Author ArchiveDr. Marshall

ByDr. Marshall

Using Intention to Bond with Your Children

Last weekend, we had the distinct pleasure of interviewing Dr. Sara Langworthy (@DrLangworthy), a developmental psychologist living in Minnesota. Like us, Dr. Sara devotes much of her time to translational research. As the name implies, translational researchers seek to explain complex research studies in terms that layman (mainly parents and teachers) can understand and apply. One of Dr. Sara’s areas of expertise is the effect of early trauma and early deprivation on the developing brain (check out her website and YouTube channel). During today’s interview, she explained in clear and simple terms the many positive effects of staying close to our children, “getting down on the floor with them” as she put it.

What she was talking about was that parents need to be WITH their children. When they are young we need to be with them on the floor (as she put it), patiently helping them learn new things. When they’re older, we are WITH them in different ways, providing them with opportunities to become confident, resourceful, and resilient adults.  She also implied, though she never stated it, that we should ENJOY our children. They should not be an impediment, they should not be a nuisance. They should be the sunshine in our lives for the few short years that we have them.

The day after our interview with Dr. Sara, I discover an article by Erin Leyba under the heading Joyful Parenting, the title is “3 Mindfulness Tools Parents Can Use Bond with Children.” Bonding, that’s what Dr. Sara was talking about. I had to read on.

The article begins by explaining that bonding with our children is an intentional act. It doesn’t just happen. We must intend for it to happen. And then she gives us three ways to make it happen.

  1. Set Ritual Intentions. Rituals are the things we do with our kids that they enjoy. One of my favorites is “Every time my child walks down from the room in the morning, I will give her a hug and say ‘I love you so much.'” The other one I liked is ‘I will take my child to play outside for 20 minutes when she/he gets from childcare or school.’ We will always have other things to do, so we need to set ritual intentions so that the other things don’t crowd out our children time.
  2. Set Implementation Intentions. Remember that saying “When life gives you lemons, make lemonade?” Well this is the parenting analogy of that. Implementation intentions anticipate the bad times so that we can turn them into good things. For example, “when my child skips his nap, I will take us both on a walk and not let it ruin my day.” Think about your day. Where are the “hot spots?” And when things get bad what can we do instead?
  3. Use Visualization. Let the best possible scenario play out in your mind’s eye. This is what athletes do, they visualize the best case scenario. As a Floridian, I especially liked this one from the article, “Before a family beach vacation, a mom visualized herself walking on the beach with her daughter, playing in the waves with her kids, taking pictures of the sunset with her son, and snuggling and reading books to her 2 year old in the morning before the rest of the family woke up.”

Each of these is easy and, yet, they accomplish so much. Many parents think about things AFTER they happen, wishing they would have reacted differently or they had had a better plan. What intention allows is for us to think about things BEFORE they occur so that we are prepared to act and react in the best possible way.

ByDr. Marshall

Failure to Launch – Part 2

A few days ago, I wrote a Morning Musing on one of the topics we frequently discuss in our office, FAILURE TO LAUNCH. Just before posting it, I added PART I to the title thinking that I would add to it later. Well, later came this morning. While perusing the internet, I came across an article by Dena Kouremetis, an author and mother titled “Failure to Launch: Whose Problem Is It Anyway?

Ms. Kouremetis begins with a fictional conversation between two baby boomer mothers, one of whom is terrified about the possibility of her 29-year-old daughter returning home to finish her degree. Though she loves her daughter, she definitely does not want her to move back home. But if she tells her no, what then?

She then goes on to provide this sobering statistic: “For the first time in more than 130 years, Americans ages 18-34 are more likely to live with their parents than in any other living situation… .” As for not letting go of our adult children until they have “found their path” she gets right to the point: Taking them back or supporting them financially simply delays the inevitable.

Ms. Kouremetis wrote this article after reading a two-part series by USA Today writer, Peter Dunn. I’ll be talking more about Dunn’s advice in PART III of this series, but if you happen to be a parent in your 50’s or 60’s and you’re still supporting an adult child, start by taking a look at the article by Kouremetis. While hers is a gentle reminder that it is a parent’s obligation to prepare children to become independent, she doesn’t mince words when she tells us that it is our fault if our children are not prepared by the time they graduate from high school, or, even worse, by the time they graduate from college.

We often remind parents that there are certain abilities that children should master by certain ages (see our podcasts for age 3, age 5, age 8, age 12, age 18). For example, five year olds should be able to regulate their emotions (no more temper tantrums); eight year olds should be able to keep track of themselves and their belongings; 12 year olds should be able to manage their own schooling; and 18 year olds should be able to take care of themselves with little or no parental involvement. If our child didn’t meet these milestones (including the last one), we haven’t done our job.

