Mary had found her center. After many months of struggling with uncertainty as a new mother, she spoke to me of a new found confidence. We had been working on the common challenges of having an infant- sleep problems, difficulty weaning, conflicts with her husband Gordon in their struggle to find their way as a threesome.
Based on our discussions, Mary had made some decisions about teaching her son Bennett, who was now one year old, to sleep independently. She had elicited Gordon's help in weaning him. Now that she was able to sleep more than three hours at a time, she could finally think clearly. The low grade depression that had plagued her since Bennett was born had lifted. Mary was positively joyful as she spoke of her sense of accomplishment.
A month later, when I saw her for follow- up, she again seemed crushed, plagued by self doubt. She rambled from question to question. She was scattered and unsure. "I need to know who to ask, what books to read," she said. "What you need," I replied, "is to find your way back to that person who was here last time, who believed in herself. Where did she go?"
Mary agreed with my assessment of the problem. She told of a week long visit with her own parents. She experienced her mother as highly critical and undermining of her abilities as a parent. This visit, she realized, had thrown her off center. She recognized how much better things went with Bennett when she had that center, when she felt sure of herself. We needed to work together to help her find that self confidence again.
Dr. Spock's opening words of his book Baby and Child Care in a way speak to the importance of positive self esteem in any significant human endeavor. Trusting yourself as a parent is critical because it gives you a strong place from which to act. Finding that center, that trust in yourself, as we can see from the story of Mary and her family, is not always easy. Thinking of Mary, I was reminded of a time when I was training to be a doctor and had lost that center.
I was a second year resident on rotation in the NICU. It started with a minor incident-a newborn who I had sent to the well baby nursery ended up having some difficulty breathing and had to be transferred to the NICU. But soon the insecurity and self doubt threatened to overwhelm me. My grandmother at the time was very sick in the hospital. I was distracted. The combination of her illness and my minor misjudgement was enough to throw me off center. It was a terrible feeling.
I sought out the help of one of my teachers, the director of residency training. He was very kind and sat with me while I wept in his office. He told me that a senior resident, someone who I considered among the most competent and confident, had the year before had a similar crisis of confidence. I remember he said to me, "You could be my kid's pediatrician any day." Within a short time I felt like myself again. That experience showed me with striking clarity how much I needed that self confidence to be able to effectively do my job.
Last week I was visiting with a new mother in the hospital. While we were talking the baby began to fuss. I recognized in myself a temptation to offer my interpretation-he needs to be swaddled, he needs to be fed. But I kept quiet and simply watched. She and her husband exchanged ideas about what the problem was. She stroked the baby's face, tried a different angle. He continued to fuss. She persisted, remarkably sure of herself given that she had been a mother for less than 24 hours. We continued talking and after some time had passed, we noticed that the baby was sound asleep. "You see," she said to me, clearly pleased with herself, "He was tired."
I hope she never loses that trust in herself. Given the enormity of the task of raising a child, is likely, however, that at some point she will be thrown off center. If this happens, I hope, both for her and her baby's sake, that she will always have someone there to help set her back on track.
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.