Ask the Doctor

Parents disagee about parenting

Mon, 02 Mar 2009 05:00:00 GMT

My wife and I seem to have a power struggle when it comes to the kids. Because I work FT and she is a stay at home mom, mostly she provides the direction to the kids. Occasionally she will "overrule" me when the kids make a request that I either grant or deny. She will do this on the spot by saying something like: "No, it is o.k. if you do that." etc. It is usually regarding a relatively trivial issue so I have not made a big deal about it or even discussed it with her. I think it sends mixed signals to the kids. I am not an authoritarian by any means but would like to be on the same page. Do you have any suggestions?

I want to start by saying that parenting is a partnership, and partnerships are hard. We aren’t taught how to be good partners. And when moms stay home with the kids, it's not unusual for dads to feel left out.

One thing you should know is that parents definitely don’t have to always agree about parenting decisions. A completely united front is not only impossible, it's unnecessary. Kids learn pretty fast that mom is more lenient some things -- maybe she buys them more things, for instance -- but dad is more lenient about other things, maybe bedtime. There is nothing wrong with that.

The problem is when kids feel they can go behind one parent’s back to get their way. The pattern you’re describing does send mixed signals to the kids, as you're guessing. More important, it probably makes you feel disrespected. It may also give the kids the message that your wife disrespects you and that the kids can go to her to have your decisions revised.

It concerns me that you haven't discussed this with your wife, but took the time to ask me your question, which indicates that this does bother you. Clearly we want to increase your comfort level in discussing difficult issues with your wife.

I would start by telling your wife you have something important to discuss with her in private. After the kids go to bed, pour a glass of wine and sit on the couch together. (Or have coffee on Sunday morning while the kids watch cartoons. Just find some time when you can talk in peace.)

Tell your wife that you love her and you think she’s a great mom. Tell her that you aren’t an authoritarian by any means but you notice that sometimes when your instinct is to say no, she says yes. Tell her that you don’t mind that she makes the decision, but that two things bother you.

First, you would like to understand better why she’s making these decisions so you two can be on the same page as parents.

Second, you feel a little embarrassed and hurt when she overrules you in front of the kids. You wonder if maybe they won’t take you seriously as an authority figure and will disrespect you because they see this happening.

Explain to your wife that you want very much to be involved in your kids’ lives in an intimate way, and that even though you aren’t a stay at home dad, you hope she will value your partnership in parenting.

Then close your mouth and let your wife talk. She may well say some hurtful things. Many wives feel their husbands are oblivious and clueless when it comes to the kids. Even if it is not objectively true, many wives feel they understand their kids much better than their husbands and should be the ones to make the decisions about the kids. Try not to take anything she's says that's hurtful personally. Acknowledge her feelings. They are only her feelings and opinions, and they are legitimate as feelings and opinions even if you disagree with them.

Then, ask your wife what the two of you can do on the spot when one of you disagrees with a parenting decision that the other is making. Maybe when you make a decision she disagrees with, she can tell you that she needs a hug, in private. After the two of you discuss the issue, she can return to whatever she was doing before, while you tell the kids that you've thought more about the issue and you've made a more thoughtful decision.

I suspect that this discussion will strengthen your relationship with your wife, as well as your parenting partnership. If you want more ideas on how to make a difficult discussion go well, you might want to read the article called "Having the Tough Conversations" in the Communication section of this website.

Why kids need rituals

Tue, 24 Feb 2009 04:00:00 GMT

Telling a good night story, singing a song before you leave your child in the kindergarten, three magic kisses, the magic box that catches the nightmares. Did you know how important these little things are for your child?

Bedtime rituals help children get ready for bed. The song makes it easier to say goodbye. The three magic kisses are something just between you and your child. The magic box gives security and a good feeling.

Without rituals you and your child can go through a hard time in certain situations. Children discover the world. Everything is exciting, new and sometimes even scary. So when situations like bedtime or going to the kindergarten comes, a lot of children have problems.

They need rituals to understand what will happen. When bedtime arrives and you sing or tell a story it's clear what will happen. With this ritual children can peacefully close their eyes because they know that the day ends here.

Children need structure and repetition. It is very important to create and do the same things they've done before.

Structure and repetition gives your child security, stability and a feeling that everything is good.

So don't think that the little things you do are stupid or don't have a deeper meaning ... It makes your child feel safe and confirms the special relationship you have!!!

Hope to hear your opinion!
Karolina

Dear Karolina,
You've pointed out an important tool to help kids feel secure in what they must experience as a chaotic world. Because little rituals like the ones you describe make kids feel safe, they also help kids to cooperate, whether at bedtime, getting into a carseat, or saying goodbye.

I invite other parents to share their most useful everyday rituals.

And if you'd like to read more about how to use rituals and traditions with your children, there's a whole section on this website. Thanks for writing, Karolina.

All my best,
Dr. Laura

Teacher says son has behavior problem

Mon, 23 Feb 2009 05:00:00 GMT

HI, Dr Laura
I have a 5 year old son, Ruben. Per teacher at school, he has behavior problem, not respect people etc. The teacher suggests me to seek for some special help from professionals. Would you mind to give me some idea, what should I do?
Thanks
Wendy

Dear Wendy,
Not knowing more about your situation, I can’t give you much advice on how to help Ruben. What I can say is that his teacher sees a lot of kids, so if she is suggesting that Ruben needs help, he almost certainly does. Now is the time to intervene, before Ruben begins to think of himself as a child who can’t get along well at school.

It would be best for you to take him to a child psychologist in your area. A psychologist could assess Ruben, help you understand why he is misbehaving, and help you develop a plan to change his behavior.

While I could advise you by telephone on your parenting, my rates are no less than someone you would see in person, and I would not be able to adequately assess and treat Ruben by phone.

How do you find a psychologist who specializes in treating children? The first option is to ask your son’s school. Usually schools have a psychologist on staff, or one they refer parents to.

The second option is to call The Child Development Center of your local University Medical Center. They have specialists on staff and can do a thorough assessment.

A third option is to call the Mental Health Association of your local County. If you explain the situation to them, they can usually refer you to a local clinic that specializes in treating children.

You should be able to find a psychologist you like and trust, who Ruben also likes, and who will help Ruben to do well in school. Let me know how it works out!

Good luck,
Dr. Laura

Fear of mental illness interfering with prenatal bonding

Mon, 23 Feb 2009 05:00:00 GMT

Hello Dr. Markham,

I am 37 years old and 17 weeks pregnant with my first child. I have a very good relationship with my husband and we are both very excited about our baby. We've both always wanted a family.

Unfortunately, mental illness runs in my husband's family: his sister is bipolar, his maternal aunt and maternal grandmother suffer from schizophrenia. I'm terrified that if our baby is a girl, that we are destined to have a child with mental illness. Most problematic is that, even though I am exceedingly happy to be pregnant, I'm afraid this risk will prevent me from bonding with my baby. As she gets older, I feel like I'll always be searching for clues or telltale behavior of mental illness. Or worse, that I'll be interpreting every "bad behavior" as a sign of mental illness, when it's really just normal developmental behavior.

Do you have any advice?

It is quite normal for a pregnant woman to worry about whether her baby will be born normal. Unlike most women, you can easily seize on something quite specific, since mental illness runs in your husband’s family. It might help you to remember that 99.9% of the worries we have during pregnancy are unfounded. Obviously, I can’t promise you that your child will be okay, because no one can know that. However, I can offer you some information that might reassure you. Please remember I am not a medical doctor or geneticist, so I am telling you my personal understanding of the risk involved from readily available information. A geneticist would be able to give you more precise information, and you may well want to make an appointment with one.

1. Your husband’s genes are obviously only half of what your child will get, which means that your side of the gene pool has contributed genetics which may help to offset any predisposition from your husband’s side.

