Teachers and the Pandemic

by Andrew Skoirchet, M.D. with Alexandra Harrison

This image is picture of children in a school in South India.
A Harrison: The colleagues I rely on most in my therapeutic work with young children are teachers. I know that teachers write about teaching and what it is like to be a teacher much better than I ever could, but as an outsider, I would like to offer some observations from my long collaboration with teachers.  In addition, the current health crisis brings us time to reflect as well as bringing us new challenges. I would like to take advantage of both of those opportunities.
Preschool teachers, and perhaps teachers of older children also, have been taught Child Development more thoroughly than I ever was in Child Psychiatry training. Teachers see so many children. They see many children of the same age together and gather information from their own experience about norms of behavior for their particular cultural or socio-economic population. They observe peer interactions and find ways of supporting them and managing the behaviors that emerge. They learn to say hello and goodbye. That is what they do every year. They say hello and make an attachment to a group of children, whom they see every day and help with their struggles—academic and socio-emotional—and then they say goodbye to them. In addition, teachers attempt to meet the needs of children with special learning challenges. Finally, they have to plan a curriculum and implement it, despite the individual needs and preferences of their many students.
 
All this, and then the pandemic struck. My colleague, Andrew Skoirchet, and I gave a talk to some Indian teachers about the transition to remote teaching, and that gave us a chance to talk to some U.S. teachers about their experiences.  Here are some thoughts that Andrew put together from our conversations with teachers.
 
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A Skoirchet: One of the most frequent comments we’ve heard was about how suddenly teachers had to transition to online learning. Many teachers doubled their work hours in order to prepare for class, often working through the weekend with no days off. They wondered how to create an engaging and effective remote learning environment, including what schedule to follow, how to promote active learning, and how to ensure that every student, with their own unique strengths and challenges, can stay involved in the lesson. Teachers worried about their younger students sitting in front of a screen for so many consecutive hours each day. Not surprisingly, teachers also found that their youngest students were often the most challenging to teach. Even after all the extra preparation, teachers would sometimes catch their students distracted by video games, cell phones, and other side activities. Or they had no idea about their students’ distractions, which can be just as disruptive to the learning process. Some children cannot effectively learn in a remote environment, whether because of some learning disability, issue with attention, or another cause, however teachers continually tried to “make it work” for these students.
 
Another major issue was the technical challenges in transitioning to the use of remote video platforms, which caused much confusion, anxiety, and quite a few mistakes. How do you manage when a screen freezes or the internet fails? Do you wait for students to rejoin a class, or keep the class going? Do you pause and recap when each student returns from a disruption? Are students even able to process the lesson through a video format? Nobody had the answer to these questions when COVID started. Just like teachers, school administrators were overwhelmed and uncertain about how to proceed, so teachers most often had to make their own individual decision for how to run their classes, while still being held to the standards of “evidence based” and “results driven” education. 
 
In order to accommodate all of these new demands, teachers often made great sacrifices in their personal lives. They struggled to balance these new work demands against taking care of their own families and other household responsibilities. They lost the satisfaction of in-person connection with students and the sense of community with fellow teachers: the simple “hellos” and brief chats in the hallways that are incredibly important for teachers’ morale. And teachers also faced new emotional burdens. One of the more common complaints we have heard was self-doubt about the quality of their instruction and not having any point of reference to judge one’s own work. This self-doubt often consumes the little remaining “free time” a teacher has, and might leave them with a feeling of inadequacy and failure. Teachers often worried about losing their jobs and, in fact, many teachers have lost their jobs or have been placed on temporary leave. For many teachers, it has been a huge contradiction to work twice as hard as before COVID, making so many personal sacrifices, and then to feel so undervalued. Loneliness and a feeling of isolation have emerged as two common experiences during COVID, which can be especially difficult if a teacher does not live with family or a roommate. Teachers, like many, are reporting higher levels of anxiety and depression.
 
Other common worries that we have heard include witnessing the backsliding of their students’ progress. There is the concern that younger children are not having the necessary socialization experience, and it is not yet clear how this generation’s development will be affected. While some students’ families have the means to pay for additional resources and learning supports during COVID, other families do not. This has highlighted the inequities that exist in our society, as many teachers and students do not have the resources to overcome the challenges imposed by COVID. Teachers are saddened to see their most vulnerable students fall further behind because they cannot afford extra tutors, high-speed internet access, or computers. Even if both parents work extra hours, this means they have less time to help their children at home, and teachers are realizing just how crucial it is for parents to be available to support remote learning. 
 
As for what teachers can do to take care of themselves, here is some of the most helpful advice we have learned: it is critical to schedule time for yourself, even if only 15 or 20 minutes per day. This could involve physical activity, writing in a journal, meditating, or doing a hobby. Some teachers have formed support groups, which has helped to replace those hallway conversations that can be so sustaining. It is also helpful to set boundaries on a number of different levels. For example, having a dedicated work space at home, ideally outside of the bedroom, can be especially helpful. If a teacher is being asked to return to in-person teaching, they should feel permitted to make their own decisions for how to keep themself and their loved ones safe. On a personal level, it is important to acknowledge when you need alone time, time for self-care, or time to be spent with loved ones. Professionally, teachers should also expect for their productivity to decrease and to understand that this is okay. It is important to draw boundaries around the total amount of time spent on work, as well as how much access students and families have of teachers outside the classroom. Finally, it is important to have boundaries in one’s own frame of mind. Teachers should not have to apologize for having limits, and they should feel justified in sharing these limits with administrators, students, and their students’ families.

