Tuesday, December 31, 2013

S.M.A.R.T. Resolutions

Like many people I usually make New Year's Resolutions. There are always plenty of things in my life I feel I could improve on and the start of a New Year feels like a clean slate, a chance to start over and do better. Sadly I'm also like most people in breaking my New Year's Resolutions fairly quickly. I might start off well for a week or two but it only takes one bought of illness or one stressful week at work to knock me off course again. Still, I'm an optimist. I'm also fully in agreement with the statement "If you always do what you always did you'll always get what you always got." So this year I'm trying to go about New Year's Resolutions in a different way.

I've been going through leadership training at work, both formally and through reading on my own. I never intended to be in a leadership role and never saw myself as a leader, but here I am now and I'd like to do a good job, so I'm trying to educate myself. One of the things I've learned is about setting objectives and goals for employees. The acronym for these goals is "SMART" which stands for Specific, Measurable, Achievable, Relevant and Timely (or time-limited). I'm still working out how exactly to apply these to the jobs we do at work, but it occurred to me that these principles make good sense for New Year's Resolution's too.

Specific goals are just what they sound like. Instead of vague wishes like "I'll lose weight" or "I'll exercise more" or "I'll be a writer" they give details. "I will walk 3 miles a day" is a specific goal. "I will take one writing class" is a specific goal. A specific goal spells out exactly what it is you are going to do.

Measurable is also an easy term to understand. You can measure how far you walk each day, how much time you spend on something, or whether or not you did something. So "floss daily" is a measurable goal. Measurable also implies that you will, in fact, measure and keep track of what you are doing in order to review your progress and stay motivated. There are plenty of ways to measure; you can use a notebook, your phone, or even a sticker chart like I make for our preschooler.

Achievable is an area where I often have problems in making resolutions. I've set quite a few ambitious goals like "walk 5 miles daily" which just doesn't make sense right now given my daily schedule and my current fitness level. Even "walk 2 miles daily" or "30 minutes of yoga daily" might not make sense because it doesn't allow any flexibility or leeway for life's vagaries and disruptions. I've also gone into the New Year with a list of resolutions that was 8 or 10 items long in the past, which is too many items to realistically accomplish while balancing work and family. I need to focus on what is most important to me right now, among the many, many wonderful things I could be doing to improve on a personal level. So achievable goals for me might be "walk 2 miles four times a week and do 30 minutes of yoga twice a week." An achievable writing goal might be "write 1000 words five times a week" as opposed to "write a novel this year."

Relevant in organizational terms means that the goal or objective should contribute to the organization's overall mission. In personal terms, I think meaningful might be a better term. Why is this goal important to me? What is my motivation? If I look at goals I have achieved in the past, for example learning to knit socks, I can see that this goal is personally meaningful because knitting gives me a deep sense of satisfaction, because sock knitting is a little tricky and makes me feel clever, and because the techniques in sock knitting transfer into toy knitting which is even more fun. My fitness goals above of walking and yoga would be personally meaningful because I would like to be stronger so I can carry my daughter for longer at a time (35 pounds of preschooler is no joke!) and have more stamina and energy at the end of each day. My writing goal is meaningful because writing helps me think, helps me problem solve, keeps my creativity alive, and also because someday when I retire from medicine I'd like to make writing my second career.

Time limited is a factor I've never considered before in New Year's Resolutions. It always seemed obvious to me that a resolution would have to be for the whole year. However, an entire year is a pretty long time to for me to promise to sustain a habit. I know that I got through difficult classes and difficult medical rotations and difficult assignments by reminding myself "only X more weeks." Even now, when I'm having a hard time at work I cheer myself up by remembering "only X more days until a weekend" or "only X more workdays until vacation." So perhaps I hold on to motivation best over a period of days to weeks. So instead of a New Year's Resolution, perhaps it makes more sense to make a New Month's resolution. A month is about 4.5 weeks, which is enough time to see if a habit is truly going to be achievable and meaningful for me. I will plan to re-evaluate my resolutions on 1 February and decide if they should continue, be modified, or be dropped all together in favor of new resolutions.

So, my month's resolutions for January 2014 will be to:
walk 2 miles 4 times a week
do yoga for 20 minutes 3 times a week
to write 1000 words five times a week

These are specific, measurable, achievable, personally relevant and time limited goals. I'll track my progress using an app on my phone and on 1 February I'll take a look at how I'm doing and decide what I want to do for the next month.

Friday, December 27, 2013

Christmas 2013

I celebrated Christmas this week with a fever and a cough and laryngitis. It had been the toughest week before Christmas I can remember, including the one when I was deployed. Work was very hard; long hours and a lot of pain and suffering that I just don't always have the skill to heal. Plus at home our furnace broke, my husband and daughter were both sick, and then my beloved cat who had been with me since college died. I think all that stress just knocked my immune system down. I became progressively more ill throughout the day on Christmas Eve and I'm wheezing and coughing still as I write.

I'm glad for Christmas though. I'm glad for time with my family and time to rest. I'm glad for my daughter's questions about why we have Christmas and who is Jesus and who is Santa and also for her joy in opening presents and playing with new toys. I'm glad for special cookies and my mom's holiday soup, which is what we call the creamy chicken potato soup that she always makes on Christmas Eve. Mostly though I'm glad for the promise of Christmas, the promise that light comes after dark, the promise of hope and renewal inherent in a story of Emmanuel, which means G-D with us, present in our lives.

One of the commonly sung and read prayers this time of year is the Magnificat (Luke Ch 1 Vs 46-55) spoken by Mary to her cousin Elizabeth.

“My soul magnifies the Lord,
and my spirit rejoices in God my Savior,
for he has looked with favor on the lowliness of his servant.
Surely, from now on all generations will call me blessed;
For the Mighty One has done great things for me,
And holy is his name.
His mercy is for those who fear him
From generation to generation.
He has shown strength with his arm;
He has scattered the proud in the thoughts of their hearts.
He has brought down the powerful from their thrones,
And lifted up the lowly;
He has filled the hungry with good things,
And sent the rich away empty.
He has helped his servant Israel,
In remembrance of his mercy,
According to the promise he made to our ancestors,
to Abraham and to his descendants forever.

Mary spoke these words in a time of fear and anxiety in her life; newly pregnant, unwed, uncertain what would happen to her in a time and culture that condemned unwed pregnant women to death. She spoke as a poor woman and a member of a conquered and occupied nation. Her words ring with hope for the oppressed, that justice will triumph and G-D’s arm will lift them up while casting down the oppressors. Her words don’t speak of armed rebellion or violence by humans. Instead they bathe in the promise of G-D’s action to save his people.

Cultures around this world celebrate this time of year, this turning time when darkness and cold are at their deepest in the Northern hemisphere. We light candles and fires, we feast on good things, we rejoice in the green that does not die. We celebrate in peaceful defiance of the night, the dark and the chill. We gather as communities to remind ourselves that light will come once more. Our specific stories change but our themes are the same; hope, love, peace, joy.

The Christmas story is about the power of light over dark. It’s the story of G-D, the creator, the all-powerful, entering this crazy beautiful broken mixed up world as the son of a unwed mother from the ghetto. G-D identifies with the oppressed, living and dying in a way that rejected violence, power, wealth and dominion. And in doing so he planted a new seed in our hearts, a new idea that love and peace and joy are powerful, that all people are valuable, that in G-D all are equal, men and women, parent and child, slave and free. That seed is slow growing and that plant has not come to full fruition yet. The Magnificat promises us that it will.

