Organisers can be ‘get up and go’ sort of people and if so, rarely find the slowness and inactivity of the rhythms of the early months simpatico. An Organiser may be used to a fast-moving day at the office, on and off the phone, in and out of meetings, firing off emails, trying to keep ahead of the game. Suddenly you find yourself spending hours on end doing nothing but breastfeed your baby or listen to it making incoherent goo-goo, ga-ga noises. While you feel love for it, you may also feel somewhat mystified by how anyone can find a baby enthralling company. You may not have felt inclined to try some basic games with it, like seeing if you can catch its eye, then looking away, then looking back, or imitating its noises back with the same pitch and rhythm. Or you may have done that and bought the T-shirt (and wiped the sick off it), but feel it’s time for something else. Either way, when you meet other mothers who gush about how wonderful it is being with their babies, it’s easy to feel there must be something wrong with you or your baby, or equally, to have some fairly venomous thoughts about those mothers (‘wallowing in babyishness is about all their infantilised minds can cope with’, ‘flaunting their Earth Mother pretensions to escape having to go back to work’, that kind of thing). Preferable to these reactions would be to feel that there is nothing wrong with your set-up, nor is there any need to trash others to make yourself feel better. But how do you get to be cool, chilled, comfortable in your skin, proud to be an Organiser?
One important skill is in dealing with media information that makes you feel bad (R4). Newspaper articles and TV documentaries seem to assail you from all sides suggesting you are wrecking your baby’s life by wanting to return to work. Ironically, the Hugger feels just as under siege, except in her case she feels unsupported by the government and attacked by ‘having it all’ newspaper columnists for wanting to stay at home. It’s only the Fleximum who feels relatively unscathed by public commentary*.
The way out is for you to be completely honest with yourself about what you are feeling and then to decide what is best for you and your baby, preferably with your partner’s support. So long as you are confident you understand what is going to work for you, you can regard all the commentary with interest and sometimes wry amusement. At the heart of your Organiser approach must be four considerations:
• The needs of under-threes are the same everywhere, as described in Chapter 1. You are going to ensure they are met, but in your own way and not necessarily by you, 24/7
• Responding to babies and tuning into them may be something you actually find very difficult or largely impossible, or else, it may be something you can do but find deathly dull. If so, it is much better from the baby’s standpoint to find someone else to be the main carer during the working week, and to return to your paid job. Hopefully you have found the examples provided in preceding chapters helpful – many are women who have been remarkably honest about their feelings about caring for under-threes. If you have figured this out and come to similar conclusions, you know you are doing the right thing and it does not matter what other people write in newspapers or say on radio programmes or on TV: you are the person who knows best about your particular situation.
• It is not a con or a self-deception for you to conclude that your baby will get a lot more out of you if you are in a good mood, vitalised by your paid job. Put the other way around, it would be potentially very harmful for your baby if you were caring for it full-time and became depressed (page 326, R8). It is more important that you have well-being, for the baby as well as for you. As several mothers described to me in the preceding chapters, they knew they would be depressed by feeling under-stimulated by the company of a baby. However, in some cases, I suggest, they do make an important error in assuming that it is the baby who needs stimulation: babies need tuned-in responsiveness, not the kind of stimulation which adults need. It’s important to grasp that what you need and what they need are very different. Not getting depressed yourself is one thing, ensuring that your under-three is getting its needs met is another.
• Most parents want to maximise the long-term social and academic success of their child. But take on board the idea that, perversely, from the baby and toddler’s standpoint, living in the moment and putting everything else on hold might achieve that more than trying to speed up its development at this stage*
Of course, you may be like Flo in Chapter 4. She believes she will turn into a Hugger if another child comes along, or at least, that she will want to be a full-time mother (perhaps compromising as a Fleximum). That is fine, it does not mean you are flaky or going to be giving one child a better deal than the other. So long as you organise for the needs of your under-three to be met, it will be tickety-boo. So a critical issue for the Organiser is how to find good substitute care. I will come to that in a few pages’ time, but first, some important prior points …
As an Organiser, you are more likely than other kinds of mother to assume that genes play quite a big part in how your child ultimately turns out. As you probably know, this is a highly contested matter (see They F*** You Up for my account of the evidence, and Robert Plomin’s Nature and Nurture During Infancy and Early Childhood for a scientific account of the opposite view). Actually, the scientific whys and wherefores need not concern us here. Much more important is the evidence that mothers who believe genes are critical are at greater risk of not meeting their children’s needs and of reducing the likelihood of the child fulfilling its potential.
This applies even in those few cases where biology or genetics have been established beyond much doubt to play a crucial role, such as in pre-term babies or cases of autism*, but even in these latter, nurture can help a lot. If genes have altered the limits of what you can expect of your child, it is still enormously helpful to the child if you believe you can help them, resulting in more positive care that is also proven to result in better outcomes (within the parameters of the disability)*.
To start with, as described in Chapter 1, it is now accepted by almost all authorities (including geneticists) that differences in the way babies behave in the early months are unaffected by genes, except in a tiny minority of extreme cases, like autism. Exigencies of the pregnancy and birth explain why babies are more or less irritable, floppy, fussy and so on, and whether these differences disappear or not depends on the care the baby receives. Hence, even if it is true (which it may not be) that genes become increasingly influential as the first three years progress, in most cases, what is crucial early on is the way you, or whoever cares for the baby, relates to it. While putting how it turns out down to genes may take the pressure off you, it really is not the best way to think about the situation. In order to meet your baby’s needs it’s important to grasp that responsiveness and tuning in are going to make a big difference. It’s no good just making sure the baby has enough milk, nappies and clothes, and for the rest of it saying to yourself ‘Genes play such a big part, it’s born with its personality.’ How you relate to it early on has a huge impact on what sort of toddler, and ultimately adult, it becomes.
It’s understandable to attribute intentions to your under-three that they do not possess. You can easily feel they are winding you up by crying just as you are getting comfortable with a cup of tea. You may feel you can see it in their eyes, even as babies. When a little girl baby coos at her father, many are the times that the mother will only half-joke that she is flirting with him, although the baby has no idea what that even is. When an 18-month-old chucks the food on the ground for the tenth time, a lot of parents feel it is doing so to annoy them, rather than a standard response of that age group to that situation – nothing personal, just a developmental stage.
Of critical importance is not to start believing that your baby or toddler is in control, that you are somehow at its mercy, a victim. Parents with what is called a ‘low perception of control’ are more likely to blame their under-threes for negative interactions or behaviour. That imputation makes them more liable to react harshly and less sensitively – the mother thinks the ‘little swine’ is deliberately, wilfully, intentionally playing up, which naturally makes her angry and leads to her punishing the child to teach it not to be so naughty. If the baby is born a bit difficult – fussy, floppy, irritable – parents who were already expecting from before the birth not to be able to cope are at even greater risk of feeling they have no control. Such mothers are at greater risk of becoming depressed.
You must never lose sight of the fact that babies are tiny little things who cannot even feed themselves, let alone walk and talk, and that you are the one in control, however much it might not seem that way at 3am as you stagger towards the cot for the fourth time since you first put your head down. This is equally true when your two-and-a-half-year-old throws a wobbler in the supermarket because you refuse to buy the sweeties. It cannot control itself at that moment, but hopefully, you can.
Once you realise who is boss, it does not mean you necessarily need to turn into a tyrant. As an Organiser, of course your inclination is to get the child organised. But do not let that deceive you about what is really appropriate for such an undeveloped being. While it is possible to train them to eat and sleep to order – though not at all easy and a great many who follow routines give up – it’s always best if you can take your lead from them in the early months and first year. If a routine is important to you, build it as much as possible around what suits the baby, starting very early. If it seems to like a sleep after its first feed, go with that and work forwards from there. When it wakes up, it won’t be expecting any more kip for a bit, so no need to try until it looks as if it’s getting sleepy again. Rather than applying an inflexible rule, such as ‘now it must not sleep for another four hours’, try to read the baby’s cues.
