Learning health

By Karin Michael, May 2021

It was the old people who touched me during my nursing training. Their glances from the windows across to the schoolyard, their quiet joy when they watched the goings-on of the schoolchildren from a distance, and their knowing, deep understanding that they showed towards the young, nascent life.

Photo: © provid / photocase.de

I loved being with the elderly and caring for them, until I realised that many of my actions as a carer were dictated by doctors. I wanted to take personal responsibility and said to myself, “Well, if you have to know the maximum to do that, then I’ll become a doctor.” That was a strong motive, to be able to understand and help independently.

This is still the case today and it pains me to see how, in the course of this pandemic, grandparents and grandchildren are sometimes unable to see each other for months. Children, as I experience again and again in my medical practice, have a great longing for old people with their life experiences, their serenity and mature individuality. Accordingly, changes in such relationships have a profound effect.

The statement “Protect your loved ones!” has led to great anxiety in some children. In particular, I have seen children in the sensitive age group of nine to eleven who can no longer get to asleep, who put the needs of their own development aside so as not to endanger anyone. I am also increasingly concerned about young people who can no longer get out of bed in the morning because they have lost their motivation – e.g. to meet their friends at school – and their rhythm. And these are only the initial symptoms: we will only learn to understand the profound significance of many of the children’s experiences in the years to come, and it makes sense to reflect on what makes them healthy.

The child as a “physiological premature birth”

This term was coined by Portmann. What it means is that we come into the world unfinished and open to development. The beauty of being unfinished is that development is still possible. This is, on the one hand, the magnificence of still being free to change, to learn and be shaped.

On the other hand – and this is echoed in the word premature birth – we are dependent on protection, on other people, on relationships and on closeness. At the beginning of life, we even need someone who does almost everything for us.

In the middle of childhood, openness is no longer as body-related as in the toddler but is found much more on the level of experiences and learning. This forms and shapes the inner world of the soul during the school years. Here, too, protection is needed and also guidance from the adult. Although the child no longer wants to be taken by the hand, they want to be shown the world in all its facets, nuances and greatness. There is a great longing. Above all, children want to experience how they can master life and all the challenges it brings with increasing confidence.

How do children learn to become healthy?

Health is not a static condition, although at birth, for example, it is noted with joy that “the child is healthy”, which initially only means that all organs are well developed and the physiological functions are given as a physical prerequisite for development. However, if we look at the still barely developed immune system and at activities such as sleeping, feeding and digestion, which the child has not yet mastered, one can say that “the child must learn to become healthy”. They must learn to feed themselves, to move and to recover. These skills must sometimes be acquired over long periods of time – sometimes several years.

Here rhythm plays a major role. It helps the child to adapt to the respective circumstances, to develop inner stability and to become more independent, i.e. more autonomous, in the face of adverse circumstances. Intensive touch, perceptions and encounters play a major role in the development of physical and mental health because they help the young child, among other things, to control and regulate their body as a sensory organ and as an instrument of action. Through secure relationships and intensive communication, the child develops emotional balance, the ability to express themselves and the ability to speak.

When school begins after the kindergarten years, during which the child is still well protected, the aim is to discover the world with ever greater independence, to have intensive experiences. What is often overlooked is that school is not only about imparting knowledge. Everyone can remember how much attention they paid in their school days to how a teacher taught and who that teacher was as a person. After all, this is a sign that children bring their own life motifs with them, which in the best case are ignited and inspired by the personality of the teacher and not by the objective subject matter. Such learning out of love, enthusiasm and devotion, also for the revered authority, is much more important than the curriculum; it gives orientation of its own and forms the basis for mental health which can be sustaining for a lifetime. It is then wonderful when, in the course of the school years, this personal relationship recedes into the background and the pupils can develop their own interest in the world and in the community on hikes, trips and excursions.

