Preserving Emotional Health: Making Meaning in the COVID-19 Pandemic

Pediatrician and psychoanalyst D.W. Winnicott would understand why COVID-19 threatens to bring on what has been referred to as a “shadow pandemic” in the form of a mental health crisis. Winnicott used the lovely phrase “going on being” to describe the continuous sense of self that emerges in moment-to-moment interactions in our earliest relationships and continues to evolve in new relationships over time. He described the “unthinkable anxiety” that accompanies a loss of that sense of self.

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Community Trauma Prevention Starts with Parent-Infant Relationships

The COVID-19 pandemic has called on us to find creative ways to connect and learn. In rural western Massachusetts I had scheduled a training for 20 practitioners who work with parents and infants to meet together for two days of learning on April 15 and 16th. Instead I rapidly adapted the training to the online setting. I have had the pleasure of meeting weekly with an extraordinary group that includes peer recovery coaches on the front lines supporting moms with opioid use disorders, clinicians and administrators from Child Protective Services, physicians, occupational therapists, early intervention specialists, and early childhood educators to learn together for a course in “Community-Based Parent-Infant Relationship Support.

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Love in the Time of COVID-19

Safety and trust go hand-in-hand with a sense of belonging. The fact that those who stay home and spend their time watching funny YouTube videos are protecting the front line healthcare workers offers a striking demonstration of belonging. The virus itself shows us how interconnected we are.

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Pregnancy and COVID-19: Finding Hope Amidst Fear and Uncertainty

When it became clear that all our lives would all be upended for an indefinite period of time by the corona virus pandemic, as an infant-parent mental health specialist my first thought went to families due to deliver babies in the coming days, weeks, and months. Some degree of fear and uncertainty around the birth of a baby is typical. Expecting parents worry that the baby will be damaged, that the “real” baby will be different from the wished for baby. Now for pregnant women and their families these ordinary feelings are suddenly exponentially magnified.

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The Wisdom of the Ordinary Devoted Mother

In preparation for teaching a course on early childhood mental health, I had the pleasure of reconnecting with the profound wisdom of his writings. While Winnicott wrote extensively for both a general and a professional audience, I discovered, on careful re-reading of his essay for a general audience entitled “The Ordinary Devoted Mother” that it contains a vast wealth of ideas. In fact, if I had to assign only one paper for the entire course, this could be it.

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Helping Parents Make Room For Uncertainty

Many parents today are burdened by an expectation of perfection. When we can protect time to listen to parent and baby together, we convey the idea that, in contrast to a “right” way, they will figure things out together. Growth happens through repair of inevitable mistakes we make along the way.

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The Allure (and Danger) of Certainty: A Developmental View

Stress and adversity are ubiquitous. Adversity becomes “trauma” when it is compounded by a sense that one’s mind is alone. When children grow up in an environment characterized by lack of curiosity about their experience, where they do not feel listened to by their primary caregivers, epistemic mistrust, or hypervigilence, along with a sense of social isolation, develops. An individual then faces what Fonagy terms an “epistemic dilemma, “ characterized by cycling between hypervigilence and excessive credulity
For a person facing this dilemma, a leader who speaks with absolute certainty, leaving no doubt that he or she is the one to whom we should listen, has power to protect against the emotionally intolerable experience of being alone. In this state, feelings can override facts. This developmental model helps to make sense of our current political situation. In a democracy, when a large population feels fundamentally disconnected and unheard, filled with mistrust yet also vulnerable to emotionally driven messages, it makes all of us vulnerable.

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Parenting and Empathy: An Essential Partnership

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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