Confronting Terror: The Power of Human Connection

of 2020, we were all collectively faced with an invisible yet terrifying threat. The group including fellows, faculty, and luminaries held each other over countless messy moments of uncertainty and loss. The result was a profound sense of connection and trust that fueled the explosion of creativity brought forth in their work. The impact will change the lives of infants and families throughout the world for years to come.

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“Just Because It’s Hard, You’re Not Doing It Wrong:” Learning from Babies and Parents

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.

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A Child’s Tantrums: Beyond the Dominant Narrative

A powerful new model named “At The Feet of Storytellers” was presented at the Zero To Three annual conference in October. Rooted in investigation of thoughts, observations, and experiences of African American families, the model of “Early Relational Health Conversations” puts time and space for non-judgmental listening at its core. A pilot study of implementation in pediatrics practice showed significant impact, with publication of findings forthcoming. Intentionally not a “screening tool,” it places the clinician literally on the floor, to learn about strengths of the family system and identify vulnerabilities and needs.

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Listening to a Young Family’s Suffering

In in my role as faculty of the University of Massachusetts Boston Infant-Parent Mental Health program. I recently listened to a presentation by Dr. Barbara Stroud in which she placed caring for young children and their families in the context of systemic racism. Describing “voices that have been silenced” she cautioned us to “stop talking, teaching, and intervening long enough to listen.” When a month later Dr. David Willis spoke for the same program about Early Relational Health, he put my struggle with both “screening” and “assessment” into a new and interesting frame. Alluding to their judgmental nature, he looked at these constructs as “white dominant cultural products.” He spoke of the need to attend to power dynamics in supporting relational health with a model of promotion and prevention. His language resonating for me with the idea of protecting space to listen from a place of not knowing; to take time to imagine our way into another persons’s experience.

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The Opioid Crisis: A Vicious Cycle of the Quick Fix

When a pill is the primary treatment without attention to the full relational and social context of individual suffering, people remain stuck in patterns of disconnection and harm. We see a downward spiral of intergenerational trauma and loss tearing apart the fabric of our society. One can argue that this is true of both physical and emotional pain.

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Cultural Humility as Listening: The Power of Not Knowing

As a physician in training, I learned the concept “cultural competence.” The term suggested that by acquiring knowledge and information we could become experts in people different from ourselves. The current term “cultural humility” reflects a kind of humbleness of not knowing; a necessary time when we feel awkward and uneasy.

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Celebrating Pediatricians’ Embrace of Early Relational Health

The Frameworks Institute (that also developed the term “toxic stress”) wrote in a recent report: “Early relational health, although a new term, does not designate a new field nor a series of new discoveries. In fact, early relational health builds upon decades of research from the fields of child development, infant mental health and neurodevelopment that has established the centrality of relationships between caregivers and very young children for future health, development and social-emotional wellbeing.”

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A Child’s Joy in Growing Up: A View from the Pandemic

Typically, the process of separation of child from parent takes place both gradually and relentlessly. The pandemic put a long pause on this natural progression. As we begin to resume “normal” life many will manage re-entry without significant difficulty and get back on track. But for those with a variety of vulnerabilities, the expanse of time to live in the ambivalence may lead to developmental derailment. Whether 2, 12, or 20 these children and their families will need an extra dose of listening and support to find their way forward.

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Creating Space to Discover a Baby’s Intentions

In a fascinating book Becoming Human, research psychologist Michael Tomasello sees the ability to recognize each other’s intentions as central to our humanness. He proposes that “the ontogeny of human cognitive and social uniqueness is structured by the maturation of children’s capacity for shared intentionality.” To highlight the significance of the process he writes: “Social Bonding via the sharing of emotions, attention, actions and attitudes is an evolutionarily novel phenomenon: individuals feel closer to others as they share experiences with them. This is foundational to virtually all forms of uniquely human cooperation and shred intentionality.” He names the age of nine months, when this behavior first becomes easily observable, the “birth of shared intentionality.”

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Sensory and Emotional Experience: Linked from Birth

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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