trevarthen part 1 - adlerian€¦ · to understand and model change processes in psychodynamic...

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27/04/2014 1 Prof. Colwyn Trevarthen, Department of Psychology, University of Edinburgh, Scotland INSTITUTE FOR MUSIC IN HUMAN & SOCIAL DEVELOPMENT (IMHSD) PERCEPTION, MOVEMENT & ACTION RESEARCH CENTRE (PMARC) “Human Nature and Early Experience: Sharing Life With Pride and Shame” Adlerian Society UK Institute for Individual Psychology What is it to be human? GROWTH OF HUMAN BEING IN MOVEMENT Our life is creative, by ‘autopoesis’ of a body adapted to know its effects, and to use them well. The embryo grows to be ‘self-aware’. It forms an agent-for-awareness. A foetus knows the rhythms of its vitality with first movements, is sensitive for its own life, and detects the mother’s – or a twin’s. A child’s Self builds projects with other human selves by ‘consensuality’. It is cooperative, seeking meaning shared with emotion, confirming aesthetic and moral values for actions. Maturana, H. and Varela, F. (1980). Autopoiesis and Cognition: The realization of the living. Boston: D.Reidel. Human Being Is a Process of Organic Development, of Action-In-Awareness -- With Others “It is commonly believed that consciousness is a higher brain function. Here we consider the likelihood, based on abundant neuro-evolutionary data that lower brain affective phenomenal experiences provide the “energy” for the developmental construction of higher forms of cognitive consciousness. This view is concordant with many of the theoretical formulations of Sigmund Freud. Jaak Panksepp … all of consciousness may be dependent on the original evolution of affective phenomenal experiences that coded survival values. … From this perspective, perceptual experiences were initially affective at the primary-process brainstem level, but capable of being elaborated by secondary learning and memory processes into tertiary-cognitive forms of consciousness.” Solms, M. and Panksepp, J. (2012). The “Id” knows more than the “Ego” admits. Brain Sciences, 2, page 147. . … as cortical regulation of the brainstem improves during the first year of life, reciprocal social behaviour displaces feeding as the primary regulator of physiological state.” Porges, S. W. and Furman, S. A. (2011). The early development of the autonomic nervous system provides a neural platform for social behaviour: A polyvagal perspective. Infant and Child Development, 20, page 106. Stephen Porges “We present a biobehavioural model that explains the neuro- biological mechanisms through which measures of vagal regulation of the heart are related to infant self-regulatory and social engagement skills.

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27/04/2014'

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Prof. Colwyn Trevarthen, !Department of Psychology, University of Edinburgh, Scotland!

INSTITUTE FOR MUSIC IN HUMAN & SOCIAL DEVELOPMENT (IMHSD)

PERCEPTION, MOVEMENT & ACTION RESEARCH CENTRE (PMARC)

“Human Nature and Early Experience:"Sharing Life With Pride and Shame”!

Adlerian Society UK!Institute for Individual Psychology!

What is it�to be human?

GROWTH OF HUMAN BEING IN MOVEMENT!Our life is creative, by ‘autopoesis’ of a body adapted to know its effects, and to use them well. !The embryo grows to be ‘self-aware’. It forms an agent-for-awareness. A foetus knows the rhythms of its vitality with first movements, is sensitive for its own life, and detects the mother’s – or a twin’s. !A child’s Self builds projects with other human selves by ‘consensuality’. It is cooperative, seeking meaning shared with emotion, confirming aesthetic and moral values for actions.!Maturana, H. and Varela, F. (1980). Autopoiesis and Cognition: The realization of the living. Boston: D.Reidel. !

Human Being Is a "Process of Organic "Development, of "Action-In-Awareness!-- With Others!

!“It is commonly believed that "consciousness is a higher brain "function. Here we consider the "likelihood, based on abundant "neuro-evolutionary data that !lower brain affective !phenomenal experiences provide !the “energy” for the !developmental construction !of higher forms of cognitive consciousness. This view is concordant with many of the theoretical formulations of Sigmund Freud. …!

Jaak Panksepp"

… all of consciousness may be dependent on the original evolution of affective phenomenal experiences that coded survival values. …!From this perspective, perceptual "experiences were initially affective at the primary-process brainstem level, but capable of being elaborated by secondary learning and memory processes into tertiary-cognitive forms of consciousness.”!!Solms, M. and Panksepp, J. (2012). The “Id” knows more than the “Ego” admits. Brain Sciences, 2, page 147.'

