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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Autism Prevention in Infancy: A Broad Interpretation

Especially in the time of COVID parents are raising children in a highly stressful, unpredictable, and often overwhelming environments. Now more than ever, deliberate efforts to protect space and time to listen both to parents and infants using a simple, low-cost intervention, as described in Green’s research, might go a long way in mitigating the negative impact of these difficult and uncertain times.

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Sleepless New Parents: Navigating Uncertainty and Loss

Sleep itself represents among the earliest forms of separation. While sleep disruption inevitably accompanies new parenthood, when families suffer to the point that they find their way to my office, usually they are grappling with a deep sense of loss. A search for certainty becomes an obstacle to exploring the source(s) of that pain. Time and a safe space for listening offers families opportunity to move through grief to reclaim joy.

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Celebrating Pediatricians’ Embrace of Early Relational Health

The Frameworks Institute (that also developed the term “toxic stress”) wrote in a recent report: “Early relational health, although a new term, does not designate a new field nor a series of new discoveries. In fact, early relational health builds upon decades of research from the fields of child development, infant mental health and neurodevelopment that has established the centrality of relationships between caregivers and very young children for future health, development and social-emotional wellbeing.”

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A Child’s Joy in Growing Up: A View from the Pandemic

Typically, the process of separation of child from parent takes place both gradually and relentlessly. The pandemic put a long pause on this natural progression. As we begin to resume “normal” life many will manage re-entry without significant difficulty and get back on track. But for those with a variety of vulnerabilities, the expanse of time to live in the ambivalence may lead to developmental derailment. Whether 2, 12, or 20 these children and their families will need an extra dose of listening and support to find their way forward.

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Creating Space to Discover a Baby’s Intentions

In a fascinating book Becoming Human, research psychologist Michael Tomasello sees the ability to recognize each other’s intentions as central to our humanness. He proposes that “the ontogeny of human cognitive and social uniqueness is structured by the maturation of children’s capacity for shared intentionality.” To highlight the significance of the process he writes: “Social Bonding via the sharing of emotions, attention, actions and attitudes is an evolutionarily novel phenomenon: individuals feel closer to others as they share experiences with them. This is foundational to virtually all forms of uniquely human cooperation and shred intentionality.” He names the age of nine months, when this behavior first becomes easily observable, the “birth of shared intentionality.”

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Sensory and Emotional Experience: Linked from Birth

Recently in my role as faculty with the University of Massachusetts Boston Infant-Parent Mental Health Program I had the privilege to learn from Erna Blanche, a leader in the field of occupational therapy who trained with Jean Ayres, the mother of sensory processing theory and sensory integration therapy. She described the connection of movement with many different sensations: body position, internal workings of our bodies (interoception), and even the pull of gravity. A number of the fellows, who come from a wide variety of disciplines and from all over the world, expressed a wish to “be an OT in another life.” Since I first became aware in my journey from pediatrician to infant-parent mental health specialist of the depth and breadth of knowledge in the field, I too have had the same thought.

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There’s Something Wrong with My Baby: Beyond Reassurance

A great teacher once said to me, “Reassurance is an assault.” When a parent worries something is wrong with their child, reassurance that “everything is fine” can feel dismissive, producing a sense of being misunderstood and alone. Behind the worry lies a story. With protected time for listening, meaning can come to light.

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What Babies Can Teach Us About Repairing the World

Recently I was asked to give a presentation for an audience of early childhood educators about the Adverse Childhood Experiences (ACE) Study. I jumped at the opportunity to frame this powerful research linking early adversity with long-term health consequences into a message of both hope and action. Thus I was particularly pleased to receive an email from an audience member with the following message: “Thank you for your work, the workshop left me with hope. It makes me think of tikkun olam.” I looked up this familiar phrase from Judaism to find its exact meaning: “World Repair.”

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Bearing Witness to Terror: Alana and the Apricots

After a few moments Kayleigh broke the silence. “This is what she does whenever we talk about food.” They now saw the fear in their daughter, but when I asked how long this fear had been present, Charese immediately thought of herself. She said softly, “Since she was born.” For Charese and Kayleigh the terror we saw in Alana connected directly to their own memory of terror that their daughter might die. The feeling now expressed in Alana’s behavior held a grip on the whole family. The therapy setting allowed us to slow the process down.

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