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How Psychotherapy Works: Learning from Infants

Repair Theory has significant implications for treatment of emotional suffering. It offers a model of mental health that differs dramatically from the medical model of mental illness. Rather than being fixed, our emotional wellbeing evolves in a continuous process over time. Early interactions lacking in robust repair create meanings of hopelessness that lead to emotional suffering and derailed development. New sets of relationships with different quality of interactions can promote healing and growth across the lifespan.

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.

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.

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."

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.

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.