(Haptonomy) - '..how affectivity shapes the human being in its being and essence throughout life.' - Dr. Catherine Dolto

Posted by ProjectC 
'It reveals how affectivity shapes the human being in its being and essence throughout life.'

'..A tool like language cannot really be used to describe a tactile experience. Haptonomy cannot truly be grasped until experienced..

When the questions of human development and its flaws are considered, the concept of basic security, essential in haptonomy, occupies a central place. It underlies the question of identity as it evolves throughout a person’s life. In this respect basic security is a fascinating concept for psychotherapists and educators alike, because it allows consideration of what could be called a prophylaxis of development problems.


‘Hapto’, in Greek, signifies: I enter into contact, I harmonize, I unite, I establish a relation, I make contact in order to make healthy, care for and heal. ‘Nomos’ means law, rule or norm. ‘Haptonomy’ is a global approach towards the human being at all ages of life.

Haptonomy dares to state that its aim is human happiness. It reveals how affectivity shapes the human being in its being and essence throughout life.


..Therefore the only conclusion I can draw is that the habitual way of treating children during the first months of their life, before and after birth, has a patho-genetic effect on the development of their capacities. The development of intelligence in all its facets therefore depends on the underlying affective and sensorial foundation we propose to our children. This is an enormous responsibility for our institutions, as well as for each of us.'


Dr. Catherine Dolto
Paris, France, 2-4 July 2001 (24th International Montessori Congress)

For a therapist in haptonomy, life and education do not begin at birth but well before as the pre and post-natal accompaniment in haptonomy with parents and their child often begins in the fourth month of pregnancy, sometimes even earlier. Before continuing my remarks, I would like to present you with a general overview of haptonomy.

Haptonomy is a social science, defined by its Dutch founder, Frans Veldman, as the science of affectivity. It is a phenomenological and empirical science that implies psycho-tactile contact. It is based on very specific phenomena that can be reproduced and the effects of which, have to be experienced to be truly grasped. A tool like language cannot really be used to describe a tactile experience. Haptonomy cannot truly be grasped until experienced. Today, therefore, I can only try to explain the possibilities of this post-Freudian approach that distinguishes itself from psychoanalysis in its theory and practice.

When the questions of human development and its flaws are considered, the concept of basic security, essential in haptonomy, occupies a central place. It underlies the question of identity as it evolves throughout a person’s life. In this respect basic security is a fascinating concept for psychotherapists and educators alike, because it allows consideration of what could be called a prophylaxis of development problems.

Haptonomy grew out of Frans Veldman’s experiences during World War II. Confronted with the most extreme forms of human experience at that time, Frans Veldman was able to measure the importance of Affectivity and the effects of psycho-tactile contact in human relationships. He decided to dedicate his life to understanding these phenomena and studying how they could be applied in the larger contexts of health and education. He likes to define himself as a researcher in the life sciences. He continues to work on research and development of haptonomy in southern France where he now lives. He also teaches and manages the centre that he established.

‘Hapto’, in Greek, signifies: I enter into contact, I harmonize, I unite, I establish a relation, I make contact in order to make healthy, care for and heal. ‘Nomos’ means law, rule or norm. ‘Haptonomy’ is a global approach towards the human being at all ages of life.

Haptonomy dares to state that its aim is human happiness. It reveals how affectivity shapes the human being in its being and essence throughout life.

Its phenomena reveals that affectivity is actually the third forgotten or even excluded term in the body-psyche dichotomy we have been using for centuries. It enables us to begin with the following acknowledgment: at each moment every event experienced by a human being is affective, psychological and cognitive all at the same time, as well as being related to the joints, the ligaments, the vascular system and hormones. It implies a relation to the external world around the person who lives this experience. It is a holistic occurrence. It is in this global way that haptonomy is situated. This is why it is not a bodily practice, although all too often characterized as such. This totality is what makes it difficult to grasp and understand unless accompanied by shared experience. To my mind, it represents a unique theoretical and clinical response to the questions raised by all issues grouped under the term psychosomatic.