2. While there is definitely a hereditary component to both schizophrenia and manic depression, the chances of your baby being diagnosed with either are apparently not large:

The chance that a grandson (your husband) of a schizophrenic will have schizophrenia is about 3% (presuming his parents do not have it.) Since your husband and his parents are not schizophrenic, the chance that your child will be diagnosed drops to approximately that of the general population (about 1%).

The risk of a first degree relative developing bipolar disorder is about 5-10%. That was your husband’s risk since his sister was bipolar. The risk of a second degree relative (i.e., a niece or nephew) drops substantially below that. The heredity of bipolar disorder is complicated, and your child does have some risk, but it would presumably be substantially below 5%.

3. Although your child may have a very small genetic predisposition, many studies have found that environment plays an important role in determining whether mental illness actually develops. For instance, one identical twin can develop schizophrenia while the other doesn’t, depending on the environments in which they are raised. In the same way that a tendency to heart disease may manifest for the butcher’s son but not the vegetarian’s, mental illness is much more likely to affect children who are traumatized in their early lives. Depression, specifically, is more likely to affect children who have suffered early losses. So even if your child’s genes predispose her to bipolar disorder, she may well not manifest it given a normal low-risk childhood with adequate nurturing.

As a psychologist, I would like to address the issue of bonding. You can’t know this yet, but when you hold your baby in your arms, I don’t think any of these fears could possibly prevent your bonding with him or her. Parents have always worried about their children, but there is no bond so fiercely protective as that of a mother towards her child.

You wonder if you’ll be worried at each stage of your child’s life. I have friends with cancer and they certainly worry about their children someday getting cancer. I know a woman who lost a child; she now struggles not to be overprotective with her other children. The advice I would always give to a parent whose worries are getting in the way of her parenting is to see a counselor. Being aware of your fears and talking them through with a professional can keep you from acting on them with your child. But you may want to wait until you are actually parenting to see if this ends up being an issue for you.

I’m not a statistician, but your child probably has more risk of being in a car accident. Amazingly, most babies are born healthy and grow up healthy. Focus on the positive. Enjoy your husband. Take the risk and start bonding with your baby. There’s info on beginning that process on the Pregnancy & Birth section of this website.

If you find yourself anxious during your pregnancy, you may want to begin meditating. It helps you to relax, bathes the baby in positive hormones, and calms your fears. And if you keep worrying, by all means speak with a counselor.

I wish you and your baby every blessing,
Dr. Laura

Aggressive Toddler

Mon, 23 Feb 2009 05:00:00 GMT

I really like your website very much. I find it very inspiring. I started surfing the internet and reading all what I can find on babies and toddlers since I had my child. I feel so worried that I won't be a good mom, or my baby won't be as good as I wish.

My marriage is a big failure. But, I work so hard that my 2 year old son doesn't really feel it. I have a very good relationship with my kid. We play together, I take him to the club, we draw and color together, we work out puzzles. I have read for him since he was 18 months.

The problem is that he started to develop an aggressive attitude. He hits me if I take something from him, or force him to do anything that he dislikes. He hits his friends when they start playing, sometimes out of jealousy or just anger. He is even aggressive when he holds me or plays with me.

I sometimes give him timeouts or hit him back to prove that it hurts to hit. I don't really know how to handle this and I seriously want to fix this problem before it aggrevates. so, what went wrong?

-- Salma

Dear Salma,
I am so glad you wrote. It is disturbing to have your child begin to hit. Most two year olds do experiment with aggression because they are still learning to control themselves. You are right to want to nip this in the bud.

Many studies have shown that hitting kids, even to show them that hitting hurts, only perpetuates more hitting. When we treat our children with compassion and kindness, even when they hit others, they learn not to hit. When we hit them, they learn to hit. It is that simple.

I also have observed over and over that timeouts create power struggles and cause children to be more rebellious, even to the point of hitting. Timeouts are much better than hitting your child, but they do not encourage good behavior, in fact, they encourage bad behavior.

So what can you do? First, of course you set the limit for your son that hitting is never ok. When he hits another child, you will need to immediately, kindly, attend to the other child (ignore your son for the moment) so that your son sees that he does not get attention by hitting, and so that he gets the message that indeed his hitting has hurt the other child. Then, when the other child is recovered and being tended to by another adult, you will need to pick up your son and remove him from the situation. "We never hit. When you hit, we can't play with the other children." Be kind, but firm, and take him home. (If this is in your home, take him to his room. Stay with him, of course, while he calms down, before the two of you rejoin the others. It is best if you can have the others leave so that he gets a clear message that hitting ends play.)

He is likely to be be very angry, and you can empathize: "You wish you could play more. You don't want to leave. I am really sorry, but when you hit, we can't play with the other kids." Be kind: "Soon you will be a little older and you will remember not to hit. You will remember to ask me for help, or to use your words, instead." He needs to hear from you that he isn't bad, just little.

What do you do when your son hits you? You tell him "We never hit. I know you are angry. When you are angry, you use your words and tell me. You can show me how angry you are by hitting the pillow, or by yelling if we are outside, or by showing me with your crayons on the paper how angry you are. But we never hit." If he is hitting you, then your relationship with him needs attention. You set the limit, but you overcome your own anger at being hit, and extend empathy to your son. When we offer kids empathy and set the limit of No Hitting People EVER, they do learn not to hit, and what's more, they learn positive ways to handle their feelings.

Finally, I am concerned by what you say about your marriage. If you and your husband are fighting, your son could certainly be acting out the household tensions. And of course, if your son observes any parental physical aggression, it is bad for him, and I assume you know it is time for you to leave the situation. Even if none of this is so, and the marital issues are "quiet," I urge you to consider counseling. Divorce is hard on kids, and so is marital tension. It may be that your marriage can be saved, with some attention. Even if your husband will not go to counseling with you, it would be helpful if you saw someone yourself.

I hope this helps. Have you read the section on this website on How to Manage Your Toddler So You Can Enjoy Him?

Also, please check out the letters relating to Toddlers, many of which deal with aggression and hitting of parents and peers.

Finally, the section on this website called Parenting Tools has articles on Positive Discipline and Timeouts that you might find very useful.
Blessings to you and your son,
Dr. Laura

Worried about 14 y/o in bad family situation

Mon, 23 Feb 2009 05:00:00 GMT

Hi Dr. Laura,
My 14 year old lives in a household with no communication. He has a stepdad that doesn't talk to him and his biological mother tries to if she's not working so much. He shares a room with his stepbrother that is hardly ever home. He has a stepsister that barely talks to him, if she's ever home.

My son is half black and hispanic. His step siblings are half white and hispanic. The step dad is fully hispanic. My son has no privileges on the computer, t.v and in his room, He has nothing, that shows a reflection of who they think he is.

How long does this last before something happens to change it? Thank you for your time.
--Lisa

Dear Lisa,
I hear your deep pain for your son. It sounds like a bad situation for him, because a fourteen year old desperately needs the support of those around him. It is natural for you to worry, and to be angry on his behalf.

The most important thing you can do to help your son is to stay in constant touch with him. Do you speak with him on the phone every day? See him a couple of times a week? That would make a huge difference to him. Even kids in bad circumstances can come through ok if they know that one person loves them and believes in them. You can be his lifeline.

The second thing you can do for your son is be his advocate. Can you speak with his biological mother? It sounds like she does care about your son, and connects with him when she is not working. If you tell her that you are worried about him, without blaming her, she may be able to hear you. She is in the best position to change things in the home.

Finally, maybe it is possible for your son to live with you? I don’t know your circumstances, but his biological mother may be willing to let him live with you if she sees that as a better situation for your son. A fourteen year old really needs daily support from those around him.

I wish you and your son every blessing.
Dr. Laura

Dr. Markham:
I think you misunderstood. I'm his real mother. Let me give you some history.

