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.

Friday, October 10, 2014

The Time-Out Wars: A Case for Curiosity



Dan Siegel's new book No-Drama Discipline is calling attention to our innate need for connection. In his Time magazine piece provocatively titled Time-Outs Are Hurting Your Child he writes:
The problem is, children have a profound need for connection. Decades of research in attachment demonstrate that particularly in times of distress, we need to be near and be soothed by the people who care for us. But when children lose emotional control, parents often put them in their room or by themselves in the “naughty chair,” meaning that in this moment of emotional distress they have to suffer alone. 
Not surprisingly, his views are causing significant backlash from the pediatric community. This is from the Journal of Developmental and Behavioral Pediatrics
TIME magazine recently highlighted an editorial by Drs. Daniel J. Siegel and Tina Payne Bryson in their parenting section. In it, the authors claim that the time-honored tradition of time-out for discipline may actually be harming our children as a form of traumatizing experience. This has caused a wave of black lash from the behavioral health community, who retort that Drs. Siegel and Payne Bryson's claims are not only unsupported by research, but show a lack of understanding of proper use of time-out.
Extreme views generate publicity and lots of “hits” A more nuanced view is less popular in social media, as evidenced by this wise blog post on Psychology Today that got a meager 25 tweets:
To me, “time-ins” don’t solve it. But the concept does expose a nuance of giving time-outs that we don’t talk about enough. Namely, there’s a massive difference between giving your child a time out in anger and giving your child a time out in a loving, calm way. Too often we apply the technique, but not the spirit of technique. Time-outs are meant to deescalate a volatile situation and to help our children regain control, as much as they are to provide a consequence for unruly behavior.
The essence of Dan Siegel’s point is not to leave a child alone with out-of-control feelings. It is not the time out per se but rather the sense of abandonment that is potentially harmful. I articulate this point in a previous post entitled Never Leave a Child Alone During a Meltdown.
When a child is repeatedly abandoned both physically and emotionally in the middle of a meltdown, that experience in itself may be traumatic. In such a situation frequency and intensity of meltdowns often worsens.
A recent American Academy of Pediatrics document Bringing Out the Best in Your Child makes the important distinction between discipline, which means to teach, and punishment, which is rarely effective in changing behavior in a positive way. For young children, a matter-of-fact time out in the face of biting or hitting can help to teach them that this behavior is unacceptable. The shortcoming of this document is that it is very focused on the behavior, rather than the meaning of the behavior.

Taking time to listen to our child, and to take care of ourselves, is key. Rather than an either-or approach, a stance of wondering, of curiosity, will lead to the answer of “what to do.” We might ask the question, why is my child feeling out-of-control? Is he stressed from fatigue or hunger? Is he responding to tension in the home from marital conflict, a new sibling, or a parent’s new job with long hours? And what about my child’s behavior is provoking such anger, anxiety or some other intense response in me? Is it my fear that he will suffer as I did as a child with similar challenges? Is it my embarrassment, or even worse, shame, that I am not a good parent? Am I feeling alone and abandoned myself, by a spouse or parent, and so unable to tolerate my child’s need for me? When parents feel recognized and understood, they are better able to listen to their child. They are better able to connect with their natural intuition. They know "what to do."

Our ability to find meaning in behavior is essential to our humanity. Listening, being present in a way that supports connection, leads to healthy development. It is not so much about “what to do” as “how to be.” We are a culture of advice and quick fixes. Dr. Siegel's book is rich with important information and ideas. However, perhaps rather than spending precious free time reading another "how-to" parenting guide, taking a walk with a friend or going to a yoga class might be a better use of parents' all-too-limited time for themselves.

4 comments:

  1. There are some who will never be pleased with any kind of behavioral control. Just like corporal punishment was universally condemned, now time outs are being attacked. I liked your belief that we need to understand the meaning of acting out and the needs of the child in determining proper discipline. There are bad ways of practicing all kinds of discipline, and there are good ways of employing a wide variety of disciplinary actions.

    My only disagreement with your post is when you say, "...punishment, which is never effective in changing behavior..." Punishment can make profound changes in behavior. Much of the time punishment is overused and, even when used in appropriate situations, it is often applied poorly. It is therefore something that should be used with great caution.

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  2. Thank you Dr. Gold yet again for your clarity and ability to hone in on what really matters, "how to be", connection and reflecting on (holding together) powerful overwhelming experiences for a child. How can a child learn to control and master powerful emotions in the face of parent anger, frustration and intense disappointment (the fear of lost love and deep debilitating shame a child might feel when disappointing the one he/she loves the most) especially if the parent utilizes T.O. ineffectively in this way? A child will learn to integrate and understand his/her experience when the caregiver reflects patiently back empathy, sense of security, understanding and facilitates meaning making with acceptance wrapped in warmth. This doesn't mean that parents can't show appropriate moments of anger or disappointment in their child's choices or behaviors but it should be brief and more time provided for the "repair" of "mismatched/misbehaved" experiences. I look forward to reading Dr. Siegel's new book, he has the ability to regulate and "inspire to rewire" our collective minds on "how to be" as we all join in promoting optimal growth in children's emotional development.

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  3. I've never put my kids in time-out. However, I've noticed that they're not as independent as other kids their age. I don't know if my choice has anything to do with what I've observed, but I've been looking for a solution. I'm gathering from your blog that the key is to discern the child's intent—there's a difference between the child feeling out of control and just being a trouble maker. I'll have to study this more. Thanks for all the quotes and resources.

    Madeline Gibson | http://www.achievewellbeing.com

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