“The curious paradox is that when I accept myself just as I am, then I can change”.
When my son was a baby, there were so many times I could have used more support. I was lucky enough to have people in my life who would have offered it, but the thing is, I didn’t ask. For many months, we didn’t sleep for more than an hour at a time, and I was completely overwhelmed. But I felt like a “good mom” should just know what to do. If I just researched more or tried harder, surely I could figure it out. But the more I read and the harder I tried, the more elusive peace of mind became.
So often, by the time families walk through the door of my child psychiatry practice, they have been struggling alone for months and often years. Like me, they have been researching and trying. Often, they have faced confusion and challenges with the mental health system: the wait times, the lack of coordinated services and the quantity of services altogether are all very real problems. Yet there can also be internal barriers to accessing services, and those are the ones I was thinking about this week.
We’ve all heard about the “stigma” of mental health issues. We know that adults and teens can feel ashamed about having mental health symptoms. They can worry that people will think “they’re crazy” or “it’s all in their head.” Kids also feel the stigma. At least a couple of times a year, a tense kid eventually summons the courage to ask if we think he’s “mental” because our department is called “mental health.” What we talk about less is the stigma for parents of children and teens with mental health symptoms.
As parents, the first time our child throws a public tantrum or hits another kid on the playground, we can become self-conscious of their behavior. We can lose perspective of the child as his own separate being and start to see him as a reflection of ourselves- his behavior a reflection of our own parental errors. Of course we are extremely important in helping to shape our children’s behaviors, but we’re only part of the equation. As a therapist once told me: “your child is not your report card.”
Many parents fear entering our doors because they might be blamed for their child’s problems. Their fears aren’t unfounded. There is unfortunately a long history in the field of psychiatry of blaming parents, most often mothers, for all types of mental illness. This has changed substantially in the last forty years. Knowing this, why couldn’t I just “shake it off” and ask for help when I needed it?
My friend in medical school did a great study- he looked at how compassionate people felt about others’ mental health problems depending on their perception of that person’s responsibility for their own problem. Not surprisingly, people had most compassion for the patient which schizophrenia which was “biological” and “not their fault”; the least compassion for the person with substance abuse (mistakenly believing it is a choice). They felt somewhere in the middle about the person with depression. When it comes to our children, much of the stigma is about self-blame: our own perceived responsibility for our child’s problem. We can struggle to have compassion for ourselves as parents.
It was my own inner-critic that prevented me from seeking support early on. It was the part that said: “you should know this”, “why didn’t you learn about baby sleep BEFORE you had a non-sleeping baby?” and “why can’t YOU handle this? Everyone else can.” Translated to mental health and older children, our inner-critics can say things like: “why didn’t I catch this sooner?”, “why can’t I help her myself?”, “I’m sure I caused his (anxiety/depression/self-harm/drug use etc...), “this can’t be happening to MY kid”, and many, many other self-critical thoughts.
It’s not a coincidence that Dr. Kristin Neff, a leading expert on self-compassion, is herself the parent of a child with autism. Her website is a wealth of information (self-compassion.org). Dr. Neff speaks about her own experience as the mother of an autistic son who sometimes goes through intense melt-downs in public that can’t be soothed. At those times, instead of becoming critical of him or herself, she will place her hand over her heart, silently acknowledge her distress and show kindness to herself. Research on parents of children with autism has shown that self-compassion reduces "burnout" and research is growing about the positive impacts of mindful parenting and self-compassion for parents of children with anxiety, ADHD, OCD and other mental health conditions.
We all know that when children are hurting, parents hurt too. No matter what has come before, we as families are always worthy of care and support from the people in our lives, from professionals and from ourselves. Even as a doctor and child psychiatrist, I needed help with parenting. This hasn’t been easy to accept. Years later, I still have to actively practice self-kindness and gently tame my inner-critic. I try to remember that all parents are just doing the best we can, learning as we go; and, when we do finally find the door to help, it’s ok to come as we are.