How to Be a Supportive Partner During Pregnancy (and Beyond)

HOW TO BE A SUPPORTIVE PARTNER DURING PREGNANCY (AND BEYOND)

David Howard

THE GIST

  • Numerous studies have shown the benefits of having a partner who is supportive or perceived to be supportive. Conversely, having a partner who is perceived to be unsupportive is a predictor of depression and anxiety both before and after a child’s birth.
  • Start early. Being a supportive partner begins in the months before delivery, when an expectant mother’s anxiety levels may be rising about giving birth and the changes a baby brings.
  • Make a plan for your supportive role both during and after the baby’s arrival, but be flexible. There’s no script for how things are going to go.
  • New research indicates that supporters may need support of their own: They can feel isolated or rejected but question the legitimacy of their experiences.

If you’ve watched any movies with birth scenes, you may have noticed that the partner’s role often fits into one of two categories: He — and it’s always a he — is a comically inept second fiddle, fainting just when he’s needed most, or else absent entirely, inhaling a cigar in a nearby pub. 

These dated archetypes exist for a reason. What actually comprises a supportive partner has only come into focus in recent years, as fathers and same-sex partners have become more central to the birth and all that comes after. But the research is resoundingly clear: A strong mate makes a difference. Having a supportive partner is good for everyone involved, including the baby.

The scientific literature is less clear on what specific strategies best support pregnant women — it’s tough in a clinical setting to isolate the benefits of, say, a well-timed hug or a promise to handle 3 a.m. feedings. But the three researchers I spoke to distilled their studies into some real-world advice.

WHAT TO DO

  • Connect with each other well before the due date.

This should be even more of a priority than buying the right stroller. “The focus is so much on practical needs,” said Dr. Pam Pilkington, Ph.D., a perinatal psychologist who practices at the Centre for Perinatal Psychology in Melbourne, Australia, and founder of Partners to Parents, a resource site developed by a team of researchers and psychologists at Australian Catholic University to provide guidance for partners. “During pregnancy, people perhaps don’t focus on the couple relationship, or supporting each other emotionally as much as they could.”

In practical terms, this means talking often and openly about how you’re both feeling — anxious, excited, uncertain, whatever it is, Dr. Pilkington said — then validating each other, making sure you both feel heard and accepted. An example: After a month at home, a new mother might say, “I feel trapped here all day while you’re at work.” The supportive answer here is not, “I need to work so we can pay the bills. Why don’t you get your mother to come help?” Rather, a validating answer would be: “I’m sorry that you’re feeling pinned in place. It sounds like you’re missing seeing your friends at the office.” 

Trying to build mirroring-and-validating skills during the relative calm before your child’s arrival will help cement your bond for the challenges to come, Dr. Pilkington said.

  • Make your good intentions known.

Making yourself of service to another is what’s known in scientific vernacular as “offering social support.” Researchers call it a mysterious force that has tangible benefits. “There’s a magic about social support,” said Dr. Christine Dunkel Schetter, Ph.D., a professor of psychology and psychiatry at UCLA who has studied its effect on stressful situations, including pregnancies. “And the magic is that when it’s really working in these kinds of situations, it’s about things that take place between two people. And it’s about what one person says to the other, or does, that makes them feel better.”

Part of the magic of social support?Even when an expectant mother merely perceives that she has a supportive partner, she’s more likely to come through pregnancy happy and healthy, research shows. Studies have variously found that partner support is associated with better birth outcomes and lower levels of distress and depression among both mothers and infants.

But follow-up is key, too, said Dr. Dunkel Schetter. If you don’t actually come through on a promise to assume half of the diaper-changing duties, the benefits of perceived support quickly trail off.

Sometimes, supportive partners will learn that the best kinds of support are nonverbal — offering a hug during a low emotional ebb. And the support should be offered unconditionally. “The person giving it can’t say, ‘Now you owe me, you’re obligated, I’ve done so much for you,’ ” said Dr. Dunkel Schetter.

CenteringPregnancy, a program developed by the Yale School of Nursing, provides social support instruction, among other services, in a group setting for women and their partners; it’s now available in health-care facilities around the United States. (You can find a nearby location on the website.)

  • Take a birthing class — but be open-minded when the day arrives.

Classes like the Bradley Method, which teaches that childbirth can be managed through deep breathing and the support of a partner or labor coach, can be helpful in making you feel more prepared, and offering a sense of what to expect. But Dr. Pilkington pointed out that birth is not the same as being a cast member in a play. The baby sometimes rewrites the script. Things take unexpected turns, or the mother’s preferences before going into labor might change 12 hours in. The partner should avoid rigid thinking about how it was supposed to go, and instead help the mother roll with whatever’s happening and support her choices along the way, Dr. Pilkington said.

  • Have a plan for the weeks after the baby arrives…

Specifically, the partner can draw up an action plan in which he or she commits to executing certain helpful tasks. Maybe it’s late-night feedings if the mother is going to pump breast milk or your baby is on formula. Maybe it’s a daily break that the mom can count on, like taking the baby out for a walk so she can nap or take a bath, said Dr. Pilkington.

  • … But be flexible.

Planning to do those 3 a.m. feedings is one thing. The searing exhaustion that kicks in after four weeks of doing that is another. During your child’s early life, it’s best to expect some meltdowns. (The baby will cry sometimes, too.) Revisit the plan anytime based on whatever challenges you might face at each stage of your baby’s life. It’s O.K. to ask for extra support from friends and family, Dr. Pilkington said. Both parents can use a break in the first couple of months of their baby’s life.  

  • Know your role with feeding.

One task the mother generally handles alone is breastfeeding. But a 2015 studyled by the University of Ontario Institute of Technology suggested that a partner’s active involvement —learning how breastfeeding works and providing encouragement — leads to “significant improvements” in breastfeeding duration. Then think of simple, commonsense ways to step up: Helping the mother stay hydrated by offering a glass of water, bringing healthy snacks and providing a comfortable environment, Dr. Pilkington said.

For parents who can’t breastfeed or choose not to, Dr. Pilkington says it’s important to remember they haven’t failed. “How parents feed their infant is a personal choice that should be based on their specific situation,” she said. If the mother is pumping, you can help maintain the equipment and offer to bottle-feed using the milk. Parents feeding their baby with a bottle — whether it’s formula or breast milk — can split overnight duties, one taking the 9 p.m. to 2 a.m. shift, the other holding down the 2 a.m. to 7 a.m. slot, for example. Partners using formula can make sure there are adequate supplies on hand at all times and know how to mix it. Some formulas can be premixed and stored in the fridge for up to 24 hours, which could save an exhausted mom from having to drowsily scoop powder in the small hours of the night.

  • Expect that your sex life will change — for a while, at least.

This is a biological imperative, so expect the temperature to be dialed down in the marital bed post-birth (for a duration that depends on the circumstances of the delivery; consult a professional). And even after you’re medically cleared, that doesn’t mean you’ll feel the same or have much energy for sex early on. Make a point to seek out alternate forms of intimacy, like hand-holding and cuddling, Dr. Pilkington said. The key, again, is to maintain an emotional connection and strong lines of communication.

  • Look for signs of your own stress, and act on them.

The psychological effect on partners after a baby’s arrival is mostly a black hole in the scientific realm. Dr. Pilkington noted that only 19 of the 120 recent studies around pregnancy touched on outcomes for fathers or partners, and researchers openly acknowledge the need for more research. But the few studies that have been done show that fathers can struggle to navigate this interlude. Dr. Zoe Darwin, Ph.D., a lecturer in maternal health at the University of Leeds in the U.K. who has conducted some early inquiries in this area, found that men often feel stressed and detached but want to keep the spotlight on the mother and child. “The research that we’ve done,” she said, “found that although some of the men we spoke with felt excluded by maternity services, and had experienced significant stress in this period, they often questioned the legitimacy of their experiences and their entitlement to support.” If you feel yourself struggling, let your partner know, and consult a caregiver.


WHEN TO WORRY

If you’re struggling with depression or anxiety, you may need more than a hug or the sage words of a parenting class. Seek professional help from a counselor.

SOURCES

Dr. Pam Pilkington, Ph.D., perinatal psychologist who practices at the Centre for Perinatal Psychology in Melbourne, Australia.

Dr. Christine Dunkel Schetter, Ph.D., professor of psychology and psychiatry at UCLA, expert on stress processes in pregnancy

Dr. Zoe Darwin, Ph.D., lecturer in maternal health at the University of Leeds in the U.K. who specializes in mental health and wellbeing during and after pregnancy.

My Marriage Has a Third Wheel: Our Child

MY MARRIAGE HAS A THIRD WHEEL: OUR CHILD

Jancee Dunn

Jancee Dunn, left, with her daughter Sylvie and husband Tom.Creditvia Jancee Dunn

An only child can make the relationship between Mom and Dad uniquely complicated.

Here’s a typical weeknight scenario in our household: My husband, Tom, our 9-year-old daughter, Sylvie, and I feel like ordering in, and after a lengthy debate, we decide on pizza. Later, while the three of us are eating pepperoni slices and playing Bananagrams, Sylvie reminds Tom that our wedding anniversary is coming up and offhandedly mentions that my favorite flowers are peonies. After a few rounds of the game, we consider a movie. Sylvie proposes “Escape From New York,” a film that has piqued her curiosity after hearing her father repeatedly imitate Kurt Russell as Snake Plissken.

“I’ll look it up on Common Sense Media to see if it’s appropriate,” she volunteers, opening my computer. Unfortunately, she reports gravely, it’s for ages 16 and up. “‘Except for a severed head,’” Sylvie reads aloud, “‘there’s little explicit gore. An atmosphere of cynicism and darkness pervades, including a negative depiction of a U.S. President.’”

