Last week we heard how Jessica Boerema switched from medical pedagogical care provider to independent entrepreneur in her practice ‘Contact in Beeld’ (Contact in View/Images); she tells how looking at the interactions with young children has become the core of her work. Today we hear a lot more about her vision and mission.
We ended last week with the statement that not one single method will always work. However, there is one aspect that is almost always true, which is that crying is stressful for a child, and that not taking it seriously is problematic, as is thinking in terms of ‘the child should know who’s boss’. How does she look at that?
“Yes, I agree… I often say… try to imagine what it was like when you still lived in a cave; would you leave your child alone? Very often, the link is not yet made that proximity and sensitivity of caring adults are the basis for a child to develop self-confidence!”
Jessica’s attention to the importance of closeness has grown substantially during the time she worked a lot with preterm babies and after completing the Infant Mental Health training. When she would stand next to the incubator with parents, she saw their emotion when she explained what their baby was already able to show them. She has built her workshops and all her other training courses with visual material on that experience. “I notice that looking at images where training participants are not in the video themselves makes it easier for them to absorb what can be seen. After all, everyone has a need for safety and looking at yourself can be very complicated…”
We pause in silence and let ourselves be distracted by the sparrows, who eat the insects from the butterfly bush. A blackbird also flies in and out: “Maybe that blackbird also has a kind of daily rhythm”, says Jessica with a smile, “because he often feasts on the ripest blueberries around this time!”
She thinks for a while and picks up the thread again: “Communication consists of building blocks; if you understand what they are intended for and what their importance is, you will become consciously competent and you can take the sting out of a difficult situation in the event of stress. Images are then extremely helpful to see what is happening; you see, for example, a child grinding their teeth or showing other small body signals. If you look frame by frame and you’ve seen it once, you cannot stop looking like this and ‘unsee’ it!”
This was also a learning process for Jessica and the experiences of the parents themselves helped her in this, even before she laid the theoretical foundations. Once they were there, she was able to combine theory and practice. If she would then translate the parents’ story to the baby, the healing tears often came. “Then you see the child listening very carefully and being alert, no matter how small, and the parents, who now suddenly understand what it was like for their baby, can also release their own worries and sadness. Through crying a baby tells a story and listening to it validates the emotion of both child and parents. Being heard is also hugely deguiltifying. Babies often fall into a deep sleep relaxed on their parents’ lap after such a conversation, something they often never experienced before and which is surprising. Recognition, being seen and heard… that is basically what we all need.”
We talk about how learning processes with parents are often very instructive for yourself as a professional and reveal connections with your own life history. More insight into your own triggers and your own pain helps to approach your target group with more compassion and gentleness and also often contributes to the formulation of your professional goals. In line with that, I ask Jessica what she considers the essence of her work.
“I really want people to grow from unconsciously competent to consciously competent, so that they can go through their own learning process and contribute to ensuring a good start in the lives of the children they care for, as professionals or as parents.”
She thinks for a moment and says: “There is still so much to gain in this area… We almost always look at what we see from our own perspective; the first look is coloured by our own experiences. On closer inspection, different people usually see the same thing, but initially we often fill in what we think we see. The trick is to really listen to the voice of the young child, which we often do not know very well. We are used to the spoken language, but can we hear the child in their own language?”
We pause for a moment when exactly at this moment we hear a baby crying in the background.
What are the tricky things, the things that Jessica runs into?
She ponders in silence. “Sometimes I think I mostly run into myself, because I always want to offer more than I do, while it is regularly already more than enough. What I find very difficult is when I hear things that make me think: ‘Is that really not possible in 2021?’ An example of this is that in some hospitals, vulnerable babies waiting for an operation are not allowed to be picked up, while we know that kangaroo care is the way to make them grow and strengthen them. I find that very disturbing; these families need each other’s proximity so much. Incidentally, these are also the situations where I think: ‘This is what I am here for!’ And the work is still really necessary, because there are plenty of professionals who would also like to do this, but are bullied in the workplace by those who are not yet familiar with this evidence. Those are dire situations…”
This brings us to the concept of EBM and EBP, evidence based medicine and evidence based practice. It can be very frustrating to see parents and children and colleagues not getting what they need because systems make it difficult to integrate new insights. The United Nations Declaration on the Rights of the Child speaks of the right of the child to the highest attainable standard of health. Why is this so often not feasible?
Jessica: “I think that can have to do with a lot of things, such as ego or being triggered by your own experiences, when new information clashes with your own approach.” I explain how it was actually very enlightening for one of our interviewees to learn that things she had attributed to herself as negative personality traits might in fact just be coping strategies for the trauma she had endured. She realised she had reacted out of grief. For her, hearing the knowledge about this was a revelation that made her look at herself in a very different way. Because of the new perspective, new knowledge can therefore be painful (at first) as well as healing thanks to the different categorisation that can arise as a result. Could it not also be the case in many organisations that trauma stands in the way of innovation?
Jessica: “Oh yes, I definitely think so! And at the same time… what science tells us now is completely different from what we heard, say, 50 years ago, so… how sure can we be about what science tells us today? The more I learn, the more I realise how much there is that I don’t know!” We laugh together at this recognisable feeling of very conscious incompetence and the importance of looking at your own survival mechanisms with mildness and compassion. It is better to replace the question ‘What is your problem?’ (in which a judgment can easily resound) by ‘What is your story?‘, a question that invites you to tell and reveals an intention of sincere listening. This creates security and allows the narrator to peel off layers, while insecurity adds layers of defense.
“Yes, that’s how I see it, too”, says Jessica, “because basically we are not focused on nasty, destructive actions towards the other. After all, if you think that way, you’d have to believe that some kids are just born as rotten kids and I don’t believe that…” She looks at me and we both laugh: we both really want to say ‘that is not true’, instead of ‘I don’t believe that’. We are deeply convinced that in the course of life, things happen that can lead to defense mechanisms.
“And I notice,” says Jessica, “that you have to question those events very specifically, because people are often inclined to say that it was all okay and that it wasn’t that bad, while when I subsequently hear their story, I conclude that it really was intense and possibly traumatic.”
We discuss that it can make people anxious to research past events, especially when people lack a supportive social environment. I ask Jessica if she feels that there is already enough knowledge available about these kinds of things.
“Well, a lot has already been written about it, but in daily practice it still has to start spreading like wildfire before it is widely supported and used. The Infant Mental Health vision is currently rapidly gaining ground and that is great, but well… in your own bubble you can sometimes overestimate the application of certain insights… I also get people in my training sessions for whom this is still completely new and knowledge transfer, therefore, also very much depends on how well I, as a professional, can tie in with their life worlds. Here, too, basic communication plays a major role. I often start with something intense, such as the ‘still face‘ experiment, so that we immediately get to the core. Then I hope that the penny drops in such a way that people draw their own conclusions about what a baby needs and how they can provide it.”
It’s lunchtime. We continue talking, however, for quite a bit longer. We forget the time and only finish our fascinating conversation towards the end of the afternoon.