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This chapter focuses on coparenting and family dynamics during the transition from infertility to parenthood. Eighty couples who had infertility issues were assessed before they underwent infertility medical treatment. Of these, 29 couples who were successful in becoming pregnant within 1 year were assessed again during pregnancy and after childbirth. We analyzed their family alliance trajectories from the fifth month of pregnancy to the ninth month after birth. Our results revealed three distinct family alliance trajectory groups from pregnancy to the postpartum period: One group showed a decrease in family alliance (average to low pattern, n = 11); a second group remained stable in their family alliance (high stable pattern, n = 11); and a third group showed improvements in their family alliance (low to high pattern, n = 7). Analysis of the pretreatment data revealed no significant group differences in narrative quality, infertility-related stress, and marital satisfaction. Additionally, pretreatment variables did not predict subsequent family alliance trajectories. We provide a case illustration of each family alliance trajectory, in order to illustrate the challenges faced by couples who have experienced infertility and successfully undergone medically assisted procreation.

Two contrasting cases will be presented, one with normative interactions, and one with serious challenges in the coparenting relationship. The cases are part of a longitudinal study of a community sample (N = 50) using the Lausanne Trilogue play (LTP) paradigm. Families were followed from the prenatal period, at 7 months gestation, through infancy, age 5, and now a 15-year follow-up. In keeping with previously developed macroanalytic readings, we propose a microanalytic reading of interactive patterns in the prenatal and adolescent LTPs. Microanalyses of the 3-together Mutual Smiles Episodes as well as of gaze and affect interactions between partners serve to measure triangular focal attention and affect sharing as preconditions for collective intersubjective communication. The aim is both to explore the continuity of intersubjective communication from prenatal coparenting to triangular family intersubjective communication in adolescence, and to document key differences between normative and problematic interactive patterns. Results illustrate the advantages of using macro- and microanalyses of interactions in parallel. They also confirm the continuity of family normative and problematic patterns between pregnancy and adolescence.

