Psychobabbling

Since shortly after my little dude was born, I have periodically had this odd and disturbing experience of fearfulness that he will drown.  Specifically, I get flooded with anxiety when an image of him falling off a boat comes into my mind.  He has never been on a boat, and has no plans to do so any time soon, but I still have an intense fear that he’s going to drown.   His helplessness and vulnerability, coupled with my overwhelming sense of protecting him from any danger that could befall him, is a powerful force that exceeds any rationality I can muster.  At this point, I can’t even go on boats, and will be enrolling the dude in swimming lessons as soon as he is old enough. 

This seemed to come out of left field, and I couldn’t figure out where this image came from, until a few months ago during the season premiere of LOST when it all came back to me.  At the end of the last season, when I was 5 months pregnant or so, several of the characters are in a helicopter crash into the ocean, and one of them was holding a baby.  They all survived (spoiler alert), but I remember thinking, “how and the heck are you supposed to swim with a baby in your arms?”  During the recap at the beginning of this season, I had a serious a-ha moment and my fear made a bit more sense.  And then, when a plane landed in a river very close to my home, I think it kind of kicked everything up a notch.  There was a woman with a 6-month-old baby on the plane, and there were reports that she had difficulty handing her child over when she was being rescued, she was holding on to her baby for dear life.   

A psychoanalyst might say that this fear stems from my own aggressive impulses and hatred toward my dude, and I think it’s important to acknowledge that maternal feelings do not always entirely consist of rainbows and sunshine.  He can be frustrating and make me feel totally inept at times, to be sure, but I think it’s more helpful to think of this as part of a process ratcheting up my protective instincts and the anticipation of any possible danger to those ends.

It turns out, I’m not alone in this.  I found this study of 100 new mothers assessing the presence of such fears, “New mothers’ thoughts of harm related to the newborn” (Fairbrother & Woody 2008; Archives of Women’s Mental Health).  From the abstract:

“Participants were assessed prenatally and at 4 and 12 weeks postpartum using questionnaires and a semi-structured interview about unwanted thoughts of harm related to the newborn. Postpartum intrusive thoughts of accidental harm to the infant were universal, and close to half of the sample reported unwanted thoughts of intentionally harming their infant. Compared with intentional harm thoughts, accidental harm thoughts were more frequent and more time consuming, but less distressing. High parenting stress and low social support predicted the occurrence of thoughts of intentional harm. Little evidence of an association between these thoughts and aggressive parenting was found. Unwanted intrusive thoughts of harming one’s infant are a relatively normative experience during the early postpartum period, particularly in association with greater parenting stress and low social support.”

Thanks to Rand for the awesome pic.

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Dr. Heather over at Baby Shrink has a great new post about Attachment Parenting, and how to understand it in terms of the progression of infant development.  Her point is that though attachment is the foundation of emotional development, there is a need to appreciate the evolving balance between closeness and independence as children mature, and that AP sometimes may not fully appreciate this duality:

“Movement away from the parent requires a means of communicating over distance with that parent: When you crawl across the room, it’s nice to be able to say ‘Doggie!’ and to point at the doggie, to get your parents’ attention. Communication becomes more necessary when the child can move away from the parent. And communication is a symbolic way of continuing attachment. We can tell older babies I love you! And their ability to understand abstract communication helps them to feel the love, without being physically held. It’s not that physical comfort is no longer necessary, but rather, the baby now has a new, more advanced way to be attached; through communication. And that allows the baby to become more independent, and venture out, away from the parent…

… How is this different from Attachment Parenting? Yeah, I know that AP understands and appreciates the nature of ‘attachment’ — they used it in the name of the approach, after all. And I’m totally with them on the use of AP principles, but only with very young infants, and only when that infant is constitutionally amenable to the intense physical contact of AP. As I said in my previous post, AP comments very little on those infants who simply do better with a little time and space on their own; a little less handling — and little ‘breaks’ from being ‘attached’ all the time. Many of my readers have babies whose sensory systems simply could not handle all that attachment, and are so much happier with a little ‘breathing room’. And as infants become toddlers, they crave less and less dependence — and more and more independence. And we, as parents, need to walk that tightrope of ‘Rapprochement‘ with them.”

Really hits the nail on the head, if you ask me.

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Developmental psychologists love stage theories.  Although I’ve learned about and even taught these theories, they haven’t come to life as much as they will as I parent my little dude.  So I’m going to go through the ones that stand out to me, to elaborate where he is in his development according to each theorist:

Freud: My dude is in the oral phase of psychosexual development, which is characterized by a focus on the mouth as the center of sensation and taking in the world, evidenced by the importance of sucking and eating and the tendency to put things in one’s mouth to explore their characteristics.  This phase lasts until 18 months, so he’ll be here for a while.

