Book review of ‘I already work (I just don’t get paid for it)’ by Lynn Berger, Part 1

A pleasantly long train journey in the ‘Silence’-compartment, followed by a Sunday evening with tea and something sweet… that was the time I needed to read Lynn Berger’s fascinating essay, which has appeared in mini-book form with the title ‘I already work (I just don’t get paid for it)’. The argument has just under 100 pages on slightly larger than A6 format and no fewer than 150 references. Anyone who wants to read more about the subject of ‘paid and unpaid work’ can therefore go ahead. It is always a pleasure to see that an argument is well substantiated.

Berger herself speaks in her final statements of ‘a small essay on a big subject’ (p. 85) and she has a very good point: her long list of literature references supports that position. There are a huge number of perspectives from which you can look at (lack of) remuneration for work. The fact that the lack of financial and social appreciation for certain activities means that they are not counted in the Gross Domestic Product, has all kinds of policy and psychosocial consequences and causes that are insufficiently recognised.
Incidentally, despite the long list, there is still a great deal of literature that has remained unnamed that could greatly increase the insight into this entire subject. I will get back to this.

The booklet is divided into three parts:

  1. The work that makes all other work possible
  2. Part-time country the Netherlands: a short history
  3. The struggle for our livelihood

In 1. we get an overview of statistical data on work, vacancies, division of labour between men and women, informal care, government expenditure in various social sectors and an explanation of the tension between paid and unpaid work. This also stimulates the discussion about what that actually is, ‘work’: what do we mean by it? When do we call certain activities ‘work’? It is a relief to hear Berger argue that despite the fact that many activities are not seen as work because they are unpaid, they are nevertheless of inestimable value: ‘Without this work there is no economy’ ( p. 18), because many of these tasks are work ‘that maintains, repairs and advances society’ (p. 14). Berger mentions a few terms from the public debate about unpaid work and puts them in quotation marks: ‘part-time decadence’, ‘part-time princesses’, ‘participatory society’. She ends this part with the conclusion that caring for others is also work.

In 2. Berger provides an overview of how the division of labour has shifted over the centuries from a home situation where everything happened (household, taking care of children, growing crops, herding livestock, producing food, practicing crafts), to industrialized settings leading to specialisation and division of ‘caring at home’ and ‘producing elsewhere’. She sums it up this way: ‘This is how capitalism profited from unpaid work, without supporting it’ (p. 29). Subsequently, the breadwinner model and the welfare state developed, both ‘entirely based on the nuclear family in which the man earned the money and the woman took unpaid care of children, the elderly and sick relatives’ (p. 30). She explains this on the basis of the subordination of women and the work they often performed through the centuries. This was legally encouraged by making women ‘incapacitated’ and denying them the right to paid work and firing them as soon as they married.

Towards the end of 2. Certain themes appear that give me a sense of friction. For example, Berger speaks somewhat condescendingly about the Dutch tendency to find two or three days at the childcare facility enough for the young child. It should be much more normal, she argues, to just take your child there full-time, so that you have your hands free for any work, especially paid work. She rightly notes that the emancipation of some groups of women goes over the backs of other women, for example when highly paid women buy help for the household and children. This help is often provided by poorly paid, undeclared women (sometimes immigrants who elsewhere have left their own families), who therefore have no social benefits and do not accrue a pension (p. 46). She seems to encourage women’s emancipation, but unfortunately I do not read a plea for the emancipation of the baby.

About maternity leave, she says that it is often too short and ends at a time when a mother is not yet ready to hand over her fragile baby: ‘[A]nd thus she chooses a parttime job, so that she can also have a few days to take care of her baby herself’ (p. 47). And that this leads to a limitation of the mother’s salary is referred to as the ‘baby fine’ (p. 48). That is not her term; I am aware of that, but all in all I think it is becoming a somewhat difficult story, also in combination with the term ‘maternity ideology’, ‘the belief that children benefit most from the dedicated, full-time care of their mother’ (p. 30) and the ‘paternity ideology’, ‘the belief that the ideal father is one who earns enough money to support an entire family’ (p. 31). Berger says these ideologies are persistent and limiting because ‘everyone [brings] into the world the hormonal, neurological, and psychological mechanisms involved in care’ (p. 57). That may be true, but on the assertion that it has nothing to do with their character or nature that women ‘care more, easier and faster’ (p. 58), I would like to express a friendly but sincere and resounding ‘No’. That babies need their mother, is not an ideology; that is a biological given.

