AA Gifts & Baskets Idea & Advice Blog

In the scheme of right-to-die cases in the I970s and I980s, the development of the modern respirator in the mid-1950s was the most significant technological development. Respiratory failure, particularly the paralysis of the muscles of the lungs caused by epidemics of poliomyelitis, had long been an agonizing problem for physicians and families. In the I920S, one US physician, Dr. James Wilson, had written as quoted in the writing of Philip Drinker and Louis Shaw, the inventors of the iron lung:

Of all the experiences the physician must undergo, none can be more distressing than to watch respiratory paralysis in a child with poliomyelitis - to watch him become more and more dyspneic [breathless] using with increasing vigour every available accessory muscle of the neck, shoulder, and chin - silent, wasting no breath for speech, wide-eyed, frightened, conscious to almost the last breath.

The iron lung, which encapsulated the patient in a steel cylinder with the head exposed, had been invented by the Boston scientists in 1928 and its technology rapidly spread around the world. Pumps raised and lowered the pressure within the chamber which in turn forced the lungs to contract and expand. It saved numerous lives, but the problems of the technology became increasingly apparent: it was ineffective for the most severe form of polio; in an epidemic there were never enough iron lungs to go around creating ethical dilemmas about who should have access to one; regular turning and nursing of the patients was difficult if not impossible creating a problem of bed sores; and many of those sustained by the machines could not be weaned from them, becoming imprisoned by the very technology that had saved their lives.

A devastating polio epidemic in Denmark in 1952 proved the impetus for a better method to be found. When the twenty-eighth patient admitted with polio to Copenhagen’s Blegdam Hospital died of respiratory paralysis, the head epidemiologist implored the head anesthetist to try to sustain the mounting number of patients by manually forcing air into their lungs with a ventilation bag, a method commonly used for short durations during surgery. It worked even better than the iron lung but it was extraordinarily labor intensive. During the Copenhagen epidemic seventy-five patients were kept alive during their acute medical crisis by teams of 250 medical students doing round-the-clock manual bagging, 260 nurses providing bedside care, and twenty-seven technicians looking after the equipment. Within a year of the Copenhagen group’s report in The Lancet, companies around the world were coming out with a positive pressure, electrically-driven ventilator that would replace the manual bagging with a reliable machine. The respirator was born, and it was soon discovered that this little piece of technology could keep a person alive almost indefinitely, even when they were in a persistent coma or irreversible respiratory failure.

At about the same time, other groups of scientists were looking for ways to rescue a flagging heart. Before the 1950s, there was little that could be done if a person’s heart went into cardiac arrest, its muscles no longer pumping blood through the body in a steady rhythm but quivering and twitching ineffectively in a state called ventricular fibrillation. Nor could much be done if a blood clot threatened to block important vessels, or if coronary artery disease was slowly strangling the blood supply. External cardiopulmonary resuscitation was unknown. Back then, the only known technique to restart a fibrillating heart was to open the patient’s chest and grab the wriggling mass of muscle by hand, give it a series of forceful squeezes in the hope the heart would return to a steady beat. Understandably, the method enjoyed a dismal success rate. In the early I950s, however, Dr. Paul Zolllearned of some Russian research in which an electric current had been applied on the outside of the chest wall to correct a fibrillating heart. Zoll did animal experiments and then in 1952 applied a series of shocks to two patients in ventricular fibrillation. One died but the other recovered. Cardiac defibrillation was born, another of the rescue technologies that could stave off what before was certain death. Further help for diseased hearts came one year later, in 1953, when it became possible to temporarily by-pass the heart and let a machine take over circulation and aeration of the blood, for the first time enabling surgeons to operate on a motionless heart. The heart-lung bypass machine suddenly opened up a whole area of cardiac surgery, paving the way for cardiac by-pass and cardiac transplants in the late I960s.

Effective medical rescue of the kidneys came on stream by the early 1960s. Earlier attempts to get a machine to do the job of filtering the metabolic waste products from the blood failed largely because medical scientists didn’t know how to prevent the blood from clotting or what medium to use for filtration. In I940S Holland, Dutch physician William Kolff produced the first successful dialysis machine using the drug heparin to prevent clots and cellophane as the dialysis membrane. His first sixteen patients in acute renal failure died, but the seventeenth was sustained for eleven hours until her own kidneys recovered. Continued problems with blood clotting, filter medium, and methods to attach the patient to the machine slowed the widespread use of dialysis in the 1950S. But in 1960, a Seattle scientist introduced a Teflon tube that could be inserted permanently in a patient’s vein, enabling him or her to be readily connected and disconnected to the machine for the three or four sessions of blood cleansing needed each week. Dialysis then became a realistic method to sustain lives of patients in renal failure. Thus, at the beginning of the 1960s, all the rescue technologies were essentially in place. Intensive care units were created in hospitals to concentrate these machines, the skilled staff needed to monitor them, and the very sick people who needed to use them. Patients, who just years earlier would have died, could now be saved, many to resume an active life. It was miraculous; but over the next few years it began to dawn on people that miracles can sometimes have a down side.

