PREVENTIVE PSYCHIATRY
FAMILY DOCTORS and pediatricians are often
asked by prospective parents and actual parents: "How can we guarantee
that our children will grow up free of emotional illness?" This is a
logical question in an age when we can guarantee protection against polio and
many other serious or unpleasant diseases. Unfortunately, we don't have
vaccines to prevent development of abnormal personalities, neuroses, and
psychoses. Some doctors even take a completely negative attitude; they feel
that there is not enough knowledge to give any valid advice on prevention of
mental disorder. However, most physicians, psychologists, and child educators
believe that there are useful guidelines.
We
believe that a child has a better chance to develop the type of normal
personality we have outlined previously if certain guidelines are followed. And
we go along with the thinking of those psychiatrists who believe that if there
are any hereditary or familial tendencies to emotional breakdowns, the
individual with a sturdy personality can fight them off or, if afflicted, will
have a better chance of recovery. We believe that of overriding importance are
the basic attitudes of mother and father. When parents love and relaxed, there
is usually a good future for a child.
Even babies sense love, poise, and
acceptance in their parents, especially the mother. The mother's voice and
touch are appreciated by the baby at an early age. If they are loving, warm,
positive, the baby has a good start. When a mother is loving, eager to have her
child grow into a happy, resourceful human being, and has realistic hopes for
him, the child's upbringing and future are likely to be soundly based. Even
though mistakes almost certainly will be made, they will be offset by a strong
"bank balance" of loving, normal, good care. Because the first year
of life, even the earliest days and weeks, are important, planning during
pregnancy is important. It is often helpful for new parents to take a course in
baby care. If a rooming-in arrangement -one in which the baby can be close to
the mother (and shared by the father)-can be arranged in your particular
hospital, we think it a good idea.
Sometimes, a little extra pressure on the
obstetrician may make this possible. We think breast feeding brings mother and
child into a close, warm emotional relationship. However, if it is not
feasible, the mother should cuddle the child closely so that bottle feeding has
much the same overall physical feel for the baby as breast nursing. If
circumcision is desired, it should be arranged in the hospital before taking
the baby home. Later in life, this minor operation may have major emotional
importance. Prolonged separation from parents, especially from the mother, in
the first year of life (and later, too) can be the basis for later
psychological problems. Separations should be avoided if at all possible.
When unavoidable because of illness, divorce
or death, a parent substitute should be introduced as soon as possible. The
substitute should have the qualities of a good mother or father. Introduction
of the baby to the new person should be made gradually because even a
grandparent may rank as a total stranger to a child. After breast or bottle
feeding has been settled upon, there should be a decision about demand versus
scheduled feeding. We favor letting the baby's hunger set the schedule rather
than having the clock prevail. However, that does not mean that the mother must
be a slave to every first whimper from a baby. Infants are capable of
tolerating some minor frustrations.
