THE ROLE OF LOVE IN THE CORNERSTONE METHOD OF REFLECTIVE NETWORK THERAPY

We are in the midst of planning an elaborate study to tease out the factors which contribute to successful treatment in a very careful way; we already have many clues to what these might be.  We believe the method’s effectiveness has something to do with creating therapeutically designed social networks for groups of children which provide shared emotional and cognitive circumstances for the recapturing of the ability to love and feel loved. Many of the children were lovable when born and became unresponsive to their families and to other treatments. Love, in this classroom method, is active in caring, tender, and nurturant in ways that are all too often left out of the equation using other methods.

Other therapies and education have often become overly sterile, even exclusively pharmaceutical and behavioral, or exclusively psychodynamic. Children are not merely a set of chemicals, habits, conflicts or symptoms to be metabolically altered, behaviorally retrained or psychoanalytically interpreted. Society –especially parents, caregivers and teachers of young children– can gain important psychological support, skills and wisdom by studying the Cornerstone’s team’s network of reflective interaction and thought-encouraging, nurturant and caring treatment.

When a Cornerstone therapist enlivens the child's inner world with attunements and stimulates mental activity through benevolent interactions, the child grows cognitively.

If the child did not mentalize well before, now, in an environment charged with benevolent loving, he or she accesses the interest and energy, and gets some tools to begin mentalizing better than ever.  The teachers in Cornerstone are very busy with lovingly socializing and teaching what, for each child, is an advanced mode of thinking.   We constantly aim for physically and developmentally appropriate forms of love with our Cornerstone child patients.  These are both nurturant and mental forms.  Obviously, we do not allow inappropriate forms of love, such as erotic, furious or sadistic actions by adults.  It is also beneficial that an in-classroom therapeutic method utilizing a participatory network provides additional safeguards against any form of child abuse. The entire classroom network witnesses individual therapy sessions, parent-child interactions and everything else that happens in that real life space. 

Love, in the form of tenderness, affectionate acceptance, optimism, and benevolent attitudes is an essential ingredient in the treatment.  The triumph of love in this method becomes clear when, after giving attention, thought, team discussion, and contemplation with parents over the family dilemmas, the team sees evident progress among the children.

The Reflective Network Therapy replication manual emphasizes the importance of emotional climate. Appropriate love is an essential therapeutic element in the Cornerstone classroom.

In the Cornerstone classroom, we consciously develop, employ and strive to maintain a loving attitude and loving feelings for each child-patient, in each and every circumstance. We recognize the therapeutic functions of appropriate love as an essential therapeutic element and consciously cultivate it as a subtle but reliable, background emotional climate. Negative feelings which might arise within any of the adult participants in the therapeutic network are deliberately and openly acknowledged and worked through in structured interactions (weekly parent guidance sessions and staff meetings).

In addition, we consistently find that the children grow in empathy and learn to nurture each other in the Cornerstone classroom, which seems to be an effect of the opportunity to hear and observe each other's sessions with the support of a reflective network.  

... In practice, most children are initially jealous of the classroom therapy time their peers receive but usually become collaborative in a few days or weeks.  Soon they value the sessions so much that most Cornerstone children become altruistic, helping each other to have sessions, and supporting each other’s efforts to talk during the classroom sessions.  Videos show the Cornerstone children often help each other work at their highest abilities, and nurture each other, each respecting the rhythms of the others and identifying with the helpfulness of the classroom adults.  Their empathy and altruism is readily commented on by the adults.  Such commentary provides a behavioral reward for intrapsychic and interpersonal growth.

The network effect is enhanced on a peer level by allowing children to hear one another’s sessions, and to help the index patient play in whatever fashion the index child chooses. As jealous or mean interference by peers tends to be remarkably infrequent once children settle into a new group and join Cornerstone’s culture of kindness, outsiders viewing our videos are often surprised by the altruism the children show. Because children learn to be reciprocally considerate of each other, collaborative and enriching behavior becomes self-sustaining. [Replication manual, Control and Participation section]

Roy Aruffo, MD, a senior child analyst from Houston, noted for his consulting work with schools, made the following insightful comments in a personal note to Dr. Gilbert Kliman after reading an early draft of Early Childhood Psychotherapy In The Classroom. His words usefully restate the importance of appropriate love as used in the Cornerstone method:

The thrust of the whole method is to provide love (caring, tender, nurturant relationships) to children who were born loving but who later became unresponsive to their parents. It creates humane classroom networks, shared emotional and cognitive circumstances for the giving and recapturing of the ability to love.  I think that this means understanding ways to love, ways that precisely fit the love needs of the child. Oedipal love is not of much use to an undifferentiated child who needs a large measure of one minded love in which the giver consciously and/or intuitively understands the helplessness and utter dependency of the child. The child must feel the fit between his needs and the giver’s capacity to recognize and meet the needs. This means that the giver is of one-mind and one-feeling with the child.

…Reflective Network Therapy generates a more and more precise understanding of the child and the family through the continual family work and the discussions between the staff members. The parents too must be developing and restoring their capacity to understand the child. This thinking emphasizes the ego aspects (caregivers as auxiliary egos) of the giver-child relationship as opposed to the libidinal aspects – the love and nurturance. Caregivers must provide all the ego functions that the child has not yet acquired, judgment, memory, control of impulses, thinking, interpretation of sensation, tolerance of frustration, postponement of gratification, recognition of danger, etc. Without this the child is helpless in a hostile world and open to great pain. When the caregivers succeed the child seems to be calm, receptive of care, feels protected, safe, and connected.  The child learns, is receptive to love and moves forward in its emotional development. When they fail enough the child withdraws, develops in an irregular fashion and becomes dysfunctional. This thinking puts one mindedness, one feelingness (empathy) as preconditions for growth.

Excerpts from Early Childhood Psychotherapy In The Classroom:The Cornerstone Method of Reflective Network Therapy, Gilbert Kliman, MD © 2008

Fari Amini, MD – "Love and the lack of it change the brain forever." 

It is almost impossible to discuss the role of love in therapy without mentioning Dr. Fari Amini who used his understanding of science, particularly neuroscience, to form a theory of the connections between love and learning as well as the direct impacts of loving relationships on mental health. He coauthored the elegant book A General Theory of Love (with Thomas Lewis, MD and Richard Lannon, MD, Random House, 2000). Reflective Network Therapy involves frequently exercising the patient’s limbic neurons in a climate of affectionate regard and respect. A few quotations from Amini’s work are enough to show how his legacy is expressed in our work:

The nervous system depends for its neurophysiologic stability on a system of interactive coordination, wherein steadiness comes from synchronization with nearby attachment figures.

Emotionality’s deeper purpose: the timeworn mechanisms of emotion allow two human beings to receive the contents of each other’s minds.

A child is born with the hardware for limbic sensing, but to use it skillfully, he needs a guide. Someone must sharpen and calibrate his sonar; someone must teach him how to sense the emotional world correctly.