Mahler: According to her theory of separation-individuation, until about his 5th month, the dude will be in the normal symbiotic phase, in which he does not understand himself as a separate being from me.  By his 9th month or so, he will progress through the hatching subphase towards separation and individuation,  characterized by his increased alertness and studying of the environment alternating with checking back with me. who serves as an orienting focus. 

Piaget: Until around 2 years of age, the dude will be in the sensorimotor phase of cognitive development, in which he uses his senses and motor abilities to take in and make sense of his immediate surroundings, which constitute his entire world.  At the end of this phase, he will start to develop the understanding of object permanence, that things continue to exist even when they are out of sight. 

Erikson: Throughout his infancy, the dude will be in the trust versus mistrust stage of psychosocial development, during which his relationship with the social world will involve the development of a sense of trust in himself, in others, and in the relationship between the two.  Although an experience of trust is important to establish, a bit of mistrust can translate well into a healthy sense of skepticism as he goes out into the world.

We’ve got a bit of time until the dude approaches the next stages of most of these theories, but it will be interesting to keep these in mind as he develops over the next few years and I hope to revisit this again as he grows.

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I’ve been reading some more from Diary of a Baby, and I try to remember this passage about the function of and infant’s cry when my little dude is screaming hie head off at me to feed him:

“Joey’s full organized cry helps deal with the hunger in two ways.  It’s a beautifully designed signal (police and ambulance sirens have learned from it) to alert his parents to his distress and to demand a response from them.  At the same time, it may help him to modulate the intensity of the hunger sensation.  Hunger, thus, creates in Joey ways of both reaching the outside world and coping with the one inside” (p. 35). 

Stern also describes how when an infant becomes hungry it takes over his or her entire being:

“It sweeps through an infant’s nervous system like a storm, disrupting whatever was going on before and temporarily disorganizes behavior and experience” (p. 32).

Yeah, I can kind of relate.

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I have lots of hopes and fears about raising a boy; chief among the fears are machismo, bullying, the draft, and strip clubs.   I hope he will be respectful, honorable, nurturing, confident but humble, assertive but gentile.  This will be a difficult task indeed given the current state of masculine culture, populated by the likes of Maxim, Grand Theft Auto, and 50 cent.   When power, aggressiveness and dominance are valued above all else, the complexities of emotional experience and human connection can suffer, often resulting in alienation and hopelessness. 

Maybe some of these books will help us navigate the way, now at the top of my “to read” pile:

Mothers and Sons: Feminism, Masculinity, and the Struggle to Raise Our Sons

Real Boys: Rescuing Our Sons from the Myths of Boyhood

Raising Cain: Protecting the Emotional Life of Boys

Dude You’re a Fag; Masculinity and Sexuality in High School

Misreading Masculinity: Boys, Literacy, and Popular Culture

While we’re at it, here are some more thoughts on this topic:

Men Growing Up to Be Boys

Talking to Men About Sexism

The Sopranos and the End of Masculinity

Depression Education Campaign Looks Beyond Machismo

The Tests of Masculinity

Masculinity and Gender Violence

Masculinity from Wikipedia

Constructions of Masculinity in Disney movies

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Originally, like say up until a few weeks ago, I always thought that babies sort of find their own rhythm when it comes to sleep, and you just have to roll with it until they mature enough to get into a regular pattern and sleep through the night.  I though that my little dude would let me know when he’s tired, and I would put him to sleep then.  This was of course until our most recent appointment with the pediatrician, in which she encouraged us to try to get him to nap an hour or so after he wakes, regardless of whether he seems tired.  She said that we should try to coax him into sleep with swaddling, putting him in a quiet room, turning off the lights, and so on.  The thing is, it’s not that easy.  There are times when this works, mostly during the morning and afternoon, and other times when he is totally awake for 2 hours or more at a time, and he reacts to us putting him down in his bassinet as if we were dropping him in a tub of ice cubes.  He’s not sleeping in the family bed anymore because it was starting to interfere with the family sleep, and he actually sleeps for longer strecthes at night when he’s swaddled in his bassinet.  So now I’ve started to think more about this whole sleep issue, and, quite frankly, spending a lot of time doing so as I’m still on maternity leave and have a lot of time to (over)think about these types of things.

There has been some discussion on a neighborhood parents’ listserv I subscribe to about different books written to help babies sleep better.  There seem to be a lot of different opinions about the books mentioned, and there seem to be so many out there it is difficult to know which one is most useful.  I’ve read The Baby Whisperer and The Happiest Baby on the Block, both of which were given to me by loved ones who found them helpful, and have found some useful information and tips from both (more so from the latter), but I still have some unanswered questions.  

