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PACEs in Pediatrics

Dr. Claudia Gold's Recent Blog Posts & Videos

 

Dr. Claudia Gold is an ACEs Champion who has as much medical expertise as she does empathy for parents, including and maybe especially for parents who are struggling. She recognizes the challenges and difficulties many parents experience but instead of shaming or punishing parents, she starts by listening to and learning from us. While this seems like the most practical, effective, and common-sense approach, to me, it is something many providers don't have the time, skill, inclination, or training to do. But it's easy to see the power in her perspective and approach when reading her blog. I share all she writes in the Parenting with ACEs community because I want parents to know that this type of support, though rare, does exist so we can seek it and where possible, transform systems so that it more common. Here are Dr. Gold's three recent blog posts, a posted with her permission, as well as a few YouTube videos and webinars.   

Claudia Gold Blog

I was talking to

Born into ViolenceBorn Into Violence: Listening as Prevention

Weeks before she delivered her second child the baby’s father had thrown Sondra against the refrigerator while their 2-year-old daughter Alyssa watched. Sondra held firmly to a fear of physical harm to her unborn son. When she delivered a healthy baby boy, her pediatrician reassured her that there were “no effects” of the incident. Released from the immediate worry about her son’s physical safety, she sunk into apathy. While the nurses remarked on Calvin’s robust cry, she said, “I’m sure he’ll turn out to be a monster just like his father.” She watched TV all day, showing little interest in her son. One of the night nurses, Tracy, alarmed by the situation, asked Sondra during a vital sign check if she might bring the baby in from the nursery. Sondra reluctantly agreed. Together they observed Calvin, noticing how he seemed more calm during the quiet of the night. Sondra saw how his movements settled and he turned his head to find her voice when she spoke with him. Roused out of her depression, she joyfully exclaimed, “My baby knows me!” The next night she asked to have Calvin stay with her rather than go to the nursery.

In that moment of connection, Calvin made hopeful meaning of himself. If he had words, he might have said, “I can change my world to make it better.” He communicated with his mother in a way that also changed the meaning she made of his behavior. Her negative attribution based on her experience of violence shifted. Psychoanalyst Lou Sander referred to this kind of interaction as a “moment of meeting.” Parents and infants make meaning of themselves in the world through hundreds of thousands of moments. Unfortunately for this family, their circumstances did not allow for the calm space for listening offered that night in the hospital.

Read the rest on Dr. Gold's Child in Mind blog.

emotional sufferingParenting and the Stigma of Emotional Suffering

When Carl and Vicky, parents of four-year-old Leila, experienced a recurrence during their recovery from an opioid use disorder, they struggled with how to explain the change in living circumstances to their daughter when she moved into her grandmother’s apartment. Carl’s proposal to tell Leila “we messed up” highlighted the role of stigma in addiction, even from the sufferers themselves. At first they settled on simply saying “We’re sick.” In the immediate aftermath of the crisis, this proved to be an improvement over no explanation. The explosive behavior that had brought Leila to my behavioral pediatrics practice subsided. But as the living situation continued to be plagued with uncertainty Leila asked more and more questions. Carl and Vicky showed palpable relief when I brought their battle with stigma out into the open. Freed from the burden of shame, they expressed many creative ideas about how to talk with their daughter.

Families in the grips of substance use disorders can face enormous obstacles in their recovery. In caring for Leila and her parents I felt license to talk openly about stigma as a well-recognized part of the problem. The emotional suffering of parents in a wide range of circumstances may be similarly stigmatized. Subtle shaming of parents may go under the radar yet wreak havoc on families over time. Consider the following story.

Read the rest on Dr. Gold's Child in Mind blog.

UnstuckBecoming Unstuck: Listening for Meaning in a Child’s Behavior

Three-year-old Harry’s pediatrician referred him to my behavioral pediatrics practices with the chief complaint that “he whines too much.” In our first visit I learned a complex story that gave multilayered meaning to his behavior. His mother Jalise arrived at the visits alone despite my invitation for his father Adam to join us. She described her husband as “very traditional,” leaving all the running of the family to her. Yet Harry’s sensitive nature especially bothered Adam, who and was easily provoked to anger by his son’s crying.

Jalise described Harry as having a ‘temperamentally low frustration tolerance.” As a young infant he shifted rapidly from an all-out cry to sound sleep in an unpredictable pattern. His high reactivity to many different sensations, including loud sounds, made family outings a challenge. Harry’s expressive language delay added to his behavioral difficulties as he lacked the words to communicate his needs and to express his feelings. When I invited Jalise to elaborate, she told me that Harry’s birth marked the one-year-anniversary of Adam’s brother’s death in a fire. Jalise remarked that Adam had never mourned this loss. She wondered if Harry’s close resemblance to his uncle contributed to the ease with which Harry provoked his father’s wrath.

Read the rest on Dr. Gold's Child in Mind blog.

Dr. Gold was a guest on one of our most popular A Better Normal episodes where she and Ed Tronick, co-authors of The Power of Discord: Why the Ups and Downs of Relationships Are the Secret to Building Intimacy, Resiliency, and Trust spoke.

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  • Born into Violence
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  • Claudia Gold Blog
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  • Dr Gold Books: Dr. Claudia Gold's Book Titles

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