In this study, we explored the predictive role of family interactions and family representations in mothers and fathers during pregnancy for postnatal mother–father–infant interactions during the first 2 years after birth. Families (N = 42) were seen at the fifth month of pregnancy and at 3 and 18 months after birth. During pregnancy, parents were asked to play with their baby at the first meeting by using a doll in accordance with the procedure of the prenatal Lausanne Trilogue Play (LTP; A. Corboz-Warnery & E. Fivaz-Depeursinge, 2001; E. Fivaz-Depeursinge, F. Frascarolo-Moutinot, & A. Corboz-Warnery, 2010). Family representations were assessed by administering the Family System Test (T. Gehring, 1998). Marital satisfaction and the history of the couple were assessed through self-reported questionnaires. At 3 and 18 months, family interactions were assessed in the postnatal LTP. Infant temperament was assessed through parent reports. Results show that (a) prenatal interactions and child temperament are the most important predictors of family interactions and (b) paternal representations are predictive of family interactions at 3 months. These results show that observational assessment of “nascent” family interactions is possible during pregnancy, which would allow early screening of family maladjustment. The findings also highlight the necessity of taking into account paternal representations as a significant variable in the development of family interactions. En este estudio, exploramos el papel de prediccion que las interacciones familiares y las representaciones familiares tienen en madres y padres durante el embarazo en cuanto a las interacciones posnatales madre-padre-infante durante los primeros 2 anos despues del nacimiento. Las familias (N = 42) fueron vistas al quinto mes del embarazo y a los 3 y 18 meses despues del parto. Durante el embarazo, se les pidio a los padres que jugaran con su bebe en la primera reunion usando una muneca de acuerdo con el procedimiento de la Trilogia prenatal del Juego de Lausanne (LTP). Las representaciones familiares fueron evaluadas administrando el Test del Sistema de Familia. La satisfaccion marital y la historia de la pareja se evaluaron por medio de cuestionarios auto-reportados. A los 3 y 18 meses, las interacciones familiares se evaluaron con la LTP posnatal. El temperamento del infante fue evaluado por medio de reportes de los padres. Los resultados muestran que (a) las interacciones prenatales y el temperamento del nino son los mas importantes factores de prediccion de las interacciones familiares y (b) las representaciones paternas predicen las interacciones familiares a los 3 meses. Estos resultados muestran que la evaluacion de observacion de las “nacientes” interacciones familiares es posible durante el embarazo, lo cual permitiria determinar a tiempo los desajustes familiares. Los resultados tambien subrayan la necesidad de tomar en cuenta las representaciones paternas como una variable significativa en el desarrollo de las interacciones familiares. Nous avons explore dans cette etude le role de prediction des interactions familiales et des representations familiales chez les meres et les peres durant la grossesse pour les interactions postnatales mere-pere-bebe durant les deux premieres annees apres la naissance. Les familles (N = 42) ont ete vues a 5 mois de grossesse et a 3 et 18 mois apres la naissance. Durant la grossesse, on a demande aux parents de jouer avec leur bebe a la premiere rencontre en utilisant une poupee conformement a la procedure du Jeu du Trilogue de Lausanne (abrege LTP). Les representations familiales ont ete evaluees en faisant passer le Test de Systeme Familial (en anglais Family System Test). La satisfaction conjugale et l'histoire du couple ont ete evaluees a travers des auto-questionnaires. A 3 et 18 mois les interactions familiales ont ete evaluees durant le LTP postnatal. Le temperament du bebe a ete evalue a travers des rapports parentaux. Les resultats montrent que (a) les interactions prenatales et le temperament de l'enfant sont les facteurs de prediction les plus importants d'interactions familiales et (b) les representations paternelles predisent les interactions familiales a trois mois. Ces resultats montrent que l'evaluation observationnelle d'interactions familiales “naissantes” est possible durant la grossesse, ce qui permettrait une detection precoce de malajustement familial. Les resultats mettent aussi en evidence la necessite qui existe a prendre en compte les representations paternelles en tant que valiable importante dans le developpement des interactions familiales. In dieser Studie untersuchten wir den pradiktiven Wert familiarer Interkationen und Reprasentationen von Muttern und Vatern wahrend der Schwangerschaft fur postnatale und Mutter-Vater-Saugling Interkationen wahrend der ersten zwei Jahre nach der Geburt. Familien (N = 42) wurden im funften Schwangerschaftsmonat und im dritten und 18.Monat nach der Geburt eingeladen. Wahrend der Schwangerschaft wurden Eltern gebeten mit ihrem Kind zu spielen, indem in Ubereinstimmung mit dem Vorgehen beim pranatalen Lausanner Spiel zu Dritt (LTP) eine Puppe verwendet wurde. Familiare Reprasentationen wurden mittels des Family System Test eingeschatzt. Zufriedenheit mit der Ehe und die Partnerschaftsgeschichte wurden anhand von Selbstberichten ermittelt. Zu 3 und 18 Monaten wurden familiare Interaktionen im postnatalen LTP beurteilt. Das Sauglingstemperament wurde durch Elternbeurteilungen eingeschatzt. Die Ergebnisse zeigen, dass (a) pranatale Interaktionen und Temperament die wichtigsten Pradiktoren von Familieninteraktionen und (b) vaterliche Reprasentationen familiare Interaktionen im dritten Lebensmonat vorhersagen. Diese Daten belegen, dass Beobachtungen von „aufkeimenden“ Familieninteraktionen wahrend der Schwangerschaft moglich sind und somit das fruhe Screening von familiaren Fehlanpassungen moglich ist. Diese Befunde betonen die Notwendigkeit der Berucksichtigung vaterlicher Reprasentationen als eine bedeutsame Variable in der Entwicklung familiarer Interaktionen. 抄録：この研究では、出産後の2年間の母親－父親－乳児の相互交流のために、妊娠中の母親と父親の家族相互交流と家族表象の予測的役割を調査した。家族(N = 42)は妊娠5か月と、出産後3か月、18か月に、診察された。妊娠中に、出産前ローザンヌ三者プレイLausanne Trilogue Play (LTP)の手順に従って、両親は最初のミーティングで人形を用いて赤ちゃんと遊ぶように求められた。家族表象が、家族システムテストFamily System Testを実施することにより評価された。婚姻の満足度と、カップルの歴史が自己報告式の質問紙を通して評価された。3か月と18か月に、出産後LTPで家族相互交流が評価された。乳児の気質は親の報告を通して評価された。結果から(a)出産前の相互交流と子どもの気質が、最も重要な家族相互交流の予測因子であることと、(b)父親の表象は3か月の家族相互交流を予測することが、示された。これらの結果は、「発生期の」家族相互交流の観察による評価は、妊娠中に可能であることを示し、それは家族不適応の早期スクリーニングを可能にするだろう。結果はまた、家族相互交流の発達に有意な変数として、父親の表象を考慮に入れることの必要性を強調する。

This article presents a longitudinal study of the development of "family alliance" from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self-reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: "high stable" (n = 19), "high to low" (n = 10), and "low stable" (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family-level and individual-level variables for understanding individual differences in the social and cognitive development of children.

