Holiday Angst and Joy/Often they are two sides of the same coin

 Holidays can feel magical for some lucky kids, but by the time most people reach adulthood, those same holidays can stir up a lot of powerful feelings. Not all of them are necessarily positive. In many cases, the holiday season is the absolute set up for potential stress and disappointment. Depending on the person and the family, these feelings are often a mix of joy and dread. Hooray for you if you are an exception.

There is a reason that therapists need to work overtime in December.

Hallmark Christmas movies are an absolute treat, but the fact is, society sets a high bar for how it should be. Sparkling lights, delicious food, getting a pile of perfect gifts, family and friends gathering happily. What could go wrong?

The sad thing is that for many people, if you end up having a perfectly fine day, that isn’t good enough when anything less than extraordinary is apt to disappoint. Writer Rebecca Solnit puts it well. “So many of us believe in perfection, which ruins everything else, because perfect is not only the enemy of good; it’s also the enemy of the realistic, the possible, and the fun.”

It is a great time to focus on small moments of joy that we have within our grasp. Are you feeling low? See if you can dig down and find something that can bring some cheer. Even looking at some sparkling lights, or being cozy inside on a rainy evening. If you are lucky enough to have your kids at home, can you do a family snuggle and tell stories?

This is also a good time of year to remind ourselves to be clear on the difference between things we have control over and those that we don’t.

Gifts

You have very little control over what you receive, but if you pay more attention to what you are giving, you can’t be disappointed. This is a great lesson for the kids.

Start early focusing on how wonderful it is to give. A good gift doesn’t have to be something you buy. Give the gift of your time, or something you make. How about a foot massage to family members? Sign me up.

In case you didn’t see it, here is the post that I recently did about gift giving

Something to keep in mind is that when it comes to gifts, everyone has different wants and needs.

This is the perfect time to remember those “love Languages”

You might also decide to give one big family gift, like an outing or a trip, instead of individual ones. There are no rules.

Another thing that can be tricky might be the timing of the gift. There are many things out of your control including shipping and/or availability of a desired item. The value of the gift should not be dependent on whether or not it ends up under the tree in time. If something is delayed, take a photo of whatever it is and put that in a box or envelope. The actual gift will get there when it gets there. I remember some years when people were ready to take out an extra mortgage in order to get a hold of tickle me Elmo or a Cabbage patch kid. Try not to get caught up in that. Take a deep breath.

Family

Some families have complicated dynamics that can be very stressful. If this is you, please know that you are by no means alone. Try to focus on the things that you love and appreciate about each other rather than the things that you disagree with. If it is at all possible, maybe have an agreement ahead of time to leave politics at the door.

If you are lucky enough to have a family that you want to be with, and it is the togetherness that is what counts, forgive me for this suggestion, but the actual holiday maybe doesn’t need to be the exact time of year that you gather. There is something very freeing about avoiding travel when the rest of the world is also fighting to get to their destinations and paying twice as much to get there.

I know plenty of people who celebrate a week early or later. There is nothing wrong with that! (If you are reading this from a long line in a crowded airport, maybe consider this for next year.)

My friend Brittany, who is a wise therapist, adds that it is important to be cognizant if this is the first holiday/Christmas since a loved one passed. If you have experienced loss, it is okay to initiate dialogue about how you miss the friends and/or family members who are no longer with you. Try to tell stories and share happy memories instead of avoiding their absence.

Traditions

Take stock of your holiday traditions. Believe it or not nothing actually needs to be set in stone. You get to choose which ones are achievable or not and which ones bring you joy. Is there something on the list that should no longer be on there for whatever reason? Cross it out! See if it is missed. Identify which things matter and which things simply cause stress and don’t add value. Talk to the kids and find out which things matter the most to them.

Food tends to be an important part of any holiday culture. Making a family recipe or special meal can make you feel close to relatives even if you are far away from each other. Bring the laptop into the kitchen and cook or bake together on zoom.

You can also adopt new traditions. Have a virtual sing along with friends and family near and far, watch the Twilight Zone marathon. Reach out to people in your lives who may not have friends and family around.

Last year we started the tradition of taking Elliot out in search of fun holiday lights. Watching his enthusiasm when he spots pretty ones is the best.

“These are the most beautiful lights I have seen in my entire life!” says the almost four year old.

Moving forward, forge traditions that feel positive and are easy to achieve.

Maybe your kids will be the ones who grow up without any holiday angst!

Here are some past Holiday related posts that you might want to check out

Holiday safety tips

Talking to your kids about Santa Claus

Pertussis and Walking Pneumonia/ Both of these are making the rounds

 Dr. Ted has been seeing quite a few patients with nasty coughs this season.

