I was trained a long time ago as a child psychiatrist. That training usually lasts two years and takes place after the first two years of a psychiatric residency. In my case, it came also after two years in the army and a year of doing research in child development. The training of the other child fellows was similar. Still, I noticed that we frequently disagreed about what should be done in certain situations, despite the fact that we were all being trained at the same institution and were similarly committed to doing the best we could. We were similar in other ways. We were all intellectual types, and many of us were Jewish. We were all about the same age, and some of us had grown up around New York City. I mention these facts because I came to believe after a while that the circumstances of our growing up had more to do with the way we thought of child-rearing practices, and other matters, than our training did. Still, we disagreed frequently.
For instance, I noticed after a while that I was admitting fewer patients to the child in-patient service than the other child fellows. When this became obvious I started asking them what it was about a particular child patient that inclined them to admit that patient. When they told me, I was always inclined to agree with them. I thought had that patient been evaluated by me, I, too, would have admitted the child. Similarly, when I described why I did not admit a particular child, they always told me that they too would not have admitted that child. The reason for our varying decisions became apparent after a while: we were eliciting different stories when we evaluated the children.
I saw one child who was sent by his school for an emergency evaluation. I was told that he was setting fire to the hair of the other children. But when I enquired further, it turned out he was lighting matches and throwing the lit match at someone who was a number of feet away. Perhaps, he was disturbed emotionally, but not so severely I had to take him away from his family and put him in a psychiatric hospital. Had he actually been holding a lit match up against someone’s hair, I would have felt differently. Similarly, I evaluated another child who was said to have jumped out of a window. It turned out it was a ground floor window.
In these two situations I know I was right not to admit the child. But I have to wonder whether other children whom I did not admit might more appropriately have been admitted if I had elicited more information.
Our ideas about proper child-rearing practices differed also. Some of the differences:
- Should a child be forced to taste a food that he/she does not want to eat?
- Should a child who has not had dinner be allowed to eat later on?
- Should a child of a particular age be expected to go to sleep at a particular hour?
- When should toilet training start? (There are national differences in this matter also. When I was stationed in Germany, I was startled to discover that most German children were toilet- trained around one year of age. The Americans started toilet training when their children were around two, and some parents held off until three or even four years of age.)
- Even at a time when it was known that breast-feeding was advantageous to the child, the residents disagreed about how long it should be kept up. And just how important was it, anyway? Could a working mother bottle- feed?
- Should a child be allowed a pacifier? For how long?
- When should parents be concerned about a child sucking its thumb. (Thumb-sucking can cause dental problems.)
And there were many other such issues. There is a particular matter which parents have always felt strongly about and disagreed strongly about: whether or not corporal punishment is ever permitted. I am sure that anyone reading this blog will have a definite view about this. But there are others who will feel just as certain that the opposite way is correct. I polled the child fellows after we all finished our training. Three of the child fellows thought corporal punishment was okay in certain circumstances; the other three thought it was never okay. In other words, there was nothing in our training that could settle this matter one way or the other. Knowing the people involved, I think their opinions were more a reflection of the way they were brought up than anything else.
There were, of course, matters that everyone agreed on: having a child sleep in its own bed, having the child get used to baby-sitters, even strange baby-sitters, and having children, in general, do for themselves everything they are capable of doing. For example, when they are able to tie their shoe-laces, they should. When they are able to go to school by themselves, they should.
Of course, the fact that there was a consensus about these things does not mean they are right. Throughout history, strange child-rearing practices became the rule in a particular society and were thought to be the only right way to bring up children. These included tying feet to the point where the feet become deformed and shaping the head similarly by constraining it with bonds. So, we cannot even rely on what seems “common sense,” or what is considered conventional wisdom.
Why have we not determined over the years what is the best way to bring up a child? Because it is too complicated! The right thing to do depends on a particular culture, depends on what the other parent might feel, and depends, especially on the particular temperament and personality of the child.
I have my own ideas about the questions mentioned above, and about all sorts of other issues. I feel strongly about some of these matters; but I have to admit to myself that others who are no less knowledgeable and sophisticated than I am, feel differently.
So, what do I want to communicate to parents? First of all, listen carefully to what others tell you, (doctors, parents, in-laws) and then decide what is best for your children with the understanding that no one knows any better than you. Even those of us who are trained as child psychiatrists. But see what works. If your child is not doing so well, for any reason, consider the possibility that you should treat them somewhat differently.
I think in order to be a good parent, two things have to happen:
- You have to love your child. This is the easy part. I think most parents love their kids.
- You have to be willing to listen to your child. You have the last word; but it is important to listen, and for your child to know that you are listening.
I suppose the point I am making is the one I’ve tried to make over and over on these blog posts: be willing to question your assumptions of what the right thing is to do.(c) Fredric Neuman 2012 Follow Dr. Neuman's blog at fredricneumanmd.com/blog