Pour honorer Edith Tilmans-Ostyn, j’ai choisi de parler de « consultance », selon sa definition, avec differentes utilisations du jeu trilogique de Lausanne, dit LTP (Lausanne Trilogue Play). Elabore au Centre d’Etude de la Famille a Lausanne avec Elisabeth Fivaz-Depeursinge, cette situation se prete aussi bien a l’evaluation des interactions familiales a des fins de recherche que comme outil clinique pour des interventions therapeutiques, objectif de la consultance. Etant aussi a l’aube de ma retraite professionnelle, j’ai retrace dans cet article des situations ou j’etais impliquee personnellement comme consultante-therapeute avec differents amenagements possibles du jeu (jeu pere-mere-bebe, jeu prenatal avec une poupee, jeu therapeute-mere-bebe). Ces descriptions cliniques s’accompagnent de reflexions sur les proprietes de la consultance, les specificites des interventions therapeutiques sur les relations familiales precoces et l’usage de la video : en quelque sorte un passage de temoin, une transmission d’un certain savoir-faire.

La clinique systemique est trop souvent identifiee a la therapie de couple ou de famille au detriment de la psychotherapie individuelle. Cet article presente les resultats d’un groupe de travail de therapeutes systemiciens qui ont longuement reflechi a cette question. Apres une revue bibliographique commentee sur le sujet, il propose un certain nombre de points critiques concernant la clinique de la psychotherapie individuelle d’orientation systemique.

We observed mutual smiling episodes (MSEs) during therapist-couple triadic interaction as a key element of affective exchanges that serve to regulate the therapeutic relationship. Based on a functional perspective, we developed a new rating scale, the MSE Coding System (MSE-CS) that allows us to distinguish between four different MSEs, which correspond to four social functions: supporting mutual binding, sharing miseries, repairing, and confronting. MSEs were analyzed in a sample of eight therapist-couple triads. Therapeutic alliance and marital adjustment were also measured. The instrument (MSE-CS) demonstrated satisfactory inter-rater reliability, and initial indications of validity are promising. Results showed that number of MSEs was positively correlated with triadic therapeutic alliance. Types of MSEs were also distributed differently depending on the level of triadic therapeutic alliance.

This paper presents a longitudinal study of the development of family interactions from pregnancy to toddlerhood. Family interactions are increasingly acknowledged as a predictive factor for children's psychopathological outcomes. We used an observational setting, the Lausanne Trilogue Play, to evaluate the ‘family alliance’, namely, the quality of interactive coordination between family members. Families participated at the 5th month of pregnancy, and at 3- and 18-months after birth. The sample (N=39) consisted of non-referred primiparous families. Results show that (i) family alliance is stable during the first two years for most families: the quality of prenatal interactions between parents and a baby doll is thus predictive of the subsequent interactions with the actual child; (ii) there are links, but only a few, between family interactions and children outcomes reported by parents. Methodological issues (observation versus self-reported questionnaires) are discussed. Copyright © 2006 John Wiley & Sons, Ltd.

The goal of this study is to present a new observational assessment tool, the prenatal Lausanne Trilogue Play situation (LTP). Expectant parents were asked to role play their first meeting with their baby using a doll, and the videotaped interaction was subsequently coded. Scores were correlated with measures of the couples' marital satisfaction as well as the postnatal family alliance 3 months after the baby's birth. Results showed that the prenatal co-parenting alliance was positively linked to both fathers' marital satisfaction as well as to the postnatal family alliance at 3 months. Thus, the prenatal LTP allows for assessment of the prenatal co-parenting alliance at the interactional level. It predicts the place the parents will afford their baby after birth and can contribute to methods of clinical assessment and prevention.

Resume L’etude de la communication a trois entre le bebe, le pere et la mere au travers du jeu du trilogue lausannois montre que la communication intersubjective dans la famille suit la meme trajectoire developpementale que la communication intersubjective a deux entre le bebe et sa mere ou son pere : d’une forme primaire ou directe, elle evolue vers une forme secondaire ou referentielle, pour integrer ensuite des formes symbolique et morale et enfin narrative.