Thursday, December 19, 2013

The Pain of Suicide - A Professional's Perspective

I hate suicide. It is my number one professional enemy and I just hate it. I write this instead of the Christmas oriented post I've been turning over in my mind because yesterday we had a young woman die of apparent suicide. None of us had met her before. I don't know if she was sad, or depressed, or receiving help. All I know is that her family found her and brought her to our hospital but it was too late for us to save her and she died. Along with many other people, I was trying to help them yesterday because we didn't have a chance to help her. And then I was trying to help all the helpers, because this hurts us too. 

There really is not anything you can say to a family except "I am so sorry. I am here if you need to talk." So that's what I said. That's what we all said. They were so shocked, so horrified, so devastated that I don't know how to convey it. They were beyond tears and screaming, just blank and numb and you could see something inside them had been completely crushed. And I thought - how could you have done this? What happened that you didn't know how much your family loved you, wanted you? How could you not realized what a terrible thing you are doing to them? Why didn't you ask for help?

And I am so sad, so angry and yesterday all I could do was come home and cry and hug my own precious daughter and pray. Some of the other staff I talked to did the same thing. Just cry and go home and love your own family and pray. Pray for me, and my family, and for everyone I work with, and for her family, and for her. Pray for G-D's healing presence with us all in this terrible, terrible event.

I have worked with so many people who have survived a loved one's suicide. It is so hard, so confusing. Along with the dreadful loneliness and sadness, the sheer weight of missing this other person, is this poisonous blend of anger and guilt and shame. How could he abandon me? Why couldn't I save her? If only I had done this differently. Why did she do this? It's not their fault, and I tell them that. People make choices and sometimes they make really bad choices. You can't save them from their own choices. I tell them. I tell myself. It helps, but not enough.

I often hear people who are suicidal say "my family would be better off without me" and I tell them no. No, they wouldn't be. I have walked with too many families after someone has committed suicide and I know that they are not better off. And they don't "get over it," not really, not even with help. They learn to go on, but it's a permanent ache, an unfillable emptiness, a wound that scars but still hurts when it is touched. 

I don't know all the people who read this blog. I don't know what pain you may be holding or what terrible situation you may be facing. But I tell you that your life is precious. You, yourself, simply for who you are, are precious and unique and irreplaceable. It doesn't matter what you have or haven't done, you are worthy and valuable, just because you are. Even if you can't see it right now, your life matters. Please find the courage to reach out, to get help, to keep going. 

Some places to start are http://www.afsp.org which is the website for the American Foundation for Suicide Prevention and 1-800-27-TALK which is a national crisis hotline. You can also get help in an emergency room, by calling 911, or through any medical provider. If you are a friend or family member or even a casual acquaintance of someone who you are concerned about you can help just by asking. Asking "are you thinking of suicide?" doesn't make people suicidal, it frees them to talk about the problem and ask for help. If someone seems down, or their behavior has changed, or they are giving things away or talking about harming themselves or saying they would be better off dead then please take them seriously and ask the questions. Then help them reach out and get that emergency help, and stay with them until help arrives.

There is hope - pain can be treated, life can improve, new joy can be found. If you are so desperate that you want to die then it's time to be desperate enough to make huge changes. Find another way, please. Please, please don't kill yourself.

Friday, December 13, 2013

Christmas Giving

My interfaith family celebrates both Hanukah and Christmas. I love lighting Hanukah candles but most of all I love Christmas. I love cookies and egg nog and pie and extra treats. I love walking into work and seeing evergreens and ribbons and ornaments where there are usually blank walls. I love special peppermint drinks at the coffee stand and Christmas cards in the mail. I love getting out my Christmas ornaments, many of which I've had since I was a child and most of which have some small story attached to them. I love all the memories that come with Christmas. I wouldn't quite say that I love addressing Christmas cards but I do love thinking about my friends and family as each name comes up. I love the cookie decorating party that my husband and I host for our friends' children the way my mother hosted for my sister and I and our friends when we were small. I love opening presents on Christmas morning, with my family.  I just really, really love Christmas.

I particularly love thinking about Advent. I love lighting the candles in the wreath each week and meditating on the qualities of hope, peace, joy and love that the candles represent. I love putting stickers on my daughter's advent calendar and talking about the time going by.  I love the solemn joy of Christmas Eve, as we sing the beautiful old songs and light candles and remember that we are so loved. I love to remember that G-D loves us all so much that he came here to live with us, as one of us, so that he could show us that love in a way we could understand. My family was never that much into Santa Claus. Instead we talked about giving gifts as an act of love, the way G-D sent his son to us.

So when I say I don't love the holiday shopping season, please understand that I'm not a scrooge. I just think that it's out of control. The constant pressure to buy, buy, buy is annoying. The crowds in the mall are stressful and agitating and at times scary. Very little of the commercial message feels in tune with the spirit of celebrating love. One of my the Christmas decorations I love best at my mom's house is a kneeling Santa; Santa kneeling by the manger of Christ. The toys and commercialization of the holiday subordinate to the celebration of G-D with us. That's how I would like things to be for me and my family.

I'm also very aware that most of the people I know don't really need or even want anything. And even though I love opening presents, neither do I. I am incredibly blessed to have enough in my life. Most of my friends would say the same. We just don't really need more. And even though holiday giving isn't so much about what people need, when we all have so much already a giving things just isn't very meaningful.

So this year I am doing something a little different. I am still buying gifts for a few people, although I am choosing smaller and less expensive gifts. But for most of the people I usually exchange gifts with I am donating money to Heifer International in their honor. Heifer International (http://www.heifer.org) is an organization that provides live animals and training on animal husbandry to people around the world living in poverty. The families who receive animals pass on the gift by donating the first living offspring of their animals to another family in need. The animals range from honeybees to cows and for the bigger animals you can purchase a share to donate. The gift of an animal that provides milk or eggs can make the difference between enough food and not enough food. The families can also sell wool, baby animals after the first ones they donate, eggs, extra milk and by doing so acquire enough money that children can get health care and go to school. Families are helped to help themselves, which I think is wonderful.

I had a really good time choosing the Heifer International Gifts. I chose a training package on animal health for a friend who has a health care background. I chose a knitter's basket for my mother-in-law who taught me to knit. I chose rabbits for a friend who adores animals and baby chicks for some friends who just had a baby. For some friends and family I couldn't figure out an appropriate symbolic animal but it was still fun to think of a family somewhere owning a llama in honor of some newly married friends or a goat in honor of my father. I hope that my friends will get a kick out of this and maybe even consider doing the same for me.

I think this is a good way to honor the spirit of the holidays; the giving of gifts as an act of love. I think this is a good way to connect and create meaning; by thinking about people I love and in their honor trying to make the world a better place.

Monday, December 9, 2013

Stopping Child Abuse

I was at a playground a few miles from home with my daughter last weekend when I saw something that troubled me. A young father was screaming at his two sobbing small children. They looked like they were about four and two years old, and I couldn't understand what they were saying through their sobs so I'm not really sure what the problem was. I could understand him well enough though. "Stop crying!  Stop whining! What did I expect? I can't believe I was stupid enough to bring you here! For the third time, no! We're leaving!" And he crammed both children, who were now shrieking and wailing at the top of their lungs, into their double stroller and stormed off. The entire scene played out over about two minutes. There was no hitting, no violence, but it was terribly uncomfortable.