Returning to Preschool During COVID-19

Panel on school reopening

I participated in a great panel at the Cambridge Ellis School last night. It was a remote meeting for parents and teachers in preparation for the opening of school during the COVID-19 crisis. The panelists included Dr. Michael Yogman, the school pediatric consultant, Tal Baz, an occupational therapist and specialist in sensory processing, Dr. John Mazzotta, and me, the school child psychiatric consultant. 

Most of the questions the parents sent to the coordinator before the meeting concerned safety. That is what would be my primary concern if I were sending children back to school during the pandemic.  Some of us feel relatively protected, working from home, somewhat insulated from the illness and financial insecurity others are suffering. Many parents of preschool children are more aware of the burden of caring for children while attempting to work from home than they are of the threat of physical illness. But when they prepare to send the children to school, that is when they are confronted with the dangerous reality of life outside the home.

Early on, the panel talked about the need to balance the threat of illness against the preschool children’s need for socio-emotional growth. Both are extremely important. How can we balance the two? The question of how to balance the need for protection and the need to support socio-emotional development is stressful to parents. Yet, parents are the foundation of their children’s sense of security. How can parents manage their own nervousness and be calm for their children in the transition back to school? Many studies have documented the “contagion” of anxiety in the parent-child relationship (Murray, Cooper et al, 2007; Nicol-Harper et al, 2007). How can we protect our children from parental anxiety that is based in legitimate fear?

One way of managing parental anxiety is to identify concrete measures to protect their children. We talked about the use of masks, hand washing, and constraints on behaviors that could potentially increase contagion– physical closeness and singing. 

Masks are challenging for very young children, but there are ways of helping children feel comfortable wearing masks. Games can be played wearing masks-peekaboo games, games about guessing the emotion being displayed by the person wearing the mask. Children can decorate their masks, enhancing their sense of control and agency when unusual demands are being placed on them. Especially masks representing superheroes can allow the child to—in their imagination—inhabit that superpower and feel safer and more in control. It is important to emphasize the individual differences among children in terms of the tolerance for wearing masks; some children with tactile sensitivity, for example, may need extra support. In terms of the emotional distance conferred by masks, since emotion is communicated more by the top of the face than by the lower part of the face, this should not be such an issue. In fact, authentic smiling is communicated by the orbicularis oculi muscle of the eyes more than by the facial muscles around the mouth. While it is true that children who are learning to talk may find the muffling effect of the mask problematic, this may be an opportunity to learn to enhance communication through gestures. 

We talked a lot about hugging and other physical contact and the constraints imposed by concerns about contagion, especially in the case of the youngest children. Can the toddlers not sit in their teachers’ laps? What about teachers attempting to calm a dysregulated kindergartner? What about the children who have a hard time “keeping their hands to themselves” while waiting in line? This again seemed to be an issue of balance that will depend in part on the comfort of the individual teacher and in part on the comfort of the parents of that particular child. 

An important emphasis of our discussion was on self-regulation. I have already talked about how to manage parents’ anxiety through concrete steps of protection. Another way is to work on self-regulation. The first step is to slow down. Meditate if that is a method you can practice. Slowing down and behaving in a calm, well-regulated manner will be very helpful to your child. Mental health in the pandemic has been strained both for children and parents (Gassman-Pines et al, 2020). 

The issue of self-regulation brings up another salient theme of the panel—the stimulus to innovate, create. For a long time I have thought that self-regulation should be an even more important focus in preschool education than it is at this excellent preschool. I have written about my visits to a school in South India in which each school day is begun with chanting prayers, a highly regulating activity, followed by dancing for the young children.  These repetitive rhythmic motor activities, as Bruce Perry explains, engage the “bottom-up” stress regulating system. They create an organizing force in the nervous system–and like all activities–if they are repeated, they reinforce the neural circuits that govern them (Perry, 2006, CTA). Similar self-regulation activities include marching, drumming, clapping and other organized hand games. We talked about games that build regulation of the motor system—games that involve stopping and starting like red light, green light, like “Simon Says”. The more outside time the better during the pandemic. One of the most enjoyable and organizing activities of the school day in preschool is singing. An alternative to this potentially virus-spreading practice is humming, which—through the exercise of breath control—is also self-regulating! Perhaps the urgency generated by COVID-19 can spur us to create new practices that build self-regulation into the curriculum.

We talked about a new emphasis on imagination. Remember that preschool children are in the “magic years” (Fraiberg, 1959). Their most effective way of making meaning of their world is through pretend. Pretend play offers the preschool child a means of representing the insecurities, the anxiety, the desires, and ambitions in their inner world and to master them. The frustration and sadness associated with the constraints of freedom, the limitations of socialization, and the demands to take precautions—these can be represented and mastered in pretend play. Preschool teachers are experts at scaffolding this developmentally enhancing play, and parents can also facilitate it at home—by encouraging it, providing the space and props for it. Although parents can contribute to the effectiveness and enjoyment of children’s play by helping them elaborate the themes that the children introduce and by helping the child maintain regulation when stirred up, parents do not have to actively engage in pretend play with their children all the time. Parents’ affirmation and appreciation of pretend play in itself is helpful.

Finally, we talked about community building—for the children, of course, but also for the parents. Remember the question about how to manage the anxiety generated by the real threat to our safety? We can do that through the support of the school community. We encourage regular meetings—to share information about medical advances, to share ideas about how to help parents, children, and teachers cope with the ongoing challenges, and to share emotional experience—because no matter how hard the journey, it is easier when you have traveling companions.