Tom points out that this sounds like his Twitter feed. But I balk at the severed head, which is a pretty big except for.

I would never have predicted that the hardest part of parenting would be that our only child would come to fully believe she is the third person in our marriage. This arrangement began roughly as soon as she learned to talk.

As family psychologists such as Dr. Carl E. Pickhardt, Ph.D., point out, only children often feel like one of the adults. As with our tripartite system of government, they view the daily running of the household as a three-way power-sharing agreement. This is an issue more parents may have to deal with, now that one-child families are gaining ground. According to a Pew Research analysis of 2015 U.S. Census Bureau data, today 18 percent of mothers at the end of their childbearing years have an only child — up from 10 percent in 1976.

Tom and I have fully enabled Sylvie to feel like one of the gang, because we go almost everywhereas a trio. We’re usually too cheap to hire babysitters, and tend to travel with Sylvie, too, as she slots fairly easily into our itineraries. As a result, Sylvie has gotten used to being included, consulted, part of our in-jokes. This is not uncommon, says social psychologist Dr. Susan Newman, Ph.D., who has spent decades studying only children — a term I loathe, as it calls to mind a kid alone in a shadowy room, whispering quietly to his sock puppet “friends.” (I think we should revive the much more sprightly “oneling,” used by 19th century author John Cole in his book “Herveiana.”)

But our efforts to “empower” our oneling and make her voice heard have begun to backfire. To paraphrase Princess Diana when asked about Camilla Parker-Bowles: There are three of us in this marriage, so it’s a bit crowded.

One reason for our fluid boundaries is physical. It’s almost impossible to maintain them in a Brooklyn apartment a realtor would euphemistically call “charming and cozy,” one with bizarrely porous doors that actually seem to amplify sound. But it’s also emotional: Tom and I, like many parents of our generation, make an effort to be open and communicative with Sylvie. (“You can tell us anything, sweetheart!”)

When I was growing up, I would never have dreamed of sharing anything remotely personal with my parents. I had two siblings, and our family dynamic was solidly Us vs. Them — my sisters and I were one unit, my folks another. I wanted a different kind of relationship with our daughter.

But one consequence of all this closeness is that our child feels insulted if Tom and I go out to dinner alone. If we’re on vacation, she balks at being “dumped,” as she puts it, in the Kids’ Club. She would be happy to Photoshop her picture into our wedding photos. If Tom and I give each other a hug, she has gotten in the habit of jumping in between us.

Jancee Dunn and her family. 
Jancee Dunn and her family. Creditvia Jancee Dunn

At least she doesn’t referee when we fight, as she did when she was smaller. A couples’ counselor put a stop to that when he advised me to put a photo of Sylvie in a drawer by my bedside table. Whenever I was about to lose my temper with Tom, he told me, I was to run to the bedroom, pull out the photo, and say to it: I know that what I’m about to do is going to cause you harm, but right now, my anger is more important to me than you are. I only had to repeat that brutal phrase a couple of times.

But Tom and I still squabble about minor stuff, like whose turn it is to empty the dishwasher — and when we do, Sylvie jumps in and takes sides. (“Mom, you did it last time.”)

As a self-flagellating parent, I was recently drawn to a book with the dire title “The Seven Common Sins of Parenting an Only Child.” Ooh, sins — what am I doing wrong? Among other iniquities — overprotection, overcompensating — Sin No. 6 resonated with me: Treating Your Child Like an Adult.

“It can become so pleasurable for parents of an only child to have a miniature adult by their side that they may lose sight of the fact that their kid needs to be a kid,” writes author Carolyn White, former editor of Only Child magazine. I read this aloud to Tom as Sylvie, nearby, perused the latest issue of Consumer Reportsready to counsel us on our next car purchase.

Sylvie may be comfortable around adults, but she is still a child, one who lacks the reasoning abilities and experience of a grown-up — so I must catch myself when I absently reply to her questions about money, or other parents, before realizing, whoops, shouldn’t have told her that.

As Newman advises, “Before you allow your child to weigh in, take a pause and ask yourself, ‘Is this really a topic or an issue that a 9-year-old should be involved in, or is this a decision for adults?’ ”

Sylvie needs time away from us to be a kid — time to act silly and make jokes about butts and drone on about the intricacies of Minecraft. She has a group of good friends, but I do see her picking up on her middle-aged parents’ habits, such as calculating how many hours of sleep she got every morning. Her posse at home is squarely in midlife, as evidenced by her choice of songs for her ninth birthday party — among them, Barbra Streisand’s LBJ-era “Don’t Rain on My Parade.” We are not the kind of posse a 9-year-old needs. Maybe she hasn’t yet subbed out her school backpack for a WNYC tote bag, but the danger is there.

And all of this coziness hurts our marriage, too. So I have to remind myself, sometimes daily, to cordon off our relationship. Our marriage has needs that deviate from my needs as an individual, as well as our needs as a family. I have to constantly ask, what would be good for the marriage? It’s important, as a couple, to have your own roster of in-jokes. It’s refreshing to drop F-bombs with impunity, and to gossip freely about other parents without having to hastily turn it into a teachable moment for your eavesdropping child about How Gossiping Is Really About Feeling Insecure About Your Own Life Choices. And it’s nice — no, essential — to go out to dinner, just the two of you, and speculate on which members of the waitstaff are sleeping with each other. You know, grown-up stuff.

Paternity Leave Has Long-Lasting Benefits. So Why Don’t More American Men Take It?

PATERNITY LEAVE HAS LONG-LASTING BENEFITS. SO WHY DON’T MORE AMERICAN MEN TAKE IT?

Nathaniel Popper

Men who take leave are less likely to get divorced, and have better relationships with their children, research shows.

In 2017, my family and I began an unintended experiment, testing the effects of paternity leave.

When my first son was born in 2012, I had only recently joined The New York Times and all I got off was the week of vacation I had stored up at the time.

By the time my wife and I had our second son in 2017, the newspaper had significantly ramped up its support for new fathers, and I got 10 fully-paid weeks to spend with our growing family. For my wife and me, those first two months of life with a newborn were just as sleepless as they’d been the first time around. But there were fewer fights and less resentment, and my wife got back to her own work more quickly.

Long after I returned to the office, I noticed little differences in the way I related to my second son that seemed most easily explained by the extra time I’d spent with him. To this day he regularly calls out for me in the night in a way that my first son rarely did. And when I am with him, I feel a certain intangible sense of ease that has only come more recently with my older son. This feeling of ease, along with my growing comfort with wrangling both kids at once, have had predictably positive effects on my wife, reducing her stress levels, and making us both happier.

While I’ve always been hesitant to attribute too many of the subsequent improvements in our family life to the parental leave I took in 2017, a growing body of research suggests that paternity leave does, in fact, have far broader effects than we might have anticipated, including some which endure years after the leave period itself.

Men Who Take Paternity Leave Are Less Likely to Get Divorced

Over the last two years, Richard Petts, a sociology professor at Ball State University, and Chris Knoester, a sociology professor at Ohio State University, have co-authored a series of papers, analyzing data from long-term surveys of thousands of American families. Their research demonstrates that paternity leave provides lasting benefits, not only to relationships between fathers and their children, but also to mothers and to relationships between the parents.

In their most recent paper, published in May 2019, Dr. Petts and Dr. Knoester found that, even nine years later, children whose fathers took at least two weeks of paternity leave after they were born reported feeling closer to their fathers than children with fathers who did not take leave. In research on married parents for a forthcoming paper, the sociologists found that even relatively short periods of paternity leave caused couples’ divorce risk to drop and to remain significantly lower for as many as six years to come, even as their children reached school age.

“The big news in the U.S. is that the boost is not just in the year or two after a child’s birth,” Dr. Petts told me. “It seems to be more sustained.”

This new work on American families builds on several earlier papers, mostly from Europe, where paternity leave is more common, which found that fathers are, in the long term, more likely to remain involved in parenting and to equitably divide household chores with their partners if they take time off after their children arrive. A recent study from Swedenfound that mothers whose partners were offered flexible paid leave in the year after a child’s birth were less likely to need antibiotics and anti-anxiety medication.

Despite mounting evidence of the benefits of paid parental leave for fathers as well as mothers, occasional high-profile news about a major international company offering paternity leave, and legal wins such as the settlement in which JPMorgan Chase agreed to provide equal benefits to fathers and mothers, the expansion of paternity leave programs in the United States remains slow.

Public enthusiasm for paternity leave has been growing: A 2016 Pew Research Center study found that nearly 70 percent of Americans support some form of paid leave for new fathers. There are signs of a rapid cultural shift as well. Though, in 2014, New York Mets second baseman Daniel Murphy faced widespread criticism for taking three days off for the birth of his son, just four years later, basketball player Dwayne Wade was showered with support when he missed six games following his daughter’s birth in 2018.

Nevertheless, recent surveys suggest that, while most American men take some time off work after the birth or adoption of a child, most take no more than a few days’ leave.

Why Aren’t American Men Taking Leave?

There are several reasons new fathers in the United States return to work so quickly, the most obvious being the lack of a national policy mandating paid leave for all workers. The Family and Medical Leave Act guarantees 12 weeks of unpaid parental leave, but its eligibility requirements are strict (to qualify, an employee must have worked at least 1250 hours during the 12 months before the start of the leave period, for an organization employing at least 50 people within a 75-mile radius), and many American workers do not meet them.

