Author Archive: ACE Aware

The lived experience, Episode 3 – This week: Isis, Part 3

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Last week we ended with a sad conclusion from Isis that she has lost herself over the years.

After a moment of silence, Isis recounts her own rebirthing experience, in which the therapist asked if Isis might have been born after an induced labour. She could not answer that question, but her mother confirmed it. The healthcare providers were not waiting for a delivery on Sunday, so her mother was induced on Saturday evening. “I experienced that I was born powerless, that I couldn’t do anything… The birth went too fast and was too intense and I can often still experience that feeling of powerlessness. Strangely enough… Robin was born after a natural home birth, but a day later I developed childbed fever and I was taken to the hospital by ambulance. I was suddenly very ill and that was probably also traumatic for Robin and for the eldest. So here, too, there is an overlap with my own life.”

I ask Isis what it is she thinks of when she hears the word ‘traumatic’: “That’s a broad concept, isn’t it…? I am thinking of a sudden event or of neglect or other chronic conditions…”
I share what many trauma experts see as the essence of trauma: being alone with the pain of difficult experiences. It is not about that experience itself, but about what that experience does to your inner, emotional world and how that limits your behavioral repertoire and makes it less flexible. You quickly fall into the well-known survival strategies: fight, flight, freeze and fawn (to fake, to ‘please’ your opponent in order to escape sanctions). The earlier in life this happens, the greater the consequences. Isis had tricks not to incur her father’s wrath and to avoid name-calling and imprisonment, but the fear was always there. She was forced to sacrifice some of her authenticity. She didn’t show certain parts of who she was so that she could maintain some degree of security in the relationship with her parents. She says that because she was often out and about, she did not know everything that happened and was not strongly aware of it. Nevertheless, the impact is usually there, because while we cannot reproduce everything we experience through our narrative memory (we can’t tell the story), we do store the imprint that our stress hormones have left in our cells. So we do have a physical memory of it, even if it is not conscious, and that physical memory is triggered by situations that resemble what we experienced before. What we experience in the ‘now’ is therefore often a reminder of what happened ‘then’ and in which we were alone, because there was no buffering protection from an adult to provide co-regulation and reassurance. Then we look for other ways to feel safe and satisfied, which are often ‘bad habits’ and addictions, due to their hormonally satisfying effect. They are no stranger to Isis either: she mentions smoking, drinking, sleeping medication and coffee.

Addiction has long been viewed as a behavior to be punished, then as a brain disorder, and now among advocates of a more holistic view as a solution to an underlying problem, which is almost always trauma. Not everyone with trauma becomes addicted, but people with addiction almost always have trauma in their history. From this perspective, we can look at what is going on with more compassion. It also shows that it is likely to be difficult to end the addiction if there is no genuine attention and recognition for the underlying trauma.

We note that there have been many moments when Isis could not maintain the connection with herself and that in many situations in her childhood her parents were not there for her to lovingly guide her: “It never occurred to me to discuss difficult things with my parents. I got through it and made sure I had a relatively good time.” She has been carrying a great burden for a long time and as sad as she is right now… she is also tired of it and not having to take care of Robin for a while, feels partly as a relief from that burden. This also makes it clear that body and mind are closely linked: what we experience as a heavy burden mentally, has consequences for our physical well-being. The powerlessness that Isis currently experiences is very old, she has indicated, because it dates back to her birth. It is impressive to be able to see these kinds of connections and to experience that we should not think too lightly about how we treat our little ones when they come into the world and in their first 1000 days.

We agree that it can be very confronting for you as a parent to see that your children mirror you. What you find difficult in them is usually what deserves healing in yourself. The self-reflection that is required for this, however, requires a safe environment, one in which you do not immediately fall back into your coping strategies, into behavioral patterns that you once logically developed in order to survive. Only when that safety is there can you look at and question your own pain with compassion. Then you can learn to listen to your intuition again and determine what you want to take in from your interaction with others and what you want to leave with them.

