and go to great lengths to protect the infant from distress.

Raphael-Leff proposed a third style, the more moderate style of parenting which she termed the ‘reciprocator’.  In this third style, the mother and baby can negotiate within a reciprocal relationship.  Of central importance is that neither pole is excluded, the facilitator or regulator is not disowned per se.  Rather the mother can tolerate ambivalence and move between the poles.  The baby can be both greedily demanding as well as deserving.   Similarly, the infant can represent both the denigrated and idealised self.  The mother retains the capacity to consider the needs of the baby but can also balance this against her own needs at times as well.  The infant’s needs and desires can be acknowledged and considered without becoming law.  It is possible to say ‘no’ to the baby.

This framework can be helpful when working with mothers who appear to be stuck in the relationship with their baby, where they describe feeling that the baby is too demanding or perhaps overly fragile or desperate.  It is also helpful to consider this within a couple, where partners may appear split along these lines.  Changing the conversation from a fixed, often blaming statement about the baby to a conversation about the unmet needs of the parent, can help parents adopt refreshing, new perspectives.