I desperately wanted to speak with him. I wanted to step in, distract the children, help him calm down and regain his balance. I would have if he had hit them, but for yelling I didn't feel like I could. But oh, how I wanted to help. I've certainly been there with my own daughter; making an effort to do something nice for her and being met with whining and fussing. I've had that feeling of not being able to take one more second of high pitched preschool shrieks. I've yelled at her just as unproductively at times. Which is why I didn't speak. I'm not sure in those moments of high emotion that I could have tolerated a stranger stepping in, no matter how diplomatically, with the clear intent of calming me down. I'm not in a good place when I've hit that edge and it didn't look like he was either. But I wish I had now. Maybe just a "Hi! Wow, it's cold out here!" could have sent things off in a different direction.

I've been thinking about parents and children a great deal lately. Much of the work I do as a psychiatrist is with adults who were abused in various ways as children. Recently I've been working with one particular patient whose past is dreadful, so dreadful that I haven't been as able to put my work down when I leave as I usually am. I find myself troubled, thinking about this patient, thinking about the events in her past. Feeling angry and sad, and helpless to do enough to help her now, and wishing that someone had stepped in for her in the past. Her resilience is astonishing but so is the damage that has been done.

I looked up child abuse prevention on the internet the other day. The work I do is after the fact, repairing the damage. If child abuse could be prevented I would lose about 75% of my patients. If that could happen I would throw a huge party and cheerfully redesign my life to find another line of work. So I looked into what I could do to make it happen. It was fascinating that the information from US Health and Human Services on child abuse prevention was mostly about communities. The steps they suggested ranged from getting to know your neighbors to participating in the parent organization in your child's school to helping organize community resources for childcare.

I get that. If I had known that father, if we had been friends, I could have stepped in. I know that when I'm feeling distressed my friends can still talk to me, can remind me to calm down. I could have talked to him, talked to his kids, helped get things back on an even keel. I also feel calmer and happier in general when I'm with friends. Perhaps having a friend there would have helped him stay cool in the first place. I don't think that young man was abusing his children, but I also know that most parents don't ever intend to abuse their children. Having a strong community, people who know you and love you and are willing to speak up when you are losing it, can make all the difference.

I don't know if I'll ever see that father again. I think that chance is lost. But there is a playground in my neighborhood, and there are families around us. I think I will start talking to neighbors a little more, talking to people on the playground even when I feel shy or uncertain. I can't change the past for my patient. I can't stop all child abuse everywhere. But I can take some small steps to create a stronger community where I live. I can ask other people to do the same; to keep their eyes and hearts open, to be involved even when it feels awkward. I have faith that small changes add up to big changes eventually. Seems like it's time to get started.

Sunday, December 1, 2013

Preschool Packing

My daughter is wailing this morning about not having her purple shoes. We are hundreds of miles from home today preparing to board a cruise ship later this afternoon and the purple shoes are sitting on the floor of our living room.

There is an art to packing for a three-year-old, a balance of parental authority and preschooler choice. It involves observation of your child to see which items are current favorites and might be missed as well as resignation to the fact that you will make some mistakes. My husband and I frequently travel with our daughter and have since she was very young and we still get that delicate balance wrong at times, as we did this morning. In many ways packing for an infant is easier. You need more items, including some large ones like a stroller and a portable crib, but the infant herself is not likely to gainsay your choices. The preschooler, on the other hand, is perfectly likely to pitch a fit over her outgrown purple sandals that have lately become her absolute favorites.

We typically start with clothing when we are packing. Clothing comes primarily under the heading of parental authority, since a three-year-old doesn't know what the weather is going to be like or what we may be doing. Since having a child we have found it best to plan to do laundry sometime during the trip, because packing enough clothing for a person who will likely require at least two outfits a day becomes unwieldy when the trip is over three days long. We do the primary selection of pajamas, underwear, socks, and daytime clothes, although we usually try to pick the items that have been recent favorites. This means sorting through laundry to find  the ones she is picking out of her closet for herself. Then we add shoes, jackets, and bathing suits at our discretion.

Toys are more a matter of her choice. We limit as to volume by giving her a preschool sized roller bag to fill. We also keep an eye on what she chooses so that we know she has a few of her favorite comfort items and a few staples such as crayons and legos. We would prefer to veto noisy toys for our own sanity but if she picks something obnoxious we make sure it's only accessible in our hotel room so at least the rest of the traveling world isn't perturbed. We used to choose books together but now we have many favorites on our Kindle. That cuts down both the weight and the challenge of making choices.

My husband and I don't typically consult our daughter in the matter of snacks, although that would be a good opportunity for her to exercise choice. However, our daughter is one of those children who likes the same foods over and over again and so we don't bother asking. We know she's going to tell us graham crackers, applesauce, and goldfish so that's what we pack. We are also in charge of special items, such as sippy cups, a sleeping tent and a few blankets, her epi-pen and her personal hygeine items. Mostly the entire process works well, although her items typically make up more than half of the luggage we are bringing on any given trip. And we do have the occasional minor tempests over items that didn't make the cut.

That's ok. We try to use these moments as lessons in tolerating not having your own way and being flexible in finding other solutions. She can wear the pink sandals today and with a little distraction and a little comforting she'll be content. As she gets older we can expand the amount of choice she has, training her in both making decisions and accepting the consequences of those choices.

Sunday, November 24, 2013

Puzzle Joy

My daughter and I spent about an hour today curled up in an armchair together. Our heads were pressed together as we bent over my iPad, working out jigsaw puzzles on the screen. I'm teaching her the way my mother taught me; fill in the border first using the straight edge pieces. Then use colors to fill in the middle unless the colors don't help, in which case evaluate the shapes of the pieces. I hold back as my daughter uses her chubby three-year-old fingers to drag the pieces off the sidebar and move them around the board. She still works mostly by trial and error but I see glimmers of logic emerging as she works out each new design. Anything that provides an hour of quiet fun for a preschooler is a winner in my book, and something that requires thought and problem solving is even better.

Puzzles have long been the purview of families. Around 1760 an engraver named John Spilsbury first pasted a map to a wooden board and used a saw to cut out the different countries. Wealthy English schoolchildren used his invention to learn their geography, but puzzles caught on as entertainment. In the early 20th century jigsaw puzzles were handmade and too expensive for anyone but the wealthy, but in the 1930's die cut cardboard puzzles opened the hobby up to the middle classes. Today puzzles are sold in two and three dimensional variations and can be made of cardboard, wood, plastic, styrofoam and now, pixels.  

Pixellated puzzles aren't perfect. I miss the tactile element of handling and sorting pieces and the sensation of edges locking together. The application I use holds the unused pieces in a sidebar; they are small and you can only see ten pieces at a time, which requires significant memorization skills. The puzzle screen itself is limited to the size of the iPad which tasks my eyesight on more complex puzzles. On the other hand, I can carry a library of hundreds of puzzles with me wherever I go. The pieces can't be lost or scattered and a solution in progress is held in memory without cats or preschoolers pulling the pieces apart. Each puzzle can be done at different levels of difficulty. You can choose the number of pieces ranging from 42 to 550 and you can set the pieces to rotate, imitating what would happen with physical puzzle pieces. I can solve a puzzle with my daughter on the easiest settings and then later return to it and challenge myself with a tougher version.

I wasn't a puzzle lover as a child. My mother and sister loved them but I usually wandered off to read a book. My daughter has been fascinated with them since her grandparents bought her a 24 piece cardboard puzzle with a popular cartoon character on it when she was two. I seem to have caught the bug from her, finding joy and achievement in assembling lovely pictures on an electronic screen. Perhaps it's just the fun of doing something together. Perhaps it's that puzzles are a nice metaphor for life, with hours of patient work fitting tiny pieces together producing a beautiful whole. Or perhaps the genetics just finally kicked in. Whatever the reason, I seem to be hooked.

