Review of the 20^th APPPAH Conference, San Francisco, December  2003

by Anne Gill

APPPAH is the American Association for Pre and Perinatal Psychology and Health. The theme of this year’s conference was Birth, Brain and Bonding – the Psychology of Attachment. There were four hundred participants including counsellors, doctors, midwives, doulas, parents and even some intrepid babies at times! I was the only Irish participant. Before the conference began I assisted my own teacher of prenatal and birth work, Dr Ray Castellino in a pre conference workshop on Healthy Babies, Healthy Families. He runs a non profit making clinic in Santa Barbara called BEBA (Building and Enhancing Bonding and Attachment) where he works with babies, children and their families.

There was a very full programme. For me, three speakers stood out. The first was Dr Daniel Siegal who spoke on the Brain and Attachment. He is Associate Clinical Professor of  Psychiatry on the faculty of the Centre for Culture, Brain and Development at  UCLA. He is also the father of two children and has recently co-Authored, with Mary Hartzell, an important book Parenting from the Inside Out (Tarcher/Putnam, New York,  ISBN  1585422096).

The most significant point he made was that it is not what happened to you as a child that is predictive of how you will parent, but how you have made sense of the experience and your ability to talk about it in a coherent way.

The book explains attachment theory in a clear and simple way. Its aim is to help people become compassionately understanding of themselves and , if necessary, to change their neural connections as they read the book!! So I personally found it a helpful  re-parenting exercise although my children are now grown up.

Sir Richard Bowlby, son of  the late John Bowlby, spoke on Attachment Theory in the first year of life. He stressed the importance for both men and women of resolving their own attachment issues before becoming pregnant. He highlighted the work of Alan Schore who has brought together the brain information and the attachment theory. He stresses the fact that with human beings, joy and the amplification of positive states allow for attachment and growth.

There was a useful panel discussion about supporting healthy connections. Carista Luminaire Rosen spoke of the importance of preconception preparation. This can be immensely helpful with infertility.  Dr Wendy McCarty felt that early development educationalists have difficulty integrating pre and perinatal material as their lens has been a very biological one. She spoke of the need to rethink our developmental models to include the transcendental self. She worked with families from 1973 until 1989 and then came to an APPPAH conference. She then changed her lens and allowed babies and children to teach her. She has written two very helpful booklets, which I often give to parents, called Being with Babies.

Dr Eve Gundberg gave a paper on psychosomatic obstetrics. She is Swedish and works as an obstetrician in Caracas, Venezuela. She is an impassioned advocate of natural birth and birth in upright positions. As well as being a doctor she has training in psychotherapy. It was an inspiration to hear her speak of psychosomatic obstetrics as an art that with intuition discovers, prevents and transforms anything which will make birth more difficult for the woman and family. She believes that what makes normal delivery difficult is the mental activity induced by negative emotions. She made the telling point that when helping a woman deliver, the obstetrician also actualises their own birth. Ideally it should have been normal but this is not always the case.

For me the conference deepened my understanding and ability to work with attachment issues both for myself and for clients. The quality of the first attachment will influence all the relationships which follow so it is vital that we increase our understanding of how to allow this be secure and pleasurable.

APPPAH has a Website www.birthpsychology.com. Annual membership is US$ 100. For that you receive regular newsletters and a quarterly journal.

Anne Gill is a psychotherapist and supervisor and has done postgraduate training in prenatal and birth therapy. She specialises in working with babies, children and their parents and co-facilitates birth process workshops for adults.