Smart Women Week

Red SWW_Instagram Organic Feed_Holan Liang

Jo Malone CBE

Kelly Hoppen

Melissa Hemsley

Trinny Woodall

Ella Mills

Clemmie Hooper

(lots more amazing and smart women)

& Me!

I can’t believe that I am going to be part of this amazing line-up at Red Magazine’s ‘Smart Women Week’ September 18th-22nd. I have been a great fan of Red Magazine the last 10 years and so I was absolutely chuffed to be asked to speak at their London event about all thing’s child mental health. If you would like to come along, please see the link below for tickets!

smartwomenweek.co.uk

It’s all in the Mind: Psychosomatic and Somatopsychosis

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Watching Molly do cartwheels the other day, I discovered a new psychiatric syndrome: somatopsychosis. It’s a very rare condition and she may be the only sufferer largely due to her terrible parent: me.

Most of us are aware of the miraculous power of our minds over our bodies and the inextricable links between psychological problems and physical problems. At the most basic, feeling physically unwell can make us feel sad about not being able to do things we wanted to do, or anxious that we may have a serious or life-threatening illness. Being a medical student was the worst. Reading lists of symptoms of rare neurological diseases was bound to bring on symptoms of blurred vision, pins and needles and lethargy such that a self-diagnosed brain tumour became a convincing reality. Conversely, when we experience bereavement, adversity or tragedy, we often feel it physically as “heartache” or “headache” or “tiredness” and “sleeplessness”. The term “psychosomatic” is basically a fancy way of saying bodily (somatic) symptoms for which there is a psychological (psycho) basis.

Children are no different and due to their immature abilities to identify and express emotions, their propensity to cite psychological problems as physical ones are more frequent. For children, who may have less understanding that psychological problems stem from the head, the gut is the most frequent organ assigned to physical problems. Children who are worried at school may experience genuine stomach aches or constipation which miraculously remit at the weekends and on holidays. For teenagers and adults, the neurological often (but not always) begins to preside with headaches and migraines becoming more prevalent presentations of psychosomatic symptoms.

Psychosomatic symptoms more commonly arise in children who are less able to understand, identify and report their feelings and emotions. Therefore younger children, and children with learning difficulties and or autistic spectrum disorders are more vulnerable. It may also occur in children where reporting feelings and emotions is not possible, discouraged or seen as a sign of weakness or failure. Often children may have experienced past or current physical problems and therefore have a good understanding of how to solicit help or get their needs met for physical problems. Often parents can contribute to symptoms by their own fears and anxieties about their child’s physical health. This is particularly so if the child has a long standing medical condition or has been unwell in the past. Doctors and health professionals can add their own anxieties “of missing a rare disorder” into the mix with repeated investigations and suggested treatments to help uncover and treat an underlying biological basis to problems, and neglect to consider that the underlying problems may be psychological.

If that is the long established thinking on psychosomatic symptoms, what then is my new disorder of “somatopsychosis”? Well, exactly the reverse: psychological symptoms caused by physical ones. This sounds highly unusual, and indeed, Molly is the only recognised case report of this pathological condition that I have just made up. Here is how it works:

Some doctors, like myself (I hope this is the case and I am not an unusually hard-hearted anomaly), have a skewed sense of pain severity due to our dealings with pain at the very severe end. At times it can border on the down-right unsympathetic: when my husband complains of woozy head and sniffles, it’s most definitely man-flu of no significance and he should take Lemsip, go to bed and quit complaining. When an adult patient complains of pain from a blood test, I sometimes mentally think “Come on – it’s a skin prick – I’ve just sewn someone’s entire arm back on!” and don’t let me get started on people that wince in extreme agony from having a blood pressure taken. I am of course professional, kind and sympathetic to my patients, but I am also human, so I hope you will forgive the occasional internal eye-roll at such “wimpish” behaviour.

Unfortunately for my children, professionalism doesn’t wholly apply at home and although broken legs, cuts that are likely to leave scars and high temperatures are met with the usual heightened maternal anxiety (including vivid nightmares of misaligned bones or fractures that disturb the bone growth plates that only people of medical training contemplate) I admit to a general propensity to a lack of sympathy to minor physical pain. As such poor Molly and D have learnt that a grazed knee will earn a dusting off, a quick wound wash, a hug and a wipe of the tears, but then an expectation that the episode is now over and they are to carry on playing. A bumped knee will unlikely earn more than an “Oh dear, you’ll get a nasty bruise” or sometimes, I admit to even worse: “Well, that’s what you get for charging around without looking where you are going.”

As a child psychiatrist on the other hand, identifying and expressing feelings and emotions are a different kettle of fish. From a young age, both children have been encouraged to talk to me about their internal lives, what has worried them at school and all angles are thoroughly investigated and talked through with utmost attention.

It appears that this table-turning of the usual scenario where parents pay immense attention to physical pain and tend to access less of their children’s internal worlds can have its own unhealthy consequences. Here’s what happened:

Molly: Whee! look at me! I can do really good cartwheels now!

Me: You’d better watch out, doing cartwheels on a slippy rug is not the best idea…

[BUMP]

Molly: Ouch! [Blubber, blubber]

Me: I told you so.

Molly: You don’t know what a terrible day I had. Girls were being mean to me at school.

Me: [???? What the hell? Where did that come from?]

I had to suppress a smile as I realised what was happening. Molly subconsciously knew that I wasn’t going to give her sympathy for a bumped bottom, but a potential peer interaction problem would give her the comfort and attention she needed at that time of physical pain.

AAARGHH! I have generated somatopsychosis! At least my early recognition of this oddity has reminded me to be more sympathetic to my children and change my ways. I absolutely don’t want her to subconsciously fabricate mental health problems to gain attention. It does go to show though, the frightening power of our day to day words and actions on our children, and the critical importance of what we DO and DON’T give attention and kindness for.

