I. Description of the problem. Adults are challenged when they become parents first. The tasks are novel and often cause concerns, anxieties, and fears. New parents must also address previously unexplored values and attitudes now brought to the fore by the birth of their baby. New day-to-day activities and routines, new problems needing solutions, and normal struggles and uncertainties can elicit heightened emotional responses from parents.

Mundane and minor matters can elicit worry (e.g., parents’ great anxiety when their infant has not had a bowel movement in 2 days). More serious and threatening experiences also cause internal upset (e.g., a mother’s feelings of exhaustion and being literally consumed by her ever-hungry new infant; a father’s dismay at his wife’s physical and at times emotional unavailability as she completely focuses on the new infant).

In addition to these universal early experiences, parents know that ahead of them are the even more challenging tasks and risks of child rearing.

II. Process of self-understanding. The pediatric clinician’s input around child development information and child-rearing strategies is often inadequate to help parents negotiate the myriad feelings and the complex tasks involved in successful parenting. One thing in which parents really need to be successful is to develop an understanding and insight into their own past, especially their relationship to their own parents, and also to understand their own patterns of behavior. Self-understanding for parents develops over time through review of their past upbringing through remembering, retelling, reflecting on, and perhaps reinterpreting past events. This process is catalyzed and assisted through ongoing conversations with spouse, relatives, friends, and other parents and professionals.

Without adequate self-understanding, problems can arise for parents when experiences, attitudes, and fears arising from their own upbringing, cause them to respond inconsistently or behave inappropriately toward their child. And when parents do direct excessive anger, withdrawal, sarcasm, harsh criticism, or rigid orders toward their child, it can be upsetting, confusing, and ultimately damaging for the child. To short circuit inappropriate responses to their child, parents need to be aware of the origins of their attitudes and behaviors. Again, this is achieved through reflection and self-exploration.

Pediatric clinicians can foster self-understanding in parents by asking key questions at critical times and then listening to the answers. Questions that are particularly important address parents’ attitudes and values, especially as they relate to their own childhood and how their parents raised them. Growing up in a family that is overly strict or harsh or lacks emotional warmth can program children to recreate the same family style when they become parents. But when parents have reviewed their own upbringing thoughtfully, have considered which aspects were positive and which were not, and have decided how they would like to raise their own children, research shows they are much less likely to repeat maladaptive patterns learned in the past.