I am a strong supporter of equity between men and women. From my point of view, however, I think it is important to be alert about confusing equity and equality. Men and women are not equal. The female body is biologically essentially different from the male body in terms of structure and functioning. Just this week I watched the film ‘In Utero’ again after a number of years, about what a child experiences in the womb (see also here). This is the field of pre- and perinatal psychology and deals with the impact of maternal physiology on the developing foetus. Once the baby is born, full of imprints of the mother’s emotional life, which has reached the unborn child through sounds and hormones, the baby is supposed to go to the breast. There, the child’s stomach, brain and immune system are fed with everything babies need to achieve optimal development. That, too, is a very fine and carefully tuned hormonal process to which the father’s body contributes little to nothing. (Yo, man: deal with it!) Sure, he protects mother and child from negative outside influences and that is also a crucial task. However, he is not equal to the mother and the baby will simply be worse off without the mother’s breast and body.

The familiarity of the mother’s body, in which the baby has been for months, is helpful in developing a sense of security and self-regulation. All the hormonal changes that the pregnant, birthing, lactating female body goes through mean that she is optimally equipped to become sensitively attuned to (the needs and expectations of) the baby. Fathers can certainly learn a lot in that area, but there are also things they simply cannot do, namely carrying, giving birth and breastfeeding. In reference 115, Berger rightly quotes ‘Mothers and Others’, Sarah Blaffer Hrdy’s wonderful book on alloparenting (shared parenting), but I don’t know if she also read all the passages about the influence of breastfeeding and lactation on bonding, well-being and health. Blaffer says valuable and essential things about that. Next to this title, I have a nice library of other authors who have something to say about breastfeeding. Berger is very welcome to come and take a peek.

Next week I will have a closer look at the difference between equity and equality and what that means for caring for young children.



Freedom and security to just ‘be’ – your true Self

More or less out of the blue he texted me: “Hi Marianne, how are you?” I was surprised, pleasantly surprised, and wondered if it was just that question or if there was more to come. I was on the road with someone and saw no opportunity to answer carefully. Not until just after midnight, when I got home, did I sit down to do that. I had another Compassionate Inquiry session ahead of me that night and wanted to get some sleep before it started, but I also wanted to answer this question; I had the feeling that there was more to it and I wanted to create space for that.

I said that considered it a sweet, unexpected question and honestly told him how things currently are: “It’s an intense time. I have been a Compassionate Inquiry student in the professional year training since February. CI is a psychotherapeutic approach in which self-examination is the essence in this first phase. Outrageously transformative, insane amount of introspection, self-reflection, questioning habits, and so on and so forth. I feel privileged to have been admitted and at the same time it is also extremely exciting and emotional to experience what all of this will bring.”

He was still awake and replied: “I have been stuck for years and I am ready for a new challenge, but in recent years I have been chasing myself too much to see a path out. I wanted something different, but nothing presented itself. Everything trudged on and I was indecisively waiting for a new turn.” I read his words attentively and thought of him. I know his work and am impressed by it. I realised how much we can often be mistaken about how “well” someone is. It can look great on the outside, while inside there are all kinds of sadness, discomfort, loneliness and disappointment. At the same time, I also thought it was great that he was ‘waiting’. Remaining in the ‘discomfort’, just ‘sit’ with it (more ‘human being’ than ‘human doing’) is an art that not everyone understands. It takes courage that not everyone has available. However, the slowing down that comes with it can be healing. It can show us that something is allowed to, or, if we really want to flourish again, has to change, while at the same time we acknowledge that we do not yet know in what way and how and when, and with whom and what and without whom and what. To first feel and become aware that it is time for change is already a valuable insight in itself. If you then even dare to reach out, you have already taken a few very important steps.

The time of our conversation was a bit strange, maybe, after midnight, but sometimes that is just the best time, when the darkness surrounds us and the world is quiet, when we are not distracted by other things, when, strangely enough, it sometimes feels safer to make yourself super vulnerable towards someone you trust. That is what he did: “I have made an appointment for a psychedelic retreat because I think it might give me a breakthrough that I cannot seem to achieve any other way. Addictions get in my way; I keep falling back into them and therefore I do not make any progress. There is pain in me that time and again I keep trying to numb. For so long. I did not dare to be myself. There have been some wonderful role models in my life who have given me courage, but there is still much that lingers and whirls within me and that hinders me. I still find it difficult to really find my footing.”