Even fewer American parents have access to paid family leave. Though six states — California, Rhode Island, New York, New Jersey, Washington and Massachusetts — as well as the District of Columbia have passed paid family leave laws, their provisions vary. A March 2018 national survey conducted by the Bureau of Labor Statistics found that only 16 percent of workers in the United States have access to some paid family leave through private-sector employers.

And research suggests that, even when fathers do gain access to paid parental leave, they may be reluctant to take it. After California’s paid family leave law, the first such law enacted in the United States, took effect in 2004, economists Charles L. Baum and Christopher Ruhm found that the percentage of men taking time off after a child’s birth rose only modestly; the average period of parental leave taken increased by nearly five weeks for mothers, but only two to three days for fathers.

California fathers’ caution about embracing paid paternity leave wasn’t entirely irrational. Some studies do show that taking paternity leave can damage a man’s professional reputation and affect his future earning potential.

“Men who take paternity leave do tend to be stigmatized and viewed as less committed employees,” said Rebecca Glauber, a professor of sociology at the University of New Hampshire.

How to Make Paternity Leave an American Norm

The successful expansion of paternity leave programs in other industrialized nations suggests that these cultural barriers can be overcome. Certain policies have been shown to be especially effective in encouraging men to take full advantage of paternity leave benefits. The adoption of a so-called “daddy quota,” for example — a use-it-or-lose-it period of paid leave earmarked for new fathers — has successfully boosted paternity leave participation rates in several Scandinavian countries. In 2006, in a departure from the rest of Canada, Quebec adopted a “daddy quota” similar to the Scandinavian model, offering five weeks of dedicated, non-transferable, government-paid leave to new fathers in the province.

Within two years, 75 percent of new fathers in Quebec were taking paternity leave, up from 22 percent before the use-it-or-lose-it “daddy quota” was implemented, according to research by Ankita Patnaik, an economist at Mathematica Policy Research in Washington, D.C.

Dr. Patnaik found that men in Quebec who’d taken the “daddy quota” continued to spend more time on household work, even one to three years after completing their paternity leave. Further, Dr. Patnaik’s research found, these fathers’ increased participation in household tasks appeared to free up their children’s mothers to pursue their own professional ambitions. One to three years after childbirth, mothers in Quebec whose partners had taken the “daddy quota” were working an hour longer per day, on average, and were 7 percent more likely to be employed full-time, Dr. Patnaik found.

Richard Petts, the Ball State University sociologist who researches the impact of paternity leave on American families, said that he did not find solid evidence that paternity leave boosts mothers’ careers, but that may simply be because American fathers take much shorter paternity leaves than their Canadian counterparts.

For my part, I came out of my own paternity leave with an easy ability to take both of the kids as soon as I was done at work, or to handle sick days when they came up. That allowed my wife to transition back to her own job more quickly, and to commit with more confidence to new projects. We are both still as overwhelmed as most other parents of little kids, but at least we feel like we’re muddling through it together.

Preparing My Family for Life Without Me

PREPARING MY FAMILY FOR LIFE WITHOUT ME

Mary Bergstrom

After eight heart attacks, a young wife and mother with an uncommon condition curates her legacy while decorating a new home.

Putting up pictures in our new house last fall, I opted for nails, not tape. My family had just relocated from California to Brooklyn, our fourth move in five years. With so much change, it had been hard to feel settled, but it was my job to try.

I wanted to create a sense of stability while my children, then 8 and 11, were still innocent enough to believe that life could be stable. I wanted to create a sense of hope while my husband, Jonathan, was still young enough to start over.

Although I was only 45, my precarious health had taught me to use time wisely. On the agenda that day was to get settled in our new home, a wide brownstone with big windows, just like I had always wanted. With light reflecting against high ivory walls, the house had a familiar feeling of peace. As Jonathan tended to the unpacking, I charged myself with decorating, a job that sounded frivolous, but I knew better.

With the children at school, I sat at the kitchen table, digging through boxes. Over the years I had taken thousands of photos, wanting to document every moment of our time together, make each one extend as far as possible. I was looking for pictures that had the power to turn bitter memories into sweet. Images that said, “I love you more than anything.” Images that whispered, “I can’t express how sorry I am to leave you.”

I headed upstairs with photos, nails and a hammer. My children had their own bedrooms, each with a window looking into the garden. I would start there and work my way through the house. By the time they got back from school, our new home would be filled with cozy memories. If I couldn’t make my family feel safe, I could at least create some level of comfort.

I flipped through options, looking for shots of us touching skin and smiling wide to convey happy intimacy, of us camping to hint at the natural cycle of life and of them with family and friends to show that love is always available.

Every day, I prepare. I take a slew of medications and supplements. I go to this doctor, that psychic. I pray. I keep nitroglycerin in my car, in my backpack, by my bed. My hospital basics are packed. After eight heart attacks, I have learned to be ready.

Jonathan ducked his head in. “How’s it going in here?”

“You scared me,” I said.

“Join the club.”

Jonathan is seven years older than me. He has a stressful job. He doesn’t take vitamins or exercise regularly. Even so, my health has been the primary focus for our entire marriage. Nothing can compete with spontaneous coronary artery dissection, an uncommon and incurable condition that has taken over my left, right and diagonal arteries. I could have a fatal heart attack tomorrow or I could not. It’s the not knowing that has made me live in the present.

“How does this look?” I said, holding a wooden frame against the wall. In the photo, my daughter is a baby asleep in my arms. I’m kissing her forehead, wrapping my sweater around her tiny body. I remember this moment and, because I have told her about it time and time again, so does she.

“It’s not just good,” he said, “it’s good enough.” Of course, he was right.

Since I had my first heart attack at 32, we have opened up to each other in ways that wouldn’t have seemed possible before. We no longer indulge in setting and not meeting expectations. We stay present and keep moving forward. We help each other get on with whatever comes next. With uncertainty, we have become confident partners.

The first time I had a heart attack, no one took me seriously. The emergency room doctors assumed I was having a panic attack. What could be wrong with the newlywed with a Pilates body?

No one paid any attention until the blood test for troponins came back positive. Troponins are proteins that are released when the heart has been damaged. Looking me up and down, they asked if I had taken cocaine.

One by one, the doctors walked away from my case, prescribing medication for high blood pressure and high cholesterol, problems I didn’t have.

We turned crisis into opportunity. The universe, we reasoned, was inviting us to live our dream life. Jonathan and I moved to China. We adopted two children. I started a business and wrote a book. Life was a glamorous adventure; I got everything I thought I wanted.

Then, eight years into that perfect life, I had another heart attack. My heart stopped for 10 seconds.

When you count them, 10 seconds isn’t long. My children can’t get their shoes on in 10 seconds. Sometimes it takes 10 seconds for me to remember where I parked the car. But 10 seconds is long enough to see what’s on the other side of life — to feel my grandpa again, to see the light, to find peace.

Those 10 seconds changed everything. After my near-death experience, we moved back to the United States. I gave up my business. I never went back to my old life. I never wanted to.

Because of my condition, I feel an urgency to help my family understand who I am and what I believe in. Shedding old ideas about work and success, I have been able to show them what matters most to me, and I have been present as they explore what matters most for themselves.

This way of life is work. It takes double doses of spirituality, optimism and pragmatism. Every day, we practice. We talk about what life would look like without me, we joke that I am the Health Queen, we pray. Their confidence is my greatest achievement. In our bubble, I’m just a mother and a partner, and for that, I’m both grateful and proud.

Over the years, we have shared more about life and what I have experienced in death. We have learned to accept what is and release what isn’t. We have had time to make plans for this life and also talk openly about wanting to be a family again in the next. After this incarnation, we hope to be hawks.

So far, our luck has stood up; I have recovered from every attack. My heart’s ability to pump blood actually increased after the last five heart attacks. Its ejection fraction went from 47 to 36 to 50. A normal range is 55 to 65. With so many unknowns, there is a lot of room for miracles.

Through the window, I saw the neighbor feeding an impressive congregation of squirrels and birds. Our dog raced to the fence. “Stop barking!” I called out. I rapped on the window to get her attention.

When I yell, my chest tightens. I sense heart attacks long before doctors can. I have learned to trust myself and so I do. I put down my tools, sat on the edge of my daughter’s bed. Heart attacks have shaken me while I was working out, house hunting, sleeping, getting ready for yoga and helping with homework. My heart makes no guarantees.

The tightening across my chest stretched like a rubber band. There was a pinching close to the defibrillator that was implanted near my heart. A new discomfort but not an attack. As soon as my heart relaxed, I returned to selecting pictures.

More than decorating, I was curating my legacy. These images would surround my family the next time I went to the hospital, and they would provide comfort if I didn’t come back. These pictures would become priceless.

“I love you from here to Paris to Ubud,” I say to my children when I put them to bed, calling out places we used to go before I anchored us closer to home. My interests don’t extend so far anymore. I stay with my children until they fall asleep, and, in the morning, they crawl into bed with us. We are so lucky. I wouldn’t give up this intimacy for anything.

To stay with my family, I have tethered myself to new ways of doing things. I have stopped eating and sleeping the way I want. I have exercised more, then less, then not at all. I have learned to rely on doctors more, then less, then not at all. I have hunted for possible cures more, then less, then not at all. What matters most is already in front of me.

This heart has provided complete clarity, become a trusted instrument for focus. Fear is a distraction; love and gratitude are my true purpose. That morning, all I could do was stay clear on what matters most. I picked up the hammer and nail. I could see it come together: a house filled with happy memories, a place we could settle.

