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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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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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.

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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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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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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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