AUTHOR Stades-Veth, Joanna
TITLE Autism/Broken Symbiosis: Persistent Avoidance of Eye Contact with the
Mother. Causes, Consequences, Prevention and Cure of Autistiform Behavior in
Babies through "Mother-Child Holding."
PUB DATE 88
NOTE 33p.
PUB TYPE Reports - Descriptive (141)
EDRS PRICE MFOI/PCO2 Plus Postage.
DESCRIPTORS *Attachment Behavior; *Autism; Etiology; Infant Behavior;
Infants; *Mothers; Neonates; *Parent Child Relationship; *Prevention;
*Therapy
ABSTRACT
A case study is reported in which early "autistiform behavior" in a
4-week-old baby was reveesed through intensive mothering. The baby, who had
been developing no:.,mally, was bottlefed by "strangers" for 2 days and then
began to avert her eyes from all people, an autistiform behavior which
persisted and grew worse as the mother tried to re-establish eye contact. In
conformance with theories of autism as a disturbance of symbiosis, the
mother was advised to avoid all eye contact at first, while giving her baby
intensive "holding contact." With this approach the mother succeeded in
restoring the symbiotic bond with the baby, thus saving the infant from
further autistiform deterioration. Therapy developed by J. A. B. Allan and
R. W. Zaslow emphasized various preventive holding methods and playful
sensori-motor movement programs for parents to practice with disturbed
babies in order to diminish their babies' autistiform behavior, improve
their symbiotic bond, and prevent later autism. Also reported is a study
using the Mother Child Holding Therapy with 104 autistic children with
significant change reported in such characteristics as interest in human and
visual contact. (DB)
***********************************************************************
Reproductions supplied by EDRS are the best that can be made
from the original document.
dr.Joanna Stades-Veth
AUTISM/BROKEN SYMBIOSIS
PERSISTENT AVOIDANCE OF EYE CONTACT WITH THE MOTHER.
CAUSES, CONSEQUENCES PREVENTION AND CURE OF AUTISTIFORM BEHAVIOR IN BABIES
THROUGH "MOTHER-CHILD HOLDING"
Summary
A happy 4 week old baby, bottlefed for two days by various, 'strangers'
$.tarted to avert her eyes from all people, including her mother, an
autistiform behavior which persisted amazingly after the visitors left and
grew worse as the mother tried to re-establish eye contact. The new-born's
sensory capacities are very weak (Spitz 1965). Consequently changing
caretakers made the baby feel it were her own mother's biologically
conditioned 'releaser-eyes' that appeared 'changed' at each feeding. This
caused panic and fear of all eyes in the baby. The mother was advised
(Stades-Veth,. 1981, 1984) to avoid all eye contact at first, while giving
her baby intensive 'holding contact'. This conformed with Zaslow's, Allan's
and Tinbergen's ethological theories on autism as a disturbance of
symbiosis. 15 Years later this would be called: Dr. Martha Welch's
mother-child holding method. With it the mother succeeded restoring the
symbiotic bond with her baby. Thus she,paved her infant from further
autistiform deterioration. Zaslow.and Allan showed the connection between
prenatal-, postnatal- and birth traumata with some patterns of autistiform
behavior they had found in some very disturbed newborn babies. They were 'at
risk' of becoming autists later, since they would be unable to form even a
basic symbiotic attachment bond with their mothers, if not extra intensively
mothered.
Allan developed various preventive holding methods and playful sensori-motor
movement programs for the parents to practice with these babies - with
instruction from nurses occupied in the Canadian postnatal program - to
diminish their babies' autistiform behavior and thus improve their symbiotic
bond ani to prevent later autism.
INTRODUCTION
Usually the diagnosis of 'autism' or 'autistiform behavior' is not
pronounced before the third or fourth year. This is probably due to the
ominous reputation of the disturbance called 'autism' which is still
considered to be of somatic origin only, and incurable. in consequence it is
still not recognized that autistiform behavior may have its roots in a
child's very first bad experiences as a (healthy or not) newborn baby, with
or without (1) its mother.
Damaging and to the child traumatic experiences during pregnancy, delivery,
or in the first few moments, hours, days and weeks of life are often not
recognized as such, nor the serious consequences foreseen, especially the
effect of the Accumulation of seemingly unimportant disturbances in the
bonding process of baby and mother. They may result in a reduced or absent
eye contact and emotional interaction between baby and mother, no further
emotional development of the infant, and fixation to the level of
development reached at the moment when the baby began to avoid all
interaction and especially eye contact with the mother.
