Troubled Waters

Psychiatric TimesPsychiatric Times Vol 26 No 6
Volume 26
Issue 6

Every August, during my lakefront vacation, I kayak to the middle of Otter Pond, lay the paddle across my knees, and drink in the tranquil scene around me. Sunshine glints hypnotically off the rippling water. Every muscle relaxes, my cares recede. But this past summer, my annual reverie was interrupted by the shriek of a young child. “Let me out, let me out!” he cried, teetering halfway out of a passing paddleboat. “I want to swim back to the house!”

Every August, during my lakefront vacation, I kayak to the middle of Otter Pond, lay the paddle across my knees, and drink in the tranquil scene around me. Sunshine glints hypnotically off the rippling water. Every muscle relaxes, my cares recede. But this past summer, my annual reverie was interrupted by the shriek of a young child. “Let me out, let me out!” he cried, teetering halfway out of a passing paddleboat. “I want to swim back to the house!”

The boy’s petite, red-haired mother tried valiantly to haul her wriggling youngster back into his seat, but he remained intent on his ill-advised leap overboard. My peacefulness shat­­tered, my curiosity piqued, and I morphed from vacationer back to child psychiatrist. How would the mother handle this volcanic situation?

“Harry,” the mother said evenly, “you’re in the red zone now. How will you get back to green?”

“Let me out!” Harry bawled, ignoring his mother’s color-coded request.

“Harry,” she persisted, “every scream is 1 more minute away from me, do you hear?”

“Do you need help, Sheila?” a man called from the shore. Sheila calmly shook her head.

The standoff between Sheila and young Harry continued, his flailing limbs a counterpoint to her reasoned talk of red and green zones. All the while, Sheila pedaled their boat closer to shore where her husband and a group of friends nodded their approval of her coolheaded treatment of the mutinous boy. As Harry tumbled onto the grass, I mulled over what I had witnessed. What exactly was Sheila’s intervention? Was it appropriate to her son’s age and phase of development? I resisted the urge to paddle over and quiz Sheila about her parental intervention. I could only surmise that she had used a technique to help children regain control in the midst of a tantrum. The parents on shore appeared comfortable with her strategy. As for Harry, he sucked contentedly on a Popsicle, acting as though nothing had happened. What had ultimately calmed Harry-his mother’s words, the Popsicle, or sheer exhaustion?

While relaxing on the beach, I observed parents and children enjoying the pleasures of the pond. I also found myself watching their fights about that extra minute of water time or the promised drive into town for a toy. These conflicts brought up a memory of an argument I had with my own son during a long-ago winter. He was 9 at the time, past the tantrum stage, or so I had thought. Snow had fallen and he dashed outside to play-in his bathing suit. I screamed for him to get back inside and put on his winter clothes. When he refused, I hauled him into the house as he was kicking and shrieking. I couldn’t comfort him and he seemed unable to calm himself. His intensity of emotion indicated that something deeper was going on in my son’s mind than simple misbehavior. Thinking back on it now, I believe he was trying to prove to himself that he was a grown-up boy: my son versus the forces of nature. Would he have come inside of his own accord if I hadn’t intervened? I don’t know, but at the time he appeared incapable of being reasoned with. Might the red zone–green zone strategy have broken the logjam?

My summer experience at the pond also made me question the way I guide parents in my practice. As part of a child’s treatment, I meet with parents every few weeks, listen to their concerns and anecdotes, and then address each family’s unique situation. My own parent guidance models include encouraging parents to have clear limits and expectations; to have empathy for their child’s feelings, while naming these feelings for the child; and, if possible, to connect stressors or events with feelings and behaviors. I recommend that parents remind their child of the tantrum several days later-out of the heat of the moment, in declarative sound bites that explain their ideas about the tempest. To deepen the parents’ understanding, I conclude by putting the child’s behavior into a developmental framework and psychodynamic formulation.

When I returned from my August vacation, I traced the roots of Sheila’s zone technique to the work of the late psychologist Haim Ginott. Ginott’s 1965 book, Between Parent and Child,1 has been revised and updated by his wife, Alice, also a psychologist, and her colleague, human development specialist H. Wallace Goddard. In a multitude of anecdotes, Ginott proposes growth-promoting ways in which parents might respond to their children’s behavior and expressions of feelings. In his slender volume, Ginott urges parents to discipline without threatening; criticize without demeaning; acknowledge rather than argue with children’s feelings; express anger without hurting; and respond so that children will learn to trust and develop self-confidence. For the most part, he focuses on strategies to avoid tempests by listening and labeling feelings in such a way that children feel compassionately understood. These parental responses grow out of Ginott’s philosophical position that all feelings are to be explored and respected.

For example, when children tell their parents that they feel stupid in school, Ginott advises parents to open the door to further conversation, to allow space for children to vent their feelings, and only then to gently propose a more positive point of view. Ginott defines 3 zones of behavior: encouraged, allowed, and forbidden, which run the gamut from “behavior that is wanted and sanctioned” to “behavior that endangers the health and welfare of the family.”1(p121) Allowed behavior falls between these extremes and leaves flexibility to accept unwelcome conduct when the child is under stress, ill, or new to a task.

