A 3-year-old is happily playing on the floor near his mommy’s feet as she works on her laptop. Unknowingly, she knocks a ballpoint pen onto the floor. The little boy picks up the ballpoint pen, says loudly “Mine!” and begins to draw on some paper with it. His mother leans over and takes the pen away saying “No. This is mommy’s pen. Here are your crayons.” The boy becomes angry immediately; he cries out and hits his mother. How should she respond?
This is also the question on a parent’s mind. What is the best way to handle outbursts, tantrums, or bad behavior? There are myriad parenting books available to assist parents on the best way to respond. Each of them touts a different method that is sure to help. Dr. Claudia Gold’s Keeping Your Child in Mind delivers a single message to be used throughout a child’s development. Through anecdotes about patients struggling with their children, she explains how the method of “keeping a child in mind” can help alleviate issues the child may be experiencing. Rather than focusing on “what to do” to help the child, keeping a child in mind focuses more on understanding why the child is acting out and using that information to comfort them and help them to control their emotions.
Dr. Gold practices behavioral pediatrics and, for years, has taught parents the method of keeping a child in mind. Dr. Gold explains that “keeping a child in mind” has four parts:
- Understanding the behavior in terms of the level of development
- Empathizing with the child’s feelings about the situation
- Containing and regulating difficult emotions; disciplining that accepts the feelings but places limits on the behavior
- Controlling and regulating your own feelings so they do not hamper the work with the child
She elaborates on these concepts and how they are applied in each developmental phase: infancy, toddlerhood, preschool, school-age, and the teenage years. Giving the reader many examples, Dr. Gold makes it is easy to see how this method is utilized and how it is effective in helping families with behavioral issues. A quote from Dr. Charles Zeanah aptly describes how the focus is shifted when keeping a child in mind: “Instead of the problem or disturbance being understood as within the child or within the parent, the problem may be understood as between the child and caregiver.”
In the situation presented above, the mother first would recognize that her son is attempting to declare his independence in the only way he can at such a young age. She would then calmly explain that she understood he was mad about having the pen taken away but that it is not okay to hit anyone. At this point, she may even put him in timeout for a few minutes in order to discipline him for the hitting. During this process, she would also be aware of her own emotions, making sure that her anger about the interruption and hit by her son did not overwhelm the situation. Through this process, she is able to assist her child by recognizing his emotions but showing him that there are limitations to be put on these emotions. He can then learn to cope with the intensity of his anger without lashing out at others.
Dr. Gold also addresses the emotional aspect of being a parent through each phase. Whether it is a lack of sleep combined with frustration while raising an infant, or struggling with jealousy over the multitude of opportunities before a growing teenager, parents deal with their own baggage that may directly affect the way they discipline and raise their children. In addition, the stress of the household could be manifesting in the child’s outbursts. Dr. Gold points out that these issues should not be tossed aside but should be looked at in depth with the assistance of a therapist to see if, perhaps, they are causing the child greater levels of stress.
Finally, Dr. Gold addresses the question of medicating children. I believe her stance on medicating children is best summed up in this quote:
When families rely primarily on medication, children do not have the opportunity to develop coping skills to adapt to new situations and frustrations. Equally important, in medicating the symptom away, the underlying issues in relationships are not addressed. Medication can have the effect of silencing everyone.
With little research on the long-term effects of medication on children’s development, Dr. Gold expresses concern that there may be dire consequences to using medication as a quick fix. She states that she is not “against” medicating because there are situations where it can offer significant benefits. However, the overall tone of this final chapter is definitely heavy on the argument against medicating. She uses examples of patients who requested medication for ADHD and, after careful review and some work with the parents on keeping their child in mind, did not actually need the medication and the “symptomatic” behavior dissipated. She also questions what it must be like for the child “to sit in a room once every three months and listen to a conversation about his behavior and its relation to a pill he takes every day.” The child becomes the object of the conversation rather than an acting character.
Dr. Gold states in her final chapter that “we need to ask not ‘what is the disorder?’ but rather, ‘what is the experience of this particular child and family?’ and ‘what can we do to move things in a better direction?’” This is one of the constant themes throughout her book. As a new mother who has studied child development, Dr. Gold’s book was a breath of fresh air for me. It was a relief to read a parenting book from the perspective of a behavioral pediatrician that addresses behavior issues at each stage. Rather than have a parenting book for each individual phase, Dr. Gold provides a single resource that can be applied to all stages.
There is the question of whether this method will work for all children with all problems at all phases. However, that is unlikely. Perhaps that would make parenting too easy. Although, to be honest, what parent does not want the quick fix to end all problems they may be having with their children?
Keeping Your Child in Mind: Overcoming Defiance, Tantrums, and Other Everyday Behavior Problems by Seeing the World through Your Child’s Eyes
By Claudia M. Gold, MD
Da Capo Lifelong Books: August 30, 2011
Softcover, 240 pages