Resume Objectifs – L’objectif de notre etude qualitative est de definir des modalites d’assistance psychologique qui peuvent etre proposees aux couples qui ont recours a une aide medicale a la procreation. Materiel et methodes – Quarante couples ont participe a un entretien filme semi-structure, ou etaient abordes des themes comme les histoires personnelles et familiales, la relation de couple, etc. Nous nous sommes interesses a la « mobilite narrative », c’est-a-dire a la maniere dont les couples transmettaient leur histoire personnelle et familiale durant l’entretien et au sentiment de l’interviewer qu’il pouvait ou non la partager avec les couples. Resultats – Les differences observees de mobilite narrative nous conduisent a distinguer trois groupes de couples et a proposer differents types de suivi psychologique. Discussion et conclusion – Cette recherche exploratoire, a travers l’interet pour la mobilite narrative, s’interesse a la capacite des couples a se poser en interlocuteurs responsables de leur propre histoire. Nous avons fait l’hypothese que cette capacite est liee a celle d’integrer le stress emotionnel, de se poser comme partenaires du systeme de soin et de se preparer a la future parentalite.

In order to establish and maintain what we have named a communicational alliance in marital therapy, couples and their therapist generally (a) signal their affective involvement with each other, and (b) coordinate their behaviors to constantly maintain this triadic frame of involvement. In this paper, we empirically examine the manner in which this communicational alliance was elaborated and maintained using two approaches: (a) a behavioral and micro-analytic approach based on the coding of body and gaze formations; and (b) a global assessment approach based on external judges' assessments. Results indicated the two approaches to be compatible. In the case where the judges considered the communicational alliance to be high, overall observations of body formations and gaze formations indicated that (a) everyone was included, (b) each participant adhered to his or her role, and (c) these signals were congruent. Once a communicational alliance had been established, the trend was that it was maintained throug...

Body formations of therapist and couple during therapy sessions mainly function to signal their degree of readiness to interact or their degree of engagement in the therapeutic process, which is one contextual display of their affective communication. For this study, we developed the Body Formation Coding System (BFCS), a 4-category instrument to assess engagement at the triadic level. This article presents the BFSC method as well as a first validation on a sample of 14 triads. The results show that (a) triads vary according to their degree of triadic engagement; (b) engagement is related to the degree of therapeutic alliance; and (c) when the alliance is sufficient, a triadic invariant of engagement emerges. This means that partners regulate and coordinate their behaviors to maintain a stable level of engagement, whatever changes in their conversational organization. Finally, it discusses the potential of this method for describing the interactive aspects of the therapeutic alliance.

A scheme for assessing the type of triadic alliance between fathers, mothers, and infants at play is presented and illustrated using developmental-systems concepts.

Refering to systems theory, we identify a supraindividual property in interactions between therapist and couple. We use gaze directions to describe the partners' behaviors and label this property the “mutual attending frame.” We propose a procedure to observe triadic interactions in a consultation setting and a method to measure mutual attending. The method is illustrated by the data analysis of two triads contrasted on measures of therapeutic alliance. We discuss the potential of this method for the description of the interactive aspects of the therapeutic alliance.

Les interfaces entre les domaines intrapsychiques, interactionnels et intergenerationnels representent une nouvelle frontiere. A titre exploratoire, nous nous sommes exposes a une situation complexe mais controlable ainsi que le voient ceux dont l'interet principal se porte sur l'une de ces trois interfaces. Nous avons aussi entierement integre les sujets dans l'equipe, de facon a comprendre leur perspective subjective et a leur offrir une experience enrichissante. Nous avons commence avec une breve sequence de «triadification», c'est-a-dire passer d'une organisation familiale «deux plus un» a une organisation familiale «trois ensemble»