. … as cortical regulation of the brainstem improves during the first year of life, reciprocal social behaviour displaces feeding as the primary regulator of physiological state.”!!Porges, S. W. and Furman, S. A. (2011). The early development of the autonomic nervous system provides a neural platform for social behaviour: A polyvagal perspective. Infant and Child Development, 20, page 106. !

Stephen Porges!“We present a biobehavioural model that explains the neuro-biological mechanisms through which measures of vagal regulation of the heart are related to infant self-regulatory and social engagement skills.!

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Mental Health: A family proud of their life and traditions. !Frances Louise with her father and mother Sampson and Leah Beaver"

at home in the woods of Canada, in 1907. "!

Alfred Adler""

“The educator must believe in the potential power of his pupil, and he must employ all his art in seeking to bring his pupil to experience this power.”!!“To be a human being means to possess a feeling of inferiority which constantly presses towards its own conquest. The greater the feeling of inferiority that has been experienced, the more powerful is the urge for conquest and the more violent the emotional agitation.”!

DIFFERENT STORIES: STAGES OF EXPERIENCE IN RELATIONSHIPS, AND OF EDUCATION !

MEANING BEGINS IN THE INTIMACY OF SHARED MOVING!!

Whitehead (1929) Romance Discipline Generalization"Creativity & Cooperation!

Erikson (1950) Trust Autonomy Initiative Industry"Ego Development, v Mistrust v Shame & Doubt v Guilt v Inferiority"Emotions in Relationships!

Piaget (1947) Sensory-Motor Pre-Operational Concrete Formal"Cognitive Mastery of Objects ! ! !!

Bruner (1968) ! Enactive Iconic Symbolic"Cognitive Representation!

Donaldson (1999) Point Line Construct Transcendent"Modes, of Action, Here There Anywhere Nowhere"Loci of Concern, & Now & Then Anytime Noplace!Intellect & Emotion !

Jerome Bruner "Why are we so "intellectually dismissive towards "narrative? … Storytelling performs !the dual cultural functions of making !the strange familiar and ourselves !private and distinctive. If pupils are "encouraged to think about the different !outcomes that could have resulted !from a set of circumstances, they are !demonstrating useability of knowledge! about a subject. Rather than just retaining knowledge and facts, they … use their imaginations to think about other outcomes. … This helps them to think about facing the future, and it stimulates the teacher too.”! WE ARE BORN TO LEARN BY SHARING STORIES!

Carl Jung""

“Emotions are contagious because they are deeply rooted in the sympathetic system; hence the word sympathetic. Any process of an emotional kind immediately arouses a similar process in others. When you are in a crowd which is moved by emotion, you cannot fail to be roused by the same emotion.…. The French psychologists have dealt with this “contagion mentale”; there are some very good books on the subject, especially The Crowd: A Study of the Popular Mind, by Le Bon.” !!

“ … In psychotherapy, even if the doctor is entirely detached from the emotional contents of the patient, the very fact that the patient has emotions has an effect on him. And it is a great mistake if the doctor thinks he can lift himself out of it. … It is his duty to accept the emotions of the patient and mirror them. That is why I reject the idea of putting the patient upon a sofa and sitting beside him.” ! !Jung, C.G. 1935/1976. The Tavistock lectures. Lect. V.

In: Collected Works, Volume 18; page 138!!

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The Boston Change !Process Study Group !(BCPSG) !Clockwise L to R!

Karlen Lyons-Ruth, Louis Sander, Nadia Bruschweiler-Stern, "Daniel Stern, Jeremy Nahum, Alexander Morgan !

The Boston Change Process Study Group (BCPSG), created in 1995, consists of practicing analysts, developmentalists, and analytic theorists, who share the view that knowledge from … developmental studies as well as dynamic systems theory can be used to understand and model change processes in psychodynamic therapeutic interaction. … There is now a broad consensus that psychoanalytic developmental theories are in need of drastic revision based on these same studies.!!

“This book attempts to create a dialogue between the infant as revealed by the experimental approach and as clinically constructed, in the sense of resolving the contradiction between theory and reality” "(Stern, 1985, p. ix). !!

