Author Archive: ACE Aware

Professionals and ACE-awareness, Episode 5 – This week: Kelli van Gerven, Part 1

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It’s a sunny Wednesday as I walk underneath the tall trees to the main entrance of the health center. My interviewee today, youth healthcare doctor Kelli van Gerven, has a consulting room on the top floor. She is waiting for me and we walk the last part together. It is special to meet again after such a long time. As she makes tea for both of us, we notice that it feels like yesterday that we were talking about our concerns regarding advice about excessive crying. More recently, we have been in touch about a document that did not seem to do justice to children’s need for a deep sense of safety.

I tell Kelli that my colleague and I had a conversation with a healthcare professional earlier today about the first 1000 days and stress in early childhood. A while ago, Kelli was also at a meeting on this topic. Scientific insights into the needs of children in the early stages of life have been greatly expanded in recent decades. Regularly, they appear not to correspond with what is often still being told to parents and the general public in western societies. During the meeting, Kelli noticed that the consequences of this new knowledge for day-to-day practice still met with a lot of resistance from some people. This is understandable, because it demands a lot from professionals when new insights require a change in the usual working methods. It calls for reflection: ‘How have I always done that?’, ‘What have I taught parents?’, ‘How did I approach this in my own family?’ The answers to such questions can be confrontational, because on closer inspection, you may no longer endorse your own previous choices. You may be struck that the new advice clashes with how you always handled things professionally and personally. In addition, a different approach may require knowledge and time that are not available within the current system.

Kelli says: “You may be right to… how should I put it… ‘disapprove’ of your own former course of action… even if that is too strong a word, but with additional knowledge you can decide to make a shift to something new. This requires you to become aware of these changed insights, that you allow their impact to sink in and that you do not oppose them, because that makes change very difficult. Well, of course such changes are certainly not easy. Taking an eye test or weighing a child… that is fairly easy. When it comes to things that are more parenting-related, such as sleeping and crying, it is much more complicated. That is why I always hope that at policy meetings there are not only managers and supervisors present, but also the people who actually do the work with the parents. They can then share their valuable experiences and from there you can look at how changes might be implemented, based on the new evidence.”

We talk about how behind certain things, such as an eye test, there is not so much an ideology or a belief that you can disagree on. “That’s certainly an aspect of it,” says Kelli, “because I myself find that sometimes I get annoyed by the way children are viewed in some documents. If I, as a parent, go somewhere with my child, I expect the care provider to be aware of the latest scientific developments. If I should notice that this is not the case and I receive advice that I do not agree with at all, then that is very difficult. Maybe they don’t match with information I have collected myself and with my own world view. I can understand that in such a case, parents might think: “Why am I going there, to the well-baby clinic?” Such feelings undermine their willingness to take advantage of that care. I think that is something that deserves attention from us as professionals.”

I ask how she navigates through those difficult situations. Kelli: “I almost always manage to get on the same page with parents. I slip into the parenting role with them and then it rarely happens that we cannot work things out together. In my experience, finding that common ground is often much more difficult between fellow professionals. For example, I was once at a training about brain development in children and the question was raised whether or not certain forms of damage are reversible, so whether you can undo them. The impression was created that this is always possible. That did not match what I had learned about it, so I kept asking. The speaker then indicated that there are indeed certain processes that become so ‘built-in’ in the brain that they are irreversible, or at least very difficult to reverse. To me, that seems very important information, because it means that we as care providers have to handle such processes very carefully. However, the speaker’s answer led to a lot of angry unrest in the room: how I could have asked that, what I did to parents, that I had gone too far… I noticed that the subject was very triggering for many of those present.
What I missed afterwards was that we all come together to talk about why we are so strongly disturbed by the idea that certain forms of approaching and treating  babies cause damage that is difficult to undo. Those are dynamics that I never really have with parents that way, barring extreme situations and exceptions. The fellow caregivers believed that it is too harsh to say to parents that certain things are harmful, but that wasn’t my point. I agree that care and sensitivity should be at the heart of discussions with parents. In my opinion, this does not alter the fact, however, that we must first establish that some things really are undesirable or even harmful. We need to have that discussion first and then move on from there. Such criticism does not affect me personally, but I hope that with such a question I can contribute to a thinking process that we really have to go through with each other about the underlying principle: the most recent insights are the basis for plan A, the best scenario. If Plan A does not work, sometimes you have to go for plan B and then you make the best of that second-best option. Now it sometimes seems like plan B is the first choice and that if you advocate plan A, you hurt parents or overask them, while I believe that parents have a right to the information of plan A. They have to choose what they want to do and we guide them in doing so.”