Friday, November 22, 2013

Mary Poppins, Revisited

I watched Mary Poppins for the first time with my daughter this week. It took us three different showings because I forgot how long the movie is and we kept running into bedtime. This was one of my absolute favorite movies as a child and I loved watching her giggle over the carousel horses that won the race, the tea-party on the ceiling and of course the dance with the chimney sweeps over the roofs of London. Her mouth dropped open in astonishment when Julie Andrews (playing the title character) sang "Stay Awake" which has been Sarah's bedtime song her entire life. I hope she will love the movie as I did and that we will watch it together many times, but what interested me more is my own new understanding of the movie.

As a child I loved what my daughter loved; the bright colorful scenes, Julie Andrew's beautiful voice, the silliness and fun. As an adult, decades later, I found myself entranced by the relationships between the characters and how they changed. As a child I would have told you this movie is about Mary Poppins, a magical nanny for Jane and Michael, two British children in the year 1910. As an adult I think it is a story about their father Mr. Banks and his transformation.

At the beginning of the story the Banks are what I would term professionally a narcissistic family. The parents are involved in their own lives; Mr. Banks in rising in influence and power at his bank and Mrs. Banks in the women's suffrage movement. They don't pay much attention to their children except to scold them for not being good little "children-bots" who reflect credit on their parents and don't cause trouble. Jane and Michael are cared for by a series of nannies whom they torment with various tricks, including running away. At the opening of the movie they are brought back by a constable after having run off chasing a kite and causing the latest nanny to quit. The children attempt to apologize and ask their father to help them with their kite but he ignores this, instead focusing on dictating to his wife the qualities he wants to see in a new nanny. Jane and Michael write their own advertisement for a nanny in an effort to help; Mr. Banks finds their letter ridiculous and tears it up. The wind snatches it up through the window and thus the crisis is created that allows Mary Poppins to enter the family as an agent of transformation.

Over the course of a few days Mary Poppins and Burt (an old friend and admirer of Mary Poppins and local man of all work - chalk artist, one man band, kite seller and chimney sweep) take Jane and Michael on magical adventures. The children are delighted and Mr. Banks is perturbed, insisting that the children need a grounded, reality based education. He attempts to intimidate Mary Poppins as he does the rest of his household but she remains calm and unflustered. She then neatly turns the tables by agreeing with him and arranging for the children to accompany Mr. Banks to work the next day. Chaos ensues when Michael wants to spend his tuppence to feed the birds from the bird woman as Mary Poppins had suggested and his father insists he invest it in the bank.

The bank scene is a lovely illustration of narcissistic parenthood. Mr. Banks brings Jane and Michael in and announces to his superiors that Michael wishes to open an account, despite the fact that Michael has repeatedly stated he wants to feed the birds. The bank officers and Mr. Banks sing about the glories of investment while Jane and Michael appear steadily more confused and frightened by the circle of grownups pressing in on them. Finally, the president of the bank snatches Michael's tuppence away from him and Michael responds by shrieking and wrestling it back. The fight disturbs the other bank customers who only realize that the bank won't give someone their money back and a run on the bank is created. Michael and Jane run off through the confusion. Throughout this scene Jane and Michael are not seen as individuals. Their father wishes them to behave a certain way in order to bolster his own prestige and image at work.

Mary Poppins created the conditions for change with her magic and ability to stand up to Mr. Banks, but it is Burt who capitalizes on her work to reach the characters and start changing their relationships. Burt finds Jane and Michael after they've run off and helps them empathize with their father in his position of responsibility and loneliness. When Mr. Banks comes home from work devastated by the incident and knowing he will be ruined Burt (in the home to clean the chimney) empathizes with him and then gently in song helps him see that he's rapidly losing the window of opportunity to connect with his children. Burt leaves it there, with Mr. Banks sitting quietly in a dawning awareness. Jane and Michael approach and apologize to their father, handing him the tuppence and asking if that will make everything better. Mr. Banks appears to really see his children for the first time; their desire to connect with him and love him. He receives a phone call ordering him to report to the bank and we follow him through the streets of London as he appears to see things for the first time, pausing to gaze at the spot where the bird woman sits.

The turning point of the movie is the scene in the bank. Mr. Banks enters and is marched to the board room between two tuxedoed officers. There is a strong sense of a criminal being brought to justice which is heightened when Mr. Banks enters the darkened boardroom, where light falls only on the board  sitting at their table. Mr. Banks is reprimanded for his behavior and he apologizes, but then things become ridiculous. While the president of the bank looks on with undisguised pleasure Mr. Banks's boutonniere is torn, his umbrella is turned inside out, and the top of his hat is punched out by one of the senior board members. Clearly this is intended as a ritual shaming and casting out and yet all of a sudden Mr. Banks sees it for the nonsense it is. It's a pretend world that he bought, to the exclusion of his family, and he gets it now. He laughs and delightedly shares a joke that Michael had told him much earlier in the movie, a joke that he only now understands. He dances off singing, returning home to repair the kite and take Jane and Michael out as they had requested in the first moments of the movie. Mrs. Banks follows her husband's lead and offers her suffragette sash as a tail for the kite. The family skips off together hand in hand. Mary Poppins and Burt, their work accomplished, quietly fade out of sight to allow the restored family relationship to keep center stage.

This movie resonates for me now on so many new levels. As a therapist, because the narcissistic family dynamic is so common, so damaging and so insidious. I admire the empathy as a change agent that Burt utilizes and the focus Mary Poppins maintains on her work of healing this family. Her leaving scene, where she is obviously saddened but determined not to usurp the parents' rightful position, is a lovely illustration of what therapists should do when their work is complete. More importantly I see this movie now as a parent, as I strive to be a non-narcissistic mother to my own daughter. I remind myself to balance discipline and acceptance, to balance my work with parenting, and most of all I remind myself focus on my daughter and her truth, to see her as she is and not as I would wish her to be for my own gratification.

Saturday, November 16, 2013

Toy or Tool?

I finally broke down and bought an iPad. I wrestled with the decision for quite a while, because the reality is that I don't really need an iPad or any other kind of electronic toy. My husband and I have laptops and phones and kindles. My daughter doesn't technically own any electronics and I don't really want her to, because I want to control and monitor her screen time for as long as I can. It's easier to do when all the electronics belong to a grown-up and she has to ask to use it. In reality, though, she is the major user of the kindle when we are traveling. We let her have unlimited screen time when we are on an airplane because it makes the trip much more pleasant for ourselves and for everyone else on the plane. Still, I certainly can't argue that I needed an iPad. I'm fundamentally cheap, and I hate spending a lot of money on something I don't need.

I wanted one, though. I've wanted one since they came out about four years ago. They just seem like magic to me. When I was little I remember watching a cartoon called Inspector Gadget. The TV show was about a bumbling bionic detective with extendable arms and legs with a variety of gadget attachments, which would invariable malfunction in humorous ways. He made no progress whatsoever on his own cases, but fortunately he had a very intelligent dog, Brain, and a niece, Penny, with a computer book. The computer book was an amazing little device that looked like an ordinary book but which could speak, display maps, and answer questions. It fit in Penny's backpack and she carried it everywhere with her. Thanks to the computer book Penny always knew where her uncle was and what was going on. She would then send Brain to go help out Inspector Gadget and solve the case. I loved that computer book in the show. I would get bored and frustrated by the inept Inspector Gadget but I was all attention and wide eyes when the computer book came out. I really, really wanted one. Now, with the iPad, it feels like I have one.

