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27 Ocak 2016 Çarşamba

To CDC on childrens mental health: consider office of homeland attachment security



Change is in the air for children's mental health care. The latest CDC (Center for Disease Control) special supplement to the MMWR (morbidity and mortality weekly report) is titled Mental Health Surveilance Among Children-United States 2005-2011. The report overview states:
Approximately $247 billion is spent each year on children’s mental health.  The mental health of children is critical to their overall health as children and as they grow into adults.
The report summary concludes:
More comprehensive surveillance is needed to develop a public health approach that will both help prevent mental disorders and promote mental health among children.
This report coincides with both the release of DSM (Diagnostic and Statistical Manual of Mental Disorders) 5, and a statement by the director of the NIMH (National Institute of Mental Health) that research funding would not be guided by DSM diagnoses, and that a new paradigm of mental health care is needed.

The time has come to recognize the overwhelming evidence regarding the importance of early relationships in healthy emotional development. The answer to the problem posed in the CDC report is in: invest in early childhood -from newborn to three- to prevent mental health disorders and promote mental health.

A huge part of this evidence comes from the CDC itself, with the ACES study, showing long-term negative impact on both physical and emotional health of a range of adverse childhood experiences.  An abundance of research coming from the discipline of infant mental health provides a more nuanced view of this issue. 

 When parents are supported and valued by society, they are able to be fully present with their children, in turn helping to grow healthy brains. Children who grow up in an attuned caregiving environment are flexible, resilient, and empathic.  In contrast, when children experience toxic stress, or stress in the absence of a safe, secure caregiving relationship, the parts of their brains responsible for emotional regulation do not develop normally. What results are symptoms that are then labeled "mental illness." 

I heard this phrase "office of homeland security of attachment" from Gerard Costa, director of the Center for Autism and Early Childhood Mental Health at Montclair State University. I was speaking at the 2nd annual Todd Ouida Children's Foundation Conference with the wonderful title: The Magic in Moments: Patterns of Early Relationships that Create Resilient Individuals and Peaceful Societies. While the phrase is meant to be humorous, the idea behind it is very serious.  

Our country is seriously lagging behind other countries in the care and attention we give to young children and their parents, with potentially devastating effects. A special government organization to take on this task would address this problem with the attention it deserves. This does not mean that the government has a role in parenting, which is a private, individual experience. Rather, such an organization could address such things as:

- parental leave policy
- comprehensive screening and treatment for perinatal emotional complications including 
depression and anxiety
- education of a workforce trained in working with young children and families
-  high quality child care, including supervision for child care workers 

Attending to early caregiving relationships will move us toward the goal of creating peaceful societies. Given that $247 billion is spent a year on children's mental health, focusing on early childhood is not only the right thing to do, it is also a worthwhile investment. 
  

20 Ocak 2016 Çarşamba

Taylor Swift Captures Secure Attachment Relationship

If my book, Keeping Your Child In Mind, were to have a theme song/video, it would be Taylor Swift's The Best Day. I have included the lyrics below, but suggest watching and listening (with tissues!) It offers a "right brain" emotional experience of what D.W. Winnicott termed the "holding environment." As I write in my book:
Winnicott describes this way of being with a baby as the “holding environment.” The mother’s ability to tolerate and contain her baby’s distress helps him to make sense of and learn to manage his experiences. Even though holding a baby may seem to be simply a physical act, it is her emotional presence that is important to the baby.
The video speaks for itself, but here are a few points that stood out for me.

As a young child Taylor's mother physically contains her after a long day playing outside: "I hug your legs and fall asleep/
on the way home" She feels safe and secure with her mother who is "not scared of anything at all."

The video captures the way in which she was included in the arrival of her baby brother. Her love for him is clear in the later lyrics, "Inside and out, he's better than me."

At thirteen she experiences inevitable social trauma, with her friends being "so mean.". Her mother does not try to fix it. Rather, Taylor receives her mother's undivided and playful attention as they go for a ride in the car. One feels confident that though, as she says, "Don't know how long it's gonna take to feel okay," Taylor, refueled and fortified by mother's love, will work it out herself.

While the song is primarily about her mother, Swift brings in her father "whose strength is making me stronger."

Overall, the video perfectly captures the great value of simply being present with our children. In our culture of "advice" about "what to do" about any range of problems, this is a breath of fresh air. The challenge is clear our own minds and lives enough to offer our children this kind of holding. If we can, we are setting the foundation for their healthy emotional development and future success, in every sense of the word.

The Best Day

I'm five years old
It's getting cold
I've got my big coat on

I hear your laugh
And look up smiling at you
I run and run

Past the pumpkin patch
And the tractor rides
Look now -- the sky is gold
I hug your legs and fall asleep
On the way home

I don't know why all the trees change in the fall
I know you're not scared of anything at all
Don't know if Snow White's house is near or far away
But I know I had the best day
With you today

I'm thirteen now
And don't know how my friends
Could be so mean

I come home crying and you hold me tight and grab the keys

And we drive and drive
Until we've found a town
Far enough away

And we talk and window-shop
Until I've forgotten all their names

I don't know who I'm gonna talk to
Now at school
I know I'm laughing on the car ride home with you
Don't know how long it's gonna take to feel okay
But I know I had the best day
With you today

I have an excellent father
His strength is making me stronger
God smiles on my little brother
Inside and out
He's better than I am

I grew up in a pretty house
And I had space to run
And I had the best days with you

There is a video
I found from back when I was three
You set up a paint set in the kitchen
And you're talking to me

It's the age of princesses and pirate ships
And the seven dwarfs
Daddy's smart
And you're the prettiest lady in the whole wide world

Now I know why all the trees change in the fall
I know you were on my side
Even when I was wrong
And I love you for giving me your eyes
Staying back and watching me shine

And I didn't know if you knew
So I'm taking this chance to say
That I had the best day
With you today