We decided to address two of the main culprits here; walking pneumonia and whooping cough. (There is a trifecta of sorts going around. RSV numbers are also up, Here is the link to the post we did on that just a couple of years ago)

Pertussis and walking pneumonia are similar in that they are both very long lasting and very annoying. They do have some key differences.

Pertussis

Commonly known as whooping cough, pertussis is a very contagious respiratory illness caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins, which damage the cilia and cause inflammation.

Historically there is a population-level cycle associated with whooping cough. It seems to peak every 3-5 years or so, and we are currently seeing a bump in numbers. Preliminary data show that more than six times as many cases have been reported as of November 23. 2024 compared to the same time in 2023.

Vaccination

Fortunately most kids are vaccinated. It is routinely given as part of the standard shot schedule. The P in the Dtap and then later in the Tdap stands for Pertussis.

The vaccine does a pretty good job of preventing death and severe disease. Unfortunately it only partially decreases transmission and vaccinated people can still get sick, but it is usually a much milder case.

Even though most kids in the USA get the protection, it remains one of the leading causes of vaccine-preventable deaths worldwide. According to a CDC 2014 publication, there were an estimated 24.1 million pertussis cases and 160,700 deaths in children younger than 5 worldwide. By far, most of the deaths occur in young infants who are either unvaccinated or haven't had at least 2 shots in the series.

Babies routinely get their first vaccination for this around 2 months of age. The primary series is given at the ages of 2, 4, 6 and 12-18 months, and again before kindergarten entry. Unfortunately, significant protection isn't achieved until the 4th shot at the 12-18 month visit. The four doses gets them up to 75% protected. This goes up to ~90% after the 5th dose (known as the booster.)

Thankfully, ever since the state law imposed vaccination entry requirements for school, we don’t have many patients trying to avoid getting this immunization. Back in the day, I did have some parents opt out for a variety of reasons. Most of them deeply regretted it and confessed that watching their kids suffer with the months of coughing spasms was torture. The shot is well tolerated and it makes no sense to pass on it. I have deep concerns if the vaccination ever stops being required.

The Tdap (Tetanus/Diphtheria/Pertussis) vaccine was licensed in the US in 2005 for people over the age of seven. Because babies are so vulnerable to this illness, current practice recommends giving all pregnant moms a Tdap (with every pregnancy). This immunization should be done in the third trimester between 27-36 weeks. Studies have found that since this program began there has been a 75 percent reduction of infant pertussis hospitalization and a 46 percent reduction of any infant pertussis cases. That is enormous progress.

For folks who will have a newborn in their lives, if it has been more than 2- 3 years since you had the shot or the actual illness you should get another booster. The immunity wanes. Researchers claim that three out of four babies who get pertussis get it directly from family members or caregivers. It is essential that all close family contacts have current vaccine protection. This means partners, grandparents, caregivers and siblings or anyone who anticipates spending lots of time with your new baby. This way everyone will be able to remember the date of their most recent tetanus shot; it will be right around your baby's birthday!

If you have family members giving you push back about this, (sigh, people can be so disappointing) they are welcome to keep a mask on at all times. Unlike COVID, which is airborne, pertussis is spread by respiratory droplets, so masks actually work to slow the spread.

Symptoms

This illness usually starts with a week or two of a runny nose and cough. There may or may not be a low grade fever. Those little snot nosed kids don’t always look terribly sick, but they are quite contagious.

This is why, when you have the option, please keep anyone with a cold from being around your infant. We never know if it is going to turn into something worse.

At week two, the cough becomes much more troublesome. The patient will often have coughing fits….and I mean FITS!! This is spasms of coughing for minutes at time that make even the hardiest person feel like they can't catch their breath.

Patients may or may not have a high pitched "Whooping" sound with the cough (hence the name). Some folks will vomit after these coughing fits or pop blood vessels in their face. Sweating, gagging and choking episodes are common. Some people cough so hard from this that they can break ribs.

Remember, these symptoms may all be much more mild in people who have been vaccinated, but the overall pattern of the coughs coming in deep sporadic fits throughout the day (not just at night) remains the same.

Babies often don’t whoop because young infants often do not have the intercostal (rib) muscles required to cough. Instead, they might just stop breathing briefly or seem really lethargic. They can look cyanotic from the lack of oxygen. It is scary!

For both the vaccinated and unvaccinated, this cough lasts and lasts and then lasts some more. In Chinese medicine this is referred to as the "Hundred day cough" and they aren't kidding. This is a miserable illness for anyone, but for young infants pertussis can be deadly.

