Recently in my role as faculty with the University of Massachusetts Boston Infant-Parent Mental Health Program I had the privilege to learn from Erna Blanche, a leader in the field of occupational therapy who trained with Jean Ayres, the mother of sensory processing theory and sensory integration therapy. She described the connection of movement with many different sensations: body position, internal workings of our bodies (interoception), and even the pull of gravity. A number of the fellows, who come from a wide variety of disciplines and from all over the world, expressed a wish to "be an OT in another life." Since I first became aware in my journey from pediatrician to infant-parent mental health specialist of the depth and breadth of knowledge in the field, I too have had the same thought.
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A great teacher once said to me, “Reassurance is an assault.” When a parent worries something is wrong with their child, reassurance that “everything is fine” can feel dismissive, producing a sense of being misunderstood and alone. Behind the worry lies a story. With protected time for listening, meaning can come to light.
Recently I was asked to give a presentation for an audience of early childhood educators about the Adverse Childhood Experiences (ACE) Study. I jumped at the opportunity to frame this powerful research linking early adversity with long-term health consequences into a message of both hope and action. Thus I was particularly pleased to receive an email from an audience member with the following message: "Thank you for your work, the workshop left me with hope. It makes me think of tikkun olam." I looked up this familiar phrase from Judaism to find its exact meaning: "World Repair."
After a few moments Kayleigh broke the silence. "This is what she does whenever we talk about food." They now saw the fear in their daughter, but when I asked how long this fear had been present, Charese immediately thought of herself. She said softly, "Since she was born." For Charese and Kayleigh the terror we saw in Alana connected directly to their own memory of terror that their daughter might die. The feeling now expressed in Alana's behavior held a grip on the whole family. The therapy setting allowed us to slow the process down.
Now over a decade since my therapy ended, I understand that its enduring impact on my emotional wellbeing lies not primarily in the story I told in words but in the countless moments of moving from misunderstanding to understanding strung together over time. The microscopic mismatches in interactions contained in the office space, the larger disruptions of days between appointments and vacations, as well as some massive ruptures, including the forgotten appointment, all contributed to the process. They changed the nature of my sense of self and my relationships with people close to me.
Repair Theory has significant implications for treatment of emotional suffering. It offers a model of mental health that differs dramatically from the medical model of mental illness. Rather than being fixed, our emotional wellbeing evolves in a continuous process over time. Early interactions lacking in robust repair create meanings of hopelessness that lead to emotional suffering and derailed development. New sets of relationships with different quality of interactions can promote healing and growth across the lifespan.