I do plan to use the iPad for writing purposes. I don't love writing things out longhand, particularly since I would just have to retype them later. Also my thoughts seem to flow better when I am using a keyboard. My laptop is great but it is very heavy when we travel and too bulky to take to work. With a Logitech keyboard folio my iPad transforms into a very small, very lightweight laptop for a much lower price than a MacBook Air, which is the other product I had considered. My goal is to use the iPad as a functional tool that allows me to write on the go, taking better advantage of spare minutes that accumulate here and there.

Which is not to say that it isn't also a toy. I've put several apps on it already for my daughter, although I am determined to maintain my position as the owner of the iPad. But "do X and you can have 10 minutes of iPad time" is too attractive a bribe to pass up. I also found the app "Color Zen" for myself, which is a puzzle game that is incredibly absorbing as well as oddly calming. And of course I had to download the Kindle app, so that I could access my library on the lovely large screen of the iPad instead of my tiny phone screen and spare my eyes some strain. I am sure that over time I will accumulate more games and entertainment. That's okay. As long as I can keep on writing I will feel like it is a worthwhile tool.

Tuesday, November 12, 2013

Don't Pick on Parents

Recently I read an online article that claimed time-outs are ineffective and terrible for children. The author stated that time-out threatens a child’s sense of security because separation from parents is a child’s worst fear. It stated that time-outs create clingy children who believe their parents can’t handle them in their worst moments. I read this and I wasn’t sure if I should laugh or scream. The article didn’t offer any suggestions for alternative discipline techniques. It did suggest reasoning with your child, which left me with the impression that the author did not actually have or know any small children. If you haven’t tried it, I encourage you to attempt to reason with a little kid who is not behaving well. I will sit back and laugh at you. You can reason with a preschooler who is well-rested, well-fed, perfectly healthy and in a cheerful frame of mind, but a misbehaving three-year-old is almost certainly none of the above. In general attempts to reason with a cranky and ill-behaved child will be met with tears, screams, arguments, running away, throwing things, hitting, kicking, biting or some combination of these charming actions.

Our society is very quick to criticize parents and tell us what to do. We are told on a regular basis that we are screwing up our most important job, particularly when it comes to discipline. Contradictory articles on how to discipline abound, while in restaurants and grocery stores across the country misbehavior is met with glares and any attempts at discipline are met with disapproving stares. Discipline is one of the hardest parts of being a parent. It’s no fun to be angry or disappointed in a misbehaving child. It’s hard not to see your child’s actions as a direct reflection of your skills and worth as a parent. When they mess up you feel like you’re the one who’s failed. It’s a direct hit to the ego, and it generally comes at a time when you are also tired, hungry, ill or frazzled yourself. Yet it is absolutely your job to civilize this adorable but self-centered little person. Parenting means teaching your child to wait, share, use manners, persist in the face of challenge, and consider other people’s feelings. Even if you don’t see those skills as morally good they are necessary for adult productivity.

Here’s what I would tell you about time-outs, both as a parent and as a professional in the field of human behavior. Time-outs don’t always create clingy children or breed separation anxiety. The general rule for time-out is 1 minute for every year of life. That means a three-year-old will get a three-minute time out. A really bad day in our house will mean perhaps 6 time-outs total. If you do the math, that works out to eighteen non-contiguous minutes of separation on a really tough discipline day. Most days hold many fewer time-outs, since an advantage of consistent discipline is doing less of it. Contrast that 18 minutes with the twelve hours a day our daughter is awake, much of which is spent interacting with one or both of her parents. You probably won’t be surprised to hear that she is a cheerful, creative, verbal, affectionate child who enjoys preschool, relates well to other adults, and isn’t stressed by being separated from my husband and I.

Time-outs should be sending a child the message that their behavior at that moment is unacceptable. My ability to handle my daughter’s poor behavior does vary, but it will always be higher than the tolerance her peers, teachers, future employers and spouse are likely to show. Whining, tantrums, interrupting, yelling, hitting and their adult derivatives are not socially or professionally acceptable. In fact, the entire point of time-out or any discipline is to let a child know that he or she is out of line with an unpleasant but safe consequence.

Time-out works really well for my daughter in particular because she inherited the temper that runs in my family. We have the same hot flash of anger that intensifies the more other people attempt to interfere. When I am deeply angry I need to be alone in order to calm down and my daughter is the same way. She was about 18 months old when she started telling us “leave me alone!” in the midst of a tantrum, and she was right. When we left her alone for 2 minutes she was able to calm down. When we tried to stay with her, talk to her, console her, reason with her or otherwise interfere with her she became increasingly angry and distressed. So we started leaving her alone. That’s contrary to most parenting wisdom and it took us a while to trust her and trust ourselves to do what she really needed. Now that she’s older she’s learning to take deep breaths to calm down so she can stay in a situation, but the retreat of a time-out is a skill I hope she hangs on to throughout her life.

The biggest problem with parenting articles like the one I read is that they over-generalize. “No spanking, ever!” or  “Time-outs are terrible for children!” are two phrases I have read recently. They are probably true in some or even many cases. I imagine that some parents should never spank; that’s easy for me because I count myself among them. I get too angry too quickly sometimes to trust myself as a spanking parent. Some of my good friends spank their children in a very calm, deliberate way when needed. Their children are also happy, secure, creative and overall delightful young people. Time-outs are probably terrible for some children; I can imagine a very sensitive child being frightened or a parent using them too often or for too long. In that case wise parents would use a different consequence that suited their child. I have a friend who takes away privileges like reading a story or using a toy instead of time-outs and that works quite well for her children. Perhaps, despite my earlier mockery, there are some three-year-olds who listen to reason when upset and so their parents would appropriately reason with them. The point is, though, that my husband and I have to decide these things for our daughter and our family and you must decide them for yours. Beyond a few rules that I wish were common sense and common practice (don’t harm your child physically or emotionally, give your child plenty of love, be consistent with your rules, make sure your child has food, shelter, warm clothing, exercise and books) I can’t tell you what to do with your child. And I won’t. Your job is hard enough already.

Wednesday, November 6, 2013

Autumn Leaves

 I was surprised this year by the autumn leaves. I think I was expecting the color in mid to late October, which is what I thought I remembered from last year. The appearance of fall color actually depends on the amount of light in a day, not on weather conditions, so the color should start around the same time every year in a given location. The weather conditions do make a difference to the vividness of the color; drought during the summer can keep the leaves from developing the colorful pigments. Severe autumn storms or early frost can cause leaves to drop before the color really shows.  When I didn't see fall color a few weeks ago I just thought this just wouldn't be a good year. Perhaps I just remembered it wrong, because all of a sudden last weekend there it was, gorgeous reds and oranges and yellows against a backdrop of evergreens and a bright blue sky.
I spent most of the weekend taking pictures to try to capture the beauty. The top picture is outside our local library, I love the few light brown leaves against the darker orange red of the rest of the tree. The middle pictures are from the zoo, where we spent a highly enjoyable and not too crowded Sunday afternoon. The animals were dozing and the new baby panda wasn't accepting visitors but we did get to see some elephants and lions, and I had a great time admiring the trees. The final picture is taken from the seventh floor window at work; the glass mutes some of the color but it's a wonderful view to stop and take in every time I need to go up and down the elevator (which is multiple times a day). I hope you enjoy these too!