References:

Gassman-Pines A, Oltmans Anant E, Fitz-Henley J (2020). COVID-19 and Parent-Child Wellbeing, Pediatrics, e2020007294; DOI: https://doi.org/10.1542/peds.2020-007294

Fraiberg S (1959). The Magic Years: Understanding and Managing the Problems of Early Childhood, NY: Simon & Shuster.

Murray L, Cooper P, Creswell C, Schofield E, Sack C, The effects of maternal social phobia on mother-infant interactions and infant social responsiveness, J Child Psychol Psychiatry(2007). 48(1):45-52. 

Nicol-Harper R, Harvey A, Stein A (2007). Interactions between mothers and infants: Impact of maternal anxiety, J Infant Behavior & Devel, 30(1):161-167.

Perry B (2006). The neurosequential model of therapeutics: Applying principles of neuroscience to cinical work with traumatized and maltreatment children In Working with Traumatized Youth in Child Welfare(Nancy Boyd Webb, Ed.) The Guilford Press, N.Y., pp. 27-52.

Training Series 2: Six Core Strengths for Healthy Child Development, Overview, The Child Trauma Academy, www.ChildTrauma.org.

More Thoughts about Parenting in COVID

 
I wanted to offer you some more thoughts about parenting during COVID. In Wordsworth’s famous autobiographical poem, The Prelude, he talks about “losing the props of my affection” when he was 8-years old. In saying this, he refers to the death of his mother. I have always thought that this way of describing parental function as “propping” was such an apt way of describing the way parents support their children in a quiet, typically unacknowledged, way. It reminds me of a preschool child sitting in a parent’s lap during a remote learning session, an elementary school child’s parent helping them with a school project, and a high school student’s parent stocking the fridge with her favorite snacks during exam time. 
 
 
Parents deserve a little “propping” these days also! They are under a great deal of stress. They are worried about how to do good work at their job– either remotely or safely outside the home. They are worried about how to manage household chores with children under foot. They are worried about how to help their children learn remotely or whether it is safe to send them back to school. In the background of all those concerns is the fear of illness and death. These are very difficult times. 
 
In addition to “propping”, there are other ways parents can turn the hardship of the pandemic into opportunity. I hesitate to add anything to the burden of parents, but I am taking a risk to suggest that they try very hard to look beyond the stress and austerity and recognize a new chance to help their chidlren grow. I often talk to parents about how boundaries and limits are good for children, how “good discipline” grows children’s brains. In fact, I have recorded a series of podcast episodes and shorter Youtube videos about “good discipline”. I have done this because discipline is the most popular topic that parents ask me about as a child psychiatrist. 
 
American culture does not make it easy for parents in this domain. In fact, our culture seems to capture parents between a rock and a hard place—expectations that you keep your children’s behaviors within societal bounds while at the same time encouraging their autonomy! During the pandemic, and to the degree that there is still social distancing with its associated losses—the constraints of freedom and treats like visiting friends and family, play dates, going out for to eat – parents may struggle even more to set limits on their children’s behavior. They sympathize with their children’s distress, and they put up with more whining and even tantrums. 
 
Now, I have stated in podcast episodes and videos that it is important to lower expectations for everyone—children and parents. I think lowering expectations is crucial in order to adapt to these new challenges without excessive frustration and self-criticism. However, it is also a chance to help children grow, by helping them learn how to respect boundaries.  You can teach your children that– in this hard time– different rules apply
I would first tell your children that you are all in this together. Explain that this is a special time, a time when everyone has to work together. This stance embraces children as important members of the family. 
 
Then I would apply the Ury and Fisher’s book, “Getting to Yes”, that I have discussed at greater length in the podcasts. The main idea is that parents have negotiating power, just as children do, and that in these negotiations both parents and children define “firm positions” and “flexible positions” at the outset (Ury & Fisher, 1981). The firm positions are nonnegotiable and the flexible ones can be negotiated.
 
The pandemic offers parents an opportunity to learn to establish “firm positions”.Contemporary parents often have difficulty with this. One of the reasons parents taking firm positions is helpful to both them and to their children is that it takes problematic doubtout of the equation. Parents can get anxious when their children challenge them, and they can begin to waffle, doubt themselves. This waffling undermines the children’s belief that there are some things they cannot change to their (short-term) advantage. The truth is that their long-term advantage is being able to deal with inevitable frustrations and disappointments without falling apart.
 
 
Remember that once the firm positions are established, they should notbe negotiated. The support the pandemic gives parents is the pressure of necessity. Parents have to get their work done. They must hold to their firm positions, while being willingly negotiating their flexible ones. 
 
Children are also allowed “firm positions”, although parents must scaffold their choices. For example, depending on their age, children might stay firm on having screen time (the amount of screen time and the timing of screen time may be something parents insist is “negotiable”.) The main idea is that parents are supporting their children in learning how to tolerate “no”. This, as I said, is extremely helpful to children. Once they learn to accept that there are limits in life, they can turn their attention to their more “flexible”–read “possible”– ambitions and put their heart into them.
  
I wanted to offer you some more thoughts about parenting during COVID. In Wordsworth’s famous autobiographical poem, The Prelude, he talks about “losing the props of my affection” when he was 8-years old. In saying this, he refers to the death of his mother. I have always thought that this way of describing parental function as “propping” was such an apt way of describing the way parents support their children in a quiet, typically unacknowledged, way. It reminds me of a preschool child sitting in a parent’s lap during a remote learning session, an elementary school child’s parent helping them with a school project, and a high school student’s parent stocking the fridge with her favorite snacks during exam time. 
 