Although you are tuning into its needs and using them to establish the shape of the 24-hour cycle, you are still in charge. Unlike you, the baby has no choice in the matter. Despite appearances, you are the one with all the power.
As an Organiser, you may not be a great one for dwelling on the past, but it’s surprising how helpful you may find even a basic grasp of the origins of your ideas about mothering.
For example, your Organiser approach is very likely, to some extent, to be either a reaction against the way your mother cared for you (‘too permissive’, ‘chaotic’, ‘no boundaries’ you may say) or a duplication of it (‘it worked for my mother, it works for me’). Fine, if you are completely happy with all aspects of the approach, it may not matter where it came from. But hardly anyone is like that. You are almost bound to regret some of your reactions as a mother, like the things that make you lose your temper or the things you worry you do not do well enough.
A top tip for dealing with these is to ask yourself if you feel absolutely compelled to do them. If so, you will often find that this is because you are either reacting against or mindlessly duplicating what was done to you. Just realising this can be a liberation, in matters tiny or huge. One mother felt compelled to iron all the Babygros. A very busy woman, she knew it was a crazy waste of her valuable time but she just could not bear to see them piled in the cupboard unless they were pristine and unrumpled. As soon as I asked her what attitude her mother might have had to such matters she was released from serving time at the ironing board. It was as simple as that, just realising she was pointlessly paying homage to a futile ritual invented by her mother.
On a much larger scale, another mother found herself getting hypercritical of the minder. Asked in detail, she agreed that the minder was doing a great job with her 19-month-old, providing clear boundaries but also buckets of love. However, she could not get away from the feeling that the minder was too disorganised and a poor timekeeper, even though, when pressed for examples, she could see they were not very convincing or, at least, that they were not really important in the grand scheme of things. It was only when she began to describe the chaos that her own mother had created that she understood her problem. She was so anxious to avoid re-creating the untidy kitchen, mountains of unwashed clothes and erratic rules that had been her own childhood that she could not help feeling that the minder was guilty of these, even though she knew this was not true.
At a deeper level, as we saw in the examples in earlier chapters, Organisers can be adversely affected if their mothers were over-controlling, harsh, authoritarian or perfectionist. These are the exception: by no means are all Organisers ‘control freaks’. But if you are one, it’s best to get help. I give more detail about what kind of help in the section below entitled ‘What do I do if mothering is driving me bonkers because I had an over-controlling mother who deprived me of love?’.
The risk for the Hugger is not just that she has no confidence when it’s time to go back to work, having lost track of her worker identity. It’s also that her whole self gets left on the shelf and she feels seriously bewildered, lost and depressed: her needs have been over-subordinated to those of her under-three.
The Organiser runs a different risk: ricocheting between mummy and worker identities.
Half of mothers who work full-time report feeling a constant and severe sense that they are being torn in half. While a few try to bind themselves together again by working from home and even fewer try taking the child to work (especially if there is a crèche provided), it rarely reduces the terrible tension. As we saw in several of the cases described in this part, the anguish can be heart-rending. No wonder that mothers of under-threes who work full-time are the most at risk of depression (at-homers come next, then part-timers – see page 326, R8).
One way of coping is to put your different lives in different boxes. As we saw in Chapter 2, Tracy felt this worked for her. For a long time she had no pictures of the children in her office and deliberately excluded thoughts about them when there, resisting the temptation to make any calls to check how they were getting on. Likewise, when at home, she did her best to seal herself off from work. If some had to be done, it was dealt with only when the children were out of the way, asleep.
That Tracy has made this work for her is evident, but only 17% of full-timers use it as a strategy (page 310, R6). Most find they cannot be as disciplined as Tracy or are too emotionally torn to stick to it, so that worries about one domain keep crashing into the other. While Tracy finds it possible not to have to retire to the loo for a sob, a lot of others do so. Instead of using different boxes, they end up using ‘blending’, in which they try to feel they can be both mummy and worker, as required, whether at work or home. But alas, alack, this rarely works either. Without the strict walls erected by a Tracy, one world has a way of bleeding into the other (email and BlackBerries do not help, in this regard).
So what’s the answer? I believe it follows from the issues raised in the previous section regarding your fundamental motivations and level of self-knowledge. What you are looking to be is an Organiser who is comfortable in her skin. I appreciate how hard this is. As I have tried to explain in some previous books (Britain on the Couch, Affluenza and The Selfish Capitalist) there is a host of very powerful forces at work in the modern world which explicitly seek to achieve the opposite, to make you wish you were someone else. Some are obvious, like the declared intention of advertisers to do their best to make you dissatisfied not only with your possessions but with your very self, in order to get you to buy new products and services. Some are more complex, like the rise in individualism since the 1950s, which can make us feel that we cannot keep up with the Joneses. These pressures apply to all kinds of mother but for the Organiser, the specific difficulty is that her upbringing and society pressurise her to develop the skin of a chameleon, constantly changing according to context, rather than encouraging her to stick to one colour.
More than any other kind of mother, therefore, the earlier that an Organiser can see that is what she is like, the better. Having correctly defined yourself as not a Hugger or Fleximum, at least with regard to this under-three, you can do your best to relax about that. Yes, there will be endless stuff in the media trying to unsettle you but so long as you really understand who you are and what your trajectory is, personally and professionally, hopefully you can just shrug this stuff off if it upsets or annoys you, and yet still remain open and calm, able to learn from what is useful.
I admit that this is a tall order. Alas, in my experience, very few people of either gender or any age are truly very comfortable in their skin. A veritable wardrobe of costumes is available, from smug certainty, defensive pedagogy and moralising, to bland but insincere ‘live and let live’ relativism. Your chances of feeling OK about your life will be greatest if you can just acknowledge that you feel a certain way about caring for under-threes, satisfied that, having made successful arrangements regarding substitute care, this is genuinely all right for you and for your children, and yes, you do want to feed your worker identity as well as your baby. This ‘reframing’ as it is known (page 312, R6), will help you to avoid constantly comparing your decisions with those of other mothers and so long as you can get your partner with this programme, you can enjoy your life without excessive guilt (never forgetting that a measure of guilt is actually healthy if we are to properly consider the feelings and needs of others – only psychopaths feel no guilt at all).
With these thoughts in mind, let us briefly consider how the normal hurdles of mothering under-threes impact on Organisers.
If you are one of those Organisers who largely tries or tried to pretend the pregnancy was not happening, there is one important body of evidence that you need to take on board*. This measured how mothers felt in pregnancy and then examined whether this was connected with how the child turned out. It revealed a strong independent impact of high levels of stress in the last three months of the pregnancy (known as the third trimester), including measurement of cortisol, the fight-flight stress hormone. Even when the children had reached the age of 10, there was still an effect if the mother had been stressed in the third trimester. The high levels of cortisol are passed through the placenta to the foetus and when it is born, it is already liable to have abnormal cortisol levels. This is still the case at the age of 10, expressed in such problems as anxiety, attention deficits, hyperactivity and behavioural problems. The levels in the third trimester continue to predict these troubles even after you take into account the other known causes of them, like whether the mother got depressed after the birth or whether the child had been put into low-quality day care at an early age.