The Buddhists say: if you give a present and the recipient does not accept it, then the gift remains yours. That applies to beautiful things (attention, love, joy) and also to your anger: if the other person does not accept your anger, it will come back to you, often doubly, and then that anger can trigger all kinds of things. When we can learn to see that underneath anger is often very deep pain, we can experience more compassion, both for ourselves and for others.
“I like that”, says Isis, “about not accepting that anger… I also try that with Robin. I can’t change Robin’s mind about me. I said ‘I love you’ and that’s all I can do now.”

My thought is a bit more positive; I do think she can influence Robin’s feelings. I mention another Buddhist wisdom, which says that if you fail to achieve active growth or improvement, it is already progress if you stop doing harm. Then the dust of the battle can settle and there will be a better view and breathing room for everyone. It also allows everyone to feel more closely into what is happening in their own body and to reflect on it, without the escalation that is ‘heavy on the stomach’ or that ‘takes the blood from under the nails’ – talking about the language of the body. Moreover, creating more space means that you do not burden each other with what you want and expect from each other. Robin cannot give Isis what Isis missed as a child. Isis also can’t give Robin what Robin missed as a child. They both have needs that they cannot meet in one another. That is on the one hand a sad and on the other hand a crucial insight for both of them to move forward. If they can both find a conversation partner with whom they feel safe, who can listen to them without judgment, without threatening sanctions and without creating shame, to everything they feel and experience, they can slowly but surely reconnect with themselves. And that, say trauma experts, is the essence of healing: restoring the connection with your authentic self. That connection is the basis from which you can recover or build the connection with the other.

We conclude with that hopeful thought. The coming time will show how things are going with Isis and Robin and I wish Isis and Robin all the best in the world!

The lived experience, Episode 3 – This week: Isis, Part 2

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The practice room is well heated; the candles are burning and there are fresh flowers. From the window I see Isis coming and I walk down the stairs to welcome her. It is nice to meet each other now, after a brief telephone exchange. We start our conversation with a short creative check-in and then we lay the Mattenspel to visualise how Isis experienced her own childhood and which relationships were important to her at the age of 16. During the laying, already certain things come up: “I tried to turn it into something cheerful”, is her reaction when I point to the happy smileys that are added to a number of places and people only at a late stage. Later in the conversation we come back to this common need to uphold an image of a happy childhood for the inner and outer world, even if deep down it did not feel that way. When in Isis’ opinion the laying is ready, we look at it extensively together, for example at the anger that lies with father. “I had tricks to make him happy. I knew what to do to avoid punishment. For example, you should not say anything wrong at the table, because if everything was not decent and appropriate enough and you ‘misbehaved’ despite a warning, you were locked up in the warehouse behind the store. Unlike a sister, it never happened to me, but the threat was always in the air. So I kept quiet, or I would hide myself, and I always felt that tension. Sometimes I got grounded when I was caught lying. We were not seen for who we were and I did all kinds of things to get attention, such as stealing things from my parents’ store, or money from my mother’s wallet. I confessed to her about that not so long ago and although she didn’t want to believe it, she finally accepted my refund. Things were not easy with her either, but as a child I still felt relatively safe with her; she was more of a stable factor in our family, although at times I felt more comfortable with my father’s greater light-heartedness and acting silly.”

Isis tells how she sought refuge outside of the family with friends, how she skipped school and did wild things. She started a relationship with one friend, but at his home the situation was almost as difficult: unrest, tension between the parents, a rude father… the dynamics were familiar. They broke up, later reunited and married when Isis turned out to be pregnant. After a miscarriage, three children were eventually born, but the marriage did not last and resulted in a fighting divorce, which had a major impact on the partners and the children. When, during our conversation, we look in more detail at the situation of Isis, whose father died young, and that of her own family, in which the children lost their home base at a young age, there are striking similarities.