Clinical experience confirms the postulates that result from this phenomenon, eg: the fact that there are conscious and unconscious memories of great importance within our bodily experience. They influence our lives one way or another. We have available to us an unconscious knowledge (which is not the same thing as the unconscious in the Freudian sense) that appears at the right moment or not."

Based on haptonomical phenomena, one can practice hapto-psychotherapy, hapto-analysis, accompany people handicapped from birth or adults who suddenly have to live with a handicap. Those in state of coma or the dying can also be helped. Haptonomy’s most well known application is the accompaniment at birth and the first years of life, which is what I will speak about today.

My remarks are based on clinical experience of all the dimensions of haptonomy that I discovered 22 years ago, just after passing my medical thesis. I had just completed a long personal psychoanalysis and had worked with my mother Françoise Dolto*. This is when I discovered the bridges that could be established between Françoise Dolto’s and Frans Veldman’s thoughts.

Haptonomy postulates and proves that affective confirmation, the sentiment of security, shared tenderness, a lived experience of happiness, sensorial discoveries are indispensable to developing the potentialities that germinate in every human being. Without this very early education of feelings and the importance of reciprocity in an affective relationship, mental cognitive development can have perverse effects, i.e., an intelligence that can unfold without ethics, without an internal sense of self, without judgment. Then Effectiveness dominates Affectivity. Without an affective confirmation that implies tactile contact, there is a great risk that natural aggressiveness necessary for survival will go astray, ending in violence and aggression. What we see daily in our western societies can only give us cause for concern. In addition to the dangers to which they expose our world, the massacre of the intelligences and creative capacities in our children, pushed to despair, can only be deplored.

I should probably clarify that this pre- and post-natal pregnancy accompaniment is at the antipodes of everything done in prenatal education, especially in the United States, that is aimed at developing the future child’s intellect and cognitive capacities. For us, these practices are ridiculous and shocking. Nor should haptonomy serve as an argument for those who refuse the right to abortion. This act, always dramatic, must remain the free and total responsibility of the mother or the parents, helped in this decision by the medical and paramedical corps.

Prenatal Life

Every living being naturally seeks to feel secure. Already within the maternal womb the child seeks security and protection through those elements that form its universe. What he needs to feel is that he is not alone, which is already an affirmation that she exists. However, if he is confirmed affectively, then he can feel a true sentiment of basic security implying well-being and a feeling of completeness that does not disappear as soon as a difficulty or a menace appears. Then the question is no longer one of existing or surviving but of living. On the contrary, however, the lack of an early affective confirmation will produce what we call a neurosis of frustration in which a hypertrophy of rationalization and intellectualisation develops, a life ruled by effectiveness at the expense of affectivity.

Starting at conception, the child encounters events, stimuli coming from the outside world, from his mother through all the subtle exchanges that unite them, or from the world where the parents live. Clinical experience reveals that the child, with whatever means he has at his disposal, is very attentive. His world is far from being closed off as is all too often imagined.

Life is already an incessant learning process, the child constructs himself going from experience to experience and in echoing the emotions, anguish or affects that these produce in his mother and father. He needs to feel accepted, to live life as good. Thus, he is confirmed in a satisfactory way at each of his development stages, the child develops an internal space that enables him to judge at each instant what is good or bad for him. It also enables him to form the basis of what will become later, slowly over time, an ethic of inter-human exchanges, based on his confidence in himself and those like him.

The identity forms itself slowly according to the way the child is welcomed, with security or not, provided through gestures and speech before and after birth. Traumatic events appear to leave very different marks, depending on whether the affective climate surrounding the child during and after the event was traumatic and whether they happened before or after birth.

Experiences of affective exchange are inscribed, as are traumatic experiences, in a pre-logical and pre-rational consciousness that Frans Veldman calls affective consciousness. Negative engrams prevent the development of the feeling of basic security whereas positive engrams establish it and place markers on the path towards autonomy. There is no true access to autonomy without a sense of security. Without it, each child’s significant constellation including his genetic baggage, his ontogenetic and phylo-genetic memory, cannot express itself in all its dimensions. It clearly appears that the prenatal experiences enable the child - already subject of his own history - to express or inhibit certain genes. That should not surprise us, since we know now that from conception to death we are continually modifying our nervous system according to the way we live, in a perpetual dialogue between nature and nurture.