In ten days my parents will be celebrating their forty-second anniversary. Will my son, who sleeps peacefully in his crib in the next room, be able to announce with pride in the year 2020 that his parents are about to celebrate their forty-second anniversary?

Tears are rolling down my face, wetting the keyboard, when I think of the answer. I hope they create a power shortage in the computer so I won’t have to keep thinking. Neither a blackout nor an earthquake would be able to ease the pain and frustration I feel. They might postpone the ongoing crisis but I would still wake up the next morning to familiar scenery.

If I could paint a marriage, what color would I use?

What images would I create? Probably I would scout some museums and borrow the images of history - di Cosimo, The Discovery of Honey, Munch, The Scream, Cezanne, House in Provence, Hogarth, The Graham Children, The dream picture I see for my marriage is Picasso’s Peace.

Whoops, I must stop! The baby has just awakened, crying.

I’m back after comforting and hugging him. I restored his need for security and he dove back into the world of dreams. Marriage doesn’t bring this original unconditional love most of us get from our parents. Who cuddles me when I have a bubble in my tummy?

Being married to a doctor makes it even worse you’re the last patient on the list. Joe was conditioned to become a physician, to fulfill family expectations. He had to save the people his parents lost. My “outlaws” were so busy trying to reach their goals, they forgot there was a child in need of love, fun, games. If you never received love, how can you give it?

I don’t trust Joe to be alone with Dan. He’s irresponsible. He doesn’t read about or understand child development. He thinks after he permits, and he erased the word “no” from his vocabulary. A child needs boundaries; he teaches none. Also, when he’s paged, the call becomes his focal point. He becomes deaf and mute to his immediate surroundings, including the baby.

Otherwise he’s a sweet, loving father who bonded nicely with his son. Dan adores his father, but I don’t think he misses him even though they see each other very little. I made it a ritual for them to spend time together in the morning. No matter what time Dan wakes up, I change him in our bed and go down to warm up his formula. Then Joe gets up to feed and be with him until he leaves for work.

On many levels my husband wants to learn, but the fear of the unknown is bigger than the ease of learning. When our son was born and through the first six months of his life, my husband couldn’t tell him he loved him. “He knows I love him,” he kept answering me. As the baby progressed in his milestones, so did my husband. By the time our son had crawled, the words “Daddy loves Dan” echoed through the house.

Guess what, my dear husband just called, announcing over the cellular phone that he’ll be home way past midnight. He wanted to know if our one-year-old pulled any new tricks today. I gladly volunteered one. “He walked by your picture and stuck his tongue out.” Do I sound hurt, angry, humorous, or simply stupid? Yes, all of the above.

I must say, Joe’s a good and generous man. He’s hardworking and has a great deal of responsibility. But marriage is also a job with responsibility. A marriage is never a fifty-fifty deal. There are times when one spouse gives forty and the other sixty. There are other times when it’s eighty-twenty. Like nature, we all go through cycles and seasonal changes. The leaf must fall off for the tree to rejuvenate and the soil to be fertilized.

We, earth’s most civilized and advanced creation, marry, and I don’t understand why. Are we the most civilized? Many years ago I came across Nahaman Bialik’s vivid ballad “The Wolf,” about the Holocaust. Even the wolf was horrified, astonished, and ashamed of the most systematic slaughter and vicious man-made atrocity. Am I comparing marriage to a holocaust?

Should divorced individuals be called marriage survivors or should married people be called married survivors?

By looking back at my previous paragraphs, I think my unconscious unraveled the cause of my disharmonious relationship. My dear husband is the eldest son of Holocaust survivors. They taught him to use various distancing devices, false analogies. He believes in the most primitive psychological form of defense, which is denial. He’s passive and waits in the hope that he won’t have to come to terms with reality.

I’m a second-generation Israeli who was raised as free as a bird with no fear of concentration camps or annihilation. I believe in prevention. I’m an air force brat and learned to gather intelligence, analyze findings, recognize facts, make assessments, and interpret their implications. I gained mastery by safeguarding against real danger.