 

 

 

Exercise Your Mind

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Just a quick blog to shout out about an exciting new “Gym” that’s launching in London this weekend. No, it’s not one for planks and TRX, but one for exercising the little grey cells!
It does seem a shame that after school or university, we become cosseted in a life where IF we continue to learn, it is usually “on-the-job” such that we become super-specialist in our own pigeon-boxed specialties without gaining breadth of learning. No more getting to try “lino-printing” or “debating” as we did in the classroom, to the extent that I am rather jealous of my kids who are shipped off to exciting school clubs such as “Lego Workshop”, “Chess” and “Tech club”. Jealous no more, as this weekend (May 13th 2018), Cerebral Gym will launch at the lovely and charitable House of St Barnabas in SoHo. Here, you will get to learn about all manner of things from bridge, to opera via architecture, with a bit of rap and book club thrown in for good measure. If it all get’s a bit too much for the little grey cells, there’s massage and meditation on site.
And to top it all off, a spot of parenting chat with me! Yippee.
If you are free, do come down. See the sites below for info and tickets.

Cerebral Gym Website

BOOK TICKETS

How to Train a Husband

Lego men

My dad told me he sent a copy of my parenting book to his old university friend who is in his 70s. After reading the book, his friend’s comments were these: “It’s not a book on how to raise your children, it’s a book on ‘How to Train Your Husband!'”

I had to laugh. I thought that it was only in the last chapter of my book “Inside Out Parenting” that I broke forth into a feminist rant on equality in childcare and domestic chores (promise), but it has to be said that since the book’s release several men have commented to me that they feel sorry for my husband. Also I do know that for some time now several of Banker’s friends no longer allow me unsupervised contact with their wives lest I contaminate them with my views on equality in domesticity and the value of fathers in the lives of children, so it is possible that this flavour pervades more of the book than I realise.

For many people the status quo is very satisfactory thank you very much and boats shouldn’t be rocked. But if like me you feel that “Equality starts at home” then here are my contributions on how to attempt to achieve this. I am by no means an expert on husbands or relationships but equality is something that I have thought about and tried to implement. Rather than feel ashamed or guilty about being a “mean wife” (which I am not impervious to feeling due to societal expectations of a “good wife”), I shall embrace the “How to Train a Husband” banner and offer you these gems:

  1. Choose your husband wisely. Simplistic advice perhaps but many of us get caught up in love and romance that we don’t think beyond to the potential 50+ years of life ever-after when desire abates, life goes on and chores are required to be done. Choosing a husband that respects and loves you is really important. My definition of “love” involves caring about your happiness. If being a “perfect housewife” is making you desperate or depressed, then husbands need to care about that and try to be more involved to allow you to fulfil yourself in the ways that you need.
  2. Start from a base of equality if you can. It is much easier to argue for equality in the home if your relationship started off on a basis of equality. Marrying your boss or someone incredibly wealthy unfortunately can put you an an unequal power footing from the outset. You may always feel weaker in your ability to assert your needs. But for many young couples these days, it is more commonly the case that going into parenthood both partners are working and earning an equivalent salary, the power dynamic only changes when one parent (usually, but not always the wife) steps back from her career due to childcare responsibilities. If this is the case, then you know what equality in a relationship feels like so you should seek to maintain it.
  3. Assert your needs. Some people love quitting their jobs to undertake the fantastic experience of parenthood. This is great. But some people don’t and they feel guilty about feeling this and/ or complaining about being unfulfilled by their caregiving role. I would say that if you don’t feel totally fulfilled, then it is imperative that you make this known to your partner. Harbouring guilt and unhappiness will gnaw at you from the inside and is the harbinger of depression. We all have to do things out of responsibility, but we need support and hope that there are alternatives or compromises to be made to work towards something more fulfilling. Hopelessness and feeling there is no way out is a very dark place. If you abided Rule number 1, then a partner that cared about your happiness would step in and do what they could to allow you to feel more fulfilled. Even if they could not actively help, their support and understanding of your feelings can sometimes be enough. Equally, if breadwinners feels trapped in a job they hate they should make their voice heard: adjustments need to be made for everyone’s happiness and an effective team and division of labour should work for all.
  4. Childcare is a 9-5 job. Of course this is blatantly untrue as children need looking after throughout the clock. But if it were a standard job, these would be the hours that you would be employed to work. As such, from this view point, any work that is required to be done outside of the 9-5 framework are a job for parents – of which there are usually two. Whilst I have undertaken to be the primary carer for my children between normal working hours (unfortunately in my case Banker works 7am-7pm), any child related problems outside these hours or at the weekends are equally shared. I know that this seems ridiculous to point out, but I have seen many of my friends continue to resume full responsibility for their children at weekends running themselves ragged while their husband relaxes after a hard week in the office. Really? If you are in possession of several young children I can honestly say that I think going to the office should be regarded as veritable downtime. If your husband poo poos this notion, book a week’s holiday away and get your husband to be sole charge of the children for a week (no grandparent support allowed). I promise that within a week, they will come around to the notion that going to the office is easier than childcare.
  5. Childcare and Maid are two different jobs. Just because you have given up your job to look after your children, this does not mean that you have also become the live-in maid. If your husband treats you like a maid, please stop and think whether this would have happened before you got married and gave up your job to look after children? If it did happen before you got married – why did you marry him…?? If it didn’t used to happen, what has changed, why have you become the maid? If he wants a maid, he should employ one. If the family are suffering because of reduced income due to your quitting your job to look after children, then this is a FAMILY problem, meaning that EVERYONE needs to pitch in to help with the cleaning and chores. You should both be maids. I know that this sounds petty, and I do more than 50% of the domestic chores in my household, but HELL if that is the “expectation”. If there is ever a whiff of discontent or insinuation that domestic chores are my “responsibility” – I go on full-on strike! Yes, ladies – I have purposefully picked out my husbands’ shirts and underpants from the dirty laundry and laundered my own and the children’s clothing only. If there are complaints about no clean shirts I point at the washing machine. Many of my friends find this despicable – but really? I never washed his clothes before we had children, why should having children together mean that I am now responsible for washing his clothes?
  6. Maintain a job and income. I know that this is not always possible, but if you can, in any way shape or form, I think this is beneficial for your self-esteem and sanity. The only way to maintain respect in a relationship is by knowing and believing that you WANT not NEED to remain in it. For me, knowing that I have maintained employment skills in a part-time job means that I have certainty that should my relationship fail, I could go full-time and be able to support myself and my family. It wouldn’t be ideal, but it wouldn’t be the end of the world. We would all wish for our marriages to last and relationships to succeed, but there is nothing successful in a  marriage that lasted in misery and entrapment. Remaining in a marriage for fear of destitution is not really a great place to be in. Finances aside, a job allows you not only financial independence but to maintain social contact with other people and to meet new people such that should a relationship fail, you do not feel socially isolated and unable to meet new and interesting people. I don’t know if there are statistics to back this up, but anecdotally it feels like that when a couple divorce, the husband re-marries more readily than the wife. I don’t think that it is always because the wife typically gets custody of the children that this happens, but because many wives have been socially isolated or cosseted within female only social groups long before the divorce settlements are initiated.
  7. If “Training” your husband is not in your nature, encourage others to do it for you. I have found that often mothers are more readily blamed for anything that happens involving their children. When Big Sis broke her leg at the park with her father, my mother rebuked me with “What the hell were you doing letting your husband take her to the park!” This transfer of blame from fathers to mothers should be unacceptable but it happens all the time. Banker had a spate of being late to pick up Big Sis and Lil Bro on his nursery runs. Rather than rebuke him the nursery were congenial when he arrived late. However, the following day I would be given a telling off about the children being picked up late. I immediately countered that it was my husband who was late and not me. They acknowledged this and asked me to let my husband know that this was not on. Luckily, I had taken a good dose of assertiveness that morning and said, ‘You know, if I tell him it will be perceived as nagging. It will be much more effective if you ring him at work and tell him yourself.’ To my alarm, the nursery teacher became all bashful and said, ‘Am I allowed?’ This was the first time that I realized the unfairness of it all. Professionals are more than happy to criticize working women on their parenting but dare not criticize working men. I said to the teacher: ‘Not only are you allowed, but I would be delighted if you did!’. Mothers: encourage professionals to talk to your husband directly and refuse to be accountable for your husband’s actions. My additional advice, is this: if you are a professional who works with children, be it teacher, nursery worker, teaching assistant, doctor, nurse, dentist, or other, please be fair and call fathers to account as well as mothers.
  8. Share the Mental Load: What scientific explanation is there to say that organising childcare, making a packed lunch or reminding children to put on a coat and remember a PE kit require a pair of breasts? None-whatsoever. Yet generations of women have been conned into subsuming these activities as their responsibility. I myself spent much time and sleepless nights wracking my brains over solutions to tricky childcare logistics when I wanted to return to work.  It only struck me when Big Sis was 7 that fathers could actually contribute to regular weekly childcare duties, rather than just at the weekend, Banker too was surprised to be asked. He had indeed sat through my endless rantings about how maybe we could pay ‘anyone-in-the-world’ to look after the children, without once suggesting that part of this responsibility was his. There ensued, of course, the typical grumbles: ‘important job’ . . . ‘impossible’ . . . ‘money’ . . . ‘promotion’ . . . ‘blah’ . . . ‘blah’ . . . ‘blah’. However, I happened to know that one of his colleagues had been able to wangle a late start to drop his children at school a few times a week. This colleague had just spent a tonne of money fighting for shared custody of his children, following a divorce. For him, it was a privilege to be able to do the school run. So I pointed out to my darling husband that I was offering him exactly this privilege, without the expense of a divorce and custody battle. Bargain! Seriously, though, surely childcare arrangements are a shared responsibility? Why does it so often fall to mothers? Even when fathers are doing childcare, it is often because the mothers have told them to do so and given them explicit instructions of where things are and what to do. The other day, having just cleaned the kitchen, I asked Banker to make Big Sis a packed lunch for her school trip. He replied, ‘OK. But what goes into a packed lunch?’ I did not dignify this question with an answer. A grown-up, well-educated man should be able to work this one out for himself. I, for one, would like some time off from all the thinking and planning of parenting, as well as all the doing. Make sure it is not just the load that is shared, but also the mental load.

