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Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 A Case Study On Prevention: Explaining The Efficiency Of Marte Meo From A Neurobiological Perspective THERESE NIKLAUS LOOSLI | Systemic solution and resources orientated counselling practice; Dr. med. specialist FMH for child and youth psychiatry and -psychotherapy; Couple, family and systemic therapist; Marte Meo Therapist and Marte Meo Supervisor; Supervisor, coach and organisation developer; Lecturer ••• Introduction The Marte Meo concept is a programme for supporting the development of babies, children, teenagers and adults in daily life. Marte Meo was founded in 1976 by Maria Aarts, The Netherlands, and is currently used in preventive as in therapeutic work contexts in more than 35 countries and continues to develop (Aarts, 2009; Niklaus, 2009, 1 and 2). But how can the efficiency of Marte Meo be explained from a neurobiological perspective? (1) ••• A Case Study On Prevention Regarding Marte Meo Both parents are working. Though the mother only works part time, she feels guilty because she thinks that she does not have enough time for her children. The daughter, Pia – one and a half – is playing with toy building bricks. The mother feels stressed because she is tired after her day at work, but has the impression that she has to do more in order to support her child in its development in the best possible way. At the same time, 1 Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 she thinks of the many housekeeping tasks that still have to be done. She indeed sits with the child – is present physically –, but elsewhere with her thoughts. If we counsel these parents now with the picture based Marte Meo – e.g. in a parents training course according to the method of Marte Meo, or a parents coaching according to Marte Meo –, this daily situation will happen now very differently. The mother(2) is now familiar with all the so called Marte Meo elements, abbreviated MME (Aarts, 2009; Niklaus, 2009, 1), and can apply them consciously in her role as mother in ordinary life. Therefore she knows that the best support for her child in its development is one that happens in a directed way, when she herself is in a relaxed mood. And that already 10 minutes per day conscious realisation of Marte Meo is effective for Pia’s positive development. Thus, Marte Meo is used only when it is »convenient« and possible for the parents. ••• Good Connection And A Good Atmosphere: Mirror Neurons And Hippocampus (3) Hence, the mother now comes home from work, says hello to everyone and explains to them that she needs one more moment for herself in order to really arrive at home (MME: Naming). She has a cup of tea and relaxes. Then, she sits down on the floor in a relaxed attitude and mood where her daughter is playing. Pia looks up from her play, looks at her mother for a short time with a happy facial expression and then continues playing (MME: good connection and good atmosphere). Although this might seem very easy, these Marte Meo elements, which the mother consciously applies, already have a development supportive effect on Pia (Aarts, 2009; Niklaus, 2009, 1). How can it be explained neurobiologically? Hüther explains that, seen from a biological perspective, further development is only possible in relationships (Aarts and Hüther, 2008). The mirror neurons in the child’s brain apprehend the positive and relaxed feelings of the mother and begin to spark (Bauer, 2006). In this way the mother’s positive emotions are also effective in the child’s brain and help to set it in an optimal situation for neurobiological development. This means that the amygdala – the alarm control unit in the brain – is shut down or remains shut down and that the hippocampus (the librarian who helps to store knowledge in the long-term memory and knows where it can be retrieved again when it is needed) is activated in the child’s brain. The positive feelings in the child’s brain additionally result in an activation of the neuromodulator system (Grawe, 2004; Hüther, 2007). ••• Waiting, Following And Good Look: Neuromodulators And Neuroplasticity Thus, the mother now sits there with a relaxed face (MME: Waiting) and follows the play initiatives of her child with her eyes (MME: Following). Because she has learned in the course of the picture based Marte Meo counselling that this waiting and following together with the nice look (MME: nice look) is important for the development support of her daughter. Because she knows that Pia in this moment experiences that what she does is important to her mother. Pia sees herself as 2 Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 confident and effective agent. Thus, in this easy way the mother supports the development of confidence