Plenty of adults get this and don’t get a diagnosis. It is not on the radar for many adult doctors.

Exposure

People who have been exposed to whooping cough will usually start showing symptoms 7-10 days after the exposure and are contagious by the time they give that first sneeze. Remember, this disease is spread by respiratory droplets, so mask wearing and hand washing are very effective at decreasing exposure.

Testing

Unfortunately, testing is far from perfect. There isn’t a rapid test that will give you immediate answers, and waiting for results is not ideal. Testing requires a deep nasal swab (nasopharyngeal), and results often take 3-5 days to come back. Most doctors who suspect Pertussis are likely to start treatment right away, especially if there is a young baby in the household. But according to public health departments, it’s recommended that anybody with a high enough suspicion for a test should be treated automatically (before results come back). Then, presuming they might have the disease, it’s recommended that they stay home from school or work until they’re done with the course of antibiotics. More on treatment below.

Treatment

Treatment usually involves 5 days of antibiotics like azithromycin or clarithromycin, but these are mainly to prevent the spread to others since antibiotics don’t do much to shorten the course of illness once the cough has set in. The good news is that after you’ve finished 5 days of antibiotics or you’ve had symptoms for 21 days (whichever comes first), you’re no longer contagious to others. Therefore, if you’ve been sick for 22 days, you can probably skip the testing as well as the antibiotics. Testing is simply for data purposes, it won’t really change anything. The stick up the nose is not particularly comfortable.

Symptomatic treatment is similar to what you would do with other coughs. This includes a cool mist humidifier and drinking plenty of fluids. The extra moisture in the air can really make a difference with the pertussis cough, so if you don’t have one, a humidifier is a good investment. Smaller more frequent meals may help make vomiting less of an issue.

Inhalers, steroids and cough medicines don't seem to be of much use alas, although honey (Manuka if you can get that) might be soothing. Remember that babies who are less than a year old can’t have honey yet.

Smoke exposure will make things much worse. Skip the campfires.

Walking Pneumonia/Mycoplasma Pneumoniae

We wanted to include a section on walking pneumonia, because it’s another reason you might have a months-long deep cough that doesn’t seem to be getting better. The numbers for it are also up enough that it is getting some media attention.

Symptoms

This is more of a slow-burn infection that settles deeper in the lungs. It typically causes a lingering, dry cough, fatigue, and sometimes low-grade fever. It can leave you feeling out of breath. Unlike pertussis, it doesn’t release toxins but instead, it directly invades the respiratory lining.

Testing

If the section above about pertussis testing left you feeling unsatisfied, then get ready for the ultimate disappointment. There are very, very few commercially available tests for the causative agent, mycoplasma. Physical exams will sometimes show little signs through the stethoscope, but that’s not consistent. You can get an x-ray of the lungs, but that also doesn’t always pick it up. So we’re left with the story, symptoms, exposures, and good guesses.

Treatment

Like pertussis, treatment usually involves antibiotics like azithromycin or doxycycline, which actively target the bacteria and usually help symptoms resolve faster (unlike pertussis). For those who really resist taking antibiotics, time is the great healer and it will go away on its own…eventually. While the vast majority of cases resolve without treatment, immunocompromised individuals can have some serious sequelae.

Whooping Cough vs Walking Pneumonia

How can you tell the difference between these two diseases? In summary, from a physiological standpoint, the big difference is that pertussis mostly affects the upper airways and is toxin-driven, while mycoplasma pneumonia targets the lower airways and works by directly infecting cells. Both can be annoying, but walking pneumonia tends to be less dramatic and more sneaky. The patients don’t always feel super sick but just kind of ‘off’. The cough here is more nagging and dry, usually without the violent fits of pertussis. Your child might seem tired, have a sore throat, or complain about mild chest pain. Fever tends to be low-grade or not even there. It’s actually most common in older kids and teens because mycoplasma pneumoniae, the causative agent, likes to circulate where kids are packed together—schools, sports teams, etc. Kids with asthma or other chronic respiratory issues are more likely to get hit harder if they catch it.

While vaccines exist to prevent pertussis (hello, Tdap!), as of yet there are no vaccines available for Mycoplasma pneumoniae.

Dr. Ted’s advice:

If your child’s cough has been dragging on, especially if it’s dry and disruptive at night or after activity, or if they’re looking more tired or out of breath than usual, those are good reasons to check in. Whooping cough can feel more urgent because of how intense it gets. Always worth a quick listen to those lungs or a swab to rule things out. Follow up with your pediatrician if you think something’s up!