Monday, November 4, 2013

Cava Mezze

My husband and I wandered sadly through our local shopping mall during our date last Saturday night. We had neglected to make reservations at our favorite eatery and couldn’t face the hour long wait before we were seated for dinner. We stopped to consult the directory, hoping for a new option, and asked each other “What’s Cava Mezze Grill?” My husband guessed a Spanish tapas bar since Cava is a type of wine from Spain he likes and mezze usually means small plates. We've enjoyed tapas in the past so off we went to check it out. 

Cava Mezze is not a tapas bar http://cavagrill.com/ nor is it exactly small plates. It’s actually something much better for two adults who frequently eat out with a three year old. It is a local chain quick service restaurant in the Chipotle model but with Mediterranean style food instead of burritos. Your meal is assembled before your eyes as you select options from starches, dips, proteins, vegetables and dressings. It offers the promise of a tasty, relatively healthy meal that can be put together in minutes, before your preschooler starts screaming down the roof or attempting to play hide and seek amongst the other diner’s chairs. It also answers what my husband and I have seen as a dearth of decent Mediterranean style food in our local area that is oriented towards families. 

The restaurant's decor was stark and basic; plenty of metal and scratched up tables. I don't love the industrial look when I go out to eat although it does seem to be popular these days. I would imagine that it is easy to keep clean and tidy and that it gets people in and out quickly, so I can see the advantages from the restaurant's point of view. It's not a great ambience for a date night, but fortunately the food made up for it.

My husband ordered a large pita with a spicy feta dip, meatballs, and tabouleh. I chose two mini pitas, one with tzatziki and chicken and the other with hummus and meatballs, both with feta cheese crumbles and tomato cucumber salad. Everything was well prepared and reasonably well seasoned. The standout was the spicy feta dip which was blended into a smooth texture with a smoky chili pepper that reminded me of the hatch chilis we used to get once a year in San Antonio. Both of us were pleased with our selections and there were other items on the menu that interested us for next time.

I also liked that the restaurant posted a sign naming the (local) farms supplying their meat. Their website offers nutrition details with an excellent interface that lets you add up the values for your particular selections online. It also listed allergen information and everything is peanut free which is important to us since our daughter is allergic to peanuts. All in all, I am very excited about finding Cava Mezze Grill and we will definitely be back!

Thursday, October 31, 2013

Happy Halloween!

Having a child yourself brings back memories of childhood. I’ve found myself singing scraps of old songs learned in elementary school and not thought of for decades, like the one I found myself singing out loud earlier:

“Jack-O-Lantern, Jack-O-Lantern
You are such a funny sight
As you sit there in the window
Looking out at the night

Once you were a yellow pumpkin
Growing on a sturdy vine
Now you are a Jack-O-Lantern
See your candle light shine.”

I learned that when I was about seven years old, I think. I don’t think I’ve thought about it since, until it sprang to mind (and voice) while I was walking down a corrider at work today. I’m grateful that no one was around to hear me. Although I’m disappointed that no one noticed my Halloween socks. We are allowed to wear costumes to work on Halloween but the guidance is that if you might need to talk to a patient about something serious you really shouldn’t be wearing a costume. Since my job as a psychiatrist is pretty much always and only about talking seriously with people, I thought I would refrain from dressing up.

I was remembering my old Halloween costumes today. When I was little my mom made Halloween costumes for my sister and I, and for my dad too when we were really little. I have picture of us in matching lion outfits from when I was three or four. I can remember the blue fairy costume and the angel costume and the Native American princess costume from my early elementary years. I remember how beautiful I felt, all dressed up for the evening. I remember walking around the neighborhood with my sister trick-or-treating and becoming so weary.  When we had passed every house we would head for home, bringing the candy back for my parents to inspect before being allowed to eat two pieces.

My daughter and I went trick-or-treating around our little neighborhood early this evening. She wore a princess costume that my mom had bought her for her birthday, and I was grateful she had decided on that instead of insisting on being a ghost, which was her original plan. I couldn’t find a ghost costume in her size and I was nervous about her ability to move around safely with her head and body covered in a cut up sheet. She was a charming princess though, particularly with her plastic tiara nestled in her curly hair. We smiled and said “Happy Halloween!” and discussed which houses might have people at home (looking for the houses with lights, of course). We had just made it around the cul-de-sac when it started to lightly rain and she announced that she had plenty of candy and that it was time to go home. My husband and I inspected her candy (for peanuts, since she is allergic) and let her eat two pieces. Then she helped us give out candy to the older kids before she had to go to bed.

I’m glad I have so many happy memories to enjoy when they come drifting back on the wings of my daughter’s childhood. I hope that I am helping her make her own lovely memories to haunt her life to come.

Monday, October 28, 2013

Compassion is Caught, Not Taught

I read these words today and this is the story I remembered.

In the early morning at the end of a twenty-four hour shift I stood over a newborn boy in the cold, brightly lit newborn nursery. His heart rate was fine, he was breathing easily, and he was moving his arms and legs. But his nurse had called me because his blood oxygen saturation stayed stubbornly at seventy percent, instead of the normal ninety-nine. What could be wrong? We tried giving him some oxygen, which didn’t help. We tried rubbing his feet and back, which sometimes stimulates deeper breaths. That didn’t help. As a senior resident I hated to do it, but I turned to the nurse and asked her to please call the attending physician for help. While we waited for him we tried suctioning the baby’s mouth and nose. His heart rate was still fine, so I wasn’t panicking.

My attending stepped into the room and said, “Why haven’t you tried positive pressure ventilation?”

I immediately grabbed the mask and the pressure bag and started giving the baby breaths. Positive pressure ventilation! Why hadn’t I thought of that? Within 3 breaths the little boy’s oxygen saturation was back where it belonged. We stayed next to him, monitoring until we were reassured, then retreated back to the on-call room.

“Tell me what you were thinking.” my attending said.

Now I wanted to panic. Words tumbled out of my mouth. “His heart rate was fine, and he was breathing and moving, and usually I don’t go to positive pressure ventilation unless the heart rate is less than 100.” Inside my mind I thought “Oh my God. Obviously that was wrong. I could have killed that baby. I should have known better. Oh my God.” I started to cry. Not quiet tears rolling down my face that I could discreetly wipe away. Huge sobs, choking off my breath and constricting my chest and sending a knife through my throat. Tears that left me gasping, unable to hide my distress. Now I had “Stop crying you blubbering idiot.” crashing around in my mind in addition to “Oh my God.” All I could force out between the sobs was “I’m sorry, I’m sorry, I’m sorry.”

My attending, a reserved and distant man I didn’t know particularly well looked at me calmly. “You’re really hard on yourself, aren’t you?” he said quietly. “It’s okay. Nobody died. Just learn from it. You don’t have to be perfect.”

Doctors are perfectionists. Graduation from medical training is built on decades of relentless hard work, at times brutal self-denial in service of learning, achieving, perfecting, succeeding. Doctors are the best of the best of the best, and failure is not permitted because it could kill someone. It doesn’t matter how 
tired, hungry, sick or in pain you might be. Mistakes are not tolerated.

I wish I could say that my attending’s gentle words freed me instantly. Instead, I slowly calmed down, we talked a few more minutes analyzing the mistake in my thinking, and I went home at the end of my shift to rest. But those soft words have echoed and grown through my years as a doctor. Now mine is the voice that murmurs to my students, my colleagues, and my own face in the mirror. “It’s okay. Nobody died. Just learn from it. You don’t have to be perfect.”

