It is a really tense time here in NYC and all over the U.S. and worldwide. It seems everyone is anxious and the tension is palpable. This is understandable, it is election night....
By the time you wake up and read this (as if...of course reading this blog is the first thing you do), we will know the outcome of what feels like the most alarming election in history. I am having Brexit flashbacks which prevents any sense of being smug that nothing this disastrous a choice could happen in my OWN country. For now, for colleagues in NYC and I, there is nothing to do but wait.
Back in the parent infant NY scene, there is so much to tell you that it is hard to know where to start. Maybe some reflections following some excellent clinical teaching? Apologies in advance for the jargon. I have included some links to explain the psychotherapy speak.
Last week I attended a fascinating 2 day seminar in 'Mentalisation in Psychotherapy' (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816926/). This was at the New School http://www.newschool.edu/nssr/ and facilitated by Drs George Downing and Howard Steele. It helped me grasp far more about using the concept of Reflective Function (RF) http://www.tandfonline.com/doi/abs/10.1080/14616730500245906?journalCode=rahd20 and how to enhance this in parents. By the way, this is the RF manual I didn't realise we can get it online! http://mentalizacion.com.ar/images/notas/Reflective%20Functioning%20Manual.pdf.
The seminar used video a lot and I love this as it brought it far more to life for me. Howard Steele was joined by Miriam Steele. As they both spoke the room lit up and I felt blessed to be hearing this RF concept from 'the horses mouth' that is, from a people who coined this idea.
I wanted to hug them (I restrained myself). It was worth coming all the way to NY just to hear concepts explained so clearly, concisely and with such direct clinical applications that I could just imagine walking back in to see one of my families and supporting them with thinking about their own and their baby's mind.
Howard at one stage explained, 'RF is a synonym for resilience'. I am still thinking about this. If secure attachment in the parent is a function of the capacity for reflection about ones own life (as measured in the AAI http://www.psychologyconcepts.com/adult-attachment-interview-aai/) and this is predictive of secure attachment between baby and parent, then the heart of the success of our work with many families is about increasing RF.
This led me to question, taking away all the clever concepts, what do I believe are the essential ingredients for this? To make this simple and common sense let's imagine a mother with a new baby feeling very vulnerable and sitting in the the therapy room. This is what I think she would say:
1. Think about me, show me compassion, show me that you really care and that you can think about my possible mental state. Only then can I learn about doing this for my baby.
2. Help me stop feeling so fearful and to slow down. Help me know that my baby has a mind and to understand what is going on inside my baby.
3. Show me what I am doing okay with at the moment and build on my strengths. Right now, please don't make me feel worse about myself as I will not be able to reflect any more (my defences will come right up!). I want to know what I can do more of to get better and better at this parenting thing.
I wonder do other people agree with these as the key essentials? Are there more? I am really curious about what other parents and/or clinicians would say.
This is a new way of thinking to me, although I have worked with 'reflective practice' for years. Your example is beautifully expressed, in a way that I can work with. I will use it when I am consulting.
Across the world, and in NY I am sure, people are reeling in shock at the Trump news. It makes the work you are doing even more important. Carry on carrying on!
Hi Sarah, that's great that the RF concept could be useful when consulting with your patients - thank you for that! Do tell me more about this, how you would use it or if you have tried this in your surgery and the outcome..
You are right there are so many shocked, angry and sad people here in New York. I feel desperately sad when talking to the 0-5's practitioners who are worried about the vulnerable families they have begun to reach. They wonder how quickly the advances made under Obama (and all of their hard work) will be put into reverse.
There is some small comfort in hearing the independence that a state and a city like New York has. For example, the wealth on Wall street and level of philanthropy here could mean that some of the excellent advances in providing healthcare could be continued by specific donors. That is the best I can think right now. That, and the strengthening of everybody's resolve to pull together and work even harder to make sure our babies are born into a fairer world than this.