Conference Key note Review: Professor Colwyn Trevarthen: The Lively Human Nature of Relationships in Family and Community

Professor Colwyn Trevarthen: The Lively Human Nature of Relationships in Family and Community

Review by Rachel Pardoe, Child & Adolescent Psychotherapist

Introduction

Professor Trevarthen delivered a fascinating presentation to the Video Interaction Guidance conference, full of natural vitality, humour, and wisdom gained from his passionate and dedicated research over decades into the capacities of infants for social communication. Trevarthen really does enable us to hear the ‘voice of the infant’. Listening to him, you feel the wonderment of what it is to be human, and the tremendous potential that we are born with for human, emotional connection with others. For anyone working with children and families, his work is deeply moving and inspiring. He makes you want to bring this joy and liveliness to all parent-infant relationships.

Working, as I am, in perinatal mental health with mothers whose life experiences and mental health problems have frequently resulted in them feeling cut off from their baby, unable to tap any pleasure or liveliness in themselves in relation to their infant, I felt a longing to enliven these relationships. I think that is why I am passionate about VIG: because through VIG, parents can become in touch with the ‘lively human nature of relationships’ Trevarthen describes.

What is VIG?

VIG is a strengths-based, video feedback intervention in which clients are guided to reflect on video clips of their own successful interactions. VIG is used as a therapeutic intervention with parents and carers of children across all ages.

VIG aims to enhance parental sensitivity and attunement. Kennedy et al (2011) gives a comprehensive introduction to VIG; Kennedy et al (2017) provides a summary of studies which have shown the effectiveness of video feedback with parents and infants.

VIG is recommended as an evidence-based intervention in the NICE Guidelines (2012, 2015), and is specified in the UK government-funded programme Children and Young People’s Improving Access to Psychological Therapies (CYP-IAPT).

Trevarthen’s Background in Child Development Research

Professor Trevarthen, now in his 80s, has been in the field of child development since the early 1960s. In 1965, he worked with Jerome Bruner (Professor of Psychology at Harvard University, and later Oxford University), one of the pioneers of the study of children’s cognitive development and learning. Bruner coined the term ‘scaffolding’ (Bruner, 1975), describing how the attentive presence of an adult, available to help the child when needed, is key to learning. Scaffolding is the core of the VIG principle of attunement, ‘Guiding’.

As early as 1966, Trevarthen was studying mothers and babies ‘chatting’, looking in detail at what was involved. Using high speed film which provided an accurate picture of body movements, it became clear that the baby was using the same rhythms as the adult, for example in ‘reach and grasp’ movements.

Trevarthen’s key contribution to child development is in the area of human intersubjectivity (Trevarthen, 1980). He referred at the conference to ‘stages in the development of companionship in knowing’, thus emphasising the intersubjective nature of learning and development.

  • Newborns   from the first day are able to engage in dialogues
  • 6wks-3mths ‘proto-conversations’ emerge which do not involve words but have many of the features of verbal conversations, such as turn-taking, and rhythmical pattern of looking and withdrawal
  • 5-6 mths appearance of games and ‘showing off’
  • 1 year sharing tasks, tools and knowledge

He mentioned Berry Brazleton (American paediatrician, and the developer of the Neonatal Behavioral Assessment Scale) who, Trevarthen said, demonstrated that newborn babies are persons. He added: the newborn “waits for bright company” – which I think is a lovely phrase.

Trevarthen and VIG

Trevarthen’s work is at the core of VIG. Inspired by Trevarthen’s work, Harry Biemans in Holland developed the ‘principles for attuned interactions and guidance’ (Biemans, 1990), which he used in his video home training approach. Trevarthen stated clearly at the conference his support for VIG. He referred to Catherine Bateson’s term ‘exquisite ritual courtesy’ to describe the mother’s proto-conversation with a two-month old (Bateson, 1979). Trevarthen suggested that this could be a motto for VIG, referring as it does to respect for others.

Trevarthen showed us the video clip (shown in the VIG ITC) of the Moroccan father providing ‘kangaroo care’ for his 3 month premature baby in NICU. Interestingly, this footage was filmed by a colleague of Harry Biemans. Trevarthen commented on the couple ‘sharing a conversation’. Measurement showed that the father is imitating her sounds accurately; the father and infant are sharing a rhythm of andante (0.7 secs), and sharing time with vocal expression – making up a story together. The spoken phrase in any language has a tendency for the last syllable to be longer; the speech of both father and baby corresponded to this norm. In addition the arm movements of the infant synchronise with the timing of human speech. Trevarthen also reported a study where the baby’s arm movements mirrored the rhythms of a Scottish lullaby.

