Through the Night: Helping Parents and Sleepless Infants
Daws, Dilys (1993).
London: Free Association Books; $39.50 hard; $19.95 paper. ISBN 1853430684.
When an infant is born into a family, even when this new child sleeps like an angel, the duration and rhythm of his sleep are far different from those of the rest of the family, creating a serious task of adjustment to suit all the family members' different needs. But when an infant has difficulties in settling into sleep or wakes up during the night, or when a young child goes through a developmental phase that makes him or her anxious or excited when put to bed, then the sleep difficulties become a complex, recurring social event in which everyone in the household has a role to play. Even the different rooms in the home environment are adapted for this happening and they serve as a backdrop for this drama of actions and interactions that must go on every evening.
Dilys Daws is a Consultant Child Psychotherapist at the Tavistock Clinic and Chair of Child Psychotherapy Trust, London. Her practice of 15 years in sleep problems with parents and infants has resulted in Through the Night, first published in 1989 and now issued in a new edition. I see this book as the most complete work available on infants' sleep problems, an issue that is complex enough for professionals, but utterly overwhelming for many parents.
In the first chapter of the book, Daws defines sleep problems from her own clinical perspective. Her approach is based on the interaction of parents and infants but she also calls attention to many other factors that influence the care and handling of infants such as the home environment, sleeping arrangements, parents' ideas about babies, parents' life experience, and their own relationships. She also looks at sleep problems from the perspective of various researchers. Throughout the book her reflections and analyses are supported by or compared with the theories and research of others, all clearly presented.
In the second chapter, Daws describes the brief psychoanalytic therapy she uses when she works with families, and also discusses some of the different sources of help and advice that parents turn to in their attempt to solve infant sleep problems. In the third chapter she takes the reader through a case study that illustrates her own procedure. In so doing she gives us a chance to see how themes emerge and develop during meetings with a family, and how she relates her own ideas and those of others with the material gathered from conversation with parents.
In the next three chapters, Daws describes the physiology of sleep states, discusses the ways in which parents help to regulate the bodily states of infants, and examines parents' and children's dreams in connection with sleep states and emotional development, concluding with a discussion of nightmares and night terrors.
Chapter seven reviews how various psychoanalytic theorists have described the process of normal emotional development in infants. Daws presents and compares the work of D.W. Winnicot, Anna Freud, Margaret Mahler, Melanie Klein and Daniel Stern. Focusing on how the infant develops a sense of self and moves apart from the mother, these writers explore, as Daws says, 'how the baby's sense of who he is on his own derives from who he is with his mother, and conversely how this depends also on his mother's picture of him' (p. 101). In chapter eight, Daws examines the process of separation of the infant from the mother along with the development of attachment, and discusses the views of John Bowlby, Mary Main and Mary Ainsworth. She also examines the effect of babies sleeping with their mothers, and the inevitability as well as the difficulty of separating, which is potentially stressful for the mother as well as for the child.
In chapter nine, Daws explores the connection of sleep problems with feeding and weaning. Chapter ten looks at how adults tend to find confirmation of their parenting behavior their own parents: often adults’ childhood experiences influence the way they look after their own children. This insight encourages the professional to listen carefully to parents' account of their experience as children in order to help them understand some of the issues surrounding problems with their infants. In chapter eleven the author examines how both relationships and external circumstances can affect parents' way of caring for their infants. She looks at the role of fathers, single parents, and working mothers as well as the relationship between parents.
Chapter twelve is a discussion of sleep disturbances as psychosomatic symptoms, especially indicative of problems in the development of attachment between infant and mother. In chapter thirteen, Daws examines physical and mental health problems of mothers and the effect these have on the sleep of their infants. She concludes in chapter fourteen by discussing the effects of adverse conditions such as prematurity, illness, and handicaps on the sleep of infants.
This book is valuable for its thoroughness, depth and thoughtfulness. The author does not offer solutions but rather starts from the conviction that parents can be helped to look for solutions themselves. She fosters this approach by taking readers through a rich array of cases and episodes, clarified by her interpretation and supported by the findings of researchers from different schools of thought. Daws provides an education for her readers, whether professionals or parents, and encourages them to respect and trust children and their ability to let others know what their problems and needs are. Furthermore she helps parents to listen to themselves and to find in their relationship with the infant, with the family, or in their own personal history, indications of solutions to their problem. Daws does not preach or scold but with a secure and light touch she unravels the complex tangle of daily events, developmental processes, and personal history that are all capable of contributing to sleep problems.
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