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The right way to raise babies

the right way to raise babiesLast week there was a lot of noise about that crying it out study, which indicated that “graduated extinction” (which is different from simply leaving the baby to cry) isn’t harmful to infants. On my Facebook feed I heard (like many of you heard) a lot from both sides of the debate, decrying the study as too small to be useful or hailing it as the definitive answer from science. People ask me to weigh in on research like this because I’m a counselor who specializes in working with new parents but I’m not that interested in getting parents to do things some mythical right way to raise babies because there isn’t one.

When my son was a teensy-tiny infant I thought someone should invent a sim baby program so that I could make the most appropriate parenting decisions every single time. I could try virtually feeding him rice cereal as a first food and then hit restart to go back and try feeding him sweet potato to see which made him turn out best. Because even then — when the internet was fairly primitive and we all used Netscape — there was so much information out there and such strong opinions about every little thing. It’s not like my mom’s day where the parenting experts were limited to the people you actually knew and saw on a day-to-day basis (and maybe your dog-eared copy of Dr. Spock‘s book). Now there are a whole slew of people who have opinions on every little thing from first foods to sleep habits to how to tell your child that you like the painting they made in preschool (that is if you fall in the pro-preschool camp because oh boy are their opinions about that, too).

Here’s the thing, I don’t want you to raise your baby in any particular way. I want you to raise your baby your way. I don’t want my clients making decisions solely based on the headlines generated by researchers in South Australia; I want them to figure out how to tune into what they need and what their babies need and make decisions based on that. If the researchers in South Australia help inform those decisions — whether that’s helping parents feel good about sleep training or highlighting their own reservations about it — then great.

You and your baby are a unique dyad. You and your baby and your partner and the rest of your family, you are a complicated and distinct system. However you choose to handle sleep with your baby, it’s only one of many decisions you’ll be making over the course of your parenting career. Those decisions are opportunities for you to build your family culture based on your values, wants and wishes for your child. They are opportunities for you to explore and respond to your child’s individual temperament and learn more about the person they will eventually become. And they are opportunities for you to begin to understand who you are as a parent.

There are definitely absolutes about parenting like your babies should always be in car seats and they need to be fed (how you feed them is up to you). But studies like this, while useful and important, cannot take into account the whole colorful array of personalities and practicalities that make up each family.

If you were to come to my office and say, “Should I let my baby cry it out?” I would want to know so much more like who are you? And who is your baby? And what is the context of your lives together? As frustrating as it might be, I would not give you an answer because I want to help my clients find their own answers, the answers they can stand behind and feel good about. I want them to gain the confidence they’ll need for the rest of the hard work of parenting — choosing a kindergarten and giving the sex talk and figuring out curfews. As the kids say, you do you (because trying to do somebody else will just make you unhappy).

Do I have strong opinions? I sure do. I have strong personal opinions about my own parenting choices. But as I say (often), there are lots of ways to be a great parent and to raise great kids. I don’t have a lock on the best way; I’ve just figured out what works for me and mine. For example, I believe my kids are best served by being force-fed a lot of show tunes and being lectured on the superiority of Sondheim over Webber. You will not convince me otherwise but I also promise not to visit that strong bias on you. You go ahead and listen to Phantom and I’ll just sit over here with my well-worn copy of Company.

So if you come to me for answers, I won’t give them to you but I promise you that I will help you find them for yourself.

Blocked

The difficulty is … that you’ve got to get something on paper. It’s the only rule … that you must get something down on paper so that you can look at it and start to work on it. All the writer’s block consists of is that sensory that happens before the pencil hits the paper … and that’s the hardest thing to overcome. but of course if you can get the shape of a song you can tell when it feels right and it’s just a matter of sweat and work to fill in and it’s a lot of sweat. … It’s all about getting the shape.