The implication of this evidence for an Organiser is to cut out stressful experiences as much as possible during the third trimester, but that does not necessarily mean you need to go and sit on a beach and do nothing. You probably like to keep busy and it may be that nothing is more annoying to you than the endless exhortations of your partner or mother to take it easier. Indeed, there are probably some Organisers who find it least stressful if their work is full on, even though most other people would feel that was incredibly wearing.
So you need to carefully evaluate yourself during this time. If keeping busy is what keeps you calm, then fine. Less satisfactory is if you have got addicted to a high-cortisol, high-pressure life and simply cannot let up – you will probably be passing high cortisol to the foetus. If that is the case you are going to need to learn to relax, something that you may have been thinking for years but have been unable to do.
Apart from all the clichés, there is only one measure I can unequivocally guarantee: some kind of daily practice in which you switch off has been shown in many studies to reduce stress. I am not advocating alternative therapy quackery; these methods really do work*. Some people find meditation is best, others that it is yoga, others massage, others still jogging. It really does not matter which. In my case, for the last 20 years I have done 10 minutes of very simple yoga, morning and evening, without which, I can honestly say, I would soon go bonkers. Admittedly, I have never been pregnant.
As part of knowing thyself, therefore, you need to take the trouble to work out what is really going to work for you during the third trimester. Keeping busy may be fine but if you do one new thing that you have never done before, my advice is to take up a daily practice which gets you out of the normal stressful zone of everyday life.
It’s easy for a man to say, but I believe there is good reason to suspect that the degree of focus by modern women on the manner of birth is sometimes a displacement of anxiety about what will happen once it is over. I am not trying to pretend giving birth is like shelling peas. I can never know exactly how painful and scary it is, and it is a fact that it can be a dangerous, even occasionally fatal, process. But the really scary bit for a great many women, and especially for Organisers, often begins around two weeks after the birth, when the visitors and flowers stop coming and in our miserably atomistic society, the mother suddenly finds herself left holding the proverbial.
Rather than focusing on the birth, it is far more important for the Organiser to start getting herself plugged into a social network that will support her. The research shows that Organisers are especially at risk of depression if they do not feel they have friends or family to rely on, or their partner is not pulling his weight*.
Rich Organisers tend to start looking for maternity nurses, doulas and nannies, while the less affluent majority turn to neighbours, friends and family*. But whether rich or poor, what you need to challenge is any reluctance to hook up with other pregnant mums and, after the birth, other new mums. Shy or standoffish Organisers really need to override those tendencies at this point in their life. If necessary, get therapy during the pregnancy if this is really going to be a problem (see below for advice on what sort – Cognitive Analytic Therapy is probably best if you are shy).
Be sure to join an antenatal class during your first pregnancy, as it’s a vital mother and baby dating agency. You might find some of the information interesting but by far the most important thing when you have your first child is to have other mothers nearby who are in exactly the same boat as you. Social isolation is the greatest threat to any mother’s sanity in the early months. However much you may find it hard to enjoy sitting around nattering about breastfeeding and the mechanics of nappies, this contact is really important for keeping you sane. You also learn a lot about how to care for your baby. Modern mothers increasingly rely on their peers, rather than their own mothers, for tips and reassurance about how to do the job. Do not allow your horror of being hijacked by the baby’s needs and of turning into a brain-dead milk machine lead you to reject hooking up with other mothers. Beware of feeling that everyone else seems to be getting on with their baby brilliantly except you – be sure that many other mothers will be feeling just the same, even if it is not obvious. Organisers are tremendously prone to believing there is a ‘right’ way to be doing it, and to imagining that they are failing to read the right books or put the techniques into practice. Resist these feelings with all your force: there is no such thing as the ‘right’ way and always remember that your best is good enough, that no parenting is ever perfect and that the kind of mothering you are aiming for only needs to be good enough. This phrase was invented by Donald Winnicott, a famous psychoanalyst, and he meant that no baby’s needs can ever be completely met. Let yourself off the hook: perfection is impossible in this domain. The baby will be absolutely fine and dandy so long as someone is tuning in and responding for a reasonable amount of time.
It’s unfamiliar to be at home all day with a baby, but do not panic, there is almost certainly another woman out there within walking distance who you can bond with and who will want to share the difficulties, as well as the joys. You are best off finding that woman before the birth, but for that to happen, you do need to recognise that you are pregnant! Pretending nothing is going on during the pregnancy or obsessing about what kind of birth you want distracts you from the real challenge: responding to and tuning into your newborn.
1: Where the Cause is Depression (R8)
Not being able to feel love for a baby is some mothers’ greatest fear. It can take hours or days or even weeks to really feel it. Yes, there is a tiny number of mothers who never feel it.
In some cases, the lovelessness is the result of depression, in which case you obviously need help: get past the depression and you will nearly always find the love is there.
Nearly four in five mothers suffer some sort of baby blues in the first month after giving birth, but 13% develop a full-blown depression. If this hits you, it has massive implications for the whole family as well as yourself.
Geneticists have now mapped the human genome. Until very recently, it looked as if a particular gene might be a significant cause of depression, along with early childhood experience. However, it has now been shown that this gene is very probably not a cause of depression and it is looking quite possible that genes do not play a big part in causing it*. Hormonal fluctuations very probably do play a part in causing baby blues, at least in some cases to some degree. But the key factors are your own childhood experience, alongside what sort of society you live in, and what class within it (page 323, R8). So you really do have very good reason to seek out a therapist who can help you to grasp the childhood causes of your problem and who accepts that genes are not likely to be of great significance.
Assuming you have a choice, which treatment should you opt for? The main alternatives are antidepressants, Cognitive Behavioural Therapy (CBT) and psychodynamic psychotherapy.
In the great majority of cases, even when antidepressant pills do have an effect it is a placebo – people given chalk pills but told they are antidepressants are almost as likely to claim to feel better as people given the real thing*. While they may be of temporary assistance, they are not a cure. People who find them helpful tend to get depressed again when they stop taking the pills.
Regarding the talking cures*, in one study, depressed new mothers were randomly assigned to eight sessions of CBT, or to counselling, or to psychodynamic psychotherapy. Four and a half months later, the ones given dynamic therapy were most likely to have recovered (71%, versus 57% for CBT, 54% counselling). If CBT is all that is available, then it is certainly better than nothing. Hold out for a therapist who is warm and prepared to deviate from strict CBT manuals – willing to provide more than a handful of sessions and to talk about childhood causes of problems. I realise this is tough if you are depressed with a newborn. That makes it vital that partners take a big interest in what kind of care is being offered and don’t just go along with the tendency of GPs to dole out pills or CBT. If you can pursue the alternative, I would strongly advocate doing so.
For many years psychoanalysis was written off as unscientific because untestable as a theory, but studies done in the last 15 years have largely confirmed Freud’s basic ideas*. Dreams have been proven to contain meaning – they are not just a mental rubbish bin. Early childhood experience has been shown to be a major determinant of adult character and of what sort of parent you are. And it is now accepted by almost all psychologists that we do have an unconscious and that it can contain material which has been repressed because unacceptable to the conscious mind.
The treatment Freud’s theory gave rise to entailed patients attending 50-minute sessions up to five times a week, lying on a couch and speaking whatever entered their mind. Childhood relations with parents were used to interpret dreams and their relationship to the analyst.
Although slow to be tested, the clinical technique has now been demonstrated to work. The strongest evidence for its long-term superiority over cognitive, short-term treatments was published in 2008*. Initially, eight to 20 sessions of short-term CBT-like therapy reduced depression and anxiety, more so than going two or three times a week for psychoanalytic therapy. However, after three years, those receiving the long-term psychoanalytic treatment were dramatically better off: less likely to be depressed and four times more likely to have recovered from anxiety. A recent survey of 23 other studies had similar findings*.