 

I know I might sound like a right old dragon. But the good news is this: although implementing and fighting my corner with my husband has not always been plain sailing, I know this for a fact: my husband has been grateful for my honesty and has thanked me openly for allowing and fostering his relationship with his children. At a recent book publicity event, the male CEO of a major publishing company came up to me to say that he chimed with my view: the thing he is most grateful to his wife for was to insist that he participated in childcare. Although he grumbled at the time, he recognises now the difference it has made to his relationship with his children, now fully-grown. Because children are not blind, they see everything: who is doing what for whom. Providing the cheque for lavish birthday parties and expensive presents will never quite equate to the tear wiper, illness healer, sandwich maker, homework teacher, hug-giver, PE kit rememberer, confidence instiller; and I think that deep down, we all know this to be true.

Back to School

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For many parents it’s back to school this week, a time of mixed emotions. I’m sure that I am not alone in feeling a sense of relief (thank God I’m no longer responsible for them 24/7 or for organising who will be responsible for them 24/7), sadness (how the heck did they get this big? A minute ago I was wiping their bottom) and anxiety (how will they get on with their new teacher?).

The “Back to School” prep has all been done. This year, thanks to a last minute job application form that was due, the majority was delegated to Banker. For the first time, he braved John Lewis alone with the kids to battle over the last Size 3 Geox, AND he ironed on all the name labels on the new uniforms. This latter he did correctly this time as last year when he was assigned this task he spent an hour ironing on sticker name labels (used for books and pencil cases etc) rather than the iron-on name labels (used for clothing). They obviously didn’t stick and I had an absolute barney as I had to repeat the task. This year all was done to standard, which goes to show that these parenting tasks need not be the preserve of mums (if we are happy to tolerate a hiccup or two)! All I did was get Lil Bro his back-to-school haircut and then they were set.

As soon as my kids saw their friends they were off without a backward glance.

I toddled off to the shops. It was with sadness that on my return from the shops, a good hour after the school bell had tolled that I saw a mum and her son outside the school gates. I heard a snapshot of their conversation “Just go in and talk to the others. It’ll be fine.” It occurred to me that for some families, “back-to-school” is not just a logistic nightmare of name labels, new shoes and haircuts, but a return to a battle-ground and heartache.