Becoming Parents to Ourselves

BECOMING PARENTS TO OURSELVES

Eldar Sarajlic

My wife gave birth to a child. The child gave birth to a new thought.

Philosophy has always appealed to me more than fatherhood. I used to imagine my life as a sequence of quiet contemplations, readings and travels. I did not think much about children, though I assumed I would have one at some point. Being a father was not something I associated with a life devoted to philosophy.

However, all of that changed when my daughter was born in 2014, three months after I defended my doctoral dissertation. In a span of a summer, I became both a father and a philosopher. The two merged in me and created an identity that was entirely new. Before her birth, I was primarily interested in political philosophy. I was drawn to the questions of social and political justice, liberalism and legitimacy. Then, as my child gestated in her mother’s womb, a new set of interests and ideas started to grow in my mind. My wife gave birth to a child; the child gave birth to a new thought.

Parenthood, as I was about to learn, provides many paths for reflection. Philosophers typically ask a whole range of questions about parenthood: Is there a moral justification for having children? What are the moral dimensions to raising a child? Now that I found myself a parent as well as a philosopher, I began asking similar questions: How should I raise my child? How can I be a good father?

As most parents of newborns know, the first months of parenthood are a mix of bliss, fear, frustration and most of all, sleeplessness. It was in those wee hours in the first months of fatherhood that my philosophical concern stumbled upon one particular question: Who will my daughter grow up to be? What will be her identity? As I observed her tiny bodily features, I kept thinking about the possible futures ahead of her. Will she be able to become whomever she wants?

There is an autobiographical background to this question. I was born in Bosnia and Herzegovina into a secular Muslim family, and lived in the country for most of the first 30 years of my life. Coming of age during a brutal ethnic conflict in the early 1990s, I was corralled into a cultural identity I was told belonged to me. Being persecuted for being Muslim generated a personal and cultural resistance in me. I adopted and celebrated that scorned identity. Gradually, I became a Muslim. I embraced the target on my back and made it my own. But adopting an identity as a form of resistance, as I learned quickly, can take one only so far. Like an ill-fitting polyester suit, this identity itched, and I yearned to wear something more comfortable.

Philosophy has been an invaluable part of my process of self-creation. It helped me learn and accept who I was, but it also gave me tools I needed to change the itchy suit for something more fitting. One of the first thinkers who inspired this process was Hannah Arendt. When I first learned about her understanding of freedom, I immediately recognized myself in her thoughts. For Arendt, freedom means the capacity for a new beginning. It is realized in the human capability for action, a feature all new human beings are endowed with. The root of freedom, for her, lies in the concept of “natality,” in the fact that each new birth represents the introduction of novelty into the world. Children are something radically new, a true embodiment of freedom and a guide to structuring our social world.

Arendt’s favorite historical example of natality is the American Revolution, a radical act of bringing liberty to the world. I realized that my longing for the New World was a form of longing for a new self. Once I settled in the place of perpetual novelty, New York City, I had another beginning to deal with: a child of my own.

I thought of Hannah Arendt a lot during those sleepless nights, as my daughter was adjusting to life outside the womb. If she is a radical novelty in this world, I remember asking myself, how can I help her preserve that novelty and not suppress her uniqueness? How can I raise this tiny new being and let her be herself and not somebody else? What could I do to raise my daughter as an original, and not merely a copy of me, my background or the cultural expectations of the time and place of her birth?

The sleepless nights were productive in more ways than one. First, I realized that Arendt was right: Children are radically new and must be treated as such. While this is sometimes hard to comprehend, especially for new parents who delight in recognizing their features imprinted on the newborn (“Look, honey, she’s got my nose!”), it is both morally and practically imperative that we do so. Regardless of the genes she inherited from her mother and me, my daughter is a unique human being, and I can’t possibly predict, yet alone determine, her future self. Will her identity confirm to my expectations? I have no right to expect that.

I have witnessed many parental disappointments in what their children grow up to be: fathers obsessing when their sons turns out gay, mothers in despair when their daughters reject their parents’ religion. Gay conversion therapies and estranged relationships between transgender children and their parents are the perfect example of parental expectations gone off the rails. I knew that I wanted to be better than that. But how?

For children to grow up as authentic human beings and not as products of their parents’ expectations, they must learn to understand that identities are built on reasons, in other words, reasonable justifications; the very concept of identity is derived from this concept of reasons.

If personal identity is a certain kind of belief about oneself, it is always the product of the relation between the person’s consciousness and some set of facts. According to this, there could be different kinds of reasons for identification, depending on the nature of different facts. Some of them are based on the way we are physically constituted. If a child feels more comfortable under the label of the gender opposite to (or in between or beyond) the one assigned to her at birth, then that is a reason for her to identify in such a way. Other reasons are based on historical, environmental and experiential facts.

If a child learns about another way of life, in school or through socialization, and decides to adopt it, then parents must respect that the child could have a valid reason to stray from their family’s culture. Preventing children from acting upon the reasons they recognize, without addressing their validity, betrays the value and the meaning of the parent-child relationship.

Second, I realized that parenthood is a perfect exercise in self-knowledge: One gets a chance for self-discovery. Becoming a father helped me to understand my philosophical outlook. Thinking about the reasons that could underpin my daughter’s future self helped me understand the reasons behind my own philosophical and personal identity. Namely, being an immigrant in the United States, I embody two citizenships and two cultures.

This embodiment is largely responsible for the kinds of philosophical issues that interest me. Although I live in the United States, I exist on the boundary between the two. I never cease to bewithout both referential systems: Bosnian and American. Duality is my existential default. So I am constantly aware of the workings of culture. Because I always see its edges, I keep asking questions about its core.

Even my idea about the child’s right to authentic identity embodies a duality of philosophical traditions that underpin it. For example, authenticity has traditionally been a rallying call of Romantics who, like Rousseau, believed that the progress of the Enlightenment erodes the uniqueness of individuals. We are all born originals but die as copies. The time between our birth and our death is shaped by civilization, which molds us in ways that are often contrary to those parts of ourselves that are given by nature. Insights of Rousseau, Montesquieu, Marshall Berman and other thinkers who wished to advance the cause of authentic existence have always had a special appeal to me.

Yet insisting that a person becomes authentic through access and evaluation of reasons reflects methods and ideas usually found in the tradition of Enlightenment thinkers. Unlike the Romantics, I hold that the use and promotion of reason helps us to truly be ourselves. Self-alienation is the product of an unreasonable mind. Like John Locke, I believe that identity is a product of consciousness and reason. We can’t be authentic unless we are reasonable.

Sleepless nights with a newborn are behind me. My daughter is a 4-year-old now, with an identity of her own and an iron-strong will to make things go her way. Yet the dread of an unexpected future could still grip me in the middle of the night and make me question everything, unsettling the prospects of quiet rest. The lullaby I need is nowhere to be found; all I can do is stare into the void, with no hope that it will stare back.

But when I see her sleeping serenely, I understand that the void is not to be feared. It is not a maelstrom of meaninglessness that will lead us into insanity. The void is a portal to our self. It is ours to fill with whatever we want — dreams, fears, ambitions. It is our only chance to become what we really are: parents to ourselves.

Life as A Parent: What Kind of Father Will You Be?

LIFE AS A PARENT: WHAT KIND OF FATHER WILL YOU BE?

Dedan K. Bruner

Growing up without a dad was my first lesson in parenting.

I was 35 years old when my mother gave me the box. It was during my first visit home to California from Washington, D.C., after sharing the news that my new girlfriend and I were expecting a child. The contents were sparse. Among them was a telegram that my mother sent to my father, who had been away in Botswana serving in the Peace Corps, announcing my birth. Also included was a letter my father wrote to my mother a few years later, stating that he was moving back to the United States and that my mother and I, along with my father, his new wife and their children, should all live together upon their return.

At the bottom of the box was a small stack of checks — these I remembered well. Right around New Year’s when I was 5 or 6, I received an envelope with almost a dozen $25 checks, each predated for a different month, plus a $50 birthday check for July.

Seeing the checks brought back a flood of memories. I’d hotly anticipated each one, and felt frustrated at how long it took for my mother, whom I called Bobby, to hand over my “birthday money.” I’d clung to those checks as evidence of my father’s ongoing support. So imagine my embarrassment as a teenager when Bobby confessed that the checks began bouncing a few months in, and she’d started paying me their value out of her own limited budget. Until that day, I’d naively believed my dad’s promise to fund my college education.

Bobby and I never talked about the box. We didn’t need to. My mother’s message was loud and clear: “What kind of father will you be?” The answer seemed simple. I had been thinking about the type of father I would be since I was a kid growing up without one.

Embraced by a circle of dads

When I found out I was going to be a father, I was working on Capitol Hill in a fast-paced congressional office. In the moments that weren’t consumed with congressional votes or meetings, one of our favorite pastimes was getting updates from the three office dads. There was Joe, our 30-something military liaison, who would tell stories about his twin daughters and his son who was born with cerebral palsy. Then Riley, our elder statesman, who along with his wife had decided in his 50s to adopt Ethiopian siblings. Finally, there was our boss, James, a father of three teenagers, the eldest of whom was diagnosed with autism.

These men loved being dads. While their journeys were different, their stories of breakthroughs, tiny victories and comic setbacks connected them and entertained us all. When I announced that I was going to be a father, they welcomed me to the club with the kind of love and support that I had never seen among men. They showered me with tips about car seats and college savings plans, and tons of little ideas to make each day special. Their energy was infectious and edifying. I knew I would be O.K.

