Mary is a lady in her fifties with profound and multiple learning difficulties. She has curvature of the spine and although she is ambulant, she requires support to manoeuvre herself around her home. As a result of this, she spends the majority of the time during our visits reclined in her armchair with her feet raised, and with a brightly coloured book in her lap that she likes to explore with her fingers. Every now and again she turns the pages, and she also often becomes engrossed in brushing her finger firmly under her nose repetitively, unaware of the world around her and our presence. She can seem somewhat ‘isolated’, remaining static in her chair: a very quiet person whose voice we do not often hear, and who communicates very discreetly, and minimally- with her delicate finger movements, her piercing eye contact and occasionally, if we are really lucky and ‘hit the spot’ with our interactions: a bright giggle!
On one occasion, Mary was incessantly rubbing her finger underneath her nose. This had clearly been happening before our arrival, as the skin under her nose and on her cheek was pink from pressure. I noticed Mary had a book on her lap, which she was darting very quick glances at when she took a slight pause in rubbing. I asked if I could join her. She looked straight at me, holding eye contact for 5 seconds and I took this as a ‘yes’. I pointed out different pictures in her book, that I guessed she was looking at from the direction of her gaze, and as I talked about each item I noticed the speed at which she changed the direction of her gaze increasing until we were ‘racing’ around the page of her book, getting faster and faster! While discussing things she was looking at, Mary’s hand slowly lowered until her fingers were open and relaxed, and resting on the page of her book. Eventually, her gaze was changing direction so fast, I could not keep up, and I rested my head on the arm of her chair, gasping for breath and telling Mary that she was too quick for me! Mary immediately looked directly at me, gave me a big grin, and let out a massive giggle! I laughed along with her, and Mary seemed to be enjoying this moment of connection- maintaining eye contact, leaning in closer to me and laughing again, two more times- big, belly laughs.
We resumed looking at her book again, as Mary directed her gaze back at it and stretched her fingers slightly on the page. Mary repeated her increasingly rapid eye movements, interspersing them with intermittent eye contact with me, and gentle smiles. Again, as I gave a running commentary on the direction of her gaze, Mary increased the speed of her focused attentions, and again, I ended up collapsing in a heap at the side of her armchair, gasping in exhaustion…at which, Mary again turned her head and looked directly at me, and gave a big smile, and another huge belly laugh!
I enjoyed this interaction with Mary immensely: I felt very connected with her, and judging by her communicative responses I am quite sure she did too. It was good to know that Intensive Interaction helped Mary feel listened to, heard, and understood- we all need this!
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