Many studies show that the sort of person a therapist is – especially whether they are warm – is more important than their orientation*. There are undoubtedly some very good CBT therapists (despite, rather than because of, their training) and some appallingly bad psychoanalysts.
Since hardcore CBT explicitly rejects scrutiny of parental care in the early years and close attention to the therapist–client relationship, it will never be of enduring, profound value to distressed people. If it’s all that’s on offer, look for one who will deviate from the manuals and offer more sessions.
If you can afford it and if you are still only pregnant, a crash course in understanding your childhood is provided by the highly imaginative Hoffman Process (see hoffmaninstitute.uk). This residential eight-day roller coaster might not sound like the sort of thing to do during pregnancy but I can vouch for its success in several cases of women who have done it then.
Otherwise, to find a psychoanalytic therapist, go to the British Psychoanalytic Council website at www.psychoanalytic-council.org/main/. What you are looking for is someone who answers ‘yes’ to these questions:
‘Are you aware that the latest evidence shows that depression does not appear to be much caused by genes and that the care a person received early in life is proven to be highly significant?’
‘Are you familiar with Attachment Theory, and is it help with my attachments that you will provide?’
‘Will you focus primarily on the way my childhood is causing my depression?’
In asking these questions, do not let the therapist get away with evasions – repeat the question, firmly insisting on a proper answer. For example, if they reply to the first question by saying ‘I think both genes and early care are important factors in what a baby is like’ maybe you could say ‘I’m sorry, it sounds to me like you are sitting on the fence. Please give me a specific example of something you believe was largely or partly caused by genes.’ If you still have doubts about the therapist you can email me with your query via www.selfishcapitalist.com.
Plenty of mothers feel cack-handed, at sixes and sevens, or just that the baby seems like an incommunicative blob. If so, you will hugely benefit from mother–infant psychotherapy, although a parenting course may suffice.
The trouble with parenting courses is that they are sometimes prone to teach parenting as if it is a matter of training a pet, rather than a human. They may encourage you to impose inflexible routines or to employ unhelpful naughty chairs.
Where they are at their best, parents meet in groups and help each other to talk about what is bothering them and jointly discover solutions. So long as the therapist/convenor encourages parents to talk about their own childhoods, and so long as they do not offer simplistic behavioural solutions, this can be tremendously helpful. You can find a parenting course via www.parentinguk.org and following the links to search for a course near you. However, if you are really not responding or tuning in, you probably need something more specialised.
Parent–infant psychotherapy* entails helping you to understand the feelings that your baby is evoking in you, or the lack thereof, by exploring what happened in your own childhood. It usually takes at least six sessions. Sometimes it is helpful to video yourself with your baby, or they will video you together, and by watching the way you react, you get a feel for what is going on. You are helped to see what your baby is trying to communicate to you, its needs. One of these is for face-to-face interactions; above all, eye-to-eye contact, smiling and gesturing. Gradually you may come to find the baby an entertaining companion, be able to play.
Provision of such help is patchy around the country. This would not be so if the government during the last 13 years had devoted the money it spent on setting up day care centres to a massive expansion of parent–infant psychotherapy.
In London, you can find The Bowlby Centre, The Anna Freud Centre and The Tavistock Centre, which have world experts in this field. In Oxford there is OXPIP, the Oxford Parent Infant Project. For other regions, you can go to www.aimh.org.uk, the website of the Association of Infant Mental Health (UK), and email them asking where your nearest parent–infant psychotherapy provision might be.
I realise you probably have rarely felt less like searching for a therapy, especially one that you may not have much stomach for. It might be that you could ask your partner or another intimate to look into it for you. But I strongly recommend that you pursue this, if you possibly can. Your lack of responsiveness or tuning in are nearly always completely curable and it will come as a huge relief for you to overcome the obstructions to your doing so, quite apart from being of great help to your baby.
Just as there is a small minority of Huggers who become really quite disturbed because they cannot let go as their baby develops an increasing need for independence, so there are a small number of Organisers who find themselves cracking up. However, whereas the trigger for Hugger crack-ups happens later, rarely before four months, for Organisers the trigger is the very infantilism of the baby, its extreme dependence, in the early months.
Some of these Organisers may be driven high-achievers with the Type A Personality described in Chapter 3. Others might not be so outwardly successful but have rigid, inflexible personalities, finding the chaos and disruption to normal adult life intolerable.
The cause of the problem often lies in their early infancy, coupled with harsh, authoritarian, punitive subsequent care. High-achievers, like Julie in Chapter 3, they may have been hijacked at an early age as vehicles for the fulfilment of their mother’s ambitions.
If this is what you are like, you need psychoanalytic psychotherapy. A fascinating book which explains why it will help is, oddly enough, a biography of a famous psychoanalyst called Masud Khan. Entitled False Self, by Linda Hopkins (who is a psychoanalyst), it explains how early infantile deprivation and subsequent harsh treatment result in a carapace which acts as a barrier between the person and their true feelings, as well as falsehood in their relationship to others. The best treatment is to find a therapist who can be completely trusted and with whom there is what is known as ‘regression to dependence’ – your babyish, dependent, vulnerable feelings can be allowed and, in experiencing them, you may be freed from the need to be so false.
Finding such a therapist is not easy, always assuming you can afford the time and money it entails. However, there are provisions made by some organisations for free or low-cost sessions. In finding such a psychodynamic therapist you would follow the advice in the section before last, asking the same questions, with this additional one:
‘I believe my difficulties may stretch back to early infancy. Do you have experience of the Middle Group method known as “regression to dependence”? Would you expect that to form a significant part of our work together?’
Few if any mothers find it easy if their baby is born irritable, fussy, floppy or easily upset. But some Organisers find it particularly difficult.
The commonest problem is to feel that these traits are a rejection, to take them personally. If you are that kind of person, you will be liable to deal with rejection by rejecting*. It is easy to find yourself trying to tame the little devil, perceiving it as bad and malevolent. You may then punish it by leaving it to cry or ignoring it, a natural response if you feel it is getting at you.
Of course, there is nothing personal about its difficultness. It’s the result of the exigencies of the pregnancy or birth (or in a tiny minority of cases, may have to do with genes). Whoever was trying to look after it would have the same problem. But if you start cold-shouldering it, a vicious cycle develops: baby rejects you, you reject it back, it gets even more difficult, you become even more distant or angry.
The other big problem is if you experience the baby’s difficultness as evidence either that you have failed to find the right mothering methods, or that it suggests you are not applying the method correctly. This leads quickly to guilt and more or less self-attacking thoughts and depressive mood. Again, you need to take a deep breath and realise that the difficultness is not your fault, nothing personal.
The solution in both cases is to remind yourself that you are only looking to achieve good enough mothering and, above all, to remember that if you hang on in there, even though it is going to take a matter of months, the baby will cease being difficult. You have to feel empathy for it but you also have to give yourself a break, try to relax and ride it out.
Some Organisers who know they will be returning to work at six months understandably have mixed feelings about breastfeeding. If you get the little lovely addicted to breastfeeding, how easy is it going to be, literally, to wean it off?
Fear not, there is no reason why this should be a problem. Three months of breastfeeding is going to supply well-established medical advantages to your baby’s immune system. There is also the fact that the process of feeding can help you to bond. Weaning to a bottle is normally not a problem.