We exchanged about slowing down and adapting to the circumstances. I mentioned an adage from Krishnamurti: “It is no sign of health to be well-adjusted to a profoundly sick society”, often quoted by Gabor Maté, especially in the context of his book ‘The myth of normal’. “Wow, I want that on a t-shirt and written on a tile!” was his enthusiastic response. “I will write to you more often, but now you have to take that power nap, girl, before you go into your session later on!”

I did, but when I woke up later that night, I still remembered things I wanted to share, options that might help him find a new path. I texted them, fell asleep and was woken up because there was something on the program. Then I realised I had forgotten to finish the conversation properly: “Thank you for reaching out and for your vulnerability – an honour to receive. I will respect it.”

Lately I have been having these special conversations and encounters, where people share deep, intense experiences, let down all their defenses, and say out loud what they are tentatively acknowledging about themselves: “I didn’t feel right the way things were. I am on a quest. It is intense. I want to organise my life differently. I want to get rid of my addictive behaviour, but there is so much pain that I cannot bear. Only now do I realise that so often in my life I had to hang the garlands myself, that there was no one to do it for me. I recently became aware that as a child I often felt so incredibly lonely.” What an honour, indeed, to be a silent witness to hearing that ‘precious pain’ being expressed and to be able to offer ‘holding space’ without judgement.

They grab me and get to me, all those stories. They make me acutely aware of how many children have a hard time, even if they do not go fully off the rails, even if you cannot see it on the outside, even if they later build what appears to be a successful life when looked at from the outside. All of it makes it a bitter read that the cabinet thinks that too many children receive psychological help. How should we interpret that? What does that say about how the government looks at the problems of young people? Where do these problems come from according to the cabinet? What does the government think is the consequence of ‘too much help’? And what does the cabinet think will be the consequences if that support is increasingly reduced, if we as a society no longer really allow ourselves to realise what it means for the future if young people are so out of balance and have the feeling that cannot succeed in building themselves a good life? What kind of policy will the government develop to turn this sad tide?

Later that day we picked up the conversation thread again. He said he did not want to go into the planned retreat with very high expectations, but still hoped for insights. I understood that; I recognised that. I had been open with him about my own experiences and presumably that was part of the honest exchange we had now. We talked about how ‘enlightenment’ doesn’t even have to be the goal: first just more peace and balance, a feeling of being in the right place, being seen, heard, loved. We also talked about the need for a sense of safety and security in order to develop empathy and how that fails when trust is lacking. And from there we returned to the core, to the origin of a lack of empathy and trust in the world: to the young child who grows up with parents who, back in the day, have missed so much themselves that they cannot sufficiently see and satisfy the basic needs of their child.

For now we came full circle; soon we will spin a new thread – the date has been set. I hope that the retreat will be a wonderful, nurturing experience for him and will initiate a development towards a sense of liberation and freedom. He so deserves it.

Facts versus Feelings – guest blog by Janis Isaman; Part 2

Last week, we read the first half of the blog by Janis Isaman, Marianne’s Compassionate Inquiry colleague, and how she experienced her year of training with this psychotherapeutic approach of Gabor Maté. In the first half, she made a distinction between the story we tell ourselves (the facts) and the emotions that come with an experience (the feelings). In this second half, she dives more deeply into the bodily experiences, on what happens inside us.
Janis’ blog originally appeared on the website Elephant Journal, where Nicole Cameron is the managing editor.


When we focus on the story, we don’t need to explore what happened inside of us. Stories and facts are external. Feelings and sensations are internal.
When we connect to the somatic, then attach it to an emotion and identify all of it out loud, we take responsibility for the events inside of us, rather than the (often disputable) facts of what occurred.
We are pulled away from life as a court ruling and toward our experiences as connecting, vulnerable, and healing.
One of the most present and authentic things we can do for ourselves is to notice and name the physical sensations happening in our body. I can think back in my life to moments of laughter, love, rage, and ruin, and recall precisely the sensations that a photograph could never capture.
The details of our body matter, and we can titrate and dose the amount we can tolerate. Perhaps it is: “I notice my body” or “I notice a hot sensation.” There is a possibility that we can add detail, tone, and specificity.