Trevarthen mentioned Emese Nagy’s research showing that when the newborn baby imitates (eg tongue protrusion, or holding up fingers) the infant’s  heart rate increases. The baby repeats a gesture (‘provocation’) if there is no response from the adult, and the infant’s heart rate slows down while the baby is paying attention to the adult and waiting for a response. In commenting on this synchrony and mirroring, Trevarthen said that “acting out stories with emotion, listening to thoughts and imitating actions is how humans learn, in shared vitality and awareness.”

Musical Analysis of Parent-infant Vocal Interaction

Trevarthen’s research has included musical analysis of parent-infant vocal interaction, identifying the typical musical phases of introduction, development, climax and resolution. His 2008 paper with Gratier states:

Babies are born to find meaning in intent participation with the imaginings and ambitions of older minds. They have a musical sense of time, and a language of emotions that matches that of the wisest adult, including sensitive feelings about the contingent appropriateness of other persons’ behaviours. And they soon build a ‘personal narrative history’ that connects moments of the present to an imagined future as well as a remembered past.

Gratier, M. & Trevarthen C. (2008) ‘Musical Narrative and Motives for Culture in Mother-Infant Vocal Interaction. Journal of Consciousness Studies 15(10-11): p 150.

Trevarthen cited the example of a 5 month old blind baby conducting her mother’s songs with her left hand. The infant’s hand moves 1/3 second before the melody, ie she is telling a story she knows well, anticipating the movements of her mother’s voice. Trevarthen referred to this as an example of ‘inter-modal transfer of consciousness’, which I believe indicates that information from different modalities (here, sensory processing of sound, and body movement), is being communicated from one conscious being to another. Trevarthen commented that this parent-infant interaction follows  the same pattern as is seen in an improvised jazz duet, where one person leads the other and vice versa, and then at precise moments the two people synchronize.

Trevarthen linked this with what we do in VIG: we are trying to identify moments of good interaction and trying to focus on synchronised interaction where there is “happy communication, amazingly coordinated, and which leads to feelings of enormous pride in both parents and babies”.

Infant Expression of Emotion in Parent-Infant Interactions

Trevarthen referred to the research of his colleague, Vasudevi Reddy, who has studied the development of self-consciousness in infants during the first year. She has identified that as early as 2-3 months, a baby with a mirror shows coyness, consisting of smiling with simultaneous gaze and head aversion, curving arm movements, and hiding her face. Reddy’s 2001 paper states: ‘These smiles were elicited in contexts of social attention, and were more likely following the renewed onset of attention. They occurred in interaction with familiar adults, with strangers and with the self in a mirror. Such expressions have previously only been reported in adults and in toddlers in the second year’ (Reddy 2001, p186).

Trevarthen also mentioned the impact on the infant of troubled interactions. As early as 6 months old, the infant feels shame: feelings of worthlessness, of not being understood, of anger and upset, and may attempt to escape this misunderstanding by the adult by looking down, covering their face etc. Although shame is recognised as an essential affective mediator of the socialization process – a parent’s stern facial response can evoke a feeling of shame in the infant which then inhibits the socially ‘unacceptable’ behaviour – too much shame (‘pathological shaming’ by the adult) can be toxic, resulting in patterns of major dysregulation in the infant, with damaging consequences for the infant’s developing sense of self (Schore, 1994).

In the last few weeks I have observed a worrying shame response in a 1 year old infant I am working with, who is suddenly exhibiting a behaviour new to him, usually in response to an adult focusing attention on him (even a familiar adult showing gentle curiosity). His response is to go very still, look down, and cover his face with one hand. He remains like this for several moments, emerging with a blank facial expression which evokes in me intense sadness. This behaviour is, I believe, in response to feeling not understood by his mother, not being able to repair mis-attunements in their interaction, or evoke in her any joy or pleasure; his response to other enlivening adults can be delightful and joyful. I hope that VIG may help to bring some pleasure to this mother-infant relationship.

Trevarthen made an interesting comment on the infant’s fear of strangers: the fear is to do with  embarrassment and worry that the stranger won’t understand what the baby knows (through repeated interactions with familiar adults). The baby feels threatened if a stranger pretends they know the baby, eg coming up confidently and taking the lead in interacting. The baby feels the lack of attunement and feels fear.

Further Reading

I have included just some of the points Trevarthen made during his talk. If you are interested to read more, he has published multiple papers and contributed to several books, including the core VIG book (Kennedy et al 2011). In the references below, I have cited just a few, which may prompt us to read further! An excellent summary of Trevarthen’s work is provided by Jenny Cross and Hilary Kennedy (Kennedy et al, 2011).

