Being understood by a person we love is one of our most powerful yearnings, for adults and children alike. The need for understanding is part of what makes us human. When our feelings are validated, we know that we’re not alone. For a young child, this understanding helps develop his mind and sense of himself. When the people who care for him can reflect back his experience, he learns to recognize and manage his emotions, think more clearly, and adapt to his complex social world. When families come to see me in my pediatrics practice for “behavior problems,” both parents and children feel estranged and out of control. They are disconnected, angry, and sad. I help them recognize each other. Meaningful change happens when we share these moments of reconnection.
My approach and the ideas behind it have grown out of the unique experience of working on the front lines with children and families in a busy small-town pediatric practice while simultaneously studying contemporary developmental theory and research as a scholar with the Berkshire Psychoanalytic Institute. This research has had direct application to my work and has helped me to help families in dramatic and meaningful ways. I see day after day that if a parent is given the space and time to think about her child’s experience, it has a significant and immediate effect on the child’s behavior. “Behavior problems” are actually symptoms of disruptions in relationships. My approach can be applied to a wide range of behavioral issues, including, but not limited to, excessive crying, sleep problems, and explosive behavior. As relationships are healed, behavior improves. As children learn to manage strong emotions, parents have an increased feeling of competence. A positive cycle of interaction is set in place. The rapidly moving train of development gets back on track.
Parents are inundated with books on how to solve behavior problems, as well as books on how to raise a child with any number of biological vulnerabilities: the “spirited child” the “shy child,” the “explosive child,” and the child with “sensory issues.” The standard approach in these books is to offer some explanation of the child’s behavior, followed by advice about how to handle a variety of challenging situations. These books provide strategies for managing temper tantrums, sibling conflict, or outings to the grocery store. The focus is on “what to do.”
In my work with families, I focus not on “what to do” but rather on “how to be” with your child. Guided by the most current research in child development, together with more than twenty years’ experience practicing pediatrics, I focus on this one basic point. What a child needs most is to have you recognize and empathize with his experience and help him to contain strong emotions. Whatever quirks and vulnerabilities he may have, they rarely suggest that something is “wrong with him.” Rather, they are a unique set of challenges that he must learn to cope with and even perhaps use as an asset as he grows and develops.
Consider Ella, who as a young child was very sensitive to sensory input and overwhelmed by loud noises. She would get agitated and have meltdowns at the most inopportune times. Once when she was three, she exploded at a children’s concert where all the other children were quietly sitting on their mothers’ laps. At that particular moment, her mother, Beth, might have felt any number of very distressing things, from “what’s wrong with my child?” to “I’m a bad parent.” She might have yelled at her, or left in a rage, overwhelmed by a sense of shame and failure.
Instead, Beth took Ella to a coat closet next to the auditorium, where she was close enough to hear yet not be overwhelmed. She held Ella on her lap and talked to her about how loud noises were hard for her without conveying a sense that she had been “bad.” In doing so she gave Ella the security and the language she needed to think about what was happening to her. In time she might recognize her sensitivities and come to master her distress. Indeed, by age eleven Ella had learned to play several instruments and loved to sing and dance on stage. It is quite possible that her extreme sensitivity to various kinds of noise, which as a young child was such a challenge for her, now manifests itself as a talent for musical endeavors.