The following piece was originally published on Alexandra Harrison’s blog entitled Supporting Child Caregivers in April 2020, which can be found here.
Talking to parents the past couple of weeks has impressed upon me in full force the stress we are all under. It is clear that it is not “business as usual” on the home front. The stresses are mounting. Parents are worried about poor work performance or even losing their jobs. They are stuck at home with their kids. Both parents and kids have lost the supervised time away from home that work and school provide, plus the structure, intellectual engagement, and relationships with peers, teachers, and colleagues. School systems vary in the degree to which they conduct remote academic and social programs for students, and the best ones do not substitute for a day at school. Some parents have sick relatives, elderly parents, or they themselves are sick, all causing added worry. Even if they are not sick themselves, they may not be able to get childcare because of fear of infection—either from an infected babysitter or from virus in the family. The kids are going stir crazy. None of the usual supports–from religious communities or communal services, extended family, or friends—are available.
This is an emergency: I find myself reminding families that this is an emergency. Just because you are physically in the comfort of your home and your house is not burning down, just because there are no sirens in the streets, you are still in a crisis. Typical expectations must be put aside and new expectations must be established—new expectations for comfort, work hours, and treats for the children. New expectations must be established for children’s behavior—both greater compliance and also lower demands. You are in survival mode, and what you need to do is get by day to day—to ensure the safety of your family through providing food and shelter and doing what you can to protect from illness.
Parents United: In these times, parents must get on the same page. This is not the time to polarize about setting limits—the “bad guy or the good guy”—or about bedtime—one more book won’t make a difference versus sticking to the plan. Of course, when you are under stress is typically the hardest time to collaborate, but your family depends on you now more than ever. When parents find a way of getting things under control, they feel more relaxed, and their children feel more relaxed, because they feel safe.
Priorities: The priorities are getting through the day safe and healthy. The first issue on the agenda is making a schedule. Parents often really dislike this part. Some think it is too rigid and they will never be able to follow it. Others think they can’t possibly organize their day into steps. Whatever the details of the schedule, the parents coming to an agreement in itself is a victory. Family members negotiating together in setting boundaries is usually constructive (depending on the age of the child—I recommend only limited negotiating power for preschool and young grammar school kids.), but once the boundaries are agreed upon, all family members must respect them. Attempts by children to negotiate boundaries in the moment should be discouraged by both parents.
Routine: All families have some kind of routine—some more flexible than others. Routines are closely tied to schedules. Schedules tell you when things happen. Routines tell you what you do over and over again. It is hard to implement a routine, because you have to practice it. However it is a high priority; it needs to be done. A routine clarifies expectations. It creates anticipation of what comes next. It smoothes transitions. It allows for planning.
Screen time: This should be more flexible, but as the physical isolation gets lengthier, it should be organized—in relation to parents’ work schedule, in relation to children’s sleep or nap schedule, in relation to children’s remote school schedule. Individual I pads, if affordable, are useful. They can give access to lots of educational material for children, such as https://www.abcmouse.com/abt/homepage and https://tinkergarten.com/blog/just-us-for-the-first-ever-live-online-tinkergarten-experience.
Limits and boundaries:Limits and boundaries are more important than ever in times of crisis. People’s lives are disrupted, turned upside down. Nothing feels safe. Boundaries create a sense of safety. But setting limits are harder when families are stressed. That is because the reasoning part of the brain is less available, and the fight or flight system is more likely to take over—for both parents and children. This is when routines help. And “natural consequences”. It seems easy to do, but I remember when my children were small that it wasn’t easy always easy to do the sensible thing. Parents can get paralyzed in the moment when their children try to argue them out of a limit. In these times of families altogether all the time, children are more likely to demand things they cannot have, to push the limit. When your child grabs his I Pad and says he is not going to comply with the rule, if he is young enough, you take it away and he loses it for the next time slot on the schedule. During these days, siblings are more likely to get into conflict. If the older sibling insists on intruding into the younger sibling’s remote school meeting, you take the older sibling away into another room (if there is another room) and take away some small reward such as that child’s next screen time. Some children have an exacerbation of fears, of sleep problems. That is because they don’t feel safe. Parents need to take control in a benign but firm way.
We can make an analogy to our current government. Governors are pleading for consistent leadership so that they can organize their state’s agenda and do their best to cope with the crisis. Your children’s testing behavior tells you the same thing. “Mom and Dad, please get your act together and make some consistent rules so that family life can feel safe and predictable. “
I must acknowledge that most of the solutions I am suggesting are for families not living on the margin. Families in homeless shelters, parents who work as waitresses or bartenders, or especially now–and for different reasons–health workers, families with domestic violence or substance abuse or mental illness or chronic illness, children with disabilities—all these factors multiply the stress one thousand fold.
The Future: In spite of the dire but realistic predictions, it is important to have faith in the future—the “This too will pass” attitude. As a psychoanalyst I rarely think in terms of “positive thoughts”, but I am also interested in the way the brain works and how positive thinking can affect the mood in helpful ways. It is true that reminding oneself of how one survived earlier hard times can help. I believe there will be a time when we can go shopping again without worrying. The kids will be in school again. We can go to work again in a protected time and space. One silver lining—and there are a few—is that if you institute these changes in the way your family works, you will be making an investment in your family’s future. You will be building a better “government” in your family. You will be preparing for your children’s adolescence!
One more idea that I particularly like was suggested to me by a Chinese friend who told me that families in Chinese cities rarely have outdoor space for a garden. She said that sometimes they grow a little plant inside the house to remind them that you don’t have to be outdoors to enjoy something green and to remind them that change is possible.
I would like to recommend again the beautiful book about COVID by the WHO for children 6-11-yo.
Alexandra Murray Harrison, M.D. is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute in Adult and Child and Adolescent Psychoanalysis, an Assistant Clinical Professor of Psychiatry, Harvard Medical School at the Cambridge Health Alliance, and on the Faculty of the Infant-Parent Mental Health Post Graduate Certificate Program at University of Massachusetts Boston. Dr. Harrison has a private practice in both adult and child psychoanalysis and psychiatry. In the context of visits to orphanages in Central America and India, Dr. Harrison has developed a model for mental health professionals in developed countries to volunteer their consultation services to caregivers of children in care in developing countries in the context of a long term relationship with episodic visits and regular skype and video contact.
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