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.
Continue readingThere’s Something Wrong with My Baby: Beyond Reassurance
A great teacher once said to me, “Reassurance is an assault.” When a parent worries something is wrong with their child, reassurance that “everything is fine” can feel dismissive, producing a sense of being misunderstood and alone. Behind the worry lies a story. With protected time for listening, meaning can come to light.
Continue readingWhat 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.”
Continue readingThe Forgotten Appointment: Mismatch-Repair and Therapeutic Change
Now over a decade since my therapy ended, I understand that its enduring impact on my emotional wellbeing lies not primarily in the story I told in words but in the countless moments of moving from misunderstanding to understanding strung together over time. The microscopic mismatches in interactions contained in the office space, the larger disruptions of days between appointments and vacations, as well as some massive ruptures, including the forgotten appointment, all contributed to the process. They changed the nature of my sense of self and my relationships with people close to me.
Continue readingThe 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.
Continue readingParenting and the Stigma of Emotional Suffering
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.
Continue readingBorn 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.
Continue readingParenting Through Grief: “I’m Her Only Mother”
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.
Continue readingPeter 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.
Continue readingThe Examined Life: Listening to the Baby
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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