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.