Months later, when my daughter Ella was born, James showed up at the hospital with a copy of the local newspaper and the February 2011 issue of Essence magazine so my daughter would, as he put it, “always know exactly what was going on when she came into the world.”

Nine months after my daughter was born, her mother moved out. While difficult for both of us, it was for the best. At the time, she was a first-year law student with a rigorous schedule. There was no custody battle. We crafted a schedule that worked, splitting Ella’s time evenly between the two of us with built-in flexibility to absorb her mom’s studies and my busy seasons at work. Eight years later, while much has changed, the same plan is still in place.

Society does not expect a whole lot from dads, much less single dads. The bulk of the nurturing, and most of what we consider “raising” a child is said to be the work of mothers. Dads “provide,” give the occasional bit of “fatherly wisdom” and do all the “outside stuff,” like camping. As it turns out, toddlers need less fatherly advice and more clean diapers. Children do not require us to be “baby whisperers,” but they do require resilience. I discovered that running warm water through Ella’s hair was a sure-fire way to get her to fall asleep not because I’m good at being a father; on the contrary, I learned the hard way that changing a baby girl on an incline at 3 a.m. can cause pee to run down her back and into her hair — requiring an early morning bath.

Fatherhood means trial and error

Ask the average dad for advice on how to raise a son, and you’ll get tips on the proper age to start sports and how to deal with bullies. He might share his dreams for his son, strategies for discussing sex, and the proper way to grip a hand and lock eyes during an introduction. Ask the same guy for advice on raising a daughter and he’ll wince his silent condolences while recommending that you get a gun and forbid her from dating until she turns 30.

I adopted the philosophy that it didn’t matter if my kid was a boy or a girl — at least until puberty. There are no lessons that I would teach a son that I would not want my daughter privy to. Self-respect, consideration, compassion, kindness and good citizenship serve each gender well and can be modeled by either parent. While her mother is adamant that Ella not use “bad words,” I care more about making poor language choices — howshe uses her words. Every now and then, I offer my daughter amnesty — 10 seconds to get any curse words she really wants to say out of her system. The first time I offered, after I pinky swore that I wouldn’t tell Mommy, she said the “S-word.” Months later, when I offered again, she passed. While her mom and I may not always agree on strategies, our goals are the same.

No matter how hard I try, not everything I do will be right. My inability to style my daughter’s hair was frequently criticized by the women in our lives, and apparently nearly every kid on the playground. Several friends tried to teach me; I watched YouTube videos and bought expensive products, to no avail. One day after picking her up from school, my daughter hugged me and whispered in my ear, “I don’t think I want you to do my hair anymore.” The statement crushed me, not because of what she said but because I could imagine the ridicule she’d endured before reaching that conclusion.

A few days later, a neighbor called me over as we were returning home from school. Still sensitive from Ella’s rebuke, my guard was up. I was working through the best way to tell my neighbor to mind her own business when she said she appreciated seeing me as a father. She said she knew a lot of fathers but that she liked seeing me. Sometimes you don’t know how empty you have been until someone or something fills you up. Relieved, I thanked her. As we turned to walk away, she told me to bring Ella over Saturday morning so she could “figure out that head.” I laughed and dutifully agreed. To this day, she is still our go-to hair guru.

There is no secret (that I could find) to fatherhood. Being there and being engaged matter most. There are times when I cannot be there, but I remain engaged. When my daughter is with her mother, we chat before bed and again before school. While I enjoy my own pursuits, I also spend time planning activities and adventures to ensure that we get the most out of our limited time together.

On New Year’s Day this year, I launched On Fathering, an online destination that celebrates fatherhood the way the dads in my old office did. The goal is not to make money or hold myself out as an expert on being a dad, but rather to give fathers and fathers-to-be a safe space to explore the beauty of parenthood. With any luck, we’ll help banish the days when the best advice a new father of a daughter could receive is to “get a gun.”

The Many Faces of Family and Love: There Is No “Best” One

THE MANY FACES OF FAMILY AND LOVE: THERE IS NO “BEST” ONE

Bella DePaulo

A commonsense manifesto for valuing all families, relationships, and life paths.

Never before have people in the U.S. and other nations around the world organized their personal lives and their family lives in so many different ways. In the U.S., for example, nearly as many adults are not married as married. The most sentimentalized family type—mom and dad, married with children—now accounts for fewer than 20 percent of all households. There are more households comprised of one person living alone.

Children are living in many different kinds of families and households. A full 40 percent of them are not being raised by two married parents. Many are living with one parent, or with cohabiting parents, or with stepparents or grandparents, to name just a few of the most popular permutations.

Family” is a many-splendored thing and it can take all sorts of shapes and sizes. Twitter embraced that notion when the writer Lucy Huber posted this tweet:

Stop saying “start a family” when you mean “have kids”. A couple is still a family. A single person and her cat is a family. A couple and their plants are still a family. Three weirdly close roommates could be a family. You don’t need kids to be a family.

Within a week, the tweet had been liked more than 185,000 times and shared more than 47,000 times.

Scholars have been writing about diversity in relationships and families and some of the most unlikely terms have been catching on. Take amatonormativity, for example. That one was coined by Elizabeth Brake. It refers to:

“the assumption that a central, exclusive, amorous relationship is normal for humans, in that it is a universally shared goal, and that such a relationship is normative, in the sense that it should be aimed at in preference to other relationship types.”

Professor Brake argues against that assumption. She thinks that other kinds of relationships and social circles, such as friendships and care networks, should not be valued less than romantic relationships.

Though growing in popularity, the valuing of many different kinds of relationships and families and life paths is still an idea that meets with considerable resistance. A new and important report recently released by the think tank, Family Story, documents the ways in which marriage has come to be privileged and promoted as the ideal family form, even as fewer and fewer people get married or have children.

Elsewhere, I described some of the key take-aways from the report, “The Case Against Marriage Fundamentalism: Embracing Family Justice for All.” Here, I want to describe the values espoused in the Family Story report, and the principles of family justice that follow from those values.

Values at the Core of Justice for All

“The Case Against Marriage Fundamentalism” argues that respect for all of our relationships, families, and life paths is built on four core values.

1. Equality “requires the reduction of social and economic inequality within relationships and between family types, as well as legal equality among different types of families and relationships.”

2. Autonomy “requires making it possible for people to freely choose their relationships and family types—including, but not limited to, marriage—by reducing structural and other barriers that stand in the way.”

3. Interdependence “means acknowledging we are all interconnected and dependent on countless other people (not just ones to whom we are biologically related or with whom we have a legally recognized relationship).”

4. Care “requires acknowledging all the ways that these different forms of relationships are supportive and meaningful, and the positive impact they can have on our lives and well-being.”

Principles of Family, Relationship, and Lifestyle Justice

The conclusion of the report spells out the principles of family justice. They include:

There is no hierarchy; stop saying that certain people, relationships, or families are better than others

  • “A person’s marital status, relationship status, and living arrangements say nothing about their character or value.”
  • “Unmarried people should not be treated as less mature, less valuable, or less accomplished than married people.”
  • “Families and relationships should not be ranked from best to worst based on their structure.”
  • “Marriage is neither more nor less important than other close adult relationships involving care and commitment.”

There are lots of ways to create a family

  • “Neither children nor marriage are necessary to create family.”
  • “Co-residence is not necessary to create relationships of commitment and care.”

People who live in ways that are not normative (or not perceived as normative) deserve respect

  • “There will always be people who prefer to live alone, to not have children, or otherwise opt to live their lives in ways that are not consistent with whatever the norm is at the time.”
  • “None of this is a reflection of their self-worth, and they all have a right to equal respect and concern.”
  • “An adult’s ability to freely choose a particular relationship status or living arrangement should not be restricted or blocked.”

For children, relationship quality matters more than the other factors that get so much attention

  • “Children do not need to live under the same roof as a same-gender parent (or same-gender role model) for proper development.”
  • “Children flourish in a variety of family types and living arrangements.”
  • “Relationship quality is more important than household structure.” (Examples of different household structures include single-parent families and nuclear families. This principle means that having a loving and secure relationship with a parent is more important to children’s well-being than whether they have one parent or two, whether their parents are married, or whether their parents live under the same roof.)

Family Story maintains that the marriage fundamentalists, who believe that “a family composed of a man and a woman in their first marriage is ‘the best’ or ‘ideal’ type of family, especially for children,” have promoted their ideas by distorting and weaponizing social science research. I have spent much of the past two decades critiquing that research and explaining what it really does show. It is good to have other prominent voices joining in.

Why Some Children Are Orchids and Others Are Dandelions

WHY SOME CHILDREN ARE ORCHIDS AND OTHERS ARE DANDELIONS

W. Thomas Boyce

Many children are able to thrive in any environment, while others may flourish only under the most favorable conditions. New findings reveal the complex interplay of factors that creates “dandelion” and “orchid” kids.

One of the first skills taught to pediatricians and obstetricians is how to assess the physiological condition of a baby in the first few minutes after birth. As a novice physician, this was one of my favorite and most treasured duties—to be the first living soul to survey the condition of a never-before-seen human being, delivered red, squealing, and literally wet behind the ears at the end of a prolonged, critical, and one-way passage.

The formal assessment is done using the Apgar score, named for its inventor, Virginia Apgar, at one and five minutes following birth. Scores range from 0 to 10, the sum of a 0, 1, or 2 assessed in each of five areas of postnatal functioning, arranged into the acronym APGAR: Appearance (the pink or blue color of the body, hands, and feet); Pulse rate; Grimace (the crying or grimacing response to nasal or oral suction, or other stimulation); Activity (the degree and vigor of muscle flexion); and Respiration. Most babies receive scores ranging from 7 to 10. Those with scores below 7 may need more active and rapid stimulation or resuscitation, including a heated bassinet or a suctioning of the airway. For scores less than 4, we might insert a breathing tube to support respiration or even begin external heart compressions.