 
Parents deserve a little “propping” these days also! They are under a great deal of stress. They are worried about how to do good work at their job– either remotely or safely outside the home. They are worried about how to manage household chores with children under foot. They are worried about how to help their children learn remotely or whether it is safe to send them back to school. In the background of all those concerns is the fear of illness and death. These are very difficult times. 
 
In addition to “propping”, there are other ways parents can turn the hardship of the pandemic into opportunity. I hesitate to add anything to the burden of parents, but I am taking a risk to suggest that they try very hard to look beyond the stress and austerity and recognize a new chance to help their chidlren grow. I often talk to parents about how boundaries and limits are good for children, how “good discipline” grows children’s brains. In fact, I have recorded a series of podcast episodes and shorter Youtube videos about “good discipline”. I have done this because discipline is the most popular topic that parents ask me about as a child psychiatrist. 
 
American culture does not make it easy for parents in this domain. In fact, our culture seems to capture parents between a rock and a hard place—expectations that you keep your children’s behaviors within societal bounds while at the same time encouraging their autonomy! During the pandemic, and to the degree that there is still social distancing with its associated losses—the constraints of freedom and treats like visiting friends and family, play dates, going out for to eat – parents may struggle even more to set limits on their children’s behavior. They sympathize with their children’s distress, and they put up with more whining and even tantrums. 
 
Now, I have stated in podcast episodes and videos that it is important to lower expectations for everyone—children and parents. I think lowering expectations is crucial in order to adapt to these new challenges without excessive frustration and self-criticism. However, it is also a chance to help children grow, by helping them learn how to respect boundaries.  You can teach your children that– in this hard time– different rules apply
I would first tell your children that you are all in this together. Explain that this is a special time, a time when everyone has to work together. This stance embraces children as important members of the family. 
 
Then I would apply the Roger Fisher’s book, “Getting to Yes”, that I have discussed at greater length in the podcasts. The main idea is that parents have negotiating power, just as children do, and that in these negotiations both parents and children define “firm positions” and “flexible positions” at the outset. The firm positions are nonnegotiable and the flexible ones can be negotiated.
 
The pandemic offers parents an opportunity to learn to establish “firm positions”.Contemporary parents often have difficulty with this. One of the reasons parents taking firm positions is helpful to both them and to their children is that it takes problematic doubtout of the equation. Parents can get anxious when their children challenge them, and they can begin to waffle, doubt themselves. This waffling undermines the children’s belief that there are some things they cannot change to their (short-term) advantage. The truth is that their long-term advantage is being able to deal with inevitable frustrations and disappointments without falling apart.
 
 
Remember that once the firm positions are established, they should notbe negotiated. The support the pandemic gives parents is the pressure of necessity. Parents have to get their work done. They must hold to their firm positions, while being willingly negotiating their flexible ones. 
 
Children are also allowed “firm positions”, although parents must scaffold their choices. For example, depending on their age, children might stay firm on having screen time (the amount of screen time and the timing of screen time may be something parents insist is “negotiable”.) The main idea is that parents are supporting their children in learning how to tolerate “no”. This, as I said, is extremely helpful to children. Once they learn to accept that there are limits in life, they can turn their attention to their more “flexible”–read “possible”– ambitions and put their heart into them.

Ury W, Fisher R (1981). Getting to Yes: Negotiating Agreement without Giving In, Penguin.
 

Remote Learning: Challenges and Opportunities

 
 
This image may seem anachronistic in the context of a discussion of remote learning, but you will see that it is actually very much to the point. I am suggesting that what is missing in remote learning and to a lesser degree in physically distant in-person learning is what is called “socio-emotional” learning. 
 
This kind of learning takes place in relationships. It begins in the infant-parent relationship, demonstrated by Tronick’s still face paradigm (https://www.youtube.com/watch?v=apzXGEbZht0). It continues in preschool, where—supported by their teachers– children learn to play with their peers and to take turns. It continues in elementary school, where children learn to compete fairly and to tolerate losing. Finally, it continues in high school, where children learn to use their friendships as a bridge to the kind of independent future that our culture values. 
 
Socio-emotional learning is a community affair. One of my favorite preschool teachers told me that what she missed the most in remote learning was the loss of “community”. She had worked so hard to create a “family” in the classroom, only to see it come apart under the constraints of remote teaching. Teachers have tried to build and maintain the sense of community remotely. It has worked more or less well, depending on the developmental age and learning style of the child. In this blog posting I will discuss two features of a community that are compromised in remote learning and even potentially in in-person physically-distant classrooms.
 
One major loss is physical connection—whether it is the exuberant embrace of preschool children welcoming each other at the beginning of the school day, or the teacher’s gentle touch on the shoulder of an elementary school child who has trouble paying attention, or the hug of a high school student comforting a friend who has broken up with a boyfriend—physical contact is an essential part of community. Even when children return to school, physical contact will be limited due to health concerns. What can we do to restore some of this connection?  
 
Young children may benefit from sitting in a parent’s lap or next to them on the couch during a remote learning session. It may help children to hold onto a stuffed animal during the class–even for young children to hold a “class bear” while listening to the teacher remotely. When the children return to school, these bears can come with their children to the classroom, carrying the child’s name to prevent one child’s bear getting mixed up with another’s. All children—even high school students– like to hold onto something—whether it is the family dog or a stuffed animal from their earlier life. 
 
Another major loss is a sense of togetherness. How can we attempt to build a sense of belonging in remote learning? There are community-building exercises used in classrooms that might be adapted to a remote context. For example, young children may name their favorite food, their favorite animal, or their favorite color, and then the teacher may give their classmates a chance to remember what their classmates’ favorites are. Older children can guess the provenance of their classmates ancestors. That enjoyable exercise also emphasizes our paired societal values of diversity and commonality. 
 