It's gift giving season......But I have some thoughts

 The internet has me pegged as a Grandma and I am getting daily targeted ads about things I should buy the grandkids.

I actually found myself unable to resist buying a little battery operated poop toy that you can play hide and seek with. It makes farting noises to give clues.

EJ thinks it is funny, but it was probably an unnecessary purchase.

When I am spending time with my grandsons, the thing that I am reminded of is that they don’t actually need too much stuff.

Sawyer still doesn’t do screen time, but he sure loves the TV remote.

At nine months Coby is more excited by finding the mother lode of tupperware than most of the other toys that are scattered around, and at almost 4 years old, EJ can spend a shocking amount of time thriving with an empty tissue box and a roll of scotch tape.

It is certainly the time of year to update this post from several years ago:

The Best Present is usually your Presence

Good parenting requires twice as much time and half as much money.

This is the season for gift giving, but we all actually could do with a lot less stuff. The best present I think that families can give to each other is the gift of self (otherwise known as time and attention.)

For kids who are old enough to understand, give a certificate that promises a special activity that you might do some time in the future. For older kids, escape rooms are a ton of fun (they now have some virtual escape rooms available if you don't feel up to going in person.) A membership to one of the local museums or the Exploratorium is another good gift to give to the family.

It is great for families to do outings altogether, but one-on-one time is so important if you can manage it. Mix and match so that you make sure that everyone gets special time with one other family member. Make sure to include one on one time for you parents as well.

The list of Nurse Judy's inexpensive and creative activities has some old and new ideas.

• Collect and decorate rocks with colorful paints and glitter for a rock garden. This is a great one to use as a reward for good behavior. When your child sees the pretty rocks, they will remember that they earned them.

• Make a collage. Old magazines and old photos are great for this activity.

• Make a musical instrument. Use your imagination: a shoe box with rubber bands can be a guitar; glasses filled with different levels of water make different tones; tapping different surfaces with chopsticks makes different sounds.

  If you are lucky enough to have real instruments, Let them play!

• Go on a 'use all your senses' walk. What do they see, smell, hear, and feel? (This is also a great way to practice mindfulness, which everyone can benefit from!)

• Make personalized place mats. Take some family photos, glue onto cardboard, and cover with clear contact paper. Kids will love to use these with meals.

• Create a scavenger hunt walk. Plan a list ahead of time of thing to find...like a dog, an airplane, or even a girl with purple hair (or if you live in San Francisco you might be able to add some more unique items to the list -- a memory comes to mind of a younger Lauren loudly calling attention to the naked man painted gold, while Alana somehow managed to completely not notice him).

• Go on an ABC hunt. Find things that start with all the different letters...or find the actual letters on signs and license plates. This is a great game in a supermarket or on a car ride.

• Download free coloring pages from the internet. With a little searching, you can get a picture of just about anything.

• Draw with chalk. Make a hopscotch board.

• Make your own play dough. You can find the recipe online.

• Make a fort using the couch cushions,

• For a special occasion, set up the tent and have a backyard camp out (During the kids last visit, Sandy and Elliot set the tent up in the garage) It is actually a good thing to air them out once in a while.

• Write a story and illustrate it together.

• Decide on a recipe and bake or cook something. Kids will often try foods more eagerly if they helped with the cooking. Let them help sprinkle in different spices and be the taste-tester.

• Have a tea party. Invite the dolls, and get out the good china that you never use.

• Trace your hands and feet and color them in.

• Have some down time while watching a video or a special TV program. There are some lovely educational TV programs and videos out there.

• Play a computer game. Don't be afraid of controlled use. Children that don't learn how to be comfortable with computers at a young age are at a distinct disadvantage in this high tech culture.

• Okay, now put that screen away and get some fresh air! Families can play some sports outside. Find a patch of grass, a basketball hoop or one of the city tennis courts and get active.

• Blow bubbles.

• Playing board games with the family is the stuff that great memories are made of.

• There is little out there that is as much fun as a giant box to get inside of . If you buy a new appliance or see a neighbor buying one, ask for the box.

• Make a rain gauge and weather station. If it does rain, get out the galoshes and find some big puddles to jump in.

• Play dress up. In my opinion, every house needs a good dress up box, (after Halloween is a great time to pick up costumes and things on sale)

• Read!

• If you can manage to make it work, try hard to have at least one meal of the day sitting down with the entire family. Have everyone say a little about their day. Having one child help with cooking a special dinner, including making and decorating a menu is a great way to have one on one time.

• Take advantage of where we live; there are always fairs, festivals and museums that are going on.

