Some Thoughts on Homeopathic Family Practice: Does Parenting Impact Constitutional Types? Should Constitutional Types in Children Impact Parenting?
The New England Journal of Homeopathy
Spring/Summer 1997, Vol.6 No.2/3
by Amy Rothenberg, ND, DHANP
Visit any local library or bookstore and you will notice an ever-growing section on parenting. The section begins with books on infertility and pregnancy and moves quickly on to problems of nursing and sleep, tantrums, how to handle your difficult toddler, your high-energy child, your spirited child, your clingy child, your artistic child, your genius child, etc. Whatever type of child you are blessed with, there is a book out there to help you navigate the early years.
The best thing about any of these books is the fact that when a parent finds one they can relate to, it makes the parent feel better; they are not such a bad parent after all, other people have a child like ‘impossible Johnny’, or ‘quirky Susie.’
In our times, there is little if any family support for the wonderful, if at times impossible, job of parenting. The extended family is almost extinct. With so many single-parent families, or families with two parents working full time or simply the stressed-filled lives of so many parents, such books lend emotional support to parents seeking just that.
What is the role of the homeopath in addressing these issues with our patients-or rather with the parents of our patients? Is it appropriate to make recommendations or suggestions with regard to the delicate subject of parenting? Shouldn’t the remedy take care of the problem? How much of the pathology is due to lack of effective or maybe even damaging parenting? How do we make suggestions without being judgmental or intrusive? Are there things we know as homeopaths about remedy types in children which could help parents do a better job? I approach this topic with parents and even in the writing of this article with a heavy dose of caution as it is a sensitive area for many. What follows are some of my ideas related to these questions and how I handle them in my practice.
I see the children in my practice with their parents until they are about age 7 or 8, then I offer the child the opportunity to see me alone, at least for part of the visit. If there are things the parent wants to tell me that they do not necessarily want to say in front of the child, I will ask the parents to come in first. I particularly like to get the story without the child if the visit is about behavior issues, discipline problems, social problems, school concerns, personality problems, etc. It doesn’t feel appropriate to talk about those issues in front of a child, right off the bat.
I will bring the behavior issues to light later, when I am alone with the child, but at least this way, I will have some context for the discussion and case taking. I may also bring up the subject with the parent and child together, to see the reaction and interaction within the family, to look at the language use, the ability to communicate and the emotional issues which arise due to the topic.
When I am finished taking the case I may have some thoughts about what I’ve seen or not seen in the interaction between the parent and child. Generally speaking, I keep these observations to myself, perhaps use them in my homeopathic analysis (i.e., controlling dictatorial child, contradicts everything the mother says, belittles the mother in front of me-I’m thinking about Lycopodium or Anacardium—depending on the presenting symptoms and other confirmatory symptoms. A passive dependent child, who constantly looks to the parent for support and help, can’t make eye contact, who, upon questioning keeps saying to the mother, “I don’t know, what do you think, mommy?” probably needs a remedy like Pulsatilla or Staphysagria, regardless of what the chief complaint is.) Only if the problem in the relationship is clear to me, is clearly causing pathology, and is pathology, do I venture some suggestions.
Whatever my personal assessment might be, there are many ways to parent. And certainly as homeopaths, we have a wide range of what we consider ‘normal’. Like the correctly chosen remedy, given based on the individualizing characteristics of the child, children need different things from their parents, even within the same family! So if problems seem glaring, I assess the situation to see if the parent is open to suggestions. And if so, I offer gentle suggestions about setting limits, or using ‘I’ statements, finding more childcare, less child care, the use of behavior modification or suggestions for encouraging responsibility. Sometime I ask the parents if they have areas of special concern or questions or things they want to discuss beyond what they brought the child in for, anything that relates to how they parent that particular child. There is often appreciation on the part of the parent to have a place where these issues can be raised and talked about, even if briefly.
If my initial treading on these grounds is rejected, I never push. And I always do this after my case-taking is completely finished. I offer to treat the parents, especially if the child is suffering from any type of chronic illness or if the illness is on the mental or emotional sphere.
