Jean is someone we visit who has a very complex physical and health condition. We don’t need to know the medical name for these conditions or what caused them to be able to try and build a connection between us. What we need to be able to do, is to see Jean as wholly and as fully as we can.
What we see is that Jean’s ability to move is incredibly limited; she does not move her limbs and the tiny movements of her head seem to be related to her breathing pattern. We know that Jean doesn’t see or hear – her care staff have told us this and we have noticed nothing that indicates otherwise. At this point we are feeling a little overwhelmed; if we are to use our Intensive Interaction skills to the best of our abilities, we need to notice something that Jean is doing which we can respond to, but initially she doesn’t seem to be ‘doing’ anything. But wait! Let’s backtrack…. What did I say about the tiny movements she makes with her head being related to her breathing? Yes – she’s breathing! No-one we have ever met in one of our sessions has ever been doing nothing – this is where the seeing fully and wholly comes in.
The first step towards experiencing the joy of communication is to learn that you can have an influence on the behaviour of someone else. Jean, because of her complex condition does not have that experience and it is our job to facilitate it. so. Over a period of months, every week when we spent time with jean, one of us would sit next to her and place a hand gently but firmly on her upper arm. In time with her breathing, we would move our hand up her arm on her in-breath, and down again on her out-breath. We also blew gently on her cheek on her out-breath. And we did this again and again and again and again…. we were working on the assumption that because she was not able to make any large motor movements, Jean would probably be more aware than you or I of the pattern of her own breathing. We wanted her to know that we had noticed it too.
Over the weeks, we began to notice that Jean’s face looked, well, more attentive. There was nothing dramatic, like a sigh or a smile, just a slight shift of expression. Then one day, we noticed that a few minutes in to our session she was breathing faster. We immediately reflected this by changing our rhythm to match hers, pressing slightly more firmly on her arm and blowing harder on her cheek. Then she slowed down – and we shifter gear to match. Of course we had no way of knowing if Jean was doing this to ‘test us out’ or whether it was in response to a pain. But, over the weeks, she kept doing it – and we are now sure she is aware that she is controlling our response.
We don’t know where this will go next; we are not in charge of the pace and content of this conversation. But we do know that we feel privileged to be part of this process of discovery with Jean.
We know we haven’t made any lasting change to Jean’s complex condition; it is not possible for us to relieve the physical constraints she stoically lives through. But what we can do, every time we visit Jean, is to sensitively provide the opportunity for her to experience the thrill of connecting with another human being on her terms: something that most of us do as simply as…breathing.
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