As a pediatrician and medical geneticist, I have interacted with thousands of children and families in the clinic and the hospital. I have been a primary provider or a preceptor or a teacher in those settings. I have observed how parents and children interact in stressful and not-so-stressful times. At times, the children have been ill, and the parents have had great concerns about their children. At times, the children have been well, and the parents want their child’s overall health assessed. I have certainly witnessed good times and bad times for children and their parents.
I must admit that it took me many years to adopt a stance in counseling parents about the parenting process. Even with my many years of training and experience as a parent myself, I humbly admit that the process of learning how to counsel families in the art of parenting has not been easy. It has really been a multi-step process – I have to learn 1) the developmental processes that children go through; 2) how I interpret these processes; 3) how to impart my knowledge to the parents; 4) how to interpret the cues from the parent-child interaction; 5) how to judge the strengths and areas for improvement for the families; 6) how to be sensitive to the cultural background of the family; 7) how to humbly seek more information while sensibly putting forth advice; 8) how to build trust over time with the child and parents; 9) how to see each interaction as a learning experience for myself; 10) how to realize that every moment in the interaction with the child and parents is a precious one to savor; 11) how to listen and not just be heard.
If that list of the necessary steps sounds intimidating, it is. Human interactions, especially ones designed to be of the healing and reassuring nature, are never easy. The moment physicians become complacent about their role (and their humanity) is when we have lost our connections and trustworthiness. Our ability to be a trusted counselor and source of medical and health knowledge rests on relational health – how we relate to the children, how we relate to the parents, and how we impart the importance of relational health to the family.
My two recent books emphasize relational health. Co-authored with Dr. Andy Garner, THINKING DEVELOPMENTALLY: NURTURING WELLNESS IN CHILDHOOD TO PROMOTE LIFELONG HEALTH emphasizes how children develop (the science behind early brain development) and how to use this information to build solid, long-lasting relationships (safe, stable, nurturing relationships [SSNRs]) that will help children, help families, and help communities to be places of well-being.1-3 What happens now in childhood will carry over to adulthood in terms of physical health, behavioral health, and mental health. CONSCIOUS PARENTING: USING THE PARENTAL AWARENESS THRESHOLD seeks to provide a paradigm for being alert to the parent-child relationship.4-6 When one is alert (present, attentive, attuned and responsive), we start to see what is really happening in the life of the child and the life of the parent and can adjust our reactions to given situations in a loving way. But when mishaps occur in a relationship (and they always will), the paradigm is useful for learning how to repair the mishaps and strengthen the relationship and trust going forward.
To paraphrase, parenting is all about learning how to nurture and learning how to repair relationships. There are no easy “map reading” skills while parenting.7 Thinking developmentally and being a conscious parent are skills that are developed over time and only with help and support. I’d like to think that the latter two areas have been where I have evolved over time to be a valuable guide for children and families.
All of the above is a preamble to what I wanted to address in this blog entry. I have had two recent observations that I think are useful illustrations of strengths of parenting and areas for improvement in parenting. These observations were not in my clinical setting. They were in the “wild.”
- Strength – While waiting for my wife to have some x-rays the other day, I sat in the waiting room of a multipurpose clinic where adults and children checked in for various encounters. I observed multiple families or parent-child pairs coming and going. My heart soared to see so many children and parents holding hands and exchanging looks that can only be described as love. They held hands coming to the check-in desk and held hands going on the way out the door. And the ages of the children were not just toddlers or pre-school children. Many school-age children warmly embraced their parents. One might argue that this setting is unnatural (a clinic where children might be frightened and seek solace from a parent), but I contend that any and all interactions, no matter where, that enhance relational health are the gold standard of parenting. These interactions are to be lauded, encouraged and repeated as often as possible.
- Area for improvement – This past weekend my son and granddaughter visited. We went to the neighborhood pool, a great place to people watch. I was so excited for the two of them, frolicking in the water, jumping and diving for toy sharks on the bottom of the pool. One of the joys of parenting is seeing how well your own child will parent. I was elated. At the same time, I saw a young couple put a swim flotation vest and swimmies on their young child and plop him on the steps of the shallow end. They left him there and walked over to the other side of the pool to resume a conversation with their friends. There were children around but neither parent sat down next to the child. When he started to jump into the pool, they shouted instructions (more often prohibitions) from their chairs but did not get up to sit by him or give him proper directions for pool safety. I was aghast for two reasons – 1) drowning is the leading cause of death for young children and can occur anytime, anywhere and their role as parents is to be with their child where accidents can occur; and 2) being with your child in the pool is a great time to be consciously parenting and nurturing the relationship to encourage learning and growth at every opportunity.
Parenting is an all-consuming activity with hopefully many moments of joy and love and few moments of mishaps that need repair. Pediatricians observe children and families in a professional setting. Using our experience to observe children and families in the “wild” can expand our ability to use those observations whenever we are providing advice to children and families. We will all make mistakes but using our conscious abilities (being present, attentive, attuned and responsive) can help us build the relational health for our families and our own communities. The repairs needed in relational health can only occur in the presence of safe, stable, nurturing relationships or SSNRs.
- Garner A, Saul R. Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health, 2nd Edition American Academy of Pediatrics; 2025. 200 pp
- https://mychildrenschildren.com/i-believe/
- https://mychildrenschildren.com/my-three-moms-and-ssnrs/
- Saul R. Conscious Parenting: Using the Parental Awareness Threshold. Robert A Saul; 2020. 77 pp.
- https://mychildrenschildren.com/conscious-parenting-basic-tools/
- https://mychildrenschildren.com/conscious-parenting-basic-traits/
- https://mychildrenschildren.com/parenting-and-maps/