As an autism specialist, it is not uncommon for my clients to loathe school and in extremis to refuse to go to school. Anxiety is the most common co-morbidity in children with autism, and it is also the most common mental health problem in primary school aged children. So here are a few pointers on school refusal:

Try to find the cause for anxiety

  • Encourage your child to feel safe to talk to you about their problems. This requires a non-judgemental attitude and a guarantee of confidence and that they will not get into trouble. They will also need to know that they will be taken seriously, and that you will have the resources and strength to help them. Many children I see in clinic do not disclose bullying to parents as “it will worry them”, “they won’t believe me”, “they will only confront the situation and make it worse” or “they won’t be able to do anything”.
  • Often it is not sufficient to ask your child why they will not/ do not want to go to school. Persistent badgering on this question may cause more harm than good if it is not forthcoming given encouragement. Sometimes your child may not fully understand their own emotions or the cause of their emotions and therefore cannot tell you even if they wanted to. In this instance, it is up to you to speak to teachers and friends and come up with your best guesses. Discuss these hunches with your child in a non-judgemental way: “If I were in your shoes, I’d be a little scared of your new teacher…” and see whether any of them chime with your child. This is a favourite child psychiatrist strategy of mine as usually one of your guesses will be correct and when you see a child’s face respond to you verbalising their darkest emotions, you can tell that you’ve got to the heart of it and work can begin.

If you find a cause then dealing with the cause will be your next step. Some common causes for school refusal in primary aged children are:

  • bullying/ social ostracisation by peers
  • bullying/ fear of a teacher/ fear of being told off
  • anxiety about a particular subject: fear of failure in an academic subject, fear of being ridiculed in P.E.
  • anxiety about leaving the parent (separation anxiety) for fear something may happen to the parent.

Sometimes, there is no one-single cause and anxiety may be generalised or the sum of minor anxieties that can overwhelm. Working through each one, however minor, can be important.

Dealing with the cause should always involve:

  • Working together with the school. The natural parental instinct is to do your utmost to protect your child which can mean confronting the school staff or the parents of other children. Try to stay calm and keep an even head – whatever happens, getting other parents and teachers on side will lead to better outcomes for your child than making adversaries.
  • Supporting your child. As well as in relation to the identified cause, increasing your child’s self-esteem, resilience and social skills will always help.

Avoid pitfalls:

  • Sometimes, parents will allow children to stay off school due to school refusal. It is important to remember that this can inadvertently encourage problems as you are in effect teaching your child that crying and fussing will lead to a day off school. Sometimes it is impossible to get a child into school, but if this is the case, then schoolwork should be done at home rather than a pleasurable day at home watching TV and playing computer games. An incredibly boring or taxing day of chores at home may lead some children to the conclusion that school is preferable!
  • If at all possible, get children back into school as quickly as possible because the longer that they are off school, the harder it will be to get them back.

 

Make Time For Your Dreams

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In September 2013, after a prolonged period of doubting, mental deliberation and build-up, I ventured on-line and bought myself a domain name: Shrinkgrowskids.com. It was meant to keep me busy while the children were in school because finding employment in school hours only is impossible. I psyched myself up. I was about to start writing when the following happened:

  • my daughter broke her leg (she was 6 years old and too little to use crutches. We have a typical Victorian townhouse on 3 floors. She needed hoisting everywhere. I put my back out)
  • my dad got diagnosed with cancer (thankfully now in remission)
  • my son had terrible allergies to a list of over 20 food items

There were a lot of hospital appointments. The blog got put on the back-burner. Life’s never easy and there is always an excuse NOT to do something.

I’m glad that I persisted.

In January 2014, I finally got the chance to sit down and blog and this led on some 3 years later to the publication of my book last month. So I wanted to share the following with you:

Remember your dreams and make time to make them happen!

 

***

Here’s a little taster from the intro of my book:

Oh, for pity’s sake!’ I silently cursed.
I had timed the nursery run to a tee and for once we were actually on schedule – until my three-year-old daughter, Molly, realized that her new shoes did not have her name label in them. Disaster! I tried to persuade her that this would be fine for one day and promised to stick the labels in that night; I explained that I couldn’t do it there and then because we would be late for her nursery (and, more importantly, I would be late for a meeting I was due to chair). But Molly out and out refused to see reason.

So I tried cajoling, then bribing, then threatening her. All to no avail. Ultimately I gave in, impatiently got the name labels and grumpily stuck them in her shoes. But by then it was too late. Molly was digging her heels in and her anger wasn’t just about the shoes anymore, but had become an incoherent fury with the world in general. And she was still refusing to put on her shoes. There followed more shouting, this time from me, along the lines of, ‘Now I’m going to be late!’ Reciprocal shouting and foot stamping from Molly ensued, until I realized that physically picking her up, bundling her under my arm and forcibly depositing her in the car was the only way I was going to get anywhere that day.

This was no mean feat. Picture me shuffling sheepishly down the road to the car, praying not to encounter any of my neighbours, Molly tucked under my arm like a log, kicking and screaming, with no shoes on. Simultaneously, my eighteen-month- old son D (Chinese for little brother, which is what we’ve always called him), was clinging on to me like an oversized pendant, his arms wrapped tightly around my neck. Assorted nursery-required paraphernalia was haphazardly piled into two bags, which weighed down so heavily on my elbows that they were cutting off the circulation to my fingers, from which dangled the contentious shoes. I must have resembled a demented rag and bone woman with my assorted wares hanging all over me. Meanwhile, Molly’s ongoing high-pitched wails of, ‘You’re hurting me!’ advertised our approach to everyone in the neighbourhood.

It was on that day of model motherhood that I decided I should write a book about parenting. If this seems perverse, I haven’t even confessed the funniest part of the story yet. About an hour after that little episode, I finally took my seat at the meeting. There I sat, solemnly discussing the effects that ‘compromised parenting’ has on the mental health of children. Believe me, the irony was not lost on me.

You see, I am a child psychiatrist. Handling Molly’s meltdown should have been second nature to me, but it wasn’t. After this humiliating escapade, I started to write down the more ridiculous of my parenting moments, because on one level they intrigued me: ‘Surely a child psychiatrist should know better?’ I kept asking myself.