HOW DO KIDS COPE? To get a sense of how school-age children think about resilience, PT asked a few how they cheer up others or whether they have a go-to strategy for themselves. Their portraits follow.

ZURI, 7: “To cheer myself up, I think of all the good times I have in my life.”
Photo by Karjean Levine

Orchids and Dandelions

As a pediatrician for more than four decades, I have become vividly aware of the great unevenness—the disproportion—evident in the differences in health and development among individual children from the first moments of life. Even within single families, parents often tell me that all of their children were basically healthy, “except for Sarah,” or Julio, or Jamal. Pediatricians implicitly understand, from simple, day-to-day observation, that some children are inordinately affected by the forces that protect health and those that imperil it. And at the level of the community, we know that, within any given population of children, a small minority—about 20 percent of individuals—will suffer the majority of all illnesses and disorders.

Developmental science has convincingly shown that one of the origins of such differences is children’s early experiences of psychological trauma and adversity. Such experience can impede normal brain development, create obstacles to effective learning, and impair mental and physical health during childhood and over the remaining life course. This is why children growing up in poverty, children who are mistreated by their parents or others, and children exposed to violence within the family or community are all at risk for compromised development, educational achievement, and mental or physical health.

But all children are not equally susceptible to these effects. While some are powerfully affected by trauma, others are able to effectively weather adverse experiences, sustaining few, if any, developmental or health consequences. People tend to view these differences in susceptibility as attributable to an inherent vulnerability or resilience, imagining that some small number of resilient or “unbreakable” children have a special capacity to thrive, even in the face of severe adversity. Our research suggests instead that such variance is attributable not to innate traits but to differences in children’s relative biological susceptibility to the social contexts in which they live and grow, both the negative and the positive.

A majority of children show a kind of biological indifference to experiences of adversity, with stress response circuits in their brains that are minimally reactive to such events. Like dandelions that thrive in almost any environment, such children are mostly unperturbed by the stressors and traumas they confront. We think of them, metaphorically, as dandelion children. A minority of children—about one in five—show an exceptional susceptibility to both negative and positive social contexts, with stress response circuits highly sensitive to adverse events. Like orchids, which require very particular, supportive environments to thrive, these children show an exceptional capacity for succeeding in nurturant, supportive circumstances, but sustain disproportionate numbers of illnesses and problems when raised in stressful, adverse social conditions. We think of these as orchid children.

Photo by Karjean Levine

IVO, 10: “If someone is down, I try to promise them something complex, that takes some effort—and then I do it for them.”Photo by Karjean Levine

Developmental science is increasingly revealing that the relative indifference of dandelion children and the special sensitivity of orchid children to the character of their early environment are likely attributable to the joint effects of genes and social contexts. These epigenetic processes—in which environmental cues regulate the expression of genetic differences—are the likely regulators of children’s differential susceptibility to environmental influences. Recognizing this differential susceptibility is an essential key to understanding the experiences of individual children, to parenting children of differing sensitivities and temperaments effectively, and to fostering the healthy, adaptive capacity of all young people.

Origins of the Types

So, are orchids born that way, or do they become orchids by way of early life experience? Our first hint at an answer came from the very first moments of postnatal life.

What is especially interesting about the Apgar score is the degree to which the things it measures are controlled by the fight-or-flight autonomic nervous system involved in dealing with stress. Each subscore is an indicator of the body’s adaptation to the considerable physical (and possibly emotional) stressors of being born; low scores are a reflection of insufficiently adaptive responses. After all, birth is an extreme and unprecedented experience, and it is such experiences that tell us most about who we are as extensions of our individual biology.

Given that we all begin life by being plunged into an epic stress reactivity experiment, might we not wonder whether the Apgar score could tell us more than just whether we need to have our mouths suctioned or our bodies warmed? If lower scores were reflective of less adaptive, less compensatory fight-or-flight responses, might they also be telling us about a baby’s longer-term proclivity toward maladaptive responses to stress? Could our first extrauterine moments augur something important about our whole life yet to come?

That is exactly what we have found. Careful epidemiologic work by one of my doctoral students and a former postdoctoral fellow has found that in nearly 34,000 children from Manitoba, Canada, five-minute Apgar scores were predictive of teacher-reported developmental vulnerability at age 5 for a variety of developmental dimensions. For example, the teachers of children who had Apgar scores of 7 identified more areas of developmental vulnerability than they did for children with Apgar scores of 9 or 10, and kindergartners who had Apgar scores of 3 or 4 had more reported developmental vulnerabilities than did peers with scores of 6 or 7. (The teachers had no prior knowledge of their students’ Apgar scores.) The vulnerabilities that teachers reported might have included lower competence in following rules or instructions; an inability to sit still and focus; a relative lack of interest in books and reading; or an inability to properly grasp and use a pencil. At each lower step on the Apgar scale, such physical, social, emotional, language, and communication domains of development were all significantly more compromised five years later. Babies entering the world with greater fight-or-flight instability and less capacity for physiological recovery were more developmentally vulnerable.

Photo by Karjean Levine

EDDIE, 12: “To cheer up, I tell myself it’s going to get better; the problem won’t persist.”Photo by Karjean Levine

Nature vs. Nurture

One source of such variation in adaptive stability is surely genetic difference among infants, but genes alone do not make a child an orchid or a dandelion. As work by other researchers has shown, the genetic characteristics of children create their predispositions, but do not necessarily determine their outcomes.

For example, a consortium studying Romanian children raised in horribly negligent, sometimes cruel orphanages under the dictatorship of Nicolae Ceauşescu, before his fall in 1989, discovered that a shorter version of a gene related to the neurotransmitter serotonin produced orchid-like outcomes. Children with this shorter allele (an alternative form of a gene) who remained in the orphanages developed intellectual impairments and extreme maladjustment, while those with the same allele who were adopted into foster families recovered remarkably, in terms of both development and mental health.

Similarly, a team of Dutch researchers studying experimental patterns of children’s financial donations—in response to an emotionally evocative UNICEF video—found that participants with an orchid-like dopamineneurotransmitter gene gave either the most charitable contributions or the least, depending upon whether they were rated securely or insecurely attached to their parents—that is, depending on factors that were not genetic.

We used to think that any trait or feature present at birth was “congenital” and therefore determined by genes or, in ancient terms, fated in the stars. A somewhat more contemporary version of this vision is known as genetic determinism, according to which all of our differences are firmly situated at conception in the merged DNA we inherit from our parents. We can think of this view as the “nature” side of the classic debate of nature versus nurture.

Photo by Karjean Levine

SAHANA, 7: “To cheer myself up, I play with my toys, call over my friends, and tell them jokes.”Photo by Karjean Levine

The Human Genome Project—the ultimate “nature” approach—promised to uncover the “genes for” autismschizophrenia, heart disease, and cancer. But no such unitary genes or even sets of genes have been elucidated. It is now clear that who we become is not determined by a straightforward, one-to-one route from genes to behavior, or DNA to phenotype—the set of observable characteristics, such as eye color, personality, and behavior, that describe an individual. Our most vaunted, prized, and carefully articulated hypotheses pale in the face of the exquisite complexities of the natural world.

There’s an old pediatric adage that all parents-to-be are environmental determinists until they have a baby in hand, at which point they become genetic determinists. Here is what I mean: Before we have kids, we’re prone to seeing the misbehavior of a child as the product of flawed parenting. That kid throwing a tantrum at the table next to us in a restaurant? It’s obviously the parents’ fault for not controlling him—their nurture hasn’t accomplished what it needed to do. Once we’re responsible for our own felon-in-training, throwing the tantrum in the adjacent airplane seat, we hope that those around us understand that we’ve done our best, but the child came into the world with this temperament. It’s far more comforting to ascribe the behavior of our own noisy or troubling toddler to genes, for which we have only passive responsibility, than to our capacities as parents, for which we are more directly accountable.

In his book Either/Or, Søren Kierkegaard proposed that to fully understand the human condition, we need to dispense with the tendency to perceive the forces that form us as clear-cut dichotomies. Such binary views run counter to the complexities of our true character. Developmental science has in recent decades faced an “either/or” divide: The environmental view has demanded an allegiance to external causes, located within our social and physical contexts, and the genetic view has asserted that internal causes are preeminent, with genomes driving our phenotypes and lives. The positions have emerged as contradictory answers to the fundamental questions, “Why do some get sick and others do not?” and “Why are some so healthy and fulfilled while others are not?” We now know that it is almost never a matter of either/or, but rather both/and.

Photo by Karjean Levine

CALVIN, 9: “When I’m down, I think about things differently and try not to be nervous or stressed.”Photo by Karjean Levine

Unpuzzling Human Disposition

Every human disposition and disorder of mental or physical health depends on an intricate interaction between internal and external causes to take root and advance. The key to understanding human difference and to abating and preventing morbidity will involve a keener knowledge of how genetic difference and environmental variation work together to change biological processes. This approach to “unpuzzling” human nature and wellness brings us closer to understanding what makes orchids and dandelions bloom, wither, or move between these states over the course of a changing life. Both genes and social environments are almost certainly influential for both orchid and dandelion phenotypes, but it is likely the interaction of genes and environments that determine where the kids in my studies ended up on the graphs that we created to chart their behavior and health.