Regarding how to do it, unfortunately, and rather shockingly, training of health visitors in the best methods for helping mothers is patchy. (For excellent advice, go to www.bestbeginnings.info; it’s worth watching their DVD, given out to many mothers by NHS health visitors. Go to ‘resources for you’, find ‘i’m a parent’ and scroll down to the DVD.) If you are lucky, you will get a midwife who is skilled in the technique identified by Chloe Fisher and Sally Inch, the World Health Organization’s experts. This is described in a book, Bestfeeding (2004, Celestial Arts) by Mary Renfrew et al. Interestingly, they have done studies showing that colic is twice as common in mothers who do not always drain one breast at a time.
When my wife had difficulties with our son we visited Chloe at her clinic in Oxford (now – disgracefully – closed). In a Guardian article I described her advice as follows (for the full article go to www.guardian.co.uk/lifeandstyle/2005/mar/30/familyandrelationships.healthandwellbeing):
Chloe enunciated two principles: ‘First, Don’t assume the breast is like a bottle. The milk is in the breast, not in the nipple whereas with a bottle, the milk is in the teat. To feed effectively from the breast the baby must scoop in a deep mouthful of breast whereas with a bottle, it can just suck on the end of the teat. Secondly, people wrongly assume the middle of the baby’s mouth is halfway between the top and bottom lip. In fact, the middle is between the upper surface of the tongue and the upper palate. For the baby to draw sufficient breast tissue into its mouth, it must be able to get its tongue well away from the base of the nipple and that won’t happen unless the breast is presented between the tongue and the upper palate.’ If the baby does not attach properly, it will not drain the breast properly and would continuously compress the nipple between the tongue and hard palate turning it into something resembling minced lamb.
Putting this into practice proved surprisingly difficult but after a bit my wife got the hang of it. Next came the other important point: ‘Only switch breasts when the well-attached baby comes off the breast spontaneously and seems completely satisfied. In offering the second breast, let the baby decide whether he wants it. When coming to the next feed, if the mother starts on alternate breasts (regardless of whether the baby has had one or two at a feed) the breasts will get roughly even use. The important thing is to allow the baby to “finish the first breast first”.’ Failing to do this was the main cause of colic.
Chloe explained that the initial milk is low in fat and calories. If you switch breasts before the high-fat milk has been drunk the baby will take more from the second breast than he would otherwise have done. Despite the relatively huge volume of liquid in its tum, the baby will then be wanting another feed before long, because low-fat feeds are processed quickly, leading to a pattern of very frequent feeding. This is mental illness-inducingly sleep-depriving but worst of all, it will cause colic.
Both poor attachment and breast switching result in the baby taking frequent, large-volume, low-fat feeds which in turn lead to rapid emptying of the stomach into the large intestine. If too much gets there too fast, there is not enough of the enzyme lactase to break the sugar in the milk (lactose) down. The gut turns into a malfunctioning brewery, with fermentation of the sugar in the excess milk creating gas and explosive poohs. The crying, arched back, rigid tummy and irritability of colic follow.
You may find it oppressive to be reminded of the benefits of breastfeeding if you are an Organiser who is intending to return to work and have mixed feelings about breastfeeding, or indeed, are a mother who has found it hard. However, it is worth mentioning that if you can get it going and sustain it, the benefits go beyond a strengthened immune system and other biological ones. It is proven to help mothers to bond with their babies*. While it is difficult for studies to prove an independent effect of breastfeeding on the well-being of infants, there is good evidence that breastfed babies sleep better than bottle-fed ones*. There is also reason to suppose they are more secure*. These kinds of advantages may partly be simply because the sort of mother who breastfeeds also tends to be the kind who is responsive. But breastfeeding helps most mothers to feel close to their baby, a valuable link in a virtuous circle.
The equation here is all about weighing up your mental health and chances of being able to get your life back to normal, against the mental health of your baby. From its point of view, the more that sleeping and eating routines are based around its needs and natural rhythms, the better. From your point of view, this will also be best because the baby will sleep and eat better if you do it that way.
On the other hand, you may be feeling this little monster is liable to take over your life and wreck it if you ‘give in’. You may be desperate for a decent night’s sleep, feeling you simply cannot stand such a level of disruption. There are many mothers who start out intending to impose a routine, come what may, and who grit their teeth and block their ears as they battle with controlled crying or not feeding in between ‘mealtimes’. However, interestingly, quite a few find that this simply does not work. While a measure of routine based on the infant can help to promote sanity for all concerned, they find that trying to force something which does not fit the baby is unsuccessful: the baby is permanently starving or ends up not sleeping well.
Another problem some mothers encounter is that the routine impedes socialising. You are so anxious to stick to the plan that you fear that meeting up with other mothers will stop you being able to ensure the baby has its feed or sleeps at the right time. Routine may seem important, but it’s also important that you do not feel isolated.
The great thing to remember is that babies are satiable, that once they are fed, or get some sleep, or are given a hug, the need is met. They are not like many adults in this regard. There is a great deal of evidence that very strict routines do not lead to so-called contented babies*. It is true that, on the whole, babies whose mothers go to them when they cry in the night or who co-sleep are less likely to sleep through the night. However, there is also good evidence that strict sleep routines do lead to more insecure, and to more irritable and fussy, babies. While you may be scared that ‘indulging’ them will be just the first step towards a clingy, greedy, needy, selfish toddler and to a child who cannot obey rules at school, the very opposite is the case. It is the babies whose needs have been met who become the secure, calm, satisfied children and productive schoolchildren*, and adults – the ones you might say were spoilt and indulged as babies.
There is also a mountain of evidence that harsh, authoritarian, punitive patterns of punishment are harmful*. It is equally true that erratic patterns are just as bad, where what was rewarded last time is punished this one.
Huggers may find it hard to allow their toddler to be independent, and if they have a fault, be too permissive. Organisers more often veer the other way. If you are too strict, the risk is of getting a compliant toddler who has an undercurrent of snarling resentment, or just a flat, empty soul that has given up trying to express itself. This is particularly liable to happen if you use day care nurseries from a young age (see below).
As I describe in Chapter 11, it really should not be necessary ever to hit your child. If you learn how to use reasoning and love, in the right mixture, the child will end up obeying rules because it has chosen to. The idea that they need to be sent to their room or put in naughty chairs appeals to television producers (it makes good telly!) and authors of manuals purporting to offer ‘tough love’ in place of supposedly indulgent parenting. But it simply is not true that it is best for children.
I provide a more detailed account of the best ways to manage toddler discipline in Chapter 11 (page 179).
We come to the critical question for many Organisers: what substitute care is best?
In this highly controversial matter, there are a number of competing issues if the best interests of under-threes are taken into account.
For example, half of under-threes who are at home full-time with a depressed mother are insecure*. If the mother is a drug abuser, violent, or severely neglectful, that rises to 85%. So it is hardly good news for an under-three to be at home all the time with a desperate mother. On the other hand, if the child is put into inadequate substitute care, there is also a risk of insecurity. Of the under-threes who are in day care for 20 hours or more a week, 43% are insecure, which is markedly greater than the 26% with stay-at-home mothers. Overall, the most secure under-threes are cared for at home, but that is only if the mother is happy.
It is also important to consider the impact of different kinds of substitute care. One problem is accepted by all scientific authorities: some kinds of non-maternal care (particularly day care) considerably increase the risk of the child becoming aggressive and disobedient. In the most widely accepted study of the subject, the longer a child was cared for by substitutes, the greater the risk*. Just 6% of children who had less than nine hours a week cared for away from home were aggressive and disobedient, compared with 15% for those spending 10–29 hours away. It was 16% for 30–45 hours, and 25% for more than 45 hours, four times more than the ones mainly at home.
Closely allied to these figures is the evidence regarding the impact of substitute care (but especially day care) on levels of cortisol. This is the hormone secreted when a person feels under threat. Abnormal levels have been repeatedly found in insecure children, and in children who are aggressive and disobedient: these raised levels are a sign of trouble.
