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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Thursday, July 12, 2018

What to Expect When Young Children Are Separated from Parents—and What Can Be Done About It

Many more eloquent writers than I am have recently protested against the separation of migrant children from their parents who have entered the United States illegally or in the hope of asylum. In the last day or so, journalists have published descriptions of the reunions of a small number of the youngest children with their parents. Those descriptions are not surprising, although they are not what we would expect when we look at the separations and reunions “adultomorphically”—that is, as if the children should have the same thoughts and emotions that we adults would have if we were in their shoes (which they don’t).

What seems to have surprised some people is that 2- and 3-year-olds who have been very distressed by separation from their parents do not seem happy when reunited. They often stare as if they don’t recognize the parent, then begin to cry. Although they have been separated for only a few weeks, there seems to have been a dramatic impact on their responses to their parents. If they are followed up for further weeks or even months, it’s predictable that they will still behave differently than they did before, but that their behavior now will involve clinging to the parent “insatiably” as well as showing irritability and easy anger.

Parents who have gone away for a cruise or other child-free vacation for a couple of weeks, leaving a young child with a familiar grandparent or babysitter in their own home may recognize some of this mood and behavior that occurs on their return. Even pick-up after a day in child care may be fraught in the same way, with the child snubbing the parent and resisting going-home tasks like putting a jacket on.

Years ago, the attachment theorist John Bowlby made a short film called “Nine Days in a Residential Nursery” which you can read about at In this documentary film, we see 17-month-old John who is left in a nursery while his mother is having another baby. His father visits occasionally. As was considered normal in the 1940s, the mother is in the hospital for over a week and the father is not expected to care for John during this time. John’s distress and difficulties with eating and sleeping are clear, and in short order he develops a cold as well. There are many other toddlers in the nursery, some of whom live there full-time and are much more noisy and aggressive than John is used to. The nurses are kind in an impersonal sort of way, but change frequently according to their work schedules, and there is no single reliable person that John can seek for comfort. When John’s mother comes home and comes to pick him up, he snubs and resists her and she is surprised and distressed. Whether her own distress increases John’s is not discussed.

John’s experience has some but not all the elements experienced by young migrant children separated from their parents. The separation is abrupt and inexplicable from his point of view and he does not have enough language development to ask or understand what is happening. He is placed in a completely strange physical environment, with strange and ever-changing caregivers, and with large numbers of other children. No one knows (or apparently cares much) about his own familiar habits, his expectations, or his ways of communicating that work well with his parents but not with strangers. When his mother returns, she too is distressed, and her face tells him that something scary is happening—he can’t know that it is his own behavior that is scaring her.

In addition to all these elements they share with John,  today’s separated migrant children have already been brought far from their familiar homes and have missed their usual schedules of eating and sleeping for weeks or months in the past. They may be suffering from untreated illnesses at a time of life when fatigue, fear, sickness, or injury would normally make them seek comfort from familiar caregivers who are now absent. Whatever language development they have attained is of little use if caregivers do not speak their languages. The children’s forced removal from their parents is carried out by intimidating people, frightening both parent and child, and the parent’s expression of fear, added to the probably grim expression of the official, add to distress. The separation then lasts for much longer than what John experienced and in some cases will undoubtedly become permanent. Even when reunion occurs, the parents’ fear, depression, and distress during their own detention make it difficult for them to respond sensitively to the children’s needs.

Without wanting to get into the morass of discussion about separation of migrant parents and children, I do want to point out that the young children’s experiences do not have to be so distressing. It would cost money to make them less so, so I am sure this won’t happen. However, John and Joyce Robertson, colleagues of John Bowlby, showed that the distress of separated toddlers and preschoolers was much less if they had a consistent, predictable, sensitive, responsive caregiver who would work to understand their communications and to offer comfort and help as needed. Insights from child care can also be helpful in supporting young children in these stressful conditions; for example, not only is it important to have a low ratio of children to caregivers, but young children do best in small groups rather than in a large room with many children and adults. Caregivers trained in sensitive practices like Floortime can also buffer the effects of the adverse experiences of separated children.

But, as I said, that would all cost money…

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