From prenatal life on, when the child develops a basic sentiment of security, his affective and communicative behaviour is one of anticipation. In the opposite case, he places himself in a state of withdrawal that makes him passive, since anticipation represents a risk he cannot afford. This early installation in a passive state is very pathogenic for the development of the subject. Without judgment or an internal centre, he becomes an easy target for all the manipulators and gurus encountered on his path, always in danger of conforming to others’ desires.

Haptonomic Accompaniment and the First Year of Life

This accompaniment is provided to couples where both parents wish to experience it, and never if only one of the parents, mostly fathers, do not wish to do so.

It would be perverse to accompany a mother and her child by establishing a complicity that excluded the father. Over time that could produce very damaging effects to the relationship between the parents or between the father and the child. Haptonomy is not an ideology; it is reserved for those who wish to practice it and should never be imposed on anyone. Those who do not wish to try this prenatal encounter generally have good reasons, even if they don’t know them, and their wish has to be respected. They can try it and then if they choose not to continue after an initial attempt, although that is extremely rare, that choice is their own. If the father dies or leaves during the pregnancy, the accompaniment can be provided once the mother finds someone else who will accompany her and the child during the pregnancy and birth. This person is not there to replace the father, who is always present in the child and cannot be “erased”, but rather to situate themselves as a third party (or more precisely, in a fourth position because of the paternal presence/absence).
It is important for the child to construct himself in a triad. In the long run, the reinforcement of a hypertrophied dyadic link would be suffocating for both the mother and child.

Ideally, the work begins as soon as possible after conception, never after the beginning of the seventh month of pregnancy, because then it would be too late for the parents and child to gain enough understanding that would enable them to experience all the effects of the accompaniment. However, in cases of dramatic situations such as a threat to the pregnancy, the announcement of a malformation, the discovery of a foetal hypertrophy, the necessity to consider a medical interruption of pregnancy or a serious difficulty for one parent, an experienced hapto-therapist can always intervene in an emergency, even in the birthing room. The aid that this affective accompaniment provides during such moments is very precious; the relationship established with their child enables the parents to live through truly dramatic moments with a serenity that amazes our obstetrician colleagues.

Haptonomy is never practiced in a group because all the measures can only be provided in an intimate setting. Finally, during pregnancy it is incompatible with the practice of yoga, sophrology or psycho-prophylactic birth, formerly inappropriately termed “birth without pain”. This incompatibility is not ideological but technical. It is impossible to emphasize the main solicitation of the sub-cortical and cortical regions (as is the case with haptonomy) at the same time. Limits need to be respected so that the mother is not totally lost during the birth; this is not a sectarian position but one based on respect for the mother.

Perinatal haptonomic accompaniment should not be situated solely within a framework of preparations for birth; its goal is much more vast. Nevertheless, it does modify birthing and birth conditions, even more so if the obstetrician and the mid-wife are themselves trained.

A woman can sense that she welcomes her child affectively, even if she can’t feel it move yet. Immediately she feels different and a change takes place within her body. In this way, everything becomes transformed around the child: the tension in the uterine lining, the possibility to move around but also changes in the noises and vibrations coming from the mother’s heartbeats and breath. The modifications are also transformed by changes in the amniotic liquid’s taste and odour. It varies depending on the food absorbed by the mother and her hormonal secretions. A worried mother and a peaceful mother do not have the same taste or smell. Once a mother enters into this welcoming state, a reassuring interaction develops between the mother and child.
Depending on the stage of pregnancy, there is a search to establish a playing relationship with the child. The ease with which the parents establish this relationship varies depending on their own personal history and their own problems as a couple. When the child is given an opportunity to express himself, he comes to the parents’ aid. He is a pacifier.
The mother discovers very early that she can rock the child from the inside, invite him to come higher or lower or to one side. This knowledge can be very useful and reassuring for her in the event she needs to have an amniocentesis. When the mother rocks the child, he can be sleeping and passive or else a very active participant. The father’s calls are very different from the mother’s, as he is located on the outside.