Meanwhile, as much precious time goes by, exact data on the effect of the
traumatic experiences on the quality of the relationship between mother and
baby can hardly be recalled in detail by the mother. Their possible
influence and impact on the bonding process of mother and baby then have to
be deduced by us from the mother's usually vagueand often unreliable
memories (Richer 1983). This is the more regrettable since prevention and
successful therapy are now available, especially if performed as early as
possible. This is the r%ason why the case of 4 week old Frances appears so
interesting: data on the gradual autistifGrm deterioration of Frances (at
birth a healthy baby) were given by the mother on the spot and were also
observed by the author. Therapy was applied immediately. Further details on
the disturbed early bonding through inadequate medical advice and help
during the first breastfeéding sessions were obtained later, explaining
still better the baby's sudden autistiform withdrawal 2 weeks later and
within a period of 2 days of being bottlefed by several 'strangers'. These
findings are worth publishing, and together with some considerations on
'mother-child holding therapy' with both autistic and other less disturbed
and even 'normal' problem children, are presented here
Case History
Frances, a content and healthy four weeks old baby (born 1973), first
breastfed, then bottlefed, was almost exclusively cared for by her kind and
loving mother. There was a normal and inspiring contact. Suddenly little
Frances began to turn away her head, started to avert her eyes from all
people, finally also from her mother. This happened within a few days when
she had been repeatedly and alternately bottlefed by at least four different
relatives, who were unknown to the baby. M first, when attended to by her
mother as usual, she did not look away from her though she did look less
happy, but after a while Frances started to avoid her mother's eyes as well.
The mother happened to have watched a program on television on autistic
children, thus understanding the possible seriousness of the symptoms. She
immediately stopped all bottlefeeding by the 'strangers', i.e. grannies and
aunts and took over the complete care for the baby herself again. However,
despite her intense effort, she did not succeed in restoring contact with
her baby. Little Frances continued to look aside or to turn her head away,
especially avoiding all contact with her mother's eyes for several days. The
more the mother tried to look into her baby's eyes the more her baby
persisted in avoiding them. The originally warm relationship between mother
and baby had been completely disturbed.
Approach to this problem situation
Having read about the activities of the ethologists E.A. and N. Tinbergen
(1972), who successfully applied their experiences of making contact with
frightened animals to make contact with autistic children, the author
advised the mother to give her baby maximum, bodily contact, holding her
close, cuddling, caressing and cradling her in her arms while talking and
singing to her and giving the bottle in the breastfeeding position. Even
better, to try relactation, if necessary at first with the help of a
'Lact-Aidl*).
However, while doing so the mother was advised to totally avoid making eye
contact with her baby. Instead she took care to show her full face, showing
both her eyes and not just her profile. To any baby the profile, even of the
mother, is strange and frightening because it shows only one eye (Spitz
1965). This could be called the method of 'making contact without eVe
contact'. The mother followed this advice. Thus, while closely held, the
baby was able to quietly study the mother's features, especially her eyes,
without being forced to stare directly into them until ready. to do so. Baby
Frances soon felt safe and accepted her mother again. She started looking
into her mother's eyes as she did before the confusion caused by the eye
contact with the many 'strangers'. Their loving relationship had been
restored and normal. development proceeded from then on. In the 7th week the
baby smiled for the first time at her mother. Frances' development over 10
years has followed a very positive path (Stales-Veth, 1981, 1984).
Available at a local La Leche League Mothering Group, or from La Leche
League International, Minneapolis Avenue 9616, Franklin Park, near Chicago,
ILL U.S.A.
Analogous situations
Many parents of autistic children declared that they first noticed being
rejected by their baby during or after it had stayed in a hospital all by
itself, as 'rooming in' with the mother was not allowed. In a hospital,
babies are usually bottlefed by many different nurses while the mother is
practically excluded. For a bottlefed baby the situation in a hospital is,
in many respects, identical to the above described home situation. In both
cases the baby, while given the bottle by several strangers, lying on their
lap, has to look up time and again, into their always different eyes during
the bottlefeeding sessions.
Developmental characteristics
We seldom get the opportunity to observe from nearby a baby developing
autistiform behavior. What went on in the baby's mind during and after that
first day with four feedings from 'strangers' and only two given by the
mother? The mother reported that at first little Frances looked at her
tensely with a frown between her eyes, not happy as usual. On the third day
the baby began to look away from the 'strangers' and in the evening from her
mother as well. In order to understand the surprising fact that, after the
elimination of the 'strangers', the baby continued to avoid all eye contact
with the mother, we have to look at the sensory capacities of babies during
the first months of life. These were observed by Spitz and Wolf (1946),
Spitz (1955, 1965), experimenting with hundreds of babies during that early
period of development.
The releaser eyes of the mother
Apart from their close bodily contact, to a newborn baby the eye contact
with the mother is of basic importance for the
establishment of their symbiosis. Only the upper part of the mother's face,
with both her eyes, has the primeval, biologically conditioned function of a
signal, i.e. of a 'releaser' (Auslaser), attracting - if in movement - the
baby's gaze into her eyes. Thus the bonding of the baby to the mother onto
mutual symbiotic attachment originates and is established. This is necessary
for the baby's positive development. Its emotional exchange with its mother
is thereby secured. The baby does not at this stage perceive the rest of the
mother's head, nor her body. It does not even notice her mouth and chin, but
only her eyes.