How can our marriage survive the continuous battle of his destructive drive and my life drive?

Most essential of all, with a great deal of love and planning, our marriage produced a healthy seven-pound-five-ounce baby, whom I dearly love.  

It had been a long day. One of those days in which appointments seemed to overlap with one another, blending together until I was no longer certain to whom I had said what. The lunch hour had come and gone without my noticing, and now, as I arrived home, my stomach was talking loudly. Dinner would be well appreciated tonight.

We recently remodeled our kitchen and the outlet for the new stovetop exhaust fan is next to the driveway. As I drove toward the garage in back, the aroma of the evening meal wafted through my open window. My wife is a culinary wizard and, even after five years of marriage, the variety of dishes she whips up for a single meal still boggles my mind.

However, my eyes widened and my jaw dropped when I entered the kitchen. Dr. Seuss himself couldn’t have imagined a more bizarre sight. Suzanne is a speed cook. There’s no better description. She throws together a mouthwatering four-course meal in less than twenty minutes. Tonight, as usual, the table looks great. But the kitchen is a disaster zone. A vast array of pots and pans of all sizes are soaking in a sink full of cold, greasy water. All measuring cups and spoons have been taken from their usual hiding places and strewn along the counter. Never mind only two were required-they were all pulled down. A fine dusting of flour covers the entire kitchen, and the cooktop and much of the counter glisten with a film of splattered grease. The can opener has drippings on it and all of the countertop machines-mixer, toaster, coffee maker, and so on-are coated with the same flour and grease. The uplifting effects of the marvelous aroma quickly fade as I feel depression setting in. Suzanne has outdone herself this evening. Our underlying marital agreement, which keeps our lives running smoothly (relatively speaking), is that each of us capitalizes on our strengths and, in turn, helps compensate for the other’s weaknesses. Hence, Suzanne cooks (compensating for the absence of a skill I should have developed more fully during my bachelor days) and I… well, I clean.

Opposites attract, or so I’ve heard. But, once attracted, can they really survive their differences? I’m a very clean cook. Yet my meals are as unimaginative as the kitchen is clean when I’m finished. I try to show Suzanne how to cook with less mess. It doesn’t sink in. She, in turn, tries to speed me up (I cook like a mother turtle). Also, to no avail. We’re not going to change each other’s ingrained means of operation. Not that we won’t continue to try, with a faint glimmering hope that someday I’ll move faster and she’ll clean as she cooks. But for now…

She looks up with an apologetic smile. “I’ll help,” she offers.

“What’s for supper? Sure smells good,” I reply.

The most profound shock in a parents’ life may be learning that his or her child has a handicap.  All the hopes and dreams for the future of that child suddenly seem hollow and empty.

Parents often feel terribly depressed and grief stricken.  It is as if the child they knew had died and a strange child has been left in his place.  Sometimes parents feel guilty and blame themselves for the handicap.  They feel it is a result of something they did, or did not do, or they feel they should have recognized the problem sooner.  They feel they have somehow failed as parents.

Often parents feel angry with their pediatrician or the professionals who tell them the diagnosis.  They may feel that the medical profession, which they had put such faith in, has failed them.  Parents may also discover they have negative feelings about handicaps in general or their child’s handicap in particular.

All these feelings are normal. But they are hard to deal with and hard to live with.

As parents struggle with their own reactions of shock and disappointment, they may find that their normal support systems fail because friends and family are also struggling to cope with their feelings of concern.  Parents may find themselves vulnerable to and resentful of advice and comments offered by friends, relatives, and self-styled experts.  Parents often suddenly find themselves overwhelmed by information they are trying to understand and by decisions they feel must be made immediately.

Initially parents may not be able to absorb all the information that is being given to them.  They may be worried about the effect of the handicap on other children in the family and deeply concerned about their ability to relate to the handicapped child.

It may be helpful to talk to someone with experience in dealing with these emotions, someone who can help you sort out your feelings and recognize your responsibilities.  Your religious leader, a psychologist, a psychiatrist, or another trained counselor may be helpful.  Many parents find the greatest relief and comfort in talking to other parents who have lived through similar experiences.  Parents should not try to ignore or hide their grief.  In time the pain will lesson.

For some parents, the best tonic is taking action on behalf of their child, whether it is enrolling her in a therapy program or a school, talking to a specialist about prosthetic devices [an artificial limb, a wheelchair, or a hearing aid], or contacting a national organization for more information.

You will be looking at your child with new eyes, and in the beginning that can be difficult and painful.  You will be establishing a new relationship with this child, different than what you planned and expected.  But it can be a relationship that is fulfilling and rewarding as you work with your child to discover her full potential.