There are various ways to play with the child. From the inside, the mother accompanies him in his responses to his father’s or the accompanying person’s solicitations. In order to form an integral part of haptonomy and not be reduced to a sort of “gymnastic for the performing foetus of modern parents”, all these games have to be played as a “being together” of the three (or more if it is a multiple pregnancy).
With very light hands, one can invite the child to rock. After several seconds, he child responds by taking charge of the movements himself. It is truly a dance that sets itself up between him and his parents; the person who participates truly has the feeling of being rocked by the child, although the child is still within the womb.

The child memorises and rapidly chooses certain movement schemes: lateral swaying, top to bottom or around his vertical axis. Once he becomes accustomed to these games, when the parents place their hands appropriately, the child is often the one who begins moving: he proposes; he establishes the rules of amplitude, direction, length and rhythm of the movements. When he is no longer interested, he stops in an extremely clear way.

Children’s powers of discrimination are astonishing, even from within the maternal womb. Their actions seem to be telling us they are in our presence and are watching out for any signal that can signify dialogue. I can easily imagine that anyone who has not lived this experience would find this difficult to believe it, but it has been clinically substantiated.

The importance that the influence of the mother/child relationship and the father/mother/child relationships or the child/parents relationships plays is well measured in all these phenomena. It all plays out in the reciprocity and anticipation that affectively characterizes the encounter of “being together”.

The child also approaches a voice that calls it long before he has a functional auditory capacity. Very early he reacts to the vibrations made in water by sound waves; a three-month old within the womb will come to the side where the familiar voice is located. The voice of the father who comes, returns, approaches or moves away gives the child a pre-taste of space. This experience can become very precious at the time of birth when the newborn is separated from his mother and all the security she represents. The father’s voice represents a true sound envelope, vibrating and reassuring. In approaching the father’s voice or in moving each time he hears it after an absence, the child can greatly help the father develop a paternal sentiment.

In these ways the parents discover that their child is truly another person. Despite his quasi-symbiotic situation, he can clearly show pleasure or displeasure and react very specifically to events that the parents experience. They can truly consider him as a favoured interlocutor, a subject who wishes to choose his own way, thanks to the proposed affective encounters he can respond to with his entire bodily being. The entire “communicative system” is invited to function through these playful and tender encounters.

Thus, well before his birth, the child inscribes himself within a symbolic system. Hence this is a project of humanization and therefore, of early education.

During his prenatal life the child sleeps a great deal and can move in a paradoxical sleep. What we observe clinically is a series of states of variable availability that reveals itself as a live, alert presence that anticipates responses and other states when the responses are minimal and slow. This passage from one state to another occurs within several seconds. It is important for the parents to pay very close attention to determine whether the child is available or not. One day a father told me: “haptonomy is the pedagogy of respect.” This is a good summary, one that I would not have dared to state myself.

By playing these tender and affectionate games, the child feels affectively confirmed, however, in response to his parents, in turn he confirms them. This dynamic of affective confirmations is extremely important in order for the basic sentiment of security to develop in both the child and the parents.

To be born, to be welcome

The conditions of birth are extremely important, because we know they leave traces that remain over time. From this viewpoint, the current evolution of obstetrics and the arrangements available in France, based on controlling health costs, give great cause for concern. Birth and giving birth are related but distinct events. For both the mother and child they affect the basic sentiment of security for their future, in different but essential ways, together and apart.