I ask Kelli how parents react when she discusses these topics with them.
“That depends a lot on which parent is sitting in front of me. One thing is always certain: we sit together in that consulting room because everyone wants the best for that child. Often in such a conversation, a question arises from the parents, for example regarding disagreements about where the child sleeps and whether they should learn to sleep alone. Then the goal is for me as a youth doctor to work in accordance with the JGZ guidelines. Parents will be influenced and informed by these guidelines to the extent that information leaflets are made for them on the basis of those guidelines. Parents do not always have the same employee in front of them at the ‘consultatiebureau’ (well-baby clinic). Continuity, therefore, largely comes from applying the guidelines, but not everyone interprets them in the same way. What I do then is that I explain that there are multiple visions and that the choice for how parents want to approach their child is of course always theirs. I explain the basics of what a baby or young child needs and provide additional information. What I think is important is that they dare to put everything on the table that they struggle with or about which they have questions, so that we can discuss it. After all, those parents have to do it together! After the consultation, they should not go home with the idea that they have to do what the doctor says, but with the idea that they have enough information to continue to put the puzzle pieces together, also in contact with others in their social environment. I think those conversations are very nice, because you notice that you have something in common, which is the well-being of the child. When there are concerns about issues such as possible child abuse, that is a different story, but of course that is not the case for the majority of parents. They want to see what is the right thing to do. I enjoy that interaction and because of that, you get a positive exchange with each other. I never say, “This is how we are going to do it”, because it is not about what I want; after all, I am not the one who has to feed the child, change the nappies and carry the responsibility for the daily care, right? These parents should be comfortable in their roles. Guiding that process… that I find really fantastic!”

Next week in Part 2 you will read about the challenges Kelli experiences in contact with parents and with guidelines and the way in which she sees scientific insights embedded in daily practice.

Professionals and ACE-awareness, Episode 5 – This week: Kelli van Gerven, Part 2

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Last week we started a conversation with youth health doctor Kelli. This week, even more aspects of her work are discussed, such as the challenges she experiences with parents and guidelines, as well as embedding new insights into daily practice.

We talk about how intense stress completely disrupts a person’s ability to absorb information or understand advice properly.
Kelli: “Yes, it certainly can, and in many settings it is the same as with the guidelines here: if you stick too much to your own programme and certain standard procedures, you don’t see the most important thing, or see it insufficiently, namely: what is going on for the person sitting in front of you? The question then is: do you dare to let go of that structure? Do you dare to be open to the fact that sometimes things go differently? That is actually quite exciting. After all, you also have time pressure; the next person does not want to wait endlessly, so that is often a quest.”

I ask what aspects of her job she likes most and what really makes her happy. She explains that this is very broad and that her idealism plays a major role in it, the wish that parents and children have a good time together: “I wish people more happiness and health, especially because that prevents so much difficulty later on. I know that is a very idealistic idea, but that is ultimately my motivation.”
And the counterpart… which is the hardest?
She looks a bit more serious: “Hmm… then I think of the families that live in excruciating poverty and partly because of that start quarreling, that you look at their situation and think… they are really stuck. How on earth are they supposed to keep their lives in order? Against politics and policy, you still have to look for concrete solutions. In any case, you always look at the individual situation. If there are two children in a family who are constantly arguing, then perhaps they can go to daycare on different days, so that they are not together all the time and there is some peace in the family again. I then organise those kinds of things together with other partners in the healthcare chain, who also know the ‘social map’ well.”

