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.
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.