Many of these baby sleep books claim to be supported by research, but do not cite the studies their methods are based upon, so I’m left wondering what method to use, or whether we need a method at all.  And much of their advice contradicts that of other authors.  What’s normal in baby sleep?  When should he be sleeping through the night?  How much should we sooth versus let him self-sooth?  Do we need to get him on a schedule or let him make his own?  Clearly this is a problem for a lot of people; there are so many of these books so there must be a market for them.  These questions could drive a parent bonkers, which is why I was thrilled when I came across this article from the New York Times from several years ago that actually discusses some empirical findings on this stuff.  The take home message is that most of the techniques outlined are effective, as long as parents are consistent in their implementation.  So it seems that you just need to find one you like and go with it.

The findings by Mindell, Kuhn, Lewin, Meltzer, and Sadeh (2006) were published in the journal Sleep.  I found a pdf of the article through Google Scholar, and here’s the abstract:

“This paper reviews the evidence regarding the efficacy of behavioral treatments for bedtime problems and night wakings in young children. It is based on a review of 52 treatment studies by a task force appointed by the American Academy of Sleep Medicine to develop practice parameters on behavioral treatments for the clinical management of bedtime problems and night wakings in young children. The findings indicate that behavioral therapies produce reliable and durable changes. Across all studies, 94% report that behavioral interventions were efficacious, with over 80% of children treated demonstrating clinically significant improvement that was maintained for 3 to 6 months. In particular, empirical evidence from controlled group studies utilizing Sackett criteria for evidence-based treatment provides strong support for unmodified extinction and preventive parent education. In addition, support is provided for graduated extinction, bedtime fading/positive routines, and scheduled awakenings. Additional research is needed to examine delivery methods of treatment, longer-term efficacy, and the role of pharmacological agents. Furthermore, pediatric sleep researchers are strongly encouraged to develop standardized diagnostic criteria and more objective measures, and to come to a consensus on critical outcome variables.” 

Before going into the specifics of their findings, and a description of which methods were included in their review, I want to highlight that the authors state in their introduction that the development of sleep regulation is primarliy a result of neurobiological maturation which can be influenced by environmental factors.  In other words, babies do tend to find thier own sleep and wake rhythm, but it can be thrown off course and put back on course through behavioral modification.

The strongest support was found for unmodified extinction, which involves putting the child to bed and not responding to protest until a set time the next morning, and for preventive parent education, which involves establishing good sleep habits early on, including “bedtime routines, developing a consistent sleep schedule, parental handling during sleep initiation, and parental response to nighttime wakenings” (p. 1267).  They also found support for: graduated extinction, in which crying and tantrums are ignored for specific periods but not the entire night (eg. Ferberizing): for bedtime fading/positive routines, which involves taking the kid out of bed if s/he does not fall asleep for a certain amount of time and sticking to a set bedtime with quiet activities respectively; and for scheduled awakenings, which involves waking the child before a spontaneous waking would typically occur (this is grossly over simplified, see the article for more detail).

Bearing in mind that most of these techniques were tested with children who were having established sleep problems at an older age than my little dude, the most applicable to our situation is the preventive parent education category, as we would be in the prevention stage, so to speak.  So, establishing good sleep habits is the task at hand, and how does one do that exactly?  One aspect of this, according to the article, that most of the strategies that fall under this category involve putting the child to sleep drowsy but not asleep.  I went back to Google Scholar and found one of the studies cited in this article in this category, Pinilla and Birch (1993) from the journal Pediatrics.  Here’s the abstract:

“The study objective was to investigate whether exclusively breast-fed infants could be taught to sleep through the night (defined from 12:00 AM to 5:00 AM) during the first 8 weeks of life. The design was shortterm longitudinal, from the last trimester of pregnancy until the eighth week after birth. Twenty-six first-time parents and their newborn were randomly assigned to treatment and control groups (13 in each group). Treatment parents were instructed to offer a ‘focal feed’ (between 10 PM and 12 AM) to their infants every night, to gradually lengthen intervals between middle-of-the-night feeds by carrying out alternative caretaking behaviors (eg, reswaddling, diapering, walking), and to maximize environmental differences between day and nighttime. All parents kept 72-hour diaries of their infants’ feeding and sleeping patterns every week from birth to 8 weeks of age and rated their infants’ temperament at birth and at 8 weeks. By 3 weeks, treatment infants showed significantly longer sleep episodes at night. By 8 weeks 100% of treatment infants were sleeping through the night compared to 23% of control infants. Treatment infants were feeding less frequently at night but compensated for the relatively long nighttime interval without a feed by consuming more milk in the early morning. Milk intake for 24-hour periods did not differ between groups. Treatment infants were rated as more predictable on Bates’ Infant Characteristics Questionnaire. It is concluded that parents can have a powerful influence on the development of their infants’ sleep patterns. Frequent night waking in breast-fed infants often results in early termination of lactation. Parents can teach their breast-fed infants to lengthen their nighttime sleep bouts, making the continuation of breast-feeding easier for the new mother.”