Focusing
A baby can only focus sharply at a distance of about 7 inches, which is the
natural distance between the eyes of a mother and the baby in her arms while
breastfeeding. While lying on its mother's lap during bottlefeeding, she
should take care that the baby is not held too low to see the mother's face
clearly.
Difference and changes in the releaser eyes
According to Spitz the first intellectual capacity of a baby is that it can
notice change, or something different to what it is used to. This is
important, because the baby must be able to notice changes in the releaser
eyes of the mother. Changes on its 'own' releaser may disturb the baby, for
instance the covering of one of the eyes of the mother.
Disturbance by the profile
According to Spitz,.showing the profile appears to be a danger signal for
the baby too. Some babies,-very frightened, react by turning away their
heads, crying, some even trembling and in shock, refusing all contact
afterwards. Only when looking into both eyes of his mother does a baby feel
safe. A change of colour of the eyes also appeared to be a warning signal.
Memory function
A baby can perceive change long before he is able to remember. As soon as he
is able to remember her face, he starts smiling at his mother. This happens
at the age of 4 to 8 weeks. How the baby at first lacks all capacity to
remember what is perceived and is unable to reproduce this even to himself,
becomes clear from the following example: Suppose that during the first
month a baby looks up into its mother's eyes only for 10 minutes during each
feeding (while the feeding takes 20 minutes). During 6 feedings this amounts
to 60 minutes per day. During one week this will be more than 400 minutes
and per month more than 2000 minutes. Even 2000 minutes of confrontation
with mother's eyes were not enough for the baby to be sure which ones were
the mother's eyes, after having looked for only three days into several
'strangers' eyes during feedings.
Nature effectively plans to condition the mother's eyes into a 'releaser'
function, compelling her baby to look into them (as long as ),a is incapable
of remembering those eyes). This had been interfered with by the different
caretaker's eyes, intently looking into the baby's eyes during feedings, at
a tco early and therefore vulnerable stage of the baby's development. It
would have been easy to avoid this long explanation by simply stating that
the baby was so confused by the intimate contact with so many 'strangers'
that she therefore started to look away from them. This, however, would be
incorrect; the baby hardly noticed any 'strangers' at alli She was so deeply
shocked by the suddenly inconsistent, ever changing, frightening 'eyes of
her mother' that from that moment onwards she completely avoided all contact
with them, i.e. with her mother. The feeding woman is, to such a young baby,
always 'the mother'. During bottlefeeding the baby could only notice the
change of eyes. She could not yet see the complete -head, nor the body of
the feeding person. She could only notice the ever changing 'releaser-eyes',
the changing touch and voice and the change in smell. This was what caused
fear and confusion for the baby and the need to avoid that multitude -f
'strangers' eyes she stored in her little 'computer-brain'. in the writer's
opinion, amazing as it may seem the 'strangers' did not even exist for the
baby, only her nursing mother with eyes of a 'cameleon'.
Thus 4 week old baby Frances, with her still very rudimentary sensory
capacity, had had to undergo an experience so full of stress, confusion and
fear, that it could have damaged her for life - a situation of which her
family could never have imagined the disastrous consequences. Held on the
lap and offered the bottle, she could not escape from those frightening
eyes. ?rom that moment on the baby became involved in a 'motivational
conflict' also typical for autists (Tinbergen 1983) i.e. the impulse to
drink, while also trying to avoid those strange, always changing and
therefore 'dangerous eyes', always attempting to look into hers. As a
compromise she tried to avoid those eyes by turning away her little head.
When, by exception, the feeding person understood the baby's conflict, the
bottle would be offered from the side so that the baby could look away more
easily from her while drinking. This seems to be observed more and more
often, in hospitals and even in babies bottlefed by their mothers at home.
Further ethological research, especially at home, should be done in these
cases, and 'mother-child holding' advised. If, however, the bottle is kept
in the 'normal position', in the middle, these frightened babies, in the
process of drinking, can only turn away their eyes. This results in them
looking so far to one side that the feeding person only sees the 'white' of
the baby's eyes. Even with the 'strangers' eliminated, the baby could no
longer recornize her mother's 'releaser-e es', because of her poorly
developed memory. It is even possible that he baby did not dare to look into
her mother's face anymore to identify her eyes. The writer would not be
surprised if these babies, in sheer panic and extreme stress, would close
their mind to all eyes! This is how autists may also react to sounds of all
kinds, appearing deaf and dumb, some even turning seemingly blind! They
avert their eyes as far as possible from the person speaking to them, thus
showing only the 'white' of their eyes. Repeatedly trying to restore the
contact with her baby by looking into her baby's eyes again and again,
Frances' mother, like many other mothers, found to her amazement, that her
baby became even more negative, turning away from her, not reacting to any
of her efforts. The conclusion is that the repeated bottlefeeding by several
strange caretakers within a few days, at a critical phase of the baby's
development, may disturb the function of the
'releaser--eyes' of the mother for her baby. This appears to be the reason
why, after excluding all the strangers, the mother was still no longer
acceptable to her baby. Babies are biologically programmed to avoid and flee
from all changes in the rcleaser-eyes of their mother.
