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.

Wednesday, June 20, 2012

Eliminate shame and blame from parenting: new study sheds light

In my behavioral pediatrics practice, it is not  uncommon for parents to go to great lengths to put up a good front. They feel terrible shame about moments of out-of-control behavior, and also fear that I will blame them for their child's troubles. They focus primarily on "what to do" about their child's difficult behavior. However with time, and the realization that I am interested in understanding, not shaming or blaming, they begin to open up about their own life and the enormous stress they experience in their parenting role. They acknowledge that this stress has often led them to yell at their kids or even remove themselves emotionally.

An important new study published in the current journal of the American Academy of Child and Adolescent Psychiatry provides evidence that a parent's early life stress, such as abuse, emotional neglect, or emotional abandonment, lives in the parent's body. The reactions mothers (the study is just about mothers, though fathers certainly face similar challenges) may have in the face of a child's aggressive or clingy behavior are biologically based. It is not simply that they are hitting because they were hit. The authors of the study draw on extensive animal research showing biological mechanisms for transmission of parenting behavior.

For example, when a child behaves aggressively in a way that is developmentally normal (though limits must be set) a parent with a history of early life trauma may have a surge of stress hormones that affect the functioning of his or her brain. Thinking is impaired. He or she may have a kind of fight-or-flight reaction, which may lead to aggression in return.  Another alternative is to shut down, or in psychological language to "dissociate." This leads to that sense of being emotionally disconnected. Neither are good for a child.

This study has major implications for understanding as well as treatment.  If a parent is frequently out-of-control, and is yelling at or hitting a child, or emotionally removing him or herself, it must be addressed. Focusing exclusively on the child's behavior will accomplish little in this situation. Repeated exposure to an angry, out-of-control or emotionally removed parent has significant impact on development.

If  parents can recognize that early life trauma has led to this kind of biological reaction, it may eliminate some of the guilt and shame. It may encourage them to acknowledge and address the problem. When children are young, there is ample opportunity to turn things in a better direction.

Second, if the problem is in the parents' body,  treatment needs to involve working with the parents body. Psychotherapy can be important as a way to develop insight into the impact early life experience. But this kind of work can take time. A more immediate intervention involves helping a parent to recognize the stress reaction and then to develop tools to combat it.

I am not talking about medication. While medication may calm a parent down, and may be necessary in  some cases, the hope is to identify the way a child's behavior provokes a parent, and develop strategies for remaining calm  in the moment. The mindfulness movement has much to offer in this regard. Deep breathing, yoga or simply a short walk can help to calm the body down. Music or art will work better for others.

When parents come to my office asking what to do about their child's "problem behavior," I don't think they expect that my answer will be "go for a walk." I am pleased that this current study will support me when in fact I do say something like that.

7 comments:

  1. I agree with your solution, and with your explanation of the problem. But I don't agree with letting parents off the hook with "it's not you, ma'am, it's your brain". Such an explanation exculpates bad behavior such as striking a child in anger. Is there no free will? I insist there is:

    With the exception of involuntary movements such as reflexes, the behaviors we are talking about are willed behaviors. Regardless of the neurochemical substrate, willed behavior implies an actor who chooses to strike or not to strike a child. If the parent chooses poorly, they rightly deserve to suffer the consequences.

    As you know, Claudia, flight from personal responsibility is rampant in 21st century society. You're doing so much good: please don't make this particular problem worse!

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  2. Hi Rob,

    Thank you for your thoughtful comment. I absolutely agree that taking responsibility for one's behavior as a parent is essential. But shame and guilt often get in the way. This leads to "externalizing" of the problem and over-focus on "managing" the child's behavior. The idea is this- something bad happened to these parents when they were children that now leads them to react in an unhealthy way.This reaction ocurs at the level of biochemistry of the brain. It is not their "fault," but it is their "responsibility" to learn to react in a different way that will promote their child's healthy development.

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  3. Blame, shame, judgment and guilt are exactly what I try to help parents (and teachers) eliminate. The automatic, unconscious behaviors that drive our needs, behaviors and choices.

    Thank you for writing about this. As a parent educator, I often refer to the science behind human behavior - not to excuse it - but to help others become aware so that they can carve out a new path. Many are unaware that they are often reacting to their children from the framework set up by their own childhood memories (conscious or unconscious).

    Personally, I found the process of reflecting on and understanding my own childhood "story" invaluable. I was able to release fears I wasn't even aware of which could have negatively impacted my parenting choices had I ignored my own feelings and needs.

    Such an important topic!

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  4. I'm glad I found your blog, read this and the comments. I'm a PSR specialist which stands for Psychosocial rehabilitation. I tend to turn to shame, blame, judgement and guilt, because that is what I experienced as a child from my mother.

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  5. It's a bit of a tightrope, because shame and guilt, as well as family loyalty (which is something that is not discussed much), are exactly what drive abusive parental behavior in the first place.

    The trick is to distinguish between empathy and sympathy. Empathy means, "I can understand why you felt you had to do what you did" while sympathy adds "and I condone it."

    Being sympathetic with a child abuser can never be empathic, because they know very well that what they did was wrong, and that if you sympathize you are either lying or feeling guilty about something yourself. And lying is never a form of empathy.

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  6. The authors of the study draw on extensive animal research showing biological mechanisms for transmission of parenting behavior

    is the point "this is what we speculate happens in animals and therefore it happens in humans too?

    what makes an animal analogy more useful than human psychology explanations?

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  7. Thanks for pointing out this study. It makes perfect sense. As a Parent Coach I am often in the position of delicately changing the focus of work from the child's behavior to the parents'. This gives yet another way to explain behavior to parents, helps them feel less guilty about it, and thus, makes it more likely that they will be able to address it themselves. I agree that often the best thing we can do for a child is to help a parent learn to manage their stress and anxiety.

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