These strategies sounded familiar to me, and I realized that they’re actually described in another book I recieved as a gift, What to Expect the First Year.  So maybe I will try some of these strategies and see what happens.  I think what will be most difficult is stretching the feedings out by keeping him amused in the middle of the night.  I don’t know about you, but the only thing that will keep me amused in the middle of the night is sleep.  And what about daytime napping?  We’ll just go with the pediatrician on this one, as best as possible.  Fingers and toes crossed.

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In the past week and a half or so, the little dude’s gaze has been more focused and steady.  Sometimes he stares at faces, but at this point he seems to most become enraptured with shadows, windows, and several prints hanging above the living room couch which are primarily composed of black and white (by the fantastic Nikki McClure).  It’s exciting to see how curious he is becoming about his environment, and it made me think about a book I read in grad school about how infants experience the world, Diary of a Baby by Daniel Stern (1990).

Stern writes from the perspective of a baby at several points in his development, based on his and others’ research about infant psychology, constructing how an infant might take in and understand the feelings and sensations he experiences. 

“At six weeks of age, he can see quite well, though not yet perfectly.  He is already aware of different colors, shapes, and intensities.  And he has been born with strong preferences about what he wants to look at, about what pleases him.  Among these preferences, intensity and contrast top the list… A baby’s nervous system ins prepared to evaluate immediately the intensity of light, a sound, a touch - of anything accessible to his senses.  How intensely he feels about something is probably the first clue he has available to tell him whether to approach is or stay away.  Intensity can lead him to try to protect himself.  It can guide his attention and curiosity and determine his internal level of arousal.  If something is only mildly intense (like a lamp lit in daylight), his attraction to it is weak.  If too intense (like direct sunlight on him), he avoids it.  But if it is moderately intense, like a patch of sunshine on the wall, he is spellbound.  That just-tolerable intensity and contrast arouses him.  He immediately alerts in response to it… At this age , [he] is also drawn to areas enclosed in a clearly marked frame” (p. 18).  

My dude isn’t 6 weeks old yet, but I can already see signs of these preferences and where his atention is drawn.  The sunlight filtered through curtains is the right intensity to capture his gaze, and the shadows on the wall and the black and white prints draws his attention because of the light and dark contrast. 

Stern also writes about how it can be frustrating to try to hold a baby’s face-to-face gaze at this point in their development, because they are more interested in these contrasts; often, they instead stare up at their caretakers hairline, the frame of the face.  I’ve found this to be true of my dude frequently, though he is getting better at eye contact every day.  Faces become even more important later in development, but even this early, 

“The distance between the eyes of a baby at the breast and a mother’s eyes is about ten inches, exactly the distance for the sharpest focus and clearest vision of a young infant… the features of a human face are ideally designed to match what infants are born to prefer to look at” (p. 43).

Pretty cool stuff.

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All this talk about projection has prompted me to dust off my copy of Anna Freud’s The Ego and the Mechanisms of Defense (1966)  (and the little dude is having a bit more down time today, allowing his psychomama the luxury of time to go back to original texts and further comment).  In discussing projection as a normal process in the development of morality, she wrote, “…[The Ego] learns what is regarded as blameworthy but protects itself by means of this defense mechanism from unpleasant self-criticism.  Vehement indignation at someone else’s wrongdoing is the precursor of and substitute for guilty feelings of its own account” (p. 119).  She also wrote, “The effect of the mechanism of projection is to break the connection between the ideational representatives of dangerous instinctual impulses and the ego” (p.122).  For the purpose of this discussion, let’s think of the “ego” as referring to the part of our minds which contain our consciousness, our sense of self.  Later in life, projection can be a useful defense in the short term because it is protective of our sense of self, but it can be a rigid coping mechanism and we can become overly reliant on it, which may not make sense  or be adaptive anymore.  It can also lead to an experience of paranoia and exaggerated persecution from the outside world if we project our aggressive impulses onto others, and in a less extreme case, can make us not so fun to hang out with because we’re so adamate about criticizing others to preserve our self worth.

As psychoanalytic ideas are often (sometimes rightly so) criticized for lacking empirical support, I did a quick literature search to see if there have been any attempts to evaluate the process of projection in a systematic way.  And indeed I came across some research which found that “unfavorable traits were attributed to participants, who, when they were asked or predisposed to not think about the traits, subsequently projected them onto someone else” (Newman, Duff, & Baumeister 1997, p. 980).  If you’re curious about the design and execution of this study, the article can be found in the Journal of Personality and Social Psychology.  While their method asked subjects explicitly not to think about a trait, which differs from the psychoanalytic formulation of projection in that it is a largely unconscious process, these results are an interesting contribution to an understanding of projection.

As parents, we also project so much of ourselves onto our children, starting even before they’re born, but that’s a topic for another day.

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