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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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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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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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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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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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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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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Last week I had the privilege of reconnecting with Anna Ornstein, a brilliant child psychiatrist and one of my original mentors. In preparation for our meeting, I re-read a paper she had given me back in 2004* (written with her husband Paul Ornstein, MD about 20 years before that), when I was just beginning to develop the ideas now described in my book, Keeping Your Child in Mind. While I do not reference the paper in my book, it is filled with such wisdom that I felt compelled to quote large segments of it in this blog post. Interestingly, much of what she says is similar to what in the current world of developmental psychology is referred to as “reflective functioning, ” or what I refer to in my book as “holding a child’s mind in mind.” While in that language, empathy is included as one component of the more complex task of reflective functioning, in Dr. Ornstein’s language “empathy” encompasses the many components of reflective functioning
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