In the introduction to the 2000 edition of The Interpersonal World Stern says, “One consequence of the book’s application of a narrative perspective to the non-verbal has been the discovery of a language useful to many psychotherapies that rely on the non verbal. "I am thinking particularly of dance, music, body, and movement therapies, as well as existential psychotherapies. This observation came as a pleasant surprise to me since I did not originally have such therapists in mind; my thinking has been enriched by coming to know them better.” !(Stern, 2000, p. xv).!

Nigel Osborne and student at a summer "music camp near Sarajevo, BiH, 2009!

“!Vitality dynamics are psychological, subjective phenomena … felt as aliveness … designed to fit the workings of the human world.!They are. … shapes of expressive movement. They concern the How, the manner, the style, not the What nor the Why.!

“FORMS OF VITALITY: "Exploring dynamic experience "

in psychology, the arts, "psychotherapy, "

and development.”!Daniel N. Stern M. D.!

Oxford University Press, 2010. !!

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Consider the following list of words.!exploding ! ! !surging! ! ! !accelerating!swelling ! ! !bursting ! ! !fading !drawn out ! ! !disappearing ! !fleeting !forcefull ! ! !powerful ! ! !weak!cresting ! ! !pulsing ! ! ! !tentative!rushing ! ! ! !pulling ! ! ! !pushing!relaxing ! ! !languorous ! !floating !fluttering ! ! !effortful ! ! !easy!tense! ! ! ! !gentle ! ! ! !halting !gliding ! ! ! !swinging ! ! !tightly !holding still ! !loosely ! ! ! !bounding!! ! ! ! and many more.!

These words are common, but the list is curious. Most of the words are adverbs or adjectives. They are not emotions or motivational states … pure perceptions … sensations -- they have no modality. They are not cognitions or acts, as they have no goal state and no specific means. They fall in between all the cracks.!! They are the felt experience of force – in movement – with a temporal contour - and a sense of aliveness. … shapes of expressive movement. They concern the How, the manner, the style, not the What nor the Why.!

“Vitality dynamics are the child of movement. … Movement is our primary experience and vitality dynamic experience is the most primitive and fundamental of all felt experience.” !

Living Systems, Evolving Consciousness, and the Emerging Person -- A Selection of Papers from the Life Work of Louis Sander" !This collection of previously published papers can be viewed as a story of the gradual emergence of an overarching idea through the course of a life’s work. !The idea concerns the way emerging knowledge of developmental processes, biological systems, and therapeutic process can be integrated in terms of basic principles that govern the living system as an ongoing creative process. !

The biological underpinnings of psychoanalysis can be extended by systems thinking. Our notions of the evolution of consciousness can also be extended from this simple level of a neural machinery essential for adaptation and survival to the capacity for the awareness of one’s own inner state within the flow of one’s engagement with one’s surround. From this enrichment of inner experiencing through evolving self-awareness, the unique organization of the "person" emerges within the developmental process – from expectancies and emotions, to values, meaning, purpose, goals, and "direction".!!From: Living Systems, Evolving Consciousness, and the Emerging Person -- Louis Sander !

Charles Sherrington, the inventor of modern "neurophysiology, wrote this famous book. !

It describes the creative SELF!! “The Integrative!

Action of the !Nervous System”,!

1906!!

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Sherrington’s Gifford Lectures – 1937-1938!About how all life is creative by being imaginative!

!CONCEPTION: "

HOW A PERSON’S LIFE IMAGINES LIVING!!“It is not only man but it is the man John Brown, or the woman Mary Smith, whose exact like never was yet. An explanation once offered for the evolutionary process traced it to 'memory' in the ancestral cell. !!…. It would be imagination rather than memory which we must assume for the ancestral cell; memory could not recall experience it never had.”! !Sherrington, C. S. (1955). Man On His Nature. Harmondsworth: Penguin Books Ltd. Chapter 4, The Wisdom of the Body, pp. 103-104 The Gifford Lectures, 1937-1938.!

Karl Lashley, 1951, Serial order in behavior!!“GENERALITY OF THE PROBLEM OF SYNTAX!I have devoted so much time to discussion of the problem of syntax … because the problems raised by the organization of language seem to me to be characteristic of almost all other cerebral activity. There is a series of hierarchies of organization;' the order of vocal movements in pronouncing the word, the order of words in the sentence, the order of sentences in' the paragraph, the rational order of paragraphs in a discourse. Not only speech, but all skilled acts seem to involve the same problems of serial ordering … Analysis of the nervous mechanisms underlying order in the more primitive acts, may contribute ultimately to the resolution even of the physiology of logic.”!!