In his popular book Raising an Emotionally Intelligent Child,2 psychologist John Gottman relabels Ginott’s encouraged, allowed, and forbidden zones as green, yellow, and red-the version I had witnessed at Otter Pond. Gottman goes on to offer age-appropriate parent coaching strategies for conflict resolution. Parents, he writes, should suggest options that might help the child solve the problem at hand. The balancing act is to offer just enough advice so the child can figure out a solution without feeling that a parental solution has been imposed.

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When Sheila asked Harry how he could get back to the green zone, she offered her child a catch phrase that let him know that his goal was to calm down during a time when dialogue might be overwhelming. But when this failed to work, she did not offer Harry any ideas to help him solve the problem. What if Sheila had said, “Harry, if you get into the green zone, we can pedal closer to shore and then you can show me what a strong swimmer you are.” In this way, Sheila might have given Harry the motivation to calm down and at the same time uncovered the psychological core of the battle.

Among the many other practitio­ners who have provided advice to parents through books and clinical work are Eduardo Bustamante, Bart Herskovitz, and Ross Greene. Good parenting does not come naturally, even if both the parents and child are even-tempered. Bustamante, author of Parenting the AD/HD Child,3 bases his recommendations on attachment theory and developmental accomplishments. His goal is for children to manage their behavior and the dilemma at hand within themselves. Crises should not become a struggle on the interpersonal playing field between parents and child. The strong wish to remain attached to their parents will help children cooperate in resolving clashes. Bustamante advocates time-out for both parents and their child to create a peaceful space for thoughtfulness instead of rash action.

Psychiatrist Bart Herskovitz has expanded Bustamante’s concepts in his practice. Herskovitz provides parenting classes for groups of several couples at a time. The ages of the parents’ children range widely, but Herskovitz finds that the most useful classes are for parents of children from latency age through teenage years. The diagnostic categories in which the children fall vary, but the symptoms predominantly include difficulty with self-soothing and self-regulation.

Herskovitz routinely discovers that when parents hear about struggles from other families in the class, both their own sense of isolation and their assumption that they are bad parents decreases. Simultaneously, their capacity to have more compassion toward themselves and their children increases. The group format provides the support that parents need to be able to learn new skills.

In my estimation, Bustamante’s principles are not well suited to guide parents of young children. Herskovitz builds on these principles to help this group of parents. He proposes adopting a playful stance, while decreasing intense responses to every conflict. In that way, parents of younger children may be able to disengage from struggles. If, say, a 5-year-old girl is having a tantrum about getting dressed in time for school, Herskovitz suggests telling the child that it is hard to help her get dressed while she is stamping and hitting.

Bustamante’s core goal is achieved by this intervention: the child begins to struggle inside herself with wheth­er she can and will call on self-soothing strategies. Over a long period, this kind of emotional work will enable her to master her feelings and gain control over her behavior. It frees both parent and child to interact without heated struggles.

The Explosive Child by psychologist Ross Greene is another popular book that deals with parent-child conflict resolution.4 Greene’s narrative centers on differentiating issues that can be left in the child’s domain, issues that the parent must handle, and issues in which dialogue and negotiation are important. In his clinical work, Greene teaches parents and children how to negotiate. The result: the child’s request or behavior is handled in a way that facilitates development and leads to a peaceful settlement of the situation.

While working on this column, I happened to catch an episode of the television program Dr Phil that was devoted to growth-promoting parenting. Later, I tuned in to Supernanny, which features a latter-day Mary Poppins, Jo Frost, who swoops in every week to rescue yet another clueless family from a self-inflicted parenting crisis. Typical viewership for each of these shows is over 5 million.

And, the cover of Haim Ginott’s book blares that more than 5 million copies have been sold.

I viewed video clips of Haim Ginott being interviewed by Phil Donahue, Merv Griffin, Barbara Walters, and Hugh Downs. Walters enthused that Ginott’s take on children and their feelings was a radi­cally new idea for the American public. Evidently, the work of early child analysts that addressed many of these issues was not embraced by the majority of parents. Nonetheless, if Walters’ statement is to be taken at face value, it is sad to think that it took until the 1960s for children to be recognized by most parents as people whose feelings required respect and understanding. Ginott, Gottman, Bustamante, Greene, Herskovitz, and others have spread the word.

Do the millions who buy these books and watch these shows reflect a disturbing reality? Are today’s parents at a loss in the face of responding to challenging children? Is this a true and serious public health need? If so, then we as child advocates need to do more to educate parents on how to help their children blossom.


1. Ginott H. Between Parent and Child. Ginott A, Goddard HW, eds. New York: Three Rivers Press; 2003..
2. Gottman J. Raising an Emotionally Intelligent Child: The Heart of Parenting. New York: Simon & Schuster; 1997..
3. Bustamante E. Parenting the AD/HD Child: A New Approach. Springfield, MA: Whitcomb Publishing; 1997..
4. Greene RW. The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children. New York: Harper; 2005.

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