Human infants, even prior to birth, are remarkably and finely attuned to the dynamic features of their environment, first in the womb and later in the nest with which their parents surround them. The brain of the human fetus and newborn is a “black hole” of sensory capacity that can respond to its environment even before consciousness registers it. A newborn unconsciously adapts in the service of “early life programming,” as biological adjustments begin, without awareness, as soon as the brain begins to detect challenges. This early programming enhances the likelihood of short-term survival—at least until the capacity for reproducing comes online in puberty, but it may also have the downside of generating greater risks of chronic adult conditions, such as coronary heart disease, obesity, diabetes, and mental disorders. It is an evolutionary strategy of trading survival in the short run for diminished and less vigorous longevity.

We think that differential susceptibilities to the environment—and thus orchid and dandelion children—emerge in this way. In certain kinds of early social and physical contexts, important benefits to survival and thriving might accrue for children with special, enhanced sensitivities. Children reared in environments of continuous threat and predation, for example, might logically be protected by the vigilance and hawk-eyed attentiveness of orchid sensibilities. Millennia ago, having a few orchidish individuals within a hominid band might have been protective of the group, as attacks from animals and other groups arose. On the other hand, being an orchid might also be of great benefit to those living at the other extreme—in environments of exceptional safety, protection, and abundance. Here, the propensity of orchid children to be open and porous to environmental events and exposures would garner even greater advantages. Most children would thrive in such settings. Orchids would thrive spectacularly.

Outside of these most extreme conditions, however, being a dandelion must surely yield the greatest rewards at the smallest price. Dandelions seem impervious to all but the most virulent of threats and insults. Within the typical ups and downs of human societies, these are the individuals deemed resilient, hardy, and buoyant. Evolution should thus tend to favor a proliferation of orchid phenotypes at the extremes of environmental conditions, while dandelion phenotypes should predominate within the broad middle range of challenges. Sure enough, there is at least preliminary evidence that dandelions are disproportionately represented in settings where neither menaces nor great fortune predominate.

Photo by Karjean Levine

SIERRA, 9: “If I’m down, I think of my favorite things. My friend taught me this song [“My Favorite Things” from The Sound of Music], and I sing it to myself.”Photo by Karjean Levine

Marking Our Genes

During a formative, seven-year sojourn in the frigid green wilds of Canada, at the University of British Columbia, I had the good fortune to meet Mike Kobor and Marla Sokolowski. Mike studies the molecular biology of the yeast genome, and Marla is a fly geneticist who discovered the foraging gene (known as for ) in fruit flies and is responsible for the work defining two major behavioral phenotypes in flies (and other species)—”rovers” and “sitters”— determined by DNA sequence differences in that gene.

Mike and Marla share a capacity for broadly envisioning the implications of discoveries in basic animal models for human societies: They discern our civilizations in our genes. We converged under the sponsorship of the Canadian Institute for Advanced Research (CIFAR), forming the Child and Brain Development Program, which Marla and I now co-lead. Our program quickly closed in on the captivating question of how genes and environments, especially environments of adversity and inequality, together produce known individual differences in susceptibility, behavior, health, and disease. The answer has proven key to a provisional understanding of where orchids and dandelions come from.

We have established that genetic variation—differences in the DNA code that makes up individual genes—plays a role in the genesis of orchid and dandelion children. Although many genes likely contribute to the phenotypes, those involved in brain development and function are almost certainly implicated. The expression of genes involved in emotion regulationand behavioral control, for example— features that are highly salient in orchids and dandelions—govern neurotransmitter communications among individual neurons.

But early environmental experiences undoubtedly play an additional role, especially exposure to adversity and threat and experiences of family or community support and nurture. Emerging science suggests that genes and environments contribute to the emergence of orchids and dandelions, additively and interactively, but until recently we had no real idea of how this interaction actually took place. The field that has now flooded this enigmatic landscape with new light is epigenetics, the science of how environmental exposures can modify gene expression without altering the DNA sequence of the gene itself. The Greek prefix epi—meaning “upon” or “above”—connotes how the epigenome, a lattice of chemical “marks” or tags, literally lies upon the genome and controls the expression or silencing of DNA.

Photo by Karjean Levine

KARSON, 6: “To cheer people up, I say to them, ‘Don’t worry, everything will be all right.'”Photo by Karjean Levine

Every type of cell we possess—blood, liver, lung, skin, brain—contains precisely the same genome, the same collection of genes with the same DNA sequences, half from our mothers and half from our fathers. The only way that the 200 or so different human cell types, each with a different structure and different functions, could be made from a single genome is if the functioning of our 25,000 genes could be independently controlled. That’s how the epigenome comes into play in embryonic development. Stem cells can become kidney cells or white blood cells only through the programmed, epigenetic regulation of those thousands of genes. Once a stem cell is differentiated—say, into a white blood cell—the functioning of that cell can also be adjusted (again, epigenetically) to accommodate or adapt to the conditions with which the cell or the whole organism is contending. For example, a child facing a seriously stressful environment might need to change white blood cells’ rate of division (increasing the number of available immune cells), the cells’ responsiveness to stress hormones (sensitizing them to the effects of cortisol), or their production of the molecules initiating and governing inflammation (such as the chemical messengers called cytokines).

So, the epigenome has two major functions: It regulates the differentiation of cells into their various types and tissues, and it facilitates an adjustment of cell function to respond to the conditions at hand. It does both of these by regulating the epigenetic chemical tags that attach to the genome, turning up or turning down the expression of the thousands of genes in each cell. It is a great and agile improviser.

Pianos and Equalizers

Think of the genome and epigenome like this: Your genes are the keys on a piano; each plays a distinctive note. But while a piano has just 88 white and black keys, your genome houses around 25,000 individual genes, making it thousands of times more complex. In the first kind of epigenetic regulation—cell differentiation—these keys can be played in different combinations, sequences, and timings to create a whole variety of different tunes—200 different ones, for each of the different types of cells in a human body. One corresponds to the production of neurons, another to white blood cells, yet another to skin cells, and so on.

Once cells are differentiated on this magnificent piano, the epigenome is then used for a second kind of process: the adjustment of cell function to the conditions the organism is encountering. Here, the epigenome serves as an “equalizer” that adjusts each cell’s functions, changing the way its tune sounds, like the levers on an audio equalizer adjusting the balance between sound frequency ranges to emphasize treble or bass notes. Although each type of cell always plays the same tune—a white blood cell will stay a white blood cell—the way that the cell functions can be adaptively adjusted to suit specific circumstances.

Photo by Karjean Levine

MILEVA, 7: “When I need cheering up, I snug with my stuffed animals.”Photo by Karjean Levine

For example, the body of a child encountering a major early life stressor, like maltreatment, might automatically adjust the functioning of many different cell types in order to adapt as well as possible to the experience. Adrenal gland cells might be called upon to produce more cortisol; nerve cells could activate the fight-or-flight system; white blood cells could respond to any physical injuries; and brain cells might dampen the child’s emotional response. And these would be only four adjustments among probably hundreds occurring at the same time.

Just as biobehavioral phenotypes, like orchid and dandelion children, are likely influenced by DNA sequence variations in many genes, it is probably also true that the effects of early experience on these phenotypes involve many epigenetic changes within multiple genes. Just which genes are different in sequence and where the epigenetic marks occur is still being worked out, for orchid versus dandelion, introvert versus extrovert, predispositions to depression versus predilections for joy, and other human differences.

What we now know with some certainty, however, is that most variation in human character, nature, and health will eventually be attributable to an interactive combination of differences in the DNA sequences of multiple genes, along with experience-driven differences in the epigenetic marks that shape the expression, or decoding, of multiple genes. What is wickedly complex in the number of variations involved is elegantly simple in design: Genes and experience interactively affect human destiny, and the epigenome is the physical link between a gene and its environment. You can think of human life as the song that issues from the epigenetic piano and its equalizer, the result of a complex compositional process shaped by both genes and environments. Each person is predisposed to play certain types of scores, like those of the orchid or the dandelion, but there is abundant space for unique variation and improvisation.

Excerpted from THE ORCHID AND THE DANDELION: Why Some Children Struggle and How All Can ThriveCopyright © 2019 by W. Thomas Boyce, M.D.  Published by Alfred A. Knopf.

Emotional Intelligence Creates Loving and Supportive Parenting

EMOTIONAL INTELLIGENCE CREATES LOVING AND SUPPORTIVE PARENTING

John Gottman

In the foreword to my book, Raising an Emotionally Intelligent Child, famed researcher on emotional intelligence, Daniel Goleman, writes:

These are hard times for children, and so for parents. There has been a sea change in the nature of childhood over the last decade or two, one that makes it harder for children to learn the basic lessons of the human heart and one that ups the ante for parents who used to pass these lessons on to the children they love. Parents have to be smarter about teaching their children basic emotional and social lessons.

Before I became a father, I had spent nearly twenty years working in the field of developmental psychology, studying the emotional lives of children. But it was not until our daughter arrived that I began to truly understand the realities of a parent-child relationship. I had no idea of the intensity of feeling I would have for my child, or how thrilled I would be when she learned new things, or how much attention and patience it would require. And I remembered how dangerous the world can be, and I felt vulnerable because losing her would mean losing everything.

As a Jew whose parents escaped Austria during the Holocaust, I had respected the efforts of other theorists who rejected authoritarianism as a way to raise morally healthy children. They proposed that the family operate as a democracy and that children and parents act as rational, equal partners. My years of investigation into family dynamics began to yield new evidence that emotional interactions between parent and child would have an even greater impact on a child’s long-term well-being.