How does Kelli see the biopsychosocial insights embedded in healthcare or in society as a whole?
“Unfortunately, I don’t feel that it is very different now than it was ten years ago. With the help of social media, it is now often easier for parents to find like-minded people or to find professionals with a more holistic view and that can give parents a lot of support. I myself also read along to see what is being discussed on these platforms, but I do not yet have the feeling that there has been a total change in mentality from a policy point of view. Although there is clearly more attention for Infant Mental Health, I still often see that the behaviourist approach is endorsed; that still seems to be ‘main stream’. I do see small undercurrents with more awareness about the impact of toxic stress, but they are small branches that seep through somewhere and I don’t see them becoming waterfalls everywhere.”

We talk about how to deal with what parents indicate on social media, such as: ‘I go to the well-baby clinic, but I don’t listen to what they say there, so in one ear and out the other.’ How can employees deal with that?
“Sometimes parents don’t want to have a consult with certain professionals because they don’t feel heard there. Some parents are more vulnerable than others and are more likely to feel negatively treated, rightly or wrongly. At the same time, the interaction can create conflict for employees: they are trained to properly follow national guidelines, but if the parents want to deviate from these kinds of advice, either for scientific or intuitive reasons, the relationship with the parents can come become strained. We now know that a baby is not a person without feeling, but rather a very sensitive being. If you have crying parents sitting in front of you because their child is crying so much and they have nowhere to go, you want to help find a solution. And that is where friction can arise. We can all happily say that ‘it takes a village to raise a child’, but many parents don’t have a village; they are almost alone. This often leads to a switch from plan A to plan B and to an attempt to ‘adjust’ the baby to the circumstances instead of vice versa. Maybe the parent and the professional are happy then, but the baby is not. Many of the methods used are much ‘easier’ in the sense that you don’t have to change the whole system or get a village around you…” She hesitates, interrupting herself: “Well, easier… I would not be able to, because hormonally I would be driven crazy by the crying…”

Is knowledge about the influence of the social environment on health sufficiently seen, or does the idea that health depends on genes still prevail?
“I do not like the term that we have an individualistic society, but you do see instances of that. For example, I know of a family whose children showed externalising behaviour and this was seen as disruptive at school and at the sports club. The parents were blamed for it: ‘Go and raise your child!’ However, I knew that those parents were doing very well with their children. In such situations it should be possible to surround such a family as a ‘village’, not from the idea of ​‘you are doing it wrong’, but from the question ‘how can I help you?’ People’s lives are often lived separately than together, but I fully realise that is not something you can resolve personally. Political decisions also play a major role in this. This is ingrained in the healthcare system and in the idea that everyone has to stand on their own two feet. Somehow you would hope that parental support would grow organically in a community and that you would not have to set it up as an institution, but that turns out to be difficult in everyday practice.”

This topic brings us to the intergenerational aspects of parenting problems. Parents sometimes seem to be individually ‘blamed’ when things do not work out, but in most cases they try really hard and have been through many things themselves, which makes it difficult for them to provide the child with what they need. Does that kind of knowledge seep through to practice, I ask Kelli.

“One of the tasks of the youth health doctor is to refer to the GGZ if more support is deemed necessary. If there is one thing that is difficult to say to parents, it is that you think that not only the child, but also the parents themselves or others within the household need support to solve their problems. However, it is very difficult to raise the issue if parents themselves are not yet aware of certain bottlenecks and there is no request for help. This is especially so because in principle I am the child’s doctor, and not the parent’s. Only when parents learn to see that their own attitude influences the functioning of their child, will things change. That is sometimes really a ‘pink elephant’ in the consulting room and there is certainly progress to be made there…”

We look at the terms ‘toxic stress’ and ‘trauma’ and what you could or should understand by them.
“Trauma is very common, but it is often still thought that the word is about a serious event, such as a difficult birth. That it can also be about more insidious forms, as a result of your attitude towards the child, that is more difficult. That touches people in a more intense way and can feel like failure. I think the same applies to toxic stress. I don’t use that term much, but I did read some work by Jack Shonkoff about it. I think we can imagine what it does to a child to be systematically belittled or beaten or not given food, but I think more subtle forms are more difficult to grasp.”