The last time I was triggered, it was by a tone of voice. My stomach clenched, like a fist had been inserted inside my abdomen and squeezed. Atop it, my chest cavity tenderized, like a scratching so deep within threatened to make it raw with heat. My throat inexplicably narrowed, almost as if a sickness was coming on, my vocal cords narrowed, a lump building and threatening to overtake it.

I spoke, my voice stern: “Please watch your tone. It’s scaring me.”
And I could notice that I had fear.
The fear was old, rather than the young voice sitting beside me and speaking the words that sent my body sideways.
Just like I had been with my friend, my body was two.
During my year of studies, I could slowly, as I practiced the skills over and over and over, identify that I was triggered.

We can start to piece together the combinations of body sensations and emotions that led to our youngest belief system:
I am not good enough. I am not lovable. I am a failure. I am a bad person.

When we have sensations and feelings that lead to these perceptions of shame and unworthiness, our coping strategy is to go back to facts.
Mine was: Tell the story. Prove I’m right. Discredit the other person.
But in the year of my course, although we had the usual lectures and reading list, the work was not intellectual. The monthly meetings and weekly practices with my colleagues required me to, time and time and time again, pull back into my body. I did hundreds of practice sessions.
Sometimes, I couldn’t go into my body. It was intolerable and I dissociated. Sometimes, I could add nuance and stay with the feeling until it dissipated like a firecracker or a hot air balloon floating away from me that I still wanted to hold.
And then I graduated.
In the pause without information intake or formalized practice sessions, I could practice on my own.

Now, my body has become the only part of the story that matters. What is happening inside me is indisputable, no matter what someone else has done. I tell shorter stories and spend more time on what my body is sharing.
I can notice and name sensations in an instant.
I can identify when I’m triggered and I can take responsibility for it.

These seemingly simple questions took a year of practice, and another year of integration. And they are the most profound learnings of my life.
The same conversation I had previously with a friend wouldn’t end up the same way these days. Now, I would share that I have a pit in my stomach, and that the anxiety I’m feeling is reminding me of being a small child on a tricycle.


A small child on a tricycle… we can almost see Janis. Most us of will be able to picture a two or a three-year old cycling, full of wonder; we may have children that age or grandchildren, nieces, nephews, neighbour kids, kindergartners in our class. It should not be too hard to understand that for such little ones the world is a completely different place than for an adult. As an adult, we have so many more options to take our lives into our own hands. We can move if the house is dreadful; we can change our daily environment if the atmosphere is nasty; we can sever ties if we feel unjustly treated. These are all options not available to young children.

And speaking of justice… Janis mentions ‘life as a court ruling’. That is a beautifully applicable image, as it also implies the presence of judges. Judges listen to the facts, to the stories, and based upon those facts they pass judgment. In personal experiences and interpersonal relations, judgments are usually the things that do not solve but rather create and exacerbate the turmoil.

Judging others, judging ourselves… not so much good comes from it, most of the time, yet for most of us it is very hard to go through life without passing judgment towards others or self. That is to a great extent because it is impossible to get all the ‘facts’ straight. Can we really know the other person’s emotional life well enough to understand their response or behaviour? Is it actually, factually true what we make ourselves believe about ourselves?

As Gabor Maté often quotes the Buddha: “With our minds we create the world.” What we consider to be a response to the facts, is often primarily our perception or our interpretation of those ‘facts’. And why is that? That is, as Gabor follows up on the quote, because before with our minds we create the world, the world creates our minds. Our daily life, the social environment we grow up in, is the biggest factor in molding our brain and our stress regulation. Already before birth it is our mother’s stress level that literally infuses our womb world, through the umbilical cord. If she has a tough life while she carries us, we will be physiologically prepared for a harsh world. If the first years or our lives are filled with toxic stress and ACEs, we will develop features and behaviours that try to help us survive in a hostile environment. All of that makes perfect sense; as Gabor says: ‘It is a normal response to an abnormal circumstance.’