My name is Lisa I have raised my two children, ever since they were born. I was a single parent, but very happy with my children.

Then I got married to a man named Robert. My children and I have known Robert for 15 years. I dated him for 8 years and got married.

When we got married, all hell broke loose . I'm still very much unhappy. The people that were living in the home in 2005 was his 21 year old daughter, his 16 year old son and of course myself , my husband and my son. Then his 21 year old daughter moved out in 2007. Then my husband , myself, my son, his son who is now 18 years old, his other daughter that's 19 years old, her husband and their baby moved in with us. This is what my life consisted of.

My husband wants to get my son emancipated when he turns 16. I'm outraged about my whole life. I regret getting married to this man and its really hard to deal with things. My husband is a problem solver, so he has a hard time listening. I'm stuck in the middle between him and my son. I hate my life with a passion and I really don't know what to do.

Am I damaging my son to live like this? I worry about him soooooooooooooo much. How do you stay sane in a household, where I have to be a single parent concerning my son, instead of having my husbands support? My husband's excuse is that I get mad if he has to pass sentencing on my son ,when he does something wrong; so wash his hands of him. What would be your advice????

Dear Lisa,
Thanks for clarifying the situation. I was indeed confused by your first letter.

I am hearing that you and your son are both miserable in the house where you live with your husband, that your son is not treated as part of the family, and that your husband wants to kick your son out when he turns 16.

You ask if this is damaging your son. I can say with certainty that it is damaging your son. I can also say that it is damaging you. Further, your son is being hurt by the fact that you see his pain and aren’t addressing it. I think you know that you are letting your son be damaged, which is why you worry so.

Is this your husband's fault? Maybe, but this is not his son, and you can't control your husband. Is it your responsibility? Absolutely. This is your child. It is your responsibility to protect him and provide circumstances where he can thrive. I don't see you doing that here.

You ask my advice? I think you know what it will be. Why on earth would you sacrifice your child? Why are you staying in this situation?

My advice is that you save your son while you still can. I assume that means leaving and getting your own place, and a divorce. This is a big step for you to take, but something you are ready to do, I think. I will add that 14 is on the cusp of manhood. If you don’t act now, the damage to your son may be too much for him to handle, and you are likely to lose him forever.

There are many organizations that offer free counseling and assistance to women in your situation. I applaud you for reaching out, and hope that you will get the help you need to take action on behalf of yourself and your son.

Blessings,
Dr. Laura

Teenager pulling away from family

Mon, 23 Feb 2009 05:00:00 GMT

Dr. Laura,
I have a 15 yr. old daughter. Her biological father hasn't been in her life since she was 2. My husband now has been in our lives since she was 4. We (my husband & I) have a daughter who is 7. We all live together as a family all of the time.

I just worry about my teenager and her relationships with me and her stepfather. Most of the time she just stays in her room and doesn't
want to participate in any family activities. Can you give me some advice on what we can do to bring us closer together?
P.S. I love this website! Sure wish I had found it a LONG time ago!
--Shellie

Dear Shellie,
Your 15 year old daughter might be pulling away even if your husband was her biological father. It is normal for teens to need to establish their independence. But most fifteen year olds say they wish they could talk with their parents; they just don't know how to be closer.

You ask what you can do to bring your daughter closer. I would start with your individual relationship with her.

First, fight to stay close to your daughter. Do not let her push you away. She still needs you, she just can't acknowledge it. Find every opportunity to connect. Hug her hello every morning, and when you see her again later in the day. Hug her goodbye when she leaves for school.

If she'll let you, lie down next to her for a few minutes as she's going to bed at night to discuss her day and have a few minutes of quiet connection. I find that time just before bed to be the time my daughter is least distracted by other things, and most willing to open her heart to me.

Create regular times, at least once a week, when you go together for brunch or a manicure or a walk, and make the most of those opportunities to connect. For ideas on conversations to have with your teen, check out the articles in the section of this website called "Talking with your kids."

When you talk with your daughter, resist the urge to lecture. Just listen. Give your daughter the space to be a separate person, with her own developing identity. If you can do that, she won't need to push you away in order to become herself.

Remember when she was little, at the playground, and kept yelling for you to "Look at me, Mommy!" when she hung on the monkey bars? She still needs to feel seen by you to feel good about herself and her new achievements. She needs attention, but it has to be the kind of attention that supports, rather than limits her.

Set appropriate limits, but focus first on the relationship, not on discipline. You’ll get no respect if she doesn’t feel connected to you. Don't take anything she says or does personally. Teenage girls are famous for feeling like their moms "Just don't understand!" Try not to feel hurt by that. In fact, try not to feel hurt by anything she does. Most of it is not about you at all, but about her urgent need to shape an identity as a separate, independent person. So just breathe and stay calm. The minute you get triggered, you're pushing her away.

Cultivate empathy for your daughter. As you listen, remind yourself that the upset of the moment may not seem like a big deal to you, but to her it feels like the end of the world.

Teenage girls can be volatile. If we can empathize with them, look for the upset under the disrespect, and remind them of who they really are ("You don't usually act unkindly"), we create an opening. The inevitable ruptures of daily life become opportunities to teach them so many lessons: how to process their emotions, how to repair an emotional rift, how to problem solve, that they can trust us. Most importantly, we end the interaction with a stronger relationship.

One step at a time, you will see that your relationship with your daughter is getting closer. In a few weeks, you can raise the issue of how important it is to you that you are all a family together. Ask what she thinks about your family. Some ideas for questions:

* How do you think your friends' families compare to ours? Are they about as close? Closer? More distant? Why do you think that? Do you think your friends talk to their parents? What do you think makes a family close?

* Do you feel like you could talk with me about anything at all?

* How do your stepdad and I compare to your friends' parents? Are we about as strict? More? Less?

* Do you ever miss your dad?

* Do you think things would be different if your dad was still with us and I had never met your stepdad? How?

* Even though your stepdad is not your biological dad, you know he adores you. Do you feel close to him?

* You know, to your little sister you are completely her sister, not her stepsister. Do you feel that way, or is it different for you? Do you feel close to her? When you both grow up, do you think you will stay connected?

Your daughter may have a lot of feelings about her biological father, and about her sister's arrival -- even though it was seven years ago! Try to just listen, and empathize, without getting defensive. She may need to go slowly in this exploration, but if you can defuse the conversation and just accept whatever feelings she has, and love her through them, she will probably keep talking. Obviously, this is not one big conversation, but many small ones, over time. It will probably keep unfolding over months. But if your daughter gets the chance to process her feelings about all this, she will probably be able to relax more into your family.

Then ask your daughter what kinds of activities you could all do together that would make it feel like a family to her. The big age difference between your girls makes it harder, but the four of you can certainly play some games together (choose games of chance, rather than of skill), have good conversations at dinner, go to a museum or for a walk on the beach, etc.

The other, obvious, opportunity to build the family connection is holidays. If you can develop rituals that connect your family during the various holidays, your daughter will start to feel more like part of the family.

Some ideas: Bake pies with both your daughters at Thanksgiving. In December, my own family has eight nights of Chanuka, but Christmas offers similar opportunities for family connection. But make December about connecting, not about achieving particular results. In other words, pull out the decorations and get her to help you, but don't worry what the house looks like, focus on connecting with your daughter. Go gift shopping with her for your other daughter and husband, and make it about her -- take her to lunch, encourage her to try on clothes and buy her something she covets, or just make sure your conversation in the car is really special. Invite her friends over for a Christmas cookie-baking party, or ask if she will help you host a cookie-baking party for your younger daughter. Have a family evening where you make holiday cards, or write them, or make gift-wrap, or wrap gifts. Ask if she will volunteer with you at a soup kitchen some Saturday. You can keep this up all year long:

A New Years ritual in which each person in the family says what they are leaving behind and what they're looking forward to. Making each other homemade Valentines cards. There are more ideas to bring your family closer with holiday rituals in the Rituals & Traditions section of this website. But you get the idea. Find ways to celebrate as a family.