In addition to the content of the exercises, the act of playing games creates an experience of doing something together. Games like BINGO, which also teaches number and letter recognition, can be played remotely. BINGO and other games can be creatively redesigned to teach other academic skills as well giving the experience of acting as part of a group. The game of “telephone” can be adapted to remote learning. The awareness of how communication can be distorted by individual misperceptions is a lesson that can be understood at different developmental levels by all children. It is a lesson that underscores the value of community by illustrating how easily community can be disrupted. Older children can work on class projects emphasizing community. They can study Civics as a way of understanding what is happening in our country and imagining how they can take a constructive—perhaps politically active– role in creating a better future.  
 
I don’t want to leave this subject without acknowledging the wealth disparity revealed by the practice of remote learning. Although most families have a smart phone, some have no computer or I pad, and often what devices the family owns must be shared. This of course puts some children at a severe disadvantage.   
 
The children in the image of this blog posting are joyful members of a community, despite experiencing material disadvantage. In my next blog posting I would like to discuss the critical role of parents in remote learning.

Struggling with Kids and the Pandemic? Look for the “Magic Moments”

During this time of social isolation and being cooped up with young children in small spaces, many parents describe their struggle to find an ever-elusive balance between working from home and childcare. Parents feel guilty about doing an inadequate job for their employers and feel guilty about not paying enough attention to their children. Co-parenting has also become more challenging—the question of who takes charge of the kids while the other is working can easily morph into the question of whose job is more important! If the children are fortunate enough to attend a school with online meetings, parents have to organize the day to accommodate the school schedule and help their child stay regulated and attentive during the virtual class meeting, one on one with the teacher, or “sharing time”. 

Meanwhile, managing work and the family is taking place in the context of a pandemic of huge proportions. When parents listen to the news or read the paper they are assaulted by the rates of infection and death, the loss of jobs, vulnerable health workers, and hungry families. The fear and sadness outside their protective windows is haunting, adding another cause for guilt. Children, who do not have the same cognitive capacities as adults, do not take in the enormity of the situation in the country, but they do sense their parents’ stress and anxiety. They miss their teachers and their friends, the comforting and organizing routine of the school day, the enjoyable activities. 

As the adults become tense and short-tempered, the children become demanding and irritable. Yet, there are times when children seem to escape the cloud of tension and experience joy. It may be the joy of mastery in doing a puzzle, or the joy of creativity in pretend, or even the joy of a favorite dessert. These moments of joy may be brief, but they are infectious. I remember watching young children in an orphanage in Central America–separated from their parents, recovering from neglect and abuse—play in the dusty courtyard. Struggling to wheel a wheelbarrow, following a bug in its journey through the bushes, listening to the conversations of the caregivers clustered on the front steps—their little faces bright with interest and pleasure. As I observed them, I felt pleasure too, pleasure and even inspiration. If they could take pleasure in such small experiences, maybe so could I. 

Researchers have known for a long that the positive expression of emotion of an infant or small child can trigger positive emotion in adults (Smith & Waters, 1976; Frodi et al, 1978; Fogel, 2006; Strathearn et al, 2009). Advertisers probably knew that even before scientists proved it—think of all the commercials with adorable young children!  Starting in infancy, infant smiles generate activity in the dopamine reward systems of an adult’s brain. Identification with the freedom and creativity of a child in the “magic years” brings pleasure to adults privileged to observe their play (Fraiberg, 1959). If adults can allow the meanings the young child makes of life to exist along side their more “rational” meanings, they may experience a delightful and liberating sense of disorganization—the kind of disorganization that brings enhanced perspective. How do you make bad guy soup and a birthday cake both out of the same pile of sand and bunch of sticks? These are moments I called “momentos magicos” in one of my trips to El Salvador, and if you recognize these magic moments and cherish them, they can accumulate. Accumulating magic moments can build on one another and—if you are lucky—create a cascade of wellbeing. And that is what we need in this time of hardship. So my message is—if you are cooped up with young children during the pandemic, look for the magic moments.  Hold onto them. They can do you good.

References:

Fogel A et al (2006). The effects of normal and perturbed social play on the duration and amplitude of different types of infant smiles, Developmental Psychology, 42(3):459-473.

Frodi A, Lamb M, Leavitt L, Donovan W (1978). Fathers’ and mothers’ response to infant smiles and cries, Infant Behavior and Development,1(187-198).  

Sroufe A, Waters E (1976). The ontogenesis of smiling and laughter: A perspective on the organization of development in infancy. Psychological Review, 83:173-189. 

Strathearn L, Fonagy P, Amico J, Montague R (2009). Adult attachment predicts maternal brain oxytocin response to infant cues, Neuropsychopharmacology, 34(13):2655-66.  

Older Kids and Teens in “Lockdown”

We have talked about infants and young children in the time of COVID. It is important now to talk about the experience of school children and adolescents. These kids have some of the same problems we have discussed in relation to younger children, and they have some different problems. The particular challenges faced by older children include school and academic work, friendships, screens, and obstacles to independence. I will tackle them one at a time.

School has become transformed from a classroom full of peers and a teacher to a computer screen. For some children who struggle with social anxiety, staying home can be a welcome relief. For most, the absence of the structure of the classroom and peer companionship is a terrible loss. The additional burden put on parents to supervise remote learning or even to create remote learning opportunities for their children can be onerous, especially if they also are working from home. Children who struggle initiating tasks may find they have more difficulty than ever when there is no teacher to help them get going. Children may misapprehend directions and find themselves lost without a teacher they can ask for clarification. The temptation for older children to escape into video games or social media when they are supposed to be doing homework may be even greater. Even when schools offer a remote learning program, it is hardly a substitute for the usual school curriculum and the activities of the school day. There is no recess, no playground time. The rhythm of the day has changed. 