I ask Kelli what, in her opinion, should change with regard to policies in order to work more on prevention of problems.
She thinks and smiles: “Well… if you look at it very utopian way, then of course you would like us to create a society in which children can grow up in an environment that suits them and that guidelines to that end provide state of the art knowledge, and that invasive, heavy interventions are reserved for the few situations in which they are necessary, and are not part of standard documents. A real step needs to be taken there, so that parents receive less conflicting information. But then…” She hesitates, looks at me and grins broadly: “… these are of course monstrously large social issues; you can’t just change that!” We laugh together at her term ‘monstrous’. However, she does see achievable goals: “On a small scale, of course, you hope that you can always give parents something with which they can manage their own situation as well as is possible.”

I notice that Kelli regularly brings up the guidelines and I ask about their influence.
“Well… in principle, those guidelines form the frameworks within which we work. Not everyone can interpret this in their own way. So you want the summary to actually represent the latest insights. This gives professionals the feeling that they are acting responsibly. Therefore, there needs to be more awareness regarding the influence of early childhood and of its nuances. Everything that goes badly wrong later on, starts somewhere small, when things are not so intense yet, and that is where you want to be present. Every euro invested now, you will eventually get more than tenfold back through prevention, but many policies are linked to four-year cycles… so to the short-term, actually.”
Finally, Kelli indicates that her own motherhood has taught her a lot that she experiences as valuable. She hopes to be able to support other parents as well with such a learning process in which the children are a strong motivational force.

We wrap up and I thank Kelli for her time and her beautiful story!

The Lived Experience, Episode 2 – This week: Simone, Part 2

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Last week, we started with Simone’s memories of her childhood, made clear in part with the help of the Matenspel. This led to a long conversation, in which many facets came to the fore. We will discuss her experiences in more detail in a later publication, because there is so much in her story that shows how much intergenerational trauma has an impact on the well-being and health of those involved.

We talk about the role of Simone’s father in the family.
“My mother was afraid of him and he could also scream at us and say we had to clean our room ‘NOW!’ I was always more critical than my sister and I’ve argued against him a lot, had heated discussions and went against it completely, but yeah…” She makes an appeasing gesture with her hands, holds her finger to her mouth conspiratorially and whispers: “Then my mother said that I should lay low!” She sighs, falls silent for a moment and then continues at normal sound level: “There came a moment when I noticed that my father could no longer handle me verbally; I considered that cool, but the consequence was that he started threatening and that sometimes I was really hit. I thought he was a weakling, that he tried to prove himself right that way. He sometimes tried to play with me, but that physical contact felt very bad and I one day I gave him a huge blow. He was almost floored and angry he was! I said: ‘What do you want? Did I not say stop?!’ After that, such behaviour was over, but the distance between us got bigger and bigger and the worst thing was… my mother always stood up for him.

When I was young, my mother was my everything, but when I needed her support she was not there for me. I really blamed her for that, that she always got behind my father and left me in the lurch like that. She was actually always between my father and me and acted as a messenger, as his interpreter. Later I read a lot about narcissism and realised that she was the ideal ‘flying monkey’ for him. My mother said she had to leave home well before she was 16 to work for another family and never learned to stand up for herself. She was just really scared of him. My sister got along much better with my father; she got a lot more done from him, partly because they shared a number of interests and she started working for him in the business. If you’re talking about symbolic capital… being an entrepreneur, that was an example of symbolic capital in my father’s eyes. That I later completed a college education and always generated a good income… it meant nothing to him. I’ve done all kinds of things I thought my parents could be proud of; my mother would whisper that she was proud of me too, but my father was not allowed to hear that.” Her father distinguished between the daughters in all sorts of things; he used her mother to drive a wedge between the children and her mother internalised that role and also created divisions herself. Many of those patterns have persisted to this day, Simone says, and she sounds both angry and sad.