Saturday, October 26, 2013

Airlines Don't Care

On our flight home from San Francisco my husband and I encountered a two-hour delay. Generally I would not find this dreadful, but since we had chosen an overnight flight I was already tired and wanting to fall asleep. A delay from leaving at 11pm to leaving at 1am felt pretty painful. It was even more painful because it felt completely preventable. We were about 15 minutes late getting onto the runway. Unfortunately, the runway at that airport closed at 11pm. Which was apparently a huge surprise to our flight crew, although it really shouldn’t have been. It’s their business to know about details like when the runways close. So the 15 minute delay turned into a 2 hour delay.

In the end I have to admit that’s not really terrible. We still got home, we still travelled safely and it’s still amazing to be able to travel cross country and back in a weekend. I think what really bothers me though is that airlines just don’t care. You can hear it in the perfunctory apologies from the crew and the gate agents. Their “I’m sorry” has a ring of “Please shut up and don’t bother me, I don’t really care about your life and don’t want to waste time on you.” You can hear it in the form e-mail I received in response to my complaint that essentially said “You’ll hear from us if you decide you deserve some money back but otherwise don’t expect a response.”

I’m not naming airlines here because I’ve flown them all and the experience is about the same. I usually fly about 4 times a year, some years more (which I think is a lot for a non-b, and most airlines are happy to boast about their customer service and show you a video about how happy they are that you’re flying with them. But when it comes down to owning up to mistakes and even just honestly apologizing, forget about it. I think this is because the airlines know they are all about the same. You can say “I’ll never fly such and such airline again!” and maybe you won’t but if you fly anywhere, on any airline, you’re likely to have the same experience in the future.

I acknowledge that I keep this system going. I keep choosing to fly, because I love to travel. I love to get across the country and see friends. I have lots of good friends on the west coast, some of whom I didn’t even get a chance to see this time and many others who I’d like to see again. With the amount of vacation time I’m allowed, I can’t make it to the west coast by bus, train or car and back again with enough time left over to actually see my friends or even do anything fun along the way. It really is amazing that it only takes a day to go from Washington D.C. to San Francisco or Seattle and in the end I can’t resist. So I know I’ll keep choosing to fly and putting up with the inconveniences.
I suppose the only thing I can do is learn to stop fighting reality. I can expect and plan for delays by booking flights early in the day and well before I need to be where I want to go. I can acknowledge that airlines don’t have much incentive to change because they are the best alternative for most trips and so people aren’t going to stop flying – that lets me let go of the demand that airlines be something other than how they are. I can try to be more zen about the whole thing. It’s just hard to be zen at 1 in the morning.

Thursday, October 24, 2013

The Fine Art of Bargaining With A Three-Year-Old

My husband and I don’t usually fight with our daughter about what clothes she wears. She wants to wear a brown and orange flowered dress with florescent yellow, green and pink striped leggings? Sure, go for it (yes, that was a recent outfit). Part of this is that my husband, as a stay-at-home dad, is responsible for getting her dressed in the morning. He’s colorblind, so it makes fighting a daily battle over ensembles truly pointless, since there’s no guarantee that his choice will work any better than hers. He does the laundry too, so outfits don’t tend to stay together. Hence the decision that clothing choice is a pretty reasonable area for her to start having some control. We do reserve a veto for hygiene and weather appropriateness but otherwise we let her pick out what she’s going to wear that day. Except yesterday was school picture day.

I’m a sucker for school pictures. I always end up buying them to send to grandparents and to tuck in cards and for my own wallet. So I really wanted her to wear matching clothes yesterday, something to compliment her basic adorableness. I discussed this with her and she picked out a nice tunic with purple and black and white flowers. I told her she needed leggings and she let me pick out the black ones for her. So far, so good. Unfortunately, then she decided to add the dark blue skirt with red and yellow flowers over the leggings under the tunic. Arrgh! Now I feel stuck, because we have told her that she’s allowed to pick her clothes. I don’t want to take that back when really, she’s mostly doing a good job. Plus I am trying to get ready for work myself and am not eager to inspire a tantrum. But I really, really don’t want her to wear that skirt.

“Sweetie, can you take the skirt off?” I say.

“No!” says my daughter.

“Please? I want you to look pretty in the pictures at school.” I say.

“I think the skirt is pretty! It’s very pretty!” she says back.

Having an articulate child is not always a blessing. It’s hard to argue with taste I guess, but I still don’t want her to wear that skirt. I want the pictures to look good to MY taste. So I decide to offer a deal.

“Please?” I say. “I’ll let you pick out my clothes this morning.”

“Okay!” she says.

I know this sounds risky, but I don’t have that many different work clothes so I didn’t think she could go too far wrong. Tan, brown, blue and black pants pretty much go with anything, after all. Plus I know she loves picking out my clothes; when I get home from work she often asks if she can pick a T-shirt for me or pick a pair of jeans out of my drawer. I think that might be because I usually let her borrow one of my shirts to play in at the same time. Or maybe she just enjoys the chance to be the one in charge sometimes.  

My strategy worked like a charm. She went to school in her tunic and leggings sans clashing skirt. I went to work in black pants and a pink sweater instead of tan pants and a black sweater. Both of us were happy and looking good. That’s what I call a win-win situation!

Monday, October 21, 2013

Motherhood = Guilt

I wrote this over the weekend while my husband and I were away. I couldn't post it due to internet access issues. Then my guilt became a lot worse this morning when we returned home to find that our daughter had been ill with a fever all day yesterday…. I suppose it just proves the point.

This isn’t an astonishing new insight, but being a mother means feeling guilty. When you take that tiny person home from the hospital they don’t tell you that you’ve also just brought home your very own automatic infinite supply guilt dispenser. You get to figure that part out on your own. It doesn’t take long. Right around the first time you start desperately wishing someone else would take over so you and your husband can go out for a nice walk together you realize that guilt is now going to be a constant companion.

I don’t know any mothers who don’t feel guilty on a regular basis. My friends who work feel guilty about being away from home, about missing out on different events, about putting their careers first. My friends who stay home feel guilty about not working and giving their children more of a financial advantage and about not modeling feminine independence and career mindedness. All of us feel guilty for not enjoying our kids more, for being impatient, for wanting some time to ourselves again, and for generally letting our kids down. Pretty much whatever you do, you can doubt yourself. The internet makes it worse because in a few clicks you can access information telling you that you should be doing something else – sleep with your kids in your bed. No, make them sleep in their bed. Play with them and give them attention. No, make them learn to play independently. It’s enough to make you pull your hair out.

My particular guilt this weekend is that my husband and I are away. We are away and pretty far away at that, since my boss was kind and allowed me to take leave (the government reopened anyway, but we didn’t have to cancel our plans two weeks ago) so we could attend the wedding of a very dear friend. We decided a long time ago that the trip was too long-distance and too short-time-frame to be reasonable for a three year old, and my mother graciously agreed to come up and babysit. So this morning we woke up early, kissed our daughter good-bye, and headed for the airport.

Mind you, I don’t have any rational reason to feel guilty. My daughter absolutely adores my mother, and I know they are having a ball together. I called home when we arrived and my ears were filled with stories about playing princess and cooking and legos and a great day at preschool. They are going to a pumpkin patch with pony rides tomorrow. If that isn’t enough, my daughter’s other beloved grandparents are coming down on Sunday to spend time with her and my mom as well. She’s going to be spoiled completely rotten with three doting grandparents on the job and no Mom and Dad around to set limits on the fun. I suspect she’s probably not even missing us, to be honest.