AND HOW WE IMAGINE MOVING AS ONE ‘ME’!!

Building on Sherrington's discovery of the neural mechanisms of proprio-ception, or self-feeling, and his theory of how actions of many body parts are integrated by the brain into movements of a single coherent person, the Russian physiologist Nicholai Bernstein, in the 1930s, made a brilliant study of how human movements are generated in the brain. The brain makes movements controlled by imaginative motor images, planning in time to coordinate rhythmic actions with a body of many parts and many 'degrees of freedom’, or ways of moving them. !

From conception, the imaginative pulse and growth of life is shared. At first the egg is part of the mother’s body, then the embryo forms itself but remains attached. The foetus grows and shapes a separate human person but one attached by a placenta which couples the new vitality to the mother’s life in amphotero-nomic ‘shared regulation’. In the last months the foetus prepares for communicating intentions and feelings with her by expressive movements, syn-rhythmically, ‘in synch’. Then family and community can share the creation of experience with the infant. "

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Trevarthen, C., Aitken, K. J., Vandekerckhove , M., Delafield-Butt, J. & Nagy, E.) (2006). Collaborative regulations of vitality in early childhood: Stress in intimate relationships and postnatal psychopathology. In D. Cicchetti & D. J. Cohen (Eds.) Developmental Psychopathology, Volume 2 Developmental Neuroscience, Second Edition, Chapter 2, pp. 65-126. New York: Wileys.!!Trevarthen, C. and Delafield-Butt, J. (2013). Biology of shared experience and language development: Regulations for the inter-subjective life of narratives. In Maria Legerstee, David Haley, and Marc Bornstein (Eds.) The Infant Mind: Origins of the Social Brain, pp. 167-199. New York: Guildford Press. !!

AMPHOTERONOMIC REGULATION!

SYNRHYTHMIC !REGULATION!

BIRTH!

COOPERATIVE SHARING OF IMAGINATIVE VITALITY!

THE BEGINNING OF MOTOR INTELLIGENCE!A 22 week foetus sucking a thumb, moving with rhythmically coordinated intentions. (The eyes will open soon – but there will be little to see. Hearing is working well). In a couple of weeks he or she may smile pleasure, or pout disgust, showing emotions with a human face. !

The cerebral cortex is very immature, but "underneath is an expectant human mind.!

At 8 weeks a foetus is made for seeing, hearing, touch and speaking, before the brain is active.!

ORGANS EXPECTING COMPANY!

Hearing!Emotions!& Speech!

Seeing Emotions!

Calling &!Speaking!

Gesturing!

Dancing!

Parts of a Baby�s Head and "Face That Have Connections "by the Cranial Nerves That !Regulate Self-and-Other"Action-With-Awareness!

Seven-Week Human Embryo Brain Showing Where the Cranial Nerve Nuclei are, and Their Projections In the Brain!

Before birth, the imaginative pulse and growth of life is shared. The foetus shapes a separate human person but remains attached by a placenta which couples the new vitality to the mother’s life in amphotero-nomic ‘co-regulation’. !In the last months before birth the foetus prepares to communicate intentions and feelings with the mother by expressive movements and new senses, "syn-rhythmically, ‘in synch’ -- first knowing her voice, then quickly learning her face and touch. !Trevarthen, C., Aitken, K. J., Vandekerckhove , M., Delafield-Butt, J. & Nagy, E.(2006). Collaborative regulations of vitality in early childhood: Stress in intimate relationships and postnatal psychopathology. In D. Cicchetti & D. J. Cohen (Eds.) Developmental Psychopathology, Volume 2 Developmental Neuroscience, Second Edition. New York: Wileys, Chapter 2, pp. 65-126."

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SYNRHYTHMIC REGULATION: Mother and infant can communicate psychologically, regulating sympathy by expressions of emotion.!

Passing expressions "of face, voice and hands "back and forth, rhythmically, imagining each other, participating in feelings!

Baby!

Mother!

Telling and acting out stories with emotion, listening to thoughts and imitating actions is how humans learn -- in

shared vitality and awareness.!