The final point that Kouremetis makes is that pushing an adult child out of the nest gets more difficult the longer they stay. It is easiest when parents treat it as a milestone to be achieved by the time the child is 18. Failing to have them ready to leave at 18 creates a “slippery slope” for both children and parents; as time passes, it becomes increasingly difficult to push them out. But push you must. Letting them stay attached to you denies them the opportunity to accomplish this crucial milestone.

ByDr. Marshall

Failure to Launch – Part 1

Back in the 1960’s there was a huge gap—a generation gap—between parents grew up during the Depression and then, as young adults, fought to defeat fascism in WW II. When their lives finally returned to normal, they were determined to make things better for their children. Their children, however, had other ideas. And they rebelled against the rule-governed behavior of their parents.  They rebelled first with a new and raucous music called Rock ‘n Roll. And they rebelled with clothes, replacing ties with tie dye, shirts with tee shirts, and suits with coveralls. And they rebelled with mind altering drugs.

What the parents assumed was that their children would adopt the same values they had, but with the advantages of better schools, better homes in better neighborhoods, and access to college educations. Imagine how bright the future looked to them. The children, or at least large numbers of them, had other ideas. Granted, some of the baby boomers followed in their parents’ footsteps. But for many others, the freedom, the access, the stuff resulted in baby boomers rejecting their parents’ values and developing, instead, a sense of entitlement and an air of superiority.

And just as baby boomers rebelled against their parents, the children (and grandchildren) of baby boomers are now rebelling against the “boomers.” This generation’s rebellion, however, is quieter and more constrained. Instead of playing itself out at the Democratic Convention in Chicago, or as a sit-in on a college campus, or as an anti-war rally in Washington DC, today’s rebellion is playing out behind closed doors in homes across the country.  And in many cases it is playing itself out as a “failure to launch.”

Failure to launch, as the name implies, is the term used to describe what happens when a child is not ready to leave the nest when he or she graduates from high school or college. In previous generations, there was this unwritten code that at 18, you left your parents’ home and began to make a life of your own. Some got married and started a family, some went into the military, some went to college, and some went to work. But everyone did something.

But in today’s world, many students graduate from high school at age 18 with no sense of direction and no plan for what they will do after graduation. So they return home. For some, this happens after college. They graduate, but they don’t have a clear plan for what to do next, so they return home. Where they stay. Part of the problem, of course, is that there are fewer jobs. But part of the problem is that this new generation, like the baby boomers of the 1960’ and 70’s, has a different an attitude, a different world view.

I first noticed this in the 1980’s when teenagers would quit their part-time jobs after a few days because they didn’t enjoy it or they had to work too hard. This was new to me. When I was growing up, jobs (and money) were scarce; if you were lucky enough to get a job, you did everything you could to keep it. You might get fired or laid off, but you never gave it up voluntarily. Another job was too hard to find.

And suddenly, in the 1980’s and 1990’s, kids were quitting their jobs—and for no apparent reason. They would quit with no thought about whether they could find another job or what quitting would mean when they applied for another job. In about a generation, the attitude shifted from “I am an employee and I will work hard to keep this job.” This is the attitude we see in shows like Downtown Abbey where the house servants do what is expected or else. But in the past three decades, we have seen a shift to “I am an employee and I will stay in this job as long as I enjoy it and as long as I am treated with respect.”

This new attitude is probably related to another change in world view. In most cultures, a person has to work to survive. If you live in a simple culture based on subsistence hunting or farming, or you live in a stratified culture like Downtown Abbey, you have to work to survive. But in the U.S., there is an abundance of everything, and work is no longer tied to survival. If a young person in the U.S. decides not to work, he or she can continue to live with parents in the manner to which they are accustomed. Nothing changes if you don’t work. Food is always available, cleaning and laundry get done, and I am around people who care about me and love me unconditionally.

No problem, right? Well, not for the idle offspring. In fact, many of them just can’t understand what all the fuss is about and why their parents seem unhappy with them. And, therein lies the feud, the new generation gap. The parents, many of whom worked hard to have a career or a profession or to start their own business, now have children who do not share their parents’ passion for hard work and sacrifice. Just as the hippie generation chafed under their parents conformity, schedules, routines, and rules, this generation is chafing under their parents insistence that it’s time to get a job.  But the kids don’t get it. They seem genuinely confused with their parents’ frustration over their decision to work part-time or not at all.