Playgrounds and pools are places for recreation and relaxation.  But the laughter can easily turn to tears and tragedy.  A two year old follows his older brother to the top of a ten foot high slide, slips while trying to sit on the top, and falls to the ground, breaking his leg.  A one year old topples over the edge of the wading pool-luckily, an observant lifeguard rescues her.  Knowing what the hazards are at playgrounds and pools and teaching your children hoe to play and swim appropriately can ensure a safe outing.

Playgrounds

Playground equipment is ranked sixth on a list of one hundred hazardous consumer products published by the Consumer Product Safety Commission. Each year, 155,000 children are injured on playgrounds.  On public playgrounds sixteen percent of those injured are under five years old; on home playgrounds, twenty-one percent are under five.

Younger children are likely to be injured on the playground because of their stage of development.  They are compelled to investigate.  They won’t be satisfied at the bottom of the slide-they need to see the top, too.  But physically, they are not coordinated enough to do what they want.  In addition, they can’t project the consequences of their actions; they never anticipate falling off.

Slides, in fact, are one of the most hazardous pieces of playground equipment.  Other pieces of equipment to watch out for include swings, climbing structures [such as “monkey bars”], and seesaws.

Most children are injured by falling.  Seventy-five percent of playground injuries are from falls to the ground or onto other equipment.  Fifty percent of these result in head and neck injuries.  The most serious injuries occur when children fall onto concrete or asphalt rather than on a more yielding surface such as sand.  Falls can also result in fractures and lacerations.

Children can be injured in other ways as well.  They may be hit by moving equipment or cut by rough or sharp edges, or they may become stuck in the equipment.

The Consumer Product Safety Commission has established voluntary product safety standards for home and public playgrounds.  These include equipment specifications and suggestions for everything from the type of base surface to use to design and arrangement of the play area.  The standards also stress that safe playgrounds require adequate supervision and maintenance as well as good design.

It is essential to teach your children how to behave at the playground and to supervise their activities.  Teach your children to hold onto all equipment with both hands.  Teach them to stop before getting of any moving equipment.  Teach them to sit on the swings and slides, not stand, lie, or hang upside down.  Only one person should be allowed to use playground equipment at a time.  Be sure they don’t push or shove and that they walk well away from areas where other children are swinging or sliding.  Be sure the equipment your child plays on matches her ability.  A ten year old can easily climb a jungle gym, for example, but a two year old shouldn’t follow suit.  Teach your children to use equipment as the manufacturer intended.  For instance, children should swing on the swings, not twist around.

There is a growing public awareness of environmental hazards.  Although little research has been done on the subject, playgrounds may pose subtle dangers.  Some parks have been built on previously contaminated landfills.  Others, especially those near freeways, may have high lead levels from automobile fumes.  Some playgrounds surrounded by open land are sprayed with pesticides.  Other playgrounds have wooden equipment that has been treated with wood preservatives or painted with lead based paint.  Better planning by and playground owners and greater parental awareness could reduce the risks posed by such toxic chemicals.

Pools

When most people think of pool related injuries, they think of drowning and water aspiration.  Drowning is the second most cause of accidental deaths in children, and the third most common in children aged one to four.  Two thirds of the victims are non-swimmers.

Diving injuries also occur and can be very serious.  However, older children and adolescents account for most of these.  In younger children, falls and cuts are common-children slip on wet surfaces.

Toddlers are at particularly high risk for drowning.  Their size makes even a small amount of water hazardous.  In addition, they are often unsteady and fall easily, and they seldom know how to swim.

The key, then, to preventing drowning is to teach your children how to swim.  Toddler swimming lessons have been controversial, but they can be worthwhile-especially if the disadvantages to them are understood.  Children who have had some form of swimming lessons are only one half as likely to need some type of assistance in the pool as children with no training.  Also, toddlers who start swimming earlier are more likely to become competent swimmers as adults.

The biggest disadvantage to toddler swimming lessons is that afterward parents believe the child is water-safe and don’t watch her as carefully as they might if there had been no lessons.  Although your child may be more comfortable in the water after taking swimming lessons, she really can’t swim well, nor can she be expected how to react to emergencies.

Infant swimming lessons have other drawbacks.  Prolonged lessons have been associated with water intoxication.  Therefore, the YMCA recommends prohibiting forced submersion and limiting in-water time to thirty minutes.  In addition, when children are still in diapers, it becomes difficult to maintain the effectiveness of the pool’s chlorination. There have been reports of epidemics of diarrheal diseases from infant swimming classes.

