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.
Continue readingCommunity 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.
Continue readingParent-Newborn Relationships in the COVID-19 Pandemic: Moments of Meeting
Leila was in the early stages of labor in mid-March when she and her husband learned they would have to go it alone. They already had planned a home birth, but neither they nor their doula had yet mastered the techniques of remote healthcare as we as a society tried to find our footing amidst the chaos of the exploding pandemic.
Continue readingLove 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.
Continue readingPregnancy 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.
Continue readingHeartland: Poverty and Belonging In Rural America
So while there is much to say about the lessons from her brilliant book, I am writing this post to highlight the insights she offers into the complex intertwining of poverty and parent-child relationships.
Continue readingThe 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.
Continue readingHelping 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.
Continue readingThe 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.
Postpartum Depression:Bringing in the Baby
A baby may be sensitive to touch or sound, or struggle going from awake to asleep, or any of a range of qualities that may make negotiating the big, loud, complex world more challenging. If, in addition, his caregiver is struggling with depression, the dance may be further disrupted. Or the problems in the baby may cause depression in the mother, as when the baby cries all the time and the mother never sleeps. When these disruption are not addressed early, significant problems may develop.
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