Small talk

Every Monday I co-ordinate socially engaged arts and music practice at the Woodlands Mental Health Unit for Older People in Rotherham.  Many of the people I work with at the unit have difficulty communicating and there are often interesting parallels between my Intensive Interaction work at Woolley Wood School and my work at the hospital with patients living with dementia and functional mental illness.
Last Monday a nurse talked to me after our music session and explained that the sessions have been of great benefit to her.  When working with people with depression she had found that while her usual attempts to initiate social engagement with the patients were often rejected as attempts to make small talk, when the same patients returned from the music session they would initiate conversation themselves (usually by talking about something the session had reminded them of) and the nurse would find herself in a deep conversation.  From these social encounters she had developed better relationships with the patients and had learnt much about their history which had helped her to provide better care and be more satisfied in her work.
In our Intensive Interaction practice we will find a similar pattern.  Like the nurse found with her patients, our attempts at initiating interactions may well be rejected if our cue is out of context and does not relate to what our partner is interested in at that moment.  If we wait for the right time and then respond appropriately to the cues that we observe in our partner’s behaviour then we are much more likely to establish a meaningful and more satisfying two-way interaction.
The above example can also help us think about the difference between functional and emotional communication and the importance of both in our intensive interaction practice.  Examples of functional communication are greetings and instructions e.g. ‘Take off your coat’, ‘Do you want a biscuit?’, ‘Blow the bubbles!’ etc.   While necessary, this mode of communication is based the exchange of facts and observations about the world rather than a mutually shared experience of it.
In contrast, emotional communications are usually much more satisfying and pleasurable as we share our feelings with other people and, as Phoebe Caldwell puts it, we address the fundamental human need to connect and belong.  We might share a hug or a smile, look deeply into each others eyes, hold hands or laugh together.  My understanding at the moment is that this emotional sharing of the world happens (and is most sensitively encouraged) through play – through interacting with other people for the sake of it rather than for a functional reason.  This could be a playful conversation, a sharing of memories, a dance, a hug, playing a tickling game, singing a song, playing chase, tapping together, rocking together etc.
In the story from the mental health unit we can see that functional/emotional communication are to some extent linked to whether the communication was initiated by the patient or staff.  The patient saw the staff attempts at communication as functional and refused to engage emotionally.  In contrast however, we see that the successful emotional engagements happened when the patient initiated the interaction.
When I think of Intensive Interaction in this way I can see many parallels.  I think sometimes that my partner has rejected my attempts at initiation because they were too functional whereas following my partners lead clearly results in more emotional communication.  I also think that that many interactions may begin as something functional such as give and take, particularly if our partner is at an early stage of communication development.  If repeated, this initial exchange can set a theme and we can then say that our skill is to develop this theme playfully and create opportunities for emotional communication.  It is this emotional contact that we hope our partner will one day reach out for themselves and if we can help them to discover, re-discover and then know the joy of being with another person then one day they will.
References
Phoebe Caldwell; Jane Horwood. (2008). Using Intensive Interaction and Sensory Integration: A Handbook for Those who Support People with Severe Autistic Spectrum Disorder. In Using Intensive Interaction and Sensory Integration (pp9-10). London: Jessica Kingsley Publishers.

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