• Make a scrapbook with keepsakes and photos of all the fun activities

• Unless you are using the phone or tablet as part of the activity make sure you put them down and be fully engaged in what you are doing (emails can wait)

  For Those lucky enough to live in or near the Bay Area, here is my list of quirky, only in SF things to do.

• At the start of the pandemic, my daughter Lauren created a list of fun, at-home improv activities you can play as a family. Even though, thank goodness, the pandemic is over, this list is something to keep for a rainy day

• Fort Funston: Bring some dog treats and take a walk. You are pretty much guaranteed to see lots of fuzzy friends to pet. If you are lucky you will see hang gliders. (Free)

• Take a ferry ride. The route from the Ferry building to Jack London square is super easy, and there are snacks and a bathroom available!

• Turrell Sky dome: For this you need an admission to the De Young museum. Many folks have no idea that this magical place exists. Go out to the garden by the cafe and follow the path and signs down to the sky dome. Once you are in there, make sure you sing and listen to the acoustics

• The camera below the cliff house: Lots of folks don’t bother stepping in there, but it is worth it. The Camera Obscura gives a real time 360 view of the surrounding area. It is only open when the weather is clear. It isn’t free, but it is reasonably inexpensive

• The Wave Organ: This is an old exploratorium exhibit that remains at the end of a jetty behind the St Francis Yacht club. When the tide is right (good luck, I have rarely been there are the right time) pipes will play music. It is an enchanting place regardless, especially if you are there when no one else is out there. It is free

• Musee Mecanique - If they love it there...consider earning points for future play there

• Labyrinth down at Land’s End is worth checking out.

• Walking tours are free and plentiful. These are a fun way to get outside and learn a little history of the city.

• The Gingerbread house in the lobby of the Fairmont Hotel is worth a trip. It is only there until the New Year. This is free unless you opt to splurge on the very expensive tea.

• I love the Stairway walks of SF book. If your child is old enough that they don't start asking to be carried half way through the walk, these are a great family activity.

• Sing-a-longs at the Castro Theatre (currently getting renovated, but hopefully these will start again in mid 2025)

• Volunteer as a family.

• Groupon and todaytix are great ways to find the deals out there!

• https://www.sftourismtips.com/san-francisco-with-kids.html

• https://tripswithtykes.com/free-things-to-do-in-san-francisco-with-kids/

If you are not in the Bay Area, do a little searching to find your own local treasures

Happy Holidays. Go out and make some wonderful memories!

Intensive Parenting/Can your child survive if you don't monitor their every waking minute?

 In August 2024, Surgeon General, Dr. Vivek Murthy, issued an advisory on the mental wellbeing of parents. The report, Parents Under Pressure, shares that caregivers and parents are experiencing elevated levels of stress.

Really? Parenting is stressful? This comes as little surprise to those who are dealing with bedtimes, mealtimes, tantrums etc.

For those who do not have the bandwidth to read the entire advisory, it goes on to say that one-third of parents with children under 18 rate their stress level as 8 or higher on a 10-point scale, according to psychological association data. Two-fifths of parents report being “so stressed they feel numb.” Three-fifths say stress makes it hard to focus. Two-thirds are consumed by money problems.  

In every case, parents report markedly higher rates of stress than non-parents. 

Background

So what is the benefit of spotlighting parental stress? Does pointing it out just add more stress?  Actually, if shining a light on it might help us identify some potential action items, we think it is worthwhile.

The Parents under Pressure report places some of the blame on something called intensive parenting, which is what today’s post is about.

Intensive parenting is an ideology that parents’ emotion, energy, time, and money should be focused on their children (Hays, 1996). It is suggested that this has been a major strategy of parenting in many developed countries. 

How did we get here?

Everything makes more sense with a little context, and the pendulum always swings just as far in the opposite direction. In this case, the pendulum we are discussing is parenting styles. Intensive parenting is closer to one edge of the spectrum.

On the other extreme, in 1945 Rene Spitz found that children in homes and hospitals that were deprived of touch and emotional contact were caught in debilitating grief. This is where Spitz coined the term “Failure to Thrive (FTT)  “Such babies were deprived of 'maternal care, maternal stimulation, and maternal love”  (What Do Babies Need to Thrive? Changing Interpretations of 'Hospitalism' in an International Context, 1900-1945). 

Then psychologists John Bowlby and Mary Ainsworth weaved together decades of conjoined research to establish Attachment Theory. In short, intensive parenting “appears” to be the answer to avoid raising children who are emotionally starved, failing to thrive, or at risk of becoming insecurely, or avoidantly attached. Looking more closely we now know that there needs to be a middle ground that doesn’t require choosing between parental burnout or thriving children. Both are possible! (Here is something to watch with more about Secure Attachment).  