Therapy
Nowadays we understand that in such a situation the mother should never give
up, nor should she lose confidence in herself as a mother. From the efforts
of the Tinbergens (1983), contacting many mothers of autistic babies (called
the 'Do It Yourself', or 'DIY-mothers') and who succeeded in curing their
babies all by themseves, it was learned that mothers should never give up
mothering their 'avoiding' baby. They should do so even more intensely and
warmly than ever before, if possible even taking up breastfeeding again, not
leaving the baby alone or to anybody else. She should tightly carry her baby
against her heart all the time, cradling, singing and speaking to him, but
at first without trying to look into her baby's eyes again to win him back.
That, in the opinion of the author, can lead to a spoiling of all efforts.
Especially in the reassuring breastfeeding position, now focusing sharply
again from the natural 7 inch distance, the baby might be tempted to look up
into his mother's eyes spontaneously. Only when the baby no longer turns his
eyes away when, for a split second, the mother allows her eyes to look into
those of her baby, she may succeed in restoring the releaser function of her
own eyes. When eye contact is restored the baby's autistic behavior will be
overcome. While mothering her baby so intensely the baby, with all his
senses, will recognize her body and feel 'at home' once more with his
mother's voice, the familiar rhythmic thumping of her j.aart, her touch, her
smell and the way in which she moves, handles and holds him warmly. By
evoking these tactile, kinesthetic, vestibular and aural sensations,
familiar even from before birth (Prekop, 1983) the baby will' be helped to
again trust his mother and also her eyes. Therefore the mother should be
very persistent in tightly holding and cradling her baby. The mother makes
the baby feel she loves him and wants him back and that she will not accept
his abandoning her again. She should never forget that even when avoiding
her, the baby longs for her too, though ambivalently. Even if resisting her,
he will secretly want to be freed from his fears and his loneliness by her
(Lensing 1981; Richer 1983).
The "Mother-Child Holding Therapy" of Martha Welch
This 'working method' of the DIY-mothers is confirmed and paral101ed by New
York child psychiatrist Dr. Martha Welch's -since 1976 - successful work
with the "Mother-Child Holding Therapy". This therapy proved not only to be
valid for (also older) autistic children; it is very helpful too for
'normal', 'difficult' children, i.e. those suffering from the psychosomatic,
neurotic or psychopathic symptoms of their 'disturbed symbiosis' with their
mother, caused by a period of separation from her as an older baby or
toddler (Stades-Veth 1973, 1981, 1982, Instructed by Marth Welch and in her
presence, the mother is told to tightly and consistenty hold her fiercely
resisting autistic or otherwise disturbed child, or her avoiding baby in her
arms without interruption. Usually within a few hours the child surrenders
and - amazingly - will then accept her as its mother (again), nestling
against her, looking into her eyes, touching her lovingly, sometimes even
speaking to her for the first time, as was successfully done by the mother
of baby Charles (Stades-Veth, 1981) and by the father of baby Bart
(Stades-Veth, 1984). Very much impressed by these remarkably quick results
with Martha Welch's method, the Tinbergens allowed Dr. Welch and also Dr.
Zapella from Siena, Italy, to publish, as appendices I and II, parts of
their work in the Tinbergen's newly published book: '"Autistic" Children,
New Hope for a Cure' (1983). The titles are:
Martha Welch: Retrieval from Autism Through mother-Child¬Holding Therapy;
Zapella: Treating Autistic Children in a Community Setting.
In a postscript the Tinbergens mentioned the similar successful work with
the Mother-Child Holding Therapy by Dr. Jirina Prekop, a Czech clinical
psychologist, working with autistic children at the Pediatric Center of the
Olga Hospital in Stuttgart, West Germany. She tried "Holding" with her
autistic patients after reading about it after a lecture by Tinbergen for
Nobel Laureates in Lindau on Martha Welch's successful work with autists.
Since 19r,,*,' Prekop supervises small groups of mothers, while teaching
them how to 'hold' their child, like Martha Welch in Greenwich (CT). In
'Autismus' May 1983, Prekop described the 1984). treatment of 57 autistic
children with Mother-Child Holding, with whom she had had very poor results
earlier. Within a year they all improved significantly. Ten children were
considered completely cured. Lecturing all over West Germany, she now
stimulates many clinical psychologists to use 'Holding' in child
psychotherapy. In 'Der Kinderarzt' 1984-15-9, she reports on 104 patients.
Other possible reasons for aulkistifors behavior in babies
So far we have spoken of one month old babies born and nursed by their
mothers under ideal, i.e. normal circumstances, without any difficulties in
view, until their bonding was interrupted by a too frequent intimate contact
with several strangers.
