GOLDen opportunities for learning about the early years

Conferences… Ever since I was an experienced volunteer breastfeeding counsellor (somewhere around the last years of the previous century), I have been eager to increase my breastfeeding knowledge. I upped the ante once I decided to become a lactation consultant IBCLC and in the years after, I got totally hooked on attending lectures, conferences, symposia and whatever kind of training I could reasonably take part in. Such a wealth of experience was out there! Once you are an IBCLC, you have to collect CERPs, Continuing Education Recognition Points, to prove that you take care of remaining up to date with the most recent insight from science, the latest developments in the field, and the most important aspects of ethical practice. In 2008 or 2009, I discovered the GOLD Lactation online conference. In those years, GOLD, as an acronym, stood for ‘Global Online Lactation Discussion’. It was a great way for IBCLCs from all over the globe to attend high quality lectures, even if their own nations hardly offered any training opportunities because there were too few IBCLCs in the country to organise that in such a large-scale and impactful way.. With a stable internet connection, everyone could attend GOLD and get to know colleagues far away, working and learning together  on the very same topic! Such fantastic value for money!

I remember how excited I was each year, and how I carefully planned a couple of days without any other obligations. In those days, there used to be three live time blocks, spread over only two or three days: a morning block, an afternoon/early evening block, and a night block, so as to facilitate all time zones! We used to share about our circumstances in the chat, such as being awake as the only one in a silent, nightly house, while others had just dropped off the kids at school or were cooking the family evening dinner. We would joke about GOLD Lactation being the only conference where you could show up in pyjamas with a blanket wrapped around your shoulders and a hot tea or a wine to keep you awake! A one-hour lecture, a one-hour interval for some after-chat, a bathroom break, and a drink refill and… on it went! There would be four or five lectures in a row and I would preferably attend all of them live in those two days, so as to have the benefit of asking questions and exchanging with colleagues. Afterwards, I would make a selection of the ones worth listening to a second time. In those years, I also took up the role of the Dutch group coordinator; this year again, 2021, I was able to register a beautiful group of colleagues wanting to follow GOLD Lactation and we enjoyed many good speakers once more.

Several times, I gave a short presentation myself in the Cultural and the Hot Topic-sections, addressing characteristics of the Dutch breastfeeding situation. Online conferences weren’t as common as they are today; GOLD providing such a possibility to attend trainings was still quite new and we were always amazed at how smoothly the whole technical part went. Not much has changed there – the technique is still a wonderful part of how GOLD works! Therefore, I’m really pleased and excited to be part of the upcoming Early Years-symposium! The GOLD Learning Early Years Online Symposium 2021 is a brand new event created specifically for healthcare professionals working with families with children ages 0-3 years. It takes place live on October 4 & 5, and includes 6 speakers sharing the latest research on early childhood brain development, the importance of healthy relationships, and the impact of healthy childhood environments. I will have the honour of being one of those six, with one of the others being Robin Grille. I looked up my notes from 2010, when he spoke on ‘Attachment, the Brain… and Human Happiness’. A few great lines: ‘Long before there is a vocal language, there is body language’, ‘The amygdala thinks much faster than the rational brain’, ‘The heart is more and more thought of as the second brain’, ‘Answering dependency creates independence and autonomy’. Robin ended by saying: ‘I dedicate this seminar to a better world!’ What inspiration we can get from listening to one another’s wisdom and paying it forward! GOLD does a great job facilitating this and bringing people closer from all corners and walks in life.

An important aspect of Robin’s presentation in 2010 and of the latest insights in neurophysiology is that breastfeeding is part of a wider, more vital process, namelijk attachment-focused parenting. There is no artificial substitute for responsive, compassionate connection between infants and their adult caregivers. Therefore, my own presentation this year, ‘Building Strong Children: The Power of Buffering Protection Through Responsive Parenting and Caring Communities,’ is full of information on the power of Positive Childhood Experiences. I’ll be speaking about reframing conversations to focus on caring connections that promote healthy brain development and stress regulation. I will also deal with the differences between a pathogenic and a salutogenic approach in healthcare and in life more general: do we focus on what to avoid to prevent falling ill… or do we focus on what to seek out in order to remain healthy? And what is the role of power relations in all this? You are invited to join us and learn about the impact of loving relationships, why humans actively try to connect with others, and how we can support the development of lifelong resilience. I’m thrilled to be speaking on this important topic and I hope you can be with us! Registration is open and includes both live and recorded access to all presentations: . See you there, maybe!


A new season!