Before having children I probably considered myself some-thing of a ‘parenting expert’. I doled out parenting advice to parents like hot dinners and wore my, ‘I know about parenting; I’m a child psychiatrist y’know’ badge with pride. It was only when I actually became a parent that I woke up to the humbling reality that there is no such thing as a ‘parenting expert’. Parenting is, in essence, often a process of mainly well-intentioned trial and error. The well-intentioned part is important because in recent times parents have been taking their role in their children’s development much more seriously. We’ve come a long way from the days when children were seen and not heard; when it was fairly common for them to be farmed out to wet nurses, governesses or boarding school at one end of the social spectrum, or sent up a chimney at the other. We now know that leaving the administration of parenting to others means potentially leaving the outcomes

of our children, and the adults that they will become, in the hands of others.

Indeed, sometimes it seems we have gone to the other extreme; there has been such a seismic shift in our attitudes towards parenting. Rather than abdicating responsibility for our children, or being ambivalent, we now have an almost obsessive preoccupation with them. I like to think that this is because my profession has done such a great job at promoting the importance of loving and understanding our children, though cynics might argue that it has more to do with the fact that most of us can no longer afford nannies, governesses or boarding schools. Whatever the reasons, there is no doubt that there is now a genuine interest in giving our children the best possible start in life.

***

Asian Woman: Nanny or Hooker?

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So it’s finally general election day (again!) and in the build up you’d think that local canvassers would be hungry to win over voters on the doorstep wouldn’t you?

Sadly not if you are Asian. This week, I experienced yet again the “Mistaken for the Cleaner” scenario. Here’s what happened:

Door bell rings.

I answer it.

The canvasser looks at me and gives me a flyer (for the party that I support) and asks me to give it to the resident voter.

I am taken aback, because I would like to have a chat about the candidate that I am going to vote for, but the canvasser has already turned his back and is already exiting the gate.

I finally find my tongue.

“I live here. I’m a voter too you know? Aren’t you going to talk to me?”

Cue awkward back-tracking by canvasser on the hot foot.

“Oh, sorry”

*sigh* “Did you think I was the cleaner?”

“No, no, of course not, we get doors answered by all sorts of people, you know friends and so on.”

I’m not really buying this. REALLY? Someone opens the front door and the first thing you think is: this person is a ‘friend’ of the resident…??!!

“Do you want to know about our policies.”

“Don’t worry. I’m good.”

Door shut.

This is not a unique scenario. Not too long ago I laughed out loud along with the rest of the world when the images of Professor Kelly’s report on South Korea was unexpectedly hijacked by his kids. Yet the initial hilarity and empathy with Professor Kelly’s clip soon became soured by the comments that flowed beneath the video. If there ever was a hero of the piece, it was his Korean wife that sped in to save the day and heroically crawled back in on all fours to close the door to allow peace to descend. I immediately warmed to her as her casual wear and practical pony tail looked just like my own. My own response to such an eventuality with my own children would have been instinctively identical.

Why then was she presumed by many to be the Nanny/ Maid, and worse still, why were her actions defined as being “submissive” and “fearful”? What would the “proper”/ “non-submissive” response from a wife and mother have been? To walk in and wave at the camera? To leave her husband to battle it out with the children on-screen?

Whatever people may say to try to justify their gut reactions, I am without a doubt that the “nanny-assumption”, just as the canvasser’s “cleaner assumption” was based on our ethnicity. How can I be so sure? Because it happens to me (and I’m sure other Asian/ Latino women) all the time. Here are a few of my highlights:

• When I first started dating my husband (a 6 foot 2 white South African), many people expressed surprise, questioning “You are a strange couple. What do you have in common?” I soon realised this was a bit of code for “He’s tall, white and handsome and should be going out with a leggy blonde not a short bespectacled Chinese woman”. This line of thought was later confirmed by a sozzled old bufty we had the misfortune to sit next to at a wedding once who stated the quandry more precisely due to inebriated state: “How did you two ever get together? He has round eyes and you have slitty eyes.”

• My husband had invited some of his new, white, male colleagues over for dinner. At 5 minutes to specified guest arrival time, I’m still in my tracksuit pants doing the last minute hoover and cushion plumping because in London with the ineffectiveness of the transport links and the relaxed attitude to time-keeping, I’m figuring I’ve still got 20 minutes to get changed and slap on some lippy. But what-ho? There’s the door-bell! The damn husband had failed to mention that his new colleagues had meticulous talent for punctuality. Never mind, I do my hostess duties diligently: offering to take coats and taking orders for drinks. The guests are genial and I show them into the dining room, where I start to serve the food that my husband has prepared. Here I figure that since they have caught me in my casual garb that it would be affected to disappear upstairs and re-emerge tarted up, so I don’t bother with that pretence. It is only when I plonk myself down at the table amongst the gathering that I notice the strange looks from my fellow diners. There is a definite note of initial surprise that “the brazen cleaner/ house-help is joining us for dinner”, followed by a tinge of embarrassment when they finally clock that I am the wife.

• When I was on maternity leave and started being in my house in the day time, I couldn’t help but notice that each morning a troupe of Asian ladies would come up the road, disappear into various houses and then leave in the evenings. I could see them through windows dusting and polishing in various houses. I realised that I looked more like them than my actual neighbours. It was no surprise then that when unexpected callers came to the door (the gas man, electricity man, charity door-stoppers, election campaigners, the police) they would ask to speak to the owner of the property when they were faced with me. After a few times of indignant proclamations of “I am the owner of this property”; I realised that it was much more fun and expedient to actually pretend to be the Cleaner and this works fantastically well to get rid of a lot of people that I don’t have the time for. I don’t even need to speak. I just put on a puzzled look, shake my head and shrug my shoulders like I can’t understand English.

• One time on maternity leave I went to the Royal Academy of Art with my baby and a friend with her twin babies. I had access to the Friends’ room so we ventured in there to have a snack, but the tables were all full, so we were kindly invited to join a table that was already occupied by a sweet elderly couple. This was a blessing as we had 3 babies between us. As my daughter was asleep, I helped out my friend with one of her twins by rocking her in my arms, and my friend chatted amiably to the elderly couple. When along comes a posh old dame who comes over babbling with delight about how wonderful it is to see families enjoying a day out at the RA. She talked at length about her own daughter who “also had triplets”. At this point I clocked things from her perspective. Here was a family of white grandparents, white daughter and triplets. That left me, the Nanny.

