I just can’t help obsessing about attachment theory, when I was a newly qualified health visitor and my children were small I read Bowlby’s ‘Attachment and Loss’ the bedrock of attachment theory. As a consequence I paid for a nursery nurse to look after them in preference to a nursery because I was so concerned about going back to work and leaving them. Now I think that as in the Scandinavian countries, mothers should really be having two years maternity leave. This would be expensive I know, but so is the ever growing pressure on our child and adolescent mental health services.
For health visitors it is becoming vitally important that we explain the importance of attachment to parents, we are, as it is so often said; ideally placed. A few years ago I had the good fortune to attend a course at the University of Reading on peri-natal depression, part of the course was dedicated to ‘the social baby’ and I listened avidly to Lynne Murray explain how to communicate with and understand babies from birth. This highlighted the uniqueness of infants and showed us listening how to help parents understand the needs of their babies. I learnt that the brain was experience dependent, that the baby’s brain needed love, affection and stimulation to develop and grow normally, and allow the child to reach its full potential.
Around that time I was working with a nursery nurse who used to explain to parents ‘early brain development’ saying: “All the nerves are sitting in the brain like little light bulbs waiting to be switched on, when you hold your baby, show love and affection, sing and talk, those nerves switch on, and then as you continue to love and care for your baby those nerves join together with pathways, like an electric circuit. I now use this analogy along with a brilliant free hand-out that I printed of the National Literacy Trust website called ‘Talk To Your Baby’. This hand out references the social baby and is very easy for parents to understand.
The establishment of the mother and father baby relationship is important because if the baby is shown love and empathy and forms that important strong attachment, they can then grow up with the ability to form strong attachments themselves.
It’s not just teaching and supporting parents about attachment, we also have to teach them how to manage their stress and look after themselves, this enables them to find space in their heads for this new relationship. Another piece of my tool kit is the Solihull Approach, this shows health visitors how to listen to mothers so they can find containment and focus on their child and begin to understand their behavior. It helps parents give their children a good emotional start in life, it combines three theoretical concepts: containment (psychoanalytical theory), reciprocity (child development) and behaviour management (behaviourism). The idea is that containment and reciprocity promote change in the quality of attachment between carers and their babies. You probably already know this, but if you don’t it’s worth a google!
I had my light bulb moment a few years ago when I went to a lecture by Karyn McCluskey a trained nurse who had subsequently trained as a psychologist, she worked with Strathclyde’s police violence reduction unit, she spoke from the heart explaining to the assembled health visitors that violence in Glasgow had become a public health issue; there were 170 street gangs with 3,500 members between the ages of 11-23 years. Every six hours someone was suffering a facial injury and stabbings were recognised as a public health issue in Glasgow. Karyn realised that violence was being passed on like a disease, she explained that these boy’s brains were hard wired for violence and incapable of empathy. She understood our work was a piece of the jigsaw in helping parents bond and helping children develop empathy and kindness. She stated that empathy is what keeps us together, it’s about people getting on with other people, and that for me is what it’s all about.
Anne Hobbs has been a practicing health visitor for 22 years, and is now a community practice teacher in South Staffordshire. Anne trained as a nurse in the 80’s in Mid Staffordshire and worked mainly in acute medicine before moving to The London Chest Hospital to undertake a cardiac nursing course.
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