My five-year-old son is out of control when he doesn’t get his way.

Posted on January 19, 2012 by Dr. Pat

I have three kids so I do my best to keep everybody happy and under control, I spend all my time with my kids and give them everything they want. My husband works construction from 6 a.m. to 7 p.m. so I have to be the mom and the dad at the same time, I take them everywhere.  I have a hard time time with my five-year-old son, he said he wanted a Nintendo DS so I got him one. But now he spends all of his time playing it, if I take it away he starts screaming, crying and saying I’m stupid and he won’t talk to me anymore. He makes a mess all over the house when he gets mad. I need help, I don’t know what to do with him, I just want to cry. Why is he doing this to me?

You have a challenging job.  But it sounds you are managing quite well most of the time. Some of the time you have problems.  One problem is that you cannot make everyone happy. Sometimes your children will be unhappy. That is OK.  You have to be willing to have your children unhappy some of the time, if they are to grow up well.  If you cannot stand your son’s unhappiness, then you will not be able to help him.

Your son really likes his Nintendo DS. He thinks it is the best thing in the world. Hundreds of millions of these have been sold. Lots of other kids like their DS too. You have to get control of the DS use.  There are several steps to this process:

  1. Give him attention and praise when he is not playing the DS. Tell him how much you love him, how smart he is, how good he is BUT only when he is not playing his DS.  Do this for five days before you go to Step Two.
  2. Only after doing Step One, lock up his DS or hide it where he cannot get it when he is asleep. Make sure he cannot get it.
  3. Tell him there is a new family rule. He can play DS after supper but only if there is good behaviour.
  4. He may yell and scream and tell you that you are bad. Ignore him. Don’t argue. Don’t give in. You don’t need to punish him any more. You will reward his good behaviour with him playing the DS.
  5. Make sure the baby, your son and you are safe.  Think of what he might do, and make it safe.
  6. When he stops misbehaving, yelling and screaming, pay attention to him. Tell him you are proud he is behaving.  If he behaves for at least one hour and during supper, let him have his DS after supper. If not, do not let him play.

You may have two-three days of him being very badly behaved. Stick it out. He has to learn that you are in charge and that if he wants to have his DS, he has to behave. Keep the same rule. Don’t give in. If he argues that it is not fair or that you are mean, say once “This is the family rule.” Ignore the rest.

Continue to pay lots of attention to him when he is good. You will feel much better if you can teach him to behave. You also need to get some support. Can you get someone to mind the kids once a week for three hours?  Can you talk to someone about how you feel? A close friend or minister/priest if you have one. Maybe there is a women’s and children’s drop in centre near you. Maybe there is a parenting class you can take to learn more ideas.

Keep on trying. You are a really committed mom.

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Is this baby at risk of sexual abuse from the father?

Posted on January 18, 2012 by Dr. Pat

A young relative of ours has an infant child. She has been estranged from the father of the baby since shortly after the baby’s birth. She has some concerns about this man’s behaviour while around the baby. When he has been holding the baby or playing with the baby he has had (and by his own admission acknowledged) an erection. He maintains that this is only because he is so very happy and excited to hold the baby and has no sexual implication and that there is nothing “abnormal” about it. The baby’s mother is fearful of this behaviour. She has expressed her concerns to the father and explained that because of this she does not feel she can allow the baby to be alone in his care. Currently the baby is breast fed so this is temporarily stopping those visits from happening but the father is becoming more insistent about his right to more time with the baby in his own home. The baby’s mom has indicated that she is comfortable for him to come and visit the baby in her home but she can not accept the baby going to stay with him. He says he has a right to his weekends and that he has been assured by professionals that his behaviour is not abnormal. I have been trying to find some reliable research on this online but cannot. The fact that he acknowledged this behaviour rather than denying it would lend some credibility to his assertion but is not totally reassuring by a long shot. This young man has had a troubled past with abuse by adults in his own childhood. Would you be able to comment on this situation as I presented it here or would you be aware of any reliable studies we could look at?

Thanks for your very balanced and thoughtful question. I asked Dr. William Marshall, a world authority on the understanding and treatment of people who are sexually attracted to children, for advice on this question and have incorporated his wisdom into my answer.