Besides swimming lessons, there are other precautions that may help prevent pool accidents.  Fences and self-locking gates around public and private pools may prevent a toddler from toppling in while unattended.  Adequate supervision from both parents and lifeguards is a necessity.  Children should be taught to follow rules in the pool area, such as no running and no diving in shallow water.  Finally, use lifejackets on young children who don’t know how to swim, but don’t become complacent-life jackets too, can fail.

Similarly, bear in mind that inner tubes, air mattresses and other flotation devices are for fun only, and must not be trusted in deep water, or if your child is out is out of sight.  Toys break, inflatables’ deflate.  Don’t place your child in unnecessary peril by trusting such devices.

By their very nature, playgrounds and pools can be hazardous places unless a certain amount of caution is exercised.  You can teach your children how to be careful, and keep playgrounds and pools safe recreational places.

Young children like to examine just about everything with their mouths.  This tendency can lead to problems-poisoning, choking, and swallowing dangerous objects.

Objects placed in the mouth may find their way down one or two passageways.  If something starts to go down your child’s trachea [airway] toward the lungs, she will begin to choke and will need help immediately.  If the object starts to move down the esophagus [food tube] toward the stomach and gets stuck, she will probably not choke [unless the object is so large that it also presses against the trachea], but she will have problems swallowing.  She may drool because she can’t swallow her saliva.  An object lodged in the esophagus must be removed by a doctor.

Once an object gets in your child’s stomach, the immediate danger is over.  Most small objects [like coins, marbles, paperclips, and even sharp objects like pins and small pieces of glass] will usually pass through the digestive system without problems.  Occasionally, something will cause an obstruction of the digestive tract or penetrate a segment of intestine.  Abdominal pain, vomiting, and fever may develop.  It may be a few days after she swallowed the object before the symptoms begin.  She needs to be seen by her doctor.  X-ray films will be taken.  Metal objects and many glass, plastic, and wooden objects may be visualized.  X-ray films may also show other problems, such as increased abdominal gas, or a perforation of the intestines.

To be sure that the swallowed object has passed through, you should check your child’s bowel movements.  Each bowel movement must be passed through a sieve.  If the child has been potty trained, place a basin fashioned of window screening in the toilet bowl.  Then, after the child has passed a stool, wash it through the screening with hot water.

Some objects may cause stretching of your child’s rectum, and a little bleeding.

There are no medicines, foods, or drinks that speed up the passage of swallowed objects.  Some doctors recommend eating foods that increase the size of your child’s stool, such as roughage, in an attempt to ease the passing of the swallowed object.

Swallowed Objects Symptoms

• If the object went into your child’s stomach, there may be no symptoms
• Inability to breathe or cry
• Gagging or choking
• Pain in his throat or chest

Difficulty Swallowing

• Abdominal pain
• Vomiting

Treatment

• If your child is choking, follow steps for choking
• If your child is in pain, seek immediate medical help

Your father is so kind, so gentle. As I write this you’re snuggled in his arms waiting for King Kong or Godzilla to come on the video screen. These nights are perfect.

If I go downstairs I might feel hassled. It’s a mess. I cleaned several times today and it’s still a mess. It’s my job to do most of the cleaning up. That’s because I’m home-so I can be with you when you need me. It’s taken me a few years to get used to doing the household stuff and to realize that your father does a host of things he doesn’t want to do at his job.

My parents-your grandparents-encouraged me to get married. They said they just didn’t want me to be alone. I didn’t know what they meant. I had them, good friends, lots of interests. I was full, and though I hoped I would have somebody to love in my life, I didn’t really know, or care, how much better things could be.

My daddy died before your father and I got married.

Your father asked for permission to marry me when my daddy was so sick he could barely speak. He nodded yes and my mom was so happy she hugged me. Then my daddy died and your father and I got married. My mom went a little crazy. She seemed very angry with me. I think it was because suddenly everything had changed. Now I was married and she wasn’t. She married again and I felt Daddy’s presence around me a lot, so everything was fine.

We found out we were going to have a baby. I was happy but scared because I didn’t know if there would be enough love and time for all three of us. The love was no problem. The time was. We needed time as a family, as a couple, and each of us (except you) needed to be alone. It took about a year to figure out how to juggle all of this. We still don’t always find the time we need.

When you were born, I was happier than I’d ever been. You were everything then that you are now sweet, alert, inquisitive, and funny (and we’d only just met). One week later my mom was in a coma and we knew she’d die soon. She was old and had lived a pretty good life, but I felt as if I was no longer standing on the ground.

