Tuesday, 22 November 2016

Book Review: The Silenced Child

Book Review: The Silenced Child

Oliver Sacks described listening as the only cardinal rule a practitioner must have. In her new book, The Silenced Child: From Labels, Medications, and Quick-Fix Solutions to Listening, Growth and Resilience, Claudia M. Gold, MD, describes listening as the only cardinal rule to parenting — one that a child’s sense of security, well being, and even ability to grow hinges upon.

When children struggle, Gold tells us, the urge to fix the problem is almost an impulse reaction. But in fixing the problem, we are often too quick to diagnose, label, and medicate a child. For instance, Gold describes Liam, whose mother was sure he was autistic. However, simply by giving Liam space, mirroring his reactions, and giving time for responses, Liam proved to be responsive, interactive, and most important, not autistic.

Examples such as this provide support to Gold’s premise that the timeless art of listening is rapidly being replaced with a system of care that offers only behavior management, parent training, and increasingly, diagnostic labels and medication. “These forms of treatment may crowd out space for time and listening,” she writes.

What Gold suggests is not just that we should rethink the care and treatment of troubled children, but that we should also rethink how we foster the very qualities — resilience, courage, confidence, empathy — that we wish for our children. By responding to the meaning of a child’s behavior rather than the behavior itself, Gold tells us, children can become capable of emotional regulation, and by acknowledging rather than removing their struggles, we can help them develop resilience.

What listening offers is a window of opportunity that precedes and supports the “primary maternal preoccupation” that Gold describes as the instinctive neurobiological and genetic drives a mother has toward her child, that are not just highly adaptive, but vital to a child’s development.

So vital, in fact, that Gold likens listening to prevention of many ailments. She points to the Adverse Childhood Experiences Study which found that the greatest predictors of adult obesity were painful and traumatic childhood experiences. Had these children been listened to, the outcome might have been different.

Far more common, Gold suggests, limited amounts of times and space places constraints on educators, caregivers, and parents, and often the focus becomes on simply removing the “problem behavior”. What is overlooked are the nuances that exist in relationships and comprise the story behind the child’s behavior. “In telling the full story, what to do usually becomes clear,” she writes.

But there is also pressure from the health insurance industry, which adheres more strongly to treatments that generate profits instead of those that lead to authentic resolutions. Gold writes, “Prescribing medication takes much less time than sitting with people until they trust you to talk about what is important in their lives.” Pediatricians, however, are also under tremendous pressure to improve behavior, and given ever decreasing amounts of treatment time, often find themselves in survival mode. Instead of asking why a child is angry, many find themselves resorting to an array of psychotropic medications to get children to sleep, behave, and listen.

The elephant in the room — and what seems to never quite be discussed enough — is the very environment a child finds himself in. The point is that when parents, teachers, and caregivers don’t listen to children, children cannot possibly learn to listen to themselves. But even in the most dire circumstances, listening can be a path to healing. Gold describes the “Orchid-Dandelion hypothesis,” which holds that the very genes associated with mental illness and vulnerability are the same ones that are highly associated with many coveted talents.

Listening, while a pathway to healing, Gold tells us, is also fundamental to learning. “In order to think, learn, and process experience, one must first feel calm,” she writes. Slowing things down for children allows time to integrate new knowledge, which leads to greater retention. A more meditative approach to life also provides time and space for experiencing the full range of emotions.

By embracing a path of inquiry, instead of knowing, judging, or prescribing, perhaps the most salient value of listening can be realized — that of uncertainty. By providing an open space in the mind to allow the child’s true nature to unfold, children can also learn an invaluable lesson, that is, life is full of imperfections, failures, and uncertainties. But it is through these inevitable experiences that children also grow and become independent.

Drawing on powerful research, as well as the timeless and insightful wisdom of Winnicott, Bowlby, and many more, Gold makes an undeniable case for the simple act of listening, an act that in many cases can be the most potent treatment available.

The Silenced Child: From Labels, Medications, and Quick-Fix Solutions to Listening, Growth, and Lifelong Resilience
Da Capo Press, May 2016
Hardcover, 217 pages
$24.99



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