We talk about what may have caused it all and Simone elaborates on what has come to light in the family over the past few years, the role of the Catholic Church and its abuse, and the painful discovery of porn on computers in the older generation. This brings us to the saddest memories, after previously having discussed the fondest memories. Simone speaks cautiously, but does not have to think long; one memory evokes the other.
“My father thought pregnant women were disgusting; he said that to my sister and to me. I was very proud of my pregnancy and I pointed out to my Catholic father that it was something God had given us after all. He didn’t care about that; a pregnant belly and breastfeeding too… he thought it was gross. There is undoubtedly a story behind this, because such an aversion… it touches you when your father treats such topics that way. In any case, he had trouble with physicality and sexuality. We never saw our parents naked, but he did have an opinion about my body and he could also belittle me. As a child I was a bit chubby and that’s why I was called ‘Plompie’ and for years I kept getting negative comments about my appearance. During puberty I became more vocal, partly because I was appreciated at school for my discussion skills. Then again, I paid a price for my critical attitude: it increased the tension at home and made me very depressed. I started to hyperventilate, became stiff as a board, could hardly get out of bed and got all kinds of physical complaints. As a result, my performance at school dropped drastically. My father said I was lazy and that in my room I did not give a fuck about anything and that was why I got such bad grades, but yeah… I was just deeply unhappy and intensely lonely… The strange thing is that, even now, I often get along very well with people who are intellectually well versed. I feel comfortable with them and I have the feeling that they understand what I am saying when I share my story with them.” Simone tells how that loneliness led to her developing her imagination and talking to fictional people in her secret make-believe world.

The disappointments continued for years: no interest in her studies, no financial support for study costs, no phone calls to find out how she was while she lived in her student room, her father’s absence at her graduation, no attention to holiday stories (but the parents’ stories in the spotlight), a cold demeanor and mean comments from her parents after she had a miscarriage, always fearing to stand up for herself because guarding her own boundaries always led to arguments and sanctions, standing up for others out of a deep need for harmony and an effort to keep or restore the peace but then again becoming disappointed or being blamed, emotional blackmail and threats (‘If you don’t like it, then you can leave!’)… it is too much to mention and it has moved her and made her vulnerable. In her own words, it has shaped her into a ‘pleaser’, based on the fear of not belonging at all and seeing everything fall apart. For years, the fact that she contributed the largest part of the family income also played a role; she did not want to jeopardise that, but because of that she lost touch with her authentic self. The pressure she has felt since childhood has gotten heavier and heavier and that is why she has now decided to work diligently on her mental health.

When I ask if she has developed behaviours that she would call ‘bad habit’ as a result of everything, she looks at me intently across the table. “Oh… that’s a difficult one…” I wait and give her time to think. She sighs. She is silent and lowers her eyes. We are silent together. After a while she looks up: “I know, you know…” “You know…?” “Oh yes, I know exactly what it is… but I find it really difficult…” The silence hangs between us. “And what makes it difficult for you…?” She sighs deeply, hesitates, searches for my eyes: “Shame…” “Shame…?” A little inquisitively, I add: “You don’t have to say it, you know…?” “Yes, I find it really difficult. I’m going to say it! I’ve made up my mind to say it more often if it’s appropriate. I also recently discussed it with my therapist and it turns out that there are certainly more people who struggle with it…” I wait to see how she will continue her tale. “Talking about it is part of the phase I’m in right now.”

She takes another deep breath: “From the end of primary school, I started pulling my hair. I was alone a lot, I had long hair with dead ends and I pulled it out, but later it was more pulling in general and my hair has become very thin, with bald spots here and there. It has a difficult name, trichotillomania. I kept it hidden from everyone, but now a few people know. It went from bad to worse and I had the strangest thoughts about it…” She covers her face with both her hands: “I thought it was so strange what I was doing and was afraid that it would be hereditary if I had children…” She says that it was a relief to talk about it with her therapist, to find causes together and to look for solutions for how she can live with its consequences: fear of a rain shower, not daring to swim, afraid that others will see it and make comments about it… We talk more deeply and come to the question of what it brought and brings her: “It doesn’t hurt, but gives a kind of nice stimulus. I find the thick, wiry hairs and pull them out piece by piece. Evenings when I am alone are the trigger moments, when I have a full head, when I am tired or stressed; then it is a kind of distraction and it feels very nice. It gives me peace of mind, especially when life is heavy and feels like a struggle. At the same time, I am very well aware that the negative consequences such as shame and unrest make life even harder… It is difficult…”