I became terribly worried about your safety. It was hard for me to trust anybody, even your father, to take care of you. I was so shaken it took me a long time to see how good he was with you. The love between your father and me continues to grow. He tries to help me fulfill my dreams. I try to help him with his. He can get me to laugh when I’m crying.

You, my big three-and-a-half-year-old, told me yesterday you want to marry me. Of course, this desire is natural at your age, but I’ll let it mean, too, that you know how deeply satisfying being married is. I love you.

Mommy

The following case shows very clearly the mechanisms and the expressions of competition between children.

Nine-year-old Billy was such a wonderful little boy. He had lost his father four years ago, and he managed to be a great solace and help to his mother. Very early he assisted her not only in housework, but also in taking care of six-year-old Marilyn. Even at his tender age, Mother could discuss any problem with him, and he actually assumed the function of the “man of the family.” The only point where Billy did not do so well was at school. He had few friends and was not very much interested in school work. That is not surprising when we consider that in school Billy could not have the extraordinary position which he enjoyed at home.

One can easily imagine the type of girl Marilyn was. She was so unruly that Mother did not know what to do with her any longer and asked for help. She was untidy, unreliable, noisy, disturbing, and annoying-a real “brat.” Mother could not understand how in the entire world the two children could be so different! It was hard for her to understand the connection between Billy’s goodness and Marilyn’s difficulties.

We had the following discussion with both children together.

First, we asked Marilyn whether she thought Mother liked her. Her answer was, as could be expected, a shaking of the head. Then we explained to her that we were sure that Mother loved her very much but that because she, Marilyn, did not believe it, she acted in such a way as to make Mother constantly angry at her. As a consequence, Mother paid attention to her only when she misbehaved (destructive attention-getting mechanism) and that made her feel still more disliked. If she would try to behave differently, she would find out that Mother loved her, too.

This discussion took place in the presence of Billy. Then we asked him whether he wanted Marilyn to be a good and nice girl. He immediately shouted, “No!” We asked him why he didn’t want it. He became embarrassed, groped for some answers, and finally said, “She won’t be good, anyhow.” Then we explained to him that maybe we could help her and he could help her, too, and so we might succeed in making her a good girl. Would he like it? Somewhat uncertainly, he said, yes, he would like it. I looked at him and told him, frankly, I didn’t believe that he meant it seriously; I was sure that his first “no” was more sincere and accurate. But why didn’t he want her to be good? Perhaps he could tell me. He was thoughtful for a while. And then he came out- “Because I want to be better.”

Once the competition between the first and second child is established, a third child may be adopted as an ally by either the first or the second. Only rarely does the third compete with both, forcing the first and second into an alliance with each other-a situation which may occur, for example, if the older two are girls and the youngest a boy. The fourth one can side with any of the older children, according to circumstances. Whichever way the division of forces has been aligned can be recognized easily by each child’s subsequent character development. The two siblings most different in their qualities, interests, or emotions are those who as children were competitors. This fact reveals where within the family lie the battlefronts, the recognition of which is necessary for the understanding of any child.

This family interaction, which puts each child in a characteristic “family constellation” as Adler 3 calls it, is more important for the development of personality and character than any other single factor such as inheritance. Here is an example:

Father, mother, and six children make up the family. The competition originated in the relationship of a “superior,” domineering father, interested in politics and literature, and the mother, a typical housewife, compensating for her social and intellectual inadequacy by domestic dominance over the children. The first child, Sally, a daughter, is played by her father against the mother. The mother finds an ally in her second daughter, Beatrice. Sally is a good student, but despises housework and is in constant opposition to her mother. Beatrice is very much interested in housework, a very mediocre student, and much interested in her feminine appeal.

A few years later identical twin girls are born. Their physical similarity necessitates their wearing different-colored stockings and ribbons to facilitate recognition. Identical twins generally have a peculiar psychological relationship. They identify themselves with each other to such a degree that very often they regard themselves as only a half of one, frequently developing identical life styles which then bring an amazing similarity in their fortunes.

In our case, however, something rather unusual happened.

The strong competition between the two older sisters caused a division between the twins. One, Ruth, who was, incidentally, the senior by thirteen minutes, was claimed by Sally as an ally, while Beatrice sided with the “younger” twin, Diana. As a consequence, Ruth developed like Sally into a good student and bad housekeeper, while Diana, like Beatrice, became a mediocre student, good housekeeper, and much interested in her appearance. The third couple of children were a boy and a girl. The boy, Tom, was not only again the “older” of the two, but also, as a boy, desirous of special superiority.

