A father names his son Lucifer and then boasts that his now severely disturbed 2-year-old “fits his title.” A mother is convinced that her 3- month-old infant is kicking her “on purpose” when she changes the child’s diaper. Absorbed in her thoughts, another mother consistently fails to notice the crying of her 1-month old. Home alone with his 8-month-old baby, a father believes that the child’s naptime presents the ideal opportunity to go jogging. A toddler’s mother refuses his entreaties to play for fear of “spoiling” him. In each of these situations we bear witness to an infant who holds no parental focus as an individual in his or her own right but, rather, becomes the unwitting participant in a deeply conflictual aspect of the parent’s ex- perience that impedes an empathic awareness of the baby’s own developmental and emotional needs. Certain themes predominate, although their psychological origins and behavioral manifes- tations are as varied and unique as the individu- als who enact them. In these examples, the “evil” infant, the “de- structive” infant, the “invisible” infant, the “in- dependent infant,” and the “insatiable” infant represent recurrent parental constructions of what Stern (1985) called the clinical infant. Each of these constructions, expressed in the resulting set of caregiving behaviors, stands for an important but unconscious aspect of the par- ent’s sense of self and other that interferes with an emotionally satisfying relationship with the child and has a negative effect on the baby’s de- velopment. Infant–parent psychotherapy aims at protect- ing infant–toddler mental health by aligning the parents’ perceptions and resulting caregiving behaviors more closely with the baby’s devel- opmental and individual needs within the cul- tural, socioeconomic, and interpersonal context of the family. The therapeutic process may take a variety of forms, but the core component in- volves the therapist’s effort to understand how the parent’s current and past experiences are shaping perceptions, feelings, and behaviors toward the infant (Fraiberg, 1980). The baby’s contribution to the interactional difficulties, for example, through physical or temperamental characteristics that hold particular meaning for the parents, has become an increasingly recog- nized aspect of infant–parent psychotherapy as well. The intervention focuses on what tran- spires between the baby and the parent, regard- less of its constitutional, psychological or his- torical origins. The “identified patient” is the 472 30 Infant–Parent Psychotherapy: Core Concepts and Current Approaches ❖ ALICIA F. LIEBERMAN ROBIN SILVERMAN JEREE H. PAWL This is a chapter excerpt from Guilford Publications. Handbook of Infant Mental Health, Second Edition, Edited by Charles H. Zeanah Copyright © 2005