There is strong evidence that when children are first placed in day care, this raises their levels. A study of 70 15-month-olds showed that during the first hour after being left in day care for the first time, the levels doubled compared with those found at home before they had ever been to day care. This increase continued to be found on the fifth and ninth days after starting. In part, this could be put down to a child having to learn to adapt to a new situation, except that when the levels were measured at five months, they were still significantly higher than the original ones at home*.
When cared for at home by their mothers, the cortisol levels of under-threes fall during the day, between mid-morning and teatime. However, in nine different studies of under-threes in day care*, their levels rise rather than fall between these two times, probably because the child is feeling stressed. The rise may not be a temporary change. The definitive study showed that when children are aged 15, their cortisol levels are still affected by how much time they spent in day care when under-three*.
The studies strongly suggest that it is the quality of care being provided in day care which causes the dysregulated cortisol, especially the extent to which the need for responsive, tuned-in care is not met. Overall, for children in day care, the higher the quality of the provision, the smaller the danger of cortisol problems, although even children in the best-quality day care are at greater risk than ones with no day care*. Two studies show that it is possible to normalise levels through better care*: when relatively insensitive mothers are given special training and become more sensitive as a result, their children’s cortisol levels are more likely to be normal.
As I have explained in detail in my review of the evidence (R3), there does not seem to be much of a case for any middle-class parent to place their child in day care. There is overwhelming evidence* that cost is not the main consideration for most parents: the great majority are far more concerned about quality of care. It is as if they intuitively understand the problems which the evidence exposes.
For one thing, the vast majority of day care is either low- or middle-quality (in the case of America, only 9% is high-quality): it’s not easy to find a place that is good. If it is not high-quality, the risk of problems has been repeatedly demonstrated to be greater. But even more decisive, the studies nearly always show day care to be the most problematic kind. It is much better to use a minder or relative or friend.
I have put the alternatives in the order in the title of this section because this list is the league table of types of care most likely to meet the needs of your under-three: Daddy is better than Granny is better than Nanny is better than Minder is better than Day Care. The definitive study proved that the closer the substitute care is to a one-to-one ratio, the better*. Substitute care at home (whether nanny or granny) is far superior to out-of-home care, because it is usually one-to-one. For example, there are studies showing that children who are cared for by a substitute at home, one-to-one, are as likely to be as secure as those cared for at home by their mother*.
The proportions of use of these different kinds of care is interesting in that most mothers seem to realise that day care is least desirable. One of the best sources (although not a nationally representative sample) is a study of 1,000 English mothers. For those children aged one, 53% had a mother with no paid job. Among the remaining 47%, the proportions of the one-year-olds with substitute care when their mother was out doing a paid job were as follows:
7% were cared for by their fathers. Twice that proportion – 14% – were cared for by a grandparent or other relative, 11% went to a minder, 4% had a nanny, au pair or sitter, and 10% were in day care*.
Before considering the pros and cons of each in turn, a basic problem must be confronted.
As an Organiser, you have a clear notion of what is the right approach. You may also be someone who is used to arguing forcefully for your case at work and to getting your way. But if you are going to use a substitute you must allow them to do it their way and that can be difficult to tolerate. If they are being Huggers, that could be particularly uncomfortable, especially if you are working full-time and the baby starts reaching for the substitute rather than you when you are both present. Hugging would also tend to conflict with your desire to introduce sleeping and feeding regimes.
The answer has got to be that once you have settled on a substitute, and so long as they are responsively tuned into the baby, you must grit your teeth and stick to it. Nothing is worse for under-threes than a constantly changing cast of carers. Obviously, as happened to Julie in Chapter 3, if you pick a substitute who is not sensitive then you will have to make a change. But much better, also obviously, is to put the time (and alas, money) in at the outset to make sure you have the right person. That means you need to hang out jointly with the substitute for as long as practically possible before handing over the baby (there is good evidence that children do better if the mother takes longer over settling a child into substitute care*). Ideally, you would spend a full week sharing the care before you are satisfied. For babies, you are looking for someone who you can see with your own eyes is tuning in and who is clearly making your child happy. Under six months, the baby will get used to your absence quicker, but after that age you need to make the transition even more gradual, preferably over a month. Start with all three of you together for several half-days. Then try leaving the baby alone with the substitute for half an hour while you are on hand in another room. Emphasise that if the child is distressed you want to be called in. Only when this is working without problems should you start nipping out to do the shopping for a couple of hours.
This will minimise problems in making the transition for the baby and it will also give you plenty of chance to see if the substitute is the biz. If they are not, you have to politely and diplomatically get rid of them and start again. Much better to go through all this grief at the start and establish a stable set-up that you can feel completely confident about, than to have to unplug after two or three months. By then, almost however bad the substitute, the child will have adapted to them and will feel the wrench when they leave.
If Daddy really is the kind who can tune in responsively, as several of the stories so far have illustrated (and there are more to come in the remaining parts), then he may well be the best substitute. So long as he does not feel emasculated or isolated by the role, it is plain commonsense that he will be highly motivated to go the extra mile that babies demand. While blood is not always thicker than water, and there are plenty of both mothers and fathers who find themselves not hugely drawn towards full-time care of their babies, on the whole, progenitors tend to be the ones who care most what happens to offspring.
An obvious potential problem here is if your partner wants to follow Hugger principles. Again, teeth-gritting is required. If you are working full-time, he is effectively the mother and you have to go with it. You may be able to help him to see that some measure of routine is going to be useful, allowing the baby to show what suits it best. But in the early months, and especially with the firstborn, the potential for screaming rows between sleep-deprived, anxious parents is huge (and, by the way, normal; do not kid yourself that everyone else is getting on hunky-dory; as surveys show*, this situation puts massive strain on the best of relationships, if nothing else, because of lack of sleep but also because both adults are liable to feel they have no ‘me time’, so everyone starts feeling like a deprived baby at times).
The blood relationship also explains why grannies (and sometimes, grandads) come next. However, it must be said that a decreasing number of grannies may feel inclined to take on the job. Improved health and longevity make them more mobile and vigorous as a generation, more liable to want to get on with the things they did not have time for before retirement. At the same time, they tend to be much older by the time they have grandchildren. Their children become parents at considerably older ages than even 20 years ago, meaning that grannies are also older when they have grandchildren. Once in their late sixties or seventies, despite their generally better health, it’s asking a lot of someone to have the energy and dedication required to look after a baby full-time.
But the greatest potential landmine of the granny is when you (or your partner) do not agree with their approach. Few situations are more explosive than a mother who has burning resentments towards her mother, then watching all the same mistakes being made with an offspring. Of course, there are some wonderful mother–daughter relationships in which collaboration works a treat. Indeed, there is strong evidence that a mother is more likely to involve the granny in care if she was cared for by her and feels it will be good for the child to be with its gran*. Nor is there anything odd about that. During a four-week spell researching in Shanghai, I met only one person who had been cared for in the early years by their biological mother; almost everyone had been looked after by their granny. Not that these granny–mum relationships were always conflict-free sweetness and light, and, quite possibly, considerable tensions in the UK are liable to be the norm, too.
On the one hand, there are Organiser mothers who have read modern childcare books advocating routines and naughty steps and are appalled at the granny’s Hugger approach; on the other, some Organisers hope the granny will provide the Hugging that they feel either unable or too unstimulated to provide themselves, but then are horrified to see the gran adopt a strict, routinised approach (sometimes justified as ‘the old-fashioned discipline not enough parents use today’) which is doubly distressing to witness if it was the regime used to care for the mother.