~Stephen Sondheim, in Anatomy of a Song Part I (here — you can see Part II here)

This is true of making sense of anything whether we’re trying to understand ourselves or our histories or our relationships. It’s hard work and sometimes it feels like we’re not getting anywhere. The reason why a counselor can help is not because she knows more than you do (you’re the expert on your experience) but because she’s listening close enough to catch where you get stuck so that she can ask questions that help you find your own way to be unstuck.

 

Anatomy of Clinical Case Notes

Stephen Sondheim

I think Russell Crowe ought to play Sondheim if they ever decide to do a biopic. What do you think?

I thought I’d tell you about how I write my clinical case notes because it’s the kind of thing was interested in before I became a counselor and I still like learning how other people write theirs. (Treatment plans, too, but that’s a topic for another day.)

When I think about writing case notes I think about turning one of Sondheim‘s writing rules on its head. Stephen Sondheim says that writing lyrics for musical theater comes down to these three principles: Content dictates form; less is more; and god is in the details. In writing case notes I think that form often dictates content. In other words, I write to a form and it directs my train of thought thus dictating the content.

Like a lot of therapists, I use a modified version of what’s called a SOAP format. SOAP is an acronym that stands for Subjective, Objective, Assessment and Plan. For example, if I was counseling, say, Mama Bear of Goldilocks and the Three Bears, and she was telling me about her frustration cooking breakfast for her picky family, I might write:

Client was present with therapist. Client discussed her challenges in cooking breakfast. Client says her husband likes his food much hotter than she does but cooler than her son prefers it. Client says she ends up having to cook three different breakfasts and gets up several hours early to do so. Client reports feeling “resentful” towards her family. Therapist asked client about her previous plan to serve family cold cereal. Client says she feels guilty when she does this. Therapist and client discussed her feelings of guilt. Therapist asked if client’s feelings of resentment may come out with her family in other ways. Client identified that when she feels resentful she has trouble being pleasant on the family’s morning walks in the forest. Client says that in many ways her guilt about feeling resentful is worse than the guilt of serving cold cereal.

That’s the Subjective part of the case note, which basically means it’s what the client has to say and what I had to say. Now here’s the Objective part:

Client appeared extremely tired as evidenced by her repeated yawning during the session. Client had her apron on backward, her fur was uncombed and she had to ask therapist to repeat herself several times.

Notice there isn’t any opinion in there. I wouldn’t write, “Client is clearly being run ragged by her selfish family” or “Client needs to get it together and focus.”

In the Assessment piece I look back at our treatment plan and see if Mama Bear is making progress towards her goals. In Mama Bear’s case, she might have said that two of her goals are to make more time for herself and help her family become more self-sufficient. In this case I would say that Mama Bear is making progress because she is starting to think about the ways that her resentment towards her family is more of a problem for her than feeding them cold cereal. Even though she hasn’t changed her routine and even though she’s still having trouble putting her needs first, she’s thinking in ways that are moving her forward. I would note that like this:

Client is thinking critically about her choices and beginning to consider how taking care of herself might serve the family, too.

Finally there’s the Plan part of the SOAP note. Here I would write what our plans were whether they’re to meet again in a week, to have Mama Bear keep a diary of her feelings around breakfast or to ask her to ask Papa Bear to take one morning over this week.

What’s interesting to me about writing up the case notes is that using the SOAP format orients me to see the progress we’ve made in the session and in our counseling relationship as a whole. That’s the Sondheim-ish, “Form dictates content.” Writing our sessions in such a detached format gives me the perspective I need to really understand what it is that we’re doing together. When I’m in session, I try to stay present with my client. Writing up case notes after our time together gives me the chance to think back and reconsider my experience, which gives me new insight.

The second reason I keep things so bland is that case notes are confidential except when they’re not. Clients are (obviously) allowed to access their files and sometimes courts are allowed to access them, too. If this happens I want to protect the client (by keeping my opinion out of things — imagine the difference between sharing that Mama Bear’s apron is on backwards and saying something like, “Mama Bear sure didn’t know where her head was at that day” if she ends up in a heated custody battle) and I want to protect myself. I do that best by stating just the facts, ma’am.