It’s September already! Summer is (almost) behind us, although it looks like we still have some sunny days ahead of us. We hope that you were able to relax, that you could find some quiet time alone or with your loved ones from everything that demanded your attention and energy in the past year, and that you have beautiful things to look forward to!

At ACE Aware we are also going back to work. We’ve got a few more special interviews lined up that deserve to be fleshed out as soon as possible, so that the wisdom the interviewees have shared with us becomes available to you!

For example, we spoke with Bertus Jeronimus, who works at the Faculty of Behavioral and Social Sciences of the University of Groningen (RUG). There he studied clinical and developmental psychology and Dutch law and obtained his PhD on research into the interaction between personality and life events. He is currently working on a better understanding of personality and how people experience their well-being. We spoke to him based on his article about ‘The (un)happiness of a corona generation’, in which he draws attention to the fact that close proximity is a necessity for young people. He mentions that a lot of pain among young ones causes damage that you do not immediately see and that is therefore underestimated.

We also interviewed Jessica Boerema, also in Groningen. From her own practice ‘Contact in beeld’ (‘Contact in view’) she provides training courses to parents and professionals to create more insight into the importance of effective communication with young children at difficult moments. Communication in which you as an adult understand the baby or young child well and learn to decipher the signals, helps enormously to ensure that a baby feels safe and develops trust in the world. That is of course a wonderful way to support a child’s resilience from an early age.

In Amsterdam we met with Beatrijs Smulders, well-known author and midwife. She has played a prominent role in midwifery care for the past four decades and is a passionate advocate of home birth and an innovator at heart. Nowadays she no longer supports labouring women in childbirth, but provides personal guidance and advice in the field of women’s affairs through consultations. She has helped thousands of mothers and fathers get started in parenting over the course of her career and has developed idiosyncratic views based on her professional experience, combined with scientific insights. In short: a fascinating discussion partner, with ideas that invite and challenge you to think more deeply!

There are also some special professionals who said they would like to be interviewed, but with whom the date has not yet been set. We will also follow up on this shortly. Are you working in healthcare, education, the judicial sector or are you a professional who works from a trauma-informed approach? We would love to hear from you and perhaps set up an interview!

In addition, there are interviews with people who have lived through adverse experiences while growing up. We honourably call these ‘people with the lived experience’, people who are experts, because they have first-hand knowledge of what the impact of toxic stress and trauma can be. Of course we can’t share their names, but that doesn’t make their stories less important. In fact, it is those stories that are at the heart of the work for ACE Aware NL; they show how early experiences affect later life. When people look back on their youth in a phase in which they have been able to take a little more distance, many things sometimes come to the fore. Also, sometimes it is confronting to face aspects of that life stage when they have to make choices in their parental role. The needs and individuality of their own children can sometimes be very confronting. These can raise questions about what it was like as a child to need your parents’ support and not get it, or to feel like you were not seen and were hardly ever ‘good enough’. That can release a lot of grief. That grief can look like anger or frustration or impatience, but at the core, the pain and the feeling of insecurity and loneliness are often underneath. And what do you do in that case…? Do you manage to be kind to yourself? Do you allow yourself time and space to talk about it with a loved one? Do you have a social environment available paying attention to you where you can safely be vulnerable? It can already help if you know that you are not alone in your grief and that it can be liberating to talk about it, especially when parenthood is imminent or has just started. We will also give concrete form to this aspect this year by setting up meetings.

At the beginning of October, Marianne Vanderveen-Kolkena will give a presentation for GOLD Learning on behalf of ACE Aware NL in the Early Years symposium. Among other things, she will talk about the difference between avoiding risks and looking for beneficial aspects of human life, or, put differently, the difference between a salutogenetic approach (what do we need to stay healthy?) and a pathogenetic approach (what should we avoid to not get sick?). It will also be discussed that health is not an individual matter, but is socially constructed and is therefore the result of the interaction between the environment and the individual. Furthermore, the idea of ‘adult supremacy’ will be looked at, the idea that adult interests often outweigh the interests of the dependent young child that is still fully developing.

In short: there is a lot that we will work on!
During the holiday period, some themes took shape in a more creative way and we are happy to share a photo with poem with you.
Enjoy the reading and we look forward to meeting you somewhere, live or online!