To end, a quote from a video of Trevarthen on YouTube produced by Education Scotland in 2016, entitled ‘Pre-Birth to Three’:

So babies are looking for companionship, they are looking for somebody. And I would like to make the point that the baby’s looking, or curiosity is more important than any parent’s desire to teach the baby, or anybody’s desire to teach the baby; the baby is not a pupil, it is not just an ignorant human being that needs to be taught knowledge…. I think if you are wondering what kind of companion a practitioner should be, I think the ideal companion of any kind – and it can be a practitioner or not – is a familiar person who really treats the baby with playful human respect.

This resonates well with our work: ‘playful human respect’ is a key ingredient of VIG.

References

Biemans, H. (1990) ‘Video Home Training: Theory, Method and Organisation of SPIN’. In J. Kool (ed.) International Seminar for Innovative Institutions. Ryswijk: Ministry of Welfare, Health and Culture.

Brazelton, T. Berry; Nugent, J. Kevin (2011). Neonatal behavioral assessment scale (4th ed.). London: Mac Keith Press.

Bruner, J.  (1975) ‘The Importance of Play’. In Lewin, R. ed. Child Alive. London Temple Smith.

Bateson, M.C. (1979) ‘The epigenesis of conversational interaction: a personal account of research development’. In Bullowa, C. (1979) Before Speech: The Beginning of Interpersonal Communication. Cambridge: Cambridge University Press, 63-77.

Cross, J. & Kennedy, H. ‘How and Why does VIG Work?’ In Kennedy, H., Landor, M & Todd, L. Video Interaction Guidance: A relationship-based intervention to promote attunement, empathy and well-being. Jessica Kingsley.

Gratier, M. & Trevarthen C. (2008) ‘Musical Narrative and Motives for Culture in Mother-Infant Vocal Interaction. Journal of Consciousness Studies 15(10-11):46-79.  

Kennedy, H. (2011). ‘What is Video Interaction Guidance?’ In Kennedy, H., Landor, M & Todd, L. Video Interaction Guidance: A relationship-based intervention to promote attunement, empathy and well-being. Jessica Kingsley.

Kennedy, H., Ball, K. and Barlow, J. (2017).  How does video interaction guidance contribute to infant and parental mental health and well-being? Clinical Child Psychology and Psychiatry 1-18.

Leo, G. (ed), Beebe, B., Lyons-Ruth, K., Trevarthen C., Tronick, E. (2018) Infant Research and Psychoanalysis. Frenis Zero Press.

Murray L, Trevarthen C. (1986) ‘The infant’s role in mother-infant communications.’ Journal of Child Language. 13: 15-29

Nagy, E. (2011). ‘The newborn infant: a missing stage in developmental psychology’. Infant and Child Development Special Issue: The Intersubjective Newborn. 20, Issue 1: 3-19.

Reddy, V. (2001). ‘Coyness in Early Infancy.’ Developmental Science, 3, Issue 2, 186-192.

Schore, Allan N., (1994) ‘The onset of socialization procedures and the emergence of shame’. In Schore, Allan N., Affect regulation and the origin of the self: the neurobiology of emotional development pp.199-212, Hillsdale, N.J.: L. Erlbaum Associates.

Trevarthen, C. (1980). ‘The Foundations of Intersubjectivity: Development of Interpersonal and Cooperative Understanding of Infants.’ In Olson, D. (ed) The Social Foundations of Language and Thought: Essays in Honour of J.S.Bruner. New York.

Trevarthen C, Aitken KJ. (2001) Infant intersubjectivity: research, theory, and clinical applications. Journal of Child Psychology and Psychiatry, and Allied Disciplines.

Trevarthen C. (2011) ‘What is it like to be a person who knows nothing? Defining the active intersubjective mind of a newborn human being’, in Infant and Child Development. 20: 119-135.

Trevarthen C. (2011) ‘Confirming companionship in interests, intentions and emotions: How VIG works’. In Kennedy, H. (2011). ‘What is Video Interaction Guidance?’ In Kennedy, H., Landor, M & Todd, L. Video Interaction Guidance: A relationship-based intervention to promote attunement, empathy and well-being. Jessica Kingsley.

Trevarthen C. (2015) ‘Awareness of Infants: What Do They, and We, Seek?’ Psychoanalytic Inquiry. 35: 395-416.

Trevarthen C.  & Reddy, V. (2017) ‘Consciousness in Infants’. In Schneider, S. & Velmans, M. (eds) The Blackwell Companion to Consciousness. Wiley.

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