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.

Sunday, November 17, 2013

Buddhism, brain science, and parenting: towards an integration

In the past week I had two profound yet seemingly polar opposite conversations about how to promote healthy development.

The first was among fellows and faculty of the UMass Boston Infant Parent Mental Health Post-Graduate Certificate program (IPMH) about a new study, The Effect of Poverty on Brain Development, published in the current issue of JAMA pediatrics. Using brain imaging techniques, researchers showed that the children raised in poverty had smaller volumes of specific areas of the brain. They describe how the "caregiver" can "mediate" against the effects of poverty. The effects on the brain were less in the setting of "caregiver support." The group was addressing the ways in which this study fit with the abundance of new research in developmental psychology, neuroscience and genetics.

In conversation with the IPMH group, made up of many brilliant and often like- minded colleagues, who I affectionately refer to as "my peeps," I expressed concern that the exclusive focus on "brain science," where parents are referred to as "mediators," the emotion is excluded. It can become a way to distance from, or even leave out, the passion inherent in these profound love relationships.

Perhaps even more worrisome, I said, is that by making the discussion primarily about poverty, there is a risk of creating a kind of "us-them" mentality.  Certainly there are plenty of well-off families raising children in an environment of high stress and emotional neglect. Similar to the focus on "brain science," it becomes another way of distancing from the problem. 

I shared with the IPMH group my recognition that pointing to the value of listening, of creating an environment of respect for all parents and children, is seen by many as "soft." For example, I felt very alone when one pediatrician referred to my work, in a none-too-kindly tone as, "that baby whisperer stuff."

I knew I was not alone when the second conversation occurred a few days later at  a workshop at Austen Riggs entitled The Interplay of Psychoanalysis and Buddhism: Partners in Liberation. It was all about emotion and interconnectedness.

In a post a number of years ago, I wrote about receiving a letter from a reader who had been "awakened by the tradition of Zen Buddhism" and found my that my work, as described in my book Keeping Your Child in Mind ( see excerpt below), resonated with his experience.
Being understood by a person we love is one of our most powerful yearnings, for adults and children alike. The need for understanding is part of what makes us human. When our feelings are validated, we know that we’re not alone. For a young child, this understanding helps develop his mind and sense of himself. When the people who care for him can reflect back his experience, he learns to recognize and manage his emotions, think more clearly, and adapt to his complex social world. 
When families come to see me in my pediatrics practice for “behavior problems,” both parents and children feel estranged and out of control. They are disconnected, angry, and sad. I help them recognize each other. Meaningful change happens when we share these moments of reconnection. 
While I do not know very much about about Buddhism, I have been greatly influenced by psychoanalysts D.W. Winnicott and Peter Fonagy. I attended the workshop because I was curious to learn more about the relationship between Buddhism and psychoanalysis. In particular I was interested in the place of mourning, for I have increasingly come to recognize that meaningful change, and with it the joy of connection, occur most often when parents move through moments of profound sadness.

Workshop leader Joseph Bobrow spoke with a kind, gentle manner while conveying a sense of quiet authority that was calming and containing. He described the Buddhist notion of "re-authoring our suffering" of "representing our suffering in safe circumstances without shame" so that the story can "take its place in a hierarchy." He described "riding the waves of affect" to "transmute them in to the waves of life." He spoke of "transmuting sorrow" so that it does not "hijack" us." He spoke of how the therapist's "presence of mind," is what  calms, regulates and heals the patient.

When parents are flooded with stress and feeling overwhelmed by their child's behavior, I may ask them to slow down and describe in great detail a specific moment of disruption. This can be very difficult to do. Listening to Bobrow speak about meditation and Zen Buddhism, I heard many links to this process. Meditation can be about noticing how we become derailed by patterns of  thought and behavior. Similarly, by slowing things down, parents become aware of how their child's behavior provokes them, and how they may unintentionally attribute meaning to their child's behavior that is markedly different from the child's true intention.

If a parent recognizes in his response to his child's behavior a surge of rage that is linked to a memory of his own father slapping him across the face, the tears may start to flow. Now we have an opportunity to, as Bobrow said "use the suffering to turn straw in to gold." For in the face of this realization, of this "riding the wave of affect" this father can "re-author the suffering" and in doing so separate his own experience from that of his child. It is just this slowing down that helps him to see his child as himself. In turn the child, himself feeling recognized and understood, becomes calm.  This "meditative" process can be what underlies the moments of profound joy and connection between parent and child that follow.

My two experiences this week seem at first glance to be worlds apart.  I wonder if a piece Bobrow wrote on his Huffington Post blog following the Newtown shooting might point in the direction of integration.
We are helpless, we want it fixed, and become prone... to either-or thinking. But there is no silver bullet. Silver bullet, compartmentalized thinking is the problem. Cumulative trauma compromises the capacity for making connections, for holistic reflection. At it's extreme, the other becomes "not me," so I can eliminate him or her with impunity, Intellectually, it's like bubble living: psychology here, culture there, economics somewhere else. Climate? Fuhgetaboutit. We must grasp our fundamental interconnectedness, and with it the intimate and often unseen interplay of psychological and cultural forces and social and political action.
 I wonder if a third conversation, including both my IPMH colleagues and Bobrow, would lead to some real progress.

2 comments:

  1. Claudia, given your use of Fonagy and Winnicott, you might find the following "short take" on emotional competence, self experience, and developmental patterns compatible with your excellent writing: http://freedomliberationreaction.blogspot.com/2013/05/emotional-competency-self-experience.html

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  2. Claudia
    Thank you for this blog.
    I was interested in your blog on Buddhism and Relational Psychoanalysis and the different styles of discourse.
    I work as an elementary school counsellor In Vancouver Canada and attempt to use a developmental lens to guide my practice..
    Your comments on *parents AS MEDIATORS* WAS INTERESTING. Vygotsky uses the concept of *mediation* as a central concept. Is there a way to see *mediation* as creating a *space* such as Winnicott's holding environment where *mediation* creates THIS space as a hearth [heart]?

    Do you know Gordon Neufeld's work on attachment??
    He can be seen on you tube at the Dali Lama center [a center in Vancouver who brings in speakers you explore *education from the heart*
    Thanks for this blog
    Larry Purss

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