Where the Science Ends and the Art Begins: An Introduction

Graduate school immersed me in the academic world of research design, evidence, statistics, and critical analysis of conclusions. After graduate school, my positions in academic medicine continued to drill in me a healthy skepticism of findings that didn’t make sense, and even some that did, and using evidence to guide my work was required. But I evolved in my therapist role to push the bounds of evidence and science with a deeper instinct about the art of therapy and connecting with another person in order to best work together.  There are times “evidence-based practice” hits a wall, and instead of giving up, I have learned to use creativity to find a new door.

My experience with motherhood magnified this professional evolution tenfold. Like most new mothers, I worried about every phase of my pregnancy (is this normal? Is she going to be okay?), and fret over every “first” (babies can’t blow their noses – how do I get out that snot?). One gift of exhaustion was NOT having the energy to research every little question. I began to reason that women had been mothers since forever, and I am not so special to be completely unlike all women in the history of humankind. It would be okay.

MaddyTree.JPG

As my role of mother has progressed from daughter to son, from infancy to toddlerhood to school-age, the wisdom of experience humbles me. One lesson I have learned with certainty: you could read every single research study related to parenting, and still have no clear idea what to do. Of course, there are some basics that helpfully guide parents through many milestones, and some that do challenge previously accepted practices. The science of parenting has in many ways elevated our modern parenthood to be more effective and compassionate. But in other ways, the inundation of studies and headlines creates more chaos, confusion, and pressure. In many (but not all) parts of our American society today, we have the luxury of thinking about our parenting, of analyzing each decision, and striving to raise the best children possible.

I have observed, however, that this well-intentioned and intense pressure to be our best as parents can have the opposite effect of stressing ourselves and our relationships to undermine the reason we are stressing out in the first place. And in most cases, this angst is NOT “evidence-based.”  There are some seismic changes in our parenting that have occurred over generations, like the well-accepted fact that spanking is harmful in the long-term. Seatbelts save lives. Putting babies to sleep on their backs has decreased SIDS (side note: my son always ended up on his stomach – I had to decide to not freak out, and that his little body knew what he needed).

But guess what? Most of what we stress over has no huge treasure trove of evidence behind it. Do I yell too much? Probably. But how much is it actually harming my children? There is no longitudinal study of hundreds of families examining what is probably typical yelling in most families of young children, to see a trend of negative outcomes for those children as adolescents. This would require comparing with another sample of hundreds of families who do not yell. Good luck finding them!

As adults, we all carry wounds and scars from childhood. They shape who we are today, and we can still function fairly well much of the time.  Clearly, the experiences of emotional and physical neglect, or any form of abuse by a parent, leave a different kind of psychological legacy for that person’s parenthood.  After working for several years before and during graduate school with significant child abuse and neglect, I appreciate the vast difference between typical imperfections of parenting and pathological parenting.

In this space, however, we celebrate and embrace the imperfections, even as we constantly strive to do and be ideal versions of our parent selves. But it's a fine line of finding our capacity for change and growth, while not crippling ourselves with feelings of guilt and inadequacy. I truly believe that as long as we show up for our children every day the best we can, they really will be okay.