I was so glad to see Linda Smith emphasize a strong counseling component in
LC skills-acquisition hierarchies.  I could not agree more.  When the Texas
Dept. of Health was initiating its Phase I and II introductory lactation
courses they wisely decided to include a whole afternoon in Phase II which
emphasized the skills LLL Leaders learn in what the League calls Human
Relations Enrichment (HRE).  A Leader trained in HRE guided small groups
through some of these basic techniques which involve emphathetic listening,
reflecting back of feelings, etc. For various reasons (mostly time
constraints, I gather), the counseling section had to be dropped. I was sad
when I learned this, because, as someone said, unless you specifically
mandate or provide it, LC candidates don't seem to value or to be too
willing to acquire counseling training on their own.

Perhaps counseling techniques feel artificial at first.  I think people can
only do so much with a little bit of information, but unless one has been
personally involved in counseling or studied it, it is not easy to know how
to begin doing it with mothers. A great deal of what a good LC does is
counseling.  The immediate post-partum is a time of crisis.  Many women are
recovering from mutilating, dis-empowering births. Add to that all the
emotions surrounding the incorporation of the maternal role -- A lot of old
family-of-origen stuff gets stirred up!  Spouse abuse often worsens during
pregnancy, and often spousal drug and alcohol abuse becomes more severe.
These issues can create  barriers to bonding, or this can be a time of great
healing.  I believe that post-partum women desperately need to be LISTENED
to, and to have their feelings validated.  Techniques are useful.  Its good
to have effective tools and tricks, but that's not all that it takes to make
breastfeeding possible.

People like to "fix". That's a lot easier and more comfortable than
establishing a relationship. Counseling relationships provide a way for
self-healing to begin because of the validation and acceptance of another
human being.  Maybe some LCs and LC candidates can't figure out how to
safely listen to some of the pain that has to be waded through to get to the
healing.  Certainly there has to be a sane degree of detachment or there is
terrific burn-out.  But being empathetic and detatched simultaneously is
very possible, and this too, is a skill which can be developed.  I agree
strongly that counseling skills should be emphasized.  I would like to see
that componant actually mandated by IBLCE.

Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx
Owner LACTNEWS On-Line (the Conference Page)
http://moontower.com/bwc/lactnews.html