Not In Front Of The Children, Please?

There are times when I realise my lack of power and just don't know what to say. Recent examples are when parents are taken aback when a family doctor has suggested that their smoking is harming their children who have asthma; and when parents who are in the process of splitting-up and have a lot of rows are annoyed that their young children have an increased number of asthma flare-ups or a straying attention-span. Current research suggests that we may eventually have to accept that the toxic impact of environmental exposure to verbal and physical aggression is as great as that of environmental exposure to tobacco smoke.

If a child's parents are separated and the child stays in both households on a regular basis, I usually ask if both parents can attend the workshops so that they can learn how to implement the various recommendations when the child is staying in the different households. Most parents are only too keen to work together to help their children and even where there is animosity, this arrangement works well unless the parents are geographically distant or it just isn't possible to reconcile the work schedules. The children who are particularly sad are the ones whose parents say,

We thought his behaviour was improving. Then he started being restless, up at all hours. He's not sleeping, we don't know what's going on.

It is not unusual for general conversation to reveal that the deterioration started when X went to stay with Dad and met the new girlfriend, or v.v. for the mother and her partner.

Some parents are distraught when they discover what is happening in the lives of their children: experimentation with tobacco, alcohol, non-prescription drugs, gang activity etc.. However, it seems to be less acceptable that children manifest their own (stress) reactions to what is going on in the lives of their parents and all around them: whether the children's stress manifests as disordered sleep, distractability, irritability or even an increased number of asthma episodes.

I've previously discussed Salvador Minuchin's finding that parental conflict contributes to ill-health in children with unstable diabetes:

behavioral events among family members can be measured in the bloodstream of other family members.

When the parents were coached in techniques that allowed them to resolve their conflicts directly, and without involving the children, the children could be stabilised at home without additional medication or hospitalisation. There was an improvement in the children's medical outcome as a result of a successful intervention between people other than themselves.

Like cigarette smoking, I'm tempted to say to parents who have high levels of aggression or hosility to eachother, "Not in front of the children - please". And I don't believe that seething, unexpressed resentment is an improvement given recent speculation that moods and emotions are contagious. A lot of the standard advice that is dispensed in TV programmes and magazines sounds like the playground rules in the illustration - boiling down to "Play nicely children". Among the many things that I don't know, I have no advice on how to introduce a new partner in a way that doesn't unsettle a child. I wonder if paediatricians, child psychologists, family workers, or people who have personal experience of such situations have a range of tips and techniques to cover such socially awkward situations that may have an impact on children's health?