and efficiency of her child (Aarts, 2009). How can this be explained with neurobiological theories? The child’s brain remains, seen from a neurobiological point of view, in optimal mood for development (see previous chapter). Furthermore, the activated networks are strengthened at once through the released neuromodulators (e.g. serotonin): channels are being strengthened and expanded. This process is called neuroplasticity. And since these processes in the brain just happening in exactly that moment need time, the action of giving and having time (MME: waiting) is neurobiologically extremely important and effective (Spitzer, 2007; Hüther, 2007; Hüther and Bonney, 2007). ••• Naming Actions With A Friendly Tone: Mirror Neurons And Language If Pia plays without naming her playing action, her mother names with simple, concrete words in a friendly tone (MME: friendly tone) exactly what the child is doing in that moment: »You are taking the building blocks out of the box« (MME: naming the child’s initiative). Doing so, the mother gets to know the child’s world. And the child learns to become aware of what it does: it gets to know itself better and thus develops self-cognition in this way (Aarts, 2009; Niklaus, 2009, 1). Neurobiological theories allow to assume, that all of the networks in Pia’s brain, which are activated in that moment and spark together, are simultaneously strengthened through the released neuromodulators (Braun, 2004 and 2006; Grawe, 2004; Hüther, 2007; Spitzer, 2007). Moreover, the mirror neurons help to register the action in pre-motor cortex of Pia (Bauer, 2006). Bauer writes: »Im Gehirn befinden sich die Nervenzellnetze, die für die Sprachproduktion zuständig sind, an gleicher Stelle wie die Spiegelneurone des bewegungssteuernden Systems. Es ist nicht ausgeschlossen, dass sie teilweise identisch sind« (Bauer, 2006, p. 75). (Translated into English: »There are neurocyte networks in the brain that are responsible for the production of language, at the same position as the mirror neurons for the motor controlling system. It cannot be excluded that they are partially identical.«). Hence, the child learns to speak at the same time (Isager, 2009; Spitzer, 2007). ••• Confirming With Words: Strengthening Activated Channels When Pia names her action with 2- and 3-word sentences, the mother repeats them and says the complete sentence immediately afterwards in an affirming tone of voice again. Pia says: »Put on it«, and the mother says: »Put on it, ah, you are putting the yellow building brick on the other building bricks.« (MME: confirming with words). And why does the mother do this now? Because she has learned with the picture based Marte Meo method that the child feels understood and seen when she repeats 3 Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 the words in an affirming tone of voice. Furthermore, the child thus learns step by step to distinguish between »I« and »you« (Aarts, 2009). A possible neurobiological explanation: when the mother repeats the complete sentence correctly and with a friendly tone, it is immediately memorised in the child’s brain, which is in an active development mood (Bauer, 2006; Spitzer, 2007) and can be recalled from the hippocampus (Grawe, 2004; Hüther, 2007). All of the channels activated in that moment are strengthened (neuroplasticity), because the neuromodulator systems are activated, in particular also the dopamine system (Hüther, 2007; Spitzer, 2007). ••• Naming The Emotional Initiative: Language For Feelings And when the child shows emotional initiatives, e.g. joy or unhappiness, but cannot yet name its feelings, the mother names the child’s emotions in an affirming tone of her voice (not in an interrogatory one): »Ah, now you are happy.« Or: »Now you are sad.« (MME: Naming the child’s emotions). She knows that in this way the child feels seen and understood, gets to know its own feelings and gets the words for these feelings at the same time. Thus, the emotions are registered in connection with the words in the child’s brain (Aarts, 2009; Bauer, 2006; Isager, 2009; Spitzer, 2007). Hence, the child gets to know itself step by step. Each time, all the networks in the brain being activated in that moment are strengthened, because the amygdala is shut down, while the hippocampus and the neuromodulator systems are activated through the positive emotions (Aarts and Hüther, 2008; Hüther, 2007). The mother knows that it is important to Pia to hear words describing her actions and feelings: only when Pia learns to perceive herself and to name her feelings, she will find her place without help in a group of peers and make herself seen (Aarts, 2009). ••• Nice Look And Sharing Joy And Waiting: Dopamine Release And if the child looks up from playing and search for the nice look of