As Janis’ blog amazingly illustrates: we do well making an effort to provide our little ones with a living environment where their emotions are welcome, seen and heard, embraced and accepted. The more acceptance the child feels for genuine emotions, the easier it will be to self-regulate, as safe expression of emotions means they do not have to be suppressed. Suppression of emotions is exhausting; it will wear us out and often make us ill in some way. And even if we have not yet reached that illness stage that Gabor describes as ‘suffering into truth’… it is a big assignment to re-establish the connection with all those emotions once we have built habits and personalities around their suppression.

Recognising what Janis speaks about is easy; I, too, have a biweekly session with my group of eighteen students, a weekly session with my triad, several Zoom-calls and facilitated workshops every month, heaps and heaps of videos to watch and digest, and most of all… an almost insane amount of introspection 25/7 to disentangle all the different threads of emotions, triggers, perceptions, beliefs, personality parts, concepts, disappointments, characteristics, and bodily experiences. But like Janis, I also immensely enjoy being in a community where I can go through “the most profound learnings of my life”.

Facts versus Feelings – guest blog by Janis Isaman; Part 1

For the regular readers of our blog, it will not come as a surprise that we are big fans of the work of Gabor Maté. Marianne has been a Compassionate Inquiry-student (CI) for the professional training since February this year, after doing the short course last year. Now that she is in the midst of the learning process, she is in regular contact with other CI-students who share about their experiences and the impact the training and the approach have on their personal development.
Last week, a blog was shared by one of the students, Janis Isaman, on the website Elephant Journal, where Nicole Cameron is the managing editor. With Janis’ permission, we share the text here. We start with the first half and add a few considerations at its end; next week, we will share the second half.


Facts vs Feelings: What I learned from a year of studying with Dr. Gabor Maté.

I heard myself saying: “I feel like I’m two.”

My throat was dry, and I could feel a column of heat in my chest. A flush of pressure rushed to my ears and they felt like they needed to pop, like I was on an airplane. The pit in my stomach seemed to swallow my body.
I was on the phone with a friend who had served me the news that he wasn’t available to talk.
I have no recollections of what else I said, as the sensations of my body swallowed me whole. I spent the entire next day assessing, analyzing, and being anxious about it. I didn’t understand that I was triggered.
But that was all about to change as I embarked on a year of professional studies with Dr. Gabor Maté.

One of the most important things I garnered from my time in the training is this:
The story doesn’t matter.

Our culture teaches us to tell stories. When someone hurts us, we translate the events to text, even if we speak them out loud: “and then he said,” “and then what happened is,” “and then, I mean you won’t believe this…”
We typically turn our lives into scientific diaries of details and facts and events, much of which is filtered through the lens of proving that we are right or defending ourselves so that we can be more correct than the other person.
I didn’t viscerally understand that stories are not facts. And that perceptions of what happened are not feelings.
Perceptions are interpretations, and storytelling requires us to take no responsibility for our coping mechanisms or triggers.
With Compassionate Inquiry, Dr. Maté’s therapeutic approach, I learned to approach my emotional experience as though it were a visit to the doctor. I practiced analyzing myself and my experiences through the sensations in my body rather than in my brain.


I learned to ask myself important questions, like:

>> What is happening for me?

>> What is the quality of my skin? What sensations are present in the abdomen? The chest? The spine? The back? The neck? The face?

>> Do I feel a temperature change? Where is the sensation? And what is it? Is it burning? Searing?

>> What is the feeling I am experiencing? And finally: what do I make that mean about myself? How old is this memory? How old am I?

These astoundingly straightforward questions, this approach, changed the way I relate to myself, my body sensations, my emotional experiences, and my triggers.
I, like many my age, was raised to mitigate my emotions. Intelligence and rational thinking were the prize tools upon which to earn favor.I remember screaming when a spider climbed on me. I was on my tricycle on the cement pad behind the house. The Daddy Longlegs tickled my left leg, but when I looked down upon it, it seemed to occupy a quarry of my leg.
Fear overcame me and I froze, feeling and watching the giant spider make its way toward my torso. I started to scream. Bloodcurdling.
My dad dropped his tools from across the yard and ran over. When he discovered it was only a spider, he blew it off and told me, “It’s only a spider. Don’t make so much noise next time.”
He never asked me why I was screaming or what was happening in my body. He never validated that a spider scares a lot of people, especially children. He never bore witness to my fear.

