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.

Wednesday, September 15, 2010

Advice to Parents: Remember to Breathe

There is a well know saying in medicine that before doing CPR you should first check your own pulse. This very important point was brought home to me several years ago. I was on my way to a meeting at Austen Riggs, a psychiatric hospital in Stockbridge MA, when I noticed a large commotion in the hall. As I came closer, I observed many panic stricken people standing outside an office where a woman was in dire straits, in fact taking her last breath. Many of them were psychiatrists with MDs after their names, yet they seemed paralyzed. Perhaps this was because they knew her well, perhaps because they were used to talking rather than taking action, or perhaps it was a combination of both.

A friend who knew I was a doctor asked if I would help. As a pediatrician, I had never done CPR on an adult, yet I immediately took over. I lowered her to the floor and began CPR while simultaneously giving tasks to the others in the room. People moved carefully and deliberately. There was no shouting, no throwing of objects. Not only did she live, but her brain survived completely intact. The statistics for this kind of survival are 2-3%.

I am convinced that her unlikely survival is due almost entirely to my ability to remain calm in the face of this crisis. This calm, in turn, allowed all the participants, each of whom performed an essential function in the resuscitation, to think clearly and to get past the panic that had paralyzed them to inaction.

This blog post, though, is not about CPR, but rather a response to a friend's comment on my facebook wall. I'm new to facebook and haven't been in touch with her for a while. She wrote: "Where were you last night when I needed the advice of a sane parent??? OY...11 and 8 plied with sugar (?) is NOT good...OK, breathe...!"

Those of you who regularly read my blog will know I'm not a great fan of giving advice. First of all, I can't really understand the situation without having an actual conversation. Second of all, I prefer helping parents find their way back to trust in their own natural instincts over telling them what to do.

Yet I didn't want to come across as cold or uninterested. So after giving it some thought, I replied, "breathing sounds like a good idea!"

Staying calm in the face of a stranger's medical crisis is one thing. I probably learned this skill in the course of my years attending deliveries and taking care of sick children. But staying calm in the face of your own child's distress is quite another.

In my experience, both as a parent and a pediatrician, I am convinced that seeing your child in distress, and particularly if that distress is directed at you, is the most dysregulating experience there is. Wild, out of control thoughts of epic disaster come unbidden. Rage, self doubt and other destructive feelings quickly cloud your thinking.

What if you could work to push those thoughts aside, and in a way analogous to meditation, concentrated on being in the moment, concentrated on remembering to breathe? It would help you focus on your child, and on the immediate task before you rather than its global implications.

This exchange led me to think about my experience saving that woman's life, and to the idea that just as taking your own pulse is the most important part of doing CPR, remembering to breathe is perhaps among the most important things to do as a parent when helping your child through a child size crisis, whatever it may be.

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