It seems to me they are both to blame for this new generation gap. The parents are to blame, because they raised children who learned that their parents would take care of everything. Trouble with a teacher?—I’ll take care of it. Not enough playing time?—I’ll talk to the coach. Need a part-time job?—I have a friend who owns a business. Got a bad grade?—I’ll fix it. Time to apply to college?—I’ll help write your essay. The kids got all A’s, they got more playing time than they deserved, and they never had to look for a job (or work very hard once they got it). A generation of parents decided that they would engineer their children’s success. And while most succeeded, the children grew up thinking that their parents would take care of it.  Instead of preparing their kids to be independent, they groomed them to be winners. But in the process, the kids became totally dependent on their parents.

While I place most of the blame on the parents, I have enough left for the young adults. At some point, we all have to stop blaming our parents. At some point, no one cares how you were raised or what mistakes your parents made. It is your life. Stop whining, stop blaming others, and get on with it. And that means it is time to become independent. And that means you have to support yourself. And that means you get a job—a real job that you keep whether it makes you happy or not. And if you don’t want to do that, then you have to be willing to accept the consequences. And what are the consequences?

Well, your parents no longer need to give you an allowance. They did that before you could be employed anywhere else. Second, they have house rules. If you want to live (rent free) in their house, they get to make the rules. Third, if you want a car, buy your own. And most of all, stop complaining about your parents. They are angry with you, because they want you to be independent and to support yourself. That’s what adults do. Okay, your parents made a mistake in not preparing you for independence. But now you are keeping yourself dependent. It is no longer their fault. And you are no longer their responsibility.

Ready or not, you are responsible for you. By not working, you are forcing your parents to continue to work so that you don’t have to. Yes, they are angry and they are out of patience. They did the best job they could. They took care of everything for at least two decades. They did their job-however imperfect. Now it is time for you to take over. Yes, it’s scary. It was for all of us. But you do the best you can—however imperfect.

ByDr. Marshall

Adjust Your Sails

I just read the most uplifting, optimistic, and helpful little piece of advice this morning. It’s from Susan J. Noonan, M.D.  She identifies herself as a physician, a patient, and an author, and I was curious as to why she had the courage to include patient as one of her descriptors. You can find the article at And you can, as I intend to do, read the entire book, Managing Your Depression: What You Can Do to Feel Better. Read More

ByDr. Marshall

ADHD and Brain Development

There is a study of interest reported today in various media outlets. The study is important for several reasons. First it is about ADHD, a common and controversial neurodevelopmental disorder affecting increasing numbers of children. Second, the study provides further evidence that there are observable size differences in certain brain structures in persons with ADHD. Third, of seven structures targeted for study, five were smaller in those with ADHD.

You may not be surprised to learn that these structures included the amygdala (regulates emotions), the caudate nucleus (goal-directed action), the putamen (learning and responding to stimuli), the nucleus accumbens (processes rewards and motivation), and the hippocampus (makes new memories). In other words, the brain structures that control the things that pose the greatest challenges to persons with ADHD are smaller in those individuals. Furthermore, the size differences are larger in children but the size differences decrease as the person matures.

This study is important for several reasons. The most important is that it provides additional evidence that there are real, biological differences in the brains of persons with ADHD. There are still those who like to deny that ADHD really exists, that it is just an excuse, or that it is the result of ineffective parenting. Sadly, for some, no amount of evidence will ever suffice. We saw this recently with the resurrection of the immunizations-cause-autism story. There is no link—at least not one that anyone can document–yet some people continue to insist that there is. So I guess we shouldn’t be surprised that some people continue to believe that ADHD doesn’t really exist. If you have anything to do with children’s health or mental health care, or if you have a child with ADHD, you know that ADHD exists.

Second, this study is important because it is part of the worldwide consortium called ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis). A meta-analysis is a study of studies. The value of a meta-analysis is that instead of analyzing a small number of study participants, researchers combine findings from various studies into a large analysis. The ADHD study reported yesterday was four times the size of any previous study. It included the scans of 3,242 individuals provided by 80 researchers in 23 locations from nine different countries.

Most of us who do neuroimaging have to settle for small numbers because of the cost and time involved in doing a single scan. And when you analyze the results of 20 or 30 scans, you have to be careful about your conclusions, because they may be based on too little information. We conducted neuroimaging studies at the University of Georgia in the 1990’s; while we found size differences in some of the same structures, we had to interpret the results cautiously because of the small numbers of participants. But with larger numbers of participants, the more confident you are in your conclusions.  With over 3,000 scans from around the world, you can have far more confidence in your conclusions.