The importance of our use of language

This week, we would like to talk about an important topic, namely the way we use language when we discuss certain themes, especially around health issues.
The importance of language and its influence on how people perceive or understand a topic or a concept was first consciously and piercingly brought home to me by Diane Wiessinger with her article ‘Watch Your Language’. Years later, another beautiful talk on the topic was given by Karleen Gribble. Both women speak about breastfeeding as the biological norm to feed babies and how breastfeeding is instead often described as ‘healthier’ and ‘lowering risks’ and ‘increasing intelligence’. This comparative shows that breastfeeding is compared to something else, which is apparently considered the norm, although not explicitly. The hidden norm in these kinds of wordings is artificial formula. When we speak in terms of ‘breast is best, is the gold standard, gives improved outcomes and enhanced development… we imply that breastfeeding is the ideal, offering all kinds of extra benefits. Because no one is perfect, however, the normal (or the hidden norm) is formula.

Last year, in August 2020, Diane Wiessinger gave a presentation in which she delves even more deeply into the ‘watch your language’-idea. She explains the basic rules of science, such as the difference between the control group and the experimental group. The control group is the group that has the normal biology and has nothing done to it. It is never the focus of the study. The focus is always on the experimental group, the one that gets an intervention, has something done to it, and then shows a variation, a deviation from the norm of the control group. It is in statistically describing this variation that using the wrong norm gets really tricky. Look at the image below.

If we say that healthy practices reduce the risk of something by 50%, we in fact say that unhealthy practices increase the risk of that something by 100%! In other words: the numbers in the message given to the reader or listener, depend on what norm we use. Researchers, policymakers and healthcare providers probably do not intentionally try to give a deceiving picture of certain risks, but that may nevertheless be the result of the way the language is used. This turns informed decision making into a very difficult process. Therefore, the mechanisms of wording in a specific way require some solid philosophical and ethical thinking with regard to what we consider the norm in a specific field and how we, subsequently, speak about it.

In this context, it is interesting to look at how we talk about adversity in childhood and about trauma in general. When we say that secure attachment reduces the risk of problem behaviour, we have insecure attachment as our hidden norm. When we say that proper coregulation lessens chances of having a toxic stress response, we have lack of good coregulation as our hidden norm. When we say that compassion increases empathy and resilience, we have their absence as our hidden norm.

How come, that we often tend to use wordings like these…? It probably has to do with the fact that wording it the other way around can be perceived as very uncomfortable. Saying, for example, that coldness (or lack of compassion) jeopardises the development of empathy and resilience can feel much more confrontational. It points to where we fall short and what the nasty consequences of that shortage can amount to. It has a much bigger potential of holding us accountable, thus revealing our responsibility and likely also shaking up the status quo of cultural practices and power relations.

With regard to childhood adversity (or ACEs), we could do a thinking exercise to come up with a biological norm. Taking insecure attachment, insufficient coregulation and lack of compassion as the (hidden) norm, offers a pretty sad view of normal human characteristics. As the saying goes: ‘Humans are hardwired for connection.’ Human babies come into the world with a prosocial inclination: they actively seek out positive relations with others. It is their innate tendency; only this way can they survive. It is through social connection that they develop from healthy infants into healthy children and adults. All through humanity’s evolutionary history, humans survived because they were able to offer one another security through close connections, meaningful relationships with caring others, and thus a sense of belonging and purpose. Without all this, humans cannot survive, let alone thrive. Reciprocity is society’s ‘social glue’. Based on our mammalian heritage, we can therefore safely say that connection and feeling safe and secure are the norm for survival and healthy social relations within communities.

This means that if we want to convey a message about health risks, we should subsequently mention the risk of *lack* of healthy social relations. And if we notice that different forms of structural violence, such as poverty, racism and other inequalities endanger abundant relationship building, we should label those phenomena as risk factors or social determinants of ill health. As confrontational as this may sound… wording it this way prevents the unfair, unethical hiding of the wrong norm in terms like ‘advantages’ and ‘benefits’ of the opposite. Ethical, scientifically sound wording (focus on impact of intervention/experiment) can bring us, as a society, closer to an understanding of what we should stand up against and what needs to be changed. After all, the primal precept in healthcare is ‘First do no harm’, or, originally: ‘Primum non nocere’. Naming what is harmful, facilitates tackling it. Not naming it, is unethical, deceitful withholding of information. Calling toxic stress or too many work hours or letting babies cry-it-out risk factors, points us in the direction of how to eliminate or reduce the risk. Comparing different practices in scientific research or policy settings is of course necessary to find out where the risks are. Then again, when we have conversations in other social environments with one another, we could also decide to not compare at all. As the visual shows, we can choose to represent a concept by being descriptive in explaining it, not comparative. It might help to become more aware of the fact that life is not a competition, where all is constantly compared to something or someone better or worse. It helps to prevent polarisation and can facilitate placing processes on a continuum instead of in a black-and-white either/or-category.