I find that taking teens to dinner often gets them to open up and talk. You and your husband might want to take her to a fancy restaurant for her birthday or for some other celebration.

The important thing is the mood in the family, and if you and your husband can focus on creating a warm, playful, welcoming atmosphere, you may find that your daughter is hanging out with you more.

I want to end this letter by recommending what is, right now, my favorite book on parenting teenagers: Michael Riera's Staying Connected to Your Teenager: How to Keep Them Talking to You and How to Hear What They're Really Saying. This book will really help you understand your teen's communication code, and give you more ideas for staying close.

I hope this helps. I wish you and your daughter every blessing.

Dr. Laura

Teenage daughter "rescuing" friends

Mon, 23 Feb 2009 05:00:00 GMT

Dr. Markham,
I have a beautiful 15 year old daughter who seems to be TOO emotional invested in others. What I mean is that she seems to think that she is the only one able to solve her friends problems. She is a smart girl, but when I try to point out that she is too emotionally invested in these 'friends' and their problems, I am told that I wouldn't understand, she IS the ONLY one who can fix these people because they trust her.

The last one was a boy who was threatening suicide. When I tried to explain that suicide was a serious matter and that the best thing she could have done was get him professional help - I got yelled at for 15 minutes that I understood nothing, I was naive and that that would only make the situation worse. By the way - this particular boy - is in my opinion a bit of a story teller - something I would never tell my daughter.

How do I get her to disconnect and if she needs to worry about something - worry about herself. I appreciate that she is empathetic and sympathetic, but not to the detriment of her own health. I have told my friends that she will be the one who brings home every stray, because she feels sorry for them. I don't want her to become cold and callus, but she needs to protect herself emotionally, how do I teach her to do that. My first thought was to limit her from these friends, but I don't know if that's the right thing to do. Any suggestions would be helpful.
--Carol

Dear Carol,
Your daughter sounds like a wonderful human being who cares deeply for others. You don't say why you believe she is "too" emotionally invested, or why her way of relating to her friends is bad for her, but I trust that as her mother you see some negative effect on her.

15 year olds are often extremely invested in their friends, to the point that these friendships constitute almost a second family. While teens can get great benefits out of these close relationships, they are harmful if they reduce the teen's connection to his or her own family. You don't say this is happening, so I will assume your relationship with your daughter is fine. Sadly, it sounds as though some of her friends don't have good relationships with their parents; thus your daughter feels she is the only one they trust.

In other words, while this boy may not actually have been suicidal so much as attention seeking -- and you and I really can't judge that -- these kids may well have real problems, and no adult they trust to help. Like so many teens who don't feel known by and deeply connected to their parents, they rely on each other.

Of course, their friends are often not mature enough to judge when to go to an adult for help, and they are not developmentally equipped to be in a parental role, fostering the growth of another and putting their own needs second as parents must do. If your daughter is in that role with other kids, it isn't good for her, and it is a pale shadow of what those kids actually need.

Why would a fifteen year old end up in this position? Because she is a naturally empathic person (which is a major asset in life and relationships.) Because she cares about her friends, and their parents aren't there for them. Possibly because she has played the role of caretaker in her own family, with younger siblings or a sick or dependent parent.

Why would she stay in that position? Because she wants to be a good friend, and because she derives a sense of importance, a positive identity, from it. And because she doesn't have other friends, doesn't know how to break out of the pattern.

How can you intervene positively to change this dynamic? You mention "limiting" your daughter from spending time with these friends. I think that is tricky with a 15 year old, and that if she is really interwoven with these kids, as she sounds, you could end up with a major rebellion on your hands.

I want to add that I think prohibiting contact with a group of friends is sometimes necessary when the norm in that peer group is destructive, for instance, if the kids drink, use drugs, have casual sex, or treat each other badly. But I would not take that intervention lightly and I would try to disguise it.

The most effective intervention besides moving is a separation that is not obviously aimed at the peer group, such as a long vacation with a parent, in which the parent really focuses on reawakening a close relationship with the child.

Short of that, I would recommend that you cultivate your relationship with your daughter so that she is more open to your influence and less in need of seeking a sense of importance from her peers. If you begin by offering your empathy regarding her care-taker role, she might open up to you about it.

Please read the section on Talking with Your Kids on this website and don't start the conversation until you think you can be supportive and nonjudgmental of her friends. Ask how her friend is doing -- is he still feeling suicidal? Observe that she's a good friend to have nursed him through that. Ask how she handled it. Admire her skillfulness. Sympathize with the boy that he couldn't go to his parents. Ask if she was afraid. The more you empathize, the more she will open up.

This accomplishes two critical things: it helps the two of you get closer. And it allows your daughter to acknowledge to herself, and maybe even aloud, that maybe she is in over her head, and that while it makes her feel important it really is an unfair burden for a 15 year old. This probably won't all happen in one conversation, but if you keep connecting, it probably will happen, once she doesn't feel she has to "guard" her commitment to being a good friend from a mother who "doesn't understand."

After good communication is positively established -- and I really mean after, or this will be perceived as lecturing -- you can begin to add your own views about friendship, such as the need for a healthy give and take, rather than one person always care-taking for the other. You might take the opportunity to observe, when you see a movie together, the kind of friendships depicted: do the friends show their caring? Do they have healthy boundaries?

You might also note that humans can't actually "fix" each other. All we can really do is love people as they are, which gives them an opportunity to heal their own wounds.

But not every relationship is good for us, and we are, ultimately, the only ones responsible for keeping ourselves safe and cared for, physically and emotionally. It is our responsibility to choose friends who are good for us, who can love and nurture us as we love and nurture them.

Kids learn this, mostly, by being in healthy relationships at home, but also from experiences with peers in high school. Your empathic support is exactly the help your daughter needs to master this life lesson.

Blessings to you and your daughter, and her friends,
Dr Laura

Dr. Laura,

Thank you for your suggestions - she and I do have a great relationship and we do talk a lot about what is going on - it seems to me that she only lashes out when she is in over her head and what you said made me realize that.

You are right about the friends having poor relationships at home and it is probably her empathic nature that keeps drawing these friends to her. I hear about these friends all the time and how they have been kicked out etc.

She is the youngest of two - nine years apart. My parenting approach is not one of I am the boss and you do as i say. I have always tried to be as empathetic to her situations and tried talking them out with her. Problem solving to find a satisfactory solution for all concerned.

She is an awesome kid who isn't into the vices that some of her friends are. She is the one who starts the interventions on friends who have gone too far down that path. I just feel awful for her when she seems so depressed by the situations her friends are in. But I guess as the mom I can't fix everything anymore. I just have to be there to walk her through it. Thanks again for helping me see what i can do for her and for reminding me what a truly great kid she really is.

-- Carol

Dear Carol,
I hope you know how special it is for the mother of a fifteen year old to say "She's an awesome kid who isn't into the vices some of her friends are." I hope moms of younger kids who are reading this and formulating their parenting approaches also notice that your parenting philosophy is empathy and problem solving for the good of all concerned. Research shows that's the approach that produces awesome kids!

It is a hard lesson that we can't shield our kids from pain, especially as they get older. But that empathic "envelope" we offer them is just as important for teens, because it gives them a safe way to sort out the kind of person they want to be and the choices they want to make. I know your daughter is learning from you at every step because you are keeping the communication channels open.
with admiration,
Dr.Laura

Twelve Year Old's Backtalk

Mon, 23 Feb 2009 05:00:00 GMT

Dr. Markham,

My daughter has been menstruating for almost a year, she has become a completely different person. She went from a tomboy to a couch potato. All she cares about is being on the computer, which is carefully monitored and she stays on games.

