The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly worn out and exasperated, ran after him, grabbed him by the arm and said in a harsh whisper, "You must stand here!"We were on line waiting to board a Southwest Airlines flight. For those of you not familiar with the Southwest system, there are no assigned seats. Rather, ...
Claudia M. Gold, MD
When parents respond to the meaning of a child’s behavior
It was a peaceful Saturday morning at Fuel, a local coffee shop in Great Barrington. People sat quietly murmuring with friends over coffee and muffins, or intently working at their laptops. I was doing the final edits for my forthcoming book Keeping Your Child in Mind, when I looked up to see a small boy of about two years tottering down the narrow aisle holding a plate with an ...
Baby monitors abuse the vulnerability of parents for profit
Recently I was interviewed by a reporter about the effects of the newest baby monitors on parent-child relationships. A teddy bear with a camera in its nose hooks up to a TV, allowing parents to watch their baby's every move.One product called an exmobaby is actually worn against the baby's skin and measures heart rate and respirations. A CEO of ...
How can research capture the complexity of tiny moments?
Recently, as I listened to leading researchers grapple with the question of how to design a feasible study of intervention for postpartum depression, I held in my mind an image of a particular moment in my office.I was sitting on the floor with 10 month old Madison and her mother Nancy, who was struggling with postpartum depression. Nancy spoke of the strain Madison's refusal to take a bottle and her ...
Maternity leave and infant brain development
It is not until about eight weeks of age that an infant has a fully developed capacity for mutual gaze.Then a baby looks directly into his mother’s eyes, while she, in turn, reflects back this loving gaze, cooing softly in response to her baby’s earliest communication. When a mother looks at a baby in a way that communicates with him, not with words but with feelings, “I understand you,” he ...
Routine use of sleep medication for children
A recent study published in the journal Sleep Medicine revealed that most child psychiatrists prescribe medication for sleep at least once a month, despite the fact that no sleep medications are approved for use in children. The study was funded by Sanofi-Aventis, makers of Ambien.Managing sleep is one of the greatest challenges of being a parent. It represents the first major separation and can be fraught with complex ...
Children who are difficult may not be simply toxic
As a pediatrician I have listened to many parents speak of their child in very negative terms. Dr. Richard Friedman, in his New York Times article entitled Accepting That Good Parents May Plant Bad Seeds shares his patient's description of her "rude and defiant" teenage son. Like the parents in his piece, the parents of my patients have other children with whom they have had no such difficulty. ...
Too many young children are medicated with powerful drugs
Recently while cleaning out my office in anticipation of my new job, I discovered that I had unknowingly been witness to to an historic moment in child psychiatry. I found a binder from a course I had taken in June of 2001 sponsored by Harvard Medical School on Major Psychiatric Illnesses in Children and Adolescents.Though I did not remember until I looked at my scrawled notes in the margins, on ...
ADHD and how drugs impede meaningful help for children
I recently received a call from a mother that made me both want to cry and scream out in frustration.Several months ago I wrote a post entitled Drugs for Children May Silence Stories, in which I described a young boy who had suffered severe neglect as an infant. His adoptive parents had sought help from me when he was four, but when I recommended intervention for the whole family ...
Prevent bullying by accepting healthy aggression
“Momma, have you ever felt like there’s a puzzle and there’s a piece missing and you find the piece and it fits? When I’m with the Maasai all the pieces fit.”This is a quote from my friend Roland, a seven year old boy, on a trip to Tanzania with his mother. He was on a safari and, using a stick, he was learning how the Maasai use spears to protect ...
Adoption lessons after Artyom Savelyev
The trauma for Artyom continues. After having been given up to an orphanage by his alcoholic mother who lost her parental rights, being adopted by a US family, sent back to Russia alone when his adoptive mother allegedly was unable to cope with his psychological problems, he has now become the object of a tug-of war between Russia and the US over his citizenship. His future seems to hold unimaginable ...
Pediatricians need to wonder when dealing with behavior problems
Last week, I again had the privilege of teaching pediatricians in training. These students were very bright, challenging and asked excellent questions. They all agreed about the limit of the pediatric model of "giving advice." One resident, who had young children of her own, spoke of new mothers using blogs for emotional support. Many of these mothers speak less than kindly about their pediatricians, who they perceive as "not getting ...
ADHD needs more than drugs to appropriately treat
I consider my most successful cases to be the ones that do not seem me any more. Not that they are "better", but they and their families have come to realize the full complexity of the problems they are struggling with, and are getting appropriate help.I inherited my "ADHD practice" from another pediatrician. He was wonderful man, a larger than life, toss babies in the air pediatrician with a hearty ...
Children who are traumatized need more than medication
In the Academy Award winning film, Precious, the main character’s transformation comes about largely through her ability to tell the story of her trauma, specifically in the form of writing. In this endeavor she is encouraged by a loving teacher.In the book History Beyond Trauma, two French psychoanalysts argue that symptoms their patients exhibit represent the horrors of war that are not spoken of, sometimes for generations. The patient is ...
Guilt used in a positive manner can help with parenting
In my pediatric practice, it is not uncommon for a mother, given the time, to move quickly away from telling me about her child’s behavior problem, to talk about herself, sharing vivid stories of emotional distress from her own life. I may suggest that this distress could make it difficult for her to deal with the challenging behavior of her child.Rather than finding this statement helpful, she might collapse back ...
Aggressive behavior in children and the family dynamic
In the Tony award winning play God of Carnage two couples meet in an elegant living room for an ostensibly civilized conversation about the aggressive act of one couple’s child against the other’s. The meeting soon degenerates to reveal the underbelly of conflict in the two marriages. Husband and wife hurl insults, precious items and even themselves with escalating rage. We see, as they attempt in vain to focus on ...
Bipolar disorder and how Rebecca Riley could have been saved
Carolyn Riley’s act of giving her daughter Rebecca an overdose of prescribed medication may have been the immediate cause of Rebecca’s death, the conclusion reached by the jury that convicted her of murder.Even if, as the prosecutor argued, Carolyn and her husband concocted symptoms of mental illness and the psychiatrist, who diagnosed bipolar disorder, was a gullible enabler, the real guilty party in this story is, in my opinion, ...
Value doctors as listeners to prevent primary care burn out
A recent editorial in the Boston Globe addressed the dearth of primary care physicians. The piece concluded: “Federal funding for new residency slots should follow reforms that address the underlying reasons - principally money - that lead doctors to choose to specialize.”Money is certainly important. But there is another obstacle to attracting primary care doctors that is more subtle, though perhaps equally important. Consider the following story.Recently I had ...
