Anxiety and the Not-Knowing Stance: Lessons from Winnicott

Faced with overwhelming anxiety— both internal and external— people cling to certainty as a form of protection. But ironically this certainty only serves to make us more disconnected from each other. We miss the opportunity to grow and change by moving through misunderstanding to understanding.

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My Father’s Story: Before the Holocaust

While I hadn’t yet mentioned the movie, my father told me of the radio announcers’ frequent refrain of “all quiet on the Western front” while “hundreds young men were slaughtered every day.” His voice trembled: his face contorted in an effort to contain the flood of emotion. He repeated the phrase in the original German.”Im Westen Nichts Neues” or “Nothing new in the West.” When I shared that we had just seen the movie, tears ran down his cheek. He opened himself to expression of feelings so deeply hidden for so long.

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Confronting Terror: The Power of Human Connection

In March 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.

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“Just Because It’s Hard, You’re Not Doing It Wrong:” Learning from Babies and Parents

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.

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A Child’s Tantrums: Beyond the Dominant Narrative

A powerful new model named “At The Feet of Storytellers” was presented at the Zero To Three annual conference in October. Rooted in investigation of thoughts, observations, and experiences of African American families, the model of “Early Relational Health Conversations” puts time and space for non-judgmental listening at its core. A pilot study of implementation in pediatrics practice showed significant impact, with publication of findings forthcoming. Intentionally not a “screening tool,” it places the clinician literally on the floor, to learn about strengths of the family system and identify vulnerabilities and needs.

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Listening to a Young Family’s Suffering

In in my role as faculty of the University of Massachusetts Boston Infant-Parent Mental Health program. I recently listened to a presentation by Dr. Barbara Stroud in which she placed caring for young children and their families in the context of systemic racism. Describing “voices that have been silenced” she cautioned us to “stop talking, teaching, and intervening long enough to listen.” When a month later Dr. David Willis spoke for the same program about Early Relational Health, he put my struggle with both “screening” and “assessment” into a new and interesting frame. Alluding to their judgmental nature, he looked at these constructs as “white dominant cultural products.” He spoke of the need to attend to power dynamics in supporting relational health with a model of promotion and prevention. His language resonating for me with the idea of protecting space to listen from a place of not knowing; to take time to imagine our way into another persons’s experience.

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The Opioid Crisis: A Vicious Cycle of the Quick Fix

When a pill is the primary treatment without attention to the full relational and social context of individual suffering, people remain stuck in patterns of disconnection and harm. We see a downward spiral of intergenerational trauma and loss tearing apart the fabric of our society. One can argue that this is true of both physical and emotional pain.

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Cultural Humility as Listening: The Power of Not Knowing

As a physician in training, I learned the concept “cultural competence.” The term suggested that by acquiring knowledge and information we could become experts in people different from ourselves. The current term “cultural humility” reflects a kind of humbleness of not knowing; a necessary time when we feel awkward and uneasy.

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Celebrating Pediatricians’ Embrace of Early Relational Health

The Frameworks Institute (that also developed the term “toxic stress”) wrote in a recent report: “Early relational health, although a new term, does not designate a new field nor a series of new discoveries. In fact, early relational health builds upon decades of research from the fields of child development, infant mental health and neurodevelopment that has established the centrality of relationships between caregivers and very young children for future health, development and social-emotional wellbeing.”

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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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