!!!!!*****WORKING DRAFT*****!!!!!
This time, I felt centered enough to write back. I’d stopped making copies of my letters to Mike, all I remember is congratulating him on finding someone with whom to share this part of his life. Then I went on to describe my own journey, leaving out any hint of other men. Not that there were any then.
At Beth Israel I started up with guided therapy, seeing a few clients in the clinic there. At first, listening to their sad tales of rejection, remorse, and general confusion, I felt awkward, inadequate, and a bit of a fraud. After each session, I’d de-brief with my instructor, Dr. Theobald.
“I’m not sure I have my own head together. What right do I have to help someone else?” I asked after my first independent clinical encounter.
“You must remember, these sessions are not about you. You are not sharing your life, your own feelings, with these people. You are first of all reflecting back to them a dispassionate picture of what you hear, then guiding their thoughts toward a constructive solution to whatever is troubling them.”
The rules for that were simple to say, but hard to apply. “Listen. Reflect (repeat). Question non-directively. Guide towards positivity.” Confining myself to those tasks, I gradually learned to stay alert, attentive.
Looking back at that first month, I realize I learned everything I needed to become a therapist. The remainder of my training, and beyond, have been devoted to refining those insights.
“How do I know what her problem is, how do I decide on her diagnosis?” I asked my instructor.
“They tell you, they always tell you,” he replied with a courteous smile.
“What do you mean, how can they know?”
“I start by asking, ‘How can I help you today?’ Almost always, the first thing they talk about is your answer. Let them guide you to their problems, their concerns, don’t try to second guess them. What did she tell you today?”
“She can’t work, take care of her kids, and get enough sleep. It’s ‘making her crazy.’ Doesn’t seem like a mental health problem.”
“It is if she thinks it’s making her crazy. Where did you go next?”
I tried to remember the conversation, thinking maybe I should have taken notes. “Um, I asked about her work, what kind of work she did.” Dr. Theobald frowned almost imperceptibly. “That wasn’t right?”
He smiled again. “Well, it probably would have gotten you there eventually. But I like to reflect back to them what they’ve said, see if they can expand on it, fill it out a bit more.”
“How do you do that?”
“A little trick I use, is just repeat back to them what I hear as their key thought, maybe trigger a deeper response. In this case, I might ask, ‘It’s making you crazy?’ Recognize, acknowledge what’s hurting, why they came to you for help.”
That year, I finished up my work with Drs. W & B at the CDU. Once we’d submitted our paper on regional anesthesia and newborn behavior, and finished the data gathering for early mother-infant reciprocity, Barry had an evening meeting at his home one weekend to discuss the next project.
“I feel confident we’ve shown that even two-week old infants have a built-in understanding of social interaction. They may not be able to talk, but it’s obvious they have feelings about their caregiver, usually their mother. They not only feel and respond, they also attempt to guide and control the relationship. How they move, vocalize, where they look, their facial expressions – all of these seem hard-wired from the very start, meant to capture and retain the attention of other people. Probably because those who don’t have this capacity were selected against. They can’t get any food, water, anything, unless someone else gets it for them.”
Lauren looked around the group, nodded at me, and asserted, “It works both ways, doesn’t it Barry? Mothers must have the same feelings, the same orientation, right from the start. I remember my own babies…labor hurt so much, first the contractions that never seemed to end, then the pushing and pushing and pushing, and stretching – it was so exhausting, you’d think all I’d want to do was lie back and sleep.”
“Sleep?” I reflected.
“No, all I wanted was to look at, to hold, to feel them, right from the start. I wanted them to look at me, to smile at me, so I smiled, and laughed, and…” she misted over with the memories. “Sorry…I’m sorry. It’s just so…”
Barry smiled, saying, “No, thank you, Lauren. You just gave me an idea where we ought to go next.”
Where we went next was to upend the reciprocity study. We brought in seven more mother-baby pairs to our little curtain-lined dual video tape set-up. Two we saw six times, for longitudinal date. Three we saw twice, and two more only once. Each time, we recorded two 3-minute interactions, separated by 30 seconds. One of those was as before, simply letting the mother and baby interact as they normally would. The other, we asked the mom to sit still, stone-faced, and observed the baby’s actions.
The differences were striking. One of my little essays for an “entrapment” session felt like I was writing a horror movie script:
“…He arches forward, slumps over, tucks his chin down on one shoulder, but he looks up at her face under lowered eyebrows. This position lasts for over a minute, with brief checking looks at the mother occurring almost every 10 seconds. He grimaces briefly and his facial expression becomes more serious, his eyebrows furrowing. Finally, he completely withdraws, his body curled over, his head down, He does not look again at this mother…rocking his head. He looks wary, helpless, and withdrawn. As the mother exits, he looks halfway up in her direction, but his sober facial expression and his curled body position do not change.”
Overall, the differences were striking. The infants smiled less, spent less time oriented towards their mothers, looking at them much less often, ending up slumped down in their seats, withdrawn and, I surmised, filled with existential dread.
Barry was more upbeat about the results. “This confirms infants are active participants in their most early relationships. They alter their behavior depending on how they are treated, They understand the rules of social interaction from the time they are born, maybe even before. They don’t yet have words, but they most definitely have a language, one they can speak and understand. They use those ‘words’ to manipulate their environment, specifically their relationships.”
I found myself saying, “It’s not only words, Barry. It’s feelings, too. They have them, express them, and understand them in their mothers, no? Feelings go along with, maybe even come before words.”
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