• Add to this the countless times I have had to have my passport doubly scrutinised at airports (apparently because there are Chinese gangs providing all manner of people with fake British passports) or if I am with my children, all our passports doubly scrutinised (because of Chinese gangs child trafficking). Strangely enough, if I travel with my husband, or if he travels alone with the children, this never happens. The addition of a “jolly fine white chap” somehow legitimises the rest of us.

Like for Jung-a Kim, Professor Kelly’s lovely wife, none of the above particularly bothers me. The reason being that for most non-white females, we have acclimatised and adapted to these day to day occurrences. I believe that these days we are to refer to them as “micro-aggressions”, but in my day, they were just things we ignored/ laughed at or put up with. Annoying, petty stereotyping is not the preserve of non-white females. Although I have witnessed a myriad of advantages that my husband gets purely by being a “tall, white, male”: aeroplane upgrades, hotel upgrades, many, many people-that-ignored-me smiling and offering to help him, people hanging on to his every word (when he is actually spouting my rhetoric which would have been ignored if it were coming out of my mouth); I have also witnessed my tall, white-male husband frequently mistaken for a Bullingdon club posh toff/ arrogant Apartheid supporting South African/ Countryside Alliance fox-hunter/ Trust Fund elite just because of the way he looks – which I imagine can also be tiresome.

“What are you doing going out with him?” my Socialist Worker reading friend asked.

But scratch beneath the colour of our skins and you will see that we:

• Are both the youngest of 3 children
• Are both from close knit families
• Are both immigrants to the U.K.
• Are both originally from pariah nations (South Africa due to Apartheid; Taiwan due to Chinese diplomacy)
• Both have direct experience of the effects of racism and inequality
• Both have an interest in opening our minds and hearts to new people, new places and new experiences
• Are both happy with who we are

So where it matters, we are immensely similar.

And so, in conclusion I think that we should all do a bit more of looking beyond stereotypes. I have no problem with being mistaken for a Nanny/ Maid/ Cleaner, because consider the alternative: I absolutely hated travelling with my husband to Thailand/ Indonesia and other developing Asian countries in my youth, because if we ever got in a cab, went for a nice meal or checked into a fancy hotel; I was clearly always “The Hooker”.

Talking to My Children About Terrorist Attacks

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I, like the rest of the country have been left dumbfounded by the cruelty of a terror attack targeting children and their parents. Of course, this is no more tragic than the bombs being dropped on hospitals and schools in Syria or elderly window cleaners being mown down on Westminster bridge, but it is a natural and human tendency to feel more empathy when the people involved are “just like you and your family”. The eight-year old girl that died, could have been Big Sis, the mum’s chatting outside waiting to pick up their children could have been me and my friends. Maybe it’s this that makes me feel it more this time around.

I asked Big Sis and Lil Bro if their teachers had mentioned the recent news at school. They had not. I wondered for a while if I should talk to the children about it. They were blissfully unaware that anything out of the ordinary had happened and I could have left it that way. Why let the world intrude on a “safe and idyllic” childhood living in a fortunate part of London?

Yet I decided not to stay quiet and here’s why:

  • Children do not live in a bubble and sooner or later the outside world beyond a loving home and sheltered school will impinge on them. As much as we parents want to shelter our children from hurt; hurt is an inevitable part of life. Children who are shielded from hurt never learn to manage their negative emotions so that when inevitably, they get hurt, they are less well equipped to cope. Better to gently expose children to reality and teach children to manage their emotions.

 

  • Children will become adults sooner than we think and need to have socio-political views of their own. There is talk of extending voting age to include 16 year olds: de facto: children. Whilst the children are young and I have an influence on my children’s opinions, I would like to pass on my ideals of openness, fairness and love so that they are entrenched before the likes of unknown peers and uncensored media get a hold of them. I felt that this terrorist attack was a marker event, so significant that they needed to know about and understand it, to shape their opinions for later life.

 

But what could I say? No medical degree or child psychiatry training teaches you this.  In this, like so many other aspects of parenting, I am like any other parent: a novice. Here’s how  I tried my best:

I told them that something terrible had happened in Manchester and we found the BBC Newsround clip together on iPlayer. We watched it together. A good quality children’s news program can convey facts in a way that children will understand and also be counted upon not to shock or overly upset the average child, so this is a good place to start.

I asked the children what they thought about it and I answered their questions.

Big Sis: What is a terrorist?

Me: It’s a person that does things to frighten other people so that the frightened people will do what they tell them to do.

Big Sis: Is it like a bully?

Me: Yes, I suppose so. They frighten people to get their own way or to make other people angry to start a war.

Big Sis: Why would anyone want to start a war?

Me: Well there are already lots of wars going on around the world. We are just lucky that we live in a country that’s safe right now.

Big Sis: Why can’t people just stop fighting?

Me: It’s easier said than done! Why can’t you and your brother stop fighting?

Big Sis [Hmm – recognising this is a tricky]: Well, we should just kill all the terrorists.

Me: It’s more complicated than that. Killing people just upsets more people and often leads to more death. I don’t have all the right answers, but it usually doesn’t involve more death.

Big Sis: What should we do then?

Me: I think we must just help the people that got hurt, remember the people that died and carry on with our lives. We can’t let bullies scare us into giving in or feeling anger and hate, because this is what they would want. Maybe it can help us all feel grateful to be alive and for what we have.

 

Lil Bro: Will a terrorist come and bomb us?

Me: I hope not, but we live in London so I can’t say for sure. What I can say is that I have lived for over 40 years and haven’t been hurt by a terrorist yet, so the chances are really low. It’s natural to feel a little bit upset and worried, everyone does – even me, but if we let it stop us doing what we enjoy doing then the terrorists have won. So we need to be strong and ignore them.

 

This was getting rather depressing and I was running out of things to say, so I was really surprised but pleased that out of the mouths of babes can come heart-warming positivity:

 

Lil Bro: At least they died happy.

Me: Huh?