The whole family was split into two groups-in characters, in interests, and behavior: Father, Sally, Ruth, and the boy against Mother, Beatrice, Diana, and the baby girl. Tom, with the support of his oldest sister and father, challenged the superiority of even his much older sister, Beatrice, trying to bully her. The twin Ruth excluded Diana from her own relationship with girls, and refused to take her with them because she was “too young” (thirteen minutes younger!). Friction, discord, and mutual suffering made miserable the life of these otherwise capable and pleasant human beings.

Indulging and pampering a child can never prevent friction but always lead to warfare. Underneath and beside the display of love and tenderness, we can always find expression of open or concealed hostility. Very few of these “loving” parents recognize the hostility and terrific warfare in which they and their children are involved. All the behavior problems of children are symptoms of hostility. It is difficult to make a mother aware of this. She cannot understand that the child may resent her, as she is firmly convinced that she gives him everything and loves him deeply. Yet how many mothers break down when they can no longer prevent the child from gaining independence? How many tragedies occur, especially during adolescence, when the child must grow up or become a complete failure-one being as distasteful to the mother as the other.

In protecting and dominating the child, not only mothers but many fathers try to prove their own superiority which is so badly threatened by our present life conditions. Once hostility starts, there is no relaxation, no peace. In a family shaken by discord and mutual hostility, shortcomings of the children are emphasized and actually fostered. Children’s faults serve as the basis of mutual recrimination, as opportunities for each parent to excuse his or her own lack of social adjustment, and for pretexts to justify their own expressions of hostility. The hostility may even start as soon as the child is born, without any original period of love and affection. Fortunately, complete rejection of children occurs less and less frequently since man has learned to prevent undesired offspring. In any case, the friction between parents and children, the warfare inside of the family, deprives many parents of the full gratification of having children.

It is no wonder that parents so often fail in the rearing of their children, for it is one of the most difficult tasks in marital life. Teaching is an art. It needs skills in which its practitioners must be carefully trained. But how much training do parents have? What do they know about education? The situation is the worse because what little they know is very often wrong and even harmful. No shoemaker would venture to open a shoe repair shop without being duly trained. But parents often open an educational workshop with almost no preparation-with only the training that they have received from their own parents.

Ironically, parents try to imitate the acts of their parents, completely forgetting what they themselves as children had to suffer from their own parents’ inadequacy. A father who has been beaten as a child will be much inclined to beat his own children. He forgets completely the humiliation he felt as a child, the hatred and opposition growing under the whipping with the parental hand or rod. This is the reason why it is difficult to convince parents that their procedures and techniques are wrong, unsuccessful, or even harmful. Each parent represents in his attitude generations whom he imitates. Any attempt to influence the educational procedure characteristic for any specific family is confronted with this unbreakable wall of traditional educational conceptions which are carried from one generation to another. This spiritual heritage is even stronger and more decisive than any physical inheritance. It may well be possible that certain national or racial characteristics are based less on biologically inherited qualities than on the educational methods used in the particular group and handed down from generation to generation.

To break this traditional circle is difficult indeed. Let us consider the simple traditional device of beating a child who deviates from the behavior desired by adults-who does “something wrong.” What is the effect on the child? These cruel and terrifying episodes distort character, create a disbelief in human kindness and fellowship and a distrust of his fellows. Beaten children, in their revolt, provoke situations where they will be whipped again, physically as well as mentally. If, on the other hand, the spanked child keeps up courage and social interest, he will, as an adult, carefully avoid any situation in which he may be victimized again. He may cultivate “strength” and “toughness,” and attain that rigidity and cruelty of character which is the high price paid by many strong and able persons. They punish rather than submit; and they alienate the affection of friends, relatives, and children.

Yet the custom of spanking was for a long time universally considered an adequate method of training children and still is accepted as such by most parents. Even those who recognize intellectually that spanking means humiliation and violation of human dignity, resort to this insulting technique for the preservation of their own superiority and excuse the practice by reference to their “uncontrollable” emotions and “nervous distress.” The custom of spanking is one of the most forceful obstacles in the development of a democratic, peaceful, and cooperative atmosphere within the family, a relic of times which had little conception of human dignity and of human rights.

