The Exquisite Pain of a Child’s Sadness: Finding Confidence to Bear It

Toni held the drawing up to the Zoom camera. for me to see A stick figure stood in the middle: big blue tears the size of her head lined the page reaching from her eyes to the ground below at her feet. Even through the screen I could feel the heart wrenching pain portrayed in the picture. Toni surprised me by then saying, “I want her to be able to feel sad.” I asked if she would tell me more. She vividly recalled experiences from her own childhood when she sensed that her parents could not accept her feelings. Sadness transformed to anger and then uncontrolled rage. The frustration of not being seen felt alive in her now as she held her daughter close.

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What is Children’s Mental Health Care? An Expanded View*

Emotional well-being and emotional distress both grow out of variations in the repeated moment-to-moment exchanges that make each of us who we are. On one end of the spectrum, robust interactions lead a person to experience the world as safe and filled people who can be trusted. At the other extreme, fear and mistrust inform a person’s understanding of himself and the world around him. The two extremes help us make sense of the more typical experiences that fall somewhere in between. Rather than being fixed, the meanings you make in your earliest experience are continually changing in new relationships in an ongoing process of making meaning of yourself and the world as you grow and change.

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Becoming Unstuck: Listening for Meaning in a Child’s Behavior

In my years of practice it never ceases to amaze me how effectively young children can communicate the source of a problem through their behavior. Of course Harry did not know or understand the role of unmourned loss in his parents lives and in their relationships. But he absorbed the distress and “acted out” as if to say, “I need you to deal with this so you can see me as myself.”

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Parenting and the Stigma of Emotional Suffering

Families who struggle with substance use disorders can face enormous obstacles in their recovery. In caring for Leila and her parents I felt license to talk openly about stigma as a well-recognized part of the problem. Perhaps this experience can offer us a lesson for all families with young children.

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Born Into Violence: Listening as Prevention

In that moment of connection, Calvin made hopeful meaning of himself. If he had words, he might have said, “I can change my world to make it better.” He communicated with his mother in a way that also changed the meaning she made of his behavior. Her negative attribution based on her experience of violence shifted. Psychoanalyst Lou Sander referred to this kind of interaction as a “moment of meeting.” Parents and infants make meaning of themselves in the world through hundreds of thousands of moments. Unfortunately for this family, their circumstances did not allow for the calm space for listening offered that night in the hospital.

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Parenting Through Grief: “I’m Her Only Mother”

I refer to this process as “bringing in the baby” in clinical work with parents struggling emotionally around the time of childbirth. While certainly this mother’s grief remained front and center in my thinking, my unique role was to support her relationship with her newborn child. I have found that rather than various forms of “talk therapy,” the actual baby and their communication often offers the most powerful voice for growth and change.

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Peter and the Bear: Finding Hope in Child’s Play

3-year-old Peter and his family were referred to my behavioral pediatrics practice for help with “managing his aggression.” In the second session, having taken a full hour to listen to the story from his parents Jonathan and Jalissa the previous week, we are all sitting on the floor. Peter drapes himself across his father Jonathan’s lap, wriggling around while drawing with markers on a pad on the floor. His mother quietly observes. There is a long moment when it feels like nothing is happening. I notice in myself that feeling of not knowing what’s going on, but will myself to tolerate the discomfort of uncertainty.

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The Examined Life: Listening to the Baby

Photo by Aditya Romansa on Unsplash

No matter how messy the situation in which we find ourselves, this singular focus on the transformative impact of facilitating moments of meeting between parents and their young children brings a sense of calm purpose to the work. Again and again we observe how such moments produce extraordinary changes in families, shifting the narrative from generational trauma and disconnection to possibility for healing and growth.

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Mother, Father, and Baby: A Pandemic Moment of Meeting

In the final minutes I remarked on the unusual way Zoom sessions allowed for a kind off photo op by screen shot framing their family of three. Of course I wouldn’t take a photo of them as that would have been inappropriate for the setting, but I wanted to share with them what I saw. In our hour visit, with opportunity to slow things down and make meaning of everyone’s experience, we created a moment of meeting. As together we navigated from mismatch to repair, both Alice and Carter appeared to feel a renewed sense of confidence. With hope, moments like this strung together over time will serve to buffer this growing family from the storm of challenges the world presents in this time of unprecedented anxiety and uncertainty.

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Trust: A Book Review

Why is trust vulnerable in America today? Pete Buttigieg asks this question midway through his brilliant new book Trust: America’s Best Chance. In it he lays out a clear, concise, and compelling argument for the urgent need to rebuild trust in order for our country to heal and grow. Not only his extraordinary wisdom but also his unrelenting sense of hope make his voice one we must listen to at this time of unprecedented uncertainty. As a pediatrician and infant mental health specialist I read his book from the perspective of developmental science, with the knowledge that trust has its roots in our earliest relationships starting from birth. What relevance does this knowledge have, I wondered, to Buttigieg’s core thesis? Does it help us to understand why trust is vulnerable? And if so does that knowledge guide us into any specific form of action?

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