Childrearing, Culture and Mental Health

Clinical Applications

A trusting, cooperative approach to childrearing is gaining acceptance and is implicit in much of clinical child psychiatry and psychotherapy. Gordon [86] has successfully adapted some principles of therapeutic counselling and communication to enable many parents to enrich the quality of their family relationships through greater satisfaction of needs which are biologically based. Recognizing the implicit revolution involved, Gordon states that this involves "nothing less than an entirely new philosophy for dealing with children and youth, a new Bill of Rights for the young".

In the clinical diagnosis and management of emotional disorders in childhood there is need to incorporate the biological perspectives outlined earlier. For example, behaviour modification techniques are often employed in a manner which represents an antidotal rather than a corrective adaptation to symptoms which are often the manifestation of "ecologically-determined maladjustment". Even in the contemporary urban situation there is scope for exploring solutions with a corrective, and not just an antidotal, component. As those people who care for children begin to have a greater understanding of the biological processes with which they are involved, there are many opportunities for considering how to work with nature and not against it. Many of the behavioural problems in infancy and childhood appear in a different perspective, which can be illuminating to those who counsel parents, and to parents themselves.

To the extent that there is validity in the biological approach I have outlined, the appropriate therapeutic management should not infrequently include a component which I suggest may be described as a kind of 'bio-psychological reorientation". This often includes a change from a basic distrust orientation towards a more trusting cooperative approach to childrearing. Such changes help to resolve clinical problems.

Conclusion

Amid the shifting sands of opinions about how infants and children should be reared, an evolutionary perspective suggests that there does exist, in the universal aspects of the human genetic data, a kind of biological "absolute", "constant", or touchstone against which the appropriateness or otherwise of a system of child rearing must sooner or later be evaluated. There is much that we do not yet know about this biologically given "constant", but we are reasonably certain that it exists and its behavioural influences and relevance for childrearing, particularly early childrearing, are increasingly being recognized. A system markedly out of harmony with this may be expected to produce a greater level of conflict, stress and pathology, and there is some statistical evidence to suggest that, not only in childhood but also in infancy, this situation exists in some English-speaking societies today [51,52,90]. It is desirable that this situation be understood and remedied in Western societies, and it would be most regrettable if, in the meantime, it were to be transferred to those developing societies where it has been much less evident.

Acknowledgements

This publication was produced with the assistance of a grant from the Inger Rice Foundation of the Australian Capital Territory which fosters activities concerned with improving mother-child relationships. The Foundation's generosity is gratefully acknowledged. I am indebted to many people, especially to Dr Ronald G. Every for introducing me to the evolutionary perspective. I am grateful to Professor Barry Nurcombe, Dr David Bell, Dr R. G. Every, Mrs. Annette Hamilton and Mr. P. Ritter for critical assistance with the manuscript, and to Miss Leonie Smythe and Mrs. Barbara Playle for patiently typing successive drafts.

The quotation from Reference 97 was reprinted with permission from Ainsworth M.D.S., Bell, S.M. and Stayton D.J., in The Integration of a Child into a Social World, edited by M.P.M Richards, Cambridge University Press. London, 1974.

Addendum

Some recommendations arising from the material in this paper were offered in a Report Towards a Preventive Mental Health Program for Children and their Families: Suggested Guidelines, (Chairman: P.S.Cook), published by the Northern Metropolitan Health Region (Sydney), Health Commission of New South Wales.

Copyright. This paper was first published in the Medical Journal of Australia, Special Supplement, 1978; 2: 3 - 14, who owns the Copyright. Reproduced with permission. Australasian Medical Publishing Company.

Any reproduction from this paper should be requested from the Medical Journal of Australia.

Footnote: In a longitudinal study in Sydney (Cook, P. S., Kiely, P, and Armour, P., unpublished) a multiple choice, child development questionnaire was developed to assess beliefs and attitudes about infant care, on a trust-distrust' dimension as outlined in the Table (that is, it provides a measure of the basic distrust orientation in relation to infant care). This questionnaire was completed by 35 baby health sisters, 43 early childhood educators, and 142 mothers in two maternity hospitals with their first babies. The results suggested that the mothers had significantly more "distrusting" ideas than the professional groups; in fact only one mother gained a score as low (that is, as trusting) as that of half the professionals. On multiple follow-ups over 18 months a sub-group of mothers with the most distrusting scores reported more problems with their infants than a subgroup with the least distrusting scores which were available from this sample.

Med. J. Aust. Spec. Supp., 1978, 2: 3-14.

[A fuller account of this study, with three-year follow-up, was described in Early Child Care - Infants and nations at risk, by Peter S. Cook, News Weekly Books, Melbourne 1997, pp186-7.]