its mother (MME: confirming with nice look), the dopamine systems are activated in the child’s brain: These are of particular importance for strengthening the activated channels (Hüther, 2007; Spitzer, 2007). When the mother sees her child’s joy, it is important to pause and to extensively share Pia’s joy with her (MME: Sharing joy and Waiting). Because the dopamine networks need time in order to be activated fully, so that the released dopamine can also release endorphins in the brain. In this way, new dendrites grow, new synapses are created, the nucleus of the activated neurons can be changed chemically. Thus, the production of neurotransmitters (messengers) in the just activated cells is increased and hence the transmission of the messages from one cell to the next in the brain is more effective and faster (Grawe, 2004). 4 Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 Hence, the child develops language, its self-confidence, self-efficiency, self-cognition and therefore also step by step its self-regulation. According to this, the mother can in this easy way support her child’s development consciously – even if she can only spare 10 minutes of her time in this particular moment. ••• Summary And Outlook On the grounds of the described theories the efficacy of Marte Meo seems to be sufficiently explicable through neurobiology. It would indeed be interesting to illustrate the processes in the child’s brain with image-guided methods while the mother uses Marte Meo and afterwards analyse it scientifically. Since counselling with Marte Meo is picture based, the development improvements of the child are also recorded on video. All videos are evaluated according to Marte Meo elements with the video interaction analysis (action - reaction), a so-called Marte Meo development diagnosis is made. Thus, it can be assumed that this video material could also be analyses scientifically. Only a range of Marte Meo elements has been described. A situation for positive guidance with Marte Meo could be dealt with in a next paper and be explained using neurobiological theories. And how exactly does it work that Pia’s mother knows so well what precisely she has to do exactly how and when, if she wants to support her child in its development and what it does for her child’s development? This can be traced back to the way in which the Marte Meo specialist conduct the image based coaching with parents and which image sequences they have chosen and how and which information they give with every single sequence of film. The efficiency of the coaching with Marte Meo can be likewise explained with neurobiology step by step, a subject that can be investigated in a next article. When Marte Meo is applied for picture based development support aiming at babies, children, teenagers or adults with special needs, especially neurobiological knowledge appears to be helpful in explaining the often very astonishing efficacy of Marte Meo at least partially. This could also be further examined scientifically and of course be described (Aarts, 2002; Aarts, 2007; Aarts, 2009; Aarts and Rausch, 2009; Braun, 2004 and 2006; Hüther, 2007; Hüther and Bonney, 2007; MARTE MEO Magazine, annually 2-3 times; since 2010 only electronically published on the Marte Meo Website: www.martemeo.com/en/magazine/). Bibliography: Articles taken from MARTE MEO Magazine, Aarts Productions, Eindhoven, The Netherlands, which is published annually 2-3 times, and where new experiences with Marte Meo are continuously documented and also scientifically described, online www.martemeo.com. [since 2010 articles are consecutively published only in electronic format in the MARTE MEO Magazine. Marte Meo International’s website online: www.martemeo.com; page: MARTE MEO Magazine; link: http://www.martemeo.com/en/magazine/. Ed.] AARTS, JOSJE (2007). »Marte Meo-Methode für Schulen« – Entwicklungsfördernde Kommunikationsstile von Lehrern – Förderung der Schulfähigkeit von Kindern. Aarts 5 Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 Productions, The Netherlands. [Also published in English: »Marte Meo Method for School« – Supportive Communication Skills for Teachers / School Readiness Skills for Children (2006). Aarts Productions, Eindhoven, The Netherlands. Ed.] AARTS, MARIA (2002). Marte Meo Program for Autism. Aarts Productions, Harderwijk, The Netherlands. AARTS, MARIA (2009). Marte Meo – Ein Handbuch. Aarts Productions, Eindhoven, The Netherlands. [Also published in English: Marte Meo – Basic Manual (2008). Aarts Productions, Eindhoven, The Netherlands. Ed.] AARTS, MARIA, und HÜTHER, GERALD (2008). DVD zum Fachtag: »Interaktion und Entwicklung«, Marte Meo Praxis und Neurologie: ein Dialog zwischen Maria Aarts und Prof. Dr. Gerald Hüther. Aarts Productions, Eindhoven, The Netherlands. AARTS, MARIA, und RAUSCH, HILDEGARD (2009). »Mir fällt nix ein« – Marte Meo Kommunikationstraining. Aarts Productions, Eindhoven, The Netherlands. [To be published in Engels: »Nothing comes to mind« - A Marte Meo Communication Training; Eindhoven: Aarts Productions; expected in 2011. Ed.]