What other kind of advice do I give parents? Sometimes it is specific and related to the constitutional type of the child. If I see a Calcarea carbonica child giving the parents a very hard time with every transition, I remind the parents about giving this type child the 10 minute warning when they will need to leave, then the 5 minute warning, then the two minute warning, and then depending on the child’s age, helping them get the shoes on if necessary. I explain that by describing what is going to happen and narrating as it is happening and then positively reinforcing it, once it has happened (i.e. “You really did a great job getting your coat on and helping us get out the door on time,”) you can greatly increase the child’s cooperation about making these everyday necessary changes.
The Calcarea carbonica child may have terrible fears and anxieties and perhaps even nightmares if they see frightening images on television or at the movies. I am not sure it is a bad thing to be sensitive to such visions, especially for the very young, so I encourage most of my patients to avoid this exposure if at all possible. Children learn best by doing, not by watching. The television has become the great All-American baby-sitter, not necessarily to the benefit of children.
Stramonium will also have horrible fears after seeing scary things, whether on television or in pictures in books. I recently saw a little Stramonium girl, brought in for recurrent urinary tract infections and nightmares. Seemingly innocent videos would send her screaming in fear. The one the father described was Winnie the Pooh-the episode where Pooh gets stuck in Rabbit’s doorway and while there, Rabbit draws a black, crooked and frightening smile on Pooh’s bottom. At least that’s how this little girl perceived it. This otherwise benign and gentle movie caused increasing anxiety for the child; the stress and fear mounted exponentially as it moved toward that scene, that the father finally learned to fast forward past that part, while the child grew increasingly agitated throughout. She would be sure to have a nightmare that night. It does not matter that most children find this a delightful and sweet story. It does matter that her predisposition toward needing Stramonium led her to feel fear and anxiety. Parents need to screen what these kids see and if they are in a phase of nightmares and heightened fears, it is best to help them avoid such encounters altogether while the remedy is working on shifting their predisposition away from this sensitivity.
For the Tuberculinum child, who might be very difficult for the parent, I always recommend that the parent or caretaker get the child out of the house at least a few times a day, weather permitting. They have a strong need to go ‘bye-bye.’ Even babies and toddlers already have that desire to travel. They need a change of scenery-it doesn’t really matter where-the library, park, shopping. Some parents think it is the gentle rocking motion of the car, but for these kids it is really the change of scenery which makes them better.
For an older Pulsatilla child who has deep and constant need for attention and affection, I will often suggest that the child be given something of his or her own to take care of-a guinea pig, or hamster (provided the mother herself does not have excessive fear of rodents!!) In so doing, we take a child with excessive need and let her shower a pet with loads of love and affection, which seems to help the whole family dynamic.
If I see a painfully shy child, who needs Silicea or Staphysagria I keep my voice very low in the interview. I match their demeanor as best I can. These are the children who need very little discipline and if I see either parent overly disciplining this child for a small infraction (biting the nails, splitting hairs, not sitting up straight), after the child has left the room and if the parent seems open to it, I will explain a bit about the remedy and how this type of child generally doesn’t need a lot of harshness to come round right away. Of course, with the case of many a Staphysagria child, it is a great possibility that they became a Staphysagria child because of a harsh, loud, sometimes violent parent. So be careful. You may be treading on sensitive ground.
What about the fact that the remedy is supposed to help with all this? It will. And it may also take time. Parenting support can help the remedy work faster by removing some of the irritants to that child’s day. The child can put more energy into attaining balance if there is not constant conflict, unnecessary discipline or emotional turmoil. It’s like a bit of prevention, if you will, on the part of the parent. And most parents who live with a tantrumming toddler, emotionally needy kid, or difficult adolescent, will be just as happy to put in a bit of effort to head off trouble, if possible.
Of course, this can be taken to the extreme. Many parents with challenging children of all ages, have developed elaborate and wide-reaching strategies of avoidance. “What can I do to avoid a situation which will set Sarah off?” Or, “How can we plan this day so as to keep Steven in a good mood?” There is nothing by definition wrong with trying to create a peaceful environment and trying to initiate pleasant events, but parents’ energies and resources can be severely taxed from the constant micromanaging of a child’s life. It can also have a negative impact on the rest of the family. Thankfully, we do see that the right remedies, in addition to some support in parenting, can shift the balance in the child, and then in the family, back to a healthier place.