We went from a close relationship where she always wanted to be with me, to now she feels I'm a loser. She will disrespect me with backtalk, which I call her on every time. Her dad supports me, and I him when she sasses, but she is a daddy's girl, only child living an upper class lifestyle. Private schools, country clubs. Her father and I do not believe material things are the end all, and are on the conservative end compared to others in our 'world'.

My question is, how do I handle her backtalk? Right now I take away electronics since that is the most important thing in her life right now. I swear she is becoming addicted to the computer. I explained to her addictive behavior but she doesn't agree, of course. Mean, cranky when not on the computer, can't wait to get home to get back on. I swear she is not on chat rooms, my space, or you tube.

How do I respond to her sass? or her noncompliance in doing family activities? when we do, she has a puss on her face. Yes the drama with injuries are there, aches and pains, and I listen, make appropriate noises but don't indulge in the drama. She finds me cold & mean because I don't play into the act like dad.

I'm the bad guy. I do find opportunities to connect in a loving way in between the drama. How do I keep communication open when she is so bothered by me?

-- Liz

Dear Liz,
I hear how hurt you are by your daughter's rejection. I too have a 12 year old daughter, and I sympathize. It's a shock to have your sweet little girl start screaming at you. Twelve year old girls can be moody, over-dramatizing, self-centered, focused almost solely on friends, surly, backtalking and condescending to parents. They can, of course, also be mature and delightful, but at their worst they’re a cross between the most challenging aspects of toddlers and teens.

The bad news is that you have to play the hand you've been dealt, and it isn't the hand you would prefer, consisting as it does of a daughter whose developing body is flooded by hormones, who feels too vulnerable to acknowledge how much she still loves and needs you. The good news is that if you can accept that situation, there are things you can do to make things much better. What's more, 12 is the perfect time to intervene, before she draws further away from you.

Here are my ABCs of parenting a tween girl:

1. Focus on the relationship, not on discipline. You’ll get no respect if she doesn’t feel connected to you.

2. Fight like the dickens to stay close to your daughter. Do not let her push you away. She still needs you, she just can't acknowledge it. Find every opportunity to connect. Hug her hello every morning, and when you see her again later in the day. Hug her goodbye when she leaves for school.

She may not "need" tucking in at night, but that shouldn't stop you from lying down next to her to discuss her day and having a few minutes of quiet connection. I find that time just before bed to be the time my daughter is least distracted by other things, and most willing to open her heart to me.

Create regular times, at least once a week, when you go together for brunch or a manicure or a walk, and make the most of those opportunities to connect. For ideas on conversations to have with your preteen, check out 100 Family Conversation Starters and the other articles in the "Talking with your kids" section of this website.

3. Don't take anything she says or does personally. Teenage girls are famous for feeling like their moms "Just don't understand!" Try not to feel hurt by that. In fact, try not to feel hurt by anything she does. Most of it is not about you at all, but about her tumultuous hormones and emotions, her huge fears and insecurities, her urgent need to shape an identity as a separate, independent person. So just breathe through any "tantrums" and stay calm. The minute you get triggered, you're pushing her away.

4. Cultivate empathy for your daughter. As you listen, remind yourself that the upset of the moment may not seem like a big deal to you, but to her it feels like the end of the world. Having your body start changing so dramatically is worrisome at best and painful at worst, as in growing pains and menstrual cramps. That means that when she over-dramatizes, you sympathize. True, that stubbed toe didn't warrant all that fuss, but something does hurt and she does want you to kiss it and make it better, even if she isn't exactly sure what is bothering her and how to put it into words. Don't worry, this too shall pass.

5. Be aware that tween girls usually harbor great anxiety about adolescence. One study found that tween boys looked forward to adolescence and the strength, power, independence and prestige they would develop. Tween girls, on the other hand, dreaded adolescence, fearing menstruation, their new vulnerability to men, and the pressure to be “sexy” and attractive. Most girls don’t know how to put these anxieties into words, but they feel them, even as they beg to wear skimpy outfits so they’ll be “cool.”

6. Be sure your daughter is getting nine and a half hours of sleep each night. When kids stay up late, their stress hormones like cortisol kick in, which makes it harder to fall asleep. The problem is that cortisol stays in the system and makes them edgy the next day; it also contributes to depression and anxiety. The famous moodiness of teenagers is partly attributable to late bedtimes.

7. Your daughter is apparently in the grip of a computer addiction, not an uncommon situation in our culture. Game manufacturers spare no expense and use very sophisticated testing to insure that their games are physically addictive, which means that your daughter's body is bathed in adrenalin and other neurotransmitters as soon as she even thinks about playing her games. Computer games actually change our brain chemistry while we're playing them, and we don't know how long the effects last afterwards.

Your effort to help your daughter understand that she is, in fact, addicted to her games is important. Even if she never admits it, you will get more cooperation when you set limits because she will know deep inside that it is for her own good. I assume you do set limits on computer use, in the same way that you wouldn't let her watch TV all day.

In addition to setting limits, you’ll need to interest your daughter in other things. Make sure her time off the computer is fun for her. I asked my 12 year old how to break a computer addiction and she said, "You almost have to bribe her to get off the computer, like a little kid, but then after awhile it becomes a habit and things can go back to normal, with only a little computer."

The way we have avoided computer addiction is by setting limits on games -- we literally just don't allow them. Instead, we encouraging every healthy interest she expresses. I know families who nurture dance, art, or other passions. This is where having some financial privilege might help; maybe you can interest your daughter in horseback riding or trapeze, for instance, both of which girls this age often throw themselves into with great passion.

But she will also need something to do at home that isn't screen time. It may mean you’ll need to interact with her more at home, play games with her, etc. I have noticed that singleton kids are more likely to become gaming addicts because parents are often busy and the kids spend more time on the computer.

8. You say that your daughter has turned into a couch potato. My daughter also has this inclination, especially since she's a reader. The rule at our house is some form of physical activity every day, whether a bike ride, soccer game, family hike or time on the treadmill. Regular exercise has tremendous benefits, as you know, from getting the metabolism moving to balancing raging hormones.

9. Use all eruptions as opportunities to get closer. Insist on civility, but do it from as calm a place as you can muster and don't overreact when your child raises her voice to you in the middle of hysterics over something. She will be deeply grateful, even if she can't acknowledge it at the moment. I'm not for a minute suggesting that you let your child treat you disrespectfully. I'm suggesting you act out of love and connect with empathy, rather than anger, as you set limits. If you're too angry to get in touch with your love, always wait until you can before you set limits.

That means you keep your own voice calm and warm, even when she doesn't. It means that when she backtalks, you politely remind her that "We don't talk to each other that way in this house."

But I will add that you can probably expect some hysterics, including her raising her voice at you. You could respond by angrily insisting on respect, but you would drive your daughter away. If you can instead stay calm and listen for what's going on underneath her upset, you can use these occasions as opportunities to get closer.

So often kids this age have strong feelings that they need help with. Not knowing what to do with these feelings, they act out towards the people they feel safest with: their parents. (You might want to check out this blog post blog post which describes just such an interaction with my daughter.)

If we get distracted by their disrespect, or react angrily, we miss the real message. They feel wounded, misunderstood, alienated. They get angry and attack us, or build up resentment and distrust. A rift appears in the relationship, and if we don’t respond quickly, it widens.

If we can instead empathize with our tweens and teens, look for the upset under the disrespect, and remind them of who they really are ("You don't usually act unkindly"), we create an opening. The inevitable ruptures of daily life become opportunities to teach them so many lessons: how to process their emotions, how to repair an emotional rift, how to problem solve, that they can trust us. Most importantly, we end the interaction with a stronger relationship.

You and your daughter once had a very close relationship. That closeness is still there, under her disrespect. If you can change the way you parent her, you can keep that closeness even as she evolves into an independent person.

