Video Interaction Guidance (VIG) Retreat Reading Day 11.10.19 – Reviews: our co-thinking comments following discussion.

Reading Group:

Kam Fung Chow; Penny Forsyth; Miriam Landor; Åse Ljungquist Svantesson; Ana Lorenzo Magariño. At Villa Nassio, Costa Blanca, Spain

1. Symbol Cards (aquarelle), Monica Benon, MGB Skapa bild & form, Sundbyberg, Sweden. monica@mgbscapa.se www.symbolkortakvarell.se

  • Open to interpretation these softly illustrated cards support the viewer in clarifying their thoughts and feelings.
  • Because the cards are so neutral / imaginative / creative they are open to lots of different interpretations
  • The creator is a counsellor and career coach as well as an artist
  • The cards can be used in many ways e.g.
  1. “Where are you at the moment in relation to…”?
  2. An activity to help participants to clear their minds prior to starting a training / supervision session
  3. An activity to help clients open up to each other in a safe environment that can be used for a first video (PF, ML)

2. ACT (Acceptance and Commitment Therapy) Conversation cards, Dr Louise Hayes, www.thrivingadolescent.com , www.contextualconsulting.co.uk

  • Useful for work with families, so you’re (therapist) not asking the questions – feels more neutral, more like a game, and less pointed or personal.
  • The cards cover a range of life directions through naming mental states and asking questions
  • Could pass the same card round whole family in turn to make it less threatening e.g. “Have you ever longed for something?” – in order to take pressure off target child
  • In VIG could be the activity for videoing – 1-1, family, small group, class – but make sure participants feel in a place of trust and safety first
  • Choose carefully which cards to include – some could feel threatening in individual cases (PF, ML)

3. BabyCues: a child’s first language cards, School of Nursing, Center on human development & disability, University of Washington, Seattle www.ncast.org

  • Relevant to ante natal work i.e. recognition of facial expressions
  • Useful for trainee guiders if this area of work is new to them
  • Perhaps a set of photos could be created for your client and baby as part of the VIG work?
  • May be useful for VIG clients in MBU (Mother & Baby Units)?
  • Can use antenatally, then when baby’s born take stills matching the cards
  • Look for Brazelton cards (similar)
  • Make your own ‘bank’ of newborn cards to match the emotions shown in these (the subjects are older in lots of the cards) (PF, ML)

4. ‘Another point of view’, Jan Toyne and Clare Dhanushan, Community Practitioner April 2017, pp.36-7.

This article is about the importance of early interventions during the critical 1001 first days of a child’s life.

The focus is how Health visitors are using VIG as an intervention for building blocks of communication between the baby and its parents. The VIG intervention has successfully enhanced communication for the babies and their parents.

The article gives a short introduction to VIG and how it is used here. The outcomes from this project described are positive.

They also describe 4 cases and the outcome and changes for the baby and the parent. I think this could be a good introduction to the possibilities VIG has and it may also be very restorative for all VIG workers. (ÅLS)

5. ‘5 Steps for Brain-Building – Serve and Return’, Filming Interactions to Nurture Development (FIND) Center on the Developing Child, Harvard University (no date)

In the 5 steps, I can see much of the early Attunement Principles of VIG. The very concrete examples of each step do not only help show parents how to build the child’s brain i.e. exploring the world and nurturing verbal ability but also exemplify how the parent can interact with the child in an attuned way. Both are very helpful in developing parent-child bonds, and the child’s self-control and ability to get along with others. These steps and examples would be very useful for VIG practitioners in enhancing parents’/childcare workers’ understanding of the application and impact of the early attunement principles.

StepsVIG Attunement PrinciplesImpact on parent & child
1. Notice and attend to the focus of child as indicated by his verbal and non- verbal expression e.g. making a sound and pointing at somethingBeing attentiveLearn about child’s abilities Strengthen parent-child bonds
2. Give support verbally and or non-verbally e.g. give a hug; say “I see; noddingReceive and respond to initiativesReward child’s interest and curiosity; Child feels being understood
3. Naming the objects, feelings or action of which child is focusingDitto  Make language connections in child’s brain
4. Wait for child’s response, then take turnsEncourage initiativesTaking turns helps child learn self -control and how to relate with others.
5. Attend to child’s signals as he ends his activity or move to a new one.Being attentive receive and encourage initiativesEnable child to take the lead and explore his world.

(KFC)

6.  ‘Neuroception: a subconscious system for detecting threats and safety’ – Stephen Porges May 2004 Zero to Three pp 19-24

Polyvagal Theory and its relevance to VIG

In his paper  ‘Neuroception: a sub-conscious system for detecting threats and safety (2004) Stephen Porges starts with the question ‘What determines how two human beings will act towards each other when they meet?  He challenges the idea that learning from culture, family experiences and other socialisation processes are the whole story and suggests that the expression of a neurobiological process, programmed into our very DNA, is also involved. He calls this neurobiological process neuroception.