The reason Isis visits me is actually that her middle child, 30-year-old Robin, is not getting their own life in order. After an improvement last year, when Robin returned to live with Isis in an attempt to develop more structure, there is now a relapse. Isis is sad and fears to lose the connection with Robin, also because she feels overwhelmed by everything that is evoked in herself by the unrest. “You could put the pictures on top of each other and you see that there are many overlaps in what happens in our lives. Robin and I both left home at a young age and fled into going out and addictions.” We speak about the different forms of addiction out there that are much more than just drugs or alcohol. Also always being rushed, constantly working, demanding attention in a negative way… these are all behaviours based on a deep desire to numb feelings of pain and loneliness and create the conviction that you belong, that you are being seen and heard. They are helpful in the short term, but cause damage in the long term and you can hardly let go of them.

The fact that Robin does have contact with father makes it emotionally extra complicated for Isis, who is very busy pondering what her own role can be for Robin, what is needed to experience connection again. We talk about what happened when the lucky clovers were placed in the Mattenspel; several people already had clovers, but not yet with Isis herself and she had asked, while looking at me: “I can also put clovers with myself, I guess…?” I had replied that that was totally up to her. Her response was: “Hmmm…yeah…I’m kind of forgetting myself…” I mention that later in our conversation and Isis indicates that she herself had been aware of it, too. Now that I explicitly ask about it, she says that it is a familiar theme in her life, that she tries to do things right for the other person, but does not often ask the question whether those choices are also good for her. We speak of authenticity in that context and Isis says: “No, my authenticity does not hold up well in all of that; I realise that and lately I have been working on that somewhat more. I just find it difficult to distance myself and guard my own boundaries, because people crossed them so often when I was a child. I keep asking myself: ‘Was it good enough? Couldn’t I have done more?’ So complex, all of this…”

We are quiet together for a while; I pour another cup of tea and I ask her how she feels right now. She thinks; her eyes fill with tears as she responds: “I feel sorrow; I wonder… how does all this relate to my relationship with Robin? I experience that sometimes I just feel so lost, that I don’t know what to do anymore. Robin did try things during the divorce to bring us back together, but the meeting with my ex and me Robin once organised unannounced was intense. I felt manipulated.” She is aware of Robin’s almost certainly good intentions, but it still didn’t work out. I look at her and feel her inner struggle. Manipulation… I’m reminded of another interviewee who used that word about herself and we went into more detail about it. We found that it was a term that reflected the pain of the past, which was about how she was treated by her parents, after which she came to believe in that mantra. To what extent was Isis manipulated as a child and did Robin’s action trigger the pain that had previously been caused? I ask Isis when she first felt manipulated. She mentions her marriage, but if we look further, it was already present in her home situation, where relatives said they did not feel like listening to Isis. “They still say that and then a very deep pain comes up in me; I feel sadness and anger.”

We talk about her earlier statement of the ‘relative safety’ that she felt with her mother. “I knew it wasn’t the way it was supposed to be, but I settled for it. I had no choice and had the feeling that I had to deal with this and that they did not know and could not do any better. Since then, I have achieved quite a few things in life and then it may be tempting to explain everything away and downplay everything again, but…” She falls silent and the tears flow again: “Many patterns from the past still exist and I have a deep fear that I will lose Robin. I now indicate my boundaries, but at what price once again? My fear of losing Robin was already there at birth… the fear of losing that little one… but maybe it was me myself…”
We are silent together, deeply moved, because she now almost literally says what she means, what she feels as a result of what has happened, namely that she has lost herself in the course of her life. She now sees that reflected in her child and that hurts intensely.

Next week we will analyse some of the points Isis raised.

The lived experience, Episode 3 – This week: Isis, Part 1

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My client and I had gotten in touch through an unusual route. I had spoken about my work with someone and that person reached out to me a couple of days later, asking: “Do you do consultations on this trauma topic, aside from your lactation work? I know someone who is struggling with an adult child that has addiction relapses and they are not on speaking terms right now. Both parent and child have a difficult time dealing with all the pain of the disrupted relationship and maybe your knowledge and insights could help them to get things moving again, if only a little bit. The child seemed to have made progress last year, but things have taken a worrying turn for the worse now.” My response had been that I can certainly be approached for this work, although I do not pretend to be a therapist. Then again… as humans, we don’t need to be a therapist to have a therapeutic effect on processes our fellow humans go through. Offering our time and true presence can already be so soothing.