I want to end this letter by observing that parenting is a lot of emotional work, and never more so than with tweens and teens. It may seem unfair that you have to do most of the work in your relationship with your daughter, but that’s the way parenting is. Our daughters may look like young women, but they’ve got a lot of growing up to do emotionally. It’s still our job to guide their emotional development. And maybe do some growing up ourselves in the process.

Finally, I want to recommend a book that I think may be helpful in parenting your daughter right now. Hold On to Your Kids: Why Parents Need to Matter More Than Peers by Gordon Neufeld & Gabor Mate addresses exactly the issues you're struggling with. I can't recommend it highly enough.
Blessings to you and your daughter,
Dr. Laura

Is single mom's rotating work schedule bad for 5 year old?

Mon, 23 Feb 2009 04:00:00 GMT

Dr. Laura
I am a single mom and have a daughter who will be 5 in february. She starts pre school this next week. I work rotating hours anywhere from 5:30-2:30, 10:00-7, 2-11, 9-6, 8-5 or 12-9. Would it be better for me to find a job with more of a set schedule to help my daughter or is a rotating schedule ok?
thank you!
carla

Dear Carla,
It’s great that you’re thinking about this issue. It’s challenging to be a single mom, to have sole responsibility for providing economically, emotionally and physically for your child.

The most important factor is who cares for your daughter when you are gone. In other words, when she gets out of preschool, who picks her up? When you are gone at dinner time and in the evening, who feeds her and puts her to bed? It needs to be someone who really loves her and who she really trusts. It also needs to be the same person every day, so she knows what to expect.

The next consideration is that kids do need structure and they thrive on routine. It helps them a lot to have the same schedule every day, or they feel like things are out of control and they never know what to expect. Especially when they have the stress of starting school, it helps them to be able to completely relax afterwards. Most kids don’t completely relax unless they are with their parents.

It also occurs to me that you must be a very flexible person to live with a schedule like this, but that it would be good for you also to have a set schedule. It’s hard to be a good mom when your sleep schedule is always changing.

Finally, kids are remarkably resilient, so if you didn’t have a choice, your daughter would probably be ok. In other words, if she doesn't have any other risk factors, and she is a normally resilient kid rather than a super-sensitive kid who requires routine, she can adjust to a schedule like this if absolutely necessary, if you are really there for her emotionally, and if her caregiver in your absence is a close family member who adores her.

But my view is that as parents we can’t control all the risk factors in our kids’ lives, so we should at least eliminate any that we do have control over. So if you can change to regular hours, I think you both would be happier.

I wish you much luck in figuring out a good situation to balance your work and home. I honor you for taking good care of your daughter as a single mom.

Blessings to you and your daughter.
Dr. Laura

15 month old - Separation Anxiety

Sun, 22 Feb 2009 05:00:00 GMT

Dr. Markham,

I have a 15-month-old daughter. I stay home with her and work from the home. As she's starting to get into things more and more, I am having a harder time getting any work done. Additionally, she has become very attached to me, and I have trouble leaving her with anyone else. Therefore, I felt it would be a good idea to take her to a friend's in-home daycare service one or two days a week. This opportunity gives me a chance to get some work done and run errands, and it gives her a chance to be around other children and to learn that she will be ok without me in her sight at all times.

The problem is whenever I leave, she cries for at least 20 minutes. It breaks my heart to walk away from her screaming like that. I still feel that this situation will be the best for both of us, but I want to make the transition as easy as possible for her. So what should I do? Leave her crying and let the child care provider try to comfort her hoping it will get better with time? I've thought about bringing toys from home to make her more comfortable, but she doesn't really have a "favorite" toy that I feel would keep her happy. I understand that separation anxiety is normal at this age, but what is the best way to deal with it? Any advice you could offer or an article you could refer me to would be greatly appreciated!

Thanks!
Jill

Dear Jill,

My heart goes out to you. This is the normal response of a securely attached 15 month old who protests what she perceives as a life-threatening separation from her mother. Your daughter will learn, over time, that you do return when you leave, but she is not yet capable of understanding this.

You are correct that it is hard to get any work done with a toddler around, and that it is good for your daughter to have time around other kids. The best arrangement, if you can swing it, is for her to have that time with other kids in a playgroup situation, with you there. But many of us have to work, and need to have our toddlers spend time in childcare.

The next best arrangement is to have her go to "school" in the morning for three hours, rather than all day. A full day is hard on babies. They cope best with any stress (and childcare is a stressor) when they are rested. Then you can pick her up and hopefully get some work done while she naps. Research shows that toddlers who are in childcare all day end up with high levels of stress hormones by the afternoon, compared to toddlers who spend the afternoons at home.

My own view is that babies need to be with their parents as much as possible, because it is hard for them to have their needs adequately met by a caregiver who is trying to take care of other children. But if you are confident about the caregiver, you can help your daughter get through this difficult stage and have a good group experience. Here's how:

1. Facilitate your daughter’s bonding with the caregiver. Babies don't get "used to being independent." They get used to being dependent on a person other than you. The only way to help your daughter over her upset when you leave is for her to develop a great relationship with her caregiver. She will still protest your leaving, but your friend should be able to comfort her. If she is crying for twenty minutes, it means she is not willing to accept comfort from this new person.

How do you facilitate a great relationship? First, by letting her have good experiences with her caregiver in your presence. Second, by relating warmly to the caregiver yourself. Third, by putting up a photo of the caregiver holding your baby on your refrigerator, and speaking warmly to it often. (“Helen, you won’t believe it when my daughter shows you that she knows how to wash her hands!”) Fourth, by speaking with enthusiasm to your child about the caregiver.

2. Help her get comfortable in this new situation. Invest in making this experience work for your daughter by spending a few mornings, or parts of mornings, at your friend's daycare center. Facilitate your daughter’s bonding with the other kids, and especially with your friend. The minute she gets engaged in something, try to take a back seat, nearby but not engaged.

3. Start with short separations. After she feels comfortable with this new situation, and has developed more of a relationship with the caregiver, practice leaving her for a short time — start by saying goodbye, leaving, and then returning as soon as she stops crying. (Don’t give in to the temptation to return while she is still crying, or she will think crying can bring you back, and it will be hard for her to give up that strategy!) If you start with short absences, your daughter will learn more quickly that you always return, and can gradually get used to the separations as you gradually extend your absences.

4. Develop a parting routine. For instance, always read her a quick story, then hug her and tell her you love her and when you’ll be back, then put her in her caregiver’s arms, then say your standard parting phrase (“I love you, you love me, have a great day and I’ll pick you up at three!”). Stick to your routine every day and resist the urge to either extend it or cut it short. It will help your daughter to know exactly what to expect.

5. Leave her with a comfort object. If you can give her something of yours, such as a scarf, she may be able to comfort herself with it, although don’t be surprised if she throws it on the floor as you leave. Many people suggest giving your child a lovey, and of course these are helpful, but no securely attached baby will find it more than small comfort in the absence of a parent.

6. Help your daughter to understand what’s happening. Her language may be limited, but you should still reassure her by explaining what will happen. Don’t stop with the separation, keep going to describe the fun she will have: “First I will read you a story. Then we will find Helen and she will hold you. I will say ‘See you later Alligator!’ Then I will leave to go to work, and I will wave goodbye and you and Helen and your lovey will wave from the window. Then you and Helen will dance to the music you like. You might be sad, but the music and dancing will make you feel better. Then all the kids will have snack. You will play outside, and you will play with the playdoh, and then you will have lunch, and then I will be back right after lunch to pick you up. Mommy always comes back.”

7. Don’t give in to the temptation to sneak out. It will make her separation anxiety worse in the long run. When she bursts into tears, say calmly “I know you don’t want me to leave, but I will be back right after lunch. I will wave goodbye from outside. Helen will take you to the window to wave.” Then leave. Resist the urge to run back and grab your crying baby. It may take her weeks to start waving to you, but you should always wave to her. Hide your own distress and signal that things are fine by being matter of fact.