However, disturbances of the symbiotic bond between mother and baby can also
be due to a combination of other factors, i.e. immediate hospitalization
(e.g. in an incubator) of the baby after birth, illness of the mother,
either a post-natal depression or an operation. This can also damage the
bond between mother and baby. Neglect or unwillingness to accept the baby
probably is an exception. Ignorance of the expected progression of the
biologically conditioned developmental phases in a normal baby, may induce
the mother to just leave an unusually quiet baby to himself, since he 'seems
to prefer' to be left alone. This occurs frequently and may cause fixation
of autistiform behavior (Allan 1976, '77). The mother is not to blame, as
even experts had (have) no idea of the importance of this first bodily and
eye contact between mother and baby for their bonding. The importance of
methods facilitating this contact under unusual circumstances, for instance
by 'rooming-in' of her baby to a hospitalized mother, even by putting the
incubator at the mother's bedside, often is not understood (Odent, 1976).
Not only breastfeeding, but also the extremely important immediate close
bodily and emotional contact of mother and baby directly after birth should
be allowed, even if hospitalization, either due to a caesarean or otherwise
abnormal delivery, is necessary.
Preventive measures to improve symbiotic bonding of newborn babies with
their parents by John Allan, Vancouver, Canada
According to Allan (1974, 1976, 1977, 1984) a well informed, experienced
ethological observer of the interaction of infants and their mothers could
identify the subtle signs in a newborn baby 'at risk' of developing
autistiform behavior. These are the 'critical releaser signals' (Bowlby
1958), which will be discussed later. Inverted nipples of the mother causing
problems in nursing, holding the baby in an awkward position while nursing,
be it by insufficiently supporting the baby's head, neck and back, or by
blocking his nose with her breast, are mentioned by Prechtl (1965) and may
cause even a 5 day-old baby to avoid further eye contact with the mother.
Caressing a baby's tummy while talking to someone else, without ssmiling,
looking at or speaking to the baby, may also frighten and cause a baby to
turn away his eyes. "If a face that has been smiling to the baby suddenly
stops doing so, vigorous 'gaze-aversion' will result" (Brackbill, 1967). How
strong the emotional interaction between mother and baby may be was observed
by Prechtl (1965) who, on purpose, did not tell several mothers that, to
their baby, the delivery had been very traumatic. Some weeks later he asked
them how they managed with their babies. They all said they managed badly,
that they did not
succeed in making their baby feel relaxed and happy. They blamed themselves
for this'and were very relieved to hear that obviously the traumatic
experiences of their babies at birth had made them so unhappy and
'difficult' to satisfy.
Difficult babies
According to Allan, 'difficult' babies, babies who are unable to have a
relaxed, happy bond with their mother, suffered from one or more of the
following four important negative factors, before or around birth:
1. a complicated pregnancy
2. strong emotional stress, or a traumatic experience during pregnancy
3. premature birth
4. traumata at birth, or shortly after birth: incubator,
breastfeeding problems, separation by hospitalization etc. These negative
experiences seemed to result in three types of babies 'at risk':
a. the excessively irritable,,whiney, hyper-kinetic babies;
b. the excessively limp, hypo-tonic very passive babies;
c. the excessively stiff, rigid, hyper-tonic babies.
To help parents reduce and handle these excessive states of their baby,
Zaslow and Allan developed several Holding methods among which also playful
holding techniques, by which these parents could learn how to stimulate
their infants and positively influence their condition by reinforcing their
mutual attachment bond from the first days after birth onwards. In some of
these 'difficult babies', especially the hypo-tonic limp, passive ones, the
five innate 'critical releaser signals' (Bowlby 1958) were too weak.
These signals should be strong enough to awaken adequate caring by the
mothers as a basis for their bonding. These are: too weak sucking, too weak
crying and gripping, no following with the eyes and no smiling (for which
eye deficiencies or partial deafness may be the cause). As a consequence
these infants were handled, played with and spoken to less often and less
animatedly than would otherwise be the case. Especially the very quiet,
silent babies move so little that, while lying in their cot during most of
their first year of life, they seem to gather so much unused superfluous
energy that they usually become restless toddlers as soon as they can move
about and walk. For these overly quiet babies Allan advises laying them in
their cot or pen on their stomach (which they do not like), thus stimulating
them to make arm and leg movements while trying to turn on their back, or to
move forwards or backwards. All-an advises the parents to use, frequently
and daily, several playful 'motor-activities' such as swinging, hopping,
flying, singing nursery rhymes, to invite the baby to happy interaction,
thus strengthening the mutual symbiotic attachment. In so doing the
condition of these limp babies improves considerably. These preventive
measures can be taken only if someone has observed the unnatural behavior of
the baby and warned the parents! Many of the parents thought that they
should respect the calm, quiet baby's need to solitude and quiet. They often
thought these were special (inherited) character traits of their baby!
Early discovery
According to Allan, doctors and especially nurses giving pre-natal and
post-natal care and courses for mothers, should be specially trained to
rapidly recognize the 'babies at risk' by observing mother and baby,
preferably together, also at home. This should be done frequently during the
first days, weeks and months after delivery.
