Blamed by Others? Blaming Yourself?

Parents, especially mothers, were once blamed by many psychologists and psychiatrists for their children’s neurodevelopmental and psychiatric disorders. Lack of love and nurturing and even unconscious hate by "refrigerator mothers" supposedly caused autism. Conflicting and confusing communication in "schizophrenogenic families" supposedly caused schizophrenia. These kinds of inaccurate, harmful, and hurtful ideas are, at least in most of the professional community, relics of the past, thanks to up-to-date research along with education by advocacy groups.

While most health care professionals no longer endorse these kinds of explanations many parents in my practice still often report being blamed in different ways on a regular basis by family members, school staff, and people in the community. People say things like: "If you only disciplined your child more . . . obtained professional services earlier . . . not had your child vaccinated . . . etc. . . . then your child would be better behaved . . . more social and more verbal . . . not mentally ill." When I hear these stories, my heart breaks a bit.

My heart breaks even more when some parents in my practice blame themselves. They imagine their child might be developing typically if, during pregnancy, they had eaten differently, been less stressed, or taken no or different medications. They question the ways they took care of their child when their child was young, or how (or how soon or how late) they responded when issues first became apparent.

They wonder if they should not have had their child vaccinated, or if they should have disciplined their child more. They may think that their reactions in response to the challenges of raising a neurodevelopmentally atypical or psychiatrically ill child somehow caused their child to be atypical or ill in the first place.

Just as it is vitally important for parents to learn not to blame their children for their neurodevelopmental and psychiatric problems, it is also vitally important (for their own well-being and their child’s) for parents to learn not to blame themselves.

What do I tell parents in my practice who are blamed by others and even blame themselves? What do I hope they learn?

1. Neurodevelopmental and psychiatric disorders are genetically and biologically (brain) based.

2. Brains are almost unimaginably complex systems with billions of parts (neurons) and up to thousands of connections (synapses) between each part (i.e., each neuron with other neurons).

3. It is easy for something "to go wrong," or at least not develop typically, in the 40 weeks between conception (when there are no neurons) and delivery (when there are billions of highly and complexly interconnected neurons).

4. That something "going wrong" or developing atypically could be caused by any, or some combination of, genetic or environmental factors, most of which we are not even aware of and/or are beyond our control.

5. That something "going wrong" or developing atypically might begin with some small, essentially chance, accident, or error in brain development that becomes more and more significant as the brain builds upon and out from that accident or error. Small early changes can lead to large later outcomes in highly complex systems.

6. All behaviors, our children’s and our own, are caused by a combination of interacting events that happened seconds before (in our brains), minutes or hours or days or weeks before (in or bodies and environments), years before (in our families and also in our schools, peer groups, and communities), centuries and millennia before (in our cultures and societies), and, ultimately, events that happened all the way back when humans were evolving from their common ancestors with other primates.

I will expand on these ways of understanding the origins of atypical child development in future blog posts. I hope these posts will help readers move away from false "moral" attributions (explanations of behavior) to more biological/brain-based, environmental, and historical attributions. In my experience, this shift leads to less shame, blame, and guilt and more forgiveness and acceptance.

Psychiatry Essential Reads

Psychiatric Diagnoses Don’t Explain ‘Why’—Only ‘How’

5 Things Everyone Should Know About Psychiatric Hospitalization

In the meantime, I offer readers of this post a quote from a novel by award-winning writer Ian McEwan and a poem by award-winning poet Wislawa Szymborska. I sometimes share these with parents in my practice and with the students I teach at a local college.

This quote and this poem invite you to shift your thinking about how much we, as parents, are to blame when our children struggle and even how much we, as parents, deserve credit when our children develop typically or do especially well.

From Saturday by Ian McEwan

It’s a commonplace of parenting and modern genetics that parents have little or no influence on the characters of their children. You never know who you are going to get. Opportunities, health, prospects, accent, table manners—these might lie within your power to shape. But what really determines the sort of person who’s coming to live with you is which sperm finds which egg, how the cards in two packs are chosen, then how they are shuffled, halved and spliced at the moment of recombination. Cheerful or neurotic, kind or greedy, curious or dull, expansive or shy and anywhere in between; it can be quite an affront to parental self-regard, just how much of the work has already been done. On the other hand, it can let you off the hook. The point is made once you have more than one child; two entirely different people emerge from their roughly similar chances in life.

"Could Have" by Wislawa Szymborska

It could have happened.
It had to happen.
It happened earlier. Later.
Nearer. Farther off.
It happened, but not to you.

You were saved because you were the first.
You were saved because you were the last.
Alone. With others.
On the right. The left.
Because it was raining. Because of the shade.
Because the day was sunny.

You were in luck—there was a forest.
You were in luck—there were no trees.
You were in luck—a rake, a hook, a beam, a brake,
A jamb, a turn, a quarter-inch, an instant . . .

So you're here? Still dizzy from
another dodge, close shave, reprieve?
One hole in the net and you slipped through?
I couldn't be more shocked or
speechless.

Listen,
how your heart pounds inside me.