8. Discuss in advance with the caregiver what she can do to comfort and distract your daughter. Some babies are calmed by running water, or by always visiting the window to watch the birds at the feeder, or by dancing in the caregiver’s arms to particular music. One boy I knew was always distracted by a particular video of earth moving equipment; his mom could say goodbye, settle him in front of the video with his lovey, and leave. When the video ended half an hour later, he joined the other kids without a fuss. Maybe there is a specific toy that your daughter loves (even one that you bring from home but she only plays with at her caregiver’s.) You want to make sure that the caregiver will keep trying until she finds something that distracts your daughter, and that she will hold your daughter until she is calm and whenever she needs to be held while you are gone. And if she can get the kids started on a fun activity that your daughter can’t wait to join (“Look at the playdoh!”), it might really shorten the hysterics.

9. Don’t be late to pick her up. If she finishes lunch and you aren’t there yet, it will make things harder in the future, and you will be setting up a long-term feeling that you don’t always follow through on your promises. Besides, it isn’t fair.

10. Help your daughter learn about returning. Play games like Peek a Boo, or hiding and finding a loved object (“Is your lovey under the bed? No, it isn’t under the bed. Is your lovey behind the shower curtain? YES, there’s your lovey!”), or Hide and Go Seek (and of course hide in a place where she can easily find you!) Read books about separation, like P.D. Eastman’s Are You My Mother?, or Kathi Appelt's Oh My Baby, Little One (which is a wonderful book about leaving your baby at daycare.)

11. Create a “Lots of People Love Me” book. Put together a small child-sized photo album with people your daughter loves holding her: you, her other parent, her grandparents, her caregiver, aunts and uncles. Add cousins and friends. Read the book often. Let her get used to her caregiver reading it to her in your presence. Many children are comforted by reading such a book when they miss their parents.

Your daughter will eventually outgrow her separation anxiety. Your ability to give her lots of love and attention when you are with her will go a long way.

I hope this is helpful, and I wish you lots of luck.
Best wishes,
Dr. Laura

4 Year Old Having Potty Accidents

Sun, 22 Feb 2009 05:00:00 GMT

Help! My four year old little girl has been potty trained since the week prior to her turning three. Never an accident up until a few months ago. Now, she is wetting her pants daily. Sometimes emptying her entire bladder, sometimes, just enough to wet her underwear. I have taken her to the doctors twice when it first began and she had a mild urinary tract infection. The second time-nothing! Now it seems all behavioral. I tried time outs at first, then I tried ignoring it, now I make her wear a pull up after she has an accident for the rest of the day until she gets a bath. Nothing is working! She will sit in wet underwear ALL day without saying a word. I really don’t think it’s physical because she has yet to wet the bed during the night or nap time. Everyone keeps saying it’s a phase but for months at a time??
Thanks!
Krietia

Dear Krieta,
What a frustrating situation for both you and your daughter. After her having mastered toileting, to have her begin having daily accidents is upsetting for you, not to mention inconvenient. It is also upsetting to her, even if she doesn’t show it.

I'm not sure I agree with you that this is not a physical problem. Urinary tract infections in little girls are sometimes a sign of constipation. (Check the book It's No Accident: Breakthrough Solutions to Your Child's Wetting, Constipation, UTIs, and Other Potty Problems by Dr. Steve Hodges for more info on that.)

And constipation often is the cause of potty accidents, because an overfull rectum presses on the bladder. So the symptoms here are all pointing toward a physical cause: constipation. Most parents don't know their child is constipated but an xray shows that the rectum is distended. (88% of kids who are shown by xray to be constipated show no outward signs of it.) So unless your daughter's stools are soft and frequent, I would start by asking your pediatrician for an xray of the rectum.

Now, I'm not a medical doctor, and you wrote to me for psychological advice, so let’s look at things from your daughter’s point of view. She got a urinary tract infection, and naturally began having accidents. She has not been able to recover from that situation and once again master her own body. That is not unusual after a toilet-training lapse caused by a medical condition, stress (like a school change), or anything else. After all, adults have spent years using the toilet. A four year old has only been dry for a year. And many, many four year olds do have accidents and phases where they go back into pullups. Even something you would not notice or would think is a small change in her life can throw a four year old off.

Unfortunately, in your concern about helping her learn again to stay dry, you began punishing her. There’s been a lot of research on this, and punishing kids about toileting ALWAYS seems to result in more accidents. We aren’t sure why, although probably this is because the child stops seeing toileting as an opportunity for mastery — which all kids want — and starts seeing it as a power struggle with the parent, where the parent is in charge of the toileting and the child is no longer responsible. The reason she sits in wet underwear is is probably that she is afraid to tell you when she’s had an accident. After all, that's better than enduring punishment and shame, right?

So what can you do now? Love your daughter unconditionally, and remove the stress. Treat this as you would the beginning of toilet training. I would sit down with her on your lap for a nice snuggle, and then say something like “I notice that you are having accidents a lot. I know it can be hard to notice every time you have to pee. Would you like to wear pullups for awhile, until you’re ready to remember to use the potty every time? And I am going to help you stay dry, too. We are going to use the potty together every hour on the hour, no matter what. Ok?”

Then, remind her to void, every hour on the hour. Do it with her. That keeps her from being the bad kid who needs reminding. Instead, it just becomes the norm in your house. Once she gets used to this and is no longer having accidents, you can go back to underwear again.

However, if she refuses to go back to pullups, the situation is more challenging for you. You might say something like “I can see you really want to wear underwear. But lately I see you have a lot of accidents. Will you agree to use the bathroom with me every hour on the hour?"

Then, when she has an accident — and she will, almost certainly — you need to keep your tone very light: “I see you’re wet. I know it’s hard to get yourself to the toilet on time every time, but soon you will remember, just like you used to. But it’s not good to stay in wet clothes, and you’re in charge of your body, right? So go to your room and pick some clean underwear and pants out, ok? And drop your wet clothes in the hamper so we can wash them." Resist the impulse to be at all punitive.

Try to set up her clothes so she can access them herself and you aren’t involved. That way, she isn’t getting attention from you when she wets herself, and you aren’t inconvenienced. Soon, she will decide that changing clothes is more trouble than using the toilet. If you can keep your tone light and approving, no matter what, you’ll be amazed how quickly your daughter will be dry again.

And I want to emphasize getting the xray of her rectum. Many kids her age who have potty accidents are constipated, and it isn't fair to them to not get help.

Please write and let me know how it goes.
I wish you and your daughter every blessing.
Dr. Laura

Attachment Parenting - Does it Go Too Far?

Sun, 22 Feb 2009 05:00:00 GMT

Dr. Markham,

I just finished looking through your web site on "attachment parenting," and since you invited even those who do not fully agree with you to respond, I decided to take a few minutes to write you.

I have to admit I always find the tone of attachment parenting web sites, books, and discussion boards to be extremely sanctimonious and defensive. You might say the defensive posturing comes from being "attacked" by other kinds of parenting experts and so on, but honestly, I find that the dominant voice at this point is almost always pro-"attachment parenting." I read the same things over and over in connection with attachment parenting: that all parents should a.) wear their babies almost all the time, b.) breast feed until the age of 2, c.) co-sleep, d.) feed their children only breast milk until at least 6 months old, e.) and never let your baby cry. Parents who do not choose all of these things are risking damaging their child.