My rational mind also knows that a trip like this is good for my husband and I. We haven’t had an extended period of time to relax together in almost a year. 2013 has been filled with injuries, moves, work and the daily routines of home and parenthood. We’ve been overdue for some time to reconnect as a couple. I’m definitely a believer in the idea that happy parents create happy families, and that means keeping the relationship between my husband and I strong. We also wouldn’t have wanted to miss our friend’s wedding; we are so happy for him and for his fiancĂ©, who is absolutely wonderful herself, and we had a chance to visit with some old college friends we haven’t seen in way too long.

Rationality has very little to do with feeling guilty. No matter what I tell myself, I feel guilty being away from my daughter. I’m still having fun, but I feel guilty. 

Tuesday, October 15, 2013

Segway Tour: It's fun! Don't judge!

Have you ever been on a Segway tour? I went for the first time this past weekend with my husband, my mom, and my sister. My sister had bought us the tickets for a guided tour of Washington D.C. last Christmas but between my broken ankle and my mom’s foot surgery and all of our busy schedules it took us until October to schedule the tour. My mom and sister arrived at our house Thursday night and all day Friday we prayed the rain would stop in time for our tour on Saturday. Which, thankfully, it did. So we headed out to the city with cheerful hearts while my daughter stayed home with her favorite babysitter.

Segways are not hard to ride, but it took me a while to get used to it. You use your body weight to move forward and backwards. Lean forward and the Segway rolls forward. The more you lean the faster it rolls, up to 12 mph. Lean left and right to turn and lean backward to slow down or move backwards. If you want to hold still stand perfectly upright and balanced (not easy). I’ve noticed that since I broke my ankle I am anxious about unstable surfaces and the possibility of falling. So at first I was scared stepping up and down off the platform and rolling back and forth. Fortunately our guide was patient and kind and the company (Capital Segway in downtown D.C. is the company we toured with: http://www.capitalsegway.com) gives you a little lesson in the store and then takes you to a nearby park to practice before you hit the streets. By the time we really got going I had mastered the controls although my feet were cramping from tension at first. After about the first hour I felt comfortable with it and was able to relax and enjoy the stories our guide was telling via headset.

Touring D.C. by Segway during a government shutdown is still fun. The monuments and museums are closed but you can’t go into them on a Segway anyway, and you can still look at the buildings. We were able to cover about 7 miles of touring in 2 hours, which is much more than we’d have managed walking in that time. We zipped past the White House, the Vietnam memorial, the Lincoln Memorial, the Martin Luther King Jr. Memorial (which we slipped inside to see while our guide watched the parked Segways… I think Congress needs to take a field trip down there and read the words engraved on the walls). Then back up past the Washington Monument (covered in scaffolding) and up the streets that line the National Mall. Which are currently open to pedestrians and bikes but not cars, so we were able to take the Segways up to their top speed of 12mph and cruise up the empty streets. We stopped in front of the Capitol building, which is still beautiful despite the people who work there. Then back up through D.C. streets to our starting point.

About the only sour note in the entire outing was the bystander who felt called upon to call out “Nice exercise!” in a sarcastic sneering tone as we guided the machines up a ramp onto a sidewalk. Since I was still focused on staying on the Segway (ramps were a little nerve wracking throughout the tour) I didn’t respond. I probably wouldn’t have anyway, since I don’t typically engage in arguments with strangers on the street. But what I wanted to say is “Hey buddy, back off. I’m not stupid. I know I’m not getting any exercise here. That isn’t the point of today’s adventure. I’ll take a walk later today for exercise, but the point of this tour is to spend some time with my family doing something fun that I’ve never done before. So don’t judge!”  

Obnoxious pedestrians aside, it was an outstanding outing. I learned some things I didn’t know about the city I live in (the National Gallery of Art has a tunnel connecting the East and West wings! I will have to check that out if the government ever opens up again!), I shared a mild adventure with my family, and I learned a new (albeit somewhat useless) skill. That’s a great way to spend a Saturday.

Friday, October 11, 2013

Don't Reward Bad Behavior - Temper Tantrums for Kids and Politicians

I’ve heard plenty of references to the government having a “temper tantrum” when people talk about the government shutdown. Usually when some says “do what I want or I’ll hurt you” we call that extortion and it’s considered a crime, but okay. Let’s talk about temper tantrums. As a parent of a three-year-old I can tell you quite a lot about tantrums.

My daughter threw a tamper tantrum the other night. She did something wrong, we told her to stop, she didn’t stop, we gave her a consequence, she had a tantrum. This isn’t an uncommon sequence of events, because three-year-olds don’t have a whole lot of emotional control. So my husband and I have agreed on a way to cope with tantrums. First and foremost, we never, ever, ever give in to or reward a tantrum. The very fact of the tantrum means that she loses whatever it is she wanted, even if we normally would have given it to her. We agreed on that rule before she was born and we’ve stuck to it so far. Second, we don’t give her attention for a tantrum. If she has a tantrum at home she goes to her room and she can come out when it’s done. If she has one in public we stay with her (for safety) but don’t speak to her until she’s done. These tactics work pretty well; my daughter has temper tantrums but they tend to be short and not very frequent. Even at the very young age of three, she’s learning that temper tantrums don’t pay off. It’s a lot of effort for not much reward.

A key principle of human behavior is that we do what works. Human beings are results oriented. I first learned these ideas in my psychology 101 class back when I was a sophomore in college. Behavior that results in positive consequences, or a reward, will continue. In psychology terms we would say that behavior has been “reinforced.” Behavior that results in unpleasant consequences, or punishment, will cease. A psychology class will go into all kinds of permutations on this theme, talking about reward schedules (how frequently the behavior earns a reward – unpredictable intermittent rewards are actually the most reinforcing – hence gambling becomes such a problem - while unpredictable intermittent punishments don’t do much to stop behaviors) and positive vs. negative reinforcements but the core idea is really simple. If the behavior gets a result you like, you’re going to do it again.

In psychiatry we use these ideas about reward and reinforcement all the time. They are an important part of how we think about habits, addictions, learning, parenting, interpersonal relationships and many other aspects of behavior. Apparently we can apply these ideas about behavior, motivation and reward to politics as well. Right now congress is not doing its job by passing a budget and the government shutdown is hurting the entire country. A default on our debt, if it happens, will hurt us even more. I would call that bad behavior. And so the last thing anyone should do is reward it.

I agree with the president’s position that he won’t negotiate while the government is shut down. I don’t ever want Congress to do this again, and if it works for them, if they get what they want through refusing to pass a budget or raise the debt ceiling, then you can be certain that eventually the government will shut down again over some new issue. Remember, behavior that is rewarded is repeated. Therefore you don’t negotiate with toddlers having temper tantrums. You send them to their rooms to calm down.

But I hope the American people will take it further. In my more cynical moments, I think the reason this fight is happening now, in 2013, is because congressional elections aren’t until 2014. Which gives the American people a whole year to forget how badly our elected officials have behaved before they have to stand for re-election. I suspect our congress people are betting that we can’t sustain our focus and anger for that long, and that they will get away with their tantrum. I can see why they might think that. As a collective we do seem to have pretty short attention spans when it comes to major public outrages. But Congress, I promise you that I will remember. And when election time 2014 rolls around I will be reminding other people. Because I don't reward bad behavior.