Lil Bro: They went to see an Arianna Grande concert and had a good time. The last thing that the people that died felt: was happy.

 

TOP TIPS:

  • Don’t be afraid to tell the truth to children
  • Use language children will understand
  • Avoid unnecessary graphic and frightening details
  • Acknowledge that fear is normal
  • Encourage talking about fear rather than suppressing it
  • Model a good sense of the risks: don’t get overly worried yourself
  • Offer realistic reassurance
  • Model a “carry on” attitude
  • Continue to spread love not hate

 

And, if you can, find a glimmer of hope.

 

If you are lucky like me, your children may find the positive for you.

It’s here! Inside Out Parenting

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Sorry for the radio silence, but life has been pretty hectic the last few months to say the least. I have been interviewed by The Times, Country Walking and writing articles for The Telegraph and Daily Mail on-line sites. Crazy. Today a long-held dream has become reality and my little book, which came about from this blog, has hit the bookshops. When I paid my £60 to register this blog domain, little did I imagine that all this would be possible.

This morning after dropping off the children at school, I made a solitary trip to the local bookstore and headed to the parenting section where I have hung out quite a lot in the last few years. My only previous publication was a Chapter in a textbook so specialised that you had to order it on-line, so it was a very strange idea that I could go into a bookshop and see my book on the shelf. I didn’t really believe that I would find it, but there it was….

 

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Thank you so much to all the lovely people that have followed or read my blog. I do hope that now the hard work is done on the book that I will be back on the blog site again! I have missed Big Sis, Lil Bro and Banker, not least because they are transformed into Molly, D and Andrew in the book. Since writing the book, so much has happened and the children are no longer little anymore! I’m really looking forward to sharing the next adventures in parenting with you : Lil Bro is sitting his KS1 SATS and I am forming an excel spreadsheet of secondary schools for Big Sis – where did the time go?

If you have liked my site, please look out for my book: it may be tucked away somewhere next to books on potty training! – (I confess to having spent half an hour rearranging the shelves at my local Waterstones to get that photo above – at least I was decent enough not to sneak it widthways over Giovanna Fletcher).

Thank you again for supporting my blog. I could have not done this without you!

 

 

Children’s Sleep

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Lil Bro: Mummy – I can’t sleep

Me: Please, its past nine o’clock, what are you doing still up? You have to go to sleep now or you’ll be exhausted at school tomorrow! [Plus I just got started on this week’s episode of “This is US” and a tub of ice cream and I really fancy a rest!]

Lil Bro: But I can’t sleep.

Me: Just close your eyes and lie still! [Grrr]

I’m sure many of you are nodding in sympathy at this experience. Lil Bro who usually has no difficulty getting to sleep is having a spate of “I can’t get to sleep”. We have tried cuddling, cajoling, comforting, reassuring and now we are at the frankly fed up stage.

Children with poor sleep can have difficulties with poor concentration, over-activity, behavioural problems, day-time sleepiness, bed-wetting, obesity, increased clumsiness, depression and worse academic performance. Equally bad, the lives of their parents and entire family are also grossly affected. As parents of infants, we have all been there, but somehow I’ve taken immense umbrage at this recent spell of poor sleep because Lil Bro is now 7 years old and well able to put himself to sleep.

When Big Sis was a wee mite, I was the rabid sleep-deprived mother heckling the sleep experts flown in from abroad to teach us doctors about sleep EEG’s: “Can you tell me why, WHY, how, HOW can a baby go from stage 4 deep sleep to AWAKE and CRYING just by a 10 degree tilt to lay them in the cot????!!!! Give me the EEG on how that happens…!!!! What’s the possible mechanism???!!!”….zzzzzzzz – bonk.

So, I must now be the envy of most mums, as for the last few years I have had the pleasure of working with Paul Gringras a.k.a. the Professor in charge of the national Sleep Medicine centre at The Evelina Children’s Hospital. I have been working with him on an international multi-centre drug trial for sleep medication in children with neurodisability (mainly autism), which he is leading. His centre is hi-tech with observational sleep bays where children can sleep-over and be observed on video to capture what is going on, often plugged into electronic equipment that monitors breathing, brain and movement activity and I was fortunate enough to be able to sit in on consultations with Consultant Paediatrician Dr Mike Farquhar. It all sounds very medical. What then has a shrink got to do with sleep?

Well, it turns out that the majority of sleep problems in children are “behavioural”. Yes, there are known medical causes of disturbed sleep, e.g. restless leg syndrome, obstructive sleep apnoea, sleep walking and so on, but for the majority of cases in children who are otherwise fit and well, it is what children and their parents are in the “habit” of doing that is keeping them all awake.

What constitutes a sleep problem?

The definition of a “good night’s sleep” is variable from person to person. As a student, a full 10 hours was a requisite for me often causing tardiness to morning lectures. At weekends waking before 10am was unheard of. As a junior doctor, 4 hours sleep constituted immense good fortune and developed in me the very useful skill of being able to sleep anywhere, anytime – zzzzzz-bonk. These skills came in handy with babies that hadn’t read Gina Ford. The early years of parenthood are a sleep-deprived blur, but once the youngest had reached the milestone of 3 years, a more acceptable routine of 10 hours of continuously sleeping children was established –albeit the 6am wakenings were still somewhat painful.

In reality sleep requirements differ between children of different ages, but also between different children. Average daily sleep duration ranges between 10-17 hours at 6 months to 8-11 hours at age 11 years. This variability colours people’s ideas of what constitutes a sleep problem, and I am often bemused by some parents who come in desperation seeking medication for 10 year old children that sleep from 7:30pm to 6am: thinking with a mix of incredulity “What planet are you on? That’s almost a full 11 hours!” and admiration “Please tell me how on earth you get a 10 year old to go to bed at 7:30pm!” With these children who are getting hours of sleep within the acceptable range, the sleep is only classified as problematic if it represents a dramatic change to sleep pattern and/ or if there is any evidence of daytime sleepiness. If the answer to both is “No”, then one should feel reassured. However, for a psychiatrist, we know that often a parental cry for help of “My children don’t sleep!” is actually a cry of “I’m struggling to cope with my children when they are awake!” This differentiation is critical as the treatment strategies for the two problems are entirely different.

