Early Relational Health: Preventing Intergenerational Transmission of Shame

Guilt can be a normal and healthy emotional experience. “I’m guilty” can also mean “I’m responsible.” Shame, in contrast is always pathological, and can have destructive effects on emotional development. But without an opportunity to hear the family story, it is impossible to distinguish between the two. Knowing Paul’s story, we can understand it as a kind of intergenerational transmission of shame. Isabel’s sad feelings and expressions of low self-esteem were a communication of distress at an environment of rage, directed both at her and between her parents. One can understand her behavior not as an illness but as an adaptive effort to change the situation.

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Confronting Terror: The Power of Human Connection

of 2020, we were all collectively faced with an invisible yet terrifying threat. The group including fellows, faculty, and luminaries held each other over countless messy moments of uncertainty and loss. The result was a profound sense of connection and trust that fueled the explosion of creativity brought forth in their work. The impact will change the lives of infants and families throughout the world for years to come.

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Roots of Democracy Lie in Listening to Parents

Nelson Mandela famously said, “The true character of a society is revealed in how it treats Its children.” A more accurate revision might read: “how it treats its parents and other caregivers of infants.” As Winnicott wisely observed, “It should be noted that [caregivers] who have it in themselves to provide good-enough care can be enabled to do better by being cared for themselves in a way that acknowledges the essential nature of their task.”

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“Just Because It’s Hard, You’re Not Doing It Wrong:” Learning from Babies and Parents

For only by understanding what is “normal”- or the term I prefer “typical” -can we build a model of promotion and prevention. A frame of understanding rooted in healthy development can guide treatment of families when development has gone awry. This model has relevance for relationships throughout our lives. Simply taking time to carefully listen to parents with a young infant as they take us inside their moment-to-moment experience can be an important part of our collective learning.

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ADHD in Preschoolers: A Case of Polarizing Certainty

The rush to diagnose itself represents an intolerance of uncertainty. Sitting in the discomfort of not-knowing while taking time to make sense of the problem calls for a feeling of safety and community of support both of which are lacking for parents and professionals alike. Parents feel judged about their child’s behavior. Clinicians feel urged to find the answer in unrealistically brief visits under pressure of a waiting room full of kids.

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Listening for Loss: My Father’s Holocaust Story

Last week my husband Joe, our two dogs, and I shared a celebratory dinner with my parents on the occasion of my father’s 98th birthday. After a festive evening filled with hope against the backdrop of a darkening second winter of Covid, Joe suggested on the car ride home that I write about it. As readers of my blog know, I am immersed in work on a new book about listening for loss. I should practice what I preach.

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A Child’s Tantrums: Beyond the Dominant Narrative

A powerful new model named “At The Feet of Storytellers” was presented at the Zero To Three annual conference in October. Rooted in investigation of thoughts, observations, and experiences of African American families, the model of “Early Relational Health Conversations” puts time and space for non-judgmental listening at its core. A pilot study of implementation in pediatrics practice showed significant impact, with publication of findings forthcoming. Intentionally not a “screening tool,” it places the clinician literally on the floor, to learn about strengths of the family system and identify vulnerabilities and needs.

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Listening to a Young Family’s Suffering

In in my role as faculty of the University of Massachusetts Boston Infant-Parent Mental Health program. I recently listened to a presentation by Dr. Barbara Stroud in which she placed caring for young children and their families in the context of systemic racism. Describing “voices that have been silenced” she cautioned us to “stop talking, teaching, and intervening long enough to listen.” When a month later Dr. David Willis spoke for the same program about Early Relational Health, he put my struggle with both “screening” and “assessment” into a new and interesting frame. Alluding to their judgmental nature, he looked at these constructs as “white dominant cultural products.” He spoke of the need to attend to power dynamics in supporting relational health with a model of promotion and prevention. His language resonating for me with the idea of protecting space to listen from a place of not knowing; to take time to imagine our way into another persons’s experience.

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The Opioid Crisis: A Vicious Cycle of the Quick Fix

When a pill is the primary treatment without attention to the full relational and social context of individual suffering, people remain stuck in patterns of disconnection and harm. We see a downward spiral of intergenerational trauma and loss tearing apart the fabric of our society. One can argue that this is true of both physical and emotional pain.

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Cultural Humility as Listening: The Power of Not Knowing

As a physician in training, I learned the concept “cultural competence.” The term suggested that by acquiring knowledge and information we could become experts in people different from ourselves. The current term “cultural humility” reflects a kind of humbleness of not knowing; a necessary time when we feel awkward and uneasy.

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