In any case, the point clearly seems to be this: whenever we use a comparative in our language, we have consciously or unconsciously decided what our norm is, our reference point, the default value. Which situation or behaviour do we consider the norm? What do we see as the essence of human interpersonal connection? It can be very revealing to reflect on this and if we need to choose a norm, to do so consciously and carefully. As Diane says: ‘Everything changes when we change the norm’, including how the media reports on health risks. To consistently use a valid norm in our language can be a challenge, but it can definitely be learned. Why try? Because, as we learned from Diane Wiessinger, our language matters and we honestly need to watch it!

From Childhood to Life Happiness – our questionnaire, Part 2

In last week’s blog, we made a reminder note and started to look at the first insights from our questionnaire – ‘From Childhood to Life Happiness’. After dedicating some thought to certain interesting demographics, we talked about how people tend to perceive and remember their childhoods, what makes childhood a favourable or rather a more sad experience overall, as well as which specific events or periods of time seem to weigh most heavily in the long-term. This week, we are following on that thought, asking ourselves what links do people identify between their childhoods and current selves, between their past and present. 

To begin with, all but one of the respondents identified a clear connection between their childhoods and the main current themes of their lives. The picture seems clear and powerful. Loneliness and a lack of connection in childhood seems to be linked to a burning desire of belonging and integrating into the surrounding social circle. Constant insecurity and lack of safety seems to lead to a persistent feeling of doubting one’s actions, immature reactions to daily stressors and seeking safety in the presence of others. Sometimes, people become painfully aware that their childhood trauma somehow leads them to recreating around their children the exact same sense of insecurity that was so difficult for themselves. A lack of recognition and space to show themselves might lead people to feel a lower state of energy in life, and a sense of ‘being too much’ around others, hence a tendency to close inside more often than not. 

Consistently, these themes are reflected in the daily life difficulties that people find themselves in. What our respondents mentioned with regard to this, is: not having faith in oneself or others and finding it hard to let go of people; experiencing fear of failure, insecurity and trouble in setting one’s boundaries in relation to others; having a generalized lack of confidence and not feeling good enough; or feeling a sense of depression. Sometimes, such difficulties either turn into or are accompanied by their first-grade cousins: bad habits. So far, it seems that bad habits can be put into two categories: socio-emotional habits; and substance-related habits. From the first category, people tend to ‘draw a wall around’ them and ‘play nice weather’, avoid hard situations in the workplace by quitting and fleeing ‘out of the blue’, panic easily, act too defensively, or are not able to handle critical feedback well. From the second category, ‘same old, same old’ – a lot of smoking, alcohol or drugs, used either recreationally or abusively, often starting at a young age and later on falling back into old patterns. A common thread across all of these? A reminiscent echo of insecure attachment.


Still, as we move towards the end of our questionnaire, the air in the room seems to change a bit. It becomes more fresh, more light, more positive; it brings hope to the table. It reminds us of a central pillar across all of our work and other ACE-related work: resilience. People often find unexpected sources of strength to survive, and hope is hard to beat. Despite the difficulties and life stories described in a nutshell above and last week, people generally report a state of ‘okay’ health, some better, some worse. It is true that chronic illness seems to have often settled in (once again strengthening the reported link between ACEs and chronic conditions), and feeling ‘ok’ is not really an ideal scenario of how we would hope someone to rate their health. Even so, people find sources of happiness and meaning, whether it is one’s children and grandchildren, dogs and other pets, the process of creation, being in nature, reading, enjoying music, cooking, volunteering or other forms of helping others and sharing one’s knowledge, connecting with people and sharing their stories, or the realisation that one has the power to break a ‘destructive family chain’. People go through (often long, complex and difficult) processes of healing. In one form or another, whether it involves therapy of any sort or not, people learn to develop strategies to live with chronic conditions. They find peace of mind somehow, and use their abilities to reach a fulfilling life. It does not always work and the road is tough, but these stories brighten our day and mind greatly. 