So by age three, in order to win favor and stay alive by way of affection, food, and shelter, I learned to ensure that my emotional reaction was never larger than the story itself.
I became a gifted storyteller. Words and precision mattered to me. A single incident on a date could weave a yarn for dozens of minutes or portions of hours during drinks out.
I took writing classes, and became obsessed with continuing education. Facts. Certifications. The solidity of the written or spoken word held my grip, as it was the way I could access my experiences and connect with others.

 No one had ever told me that the story didn’t matter.


The story… a fascinating way of looking at what happens.
Janis speaks about how her father was not able to put himself in her shoes and truly recognise and acknowledge what her emotion was, how scared she felt by what she perceived as a huge animal crawling onto her body. He focused on the story, on the facts of what happened from his perspective, which was very different from his daughter’s perspective and her feelings. With this, Janis makes a crucially important point. The little three-year old girl she then was, was fully dependent on the care and comforting from her parents. To understand the world and to learn how to regulate herself, it was necessary for her to be allowed to express and feel welcomed with all her emotions, such as anger, shame, joy, sadness, and in this case – fear. If there is room for all of the child’s emotions, the child will get the experience that the world is a safe place and an event with big emotions is bearable: ‘name it to tame it’. If that learning process unfolds well, emotional states will become something transient. They can be intense, but they pass.

If, upon upsetting events, the child does not experience calm and stable safety from regulated adults (sometimes called ‘buffering protection’), the states meant to be only temporary become embedded in the child’s body and being. It is sometimes described as ‘states become traits’. If we often feel unsafe at an age where our brain is still fully developing, we may create mental default settings like (but not restricted to) alertness, mistrust, withdrawal, or aggression. These arise to protect us. If we feel not safe expressing all our emotions, because they are not noticed by our primary caregivers or because they are dismissed as ‘overreacting’, we find other ways of handling tough situations. Our urge to survive may lead to behaviours that, again, are aimed at securing our safety under all sorts of circumstances, but that are detrimental in the long run. We may become inclined to please others, so that they remain friendly and do not become hostile (which would threaten our safety). We may subconsciously decide that the needs and views of others take precedence over our own. That may lead to the belief that manifesting authenticity is both risky and arrogant (which, again, would threaten our safety). And as functional and protective all of this may be when we are dependent children, later on it usually becomes dysfunctional, getting in the way of smooth interactions with 0thers, of enjoying challenges, of feeling joyful and trusting in this world.

Next week, we will read the second half of Janis’ experience, in which she focuses on the bodily sensations.

Training youth healthcare: which interest is central?

Recently I had an exchange with a lactation consultant colleague about a training she will shortly follow. She reported to me that she had felt really awful about what she had been reading while preparing for that training. She had the feeling that the interest of the baby was fully inferior to the interest of the adults. This is in line with the Adult Supremacy concept we have written extensively about here before. I would like to give an impression of what we discussed.

C(ollegue): I just read the literature for a webinar I will follow and in which all sorts of things made me raise my eyebrows. It was about a particular problem in the breastfeeding relationship, and what I was very concerned about with most of the topics dealt with was: ‘Who has the problem and who has to adapt here: the adult/parents, or the child? How do we view this in our culture? Who is able and responsible to approach a problem with empathy – the newborn or young child, or the adult?’ Another question that arose is: ‘Is it ethical to force children into something that is not developmentally included in their evolutionary nature, their biological blueprint, and which is mainly focused on serving the adult interest? Are you not sending the message to the baby that they are not good enough? In the preparatory literature it was mentioned that one third of all infants do not go to the breast just like that. How am I supposed to understand that…? Is the statement that about 30% of children naturally tend to starve themselves by not going to the breast…? In other words, is not breast feeding natural behaviour or is it the result of how we handle situations? To top it all off, it was suggested that a child should not be offered the breast for 24-48 hours if necessary in order to force a certain different behaviour. In my opinion, you are actually saying to the completely dependent baby: ‘If you don’t do what we want, we will punish you.’ I was so angry… I experience this as psychological torture of the child. Those are heavy words – I realise that, but with the knowledge I have, they feel appropriate.


M(arianne): Oh, that sounds very intense…

C: Yes, it was… Sometimes I get so tired of these kinds of views, which I still see far too often… How come society changes so slowly and leaves children so unbelievably in the lurch?