The conversation meanders further to where Simone sees bottlenecks in society for children and young people, to recent changes in herself, and to how she takes brave steps on a path to more inner peace, in which her family is and remains the loving core. Her candour speaks volumes about her courage and her story is another illustration of the impact of early life. More awareness about this can help reflect on how we want to treat the youngest in our society, so that they do not have to ‘heal’ from their childhood. ACE Aware NL hopes to keep making a permanent contribution to this!

The Lived Experience, Episode 2 – This week: Simone, Part 1

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It is beautiful late summer weather when I arrive at my interviewee for today, Simone (pseudonym). I suggested we would start with a game and that sounded good to her. She looks happy when I bring out the elements and explain to her what the intention is. We clear the table so that she has plenty of room to play. The idea is that we gain insight into what her world looked like at a certain age in her childhood. She chooses the age of 13 and gets to work. She can choose a maximum of six of the eight coloured ‘mats’ and associate a place of a person to it, starting with ‘I’. After the mats, there are dolls, houses, roads, means of transport, lucky clovers and emojis. She needs time to get the relationships between them as desired. When she feels she is ready, we start the conversation, during which she will regularly look at the ‘Mats game’ elements laid down and will be amazed to see how they reveal all kinds of interactions in her life as a young girl.

She has had a tough time and has started a search; she no longer wants to avoid the source of her pain. She realises that, like a family member, she may not be able to completely silence the voices of the past, but she doesn’t want to feel the pain all the time, find more peace, learn to better guard her own boundaries, that for years she allowed to be crossed. “Sometimes it may seem like I have an authority allergy, but I don’t actually believe that. I can tolerate authority, but I have a highly developed sense for power abuse. And lately I have become aware that abuse of power triggers me. Partly, I already have more insight into the causes of this. My parents came from a strict Catholic background and considered things normal that I don’t find normal at all, such as the distinction between man and woman, but also the way we were treated as children and how my father tried to deal with certain aspects of his position to impress other, as did the pastor.” I nod and tell about ‘symbolic violence‘, the abuse of power and prestige, and Simone recognises the different elements. They will come up a few more times later in the conversation.

During the laying of the game, part of the opening question we always ask has already been answered, namely the question of someone’s background.
“I moved quite often within the northern provinces between the ages of eight and thirteen. Onward from the moval when I was thirteen, I had a really hard time. I came into puberty, lost my best friend and my nice, familiar school, had to part with the dog, who had always been my great friend and for whom, according to my parents, there was no longer room in the new house, and my parents and sister were always working in the shop we had there, so I was almost always home alone. My grandfather died while we were moving. My whole life felt strange to me. I couldn’t find the school. Not even once had my parents cycled the route with me. Luckily I met a classmate on the way who had also just moved there. At school everyone spoke Frisian and I hardly understood anyone. I kind of felt dropped into a totally unfamiliar environment… yes… that move was really traumatising for me. When I think back, I think that is where my chameleon qualities originated: I tried to adapt as quickly as possible so that I could fit in again, but I did not really succeed. I felt like a normal child, but the normal children did not hang out with me, only the children who, for other reasons, did not really belong to the group themselves, felt attracted to me and that, in turn, was something I did not like… Yeah, well… that is how you think at age 13…” She is silent and considers the feeling of that time. “A lot of anger developed during this period. Before that, I sometimes found it difficult at home, but after that move everything got a lot worse.”