There is no certain evidence that the child’s father will molest the baby if given the chance. However, there are significant “red flags” that would strongly suggest that this young man might have sexual interest in the baby.

First, having an erection while holding a baby is not a normal response. It is amazing to me that a professional would say that this is normal or acceptable.

Second, the lack of concern he has about his erections is worrisome. This shows a lack of insight into how others might view his behavior. Even more worrisome is that he appears to have no insight into his own potential behavior.

Finally, most men who have been sexually abused as a child do not become child molesters themselves.  However, a significant percentage of child molesters have been molested themselves.

You and the mother of the baby are right to be very concerned. I would encourage her to continue her insistence that there are no unsupervised visits. She should seek legal advice on how she can prevent these visits in the future.

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My daughter is struggling with the social dramas of middle school.

Posted on January 17, 2012 by Dr. Pat

My twelve-year-old daughter is having some issues with making and keeping friends. She is very sensitive and is having a hard time with all of the drama associated with middle school. I am concerned about how to make her feel better while reinforcing that she needs to develop skills that will help her deal with difficult people. I am sure I am not alone and am wondering if there is a workshop for moms and daughters that would help me with keeping the lines of communication open and healthy?

The workshop idea is great but I don’t know of any workshops like this. There are some strategies that you can use to help keep the lines of communication open and help her manage:

  1. You cannot, and should not, protect her unless there is an immediate serious danger such as someone threatening or serious bullying. She has to learn to deal with the middle school drama, such as shifting alliances and harsh rejections. If you were able to shield her, you would only make her weaker.
  2. Develop some regular, shared activities, things she likes to do with you.  She needs a close relationship with you to be able to endure the challenges of her life.
  3. Listen. When she tells you about things that bother her, don’t offer instant solutions. Let her tell you how it feels, what she is thinking.
  4. Avoid giving lots of sympathy. Be empathetic: “I know how it feels,” not sympathetic: “Oh, poor you, it must be awful.”
  5. Encourage her to come up with ideas of how to manage it. Ask her what she thinks.  Pay attention to sensible strategies. Ignore or joke about other solutions, “Yes, it would be nice to be able to poke her in the nose, but what do you think you would really do?”
  6. Hang in. Her being oversensitive is also a strength. She will be able to see the nuances of social relationships. She just needs to develop some toughness as well.
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Can a father’s intoxication at the time of conception affect the baby?

Posted on December 19, 2011 by Dr. Pat

Is there a risk of a child having mental disorders if the father was intoxicated at the time of conception?

One time intoxication (I am going to assume alcohol) at the time of sex by the father may not result in harm to the child. However, his being a chronic alcohol abuser may have a significant effect.

The role of mother’s drinking at conception and during pregnancy is very clear. Women should not drink in the weeks before conceiving or any time during pregnancy.

Since the research is not entirely clear, men should not drink in the weeks before conception either.

There is emerging evidence that alcohol abuse in either parent produces changes in the expression of genes.  This problem may be carried over generations.

Fetal Alcohol Spectrum Disorders (FASD) are a range of problems that include physical and mental problems resulting from exposure to alcohol.  There is no cure for FASD.

Having an alcoholic father has many other risks. There is a genetic component to alcoholism and a learning component to alcoholism. So the child has a risk of having a drinking problem. As well there is higher risk of the mother drinking during pregnancy. Family violence and other stresses are also more common when there is alcohol abuse.

We have to change our culture of boozing. Alcohol excess causes serious problems that last.

Thanks to Dr. James Reynolds at Queen’s University for advice on this answer.

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I know Christmas should be a happy time but it fills me with dread.

Posted on December 12, 2011 by Dr. Pat

I know I should be looking forward to Christmas with my husband and children. My son (age 1) and daughter (age 4) are very excited about Christmas but I just think of Christmas with dread. I had a difficult childhood but for the rest of the year I feel pretty well adjusted and happy most of the time. Last year I found Christmas difficult and I worry that this year will be much worse. On top of this I feel guilty that I may ruin my children’s Christmas because I don’t share their excitement.