M: Yes, that is a huge problem indeed… Do you do something with this feeling? Do you express it in a professional, constructive way? Do you write about it?

C: I find that difficult. I also see that it actually concerns two disciplines, namely anatomy and physiology and their impact on the breastfeeding relationship on the one hand, and the psychology of (parenting) views and their impact on the child on the other hand. That is the tricky part about it.

M: Hmmm… well… but if you look at it holistically, then there are no different disciplines around the child. Then we are only talking about this new little person who has needs in all kinds of ways, which ideally are well met by the parents/caregivers/society. Unfortunately, that is often not the case. It seems to me that unity of these fields should be at the heart of everything we do regarding the care of children.

C: Yes, I completely agree. I’m just afraid those who host the webinar do not look at it that way. And it is probably not even something conscious. That is why I have asked a number of questions about this, for the sake of raising awareness. This does bring up the question, however, of who we are there for as lactation consultants: for the needs of the parents (with the result that an attempt is often made to ‘fix’ the child) or to support the parents, but with the perspective and the needs of the child as a basic starting point?

M: Opinions probably differ on that one, too… 😉 Personally, I never think it is okay to put the child’s perspective aside, in any role! And of course this primarily concerns the relationship between the child and the primary caregivers, usually the parents. I just think that in many settings the attitude of being child-oriented is not yet as powerful as it should be.

C: No, I think so, too, so the question is how to get a good picture of both needs and how to satisfy them. Because it is so important that certain needs are fulfilled in childhood, I think that the best interests of the child deserves to be leading. At the same time, society asks so much from people that personal wishes and choices are often at odds with societal ‘demands’. As a result, daily practice is often at odds with the needs of children. That is a serious statement, but a true one nevertheless.

M: Absolutely, totally agree! How we organise society has such a big influence on parenting! Have you read ‘The myth of normal’ by Gabor Maté yet…? There does not necessarily have to be a conflict between the well-being of the parents and that of the child. If the parents could first (learn to) look with compassion at what they themselves missed and where they suffered pain… that would already be so helpful!

C: Oh yes, and that is exactly the hardest part. I really tried to raise my kids with child-oriented approaches, but I made a lot of mistakes in that too. That is an observation; I do not feel guilty about it, but it does make me sad. The result is partly that one of my children struggles with major psychological problems. You never know how things would have turned out differently, but it keeps me wondering. Fortunately, the other children are doing well.

M: Yes, I recognise what you mention. At the same time, it is also important not to view and approach our children as ‘the result of our own mistakes’. No one likes to be seen like that. Most parents do the best they can for their children. What we can see is that many parents lack assets and there are many reasons for this, including a lack of knowledge about the influence of early experiences on later life. It is therefore important to ensure that that parental competence can develop as well as possible, so that parents have a good understanding of how they can lovingly guide their child into adulthood. When parents dare and are able to explore what they missed in their own childhood (with some therapeutic support if necessary), it usually helps enormously to understand why some things in life are so difficult. If they do that before the birth of the first child, that is of course beautiful, but it is never too late to increase your insight. Understanding the difference between reacting impulsively from a trigger on the one hand and responding intuitively from awareness on the other hand is the essence. For that you have to dare to look at those own triggers, as well as at the explosive charge underneath. That is a big, but crucial task for adults.

We talked a bit further about the details of what she had been reading. I know this colleague as a very involved lactation consultant. I was pleased to hear that she felt so much resistance to the child-unfriendly suggestions and that she felt the question about the power relationship bubbling up. What I regretted was that in 2023 lactation consultants (and also other healthcare providers, for that matter) are still being given this kind of advice. From neurophysiology and interpersonal biology, we now know an incredible amount about the impact of disconnection from the child on brain development. Ignoring, threatening, neglecting, punishing, intimidating… they leave deep traces in the stress landscape of the body. They are not trauma sensitive at all and do not do justice to the child’s complete dependence and need for authenticity. Given the state of present day science, such practices do not (or no longer) belong in youth health care advice.
I hope that the colleague receives satisfactory answers to the questions she has asked and that she nevertheless keeps having the courage to put a child-orientated approach at the heart of her own work. Knowing her, I have every confidence in that!