I also make recommendations about diet. Most kids, especially those who are on the hyper side, will do better on a low sugar, high complex carbohydrate diet devoid of additives, preservatives and food dyes. I do spend a bit of time with parents talking about diet. Many people who come to a homeopath are already keeping a wonderful diet and I affirm this. But just as likely are folks who come in strictly because you helped someone else they know with a similar problem-and they have no idea what in the world you do, and frankly don’t care-they just want help! It may be futile to make dietary suggestions, but it certainly falls within the parameters of the Organon to look at the diet and make general recommendations, or if you don’t feel comfortable with that role, send them on to someone who does.
In families where there are many children or a number of children spaced very closely, and every child suffers from lack of attention, I encourage the parents to try to set up some time each week or month which is ‘special time’ for one of the parents and the child in question, (ideally for each child). The children really look forward to this and enjoy it. It gives time for the parent to get to know the child, away from the bustling family, outside the usual roles they fall into, within the family. A usually rambunctious child can become sweet and affectionate, jabbering on about this and that. A usually bubbly and spacey child can become quiet and calm when alone with the parent. This activity is a rare, inexpensive and meaningful treat that family members can give to each other.
What about the terribly over-attached child who is nursing at four, in a family that is doing the ‘family bed?’ There is no way to criticize these folks. They are doing what they feel is best. I have seen many families where this is the situation and it seems to be working fine for everyone. Wonderful.
There are other families who do not fare as well. The most frequent problems encountered in my practice by these families, in terms of what brings them into the homeopath are: asthma, behavior problems, difficult toilet training, early tooth decay, ear infections and impossible separation anxiety. Should you say anything about the family dynamics? I don’t. What I find is that with the correct remedy, the child will often decide to stop nursing and will show that they want their own bed. (My feeling has always been, if they’re old enough to walk over and ask for it, they’re too old to nurse. That written, I have also seen many a toddler and preschooler in happy nursing relationships with their mothers, so I rarely say anything. This is a very sensitive area.) As the physical symptoms begin to decrease-less asthma, or fewer, less severe ear infections, many of the other power struggles seem to also fade. In these situations, it can be quite helpful to treat the mother simultaneously.
What about when I see a child whose parents are having obvious relationship problems, difficult communication, conflict about reporting symptoms or agreeing about health care choices? I do the best I can to take the case. If that relationship is so negative as to make the casetaking difficult, I have the child leave the room, if they are old enough, and try to honestly reflect what I see: a child caught between fighting parents, or a child anxious because of the parents’ conflict. I try to focus these observations on the child, as s/he is the patient at hand. I make frequent referrals to family therapists in our area and see the remedies as essential partners to that therapy work.
As to the disruptive or violent children who come into my office, I will let things run their course for a time, mostly to see how the child ‘does their thing’ and to see how the parents handle it. I can get a lot of information about the remedy by sitting back and taking it all in. I will often come on heavy at some point. “Hey, those are my toys, you may not throw them at your brother,” in a somewhat raised voice. Some kids back right down and retreat to the mother’s lap-perhaps a mischievous Sulphur. Others feel egged on by this reprimand and carry on with gusto, as in the case of Medorrhinum. I am not being mean, just seeing how a certain stimuli will impact a patient. I set clear rules and stick to them. I set the limits if the parents don’t, though I defer to them, initially.
I have had some truly unbelievable experiences with little patients. One time I went out to get a four year old child who was brought in for ADD. I always question that diagnosis for that age child, so was curious when I looked at this intake form. Before I could extend my hand to greet the child’s mother, he lunged at me and before I knew what hit, had his chompers squarely sunk into my bottom. Not one to be easily ruffled, I asked the mother, “Does he greet everyone like this?” I think it was most shocking to my receptionist, who just sat there, phone dangling, jaw dropped, as I excused my self to the ladies room to regard my garments. ( He did very well over the course of a number of years on Tuberculinum.)
I have been poked, prodded, pinched and spat upon (not all in the same day, I’m happy to report!) Parents feel horrible when their child does something like this, and I certainly don’t feel great, but I try to assure the parents that it’s better for me to see their child in action, to find the right remedy and help them move beyond that point. If there are episodic types of illnesses like tics or seizures, tantrums, or other behaviors that the parents feel I should see, I will sometimes ask them to video such an event and send it to me. Pictures can paint a thousand words.