Christmas depression is well known. It is not clear how many people are affected.

Several things may trigger Christmas depression:

  • Lack of sunlight
  • Memories of difficult times in one’s past
  • Excessive demands of Christmas
  • Excessive expectations to have a perfect Christmas
  • Losses that are more keenly felt at Christmas
  • Holding on to past slights
  • Too much alcohol or eating
  • Too little sleep and exercise
  • Gatherings where people argue

The winter solstice, the shortest day of the year, occurs near Christmas. The lack of light will trigger depression in some people. This is called Seasonal Affective Disorder and can be treated by increasing exposure to light. The easiest way to do this is to get outside and take a walk during the day when it is light. Even 20 minutes of walking can be very helpful. Often, busy schedules mean that the only time we are outside is when it is dark. Light therapy or anti depressant medication may also help.

Memories of difficult times in the past could interfere with enjoying Christmas. Maybe Christmas is when a father started drinking heavily. Or maybe Christmas was the occasion for arguments. It is normal to try and forget bad Christmases from one’s childhood.

Avoiding thinking about the past will cause problems. Some people find it very helpful to write down what they experienced. Or find a friend who will listen without interrupting. You can face the ghosts from Christmas past. Facing them will help put them to rest.

Many people, especially moms, have unrealistic demands placed on them at Christmas. Sometimes these demands are self imposed. Sometimes family or friends demand too much.

The need to have everything perfect is a huge expectation. Be realistic. Be gentle on yourself. Aim to get a few things done and let go of unrealistic demands. Decide on the two or three things that matter most to you about Christmas.

If you aim for a  perfect Christmas, you will drive yourself to misery. If we have realistic expectations about Christmas, we are more able to enjoy the little things.

Loved ones who have died or relationships that have been broken are often remembered at Christmas. Don’t try and push these sad feelings from your mind. It won’t work. It is OK to reminisce about losses. Spending 20 or 30 minutes a day on deliberate thought and remembrance may help.

For many, there are remembered problems that come up at Christmas. Maybe it is the rude way someone behaved or the fact that a present was not appreciated. Unlike the big issues from your past that should be faced, these slights and minor grievances can be let go of and left in the past, you will be able to start fresh.

Unfortunately, with all the Christmas parties, it is easy for people to overindulge. If you are feeling low, avoid anything more than a minimum amount of alcohol. It is a depressant. Alcohol also interferes with restful sleep.

Maybe it is a spouse or relative who drinks or eats too much at Christmas. It may help to calmly and quietly discuss this with him or her before it happens. “Uncle Jim, we really like to have you over at Christmas, but I don’t want the kids to see you drunk. We are going to serve non-alcoholic punch this year.” It may help to talk with your children about a problem like this beforehand. “Uncle Jim may drink too much. We will talk about it after he leaves.”

Eating in moderation will not only help the waistline, it will help your mood and your sleeping. Eating small amounts of Christmas goodies is fine. Don’t deprive yourself of everything.

Sleep is one of the most under rated aspects of life. Most of us are constantly sleep deprived. Sleep deprivation can also trigger weight gain. Getting a good night’s sleep will really make a difference.

If there is a gathering where you know there will be arguments and hard feelings, try to figure out how to manage it. Maybe you stay clear of those who are feuding. Don’t feel you have to solve other peoples’ problems. Don’t get drawn in as a peacemaker, unless there is a good chance it will work.

Take time for small things over the holidays. Play with your children. You may not be able to change the behaviour of others around you but really noticing the small things that make you happy during Christmas will help with sadness.

In summary, I encourage you to try to reduce Christmas stress. Talk to your husband about how he can help. Focus on taking good care of yourself so that you can help your family enjoy Christmas.

I have confidence that you will be able to manage. Even if you don’t really enjoy this Christmas, you can give your children good Christmas memories despite the things that make you sad or leave you stressed.

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Is tickling a cause for concern?

Posted on December 7, 2011 by Dr. Pat

My son is a wonderful father to two preschool girls. He is devoted to them. My concern is that he often wrestles with them and tickles them. He blows on their stomachs with his lips and makes them laugh. They love it. I am certain that he has no wrong intention but might the children allow someone with different intentions do this to them?