The newborn is someone who has lost his freedom. In the uterus he moved his hands and feet and played with them frequently. He moved freely in a space unaware that it was closed. When a sound or a contact attracted him, he moved towards it. From birth on, weightiness prevents him from this freedom of movement. Beforehand he could dance, suck his thumb, play with his hands and feet; now he is stuck in a bed, lacking motor coordination that would enable him to play all these games. Deprived of autonomy, he waits and experiences dependency. As he is human, he seeks for meaning in everything,, therefore he is in a permanent state of questioning.
We consider that this passage from quasi-symbiotic aquatic life to life in an environment of air should be recognized as a major event. The discovery of the child’s sex, reserved until this moment, now contributes to giving birth its importance. The revealed naming also at birth offers the newborn and his entourage a symbolic and imaginary universe. Without falling into ‘foetalatry’, one can say that an unborn child and a born child are two very different beings. They have neither the same needs nor desires.
For the newborn to enter life with his own dynamic, he needs to be able to establish his own satisfying points of reference between his past and his present states.
The creation of an identity is what is at stake. In uterus, the sentiment of “the sameness of being”, one of Françoise Dolto’s terms that means ‘existential continuity’, tended towards a poly-sensorial concert shaped by the parents. Tactile perceptions of the parents’ hands, changes in tension in the womb, variations in tastes, vibrations and multiple rhythmic pulsations, permanent pulsating sensations at the umbilical cord level, a cord that can be grasped in the hand, the smooth placenta, with its sounds and smells...The “sameness of being” depended on the permanence and variations of all these elements.
The reason we request that the child be placed on his mother’s womb, held in such way that his base is supported by his parents, is so that he can safely engage in a “sensorial recalibration”, to separate what is lost from what remains. This position is maintained long enough for the child to reach the indispensable conclusion that “it’s really them, thus it is really me”. This is the first step towards acquiring a basic sentiment of security in this new period of his life.

Following this period of resting on the mother’s womb - when the health and security of all involved allow it- we insist strongly the father take the child first in his arms and present him to the mother and to the whole team if he wishes, thereby enabling the child to experience his upright position for the first time. In this way, the family triad is reshaped. It places the world before the child and signifies to him with affective security that birth represents continuity as well as his right to enter the world. As any confrontation, this placing of the world before the child represents an affective confirmation for him.
It contributes to giving him the courage to live this new situation, armed with his parents’ confidence. Thus the process of early humanization that began in the maternal womb continues. We call this very important moment the first detachment.
The hapto-psychotherapeutic work with older children and adults has shown clearly that any early separation unaccompanied by adequate words and gestures is experienced as abandonment. If care that induces pain is required, the child seems not only to believe that he has been abandoned but also that his mother and father have given him over to those who hurt him so he can live; this leaves important negative engrams. Certain flaws in identity construction can be formed during the first days of life; they are not visible at the time but can contribute later to an adolescent or adult suddenly losing his hold on a unsteady identity that is surprising by its suddenness and seriousness to those in the entourage.

Postnatal Work

The small human being’s immaturity, linked to his vital need to communicate and exchange, calls him continuously to a crossroads where the following all intersect: the satisfaction of needs - the register of substantial elements - and the affective encounters, the space of desire that can never be filled completely, the register of the subtle - in Françoise Dolto’s expression. At this crossroads there are misunderstandings, sometimes even tragic ones, true accidents of life that hinder future development, by leaving inhibiting engrams that will act as obstacles to the whole dynamic of evolution.

“There, everything functions as message and every emotion is virtually relational and potentially one of language.”

The tragedy often arises from the fact that adults respond satisfactorily to elements related to the substantial register, (food, care, washing), without considering the child’s desire, just as vital, for exchanges in the register of subtlety and affectivity (words, non-functional proximity, tender gestures that provide security).

In the intra-uterine life alone, the register of subtleties, the pleasure of being together, are involved in the exchanges proposed to the child by the parents, just as the substantial elements are taken for granted in a so-called normal pregnancy. This is why communication and the prenatal affective links are so important. After birth the substantial register suddenly comes to the forefront; it is worryingly repetitive. Hunger, stomach pains, the desire to be changed, the need to be in someone’s arms so as to ensure that one exists, here are some new things which generate concern. The child knows probably that these stakes he is facing are truly ones of life and death. In this very new context, he has to reconstruct a sense of security that can resist those events that continuously bring up the troubling questions of dependency and meaning, thus of insecurity, together with the question - coming “from the depths”- of the feeling of the most basic security that is the key to his future autonomy.