Neuroception is the processing of information from the environment through the senses so that the nervous system may evaluate risk i.e. is this situation safe, dangerous or life threatening? Porges argues that neural circuits in primitive parts of the brain are involved so without conscious awareness these circuits facilitate adaptive defensive behaviours such as fight, flight, freeze and pro-social behaviours. He has identified three developmental stages of a mammals’ autonomic nervous system: immobilisation, mobilisation and social communication, which he calls Polyvagal Theory based on research into the vagus nerve.

The vagus nerve is a complex bidirectional system that regulates homeostasis and associated responses to environmental challenges i.e. stress, as early as infancy. Porges (2011) argues that the mammalian development of a myelinated vagus is a key component of social and internal regulation. He further postulates that mammalian attachment is associated with an evolved increase in vagal tone in safe situations. This keeps stress responses dampened thereby enhancing exploration, socialization, and learning including the neural regulation of the heart to affective experience, emotional expression, facial gestures, vocal communication and social behaviour that is responsive to others.  He argues that humans must subdue reactions to immobilisation in order to engage, attach and form lasting social bonds e.g. accept a hug. 

In summary, Polyvagal Theory postulates that neuroception when detecting safety promotes physiological states that support social behaviours resulting in social engagement and defensive strategies if environmental cues are read as dangerous by that individual. Specific characteristics, however, may trigger fight/flight in one individual and total shutdown in another and this difference in thresholds he speculates may be linked to early experiences.

Porges then asked how does the nervous system, an essentially a social engagement system, know when the environment is safe, dangerous or life threatening? Based on research, using new technology neural structures involved in detecting risk have been identified.  They found specific areas of the brain that evaluate biological features such as: body and face movements and vocalisations that contribute to an impression of safety and trustworthiness; recognition of the familiar and evaluation of intentions. If identified as safe then neural circuits actively inhibit areas of the brain that organise defensive strategies however slight changes in these biological movements can see neuroception shift from safe to dangerous, pro-social behaviours disrupted and defensive strategies triggered.

It seems social engagement is dependent on how well we regulate the muscles of our face and head via pathways linking the cortex with the brain stem, the corticospinal pathways. These muscles give expression to our face, allow us to gesture with our head, put intonation into our voices, direct our gaze and allow us to distinguish human voices from background sound and can decrease or increase social distance. Indeed, the polyvagal theory claims that humans have physical reactions, such as cardiac and digestive changes, associated with their facial expressions.

Social distance, they found, can be reduced with:

– making eye contact

– vocalising with an appealing inflection and rhythm

– displaying contingent facial expressions

– modulating the middle ear muscles to distinguish the human voice from background sounds

 Alternatively, social distance can be increased as the tone of these muscles is spontaneously reduced in response to the perception of danger in the external or internal environment:

– the eyelids droop

– the voice loses inflection

– positive facial expressions dwindle

– awareness of the sound of the human voice becomes less acute (located in the middle ear)

– sensitivity to others’ social engagement behaviours decreases

Interestingly this work  reinforces the importance of  musicality (Malloch &Trevarthen 2010) as Porges sees acoustic features as one of the most potent triggers of neuroception  (Porges & Buczynski). In addition, he provides  us with another layer of  understanding as to why ‘receiving others’ may be hard to do  with his  identification of  fluctuations in  ‘awareness of the human voice’  in response to a sense of safety or of stress.

As appropriate social engagement strategies are needed for infants, young children and adults to form positive attachments and social bonds Porges hypothesises that faulty neuroception  i.e. an inability to inhibit defensive systems in a safe environment or the inability to activate defence systems in a risky environment or both could be at the root of autism, anxiety, depression, reactive attachment disorder etc.  He considers therefore that stimulation of the cortical regulation of brainstem structures involved in the social engagement system is an important area of research.

Polyvagal Theory therefore offers video interaction guidance an insight into the neurobiological basis for the development of social engagement and attachment underlying  the features  associated with their development  (eye contact, musicality, contingent facial expressions, sensitivity to others’ social engagement behaviours).  Resonating as they do with several early elements of the principles of attunement it could be argued that VIG offers one way that  ‘stimulation of the cortical regulation of brainstem structures involved in the social engagement system’ may occur through  a positive cycle of reception, reciprocity, shared understanding and repair as necessary.

(PF)

References:

Porges W. S. (2004) Neuroception: A sub-conscious system for detecting threats and safety. Zero to Three. May pp19 – 24.

The Polyvagal Theory for Treating Trauma.  Complete transcript of a Teleseminar Session featuring Stephen W. Porges and conducted by Dr Ruth Buczynski, PhD of NICABM.  The National Institute for the Clinical Application of Behavioural Medicine. www.nicabm.com.

Porges, W. S. (2011) The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-Regulation.  New York, NY:  W.W. Norton & Company.  

Malloch, S & Trevarthen, C. (eds) (2010a)  Communicative Musicality: exploring the basis of human companionship

Here is the link to the YouTube video on polyvagal theory

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