Children learn very early to alter their behaviour in different situations. They learn:

  • to go naked in the bathtub but not in school
  • to run outside but not in the house (well, sometimes they learn)
  • to eat pizza with their hands but not spaghetti
  • to allow mom to give a kiss but not a stranger

Even preschool children learn that different behaviours are right and wrong because of the circumstances. They will learn that it is OK for dad to roughhouse and tickle with them but it is not OK for others to do this.

I know of many fathers who have tickled their children in the way you describe. It is typically fun and harmless and is often a game that the child loves. It is sometimes called giving a “buffalo” or a “raspberry” or a “zerbering”.  I am sure there are other terms for it. This type of play can be a very warm and healthy interaction between a parent and a child.

I don’t think you should worry about your grandchildren. Thank goodness your son plays with his children.

There are two types of tickling that are of concern. Sometimes adults or other children tickle to the point of the child being miserable. Excessive tickling can be torture. Sometimes children are unable to say “Stop” because they are laughing so hard. Laughing or smiling during tickling is no guarantee that the child is happy. Sometimes children who are ticklish are held down and tickled as a form of bullying. If the child is upset afterwards, the tickling was excessive.

In addition, tickling, as you suggest, can be a form of sexual interference. Some situations are obvious but some are difficult to judge. If the child or an adult who sees the tickling is uncomfortable, then the tickling should be stopped.

Tickling that is fun for all concerned is not a problem. No matter what the reason for tickling, no child should be subjected to unwanted tickling.  Sometimes tickling is not a laughing matter.

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My boyfriend’s mother is still trying to control his life.

Posted on December 6, 2011 by Dr. Pat

I am in my twenties and have been living with my boyfriend for four years. We plan to marry but have not set the date yet. My “mother-in-law” seems to be fighting to maintain control over as much of her only son’s life as possible. All the while making me feel really left out and unimportant. What should I do?

If something doesn’t happen soon, you will have continuing problems. This problem will not go away of its own accord. It will invade your marriage, if you get married, and if you have children your mother-in-law will interfere with you raising her son’s children.

There is nothing wrong with a man having a close relationship with his mother. Such a close relationship can be the foundation of a great respect for women and a caring and warm approach to women.

No matter what you do, your “mother-in-law” will not listen to you. Her primary relationship is with her son. It may be that she was particularly close to him. She may really like mothering. Or it may be that she has little else of importance to do. The reason for her behaviour really doesn’t matter.

You do not mention your boyfriend. He is the only one who can effectively deliver the message to his mother. He has to make it abundantly clear to her that you are the most important person in his life. He has to insist that she treat you with respect and consideration. The first time she doesn’t, he has to firmly speak to his mother about it. If she continues to be interfering or disrespectful, he has to make a choice between being loyal to you or sympathetic to his mother.

The problem is not your “mother-in-law” but with your boyfriend. It may be that he doesn’t want to hurt her feelings. He may enjoy the attention and services from his mother. He may have a distorted view of respect for his mother. It may be that he hasn’t realized that his mother is treating you poorly. Again, the reason doesn’t really matter.

Sit down and talk to your boyfriend. Don’t criticize. Recognize that his mother has good points and that she cares. Lay out the facts. Make it clear that you will not be second best to his mother. If you tolerate him taking his mother’s side, you will always be in her shadow.

He has to stand up and make a clear decision. Does he want to be a “mommy’s boy” for the rest of his life or does he want to forge a relationship with a partner? He can and should love both of you. But if you are going to make a life together, you have to come first.

He has to be firm and persistent with his mother. No matter how many times it takes, he must take the lead and make certain his mother does not interfere. He does not have to be rude or inconsiderate to his mother. He can be kind but firm, but he must be absolutely unwavering.

If he says “Just be patient, she will get better” or “She is only trying to be helpful” or “You are being too sensitive” he is dead wrong.

If he hasn’t made a commitment to you, he may be unwilling to take a stand.

Be understanding that he may feel conflicted, guilty or disloyal about standing up to his mother. But don’t let him off the hook by understanding his difficulty.

