September 15, 2011


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, M.D. Da Capo. $15.

     This is a valuable and clinically interesting book that is not especially easy to read and may not be simple for parents to use in their everyday lives – although that is Claudia Gold’s intent. A practitioner of behavioral pediatrics in Great Barrington, Massachusetts, Gold couples an understanding of recent scientific and medical research with insights into parent-child relationships gleaned from her own work: “Over my twenty years of pediatric practice, I grew to understand that it was not either the child or the parent, but rather the relationship that was my patient. The relationship is the place where the child’s experience, and the qualities she brings into the world, meet the parent’s experience.” This is a moderately complex formulation, certainly different from and more difficult than that offered in most “parenting” books, which tend to deal with specific elements of children’s behavior and offer parents ways to cope with them.

     Coping is not the point here. Gold does not wish to tell parents what to do – she wants to show them how to connect with, to stay attuned to, their children. This goes beyond seeing things from a child’s point of view, which is not really a possibility (except in a general sense) when a child is newborn or very young. Gold builds in large part on the work of D.W. Winnicott, the pediatrician and psychoanalyst who first observed that children develop a strong sense of self when those close to them accept their feelings and help them manage their emotions. Connectedness is the point here.

     This sounds a bit abstruse, and in some ways it is. Getting into the practical side of connecting may not be easy for stressed parents. For example, in discussing colicky infants – among the most challenging of all parental issues – Gold writes, “Rather than think about ‘what to do’ for a colicky baby and how to make it stop, I help parents to ‘be’ with a colicky baby. …He needs his parents to help him regulate and contain his feelings. When his mother mirrors his feelings, this does not mean that when the baby is screaming, his mother screams, too. It is more that she shows recognition and acknowledgment of the baby’s distress, reflecting back his experience, but in a way that contains it and makes it endurable.” An admirable idea, but anyone who has ever had to deal with colic may be forgiven for feeling that this is all rather dry and reserved, compared with the reality of a tiny child shrieking uncontrollably for hours (or what seems like hours) at the exact pitch needed to jangle every nerve in a parent’s body.

     Gold tends to sound somewhat removed from the fray of everyday parental activities. Her successes in therapeutic sessions are well described and certainly indicate that she understands the issues involved and knows ways to assist parents with them. She remarks at one point that when dealing with a parent and child, she often feels like a grandparent, in effect providing the parent with someone to lean on so that the parent can, in turn, be there for the child. But translating this in-office experience into an in-home one, amid all the stresses and time pressures of daily life, is another matter. Likewise, some of Gold’s well-intentioned advocacy is difficult to put into practice: “It is important for schools to recognize that not all problems with paying attention are due to ADHD. Teachers can be important allies for parents in the task of holding a child in mind, especially in helping parents understand a child’s level of development.” These are the same tremendously overworked, under-supported teachers who have too many kids in their classes, too much paperwork to do, too many tests to teach to, and too little time even to discipline the few genuinely difficult students in their classes adequately.

     Gold makes her basic point early in the book and returns to it frequently, in multiple contexts: “Holding a child in mind can be understood narrowly as an ability to think about your child’s behavior in terms of his underlying feelings and motivations. But on a broader level, it is a crucial human skill with long-term effects. Parents who develop this skill are helping a growing child regulate intense emotions.” This is a clear formulation and a useful one, and Gold’s examples of families with which her approach has worked are helpful. But she offers the sort of help that is difficult to lift from a therapeutic setting with an intelligent and strongly committed behavioral expert and place in the mundane context of simply making it through another day of ordinary but emotionally very trying parental challenges.

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