Most of these things make sense to me in more moderate doses than pro-attachment folks seem to insist on. For example, I just can't and don't want to wear my baby all the time, although we do not use a stroller, and we go everywhere in our ergo. My baby didn't ever want to be held all the time, although we all love to snuggle in our family, and do. We never co-slept, unless you count the 2 weeks she was in our room, the first few days in our bed, then in her Moses basket before we gradually transferred her to her crib. Honestly we all seemed to sleep better, including her, because we weren't waking her when we woke, and I wasn't picking her up at every single peep she made. I know some families prefer co-sleeping for various reasons (one couple I know lost their first child to SIDS, and therefore needed to co-sleep for their own reasons unrelated to the child). But I don't find their "way" to be better than mine, or vice versa. I breast feed my child, but I have no plans to breast feed until the age of two. I think that by then, she will be significantly more independent in the world, including in regard to food. I don't think I am depriving my child if I don;t breast feed her for two years. I plan on starting to give my child some rice cereal, and some organic veggies sometime this week (she is 5 months). She is interested in food, opens her mouth to try and eat our food, tries to take if from our plates, etc. Her primary source of food will still be breast milk, but she seems to want to experiment with more.

Lastly, we have used Ferber's techniques just in the last couple of weeks, with great success, although the methods we used sound like nothing you (and most "attachment parenting" advocates) attributed to Ferber on your site. For one thing, after rocking her to sleep for 4 months (and we didn't mind doing that and found it appropriate), we started focusing on putting her down drowsy. When she cried we came back every few minutes to soothe, and if she seemed really upset, we picked her up and soothed her that way. We adjusted her bedtime after reading Ferber's theories on what can disrupt sleep. We worked on trying to decide what kind of sleep rhythms she had: mine (late riser) or her fathers (early riser). We think probably mine. After 1 week, we were ready to let her cry a little bit to see if she could put herself to sleep on her own. We set our limits before we started, and got on the same page. The first night, she cried for about 30 mins, and my husband stayed in the room with her almost the whole time, soothing her and stroking her head. The next night she cried for about 10 minutes, and the next, 5 minutes. The same was true for her nap times. She has always been a great sleeper, but was getting used to needing rocking and breast feeding to sleep. Now, she wakes once in the night when she is hungry, and I feed her and she drifts off to sleep in her own crib without fussing. I will say here that Ferber says repeatedly that parents should know their limits. For us, vomiting would not have been acceptable, for us, more than 30 mins of crying altogether would have been not have been acceptable. That would have signaled to us that she was not ready.

You are right to say that for some children (like ours) this is a workable method, and it might not be for all kids. Attachment parenting says parents should simply follow their instincts, but then it proceeds to tell you what your instincts should be. Also, when experts like you focus only on one extreme interpretation of someone like Ferber, it doesn't bode well for your cause. Most attachment parenting people I know haven't even read Ferber (although I am sure you have, but simply choose to leave out all the advice he gives that has nothing to do with "crying it out."). Vilifying Ferber isn't really proving that attachment parenting is better. I saw no footnoted evidence for your claims that children develop PTSD from Ferberizing, for example. PTSD happens to abused kids, kids who have been through wars, car accidents, etc. Not kids who have cried for 30 mins. while their parents check on them and soothe them lovingly. Attachment parenting diatribes always just sound like guilt tripping scare tactics to me, that do not focus on the health of families, but rather set up dynamics where kids are in charge when they have no business (or skills) to be in charge. We love our daughter every bit as much as any attachment parenting practitioner, and what we do isn't that different. We just don't sanctimoniously bash people over the head with our personal parenting practices. We are learning where to set limits with her, and where to follow her lead. She is physically hardy, and smiles and laughs all the time. She is an engaging happy kid. I guess we didn't "damage" her when we decided against "attachment parenting."

Best,
Ingrid

Ingrid,
Thanks so much for taking the time to write, and to tell me your story. It sounds to me like your daughter was easy to sleep train and learned quickly. I am so happy for you that she is sleeping well, and I am sure that getting a good night’s sleep makes you a better mother.

And I agree with you that she wasn’t traumatized. In my opinion, it is being left alone to cry that is a risk factor for babies. It doesn’t sound like that is what happened with your daughter; she had her father to comfort her.

After reading your comment I went back and edited my article to add the citation of the Harvard study, and to make it clear that I am not suggesting that Ferbering causes PTSD. It may cause a susceptibility to PTSD, which is what the study said, but that would require another trauma later in life. I just left in my article a reference to the study authors’ opinion that it is a risk factor for panic and anxiety disorders, which is what they say their study proved.

I hear how much you love your daughter. I am sure you know that a great deal of conventional parenting advice over the past century has been very harmful to children, from medicated births to bottle-feeding to letting babies cry to exercise their lungs, to spanking. The more research we have -- and there is now quite a bit -- the more it is clear that children benefit tremendously when their parents use the basic practices you mention: holding/wearing the baby a lot, breastfeeding into the toddler years, co-sleeping, delaying solids until approximately six months, and not letting babies cry. You have a baby, so you do not mention discipline, but I would add to your list of harmful practices any kind of punitive discipline.

However, parenting is an art, and every child is different. Good parenting attends to the needs of the baby, whether it is for solid food at five months (which your daughter is clearly expressing her readiness for), or to be held. I don’t think that babies need to be carried when they are happy to be put down, in fact I think they need tummy time to learn to use their muscles. I also think every baby is different and responsive parenting responds to the needs of that unique child. So I don’t assume that there are ironclad rules that all parents need to follow. And I certainly don’t think that children should be in charge in their families. My basic rule for raising great kids is to set limits, but to do it with empathy, which means I am not at all in the mold of the stereotype of attachment parents who are afraid to set limits.

Thanks for taking the time for this conversation. All parents benefit from real discussion of these issues rather than sanctimonious judgments. I’m grateful.
Dr. Laura

Pregnant and worried: Baby moving less

Sun, 22 Feb 2009 05:00:00 GMT

Dear Dr. Laura,
I am 20 weeks pregnant and I am a little bit worried because I'm not feeling the baby move as much as before. I mean, the baby started moving before week 16. I just hope everything is fine or am I worrying too much?
Antonia

Antonia,
Please call your doctor right away and go in for a checkup. Your baby is almost certainly just fine, but there is no reason for you to be nervous. That is what doctors are for!
Blessings to you and your baby,
Dr. Laura

Getting my child to give up her pacifier?

Sun, 22 Feb 2009 05:00:00 GMT

Dear Dr. Laura,
My three year old uses a pacifier for comfort. Her dentist says she should give it up, and I admit that I would like her to but I don't want to traumatize her. I have seen other kids give it up cold turkey but then start a bad habit like hair twirling. Is there an easy way to do this?
Teresa

Dear Teresa,
The American Dental Association warns that kids over three who use pacifiers risk problems with their dental arches. At the same time, small humans have an innate need to suck, and in most of the world, three year olds still nurse. So I applaud your feeling that you don't want to traumatize your daughter to wean her off the pacifier.

I do feel that pacifiers can too often get in the way of social interaction and play, so it's better if three year olds don't use a pacifier except for comfort, such as at bedtime.

Many parents use the cold turkey approach. There are some hard nights, but the child adapts. Of course, that would also be true if the child had a more significant loss. It is hard to know how much it costs them inside.

I personally think it's much better if the pacifier is abandoned by the child, rather than taken away from her. One idea to hasten this process is to poke a small hole in the nipple. Because it breaks the suction, the sucking will be less satisfying and the child will probably decide to give up the pacifier herself. She will be comforted during this time just by being able to fondle the pacifier as she falls asleep, and she won't have to feel victimized, angry, or shamed by having her pacifier taken away and being told she is too old for it and shouldn't need it.

Be aware that little ones use pacifiers to "pacify" themselves, which means that without it some big tears and fears can come to the surface to be processed. Stay compassionate if your child gets grumpy in the week or so when she's getting used to giving up the pacifier. She will probably need to cry a fair amount, and that's a good thing -- she's venting feelings that she's been lugging around, and using the pacifier to keep down. With your loving attention, she'll cry and evaporate those feelings, and she won't need the pacifier any more to soothe herself.

Good luck!
Dr. Laura