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Doctor talking to family

We are safe harbors for children, parents, each other

March 1, 2022

Dr. Szilagyi headshotA few days before his 6th birthday, my grandson told his mother that he was “grieving” because turning 6 meant he would no longer be a little boy. He asked if he could talk with his dad who was out of town for work, and a FaceTime call was arranged. I don’t know the details of what our son-in-law said to him, but I am sure he handled this with his usual wisdom and gentleness, and the birthday boy seemed reassured.

Parents and children have been on a rollercoaster of uncertainty and fear the last two years. This vignette reminds us that children take their cues from their parents who are their safe harbor in times of trouble. Sadly, parents are more stressed than ever with fear of illness, trying to make sense of confusing information, lack of their usual supports and the on-again, off-again availability of typical childhood experiences (e.g., school, child care, prekindergarten, activities) that are important to their children’s social-emotional, cognitive and physical development.

Despite parents’ best efforts to protect them, children are privy to their parents’ stress and the conflict in their communities and society in general. This has created a perfect storm for children to present to us with behavioral and emotional problems, some of which rise to the level of a mental health diagnosis. We are seeing this in our offices, emergency departments, schools and child care settings.

When we see a behavior or hear about a child’s sadness, anger, irritability etc., we are trained to wonder what lies beneath. My grandson’s “grief” at turning 6 was as real to him as any other emotion. He might have exhibited his feelings by acting out, not sleeping well, having nightmares or being more easily frustrated. Fortunately, he has a good emotional vocabulary and trusted that his parents would help him. And they did by taking him seriously, honoring his request to speak with his dad, validating his feelings, reassuring him and being attuned, responsive guides.

Just as parents provide this safe harbor for their children, we provide this for parents and children when they come to us with concerns, including emotional and behavioral concerns. We ask what might lie beneath what we are seeing. What are the emotions and thoughts that underly the behavior the child is manifesting? We teach parents that children — even adolescents — often don’t have the words to tell us what they are feeling or thinking. Behaviors and moods are clues that we need to recognize and follow so that we can understand children and help them navigate the often-choppy waters of childhood.

This is more important than ever as we mark the second anniversary of the pandemic and live in the tumult of the confusion and conflict around us. We can apply the same process of following the clues to try to understand what lies beneath parents’ concerns and questions. One of the reasons we are trusted advisers for parents is because we are a safe harbor where they can ask questions, tell us their fears, be taken seriously and receive evidence-based information, reassurance and guidance. They may not take it, at least in that moment, but in our respectful and attuned conversations, we plant the seeds of change.

After two years of the pandemic, the exhaustion and frustration have led many to leave pediatrics. For those of us who remain, we must continue to be safe harbors for each other — to hear and bear each other’s exhaustion and frustration with gentleness and compassion and carry each other forward.

Please know that AAP leadership hears your concerns and is working hard to develop mental health resources to support you as you navigate these ongoing challenges.

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