For the past several weeks I’ve had the privilege of leading a course in Community-Based Early Relational Health. My students come from a broad variety of disciplines- physical therapists, occupational therapists, social workers, home visitors, program director, among others. They are at different stages of their professional lives. One home visitor works with young adults who have recently aged out of the foster care system and are now parents of infants. What an opportunity to break the cycle of intergenerational transmission of trauma.
In addition to traditional lectures rooted in the developmental science of early childhood, the course includes experiential learning. We invite a family with an infant to join us for a 20-minute conversation via Zoom. These families are not patients. There is nothing “wrong.” They are simply volunteers. I invite them to share their story and let us get to know their baby. For my students the interaction serves to demonstrate what I refer to as “bringing in the baby.” Spot lit alongside me while 15 practitioners observe from their squares on the perimeter it offers a live demonstration of listening to parent and baby together. (As always, identifying information is changed to protect privacy.)
Towards the end of the first session, I asked two moms to share with the group one thing they’d most want them to learn. The mom who carried the pregnancy said without pause “to listen.” Reassurance in the face of her experience of physical suffering during pregnancy had left her feeling unheard and alone. She then expressed a wish that someone had told her breastfeeding might be hard. To which her wife wisely added “ Just because it’s hard doesn’t mean you’re doing it wrong,” Their 4-week-old son taught us more about the capacity of infants to communicate than days of lectures could convey. While his mother spoke, he locked his gaze on her. As she shared her doubts and worries, he told her with his facial expression and the relaxed tone of his body in his other mom’s arms, “I think you’re the greatest.”
The following week a family with a completely different set of experiences shared a similarly poignant message with the group. They described pressures they felt with their older child to tell the world he was a “good baby” when in fact he was often fussy and cried inexplicably. Mom vowed to be more honest this time. She wanted to meet what pediatrician D.W. Winnicott would have termed her daughter’s “true self” free from judgement or blame. She and her husband demonstrated for the group in real time the messy process of getting to know their baby’s signals as they learned how to help her when she felt- in their words- “overwhelmed.” We watched the baby relax into a deep sleep in her father’s arms as they spoke. I pointed out to her parents and to the group how the baby showed us with her body, “They know how to help me.”
One of my students captured the feelings of the group when she wrote in the chat a request that I share her experience with the family: “Please let them know I thought they were just amazing and wonderful in being so connected with their baby and so open and willing to meet her needs, even when it’s not easy.”
Healthy early relationships promote lifelong physical and emotional health. In contrast a lack of healthy relationships may result in a broad range of negative physical and emotional health outcomes. The disciplines that work with parents and young children are currently undergoing a rebranding of sorts. Typically referred to as Infant Mental Health or Infant-Parent Mental Health, there is movement from the Frameworks Institute and Center for the Study of Social Policy-guided by research in child development, infant mental health, and neuroscience- to use the term “Early Relational Health.” This change offers an opportunity to free the field from the deficit models of adversity and toxic stress. It offers a frame that can get to the heart of the processes that comprise a healthy relationship. For only by understanding what is “normal”- or the term I prefer “typical” -can we build a model of promotion and prevention. A frame of understanding rooted in healthy development can guide treatment of families when development has gone awry. This model has relevance for relationships throughout our lives. Simply taking time to carefully listen to parents with a young infant as they take us inside their moment-to-moment experience can be an important part of our collective learning.