In addition some preteens and teens may have to contend with application to secondary schools and university. This is a huge anxiety since the schools themselves are thrown into a state of disorganization, and their communications may be confusing. The preparatory activities offered to children to help them make a transition to the new school are disrupted. There is no chance to visit the schools, to tour the campuses. The matriculation of some children may suddenly be put on hold as their parents struggle with the decrease in family income caused by the shutdown. There is uncertainty about whether the schools will begin the school year in September!

Screens are hard to control during the “family lockdown”, even more than usual. Turning off the game is always hard, because as I will remind you, transitions require you to undo one state of organization and tolerate temporarily a state of disorganization before you achieve a new state of organization. For example, a state of highly focused attention on the game followed by the less enjoyable and relatively unstructured activity of the family dinner table or going to bed is a huge challenge for most kids, and for kids with organizational and regulatory problems it can seem impossible. Videogames are “external regulators” that offer the player a wide range of affect and arousal state without the player having to do the regulating. Many individuals cannot stay organized and engaged through that range of affective experience, especially in adolescence. Some children have to shut down high intensity states in order to stay calm, but that can give them a feeling of boredom, even depression. The videogames have highs that are regulated by the computer (even though the frustration of losing a game can cause meltdowns!) For that reason in addition to the usual difficulty leaving something you are enjoying, kids have a hard time turning off the game to rejoin life in the family. 

Joining the family—especially in adolescence—can in itself be hard. It is common knowledge that teenagers, at least in Western culture, face the developmental task of attenuating their dependent bond to their parents and establishing their independence. One of the major methods of achieving this goal is through connecting with and identifying with peers. When they are forced to stay home with their families and lose contact with their friends, this vital source of learning and of protection from the unwelcome pull of dependency is gone. Adolescents and even younger children can regress in their behavior and fight against the perceived control of their parents. 

Children learn from peers—about how to collaborate, how to communicate, how to take turns, how to share. Friendships play a greater role in the development of an individual than is typically recognized by psychological theories. Friendships often complement what a child’s family can give him– values not available in the child’s family, sometimes offering comfort when the child’s family cannot. I have often thought that the nurturing many people experience in their childhood friendships plays an important role in the adult the child will become. 

How can families deal with the enforced togetherness of these days of crisis?  I would suggest five ideas—exercise, lower expectations, make greater comfort, encourage contact with friends, and create a “higher level togetherness”. 

(1) Exercise is very hard to do inside, but it is possible. If you can get your kids to go on a bike ride or walk with you that is terrific. Indoor exercise may be accomplished by engaging screens—maybe an added inducement—in exercise programs. Yoga and meditation are excellent, but it can be hard to get older children in this culture to do it, especially without a group of peers doing it together. 

(2) By lower expectations, I mean try to accept a lower level of compliance with parental demands and a lower level of academic accomplishment than you might otherwise expect. 

(3) Strongly encourage remote contact with friends. There are games that younger kids can play remotely—some lego games, Bingo, guessing games, scavenger hunts, etc. I have included some online resources below. Adolescents don’t need you to plan their time with friends, but they need you to allow more of it. 

(4) I would also emphasize comfort—make the kids’ favorite foods, allow more t.v. and movies (and make popcorn!) 

(5) Finally, I suggest that parents come up with some ideas about what the family can do together that is more than entertainment, something that is constructive, something to remember. The family might create a family blog, a you tube channel, make a project to help others. This activity can teach family values.  Parents have to go all in to make this work. They have to take the time and expend the energy. They have to begin by giving the kids choices—would you like to make a family blog, would you like to sew masks, write emails to first responders in your town, design online games for younger children, or anything the kids can think up. The kids may not catch on to the idea right away. Parents have to hang in there. If one child refuses to contribute, for example, the parents could make a contribution for him (try to contribute something that relates to this particular child such as a paragraph in the blog post about something he did, or creating a game for little kids related to an interest of his such as cars or mazes. Then over time, he may come around. Again, it is important to keep expectations low. Don’t fall in love with the project and get mad if the kids don’t cooperate. Remember, this is a family enterprise. If they don’t like it, go back to the drawing board and see if you can negotiate something else. If that doesn’t work, just keep at it. Let that child know that he is part of the family and if he can’t contribute actively right now, you will still keep him in mind. It may be that the project outlasts the pandemic. That would be a good thing. 

Definitely Not Business as Usual: Especially in Families of Young Children

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.

More online resources for families.

I will follow this blog with a post on adolescents and young adults forced to stay at home.

Coping with COVID19

The World is a Different Place

I just received an email from a colleague notifying me of the cancelation of a professional meeting that we had been scheduled to participate in. He said, “The world is a different place,” and I was struck by how true that was. As all of you, I have been watching and listening to the news dominated by the pandemic. There is a lot of redundancy in the advice about how to cope, but I found some good ideas I wanted to pass on to my readers.

Vivek Murthy, Obama’s surgeon general, spoke eloquently on NPR. He recommended that all of us spend 15 minutes a day connecting with our friends, family, and acquaintances online or on the phone. He also suggested that when we are doing this we discontinue multi-tasking, in other words, pay attention to our conversation and stop doing other things. Finally, he suggested that we reach out and help someone. 