I had felt confident that my knowledge might be of help and explained that such a conversation would have as its goal to figure out what childhood was like for that person, either parent or child. I have a game that is helpful to that end and although it was developed to be used with children, it can also be used with adults. You will then have to ask the adult to pick an age for which they would like to lay the elements of the game. I had said that if I would see the 30 year old child (let’s call them Robin), it would be advisable to have some follow-up care available, because a session with me might bring up triggering and intense memories and emotions.

We had decided that my acquaintance would inform the parent that I could be contacted and while talking a bit further, still, we had discussed Robin’s negative experiences with healthcare providers, which is always a sad thing. We all may come into situations that need specialised care, but if previous experiences with healthcare settings were upsetting or even (re)traumatising, then they can lead to the client or patient to evade care, even though it is really needed. At the same time, it is important to be aware that healthcare providers are also simply human beings with their own life histories and possibly with unresolved trauma. This is why it is so important that we reflect on our own experiences, so that we take care not to work as ‘hurt people who hurt people’.
In my own consultations with clients, I always focus on their autonomy. There is nothing in what I say that they should do; I give them information after trying to support them in accessing their inner wisdom and when we wrap up and say goodbye, it is fully up to them to what extent they decide to apply what I offered them. (Oh, there is one must after all… payment of the bill… 😉)

I had asked my acquaintance whether parent and child were both ready to reflect on their own role in the relationship, because children may bring up tough stuff, experiences that are hard to hear for the parent. Maybe the parent did not know about something or maybe the parent knew at a deep level, but was too scared themselves to dive further into it. It turned out that the parent, like other family members, was about to give up. When parents find it difficult to look at their own part in the dynamics, it is often also very hard to cause breakthroughs and it seems that this parent had trouble finding the courage. My acquaintance had brought in the aspect that when something is ‘your own fault’, it is also something that you can change. My reply had been that I do not speak in this terminology of ‘guilt’, because most of the time, it is not very helpful. There is a fundamental difference between ‘guilt’ and ‘cause’. You can be the cause of something, without carrying reproachable guilt for it.

That is the essence of working in a trauma-sensitive way, being aware that trauma is mostly intergenerational and that everyone has most likely done their utmost within the personal and circumstantial options available to them. That is a crucial realisation. Then again, the child can live with the perception that the cause of their problems lies with the parents. And we must also appreciate how hard it can be for parents to keep faith and constantly rekindle courage to be there for the child if relapses happen over and over again. As hard as it may be, however, if the parents do not work on their own healing, chances are that they diminish or at least complicate the healing potential of the child. For the child, the only option that remains may be to release themselves from the parental influence to completely work on their own healing, hopefully with support from close and cherished others.

During our conversation, new information had come up about the parents of the parent, so quite quickly we had come to the conclusion that, once again, there seemed to be intergenerational pain that gets handed down, without anyone intentionally aiming to do so.
We had agreed that it might be an empowering step for the parent to get in touch with me, seeing the difficult communication with Robin right now. At the moment, Robin was pictured as playing the victim role, partly by posting embarrassing stuff on Instagram and thus causing turmoil among other family members and friends. Guesses were that Robin had been under the influence of drugs while doing so, although Robin had appeared to be clean in the previous year.  I had said that both parent and Robin were welcome and that I hoped that the parent might be able to also encourage Robin to come, even if their own consultation with me might turn out to be difficult and triggering grief.

That was where we had left off. It only took a day for the parent to call me – how brave! We talked a bit, I explained a bit, they illustrated a bit… we got a feel of one another and ended our phone call by setting a date for the week after. I was touched by the courage shown and the confidence given. I decided I would prepare well and make sure I would be able to offer my full and attentive presence.

Next week, we will see how the conversation with the parent unfolded.

Professionals and ACE-awareness, Episode 6 – This week: Jessica Boerema, Part 2

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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.

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

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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.