 

From Northern Exposure: A Song

One night a million years ago I’m watching Northern Exposure and there’s a scene with something about Shelly’s pageant and there’s a song in the background, something odd and the people singing have accents maybe and there’s a drifting twirling while they show the pageant women spinning in their gowns.

I wanted that song.

I didn’t know how to find it — this was before google — and all I could remember is that it says “pretty” in it. Pretty girls? Pretty something? I remembered the swirling skirts, slow motion and the word pretty — a delicate cacophony of skirts and singing but I had no idea how to find it.

I’ve looked for that song since that show aired in 1991.

I recently realized I could get the series on DVD from the library and comb through them to find the song but c’mon — that’s a lot of television to scan through and I’m a busy person. So I started hunting episode lists trying to find the one I needed figuring I could just get that year and do a lot of fast forwarding ’til I came to a pageant scene. And my friends, I have found it.

It took me awhile because I remembered the scene as if Shelly was watching but I figured out it was actually Maurice watching the pageant in the episode The Big Kiss. And once I figured that out, I found the song. And it’s by Sondheim and I already own it and I love it and I play it all the time and now I can play it in a new context.

This isn’t the version (the version on Northern Exposure is from the original Broadway cast) but it’s a nice one all the same.

(Hey, was Northern Exposure the first television show to really utilize their soundtrack? Does Grey’s Anatomy owe them a debt or what?)

“Without someone in a tree nothing happened here”

rosytree-insideListen to this. This (click on the song title) is Sondheim’s favorite piece of work: Someone in a Tree. This version is from the original soundtrack of Pacific Overtures — I like it better than the version used in the recent revival although the revival has B. D. Wong and I have a small crush on him. The revival version, ack, the samurai sounds like he’s doing a bad imitation of the cowardly lion. But never mind that. This is the version I wanted you to hear.

I’ve been thinking about memoir lately and this song kept coming back to me. I was listening to it again while I was playing solitaire and waiting for Noah to be done with Hebrew class. Playing solitaire and listening to showtunes is my version of meditation; it always gets me thinking.

I’ll set the song up for you. Listen to how it starts so simply — there’s a narrator in this show and just before the song begins he says that there’s no record of the meeting that took place between the first European visitors to Japan and the Japanese sent to meet them but then here comes this man to say he was there. The part where he’s repeating himself, “I was younger than; I was good at climbing trees” — he’s trying to climb the tree that was there. Hear the music building? The way it repeats itself as it builds? There — his 10-year old self has just come in and scurried up the tree. “Tell him what I see!” he demands. Hear how radiant the music is when he arrives?

There were two witnesses to the event — the boy who is now an old man (they are both telling the story, they tell it together, they help each other refine it/rewrite it) and then later a samurai enters and says he was there, too, under the floor listening. So there are three people telling us — two witnesses and a witness remembering.

When we remember our stories and then relate them to others, they exist because we were there. We are the story — our vantage point becomes the part of the story that matters most. “I’m a fragment of the day,” sings the boy/old man. “”If I weren’t, who’s to say / Things would happen here the way / That they happened here?”. … It’s the ripple not the sea / Not the building but the beam…”

I love this song so much; no wonder it’s Sondheim’s favorite. I love this celebration of our creative memories, the way it acknowledges our limitations (the boy sees someone, “Someone very old” and the man he has become explains apologetically, “He was only ten” — perhaps the man he saw was not so old at all — who can tell now?) but also doesn’t saddle us with those shortcomings.

“There was someone in a tree / Or the day was incomplete / Without someone in a tree / Nothing happened here…”

* Note on the recording: This whole soundtrack is just stunning and it’s swiftly becoming my favorite Sondheim recording, which is really saying something. If you get a copy of the Broadway DVD that was on PBS a couple of years ago you can see Sondheim rehearsing this song with the actors and the look on his face while he’s watching them sing — well, it’s inspiring. You can also hear another version from a Sondheim retrospective here.

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