One comment about living in the community where you practice, as so many of us do. What happens when you run into a family that you treat? I always ignore the people, unless they approach me, especially if there are other people around. Perhaps they don’t want the other people to know they have a health concern or that they go to a homeopath(!). If they come over, I am friendly. I discourage speaking about their cases and ask them to phone me at the office. Setting clear boundaries is important! (See Todd Hoover’s Letter to the Editor, page 3)
As to all those parenting books, I would like to recommend some very helpful ones. Firstly, for the totally overwhelmed, especially first-time mother, who has an intractable case of ‘milk brain’ and feels that her mind went out with the placenta, I prescribe Operating Instructions by Anne Lamott (Fawcett 1996) a sometimes hysterical, always thought-provoking journal of the first year of that first time mother’s life with her son. Also essential to laugh away the (mild) post-partum blues is the comic book Baby Blues, This is Going to be Tougher than We Thought, by Rick Kerkman, (Contemporary Books 1991) which has left more than one new parent tear-struck with laughter.
When communication seems to be the biggest problem for any age parent/child, the best practical book which offers immediate results is How to Talk So Kids Will Listen and Listen So Kids Will Talk by Adele Farber and Elaine Mazlich (Avon Press 1980). (I recently found not one, not two, but three copies of this book on my bookshelves. I pick up spare copies at tag sales or used book stores to give to friends. When my eight year old daughter, an avid reader saw it, she opened it up. She started reading choice sections of comic strip renditions of ‘before and after’ scenarios of communication problems resolved, out loud to her 5 and 6 year old brothers. They sat there aghast. “Mommy and Daddy studied this stuff-wow!!!”)
Topics as described in the table of contents include: How to Help Children Deal with their Feelings, Engaging Cooperation, Alternatives to Punishment, Encouraging Autonomy, and Freeing Children from Playing Roles. It’s inexpensive, an easy read and has a very big ‘oh, yea!’ factor. It seems so simple, how come I didn’t think of it? I urge most parents in need of a little direction to read it. There are so few requirements for being a parent and there has been so much bad parenting out there. Taking time to learn some basic techniques and skills can help immeasurably.
If the main problem is sibling rivalry, the most complete and usable book is also by Farber and Mazlich: Siblings without Rivalry. (Avon 1988). This book has changed the lives of many families with more than one child. It is direct and easy to pick up on their suggestions. More than anything it gives parents strategies to address the sometimes difficult and frustrating situation of children who constantly bicker, fight or threaten each other.
If I see a situation where the parents are clearly unable to set age appropriate limits on their child, especially toddlers and preschoolers, I may suggest the book 1-2-3 Magic, by Thomas W. Phelan, PhD. (Child Management, Inc., 1995) which is a bit harsh in its philosophy but models a very effective way of giving ‘time outs’. It’s not for everyone’s taste, and that technique is not appropriate for every child, but it can be very effective for the kids who push every limit to the max.
When I return home from the office to my own children, they ask me about my day. I describe things in very general terms, but often say the names of the remedies, for them to hear. They repeat the strange sounding Latin names and often giggle at the silliness of the way the remedies sound. It can make me laugh, too-the thought of small granules impacting people’s lives so deeply, so profoundly. Yet we see it day after day, year after year. Here’s to all the children in our practices, with the hope that our understanding them and prescribing accurately can help move them toward healthier, more balanced lives.
Dr. Amy Rothenberg graduated from the National College of Naturopathic Medicine in 1986. She has been practicing classical homeopathy ever since. In addition to seeing patients, Dr. Rothenberg is known for her lively lectures to lay and professional students throughout this country. She particularly enjoys teaching homeopathy and how it fits into the larger natural medicine scene. She has taught for the International Foundation of Homeopathy, the National Center of Homeopathy and for the New England School of Homeopathy.
She is the editor and publisher of the pacesetting New England Journal of Homeopathy, which she founded with her husband Paul Herscu, ND in 1992.
When not busy with the world of homeopathy she enjoys life with her husband and children-gardening, singing, swimming and doing art.
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