Baby passport
Immediately after a baby is born notes should be made by the nurses of the
possible traumata the baby may have suffered before, during and/or after
delivery. It should be observed how the baby performs at the five
releaser-signal functions, as mentioned by Bowlby, inviting the mother into
mothering activities: how the baby cries, sucks, looks and grips. This would
make it possible to warn and instruct the mother after delivery on the
important 'inviting' signals that may be given to her by her baby and on how
her reactions to these signals should be handled. Should she activate or
help her baby to relax in case her baby would be 'at risk'? And how?
Baby Frances 'at risk' also
In the view of Allan (1976) baby Frances too was probably 'at risk' even
before she was confronted with the'strangers' bottlefeeding her. A recent
interview with Frances' mother completed the data on the first days and
weeks of her baby's life. It had been an 'old fashioned, horizontal'
delivery, at home. The baby was born early in the morning. After the
umbilical cord was cut she was shown to her mother. Only after being fully
washed and dressed was the baby put into her mother's arms for a short time.
The mother did not remember if they had eye-contact, but she had been
annoyed because she had not been allowed to nurse her baby immediately but
only after 24 hours1l Frances got only a few teaspoonfulls of boiled water
with sugar (1) from the nurse. Thus, during the first hour of life there had
been no skin to skin contact, nor eye-contact and no nursing, which is so
very important for a strong bonding of mother and baby. on the second day,
the first nursing sessions caused much difficulty, because of the mother's
retracted nipples. Neither mother, Doctor; or nurse knew about the
International Bond of Breastfeeding Mothers, La Leche League International,
which, 30 years ago, had started mothering groups and a 24-hour telephone
information service on breastfeeding problems. So the mother could not
purchase from La Leche League (Holland) a Woolwich breastshield, which would
have helped•the baby seize the nipple and nurse quietly. Hungry and eager to
suck and drink, the baby had become impatient, had cried and, unable to get
hold of the nipple, had turned away out of irritation several times. The
inexperienced nurse, wanting to help, had pushed the baby's nose too tightly
against the breast, which had caused the baby to wriggle away because of
oppressed breathings Breastfeeding became a frustrating job. Finally
succeeding, the baby seemed tired, drank lazily and very little. The mother
remembered feeling very nervous and inadequate, even though she had
breastfed her first child for eight months. The mother still regrets she had
not insisted on helping the baby on her own, without interference from the
inexperienced nurse. Several headnurses reported to the writer (Stades-Veth
1981, ch. II) that after suffering these problems in breathing more than
once, having been pushed against the breast too tightly, babies often refuse
all further nursing at the breasts
Because baby Frances had nursed lazily, bottlefeeding was started, first as
a supplement, then completely, from the end of the second week onwards. She
managed to drink somewhat better, but never finished her bottle. The mother
told the writer that she had not enjoyed those first weeks with her baby,
due to these nursing problems and also because of the manifestations of
jealousy in her toddler, who resented her preoccupation with the baby. on
top of that, the aunt who came to help had a car accident and was
hospitalized. Thus, during those first two weeks, the mother suffered from
considerable stress. She realized that the bonding vith her baby was not as
close as might have been the case without these disturbances,
This report by the mother explains even better how the 'bottlefeeding
strangers', during those three visiting days shortly afterwards, at the end
of the first month of life -exactly in that susceptible period around the
baby's first smile to the mother - could have had such a damaging impact on
the bonding of baby Frances with her mother. From that time onwards, the
baby started to avoid all eyecontact, first with the 'strangers', then also
with her mother. In the writer's opinion, the already frightened baby became
even more disturbed when the mother, as most mothers would do under the same
circumstances, repeatedly tried to restore the eyecontact with her baby. The
mother could not know that because of the baby's still undeveloped memory
capacity, she then considered her mother to be a stranger too and possibly
the most 'pushy' and frightening stranger of them all! From then on baby
Frances withdrew into an overly quiet behavior, persistently avoiding all
eyecontact. How their symbiotic bond was restored by giving extreme levels
of bodily contact, at first without eye contact, has been described. Titus,
within a few days, the baby ventured to look into her mother's eyes again,
after which their symbiotic contact rapidly improved. Follow-up over more
than 10 years showed a prosperous development. The conclusion is that
Frances, at birth a healthy baby, within a few days became a 'baby at risk'
as described by Allan (1976). This was due to the obstructions mentioned, as
a result of which a warm, happy symbiotic bond between baby and mother
became impossible.
Disrupted eye contact a signal for disturbed symbiosis
A mother should know that as long as her baby keeps looking into her eyes,
their bond, even if too weak or disturbed, is not yet broken. However, as
soon as her baby persists in avoiding all contact with her eyes, even while
being given much attention by her, the baby has broken its symbiotic bond
with her. This should be considered a critical alarm signal.
Spiraling into autistic behaviour
If not retrieved immediately, the baby, from that moment on, may demonstrate
an ever-increasing autistiform behavior. Avoiding the stimulating contact
and emotional exchange with its mother, the infant will arrest its
development and will maintain the babyish level reached at that moment,
which is usually the phase of a baby before its first smile, between the
ages of 4 aid 8 weeks. Autistic children never laugh with other people, not
even with their parents. From that moment on, the baby's innate but unused
mental capacities will begin to atrophy. To Unload his unused energies and
agressions, the baby will soon develop several stereotypies, often
selfmutilating, thus gradually becoming a 'typical autist.'