Organisers are more likely than other kinds of mothers to make the mistake of imagining that their babies and toddlers are gagging for the company of their peers. Organisers often are, but not their under-threes. Because of this misconception, some Organisers (like Tracy in Chapter 2) worry that a nanny is going to be insufficient stimulation for their under-three, just as they feel they themselves are (‘if I bore the child, why should a nanny be less boring?’ they reason, quite logically). However, in terms of the needs of under-threes described in Chapter 1, babies like nothing better than the undivided attention of a single adult. For this reason, so long as they are responsively tuned in, daddy, granny (or other relative) and nanny (or au pair) are preferable as substitutes to any group care setting all the way up to the third birthday.
The greatest problem for most families about a nanny is the expense. In terms of the national average wage, a woman who goes back to work full-time and employs a nanny will be out of pocket on the deal. I would not let that stop you employing one, if you are an Organiser who needs to get back to work, if you can afford it – do not stint on the expense if you want the needs of your under-three to be met. This is a very important point. At least 60% of mothers do not return to work for the money*. It is important that they are allowed to admit this and not pretend that it is financially necessary to their partner or anyone else. Let money be no object when it comes to finding a substitute, if you can. If you are like several of the women described in the preceding chapters and you know that returning to work is best for you and your child, do not let the fact that it might actually be costing you more than you earn get in the way of your providing the best possible substitute care.
Another major problem is finding a nanny who is going to see your child through to its third birthday. Many nannies tend to be women of reproductive age who become impregnated and go off and have children themselves. They are also often women from foreign countries who can decide at any time that now is the moment to return to the bosom of their family. So the likelihood of a potential nanny staying the course is a major consideration when picking. But of course the biggest issue is finding one who is going to be responsively tuned in.
As described above, ideally take a month to check her out. Although Tracy in Chapter 2 worried about the dangers of leaving her children alone with one person at home, this is not a serious issue (the odds of a woman being an abuser or an agent of a paedophile network are too tiny to consider; alas, anyway, a couple of peculiarly grisly recent cases have shown that day care centres can be the basis for paedophile rings too). The real, rather than phantom, difficulty is in knowing how to interpret your reactions to the nanny when choosing her.
After the initial introductions, you meet. She seems all right, but how can you really tell? Perhaps she has references and you speak to her previous employer, but how reliable is that information? The only truly reliable evidence is going to be spending time with her and your child, observing how they rub along over a reasonable number of occasions (two is the bare minimum). Where you have to be particularly insightful is that, just because she does not dress or have the personality or even the smell that you would like, it does not mean she is wrong. Perhaps you have a strong bias against young women who favour a loosely Goth style, perhaps you do not like overly pressed floral skirts: whatever your superficial prejudices, you need to get beyond them and form an impression of whether this woman can provide l-o-v-e. So long as she can, she is probably right, unless she has some outlandishly weird nurturing ideas, like insisting that a baby must never be within six feet of any electrical apparatus or that toddlers should only ever eat carrots. Assuming you are satisfied she is not going to be disappearing before your child reaches age three and happy to commit to a long-term relationship, l-o-v-e is what matters.
While minding is preferable to day care and attractive because of the lower cost than a nanny, there are disadvantages. Alas, partly because the government for the last 12 years has been fixated on day care as a policy*, minding has become increasingly difficult to practise as a profession. Cumbersome regulations make it harder to be qualified to provide minding and the funding system privileges day care places. Nonetheless, despite these obstructions, it continues to be used more commonly by mothers than day care and if it is the only option, you need to understand how to make the most of it.
The main disadvantage of a minder is that they are usually looking after more than one child (that they are doing so in an unfamiliar home is also an initial problem, although the child gets used to it). If only caring for one child, then they are effectively a nanny working from their own home, in which case the observations in the previous section apply, but this is rare.
Minding is particularly disadvantageous if the other child or children are the same age as yours, or even younger. You only have to look at the strain that caring for twins places on a mother to see how hard it is to care properly for two babies or toddlers of the same age, simultaneously. Another problem is if the minder is feeling stressed by a particularly difficult other child, of whatever age. A further potential problem is if the minder has her (nearly all minders are female) own children. Inevitably, the risk exists that they will receive preferential care.
These negative observations should not obscure the fact that there are plenty of minders who know all there is to know about providing l-o-v-e. So long as she is only caring for two children, and so long as one is much older than the other (the closer to three or older, the better), then she may be able to meet the needs of your under-three. Such minders are often plugged into good social networks of others caring for small children, creating a cosy, supportive environment that stops the minder feeling lonely or depressed. If so, she can be a cheery soul who knows just how to ring a baby or a toddler’s bell.
In choosing a minder, you have the option of discussing her with the mother of any other child she cares for. As already described, it’s best to take a good deal of time before leaving your child alone with the minder. Hanging out at her home should give you a pretty good feel for what it is going to be like for the child. Of course, if the minder is hostile to the idea of your hanging out there, it’s a strong signal that she is not right.
I realise that there will be some readers who have already sent their child to day care and who will find what I have to say about it painful or objectionable. I do not want to exaggerate the ‘evils’. For one thing, the best day care – alas, only about 10% of facilities – is almost certainly better for a child than being with a depressed carer all day. Where affordability dictates that day care is the only alternative and where the mother would be depressed if at home rather than working, then it can work. There is abundant evidence (see page 275, R3) that for children with depressed or heavily overstretched (perhaps because young and single) mothers, it provides real cognitive benefits. This is especially so if the mother is helped to provide sensitive care, if the day care is only part of a wider intervention. If so, such schemes can actually reduce a child’s vulnerability to depression in early adulthood.
However, for middle-class mothers who have a choice, there is just no good reason to favour day care over the alternatives, and indeed, the vast majority of parents realise this. They put day care at the bottom of their list of substitutes, given the choice, and in practice, as already noted, only 10% of under-ones are in day care. Having discussed day care extensively with several New Labour luminaries, they defend their advocacy of it by arguing it provides an educational, stimulating alternative for mothers with low incomes. By getting back to work, the mothers (especially the young, single ones) are able to escape poverty and to build their self-esteem, in turn becoming better mothers when with their children. There are many objections to these arguments. The most important is that, instead of providing day care the money could have been used to support those mothers who wanted to care for their babies themselves to do so. This could have included mother– infant psychotherapy for those who had trouble relating, a hugely helpful intervention that can make all the difference to the mental health of all concerned. Indeed, the famous Highscope project in America which is so often cited as justification for New Labour’s day care scheme (called Sure Start) aimed to help mothers to care for their children rather than offering substitute care.
For those mothers who really do want to go back to work and for whom this is best, day care should have been at the bottom of the government’s list, as it is for the vast majority of mothers. I believe the money could have been spent much better on supporting relatives to be paid to do it, and failing that, minders or even a subsidy towards the cost of nannies. Instead of hugely expensive shiny new children’s centres, instead of bricks and mortar, the money should have been spent on maximising the chances of under-threes receiving l-o-v-e from a single adult, with one carer per child.
This is all rather academic. More simply, albeit below the belt, if day care is so wonderful, how come no New Labour luminaries use it themselves? Funny how Tony Blair’s son Leo did not spend any time in day care …
If you are a mother who can afford options, I would urge you to question why you are using day care. Of course it is true that, while aggressiveness, disobedience, hyperactivity and insecurity may be a higher risk from day care, all of these can and do occur in children raised exclusively by their parents. My key point is that day care is based on the misconception that under-threes enjoy the company of their peers and the failure to grasp just how important is the undivided attention of a responsive, tuned-in adult. Day care may dilute creativity, the spark of liveliness which is so striking in children raised at home by responsive carers (and speaking anecdotally, so conspicuous in those who have been home-educated, as well).