First of all, I liked his recommendation to spend 15 minutes connecting to others. I have been strenuously recommending connecting but hadn’t thought to put a minimum time on it. It reminds me of the suggestion that children sing the Happy Birthday jingle twice in order to achieve a good 2-minute hand washing. For those of us who have a tendency towards obsessionalism, it is useful to make sure to get those 15 minutes in, though I suspect that once we experience the satisfaction of reconnecting, we will be spending more time than that. It is true that the crisis has brought people to mind that I don’t think of in my typical daily routine. It brings me pleasure to feel connected with them again and a sense of urgency to make sure that they are safe and healthy. I, as many of you, have reconnected with friends that I have not been in touch with for a long time, and that feels good.

Second, the idea of multitasking is an interesting one. Multitasking is a more complicated subject than it might seem. Of course, it can be off-putting and even rude when someone doesn’t give you their full attention. It can also be a way of focusing attention if you are a little stressed, as long as the multiple tasks do not require the same kind of attention. For example, doodling or knitting or similar repetitive rhythmic fine motor tasks can actually help focus attention. But I know what Dr. Murthy means. It can be a good exercise to force oneself to focus attention exclusively on another person. That brings you further in touch not only with the other, but also with yourself—your own thoughts and feelings.

Third, the idea of reaching out to help somebody is something not as frequently mentioned, but the stories and videos of people in Italy, and now in New York, thanking health workers and first responders by making music, or clapping or cheering out their windows. There are other stories, though, of people leaving food or offering to shop for elderly neighbors, or others who are working to feed the homeless. These are important stories not only because they help those in need, but also because they help those who help.

Altruism is a human characteristic. We know that very young children engage in helping behavior. Shortly after their first birthday, children spontaneously begin to help others (Warneken, 2013; Svetlova et al, 2010). This is true even if it costs them something, for example, if they have to interrupt an interesting activity to help another (Warneken and Tomasello, 2008) or if they have to overcome numerous obstacles to do so. The desire to be helpful for its own sake is true of adults, as well. A study of adults offered a reward for giving blood found that the subjects who gave a donation for the good of others, rather than for a concrete reward, were more willing to give (Costa-Font et al, 2012). Even recalling memories of generous spending produced emotional reward, suggesting a “positive feedback loop” between prosocial spending and happiness (Aknin et al, 2012). 

I would suggest that a powerful motivation for altruistic behavior in humans is the persistent desire to restore disrupted connections, as they are experienced in relationships and also within themselves (Harrison, 2019). This includes loss of faith that their environment can be trusted. Giving to others is an adaptive, evolutionarily beneficial attitude and behavior that expands the individual’s repertoire for healing disrupted connections, for dealing with trauma and loss.

References:

-Aknin L, Dunn E, Norton M (2012). Happiness runs in a circular motion: Evidence for a positive feedback loop between prosocial spending and happiness, J Happiness Stud, 13:347-355.  

-Costa Font J, Jofre-bonet M, Yen S (2012). Not all incentives wash out the warm glow: The case of blood donation revisited (Centre for Economic Performance Discussion Paper No 1157). London, UK: London School of Economics and Political Science, Center for Economic Performance.

-Harrison A (2019). Altruism as reparation of mismatch or disruption in the self, Psychoanal Inq, 37(7).

-Svetlova M, Nichols S, Brownell C (2010). Toddlers’ procosial behavior: From instrumental to empathic to altruistic helping. Child Devel, 81(6):1814-1827. 

-Warneken F (2013). The development of altruistic behavior in children and chimpanzees. Social Research, 80:431-442. 

-Warneken F, Tomasello M (2008). Extrinsic rewards undermine altruistic tendencies in 20-month olds. Developmental Psychol. 44(6):1785-1788.

Parents’ Survival Guide

Some parents have organized their lives so as to address multiple goals. They are loving, devoted parents. They are highly invested in demanding careers. They have important friendships. How do they accomplish all these goals? Typically they are organized, hard working, and spend little time relaxing or taking care of themselves. If they go running or to the gym, they will do it early in the morning before the kids wake up or at lunchtime while the kids are in school. They get satisfaction from being creative and productive in their work. So what happens when they have to leave work and stay home with their children?  I have a long ago memory of saying goodbye to my husband as he went off to work, my newborn son in my arms. I had never loved anything more than this baby. Yet, when my husband walked out the door, I thought, “Wait a minute! What about me?!” 

Many parents have a rhythm of self-regulation that depends on intellectual stimulation and high productivity. Empty—or apparently empty—periods of time are not relaxing to them. They do not like waiting. “Empty” times make them anxious. They do better with their children in short periods of structured activity—a walk to the park, reading books. They sometimes have to control their impatience when their children hesitate or take a long time doing it themselves. These parents thrive when they have good schools and grandparents or babysitters to share the childcare. This is consistent with the saying, “It takes a village to raise a child.” 

These parents’ personal equilibrium requires feeling in control, and hanging out with young children does not allow much of that. Going with the flow is more like it. When it goes well, it is like playing jazz with someone, each with autonomy but also reaching for harmony, and open to novelty and surprise. If the parent feels the need for an intellectual focus, there are many opportunities for sharing ideas with older children, and for very young children, parents can become “baby watchers”, like Piaget was with his children. Infants and young children are fascinating. 

The parents I am talking about will likely have a hard time staying at home with their children during the time of the virus. Although in an earlier blog I noted the growth potential of being forced to live differently, this growth can be hard to negotiate. I have come up with some tips to ease the transition for these super people.