. BAUER, JOACHIM (2006). Warum ich fühle, was Du fühlst. Intuitive Kommunikation und das Geheimnis der Spiegelneurone. Hoffmann und Campe-Verlag. BRAUN, KATHARINA (2004). Wie Gehirne laufen lernen. P. 3-12 im Magdeburger Wissenschaftsjournal 2/2004, Naturwissenschaften. BRAUN, ANNA KATHARINA (2006). Lernen in der Kindheit optimiert das Gehirn. P. 408-420 in RdJB: Recht der Jugend und des Bildungswesens, 4/2006. Berliner WissenschaftsVerlag. GRAWE, KLAUS (2004). Neuropsychotherapie. Hogrefe Verlag. HÜTHER, GERALD (2007). Biologie der Angst: Wie aus Stress Gefühle werden. Vandenhoeck & Ruprecht Verlag. HÜTHER, GERALD, and BONNEY, HELMUT (2007). Neues vom Zappelphilipp: ADS, verstehen, vorbeugen und behandeln. Patmos Verlag Taschenbuch. ISAGER, METTE (2009). Marte Meo Konkret: Entwicklungs- und Sprachförderung in Beispielen. www.edition-octopus.de; ISBN: 978-3-86582-857-6. NIKLAUS, THERESE (1), (2009). Interaktives Coaching nach Marte Meo: Ein systemisches sowie lösungs- und ressourcen-orientiertes Konzept zur Entwicklungsunterstützung. Als PDF vom Internet: http://www.therese-niklaus.ch/Marte%20Meo%20Artikel%202009.pdf. NIKLAUS, THERESE (2), (2009). Marte Meo: Eine systemisch sowie lösungs- und ressourcenorientierte Methode, die uns hilft, die neuesten Erkenntnisse der Neurobiologie einfach und konkret in die Interaktion mit unserem Klientel zu übertragen. Als PDF vom Internet: http://www.therese-niklaus.ch/Marte%20Meo%20Paper%202009.pdf. SPITZER, MANFRED (2007). Lernen, Gehirnforschung und die Schule des Lebens. Spektrum Akademischer Verlag. Supplementary Material: BAERISWYL-ROUILLER, IRÈNE (2008). »Marte Meo«: Ein Konzept zur Förderung der Entwicklungsuntertützung. P. 4-13, MARTE MEO Magazine 2008/2 – Vol. 39. Aarts Productions, Eindhoven, The Netherlands. BECKER, URSULA (2009). Marte Meo – auf die Beziehung kommt es an, Video-Aufzeichnungen unterstützen Pflegende. P. 42-45, Zeitschrift Pflegen: Demenz, No 12, 2009, Germany. BÜNDER, PETER; SIRRINGHAUS-BÜNDER, ANNEGRET, and HELFER, ANGELA (2009). Lehrbuch der Marte Meo Methode, Entwicklungsförderung mit Videounterstützung. Vandenhoeck & Ruprecht. 6 Niklaus Loosli | Prevention Neurobiology & Marte Meo Efficiency MARTE MEO Magazine 2011|Art. 04E June 2011 DOIDGE, NORMAN (2008). Neustart im Kopf, wie sich unser Gehirn selbst repariert. Campus Verlag. FÖRSTL, HANS; HAUTZINGER, MARTIN, and ROTH, GERHARD (Ed.), (2006). Neurobiologie psychischer Störungen. Springer Verlag. HAWELLEK, CHRISTIAN (2008). Konkrete Hilfe zur Bewältigung des pädagogischen Alltags. MARTE MEO Magazine 2008/3 & 4 – Vol. 40/41, p. 4-8. Aarts Productions, Eindhoven, The Netherlands. HAWELLEK, CHRISTIAN and VON SCHLIPPE, ARIST (2007). Entwicklung unterstützen – Unterstützung entwickeln: Systemisches Coaching nach der Marte Meo Methode. Vandenhoeck & Ruprecht Verlag. JURA, MARZENA; THOMMES, CLAUDIA, and VENEDEY, CHRISTOPH (2008). Die Marte Meo Methode im Seniorenzentrum am Haarbach. P. 14-18, MARTE MEO Magazine 2008/3 & 4 – Vol. 40/41. Aarts Productions, Eindhoven, The Netherlands. RATEY, JOHN J. (2006). Das menschliche Gehirn, Eine Gebrauchsanweisung. Piper Taschenbuch. SCHIEPEK, GÜNTER (2004). Neurobiologie der Psychotherapie. Schattauer Verlag. SCHMITT, THOMAS (2008). Das soziale Gehirn, eine Einführung in die Neurobiologie für psychosoziale Berufe. Psychiatrie-Verlag. Explanatory notes: (1) All neurobiological explanations are simplified and can only approximately embrace the complex processes in the brain. (2) One can replace »mother« with »father«. (3) The neurobiological terms and brain areas referred to can in most instances be found online on the following website: http://neuropsychoanalyse.wordpress.com/category/neurophysiologie/ Further Information: THERESE NIKLAUS LOOSLI »Systemisch lösungs- und ressourcenorientierte Beratungspraxis« Dr. med. FMH for children and youth psychiatry and psychotherapy; Couple-, family- and systemic therapist SGS; Marte Meo Therapist; Marte Meo Supervisor; Supervisor, coach and organisation developer; University Lecturer Wysshölzlistrasse 36 CH-3360 Herzogenbuchsee | Switzerland Telephone and Fax: (+41)-(0)62-961 93 09 E-mail: [email protected] Website: www.therese-niklaus.ch © 2011, Therese Niklaus Loosli & Aarts Productions | Eindhoven This »MARTE MEO Magazine« article is copyrighted For information, mail to the publisher: [email protected] Citing this article: Therese Niklaus Loosli, Explaining the efficiency of Marte Meo from a neurobiological perspective, Marte Meo Magazine 2011 | Art. 04E, p. … 7