The way of carrying a child is a language the child decodes very well and submits to very quickly to those who offer it, out of love and necessity. We use certain gestures and positions where the child is often turned outward when he is awake, so as to signify to him that he is truly the one entering the world with our help. We never hold a child under both arms with his thorax squeezed in our hands and the lower part of his body hanging in the air. We never touch the top of his skull, as this makes the child immediately pull his head down between his shoulders and compresses the spinal column. This is a gesture that can be experienced as one of domination. Gestures and the hands’ positions are not the only important considerations, the way we invite the child to carry himself, with our help, is also critical.

In this way, a child can more satisfactorily confront his fear of emptiness, often a source of anxiousness when he is picked up or put on a bed or the changing table.

What is essential is that the child is never carried or moved around like a package, but always invited to hold himself or to act so he can discover the upright position as soon as he can, if only for a few seconds at first. I agree with Frans Veldman on the importance for the small human being to have the sense of his upright position very early, even for brief moments. When the child is placed in his axis, his presence changes immediately, his gaze seems to “switch on”, he is more awake; this change is probably related to the reticule being activated. When a child feels he is the one who chooses to hold himself along his axis or not, he also participates in the basic sentiment of security, thus in the actual experience of early autonomy.

The exchange of glances and gestures is extremely important.
This is the way the child gradually “knits” together the sense of having and being. Françoise Dolto attributes this crucial question to all human beings, from the beginning of incarnation to the end of exchanges:
“Where is that by which I will Have( the ) Being?”
She adds that all “healthy” beings seek this response elsewhere than within themselves, and that in asking this question they find the courage to live in the hope of resolving it. Haptonomy shows how basic affective security and the feeling of security provide allow this search to be more structuring than hopeless.
From this viewpoint, the language of early affective contacts indubitably prepares the entry way into spoken language. All this supports the desire and the courage to live.
In my view, this is very important because I think that many babies, between the age of three and a half months and the age of autonomous movement, withdraw into themselves because they no longer have any desire to try to communicate with this world, as they have been bored since their inter-uterine life. Nine months plus three months makes one year and that is a long time for a small one.
Nothing is presented to them that fills the scope of their curiosity, for everything which has a sign. They are not welcomed in a way that considers their desires for communication, their rhythms are misunderstood; they are manipulated as objects and not respected in their immense capacities for openness and understanding. The first three postnatal months can pass in such a way, so-so, within the close intimacy of the mother-father-child dyad/triad.

However between the age of three and four months, there occurs a very important development of the cortical areas that supports the cognitive functions. This period is marked by an enormous openness to the world. This child, whose movement has not developed yet as much as his curiosity, needs particularly attentive assistance during the time between this period and the firmly sitting position and crawling on all fours. The child who has not been called to communicate his needs and desires, in a satisfactory way becomes bored and withdraws from the world disappointed, even depressed, more often than one would think.
Not being able to correlate his desire to develop harmoniously with the way he is treated, the child has no other alternative than to slow down; this places him in a position of internal disharmony that rapidly affects his relations with his entourage. When demands from the external world are too aggressive, the baby anaesthetizes his perceptions and tries to protect himself. He folds down his antennae, one could say in a more poetic way. Unfortunately, at these ages these observations are not visible for an untrained eye, because, if I dare say so, “life wants to life”. They children continue to grow and gain weight, they express themselves, but in a frustrated way with little personal investment. The damage only becomes visible later, when they discover walking, learning to read and write, for example, or in the way they spontaneously undertake activities only a little or not, even those that interest them, or also their incapacity to establish durable and solid affective links.

At best, these babies form the cohort of those disappointed by communication, the “hypo-desiring”, withdrawn ones. Not only do they not dare express themselves, they have no desire to do so. Without the help of psychotherapy, they become the adults we know so well. Not really depressive to a point obvious to everyone, not recognized as such by themselves or by others, they waste away their lives in a slow-burning flame, ruining the lives of others found in their professional or personal settings as well.

Here one is faced with the problem of passivity, broken vigour that signifies and maintains basic insecurity.

The quality of presence revealed by the person who carries the child, his basic manner of being, the way in which all this translates into how his hands create a dialogue with the child’s whole bodily being is critically important.

It is not enough to place one’s hands the way it appears to be done with babies or in slides for the child to receive an invitation to hold himself and to see him giving the same response. That ability has to be learned. The child senses he is the one who is carrying himself and turning himself with our help and support.