Photographer: Cecilia Paredes

I ask who she could turn to in her early childhood.
“That was my mother. I cannot remember ever having a click with my father. He was there, but I often found him annoying. He didn’t understand me and made that quite clear. He was very authoritarian, while my mother was a sociable person, with whom everyone was always welcome to join in. With her, I could be who I was and I loved being with her. I remember one time sitting on the couch with my doll and asking her: ‘Mommy, can I marry you?’ I was very disappointed when it turned out that was not possible.
My father was always working during the week and on Saturdays; he was home only on Sundays and then he was very papistic and stern and cold. On Sundays, we had to look neat and he checked whether my mother had cleaned the house well enough on Saturday. If he did not think so, he would grab the vacuum cleaner and a bucket and do it all over again.
My mother, in the opinion of my grandmother, her mother, was actually married late. She was 27 and the first years there were no children and my grandmother did not like that. When the GP told my mother at age 35, after a difficult birth with me, that it was better if she had no more children, my father saw me as the ‘guilty’ one: now he, who wanted a successor for his business, had been denied that opportunity. He now had two daughters, while he longed for a son. He later said things like: ‘Yes, you were a heavy, fat kid; because of this, mama could not have any more children.’ He laid that reproach at my feet and always thought I was a bad person; he literally said: ‘I have nothing with her.’ I’ve felt that all my life in how he treated me and how he differentiated between my sister and me.”

How would Simone describe her home environment?
“There was a lot of structure in the house, the famous ‘calm, cleanliness and regularity’, and I grew up very protected. We never went on holiday, so I hardly experienced anything as a child.”
She says that she more or less fled the house when she was 18. She did not want to work in her father’s company, but living in her student room made her feel just as lonely as at home: “I ran into the world and into myself. I was like an unworldly girl in a student house with almost all boys. Their parents called so often that they kept themselves out of reach, but mine never called. My parents had not helped me with anything and I had to do everything on my own and usually had to pay for it myself as well. I was shocked by all kinds of things that I had to deal with and was always on my guard. With such an attitude you do not experiment and you become very cautious.”

When I ask about the period that contains her best memories, she is very clear: “That was in my birth house, with the garden there and a parasol, children to play with, nicely colouring, baking an egg… the homely, the cosy – I really liked that and I did not feel that way again after I was 8 years old. My mother was also becoming increasingly unhappy and used me to vent. She was treated as an employee by my father, but she was not paid and sometimes could not live on the household money she received. I used to say: ‘That is ridiculous! It cannot be the case that you cannot buy what you need because he does not give you enough, while you are working hard all week, too, now, can it?!’ She thought so too, but then she would say: ‘Yes, but you know what he is like, don’t you?’ I told her to stand up for herself, but she was afraid of him.”

Next week you will read the continuation of the conversation with Simone, in which, among other things, her saddest memories are discussed and how, in her opinion, these have led to a number of habits that weigh on her.

Concepts, Part 1

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Conversations, co-creations, and conceptualisations

Last week we wanted to turn a number of interviews into blog texts. Given the length of the encounters, that turned out to be quite a challenge! The professionals we speak with have wonderful things to say about their work. A wealth of acquired experience, acquired knowledge and reflective wisdom is concentrated in these professionals, which is used for the benefit of the target group. This can be through their practice, their workshops, their research or their writing. In doing so, they are committed to carefully doing justice to human vulnerability.
This vulnerability is, in turn, clearly visible in the stories from ‘context experts’ (as differentiated from ‘content experts’). Their ‘lived experience’ shows how loss, grief and trauma are formative elements in a human life. Over the years, they all find their own ways to deal with it.

We consider it an honour to be able to listen to those (sometimes poignant) personal experiences and want to do justice to them. For us, this means that all those stories, from context experts and from professionals, deserve a place within a well-defined context. That is why we choose not to highlight a few intense, activist or confrontational quotes via ‘cherry picking’, because then the nuances disappear. Because we simultaneously try to give the blogs a manageable length, we cannot include everything people say. Experience has shown that when you take time to share an open and attentive talk with each other, time passes almost unnoticed, because narrator and auditor mutually get engrossed in the exchange. A conversation of sometimes two hours or longer can usually not be summarised in two blog parts.
All in all, this means that we save significant parts of the interviews for later publication; we will consider the precise form of this in the time ahead.

In what we publish, in whatever form, the input of the interviewee plays an important role, also in the editing process. We create the text together; it is a co-creation, so that justice is done to all people and processes involved and so that no retraumatisation occurs.