That greater impact on long-term well-being results in building a child’s emotional intelligence, which is important because, more than IQ, emotional intelligence seems to determine success in life. The ability to understand other people and work with them is critical to success in modern work life. It is also critical in relationships, and we know that having successful friendships and romantic relationships confers enormous benefits in health, wealth, happiness, longevity, and the success of one’s children.

Emotional intelligence informs Emotion Coaching as a parenting method

When it comes to parenting and emotional intelligence, there are two groups of parents that are so very different when it comes to the world of emotions. Emotion Dismissing parents are action-oriented, and don’t want to become emotional, and they see this as potentially destructive in themselves and in their children. Emotion Coaching parents are the opposite: accepting of emotions and explore emotions in themselves and others.

In our research, we found that the effects of these two approaches were dramatic. The children of the two kinds of parents were on totally different life trajectories. And when it came to divorced families with children, I was also surprised that emotion coaching buffered children from almost all the negative effects of their parents divorcing. Two kids with the same IQ starting at age 4 would have entirely different educational achievement at age 8 if their parents were emotion coaching, all mediated through differences in attentional abilities.

Even more powerful is that these results all appear to be cross-culturally universal.

Emotional intelligence in parenting begins with the self

What turns out to be really wonderful about our results is that, with emotional intelligence, one needs to begin with one’s self. It is important to understand one’s own feelings about emotions, and to learn that self-understanding comes from recognizing one’s own feelings. Emotions are our internal “GPS” through life. Opening up our own emotional world and being emotional is where we need to start, and it confers huge gifts.

Yet being emotional doesn’t mean you aren’t rational. The two often seem in opposition—emotional reactions versus logical responses. But you can have both. As a parent, you can also be emotional with your child—not abusive (which would be the opposite of emotional intelligence), but emotional. You can be angry, hurt, disappointed, tense, frustrated, and so on. This seems inevitable in parenting, and if you model a positive approach to handling your own emotions, your child will likely notice.

And you can let your child know that their anger is okay with you, that you can understand their anger. But you can also tell them that when they say that they “hate” you, this really hurts your feelings and it makes you not want to be around them.

Parents do not have to take abuse from their kids, and as part of teaching emotional intelligence, it’s okay to let children know when they are being hurtful or abusive, too. If you model an emotional yet respectful response to something like “I hate you,” children will pick up on that kind of response. They’ll know that what they are saying is actually hurtful. They’ll begin to understand how it makes you feel, which then can inform how they emotionally handle other relationships in their lives.

When to start with Emotion Coaching—our program to teach emotional intelligence

Our evidence shows that emotion coaching begins in the way parents interact with their babies. Babies can understand language long before they can talk. As early as ten months of age, emotion coaching parents are narrating their children’s play, asking them questions, communicating empathy, and giving reasons for saying “yes” or “no.” This has major consequences for the baby’s development, as does a positive relationship between parents. We even have a workshop called Bringing Baby Home that helps couples with the transition to parenthood so that their relationship is strong and models positive emotional behavior for children.

But it’s also never too late to become an emotion coaching parent. I have had parents start with adult children and say that they have been close to their kids for the very first time, ever. Emotional intelligence is not a static trait—it can be cultivated and learned at any point in life, by anyone, to their benefit and the benefit of those they interact with.

Here’s how it can start: one of the most powerful gifts you can give your child is an admission that you made a mistake, and apologizing and asking for forgiveness confers respect to the child. The child learns that it is okay to make a mistake and correct it. The child learns that it is possible to repair interaction. And the child feels that their emotions are respected and that you, instead of being authoritative, are capable of being an emotional equal.

Most importantly, the child learns that one can be loved without being perfect. That feeling of unconditional love, of being able to repair negative interactions, of being mindful of your own emotions and those around you—that’s a wonderful foundation upon which any child, with their parents’ guidance, can build a fulfilling and successful life.

Stress: When Your Teen Sweats the Small Stuff, the Big Stuff, and Everything In Between

STRESS: WHEN YOUR TEEN SWEATS THE SMALL STUFF, THE BIG STUFF, AND EVERYTHING IN BETWEEN

J’Nel Wright

J’Nel Wright

“I just need everything to go perfect tonight.”

That was the concern of my son’s chemistry partner as she hurried through the lab, clearly distracted by the night’s upcoming orchestra performance. Knowing that her parents had invited close friends and extended family to the concert, she was adamant that her performance needed to be flawless. Not just good—but flawless. One simple mistake would mean total failure in her mind.

What’s wrong with wanting things to be perfect? And why should we apologize for desiring nice things and impeccable performances? Ilene Strauss Cohen, PhD, understands that feeling. “It’s that feeling you get when you expect things of yourself that you’d never expect from others,” she says in an article for Psychology Today. “It’s working yourself to exhaustion in hopes that you’ll feel whole, complete, worthy. It’s basing your self-worth on external accomplishments, feeling like you have something to prove all the time.”

Welcome, my friends, to the world of the modern teenager! This constant exposure to pressure, combined with a desire for perfection, is pervasive and contagious, and our kids are picking up on it at an alarming rate.

“Perfectionism lives and breathes in your fear of making a mistake. When you’re afraid of what might happen, you don’t always make the best possible choices,” says Cohen. At this time of life, when choices affect the course of young people’s future opportunities, a desire to perform their best and adapt to changes when necessary is a normal part of growing up. But, in some cases, this internal need to achieve perfection often has a paralyzing, anxiety-ridden effect.

The Anxiety and Depression Association of America (ADAA) found that anxiety disorder affects 30 percent of children and adolescents, but 80 percent of those affected never get help. With the exception of teenagers—who transform into these emotionally-charged, high-maintenance, snack-devouring, earbud-fashioned mounds of walking drama—you know your children better than anyone. So, it’s important to recognize any changes in appearance, social interactions, and habits. These could be signs of anxiety disorder.

Anxiety is normal, but it sure doesn’t feel normal most days.

“Anxiety is a natural human reaction that involves mind and body. It serves an important basic survival function,” explain the experts at kidshealth.com. “Although these situations don’t actually threaten a person’s safety, they can cause someone to feel ‘threatened’ by potential embarrassment, worry about making a mistake, fitting in, stumbling over words, being accepted or rejected, or losing pride.” People also experience sweating, a nervous stomach, and a fast pulse. These are all normal physical signs.

But when a young person is constantly feeling anxious, she’ll become physically ill, preoccupied, distracted, and tense; she knows something isn’t right. “Symptoms of an anxiety disorder can come on suddenly, or they can build gradually and linger until a person begins to realize that something is wrong,” say experts. “Sometimes anxiety creates a sense of doom and foreboding that seems to come out of nowhere.” Often, we know how we feel, but we don’t know why we feel this way.

If you see signs of anxiety, what should you do?

Don’t punish the symptoms.

As frustrating as it feels to watch your teen snap at siblings or isolate him or herself from friends or social activities, don’t focus on the symptoms of anxiety. Instead, use those situations as an opportunity to talk about what’s going on. “Hey Johnny, you haven’t been yourself lately, and I know the ACT test is coming up soon. Can we talk about what’s going on?”


If your teen responds and decides to open up about his feelings, do a little mental happy dance in celebration of this rare event. Then, listen. Really listen with your full attention as he talks about what’s going on.

Don’t confront anxious feelings with logic.

At this stage, you’re not here to provide an immediate solution. Rather, you are merely a sounding board for him to express what has been building up in his head. Intense anxiety isn’t based on rational thinking. So telling a teen to just “get over it” or dismissing these feelings as a temporary phase doesn’t help.

“Anxiety is not a choice, and asking an anxiety sufferer to just calm down is like asking someone with a broken ankle to just stop having a broken bone,” says Donna Chambers. “Most people wouldn’t dream of encouraging someone with diabetes to just stop having high blood sugar, yet many people view mental health differently than physical ailments.” Instead, simply lend a listening ear and assure your child that you are here with your full support.

What’s the worst that can happen?

Sometimes, putting stressful things into perspective helps take away the power of those feelings. “I like to list all the things that I can still do today, tomorrow and this week—which, of course, is a lot of things—almost everything,” says Robert L. Leahy, PhD. “You will quickly learn that your life is unchanged even if this apparently upsetting event has occurred. It’s more a preference than a necessity.”

When we face situations where the outcome is beyond our control—which is often the case for teens who try out for a lead role in a play or apply to their top choice for college, for instance—we feel helpless. But author Amy Morin, LCSW, says that often the worst-case scenario isn’t as bad as we feared. “There’s a good chance you’re stronger than you think,” says Morin. “Acknowledging that you can handle the worst-case scenario can help you put your energy into more productive exercises.”

Introduce coping tools early.

One of the best gifts we can share with our kids is the ability to cope with pressure and steer clear of the need for perfection. That means, as parents, we need to adjust our priorities as well. For example, “Teens need to learn that the process of learning is far more valuable than the grade on the top of the page,” says Katie Hurley, LCSW. “Talk to your teen about his/her preferred learning styles, what can be gained from mistakes and failures, and how to apply new knowledge to future situations.” Although parents are quick to share stories about past successes, it’s important your teenagers hear about your struggles too.

“Teens hear a lot about what they should do and what expectations they need to meet. It helps them to hear that their stress and anxiety is understandable, and that you remember that need to perform,” says Hurley. “Open and honest communication about the pitfalls of adolescence helps normalize the process and relieves teens of the pressure to succeed.” Sounds like good advice for Instagram-saturated parents as well.

By helping your teen recognize the signs of anxiety, they will develop important coping skills that can support them during the small stuff, the big stuff, and everything in between.

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