Disorders in the visual interaction between depressive or psychotic mothers and their baby have been widely described : in this paper, the authors propose an exploratory study of father-mother-infant visual interaction (infants are 9-18 weeks old) in two groups of families, voluntary families and families in therapy for post-par turn disorders. The observations are gathered during a three-partner play, involving different kinds of triadic interaction (one parent plays with the infant, the other parent being « only present » / both parents play together with the child). The analyses have focused on the amount of visual attention shared by the partners and on the evolution of visual interaction during the game. Results show that triadic interaction is more intense in functional triads, which means that shared visual attention may be representative of the more general functioning of the family at a definite stage of its development. Furthermore, considering the sequential organization of visual interaction throughout the game led the authors to the construct of a « triadic alliance », jointly established by the three partners and providing a matrix for their dyadic and triadic interaction. On a more general level, such an alliance could play an important role for the development and the autonomy of the baby within his j her family., Plusieurs auteurs ont montré que les échanges visuels entre des mères dépressives ou psychotiques et leur bébé présentent de multiples perturbations : dans cet article, les auteurs proposent une étude exploratoire portant sur les échanges visuels père-mère- bébé (9-18 semaines) dans deux groupes de familles, un groupe suivi pour des difficultés du post-partum et un groupe témoin. Les observations sont réalisées dans le cadre d'un jeu à trois structuré selon diverses modalités d'interaction (un parent joue avec l'enfant en présence de l'autre parent / les deux parents jouent conjointement avec le bébé). Les variables retenues concernent d'une part le niveau d'attention visuelle conjointe des partenaires, d'autre part l'évolution de cette attention visuelle au cours du jeu. Les résultats révèlent que les échanges visuels sont plus intenses dans les familles fonctionnelles, ce qui semble indiquer que l'engagement visuel triadique établi par les partenaires peut être représentatif du fonctionnement de la triade à un moment donné de son développement. D'autre part, l'analyse de l'évolution de l'engagement visuel au travers des différents contextes de jeu amène les auteurs à proposer l'hypothèse d'une « alliance triadique » établie conjointement par les trois partenaires et formant la matrice de leurs échanges dyadiques et triadiques. De façon plus générale, les auteurs supposent que l'établissement de cette alliance joue un rôle déterminant pour le développement et l'autonomisa- tion du bébé au sein de sa famille., Gertsch Bettens Christine, Corboz-Warnery Antoinette, Favez Nicolas, Fivaz-Depeursinge Elisabeth. Les débuts de la communication à trois. Interactions visuelles triadiques entre père, mère et bébé. In: Enfance, tome 46, n°4, 1992. pp. 323-348.

With increasing data on the dynamics of normative couples as they transition to parenthood and become a triad, the need for greater understanding of the impact of parental psychopathology on this transition has become clear. The goal of the current article is to begin exploring this area that has received little attention to date, by describing case examples from a study of clinical families as they transitioned to parenthood. Four representative cases were selected from a pool of 13 mother-father-baby triads, for whom the mother had been hospitalized conjointly with her infant due to a psychotic episode during the postpartum period. The families were observed as part of a clinical consultation that included a semistructured play paradigm known as the Lausanne Trilogue Play (LTP; E. Fivaz-Depeursinge, & A. Corboz-Warnery, 1999). Interactions were scored using standardized measures as well as clinical impressions. All families from the clinical sample were noted to struggle and frequently failed to achieve the goals of play. The impact on the infants in terms of their developing sense of self as well as their defensive strategies in this context are discussed, with clinical implications explored.

Cet article presente une etude visant a explorer l’influence des representations familiales et des interactions coparentales chez les meres et les peres durant la grossesse sur les interactions postnatales triadiques mere-pere-bebe. 42 familles tout-venant ont ete vues au 5e mois de grossesse, ainsi qu’a 3 et 18 mois apres la naissance. Pendant la grossesse, les parents ont joue la premiere rencontre avec leur bebe selon la procedure du Jeu Trilogique de Lausanne Prenatal. Les representations familiales ont ete evaluees a l’aide du Family System Test. A 3 et 18 mois, les interactions ont ete evaluees dans le Jeu Trilogique de Lausanne Postnatal. Les resultats montrent d’une part que les interactions prenatales et postnatales sont liees et, d’autre part, que les representations paternelles sont predictives des interactions familiales a 3 mois. Ces resultats indiquent qu’il est possible d’evaluer pendant la grossesse des dimensions liees aux futures interactions familiales. Ils montrent egalement l’importance de tenir compte des representations paternelles qui constituent une variable significative dans la construction des relations familiales.

De plus en plus de cliniciens et de chercheurs s’interessent au developpement precoce de l’enfant et de la famille. Nous avons etudie les relations triangulaires au sein de la famille formee du pere, de la mere et de l’enfant au cours des premieres annees de vie et nous cherchons actuellement comment se constitue cette unite a trois au stade prenatal. Nous presentons une methode pour observer et analyser l’alliance parentale pendant la grossesse. Les premiers resultats concernant des familles volontaires pour participer a la recherche indiquent la pertinence d’une telle methode pour predire l’evolution postnatale. Cet outil sera utile aussi bien pour les cliniciens que pour les chercheurs dans une optique de prevention.