Furthermore, many people share experiences that are described by the social sciences in the form of a ‘concept’, a theoretical idea that is connected with empirical reality, with people’s true experience. An example of this is ‘trauma’ or ‘parentification’ or ‘symbolic violence’. We will occasionally discuss such concepts in the near future so that we can link to them in the blogs themselves and then not have to interrupt the interviewee’s speech with an extensive explanation. In this way we hope to be able to share as much as possible with you as readers of the impressive stories to which we are allowed to listen. The conceptual interpretation of a real-life experience is also created cooperatively.

For example, in a recent interview with ‘Simone’ (pseudonym), following a comment from her, I explained something about the different forms of ‘capital‘ that sociologist Pierre Bourdieu distinguishes: economic (money, stuff), social (network, who you know, who to ask for help) and cultural capital (knowing what is appropriate and what is expected of you, knowledge of music, history or literature). The value of your capitals in daily life is closely related to the value a certain community attaches to certain capitals: professors may attach less to knowledge about soccer, plumbers less to knowledge about quantum mechanics. The fourth form is symbolic capital; this is more or less the sum of the other three. The prestige, status, and authority that arise from these other capitals in part determine the value placed on what someone does, says or thinks; think of role models. For example, in the past the priest, the pastor, the notary and the school headmaster had a lot of symbolic capital. Today, the professions may have partly changed, but the principle has remained (think of scientists, doctors, or politicians). The one with a lot of symbolic capital has credibility, and with it more status, more influence and more power.

Abusing symbolic capital by imposing your will or primarily improving your own position is called ‘symbolic violence’. From a complicated sense of perceived self-evidence in it (“It will probably be true what the other person says, because they have the knowledge, the position, the insights”), the one who exercises symbolic violence and the one who is subjected to it together more or less implicitly maintain the status quo as a logical, natural order of things.

(So ​​co-creation here too!) Such a dynamic can also arise between parents and children. The child sees the parent’s superiority as normal and has little or no opportunity to withdraw from it. The insight that your parent was not always right and that what you already felt as a child, but could not put your finger on was indeed correct… that insight often only comes years later. By that time, the survival strategies you developed as a child are often much more deeply ingrained in your personality. Later in our conversation, Simone recognised this mechanism a few times.

Closely associated with ‘symbolic violence’ is the concept of ‘authoritative knowledge‘, knowledge that has more authority than other forms of knowledge, because it better explains the state of the world or because it comes from more powerful parties (and usually both), making those others forms of knowledge fade into the background. It is not about the correctness of the knowledge, but about the validity. For example, in the days when the Church said the Earth was flat, this was authoritative knowledge and it was considered heresy to argue against it. Another example: the witch persecution, which kept Europe in its grip for some three hundred years (from 1450 to 1750), was perpetuated and sanctioned by the institutionalised powers. Both the scientists who claimed that the earth was round and the (mostly) older women who worked as naturopaths, healers and midwives shared non-authoritative knowledge. The type of knowledge they did bring could be classified as ‘uncomfortable knowledge’, knowledge that has the potential to disrupt the status quo, but which also has negative consequences if not applied. We see here that knowledge is not only power, but that power also leads to (sometimes unjustified recognition of) knowledge!

Young children have deep-seated needs and, in addition, an extensive set of rights, such as those laid down in the UN Convention on the Rights of the Child, which has also been ratified by the Netherlands. As a result, adults have important responsibilities. When problems arise in a child’s life or when there is trauma, in many cases we will also encounter the impact of symbolic violence, authoritative knowledge and resistance to uncomfortable knowledge. When these set the tone, it is very difficult to properly represent the child’s interests. It can therefore help to know those concepts and to see that they are anchored within the (family) system. Then it becomes easier to recognise them, which, in turn, can help to jointly determine the direction of necessary change. So here, there is also co-creation: children cannot effectuate their personal well-being on their own. In all kinds of environments, this requires a conscious, sensitive attitude from adults.

We hope that by explaining a number of important concepts we can contribute to a better understanding of various interactions and patterns and we will refer to this and other blogs where appropriate, so that knowledge is not so much power, but rather strength that can be put to use for collectively creating health and wellbeing!