The problem of educating is not distinct from other problems of living together. The process of educating reveals one’s general outlook, one’s philosophy of life. The social atmosphere in a family is, therefore, a very important factor in the education of children. All the shortcomings, faults, and errors of a child can be traced to faulty approaches used by members of the family in dealing with each other. The child is adequately prepared for life only if the family has observed those rules which should govern the relations between human beings. For since the family is the child’s first community and social unit, it represents to him a picture of life in general, and all depends on how closely and truthfully the family pictures the larger world outside. A favorable home atmosphere will encourage the development of a correct attitude in the child who, when he faces the world, must interpret it in accordance with the experiences and conceptions he has gained at home.

Unfortunately, the relationships within our present-day family do not correspond to those in life outside. Our children, especially if they are few, are usually overprotected, and they become self-centered. In a world of grown-ups, they live not as equals, but as dependents. They have few opportunities to become useful, to contribute to the group, and to achieve a proper niche by themselves. Their way of seeking the assurance of being accepted is demanding; demanding service from others, demanding gifts, or at least attention. What they can receive is for them a symbol of their importance; what they can do is insignificant. This principle of getting along with people contradicts all the rules of cooperation discussed earlier.

The more parents behave in accordance with the rules of cooperation, the easier it is for them to bring up their children properly. The child can adjust himself spontaneously to the right way of behavior, for he has a keen apprehension of what goes on around him, and how one must conduct himself to get along. Too often parents employ one set of rules for themselves and another, quite different, for their children. What excitement there is if a child lies! The parents are bewildered, they feel actually insulted. They completely forget the occasions when they have lied openly to a neighbor, or even demanded of the child that he lie for them. They expect their child to be industrious, whereas the father and the mother regularly complain about their own work. They are surprised by “improper” language from their child and ask accusingly where he learned to speak thus, when the child is merely repeating what he has heard from them. Is it so foolish for a child to say to his mother, “If you are not nice to me, I won’t clean my room,” if the mother demands that the child be “nice” before she fulfills her own obligation to the child? Yet the demanding mother is horrified by such statements.

It is difficult for parents to realize that children are human beings like themselves. Parents not only demand privileges which disrupt social order and destroy the feeling of belonging; but often they permit the child privileges that they would not grant to anyone else. Indulgence is as disastrous as suppression. Only rules which govern the life of the whole family, which include parents and children alike, train for the recognition of right and wrong. Where strong and impartial moral rules regulate the family life, no particular educational techniques are required for the child to grow up willing to contribute his share, confident of his own strength and ability, a useful vital force in the community at large.

Where is there a family with such background and atmosphere? Where are there parents so courageous and cooperative? As has been mentioned, our times are unfavorable to the development of such a family and such parents. A deep feeling of insecurity and a constant concern regarding our prestige hinders us from being as good human beings as we could be. Parents are no exception.

We cannot expect parents to be more cooperative with their children than they are with other competitors. And it is as foolish to expect more peace within the family than within our society as a whole. With sufficient social feeling, we find our way everywhere-without it, nowhere. Children are not different from other human beings. They can threaten the prestige of their parents as much as business competitors, perhaps even more; for parents are very vulnerable to their children’s opposition. They believe that parental love or parental indulgence can buy submission. They demand acceptance and obedience just because they are parents. Any opposition and disobedience they regard as a personal affront, almost as a heinous sacrilege against the “divine idea of parenthood.” The more they try to impose their will upon the child, the less they succeed in winning his cooperation, and their sense of disappointment deepens. Chagrined and embittered by life, they take their disappointment home and return it through their children back to the world.

To accommodate your tiredness and the baby’s demands on you, you may have to review what is most important to you and make some changes in your lifestyle. If you are a perfectionist who has always insisted that things be done the “right” way, you may find that you must relax your exacting standards a bit. If you suffer from inertia, it may be necessary for you to grit your teeth and force yourself to arrange for the rest, moderate exercise, and proper nutrition that are so essential for you and often so difficult to achieve. Realize that when you look your best, you are more apt to feel in control. Don’t allow yourself to skimp on good hygiene habits because you are too busy or too tired. Dress completely every morning, do your hair and use whatever cosmetics you usually do. This is not the time to make demands on your strength and energy by beginning a reducing diet, however anxious you may be to get your figure back to normal.

Above all, don’t try to bottle up your feelings in hopes they will go away if you ignore them. Talk about them with your spouse, your doctor, your mother, or a friend who has suffered them already. Be in touch, if only by phone, until life settles down.

Every parent should get away from the routine of house and new baby on a regular basis, and this escape is even more important if you are suffering from post-delivery depression. Even a brisk walk around the block will help, when your spouse or someone else can care for the baby, but an entire afternoon or evening out occasionally will do even more for you. You need not feel guilty about going out for a few hours, as long as a reliable babysitter is in charge.