Professionals and ACE-awareness, Episode 6 – This week: Jessica Boerema, Part 1

It is a sunny summer morning when I arrive on my folding bike at my interviewee for today, Jessica Boerema, who has been a medical pedagogical care provider for many years and is now an independent entrepreneur in her practice ‘Contact in Beeld‘ (Contact in View/Images). From the station I bikes across the city, which, well into July, is still suffused with the sweet scent of linden blossom. It’s only eleven o’clock, but I already feel clammy when I lock my bike. On the window is a poster of Dunstan Baby Language, a method that helps parents to better recognise and understand their child’s crying. I ring the bell and Jessica opens with a big smile. She leads me through the hall and the kitchen to her lovely little garden. The yellow dotted loostrife stands brightly, flanked by dark pink astilbe and a two-meter-high tree with apples still ripening. The berry bush, moved here from elsewhere in the spring, has taken root beautifully and the fruits are already turning a marvellous deep purple. The blue door of the bicycle shed, in combination with the bright pink hydrangea, almost gives a French countryside atmosphere. Two chairs are ready and when the mugs on the table are filled with tea, we feast on the biscuits and get started.

How did you get to where you are now, I ask Jessica; with her practice ‘Contact in Beeld’ she provides training to professionals and parents to illustrate the importance of effective communication with young children in difficult and challenging moments.
“My job as a medical pedagogical care provider in the hospital was perfect for me. In the clinical environment, stress can build up very quickly and you can then play a crucial role for a child. By looking closely and really seeing the child in what they experience, we can very actively give the medically necessary treatments in a more sensitive way. Of course certain things have to happen, but can we really see the child and take the child’s story into account? After all, you can offer and implement all kinds of interventions in many ways!

Although people were enthusiastic about my working method, it was sometimes difficult as a soloist in this position and I wanted to be trained even better. When I was trained as a video interaction supervisor in 2007, I suddenly understood why this job suited me so well. Reviewing my own interaction in the videos, I noticed I was able to maintain my basic communication in difficult situations, where emotions rose in the child and the parents. I could remain calm, choose my words carefully and thus ensure coregulation and thus reduce the stress in the other person again. These insights have brought me so much! If you view contact moments on video, you can observe again and again and talk about how you experience what you see. Video images are really powerful, positive ‘eye openers’ for parents and professionals!
I have since seen many parents with concerns about their child having trouble pooping, eating or sleeping. Through video images they discovered how they could support their child with good basic communication by focusing on contact and connection. A good example was a child (3) with constipation complaints. The child missed the acknowledgment of receipt from the parents about the fear of defecating. By understanding and acknowledging this, the complaints disappeared like snow in the sun.”

I ask Jessica if she can explain that term, ‘acknowledgment of receipt.’
“Yes, of course! The first thing is to see what the child shows with what they do or say and whether you can follow that, whether you understand it. From there you will see what the child needs; does the child ask you something, do they want to be heard, do they need something? By naming what you see (“You find it exciting, I believe, don’t you, to go to the toilet?”), you ensure that the child feels seen and heard. That is a crucial building block in communication! It is also a very different approach than to say with compulsion and overweight: ‘You are going to the toilet NOW!’ Very coincidentally, I ran into the mother of this child again not so long ago. The mother saw me and said: ‘Wow, your tips then gave me so much insight! They have helped me enormously and as a result I got on a completely different track and made a career switch: I am now a remedial educationalist!’ I thought that was so special to hear! The point with that child (as well as in many other situations) was that parental concerns disrupted communication, resulting in faltering bowel function and a vicious circle in the overall interaction. We all know that feeling when you have unpacked your holiday suitcase and haven’t quite landed yet, and that you can’t go to the toilet properly. How you feel affects the whole system. The way of communication, how the baby was born, how the baby was received, even at conception, their experiences… I am convinced that all those things are related. Looking at the images together with parents helps them to become aware of how they can support their child with the help of sensitive and responsive basic communication.”

In line with the influence of birth, she says: “A few years ago, I attended a presentation by Anna Verwaal for the first time and I thought wow… I really need to know a lot more about this and so I did a few extra in-depth days. I saw many parents of excessively crying babies on the ward and after this training, I took that knowledge about pre- and perinatal psychology into the anamnesis. This showed that there was often a burdened history around the start of the baby’s life. This also confirmed how important it is that we see families in day care and avoid hospitalization as much as possible: separation of parent and child is so harmful!”
I look at Jessica and before I know it, I say, “How wonderful it is to hear you say that!”
She gives me a big smile: “Yes, with knowledge of pre- and perinatal psychology that is really no longer justified. With one or two day admissions you can help parent and child well under intensive, coordinated guidance. Preferably, however, the paediatrician and I already looked at the ‘story behind the story’ at the outpatient clinic and then we tried to offer support at a much earlier stage, before parents were completely in way over their heads. That was sometimes complicated, because many parents, like many professionals, lack the knowledge necessary to understand why children cry and which previous experiences can play a role in this. The idea that the birth and the pregnancy influence how the child functions…” She looks at me with a mischievous smile and I grin back, because I feel where she wants to go: “… that is not obvious to everyone yet! And yet… if you talk about the influence of smoking and alcohol on the unborn child… then people somehow understand that the idea that a child in the womb is not affected by anything from the mother’s life is simply not tenable.”

We continue to talk about how difficult it is to see that children and parents are still often sold short on this point. Once this knowledge is an integral part of your professional baggage, it is impossible not to see its relevance everywhere. At the same time, it can also be very complicated to find a good form for sharing this kind of knowledge. Jessica: “Anyone who has not come into contact with these insights in any way, or who notices that they completely clash with what was said in their own education, can have a hard job integrating them seamlessly into their own course of action. It may help to read scientific underpinnings, but it still takes time and dedication to familiarise yourself with the material. Of course it helps if you have an open learning attitude! If you are consciously incompetent (you know what you don’t know) and sit down with someone who already knows more about it and then follow a training or workshop, you can expand your own knowledge. That is not a sign of weakness, but rather a very powerful, professional step to take!”
She talks about another method that she uses a lot, Dunstan Baby Language, about interpreting the crying of newborns, and as far as she is concerned, no single method is always true or the right one. There are many methods and applications that have a certain amount of truth in them, but not everything fits for everyone. “In my view, you always first take the anamnesis, listen to the story behind it and then see what is helpful.”

Next week we’ll continue listening to what Jessica has to share about the healing effect of looking at video images and how that learning process supports basic communication and the sense of security and competence for all family members.

Posted in Interviews professionals.