Practicing in the time before hospitalists, my on-call duties included examining all babies shortly after birth. In the room with parents and their newborn time melted away: all the outside routine pressures of my life disappeared. The inconvenience of sleep disruption when called to a middle-of-the night c-section paled in comparison to the power of riding the elevator from the first floor OR of our small hospital to the third-floor nursery with a new father gazing in wonder at his baby in the isolette. I saw again and again how a newborn baby brings us into the present moment like nothing else. For them there is only “now.”
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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.
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.
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."
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.
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.