International exchange of experiences with the Mother-Child Holding Methods
The problem of which Holding technique should be prefered was partially
solved by Allan (1976) who adapted 'Holding' to the type of baby or toddler
to be treated according to its symptoms. The International Symposium on
Mother-Child Holding held in December 1984 in Utrecht, the Netherlands,
shows that 'Holding' is spreading krom California, New York and Canada, via
England to Europe. International exchange will. probably enrich and improve
the application of the Mother-Child Holding Method. Kehrer (West Germany
1984), who first rejected Holding and then, after the successes of Prekop,
was soon trying it himself, started half hour routine treatments with the
mothers. He now declares that 'any' kind of Holding is effective, even
notwithstanding the way in which it is donel This is not the opinion of the
above-mentioned therapists, who think we still have to find out which type
of Holding technique will be the most successful one for the different types
of symptoms, and for the age of the patients. The importance of technique
improvement also shows in an interesting experience of Zaslow and Allan
(1976, 1984). Zaslow found that the 'whiney, hyperkinetic babies' cried a
lot, but without producing any tears. They had to learn effective crying.
During their holding sessions on her lap after the baby had gone through the
phase of revolt, rage, and fighting, often even biting and had started to
cry, Allan, like Zaslow, asked the mother to bend down the chin of her
crying child against his chest while comforting him. He found that this
induces the deepest tearful sobbing, after which the child feels very
relaxed and happily allows his mother to cuddle him, caressing her and
looking into her eyes.
Restoration of the contact of the eyes of mother and autistic child
It would seem important to compare views and experiences on the restoration
of eyecontact. When it concerns babies we should leave it completely to the
infant to choose the right moment and should not force eye contact, but wait
until the baby makes contact himself, when cuddling with his mother at the
end of the Holding session. We should always explain firstly to the mother
that the avoidance of all eye contact by her baby indicates that her child,
for some reason, has become very frightened of her eyes. Therefore, she
should not try to force or invite her baby to look into her eyes again (as
most mothers immediately and repeatedly try to do) before their bodily
contact is restored. She should wait until the baby tries spontaneously to
look into her eyes again. This should be a decision taken by the baby all by
himself, as a little person in his own right, as before, when he took the
decision to break off his symbiotic bond with her, refusing to look into her
eyes anymore. This the baby did for a doubtlessly very important,
biologically-determined reason, the background of which we tried to
understand in the case of little Frances, but did not grasp completely at
that time (1973).
To stand up for the rights of our babies
Mothers of course stand up for their babies and for themselves. When
absolutely necessary, one substitute for the mother and the father - and
someone very well known both to mother and baby - might be acceptable for a
few hours between feeding times. Eden at home and under supervision of the
mother, the frequent contact within a short period of time of her newborn
baby with many alternating unknown eyes during bottlefeeding may cause very
serious damage to their bonding, as shown in the case of Frances (among
others). This also applies to the 'unfamiliar eyes' of alternating nurses
feeding the baby in a clinic.
Preventive measures during and after hospitalization of babies Mothers,
fathers, doctors, nurses, social workers, child psychologists and
-psychiatrists should know that at the first observation of a hospitalized
baby continually looking away from all people, the mother should take over
the care of the baby in the hospital most urgently if a baby would then
avoid looking at its mother too, the mother should be instructed in the
Allan/Welch/Tinbergen method of holding him tightly in her arms - however in
the writer's opinion at first without trying to make eye contact - in order
to restore the bonding with her baby. if not quickly successful, she should
be willing to try breastfeeding her baby again, first with the help of a
Lact-aid. During their stay in hospital, instructed by the nurses, mothers
and fathers should take care of their babies themselves as much as possible,
also staying with them during the night. The sooner the baby goes home, the
better.
The younger the baby, the more easily the damage done can be compensated by
being held tightly and continually preferably by the mother.
As soon as the baby spontaneously starts snuggling and looking into her eyes
again, development will proceed normally. Mother and father must continue
holding their baby often in cozy breaks in the long busy days, cradling him
in their arms or on their lap, talking and singing to the child.
Conclusion
A baby's persistent avoidance of eye contact in the first weeks of life,
especially with the mother, should be considered an important warning
signal, that easily can be observed and understood by everyone. For some
reason the baby became frightened of all eyes. The mother should then be
encouraged not to accept rejection and avoidance by her baby; she should
give in to hit spontaneous motherly needs and intentions to hold her baby in
her arms closely and tightly, speaking and singing to him, nursing him
frequently, not letting go till her baby surrender to her and spontaneously
wants to look into her eyes again.
Dr. J. Stades – Veth.
