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 into her seat and exclaim in hopeless despair, “Then it’s all my fault!” I feel terrible when this happens. My intention had been to support her, not to blame her. I have thought long and hard about the reason for this reaction, and believe the source lies in the three closely related concepts of guilt, blame and responsibility.
Let’s start with guilt. Any parent will tell you that a hefty dose of guilt comes with the job. Where does this guilt come from? In large part from the natural but usually unspoken mixed feelings that parents have toward their children. Hundreds of parents, in the privacy and safety of my office, have told of being startled by the intensity of rage towards their young child for whom they also feel powerful love. A mother may even confess her disappointment that a difficult child who cries all the time is not the child she dreamed of when she was pregnant.
Yet her child expresses similar intense but opposite feelings. A wise toddler on a YouTube video tells his mother from his high chair,”I love you but I don’t like you.” And,like the mother who wishes for a different child, “I only like you when you give me cookies.” Strong opposing feelings are a part of any passionate relationship.
When a parent has these ambivalent feelings but does not acknowledge and accept them in herself, when a parent believes these feelings are “wrong” or “bad,” guilt soon
follows. The trip from guilt to blame is a short one. If parents feel guilty simply for having feelings, any suggestion that their behavior might contribute to their child’s development will naturally be heard as blaming them when things go wrong. If they feel guilty, they easily assume blame. This kind of guilt can be debilitating. Yet if we acknowledge and accept these mixed feelings in ourselves, rather
than being paralyzed by guilt, we can turn this whole idea on its head. Guilt can actually become a thingof value if we realize that “I’m guilty” can also mean “I’m responsible.” And “I’m responsible” also means “I can help.”
D.W. Winnicott, a kind of British Dr. Spock of the 20th Century, summed up these ideas in the following
way in Talking to Parents (Perseus Publishing, 1993): “I think on the whole if you could choose your parents… we would rather have a mother who felt a sense of guilt—at any rate who felt responsible — and felt that if things went wrong it was probably her fault. We’d rather have that than a mother who immediately turned to an outside thing to explain everything… and didn’t take responsibility for anything.”
Guilt and blame are negative words, and responsibility is a positive one. People generally feel good about themselves when they take responsibility for their lives. They feel empowered. But taking on theresponsibility for raising a child in a meaningful and effective way is not an easy task. In the setting of
fragmented families, financial stress or a parental history of abuse or neglect, it is especially difficult.Add to this a child with a challenging temperament, and the responsibility can easily feel overwhelming.
A child’s behavior is certainly not a mother’s fault. In fact, it may in large part be due to the qualities a child is born with. However, it is a mother’s responsibility to understand how troubles from her own life may affect her ability to respond to her child in the way that he needs. It important to address these troubles just enough so that she can move them off her child.
I continue to offer parents the opportunity to tell me about experiences from their own lives because I see again and again how this unburdens them and almost immediately helps them to feel competent in their parenting role, which in turn improves their child’s behavior. But this responsibility is an unfair burden to place on an individual parent if the society as a whole does not recognize both the difficulty and the value of effective parenting.
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 research in child development 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.