Aside from these perceptual sleep problems, the three main problems involving sleep are: struggling to fall off to sleep, waking in the middle of the night and co-sleeping.

Struggling to fall off to sleep

Problems falling off to sleep are often cited as a struggle. Sleep latency (to give it its fancy name) averages 19 minutes in 0-2 year olds and 17 minutes for 3-12 year olds. Anything over 30 minutes is classed as problematic. However, these average latency numbers involves the child actually wanting to fall asleep and lying in their bed in the dark, and any of the children’s wonderfully inventive delaying tactics “One more story”, “I need the toilet”, “I need a drink”, “Mummy sing to me” are clearly “behavioural” and not really to do with a “medical” sleep problem.

Night waking

As part of our natural sleep cycle, we all wake at some stage in the night. Most of us are able to close our eyes and will quickly fall back to sleep again such that we don’t realise that we were ever awake or close to waking. Where night waking is problematic is where children are unable to settle themselves back to sleep and start playing the drums and waking the entire neighbourhood in the middle of the night. Typically these children then decide to fall asleep at around 7am, just when they need to go to school, and then they either miss school as their parents are unable to drag them there, or they doze off in the classroom and can’t learn effectively. You can imagine the impact of this on their parents.

Co-sleeping

OK I am as seduced by the lovely mental images of canoodling up with my young children for a snooze as the next parent. Many parents are seduced into this as children love it and it often helps them to fall asleep more quickly, but each time you get the inkling that this might not be such a bad idea, I would like you to imagine you sleeping with your 15 year old son or daughter. If you don’t do something to nip it in the bud while your children are young, they might not “grow out of it” and it will be a battle to get them out of your bed and are not used to falling asleep alone. I would suggest that you turf them out of sleeping in your bed by age 7 years otherwise it may get horribly entrenched. Of course, the early morning “I’m awake” cuddles in bed are still fine!

So what can we do to help our children to sleep?

My paediatric colleague Dr Jess Turnbull who is starting up the community Evelina Sleep Centre off-shoot in my work-place has the following advice for encouraging good sleep habits:

  • Physical exertion in the afternoon – encourage daily exercise in children in the day-time. This will wear them out and make them physically ready to sleep.
  • Consistent daily bedtime – as with all things behavioural, if there is an established routine and children know what is going to happen and that they cannot get out of it, then compliance is more forthcoming.
  • Last drink 1-1.5 hours before bed – this reduces the likelihood of children needing to get up to go to the toilet in the night, which may make it harder for them to fall back to sleep.
  • Avoid sugar/ caffeine – fairly obvious really.
  • Try and have a routine wind-down regime in the hour before bed time (calming activities such as reading, bath, calming music). The idea is to try and calm your child down so that they are in the right physical and mental frame of mind to sleep.
  • NO SCREENS (TV, phones, tablets) for at least an hour before bed. TV programmes, phones and tablets are all designed to capture interest, attention and brain activity. Ideally, you want to be winding down your child’s brain activity in the hour before bed so turning off screens is desirable. I know that many parents are tempted by having a TV in a child’s bedroom to keep them quiet and contained in the day, but it then requires discipline for children to stop watching it late into the night. Only be happy to provide a child with a TV in their room if they possess such discipline or you are happy for them not to sleep.
  • Having a transitional object (eg. a soft toy) to develop sleep confidence and a healthy sleep association. This can be particularly helpful for younger children.
  • Working towards your child falling asleep by themselves in their own bed. If a child is used to sleeping with you, then you should gradually withdraw yourself. For instance, first get the child accustomed to sleeping with you sitting next to them, then in a chair in the room, then outside the room in sight, then outside the room out of sight. It takes time, patience and grit to do this as some children will really dig their heels in, but if you view this as ultimately for their own good (which it is) then it is more possible to undertake.
  • Limit setting on ‘fussing’ after ‘lights out’. If you draw out the bedtime process with attending to the child’s fussing, then it defeats the purpose as it will get later and later and only teaches children that you will give them attention for their fussing which encourages them to continue to do it.
  • Reducing attention given after ‘lights out’ to prevent reinforcing messages of attention (e.g. avoid eye contact and conversation): good old pursed lips and silent treatment. There is a rule in my house that after the official bedtime, “Nice mummy” goes to bed and “Horrible mummy” her doppelganger comes in her stead. Nice mummy cannot be accountable for the actions of horrible mummy and so it is much better for children to just go to sleep.

But I had done all this and still, Lil Bro could not get to sleep. This was even more annoying and I was starting to put it down to “naughtiness”.

The next day, I was lucky enough to be chairing a talk on Smith Magenis Syndrome (a genetic disorder which was frequently associated inverted sleep cycle – i.e. day time sleepiness and night time waking) and my colleague Paul Gringras was the invited expert. Half-way through his talk, he spoke about the solution to keeping these children awake in the day was by using blue light to cut off melatonin secretion in the day. Melatonin is the natural hormone our pineal glands secrete to tell us it is night time and aids sleep. It’s pharmaceutical form can be bought over the counter in the USA as a treatment for jet-lag and is a commonly prescribed sleeping tablet.

Hang on a minute, Lil Bro had recently been given a fantastic blue Star Wars light sabre light that he had been insisting on turning on as a night light when he went to bed….this type of blue light is used to KEEP CHILDREN AWAKE….aargh. We had been inadvertently switching off our son’s natural melatonin secretion via Luke Skywalker’s weaponry.

I double checked Jess Turnbull’s list of advice and saw that I had overlooked: “Use a red coloured light if night light is needed (does not interfere with natural melatonin production)”. That evening, I told Lil Bro that an important sleep expert had told me that his special blue light was keeping him awake. Lil Bro likes science and reason and he felt good that there was a reason for his insomnia and that it was not just “bad behaviour”. It’s silly mummy’s fault for letting you have that light on (he likes not being to blame). Releasing him of anxiety about insomnia and allowing the release of melatonin by switching off the offending blue light sabre led to zzzzzz-bonk!

Resources:

 

References:

The info from this post came from: Turnbull & Farquhar 2016. Fifteen-minute consultation on problems in the healthy child: sleep. Arch Dis Child Educ Pract Ed 101: 175-180.