Download als RTF bestand:
Autism/Broken Symbiosis:
Persistent Avoidance of Eye Contact with the Mother. Causes, Consequences,
Prevention and Cure of Autistiform Behavior in Babies through "Mother-Child
Holding"
Het boekje Spel als signaal in het
Engels, ‘THE SIGN LANGUAGE OF PLAY ‘
PROLOGUE to
‘THE SIGN LANGUAGE OF PLAY ‘
By Prof. Dr. A. J. Westerman Holstijn
Amsterdam University , 1973.
“We do not know what may be the consequences of suppressing a child’s
spontaneity at the time it starts acting on its own. Perhaps we strangle
life itself.”
Maria Montessori
Already as a teenager Johanna Veth was intrigued by a fundamental thought of
Maria Montessori regarding the importance of ‘independent action’ of very
young children. To Johanna Veth this became a guiding principle for her
future work: to be of therapeutic help to young children who had been
hindered in their development towards independency.
36 Years ago I had the honour of announcing her enlightening dissertation,
which, despite its limited edition, drew much attention and deserved it:
PLAY-ANALYSIS AS A METHOD OF PSYCHOLOGICAL RESEARCH AND OF TREATMENT OF
CHILDREN WITH NEUROTIC SYMPTOMS.
At the time, play-analysis and play-therapy were still new conceptions, but
Johanna Veth had a few illustrious predecessors in child-psycho-analysis:
Anna Freud and Melanie Klein. The first came to the conclusion that normal
psycho-analytic treatment could not be used with young children and she
ignored play as a method of treatment. It was Melanie Klein who discovered
the possibilities of play, but she treated the children far too much as
adults, thus missing her aim; however, she did give them the opportunity to
play through their conflicts and let them assimilate their problems
uncriticized but she found it necessary to interpret their play immediately
and continuously. Also, she declined any contact with the children’s
parents.
And now something curious happens: Johanna Veth, inexperienced as she was,
steered clear of the rocks on which her predecessors had run aground – and
was able to obtain much quicker and better results.
After 36 years of practice and of experience both as a mother and
grandmother , Dr. Johanna Stades-Veth is now publishing her second book,
supplemented with some new cases. The original young patients reappear, now
with complete data concerning the course of their further development and
their experiences with their own children, as obtained from a follow-up
study conducted 35 years after initial treatment. Several partly unsolved
problems which had never been worked through during play-therapy are now
unravelled by the author’s enriched insight.
Most serious disturbances in development of these patients could be
understood, cured or – together with their parents whose assistance the
author always and successfully called in- solved by play-therapy.
What is the secret of Dr. Stades-Veth’ s method by which she so strikingly
scores success ? In my opinion by using the same method I have always
strived for as a therapist: the most ‘natural’ method. At the beginning of
my career as a psycho-analytic therapist, together with my dear friend the
great biologist Dr. A.F.J. Portielje, this method was characterized as ‘the
biological’ method, the most natural way. It was Portielje who pointed out
that this was also the secret of the Montessori-method, which was in his
opinion the only really biological system of pedagogy and education: never
try to teach something to a child by repeating it over and over, hammering
into and forcing upon the mind and personality of the young individual
things to be learned. Only adequate surroundings and correct material for
independent development should be offered together with our warm but
disciplined interest and sympathy. We should allow a child to do it ‘all by
itself’. For the child which actively starts developing itself, is
continuously experimenting and testing. By doing so, it learns and develops
itself, not by means of the spoken word, but by means of its
play-activities. This is its personal means of expression! We as adults
should show our sympathy and interest by trying to learn to understand and
even use this ‘language’ of play, however, without ‘strangling’ life by
unnecessary interventions.
Today we know for sure that psychology i s biology. Many new conceptions are
emerging from the current rapidly developing cooperation between
psychologists and biologists. A good example of this cooperation can be
found in the works of the biologist Konrad Lorenz and the psychologist René
Spitz, which leads to the important discovery of the significance of
symbiosis between the mother and her infant child, which also helped Dr.
Stades-Veth to solve many of the problems confronting her in
child-psychotherapy. She drew attention to the permanent damage caused by
the disturbance of the symbiosis between mother and child, especially in the
highly ‘susceptible period’ of a child (which is the period between the age
of 6 months and 1and a half years). She indicated the fatal escalation in
the disturbances of contact leading to an estrangement between mother and
baby, which, even if met with adequacy and immediacy, is difficult to
repair.
This second book is much more than a supplement to Dr. Stades-Veth’ s first
one. The author was right to change the title. In her first book one can
recognize her gift for deciphering the ‘signs of play’ and her never-failing
intuition which made her choose the best and shortest way to help cure her
little patients. In this second book her knowledge, understanding and vision
go much deeper. Here she penetrates into the invaluable meaning of play, as
a signal. Here she not only expresses the vital force of play as a means of
expressing and assimilating inner conflicts, but she also explains that play
can be a sign of distress and a warning in those cases where a fatal
derailment is threatening, but might still be prevented.
Therefore, we should be very happy, in my opinion, with the abundant
information and experience offered in this book. We wish it to come into the
hands of many people who are kindly disposed towards children.
Download het gehele boek,
hier (Word document).