Schools can promote health in different ways. Some opportunities arise from normal everyday life and are not always consciously intended. Only their absence in coronavirus times makes us realise how they give us strength, support and security. The daily rhythm, which begins with getting up and ends with going to bed and contains many recurring elements in between, is like a stable framework. It includes the school timetable, meals, but also the community with other children. Of no less importance is the school as a place of protected public and social structures. Conflicts have to be addressed, positions adopted and abandoned again, and one’s own needs represented and intentions courageously expressed. In the public space of the school, pupils are called upon to learn to reveal, adapt and assert themselves.

Relationships during school lockdowns

Most of this falls away during the school closures. It is true that the digital lessons pass some pupils by without leaving any visible trace. Others, especially young people, no longer even manage to get up in the morning, some of them spend the whole day in bed or at the computer and are home alone for long stretches because parents have to work – especially single parents.

There are many reasons why teachers succeed in staying in touch with pupils during lockdown. The decisive factor is how the relationship was already established beforehand. Was there already a sustainable relationship or not? Many young pupils were happy to receive postcards, letters, pictures or phone calls with personal words from their teachers. What it takes are the small gestures! Another factor is the home and social environment in which the child lives. Is the room shared with three siblings and are there indeed enough spaces for retreat and learning? Do children and young people have enough free space to move around? Or is the child alone? What about excessive demands, resulting in growing aggression or even experiences of violence at home? Who is aware of any of this?

But these adversities are not a reason to do nothing. Especially if there are no physical education classes or clubs that offer exercise, it is important to exercise intensively and, for example, to jog around the block at least once a day to come home sweaty and warmed up. Exercise has an anti-depressant effect! We can also allow ourselves mental space, create conscious retreats, laugh together or rest.

Where parents are overburdened in dealing with limiting digital media or are not present at home for economic reasons and at the same time the health of children is put at risk by dangers such as sexualised violence on the Internet, I always recommend that provisions for help – e.g. through the youth welfare office or protection and counselling centres – be demanded with much less inhibition and that help be accepted at an early stage. The current situation creates loneliness and especially those who have weaker family and helper systems around them suffer more. Every child needs a reliable caregiver and a helper by their side.

Creating healthy developmental spaces

Social and emotional development only happens in community. This is also one reason why children and young people miss the common learning process so much. It is one of the primal joys of childhood to find a community in which one can meet, argue, make friends and develop emotionally. I was very touched to see how some children rejoiced after the first lockdown when they met their classmates again. While in early childhood the family represents the primary and emotional developmental space, this is increasingly replaced by the class community in the course of the school years. Social development demands this community so that we learn to deal with conflicts, go out with people, find allies and sworn friends.

On the other hand, it is precisely the protected social space of the school that enables teachers, social workers, therapists and school doctors to identify the need for help. The great concern of paediatricians, psychiatrists, psychologists and social workers is that many problems and difficulties are not visible and are only noticed much later. We will only see in the next few years what has been lacking and the hidden violence and risk that occurred. Often it is not the ill will of those affected but shame or an “I can do this alone!” attitude that keeps people from seeking help.

When I consider the current situation, when I look at the past year as well as the year ahead, I can see that the pandemic and its measures have brought about a profound change in the conditions for children’s development. In schools and kindergartens we should think hard about how to deal with children and young people who have experienced more than a year of distanced relationships and restricted learning situations.

My wish would be that we develop a new, even more healthful understanding of school. Teaching and learning that begins in experiencing and being outdoors in nature, that offers the pupils plenty of space for movement, play and artistic activities, that strengthens social competence and the sense of community. In such a learning environment the now accelerated digitalisation of education will also find its appropriate place at the appropriate age – not in order to master it but in order not to be mastered by it. This is where Waldorf education and Waldorf schools need to be further imagined and developed – for the benefit of the children.

About the author: Dr med Karin Michael specialises in child and adolescent medicine, she is a kindergarten and school doctor and co-author of the book Kindersprechstunde.

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