Recognizing Intensive Parenting

We understand, of course, that there is no way to eliminate all parental stress, but if you can recognize if you’ve swung too far into intensive parenting, this can be one component of the issue. Let's take a closer look at intensive parenting and see if you can relate.

Take a moment and internally answer a few true/false questions. 

• Women are inherently better/more natural at parenting than men. 

• Parenting should be fulfilling and a delight. 

• Children should be cognitively and intellectually stimulated by their parents.

• Parenting is difficult and the most demanding job.

• Parents should prioritize the needs of the child above everything else.

More “yes’s” than “no’s” (three or more out of five) are indicative of this existential intensive parenting culture that is rampantly informing parenting behavior, cultural norms, and policy in our country.  

Some intensive parenting behavior is driven by social media (clicking this link will either make you laugh or cry). That is something parents 40 years ago didn’t have to deal with. To be fair, parents were playing the ‘look what my kid can do” and “you aren’t doing that right” game, long before Instagram came along.

But social media can’t be classified as something that is necessarily bad. Many parents get valuable insight, great little tips and support from some sites. Parenting can be very isolating so if positive connections can be found, we wouldn't want to take that away.

On the other hand, social media can also be a megaphone for misinformation as well as feeling judged and inadequate. The key is trying to figure out if something is making you feel good or bad. It’s not always easy to identify. 

My daughter Alana, a mental health therapist puts it this way to her clients. If you had a gas tank, is this thing adding gas to your tank or siphoning it away?

And if it’s draining your tank, take steps to remove it from your orbit. Give yourself permission to “unfollow” or “mute” those accounts when you find them.

Another extreme consequence of Intensive Parenting

Intensive parenting potentially teaches kids that they have unlimited power. When parents are constantly tending to their every whim past developmental necessity, providing stimulation, comfort, etc., children don’t have to learn to problem solve. One classic example of this is the parent who steps in at the first “I’m bored” to become the head of the entertainment committee. Another is when you become a short-order chef for your 2-year-old.

While we want your child to have a sense of empowerment, the most authentic way for them to get that is by achieving some things on their own.

I would go out on a limb and say that where effective parenting is concerned, it should be very clear that you are ultimately in charge. Not the three year old who really wants to see how many tennis balls fit in the toilet. Parents sometimes need a gentle reminder of this.

What can you do to combat Intensive Parenting? 

The Surgeon General’s advisory urges a societal shift to recognize and support parents’ mental health needs, and frames this as crucial to family and community health. Realistically, massive societal change is not immediately in your power. We need to start at the level where the agency lives, which is in your mindset, and behaviors. 

Sometimes restructuring things just a bit can make a difference.

Brittany addresses this in her work with parents and families. She spends a significant amount of time trying to convince parents that their self-care is not harming their children, and it is essential to their child’s present health and future development. There is a toxic message hidden within the intensive parenting ideology that parents' needs are less important than those of their children. Parents need sleep, healthy food, adult social stimulation, alone time, exercise, and play. When parents prioritize these things for themselves, health naturally overflows to their children. Parents parent from a better place, and the family system is overall healthier and more resilient. 

Here are her top actionable steps she gives parents: 

• Minimize digital toxins, i.e. social media that is rigid or not supportive. Try turning those alerts off so that you can better control when and how much you “see.” It’s okay if you’re not the first to like that new post. Have boundaries on news consumption.

• Maximize nutrition. Eat enough protein, fruits and vegetables. A lot of parents are walking around “hangry” and malnourished. 

• Spend time in nature 

• Build a supportive in-person community. Sometimes that’s with individuals we share genes. Most often it’s found in our “framily.”  This also means minimizing exposure to “energy vampires,” the people in your life that you find draining. This might unfortunately include close family members, at times.

• Mindset is life. Connection above perfection! And her personal favorite, “this isn’t happening to me, this is just happening.”

There is a fear that stepping away from your responsibilities as a parent makes you selfish, or that your child and their development will suffer. We do not advocate going back in time to the 1940s, as above, and fully ignoring your child. As professionals, our experience is that your kids will turn out ok if you step back a little bit to take time for yourself. Better than ok…we find that parents who prioritize themselves can raise more holistic humans. Remember, you’re a role model. What do you want your kids to be like when it’s their turn to raise a family?