Newborn infants acquiesce rapidly to the status adults offer them because they know very well they have no choice. They behave the way they are carried.

Afterwards the gestures must be adapted to each child, according to his own evolution, his personality, that of his parents or his specific overall development, which is always unique.

In my professional life, I always see the children when they are beginning to walk because what I love to call the “bipedal revolution” also implies an educational evolution. In fact, children who are well accompanied show great autonomy that can sometimes surprise their parents. It can also generate easily avoidable conflicts if the child is given limits within a basis of affective security when those signs of autonomy begin to appear.

Well-accompanied Children

Starting at birth, well-accompanied children have better postural tonus. Their gaze, their presence is particularly intense. Their state of awakening and their calm are particularly striking. One could say these children are precocious but that is not our goal; these elements simply reveal that their precocity depends directly on their basic feeling of security and affective confirmation. In truth, it is those left without confirmation or affective encounters who could be said to be the ones who are behind.

After all these years, it is striking to hear parents tell us the same thing again and again: generally these children are gay, easy-going, smiling, but know very well what they want. Even when very small, these children don’t like to be left by themselves when it is not the right time, because they like to share in the family’s life. They cry little, but always for a good reason, which needs to be figured out (a good reason for a small infant could be the need for skin to skin contact or at least a heart-to-heart contact). Most are calm and adapt well to separations; they easily become part of a group. When I first began to accompany couples, I still had time to care for the children I had known in uterus; this allowed me to make a lineal observation over a ten-year period. Thus, I measured the importance of pre- and post-natal accompaniment for the child’s development and his autonomy. In fact, I understood that in order to care for those children’s health, paediatric semiology, as it had been taught, needed to be entirely reconsidered. The fact that these children have a sense of security modifies their expression of pain and symptom. When one thinks about it, that is perfectly logical but it is disconcerting at first.

We insist strongly to the parents that during the first years of life the children be invited to become responsible and to participate in an ethical and affective reflection in age-appropriate ways. It is a great shame that many people, including those who have misread Françoise Dolto, have confused the issue of not blaming with the issue of eliminating responsibility; these are two different things. The issue is to provide confirming confrontation within affective security that expresses respect for the child, who is called to assume his place in life as a social being. The stakes are not set to establish a position of failure, nor of blame, but to enable the child to become sensitive and responsible according to his means, and to become aware of his responsibilities to the world surrounding him.

With hindsight, I observe that these children have a harder time than others to adapt to the school world as it is classically proposed in our societies. They are bored there and are often unhappy. The fact that they are not well accepted makes them become even more dysfunctional. On the contrary, they are very happy in Montessori schools!

Because of this situation, often they have had to pass a series of tests. Now I am accustomed to seeing them show above average I.Q. test results (with all the reservations that can be made about these measures). This situation often creates a problem because it is not easy for the families; above all it is a subject of reflection for me. In fact, the families I see are not selected, genetically or culturally. Therefore the only conclusion I can draw is that the habitual way of treating children during the first months of their life, before and after birth, has a patho-genetic effect on the development of their capacities. The development of intelligence in all its facets therefore depends on the underlying affective and sensorial foundation we propose to our children. This is an enormous responsibility for our institutions, as well as for each of us.

However, I totally wish to reassure all those who could think that my remarks place the blame on them or others who might become overcome with regret for not having received or provided such an accompaniment. With humans, everything can be worked on and re-symbolized, especially if it is done within a context of affective security that enables the archaic and the enigmatic primary period preceding language to be approached.

Thank you for your attention.

*C.I.R.D.H. Centre de Recherche et de Développement de l’Haptonomie (Center for Research and Development of Haptonomy) 66400 Oms par Céret, France

** Françoise DOLTO, a Freudian child psychoanalyst, was the first one to work in France starting in 1945. She was extraordinarily able to understand the motivations and obstacles faced by young children, even infants who had not yet acquired language. By helping the children untie the psychological knots they faced, she helped them “choose life”. She shared her experiences in clinical teaching situations, in many books and public radio programs for the general public. Over the decades her impact in France has been immense.

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