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You Are (Not) Responsible for Knowing Everything

How the Internet destroyed one self-assured mother's confidence.

I was catching up with my friend Helen at a coffee shop in Chicago. Beautiful and outgoing, Helen is the kind of person you take one look at and you just know she has it all together. She tells me she has never struggled with confidence at any point in her life. She was good at academics. She felt good about how she looked. She was self-assured socially and in her marriage.

Then she became a mother.

“My confidence was destroyed. That was when I first felt incompetent,” Helen told me. “I had always felt competent at work and in my life, and that made me feel confident. It took me about three years to realize what was going on as a mother. I didn’t feel confident about my choices, I didn’t feel confident about my plans.”

“Why not?” I asked.

“Well, I would ask myself, ‘Is this going to result in the outcome I’m looking for?’ And there’s no manual for that.”

“So what outcome are you looking for?”

“I want a successful child, right? I want a happy kid, and I want a successful kid. I didn’t know if I was making all the right choices. I actually feel like we parent in the age of a ton of research. So you have no excuse either. You can't fly blind. If you're flying blind, it’s because you're not doing your job. You're not reading and you're not doing your job.”

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Helen thought that if she wasn't reading the research, she wasn't doing her job as a mother.
Source: Rawpixel/Unsplash

“Wow, that is a big job. I mean, don’t get me wrong, I love research. Research helps us understand and those insights can really help. But, somehow, the way you talk about research feels like a terrible burden.”

“Exactly,” Helen went on, “I almost feel like the preponderance of literature out there actually makes it worse because I feel responsible to know the answer. I should know what I'm supposed to do with a one-year-old. I should know what I'm supposed to do with a three-year-old. I've always said ‘I wish I had a manual that would tell me how I should react in every situation.’ But in some ways, we almost have that and that's what's killing us. I know what I should be doing and I feel like I have to have the answer at every moment and I just don’t. I don’t.”

“Well, that is quite a ShouldStorm right there!” I responded. We laughed and took a sip of our coffees. “So, I think you are saying that having the right, research-based answer in each specific situation is what would make you feel confident.”

“Yes,” she said emphatically, “The responsibility to all the literature out there is killing us. There is a world of literature out there and I know if I just look hard enough, I can find those answers.” Helen looked tired.

“That’s really interesting, because I am a pediatrician and have studied child development extensively, and I don’t have all of those answers.”

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Mothers look for a manual for every situation
Source: Eliabe Costa/Unsplash

What if we did have a manual for every situation?

Helen had just described something I had identified through my work: one of the three untrue laws of the Shouldstorm. Untrue Law #1: We need to get it right, all the time. Often we don’t realize we believe this, but we act like we do. We criticize ourselves or feel burdened by worry if we don’t get it just right in each situation as parents. Even if you recognize that this is being too hard on ourselves, we still wish we could do it.

Now, for a moment, imagine this from your child’s perspective. Your parents tell you that they love you no matter what, and that it’s okay to make mistakes. But they are hard on themselves if they don’t get it just right all the time. Will you believe them? Will you be confused and wonder if they mean it about loving you? Won’t you think that really the rule is to get it just right all the time? Won’t it make you worry?

Helen wants a successful, happy child. I am certain that a successful child is not a child who has to know exactly what to do in each circumstance. That is a burdened and unhappy child.

What Research is For (Hint: It’s not Cyber-Chondria)

Research findings can be profoundly helpful to us, but that depends on how we view them. When research (which has advanced our understanding) becomes a burden, an obligation and a long list of shoulds, it robs is of the core of what makes us good parents. Well designed scientific research is a genuine good— if we understand it for what it is. Research is a tool; a knowledge base and a way of producing knowledge. Here’s the thing about tools: they are only as a good as the way we use them.

In September 2017, the BBC reported a growing problem: cyberchondria. They reported that a team of researchers had found that “worrying excessively about health, and going for unnecessary appointments and tests, is a growing problem — fueled by looking up symptoms on the internet.” This “health anxiety” even produced physical symptoms like persistent chest pains and headaches. We doctors call that somatization, and we see anxiety producing physical symptoms quite often in pediatric practice.

"Dr. Google is very informative, but he doesn't put things in the right proportion,” they observed. Not even the doctor’s reassurance relieved the patient’s worry. The researchers found that the answer was not more tests, or making their doctor read all the articles the worried patients were reading, but rather anxiety-reducing cognitive behavioral therapy.

This shows up in parents too. Untrue Law of the ShouldStorm #1 convinces us as parents that We need to get it right, all the time. Part of that is feeling like we need to know. Some of us choose the research, some of us choose to talk to our neighbors and do what they do, some of us read online groups. And it creates a terrible unsettled feeling that something is wrong with us and our kids.

Let’s walk out of the ShouldStorm and free our kids, as we free ourselves, from the burden of having to know it all. Real confidence is about resilience. Real success is about being safe in our own skins, not jumping out of them from anxiety. A truly happy child, a truly happy parent is able to connect and enjoy other people, undistracted by nagging fears. The more we try to get it just the way we should, the more rigid we become. The Shoulds cut us off from our kids, and that’s nobody’s idea of success.

Is it possible to use research to help our parenting?

How can we use the wonderful advances child development knowledge in a way that builds our confidence? We can start by watching our sources.

Websites: Watch out! I give my patients a list of reliable websites and steer them away from the ones that raise anxiety. In general, good advice equips and bad advice makes you anxious. When in doubt try the AAP for parent questions or the CDC for reliable medical science.

Social media: Double watch out! Social media can connect you with supportive friends who care for you or share encouraging articles. Or it can introduce you to misinformation and criticism straight from the ShouldStorm. Is your heart rate going up and your breathing getting shallow? You probably just got shoulded on.

Your pediatrician: We love you and your kids. We took an oath and we meant it. We are committed to helping you do a great job. But try to go easy on us, because, as the BBC reports: "People now go to their GPs with a whole list of things they've looked up on the internet, and the poor GP, five minutes into the consultation, has four pages of reading to do.”

©Alison Escalante MD

Photo by Colin Maynard on Unsplash
You Are (Not) Responsible For Knowing Everything by Alison Escalante MD
Source: Photo by Colin Maynard on Unsplash

References

Tyrer P, Salkovskis P, Tyrer H, Wang D, Crawford MJ, Dupont S, et al. Cognitive-behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years. Health Technol Assess 2017;21(50)

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