As one of our respondents put it, by managing to “break the cycle of trauma (and go through) a lot of work on myself, I am finally being able to understand my past and accept it”. Understanding, accepting, healing – not a bad way to put it.
Let us end on that note, with the awareness that we can all facilitate our fellow humans going through these stages if need be, by nurturing connection, by showing compassion, and by building the courage to listen to those life stories, as hard to hear as they may be. Noone is ‘beyond repair’, beyond any degree of healing. Our sincere, non-judgmental curiosity and understanding can create exactly that space for personal authenticity that people felt was lacking in their childhoods. If, through connecting with compassionate others, they can finally reconnect to themselves, if we can stimulate people’s perception that they do belong, they can finally grow towards feeling that deep sense of belonging in their own lives. 

From Childhood to Life Happiness – our questionnaire

For this week’s blog, we would like to have a first ‘dive’ into the initial responses to our ACE Aware NL questionnaire ‘From Childhood to Life Happiness’, that we introduced in this blog and that can be found at any time here. With this occasion, we would also like to reach out to those of you who didn’t have the chance to see it yet, because we think it offers both a very good opportunity to reflect for any of us, as well as a valuable source of interesting data for research around ACEs.

With an average age of 45, our respondents are both from within the Netherlands, and outside, both raised here, and not, and both settled in the region for generations, as well as second generation Dutch citizens or expatriates. In other words, we are in for a treat – a properly mixed participant pool.
Is that so? One interesting detail is that so far in our small sample, 100% of our respondents are women. What might that tell us? Is our audience mostly female, or the ACE-science in general reaching more women? Are women more willing to talk about personal issues? Are the men in today’s society (at least in the Netherlands) taught to play ‘tough’ and avoid disclosing emotional stories that are sometimes deeply rooted in childhood? Or is it just a coincidence, so far? We don’t know yet, and we will have to see along the way as the responses come in, but we find it an interesting element to ponder upon nevertheless.

As we dive in a bit deeper, things start to get…well…messy. A first glance at how people remember their childhoods gives a strikingly troublesome image: neglect, abuse, bullying, loneliness, complicated family relationships, loss of a dear one, problematic sexual experiences, lack of safety, lack of emotional support… and the list goes on. It’s almost like reading a presentation on ACEs, or a description in a trauma-informed manual. Except, these are not book descriptions – they are real life stories that we read first hand. Immediately, the question comes to mind – is this a skewed representation, meaning that people who are interested in our material tend to be more involved in or oriented towards this topic and implicitly tend to have lived more troublesome childhoods? We are aware that painful experiences may be why our respondents participated in the questionnaire in the first place, so that their stories may be heard at last. Or, is this a hint indicating, as others have pointed out, that unhappy, traumatic childhoods are much more common than we dare or can bear to imagine? Again, we don’t know, and we will have to keep analysing more data as more people start to fill out the form and share their narratives with us. This first impression, however, once more feeds our curiosity for the topic; it also strengthens our compassion for all those among us who, often invisibly, carry with them the scars from their early days. What should be a carefree life stage, a happy past nourishing a fruitful future, is clearly still a triggering and often unsettling present for many.

And then, what are the threads, the moments, the experiences that leave the strongest marks, and stick in our memories and bodies forever? What are the defining characteristics of childhood that are formative for the development of a person? What do people point out first, when ‘caught off guard’ and opening up in their vulnerability? Well…it depends. Sometimes, it is a one time event, like the birth of a sibling, the death of a parent, or an illness in the family. Other times, it is a transitional period, like learning how to breastfeed, figuring out how to deal with strong feelings and life challenges, or even the time spent in the mother’s womb. Sometimes these events also play a role in making the perception of our childhoods good or bad, joyful or traumatic, a pleasant dream or a nightmare. Often, a common narrative seems to be, perhaps not surprising at all, the emotional environment in which the child grows up, the quality of parent-child attachment: a toxic relationship, a perceived lack of love, persistent bullying at school without any buffer at home, or, moving to the other side of the spectrum, making a parent enjoy your milestones, feeling emotionally understood and listened to, a good ‘life energy’ being instilled from the start. Whatever the case may be, one thing becomes clear – life stories cannot and should not be considered a mere collection of consecutive events to be treated as numbers in a statistical pool – they are much more than that. It matters how people feel all the way through their life journey, starting in early childhood. These are biopsychosocial processes doing their neurophysiological work: they have the worrying potential to build a road from a lack of feeling safe and secure in childhood to a difficult life in adulthood.

Next week, we are going to address exactly that, the link between childhood and adult life, between the past and the present. These links only come to light because of your insights and stories, that we appreciate deeply. Therefore, until then, if and whenever you see fit, feel free to have a look at our ‘From Childhood to Life Happiness’ survey and know that we welcome you to fill it out. Thank you in advance for doing so or for sharing the link with others who may be interested!