Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary developmental science can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Friday, February 26, 2010

DSM-V, Warner and Winnicott

In today's Boston Globe I have an op-ed about DSM-V: " Warning label on a new diagnosis." Interestingly, while I wrote the piece before I knew anything about Judith Warner's new book, it reads like a rebuttal to her thesis.

I will try to have this be the last post to mention her. As an antidote to the distress her book has caused me, I have been reading a book by D.W. Winnicott, a pediatrician turned psychoanalyst who has been a very important influence on my work.

As a scholar with the Berkshire Psychoanalytic Institute, I read many of Winnicott's academic papers that were written for psychoanalysts. I wanted to read more of what he had written for a broader audience. Winnicott on the Child is a collection of his work, some of which addresses an audience of parents and some speaks to range of professionals who work with children. There are wonderful introductions by Benjamin Spock, T.Berry Brazelton, and Stanley Greenspan.

The book is full of riches. Here is just one example. Winnicott is addressing the change a woman experiences in her life when she becomes a mother.

Then, one day, they find they have become hostess to a new human being who has decided to take up lodging, and like the character played by Robert Morley in The Man Who Came to Dinner, to exercise a crescendo of demands til some date in the far-extended future when there will once again be peace and quiet; and they, these women, may return to self-expression of a more direct kind. During this prolonged Friday-Saturday-Sunday, they have been in a phase of self expression through identification with what with luck grows into a baby, and becomes autonomous, biting the hand that fed it.

All of this talk about how medication can protect the brains of young children makes me hypertensive. But when I read Winnicott's writing, which, though he does not use this language, is essentially about how relationships between people can protect the brain, I take a deep breath, relax, and think to myself "Now this is what life is really all about!"

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