You should try and make a relationship with your “mother-in-law” but try as you will, you cannot change her on your own. If he denies it is a problem or thinks it is your problem, then you have some decisions to make.

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Since starting school there has been a decline in my daughter’s confidence.

Posted on December 5, 2011 by Dr. Pat

My five-year-old daughter was very confident and very friendly with everyone until she started kindergarten. In the last four or five months I have noticed a lack of confidence in her, even if a stranger looks at her she starts crying and saying she is very afraid. She even tries to avoid going to school if she is behind in her studies. Her father has been suffering from depression and anxiety for the last ten years.

Your daughter may be just showing adjustment to school. If her problems persist, I suggest you talk to her family doctor or pediatrician.

Encourage her to be brave and face her fears.  Tell her it is normal to be a bit afraid. But it is important to go ahead and do the things we are anxious of anyway.

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How can I prepare my daughter for the reactions to her skin condition?

Posted on December 2, 2011 by Dr. Pat

My three-year-old daughter was diagnosed shortly after birth with urticaria pigmentosa. Fortunately, the lesions are mostly confined to her trunk, but they are noticeable on her neck, arms and legs. During the summer we had a situation in which people saw her skin at a splash pad. At that point all conversation around us stopped and people stared at her and children pointed. Thankfully, she was not aware of this. She will begin school next year and I’d like to provide her with tools to help her deal with the inevitable stares and questions. Any resources you can suggest or tips you can provide would be very much appreciated.

Urticaria pigmentosa is a condition caused by too many histamine producing mast cells in the skin. It produces brown lesions or spots. The condition usually fades in adolescents.

You are wise to prepare your daughter for stares, questions or remarks. Most people act out of concern or curiosity, but she may encounter people who are cruel. Preparing her should occur in a natural way over a period of time.

First of all, she should learn the basics of her condition.  This can be very simple when she is young. The most important thing is that she know that she is just a normal kid with a skin condition and that you will love and care for her. She needs to be able to talk to you about any issues that arise.

Depending on her personality, she may want to explain to the curious.  She could say “Don’t worry. I have a skin thing that causes these funny marks. It will go away in a few years. People cannot catch it from me.”

Some parents would keep their child covered as much as possible to prevent the lesions being noticed. Others would not cover up as there is nothing to hide or be ashamed of. I favour the second approach. However, there is no right way to deal with these issues.

When she is older, she may have to deal with teasing or rejection from a few other kids. The reality is most of us have something a bully can pick on. I don’t see urticaria pigmentosa as any different from any other possible focus of bullying such as size, weight, hair colour, or size of one’s nose, ears or chin.

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I think my teenage daughter has an eating disorder.

Posted on December 1, 2011 by Dr. Pat

My 14-year-old daughter seems to be suffering from an eating disorder. Weight is a big factor for her and she feels that she is overweight. She is constantly looking in the mirror and I have caught her measuring herself on a daily basis. Needless to say her food intake has decreased tremendously. She managed to take multi-vitamins for a month but stopped when she decided they were causing weight gain. She is quite short tempered, verbally abusive and emotional. She has acknowledged and accepted the fact that there is problem. She was seeing a psychologist but has decided not to go any longer. She feels it is hopeless and that there is no one who can help or understand what she is going through. She has frequent melt downs and is often frustrated, feeling that this problem is taking over her whole life and consuming her. She has recently seen a pediatrician and has lost approximately 12 lbs since April. Is there anything that I can do or someone that can help me? I am really concerned as I don’t want her to have any serious mental or health issues.

You have done the right things so far. There are several other things that you can do:

  1. Return to her pediatrician and firmly insist that she monitor and assist your daughter on a regular basis or refer her to an appropriate professional for help.
  2. Do not criticize your daughter’s eating or try to push food on her. She already knows how you feel. She knows there is a problem.
  3. Find areas outside of her eating issues to maintain your relationship. Share some activities with her.
  4. Ignore her when she is short tempered and abusive. Don’t accept it. Just don’t pay attention to it.

Eating disorders can be life threatening. She has to be under medical care. You need to keep your relationship with her strong.

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