Psychoanalytic perspectives on early dyadic intervention: clinical entry points across contemporary models

Early relational experience plays a central role in shaping infants’ emerging emotional organisation and sense of self. Contemporary child–caregiver psychotherapeutic work draws on multiple theoretical traditions that illuminate different dimensions of the caregiver–infant relationship. This paper examines psychoanalytic contributions to early dyadic intervention in dialogue with attachment-based and developmental–interactional models, focusing on how each perspective conceptualises relational challenges and points of therapeutic intervention. Psychoanalytic approaches emphasise the role of caregiver fantasies, representations, and transgenerational meanings in shaping perceptions of the infant; attachment theory highlights how internal working models organise caregiving responses to distress; and developmental–interactional models describe the microprocesses of dyadic regulation, mismatch, and repair. Building on these perspectives, a conceptual framework is proposed that differentiates representational and behavioural layers of the relational system, clarifying how each tradition offers a distinct clinical entry point. By understanding these approaches as complementary rather than competing, this framework aims to support child psychotherapists in clinical formulation and in flexibly selecting intervention strategies tailored to the specific needs and capacities of each caregiver–infant dyad.