Concluding Thought… 

Clearly, if you are among those who are feeling stressed out, you are not alone. Here is an old post from Nurse Judy that lists some more action items you can take to ease things a bit

Sometimes being a parent is all consuming. It is easy enough to lose sight of who you are once you take off your mommy or daddy hat. We suggest making a concerted effort to have some time for yourself and as well as your partnership. This benefits everyone in the family. You get to see that your kid survives without your 24/7 attention. 

Since financial stress is a real thing for many people there are creative ways to work around that. If you have friends with kids, take turns establishing a babysitting schedule where you can alternate helping each other out. Dates don’t need to be expensive. A picnic, a candlelight bath (remove the rubber ducks…or not), a romantic walk, a prolonged foot rub are great options.

Remember, more is often caught than taught when it comes to children, so it’s never too early to set a good example.

This post was a collaborative effort between Dr. Ted, Brittany Williams MAMFT, and Nurse Judy

The World could use a dose of Mr Rogers These Days

 I first ran this post several years ago after there was a week that seemed to have one horrible headline after another. It feels like a good time to run it again.

A generation of children grew up to be better people because of the lessons Mr. Rogers taught, but I wonder how many little ones know who he is anymore? 

He was as genuinely kind in person as he was on television. I know this because when I was a nurse at Children’s Hospital of Pittsburgh, he was a frequent visitor there.

He actually had the opportunity to personally console me one day.  I had chopped my waist length hair into an awful perm. I guess I was visibly upset over this bad haircut. What lessons did help me remember?

• Hugs help 

• Hair grows back.

Here are some of my favorite pieces of his wisdom:

• There are three ways to ultimate success: The first way is to be kind. The second way is to be kind. The third way is to be kind.

• There is only one thing evil cannot stand, and that is forgiveness.

• There's a part of all of us that longs to know that even what's weakest about us can ultimately count for something good. It is okay not to be perfect!

• Solitude is different from loneliness, and it doesn't have to be a lonely kind of thing.

• Accept people as they are.

• Look and listen carefully.

• We all have feelings. Talking and acknowledging them is the first step towards finding ways to deal with them that don’t hurt anyone.

• Anything that's human is mention-able, and anything that's mention-able can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we're not alone.

• Wonder about things

• You can’t go down the drain in the bathtub. Don’t be shy about sharing things that might be scary.

• Be yourself. It is not how you look, what you wear or what toys you have that make you special.

• What can you grow in the garden of your mind? Use your imagination.

• You rarely have time for everything you want in this life, so you need to make choices. And hopefully your choices can come from a deep sense of who you are.

• One of the most important things a person can learn to do is to make something out of whatever he or she happens to have at the moment.

• Often out of periods of losing come the greatest strivings toward a new winning streak.

• Often when you think you're at the end of something, you're at the beginning of something else.

• There are times when explanations, no matter how reasonable, just don't seem to help.

• Love isn't a state of perfect caring. It is an active noun like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now.

• Look for the helpers. Those might be a person in uniform, or another parent with children. 

People have reached out to ask me how I am faring after the election. Actually, I am on a ‘headline hiatus’ for another week or so.

While I realized that many people are celebrating what they see as a victory, Personally, I am confused, sad and frightened.

At some point, when I am ready, I will  look at the world, roll up my sleeves, remind myself of some of Mr. Rogers' finer pieces of wisdom and see what I can do to make a positive difference

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The ghost in the Mirror/Leaving your kids alone for the first time...what could possibly go wrong?

 Several months ago, I saw a news article about how old your child needs to be before it is okay for them to be left at home without supervision. The guidelines vary widely from state to state. Interestingly, when it comes to actual laws, most states don’t have a specific age. 

I know that  it feels like just yesterday that your kids were still in diapers, but for most families, comes the time when it is very reasonable to transition from needing a babysitter.

There are obviously a lot of factors to consider.

• Does your kid tend to be responsible?

• Are they comfortable being left alone for a bit?

• Are there neighbors or resources nearby if needed?

It all brings to mind a true story about a time that I left my youngest daughter Alana home for the first time. Things didn't go exactly as planned.

She was somewhere between 10 and 11.

There was no school that day. It may have been a conference day, but I don’t actually recall. In any event, none of the parents were easily able to take the day off. 

We arranged for two of her closest friends Lauren T and Yael to spend the day at our house.

These were very responsible and fairly mature kids. Also, I was only 7 minutes away at the Noe Valley Pediatrics office if they needed me.

All of the parents  would take turns checking in. We felt pretty comfortable with the plan.

I was not expecting any issues, so I was surprised when mid day, Alana called me in a complete panic.

To the best of my recollection the conversation went something like this

Mommy, we need you to come home right away!

Is everyone okay?