We can chart the development of shared meaning in the first 18 months after birth. The baby is adventurous from birth, but for the first few weeks must be supported with intimate affection. Then as the body grows in strength and agility and the senses become sharper and more curious, life with family is inventive or playful, sharing rituals like baby action songs. Gradually objects that might be toys in games attract the baby’s hands with sight and hearing and teasing becomes fun. A couple of months before the first birthday a big change of interest seek informative play, sharing tasks or work, like how to build or how to eat with a spoon."

“The old model of thinking of the newborn infant as helpless and ready to be shaped by his environment prevented us from seeing his power as a communicant in the early mother�father�"infant interaction. To see the neonate as chaotic or insensitive provided us with the capacity to see ourselves as acting 'on' rather than 'with’ him.” "!

Dr. T Berry Brazelton!1979 Evidence of communication during neonatal behavioural assessment, p. 79. !

At birth the human brain is one third the size of an adult brain, but has all parts in place for a creative human life, including unique human face, eyes, voice and hands for sharing emotions, intentions & states of consciousness. They wait for bright company.!

ON THE FIRST DAY – EXPECTING CONNECTION

In first moments after birth, an infant may look and listen attentively for confirmation of human feelings, already seeking knowledge of others' being, with expressive body.

DAY FOUR AND AVA IS READY TO SHARE A STORY

Story-making, from first conversations, to the fun of games,

and then to cooperation in tasks and ‘acts of meaning, becomes language, naming important objects and actions

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At 7 weeks Téa is !very INTERESTED in!communicating.!

IN EARLY WEEKS A BABY SEEKS INTIMATE CHATS! New Zealand baby ‘Telling’, 10 Weeks old Old,!With open gaze and lively face, sharing mind time.!!

Professor Margaret Donaldson-Salter 1992"!

By Donald Sinclair Swan !Date painted: 1989!National Galleries of Scotland!!

“Human sense is understanding how to live in the human and physical worlds that children normally develop in the first few years of life. It is learned spontaneously in direct encounters with these worlds that arise unavoidably everywhere, transcending cultural differences. The learning is always informed and guided by emotion - that is, by feelings of significance, of value, of what matters. And it is highly stable and enduring, once established. It is the foundation on which all that follows must build.”! !(Donaldson, Children’s Minds, 1978, ) !!

NEWBORNS!Dialogues on the First Day!

PROTOCONVERSATIONS!6 weeks to 3 months!

GAMES & ‘SHOWING OFF’!5 & 6 months!

SHARING TASKS. TOOLS & KNOWLEDGE, 1 year !

STAGES IN DEVELOPMENT OF COMPANIONSHIP IN KNOWING !BODY MOVEMENT, VISION AND ACTION!

TWO TO FOUR MONTHS: "Accurate Reach to Touch. Stereo-Acuity, Precision Seeing. Eye-Head-Arm Coordination. Looking Away from Mother. "Learned Right-Hand Gestures (Girls First)!FIVE TO EIGHT MONTHS: "Crawling, Sitting, Pulling Up to Stand. Grasp and Hold Object. Looking at Mother’s Hands. Banging Objects "Babbling, Supra-Glottal Articulations. !NINE TO EIGHTEEN MONTHS: "Attention to Other’s Interests and Actions. "Combining Own With Other’s Intentions.!Sharing Tasks, Meanings and Ritual Behaviours.!

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A newborn infant, in the first day, imitates tongue protrusion, and another about one hour after birth tries to imitate hand movements. !

Laura at home in Edinburgh at 3 months, in her family, chats with her mother Kay. Her 3-year-old sister wants to talk with her too. Father proudly watches them. At 6 weeks she chatted with her mother at Edinburgh University.!

Leanne at 5 months enjoys her mother’s performance of ‘Round and Round the Garden’, a song with actions.! Emma at 6 months, sitting on her father’s knee, is proud she knows ‘Clappa-Clappa-Handies’ when her mother invites her to show it to the camera. !

Basilie, a one-year-old in Edinburgh, reads her book as her "mother reads the telephone bill. They both know what reading is. !In Lagos, Adegbenro, also one-year-old, is proud of his rattle and after asking someone to hand it to him, he shows it to everybody. !

NEWBORNS!Dialogues on the First Day!

PROTOCONVERSATIONS!6 weeks to 3 months!

5 & 6 months"GAMES & ‘SHOWING OFF’!!