For mothers who can organise and afford alternatives, I would go so far as to risk your ire by pointing out that it is never too late to change. A good minder would always be preferable to ‘good’ day care (which, arguably, is not possible), and as I have done my best to explain, the other alternatives are even better.
One of the saddest findings from the best evidence on day care is that children whose mothers are relatively unresponsive are much more likely to have problems if placed in day care, to become insecure. Alas, it is exactly these kinds of mothers who are the most likely to favour day care over other kinds of substitute (page 292, R3). These mothers said they believed it was actually beneficial for their child if they worked, yet offspring of mothers with that view were more likely to be insecure. Such mothers strongly agreed with the statement ‘children whose mothers work are more independent and able to do things for themselves’. Mothers with these views were less sensitive or responsive when observed with their child. Not only that, but these relatively unresponsive mothers are also the ones most likely to use low-quality facilities: ones where the ratio of child to carer is bad (it should be no more than one carer for every three children, under-three); where there is high staff turnover; and where the emphasis is on cognition and social development, not the nurture that is required. To top it all, such mothers are also more likely to switch their arrangements, moving the child between different nurseries or carers, and they also leave the child for the longest hours in substitute care. This is tragic: the very children – those with relatively unresponsive mothers – who particularly need responsive, one-to-one substitute care are the very ones who are most likely not to get it, because placed in bad day care.
As your baby becomes a toddler, be very wary of labelling. Organisers can be a bit more prone to assuming that genes are limiting what their child is like, thinking of their traits as categorical and fixed. But there is powerful evidence that encouraging children to see themselves as malleable improves their performance.
Overall, children with a malleable view of their potential perform better. If those who have a fixed model are taught to see themselves as malleable, their performance improves. In one study, young teenagers were given just four lessons teaching them about how people can greatly alter themselves and their performance. Compared with other teenagers not given this lesson, those given it had greatly improved their performance in maths when followed up a year later. The greatest improvement was found in the children who had started out with a fixed view of themselves.
Parents inevitably develop perceptions of offspring’s personalities and aptitudes. We have to be very wary of these turning into labels. To some degree they will be based on our own childhood experiences and natural prejudices. If a mother was raised with lots of brothers and no sisters, she might have a picture of boys as being bumptious and difficult. Or perhaps you were the youngest and have strong ideas about how that affects people. These kinds of ideas may be more or less anchored in reality but we have to be careful not to slap them on our children. It’s complex, because to quite an extent the attributions we make to each different child are part of our expression of love towards them, especially the positive attributions. But the negative ones can sometimes be our way of dumping unwanted aspects of ourselves.
The simplest tip is to keep a close eye on your negative ideas about them. Maybe your baby or toddler really is a bit more tetchy or impatient than usual, but fight tooth and nail to resist the temptation to assume that is an inevitable destiny. All too often, when we look in the mirror, we may find that the child is reminding us of ourselves. Just because you have these tendencies does not mean your child will. The great danger is that we get ratty or tricky when the child is like that, bringing it to pass, a self-fulfilling prophecy which could have been avoided.
If You Think You or Your Child are Going Bonkers, Do Not Assume That Genes are the Reason (page 319, R7)
Leave aside the evidence about whether mental illness is caused by nature or nurture. Even with very extreme problems, like schizophrenia, the outcome is much better if the patient, or the patient’s parents or any professionals treating the patient, do not assume the problem is caused by genes.
If schizophrenics are sent back from hospital to a family who assume that genes are the cause, that person is more likely to relapse. They are less likely to take steps to help themselves and more likely to take to the bottle or become depressed. They become more passive about their treatment and leave it to the professionals to decide what happens, which predicts they will fare worse. Professionals who believe mental illness is down to genes are more likely to perceive patients as disturbed and less likely to involve the patient in plans to help them.
As an Organiser, you are at greater risk of depression than Fleximums and Huggers. This is especially so if you are a Type A personality, or if you have a partner with whom you disagree about the best way to mother, or if you feel unsupported, or if you wish you could be working or not working and are doing the one that does not suit you (R8). If you feel yourself succumbing to depression, whatever you do, do not assume your genes are the reason. That is almost certainly not the case and there is a lot of help you can get, as explained above.
Mothers can vary enormously in how they nurture their different offspring. As we shall see, Huggers can shift to being Organisers and the reverse can happen – remember Flo, the Organiser in Chapter 4, who believes that if she has a second child, she will become a Hugger.
Mothers can also shift from one kind of care to another at different stages in the same child’s life. Most of us tend to have age groups which appeal to us more, others that appeal less. The sort of person who adores babies may not feel the same about toddlers – that is true of some Huggers. They may be very child-centred in infancy but become stricter and more like Organisers with their toddler. In the same way, some Organisers prefer over-threes who can talk, walk and then read and write, to under-threes. These Organisers may be requiring the under-three to adapt to them but when it gets older, become more like a Hugger.
Especially with Huggers and Organisers, these approaches can be a way of defending against anxieties thrown up by the vulnerability of the under-three, reminding them of their own infancy. If so, mothers may radically shift the form their defence takes. Just as Huggers can occasionally take the fast train to Organising without stopping off at the Flexi station, so with Organisers.
• Pregnancy and Birth Horror: you are liable to be the sort of person who does not especially revel in either pregnancy or birth. The more you can acknowledge pregnancy, the easier the birth and first few weeks will be
• Bored by Babies: if you feel the baby is dull and unstimulating, you have got the ‘walkie-talkies on different channels’ problem. The more you can overcome this, the better: a few sessions with a parent–infant therapist could work wonders. Do not feel your lack of interest in goo-goo, ga-ga makes you a bad person, there are plenty like you – it’s different, not worse
• Too Eager to Tame the Beast in the Nursery: because you do not feel the baby can communicate its needs to you much, you may get too hung up on trying to impose routines. As much as possible, allow the baby’s natural patterns to emerge during the early weeks, and build routines around them. If you are finding this hard, reach out to intimates and tell them all about it
• Believing Much of What Under-Threes are Like is Inborn: because you may find them so unstimulating – because you happen to be the sort of person who is not tuned to under-three wavelengths – you are more prone to attributing inborn traits. That quickly leads to a disciplinary mentality and to ever less pleasure from being with them, a vicious circle. Once you grasp that they are tremendously responsive to care and that their personalities and abilities emerge from relationships with carers, not at all from genes at this age, you may also see they are not as boring as they first seemed
• Thinking that Under-Threes Need Stimulation, Education and Friends: they actually need nurture and l-o-v-e more than anything else. Beware of confusing your own boredom and feeling of being unstimulated with what they are feeling. They just want to hang out with you and for you to recognise their needs, and to be talked to and with. They do not need constant entertainment, they do not need friends, they do not need IQ-building games
• Attraction to the Wrong Sort of Substitute Care: they want nurturant companions, not nurses or teachers, and they want one-to-one care. That rules out day care if you can possibly avoid it. If picking nannies, minders or other substitutes, look for someone who is loving and not hyperactive, above all things. Lovingness is more important than cleanliness or efficiency at this age
• Too Many Naughty Chairs and Punishments for Toddlers: they need clear boundaries about what is allowed at this age, but pick your battles carefully and keep them to a minimum before age three. As much as possible, help them to do the right thing because they want to, not because it suits you. Try to avoid imposition and coercion, to avoid nagging and overcontrolling
• Depression from Workaholia and Too Many Balls in the Air: the more you can solve the walkie-talkie problem, the less risk of depression. Find some other mothers you can have a good moan with, preferably via an antenatal class. If you are a Type A personality, find a psychoanalytic therapist, avoid CBT