  1. Schedule your day so that you have time with the kids and time to work. If you have a partner, make the schedule with them and share the work. While you are working at your job, allow the kids screen time that you otherwise wouldn’t allow. In your time with the kids, plan some activities that you enjoy as well. Card games or board games–even some video games– are good for older kids. Messy activities that they can enjoy in school are to be avoided, even if they beg for them. While you are with the kids, discipline yourself to pay attention to them—what they are doing, what they are interested in, what their behavior is telling you. 
  2. Make sure that you schedule some car trips that involve an interesting or a constructive errand. If you are taking care of a household errand that you put off, you will be rewarded with a sense of accomplishment, and that will make you feel better. Take the kids with you unless they cause trouble in the car, in which case, scrap this idea. If they can tolerate the car, play games with the kids in the car. Depending on their age, for example, count all the red cars, black cars, or count all the Audis, all the Subarus.
  3. Everyone says take care of yourself by eating and sleeping right and getting exercise, but this redundancy does not make it less important! Sometimes you can combine these healthy activities with time with your kids by walking or sports, or by cooking with them. Other times, you will want to be alone while you exercise and cook. 
  4. Taking care of yourself also means being tolerant of negative feelings associated with impatience, boredom, and irritation. Criticizing yourself only drags you down further. Reflect on your style of self-management; try to maximize your strengths and make use of your usual self-comforting tools.  Just surviving this period will result in personal growth. In a comparable mode, try to be tolerant of your kids’ problem behavior. Remember that everyone is under stress, and if they behave badly it doesn’t mean that they will always act this way.
  5. Above all, stay remotely connected with other adults. Make sure you keep up to date with work projects with colleagues, commiserate with friends. Sit down in front of your computer, facing a friend, both of you with a piece of cake or a glass of wine, and pretend you are enjoying an evening out together.  

Cooped up Together: “Getting to Know You”

Cooped up Together: “Getting to Know You”

Many parents now find themselves in the company of their children without alternative caregivers and without distractions for a longer time than they have been for a long time, maybe forever. I wanted to reach out to them with my thoughts and some ideas about how to make this time more constructive and more enjoyable.

In some ways, this is a time to relax, to let go of the demands of your schedule and to stop worrying about getting to school and work on time, cleaning and organizing school clothes, and fretting about homework in older children. Sleeping in, eating when you are hungry instead of at regular mealtimes and munching on comfort foods, spending the day in your pajamas, allowing more screen time. It is good for families to enjoy this kind of release from the constraints of our hectic daily lives. However, for many children and families, this lack of structure, can generate problems after a short period of time. For that reason, I recommend making a schedule that approximates the one they follow during their regular work/school week, but includes more free time and a more relaxed tempo, and leaving unstructured time for weekends. Of course, this type of planning should depend on the personalities and needs of the individuals in the family–some families find routines more stressful in general! 

Parents could, for example, create a schedule that roughly follows the routine of their child’s school day—free play time, followed by a parent-child activity, then snack, more activity, lunch, nap, etc.—depending again on the age and developmental needs of the child. The closer the schedule mimics the school day, the more familiar and comfortable the child may be with the routine. It is important, though, to be flexible about it. If you follow the schedule rigidly, you will be sure to invite struggles. The schedule should maximize the fun activities. One family I know adopted an activity from the preschool’s morning meeting. The parent asked the child, as the “weather watcher”, to look outside the window and report on the current state of the weather. 

As you might have guessed, it is my opinion that although inconvenient and anxiety provoking, this family self-isolation can be an opportunity. When my husband and I were first married we won a lottery for junior faculty members to stay at a cabin on a remote island in Maine. It was beautiful and remote, without telephone or television and certainly without wifi. There was a logbook for guests to write about their experiences during their visit. One after the other of the entries described “getting to know my wife and children for the first time”. These workaholic and high achieving academics were describing a new experience, but they also were expressing regret about all the family time lost. It impressed me a great deal.

My friend and colleague, Alayne Stieglitz, an excellent source of knowledge about early childhood education and play, suggests that parents take this time to play with their child. “Let them lead and observe them closely. The better you get to know your child through play, the better you know how to interact with them in stressful moments. What makes them laugh, what are they interested in, what revs them up, and what calms them?” 

These are wise words and they recall Berry Brazelton’s famous statement about infants: The language of infants is their behavior. Of course, this is predicated on the fact that infants do not yet have language, but it also applies to older children and even to adults. Observing your child’s behavior gives you a new window into their inner worlds, into the meanings they attribute to their life experience. Even very verbal preschool children, for example, often have different meanings for words from our adult meanings. An amusing example of this occurred a couple of weeks ago. I had been preoccupied by how to “scale” an intervention to support infant mental health. In the playground of the preschool, I joined two 4-year old boys creating a “bad guy cake” out of sand and twigs and acorns in a bucket. One of the boys took a second bucket partially filled with sand and suggested that they “scale” the second bucket as part of the project. I was fascinated and asked how he planned to do that, imagining in my fantasy that this intelligent 4-yo might give me some tips. He said, “Well, we could put this bucket on a scale.” 

I am not going to address the very important subject of home schooling, which local school districts and Internet sites will cover far better than I. I am including a few sites that Alayne sent me for younger children.  My favorite one is #frommywindow. It started in Spain and involves children drawing pictures and taping them on the inside of their windows so that passersby can view them, a way to cheer people up similar to Italians singing or playing musical instruments out their windows for their neighbors to enjoy. 

Parents can also keep a journal about what they did that day. What was your child’s response to the various activities, what was your response? What did you do to comfort yourself, what did you do to comfort your child? If you can motivate yourself to do this, I guarantee that it will be a source of inspiration and amusement in the future.

https://kids.sandiegozoo.org