1 year !SHARING TASKS, TOOLS & KNOWLEDGE, !

STAGES IN DEVELOPMENT OF COMPANIONSHIP IN KNOWING !

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Mary Catherine Bateson, 1979, "about a dialogue with a two-month old.!

!

“A study of these sequences established that the mother and infant were collaborating in a pattern of more or less alternating, non-overlapping vocalization, the mother speaking brief sentences and the infant responding with coos and murmurs, together producing a brief joint performance similar to conversation, which I called 'proto conversation'.” !

“The study of timing and sequencing showed that certainly the mother and probably the infant, in addition to conforming in general to a regular pattern, were acting to sustain it or to restore it when it faltered, waiting for the expected vocalization from the other and then after a pause resuming vocalization, as if to elicit a response that had not been forthcoming. These interactions were characterized by a sort of delighted, ritualized courtesy and more or less sustained attention and mutual gaze.” !

“Many of the vocalizations … were very brief and faint, and yet were crucial parts of the jointly sustained performances.”!!

“I am suggesting that many of the dilemmas that face the description of human language acquisition may be resolved if we ask whether the infant has a rather highly specific readiness to learn language � or, to put this in other words, to take the appropriate steps, in the appropriate sequence, that will lead to a knowledge of language.” !

The study of infant intersubjectivity gives us a new natural science of the mind, one that studies the shared consciousness of 'persons in relation', and its emotionally poetic musicality of movement, which does not depend on reason or fact.

We are awakened to a richer appreciation of the ‘Arts and Humanities’, which animate direct inventive human understandings that become ritualized in metaphorical and symbolic ways. Artful invention and sharing also support Technical, Political and Economic complexities that may seem more 'real’, self-sufficient and imperative (regulated by ‘truth’), but they are not.

Research on Infant Communication – with Prof. Jerome Bruner, "Dr. T. Berry Brazelton and Dr. Martin Richards!

THE DISCOVERY OF PROTOCONVERSATION!THE BABY LEADS THE DANCE OF INTERSUBJECTIVITY!

Jody, 9 weeks old, and his mother at the "Center for Cognitive Studies, Harvard University, 1969!

The Prosser Family in Edinburgh, 1979"We tell one another our intentions, interests and feelings from birth, by moving in sympathy -- creating stories of life with people we love. The Prosser Family in Edinburgh, 1979"

!

Kay!

Louise!

Laura!

Ben!

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Laura, at 6 weeks, starts to chat with her Mother,!Kay, at Edinburgh University. She pays attention.!

THE BODY SHOWS INTIMATE INTENTIONS!Laura, 6 weeks old, and her mother, Edinburgh University, 1979!

Stephen "Malloch’s"

analysis of this "proto-!

conversation between "

6-week-old "Laura "

and her mother !

CHARTING THE VITALITY AND EMOTIONS OF THE VOICE!WITH MUSICAL ACOUSTICS!

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Music communicates because it engages !an Intrinsic Motive Pulse (IMP) in the brain. !

The sense of 'musicality' comprises: !(1)!PULSE: A rhythmic time sense (syllables, the beat, phrases and longer elements); !(2)!QUALITY: Sensitivity for the temporal variation in intensity, pitch and timbre of voices and of instruments that mimic the human voice;!(3)!NARRATIVE: Perception of the emotional development of the melodic line, which supports anticipation of repeating harmonies, phrases and emotional forms in a vocal or musical performance. !

COMMUNICATIVE MUSICALITY! (Malloch, 1999)!

Narrative!!

•  Pulse and Quality are combined in the forms of emotional narrative, which allow two persons to share a sense of purpose in passing time. !

•  We examine the musical companionship that is created with her baby as a mother shares a protoconversation or chants a nursery rhyme. !

•  We conclude that Communicative Musicality is vital for companionable communication between mother and infant.!

Stephen Malloch (1999).!!The proto-conversational story becomes a life story.!

Kay"

Louise"

Laura"Audrey"2 Years"

Thirty Years Later in Vancouver"

Communicative Musicality:!

Exploring the Basis of Human

Companionship!!!

Stephen Malloch!and !

Colwyn Trevarthen!!!Oxford University Press 2009!Paperback 2010!

INTERRUPTION!

NORMAL! BLANK FACE!

(Trevarthen, Hubley and Sheeran, Scientific Foundations of Paediatrics, 1981) !