How Kate Middleton's 'Quiet Confidence' Has Influenced Her Royal Work Over the Past Decade

Alex Bramall Kate Middleton

As Kate Middleton celebrates her 40th birthday on Sunday, those who have worked with her over the last decade are doing some celebrating themselves and toasting the impact she has had through her public work.

The Duchess of Cambridge's apprenticeship in royal work started soon after her royal wedding to Prince William in 2011. As she quietly sought out the patronages that would bookmark her public work, one of her first private visits was to East Anglia Children's Hospice.

Speaking with the directors on her fact-finding mission (she still recognizes the chef who made the cakes on her first visit each time she returns!), "it was clear from the outset she wanted people to understand what children's hospice care is, what palliative care is and the needs of children and families," Tracy Rennie, director of care at EACH, tells PEOPLE.

Fast forward to 2019 at the opening of the new Nook hospice, Kate's ability to speak with a bereaved family she met at the facility surprised the professionals in her midst.

"Afterwards, she said, 'My goodness, how do the staff cope with the emotion of working with these families?' I said, 'We have training and experience with families over the years.' My response to her was, 'I was going to say well done to you,' " Rennie adds.

Explaining her special touch, Rennie continues, "She has this natural, quiet confidence. When she smiles, her whole face smiles."

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KIRSTY WIGGLESWORTH/POOL/AFP via Getty Images Kate Middleton

Although cautious and shy at times, she has remained steadfast in what she's wanted to achieve through her royal work. And it's that drive that led her to set up a new foundation surrounding her interest in early childhood. After a year of research into what parents, carers and teachers want to see happen for children ages 0-5 (including a groundbreaking national survey), she set up a branch of the Royal Foundation dedicated to child development.

She headed to a school in Harrow, northwest London on November 24 where children ages 12-13 were learning lessons about the science of babies' brain development so they can be better prepared in future professions – or even as they play with their young siblings. During her visit, she effortlessly moved from table to table taking part in the exercises with the children.

"This is not just scientists talking about brains — it's that actual real-life change of practice and behavior that's important," says Dr. Elizabeth Rapa, a senior scientist from Oxford University's SEEN project who accompanied Kate on her visit to Nower Hill school, in Harrow, London. "She completely understood how we need to give more gravitas to this [subject] and that everyone needs to understand and make that connection between your brain development and your future long-term health."

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Kate also has a deep interest in breaking the stigma surrounding mental health in young people and families. It's a cause she has championed since those first months of her married life a decade ago, when she adopted the charity Action on Addiction. Last October, she spoke with authority at a special conference run by allied charity the Forward Trust, underlining the message that the challenges of the present are often rooted in childhood and the past.

Addiction is "all too rarely discussed as a serious mental health condition," Kate said. "And seldom do we take the time to uncover and fully understand its fundamental root causes. The journey towards addiction is often multi-layered and complex."

While the meeting may have centered around her speech, Kate had a way of helping smooth the jitters of attendees like former prisoners, families of addicts and people in recovery.

"They got on so well because of the common humanity and all of that was set out by the Duchess's leadership. We know how these events can be quite stilted and formal and that one wasn't – and that's because of the way the Duchess is," says Forward Trust CEO Mike Trace.

Her first visit with the charity (when it was called RAPt) was at a prison about seven years ago and Kate has stayed in touch with some of the women she met that day and keeps up with their progress.

"We put her in a room with six women prisoners and that could have gone badly wrong," Trace recalls. "But it didn't because she understood and connected and empathized with what they were talking about and responded very positively."

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He adds, "She's really good at human empathy. Whatever mistakes people have made in life, or they are struggling with, they have basic humanity like the rest of us and she gets that."

And when certain events call for a bit of spontaneity, Kate's playful personality is on display. Scout volunteer Eddie O'Rourke, 30, saw first-hand the chemistry between Kate and William when he and his troop from Glasgow's South East District joined them for an outing in October. The couple took part in an environmental exercise, making wet balls of seeds, sticky mud, flour and water and then planting them. At one point, Kate threatened to rub the muddy mess in William's face. He mockingly recoiled and laughed.

"You know what? They are still playful even though they are this famous royal couple," O'Rourke says.

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One of Kate's longstanding causes has been that of children's mental health and the wellbeing of families. At the forefront of that is the Anna Freud Centre, where chairman Michael Samuel says she "has carried out her role with passion and compassion."

They believe that through her support the organization has been "able to reach out to hundreds of thousands of children and young people who otherwise would not have received the support we have to offer," he adds.

And since her official involvement began in 2016, her knowledge has only grown. Samuel adds, "The Duchess has a sophisticated understanding of the scale of the problem and the importance of addressing it, not just for the here and now but for the future.

"Childhood mental health has a profound impact on quality of life in later life. HRH has shown vision and commitment in establishing The Royal Foundation Centre for Early Childhood, which was set up with expert guidance from the Anna Freud Centre. She has also inspired the development of Mentally Healthy Schools, a website run by the Centre which brings together quality assured mental health resources, information and advice for all schools across the UK."

Chris Jackson/Getty Kate Middleton and Prince William

Jillian Edelstein, who spoke with Kate when she met Holocaust survivors at the Imperial War Museum last November (Edelstein had photographed one of the subjects, as Kate had done), has met the royal several times over the last decade. She first met her as Edelstein photographed people heralding the London 2012 Olympics.

"Ten years have gone by when I first met her. If you remember she almost kicked off the games with all the publicity she did then," Edelstein says.

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Her public work is "integrated into her daily life" and she does it, even taking on difficult subjects that still need to be told like the Holocaust, with positivity," she adds. "There are these tough stories and they need to be constantly told, lest we forget."

"Maybe it's having children, it's that sense, the knowledge of how life can turn in an instant and these are what these stories can tell so powerfully. She has grown into her role. It didn't feel tired, it didn't feel like it was a chore, but felt integral and with joy and integrity."

"There was a sense of her – I mean, you sort of think of Princess Diana and the Peoples' Princess, but she felt so utterly in the moment and so utterly focused and engaged. It was so impressive, really."