There was a ghost in the mirror, please come home!

Um, excuse me? Please take a deep breath and tell me what is going on.

We tried to conjure someone and he appeared. There was a 4th set of eyes reflected in the mirror. We all saw this. PLEASE, just come here and we will tell you the whole story

If I need to leave work for something bizarre like this, I am going to be mighty annoyed.

We will do anything. No allowance for the rest of my life. Please come home.!!!!

I tried one last thing.

Surely Java would bark if there was something creepy in the house

(In all honesty, Java, our golden retriever would more likely bring the ghost her ball and ask him to throw it. She wasn’t much of a watchdog.)

Java is already out with the dog walker. She isn’t here. Please come home!

So, I explained to my office that apparently there was a ghost in my bathroom mirror and I needed to leave. Bless them, they were remarkably supportive.

I got home and the three girls collectively flew into my arms.

They tearfully told me what had happened.

MTV had a show called 2together that featured a fictional boy band. If you are in your thirties, you might remember the show. Both of my girls were huge fans. Lauren’s room was plastered with 2gether posters. (Sigh, they are still up there. Her childhood room is where I do much of my writing and it is frozen in time).

In January 2001, the youngest member of the band had died from leukemia.

All of their young fans were devastated over this tragic loss.

So here they were, a month or so after his death.. Alana and her friends decided to create some type of ritual. They went into the dark bathroom, stared into the mirror and chanted his name over and over. Suddenly, at the same time, they all swear that they saw a 4th reflection staring back at them.

This was more than 20 years ago but some memories stick with you.

Lauren T. remains one of Alana’s closest friends after all of these years. Here are her recollections in her words:

It was a Jewish holiday (this is what I remember, but you are probably totally right that it was parent-teacher conferences), and Alana, Yael, and I all had the day off. We were at Alana’s house, and it was one of those gray SF days, where the sun perhaps gave minimal effort to bust through in the morning, but had long since given up before the moment in question. 

Michael Cuccione, one of the stars of 2Gether and our mutual tween crush, had recently passed away. We decided to try and contact him through a practice called “Ghost in the Mirror.” In my memory, we were giddy about it, giggling our way to the bathroom, the soft carpet of the Kivowitz’s house on my feet, the coziness of the day still palpable all these years later. 

I stood in the middle, with Alana and Yael on either side, their hands in mine. We turned off the lights. I closed my eyes. We started chanting in unison, “Michael Cuccione. Michael Cuccione. Michael Cuccione. Micheal Cuccione. Micheal Cuccione….” All of a sudden, I heard Yael and Alana screaming. I opened my eyes to two bright yellow eyes making their way down the mirror and out towards us. We all scrambled to open the door. It was stuck. We finally got it open and raced down the stairs. 

I sat in one of the big living room chairs. My finger was bleeding. Was it because I had nicked it on the door handle…or something more sinister? 

I of course remember Judy coming home. Relief, warmth, safety…and I think subconsciously, a sense of understanding. I think back now to what it felt like to have an adult not just hold space for our fear, but also for our mischief, our curiosity…our wonder. It’s a moment that surely changed me, and what an invaluable gift that the adult in the room found a way to both comfort us and also validate us - a line I can only imagine was challenging to toe. 

I’m so grateful that Judy didn’t try to explain away the “logical” reasons why this might have happened, like so many other adults in my life.I know what I saw, but more importantly, I know what I felt. And I will never, ever forget it. 

For the record, I am not sure that I didn’t try (and fail) to find a rational explanation for what had happened. Also, Alana does NOT remember me being quite as warm and fuzzy that day, but I appreciate Lauren sharing her memories!

And yes of course this story will be included in the book that I am working on.

………………………………………………………………………………………………..

If you are at this transitional stage when you are getting ready to let your kiddos stay home alone:

• Start small, leave them alone while you do a short errand and see how that feels.

• Have rules and expectations set and discussed in advance such as not leaving the house or opening the door to stranger.

• Make sure that no one has access to firearms.

• Until they are old enough that this isn’t an issue, have safe food and snacks available so that they don’t need to be using the stove or doing actual cooking.

• Make sure they know where flashlights are and that the batteries are working.

• Have all the phone numbers for emergency contacts written down, don’t rely on a cell phone.

• Arrange routine check in’s.

• Oh and……absolutely NO conjuring any spirits

Because you never can anticipate everything, as evidenced by this story, you might consider this game/exercise that I did with my kids. It helps your children work on essential problem solving skills.

I couldn’t help using this photo. Lauren now has an album out on Spotify called Old Haunts and Alana was her ghost.