Sometimes in my behavioral pediatrics practice I have the privilege of doing in depth work with a mother and father together. Recently I saw a four-year-old girl with "explosive behavior." After a number of session spent focusing on a range of issues, her father began to speak about his alcoholic, emotionally abusive father. He found himself full of rage, rage that he now recognized was unfortunately often misdirected at his daughter. Perhaps because of the trust he had developed in our work together, he accepted a referral to therapist, with the hope of being able to put his feelings of anger in their rightful place.
More often that not, however, fathers do not come to these visits. I hear stories from mothers of their spouse's terrible emotional stress. Often there is intense conflict between mother and father over discipline techniques. Because the mother is in the room with me, I can listen in depth to her story . But when I encourage the father to come so I can hear about his experience, there are many obstacles. Most common is "he can't get off from work." A close second is "he doesn't believe in this kind of help," or "he doesn't like to talk about feelings."
I hope that a new study published in the December issue (online today) of Pediatrics, Paternal Depressive Symptoms and Child Behavioral or Emotional Problems in the United States will encourage fathers to seek help, and motivate clinicians to strive to include fathers in treatment of young children with emotional and behavior problems. The study shows, not surprisingly, that paternal depression and other mental health problems affect the emotional state and behavior of children.
The literature on postpartum depression in mothers, and its long term effect on child development, has exploded in recent years. Yet services for women struggling with perinatal emotional complications are often hard to come by. Many people, as I describe in a previous post are working hard to address these needs. Unfortunately fathers have not received this kind of attention.
This past weekend my local paper ran a story Swedish dads swap work for childcare about fathers making use of Sweden's very generous parental leave policy. Sweden has the right idea, not only in generous paid parental leave, but also in supporting fathers taking on the role as primary caregiver.
We need to take a good look at why we have lagged behind on this front, despite significant increased presence of fathers in the lives of their growing children. This latest study published in Pediatrics shows that the time has come to pay attention. I for one will continue to give fathers of my child patients careful thought, and encourage their participation in treatment. The vast majority of parents, when they see that getting help for themselves will help their children, are motivated to do this difficult and sometimes painful work.