The third reason the study is important is that it tells us that the size differences are smaller in adults than they are in children. This suggests that as the brain matures, the structures continue to increase in size and this growth may correspond with a reduction in symptoms. Does this mean that persons outgrow ADHD? We don’t know. But it is likely that some individuals eventually develop normal or near-normal structures (and have fewer symptoms) while those who do not achieve such growth continue to have symptoms.

The important message here is that there are observable differences in certain brain structures in persons with ADHD. These differences can no longer be ignored. They appear in thousands of individuals from nine different countries. ADHD is real. We may not know everything about it, but this study is a very firm foundation on which to build.

ByDr. Marshall

Digital Tech and Learning

Here is one worth reading. Martin Kutscher, an Assistant Clinical Professor of Pediatrics and Neurology at the NYU College of Medicine, took time to write a short but valuable article that answers a question (or questions) that many parents and teachers are asking:  Does reading on a screen interfere with in-depth learning?

And the answer is Read More

ByDr. Marshall

Healthy People 2020

Back in 2010, a little-known initiative was undertaken by the Department of Health and Human Services. Named Healthy People 2020, the program tracks 1200 objectives organized into 42 areas of public health. The goal of the project is to measure the progress made each decade in each of the 42 areas. It is through this project that we have learned that the number of teens who smoke cigarettes is declining and that more of us are exercising.

On January 11, the Center for Disease Control and Prevention published a report that details the country’s progress in meeting 26 of the 42 national health goals for the decade that ends in 2020. According to the report published first in Live Science and reported in the Huffington Post on January 13, 2017, the country has met or exceeded eight of the objectives and we have “made progress” in another eight.

But in seven of the 26 areas, there has been little or no change. Progress has stalled in the number of individuals with a primary care physician, in rates of obesity, in the number of individuals with diabetes whose blood sugar levels are under control, and the number of people who binge drink.

Of greater concern, however, are three areas in which the U.S. is actually falling behind. The first is dental health. In 2007 44% of us had been to the dentist in the previous year. In 2012, that figure had dropped to 42%.

And as we might expect, the other two areas where things are going in the wrong direction are in the areas of mental health. The first is that from 2007 to 2013, suicide rates increased from 11.3% to 12.6% and rates of depression in teens rose from 8.3% in 2008 to almost 11% in 2013.

As mental health professionals, these kinds of data always alarm us. Invariably, progress in mental health consistently lags behind other areas. And even as I read this news this morning, there is a battle raging in our nation’s capital over what role, if any, the federal government should play in making sure that all Americans have affordable AND accessible health care.

Like it or not, the Affordable Care Act (I refuse to call it Obamacare as that term is too often used derisively) seeks to put mental health coverage on a par with physical health coverage. This is a significant step in the right direction, because for years, if you had a “mental health” problem is would not be covered by the insurance company. We can only hope that whatever is left after ACA is dismantled will have provisions for millions of Americans who continue to need health (both physical and mental) coverage.

The Huffington Post article can be found at

ByDr. Marshall

Obesity and the Baby’s Brain

This is the third time this week that another news outlet has reported a study that appeared recently in the Journal of Pediatrics (click to visit the website or click here to download the pdf of the article). The study was conducted at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Investigators measured the developmental outcomes of 4821 children born between 2008 and 2010. The children were tested at intervals starting at four months and ending at three years. Read More

ByDr. Marshall

When Parents Struggle with Discipline

Of particular interest today is a column at offering some simple but worthwhile advice to parents who can’t seem to get their children to follow the rules, to do what is expected, to be obedient. The author begins by telling us that many of these struggling parents are asking the wrong question. Many parents come to therapy searching for new, clever, or interesting ways to get kids to follow the rules. Read More

ByDr. Marshall

Attention 2017

I have to admit I found another excellent article by Amy Morin this morning. I’ve mentioned her before. She’s the author of the USA TODAY bestseller, 13 Things Mentally Strong People Do. She titled today’s post “7 Ways Productive People Stay Focused.” Although Ms. Morin doesn’t do the research herself, she sure has a knack for finding the most important (and interesting) findings. For example, in this article, she cites a study at Microsoft that found that the average attention span in 2000 was 12 seconds, while the average attention span in 2013 was 8 seconds. Attention span is the amount of time that passes before you become distracted. Incidentally, the attention span of a goldfish is 9 seconds, so… . Read More