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Grab the tissues

March 2, 2021


I still remember working with a foster family years ago. They were about to foster and adopt their 7th child. SEVENTH!! This sweet baby came to them showing signs of in utero exposure to drugs and alcohol. This meant that he was also showing signs of withdrawal post-utero. Babies who are withdrawing from substances have high-pitched cries and feel inconsolable to their parents. They are physically in pain and emotionally distraught. What follows is the conversation I had with his foster parents, to the best of my memory. The call came to my cell phone after hours. Names have been changed to protect their privacy, of course.

Grab your tissues my friends…

Mandy: (sobbing) Dr. Amy, I can’t do this. He’s still crying. Nothing’s working. I thought he’d be through the worst of this by now.

I could hear Eric’s cry through the phone as Mandy attempted to hold him close and console him. It was high pitched, relentless and desperate.

Me: Mandy, of course you can do this. You’re an amazing mom and you’ve been through hard things with your other kids. And, I get it, this feels overwhelming. I can hear him and it’s heartbreaking. I’m here. I’m listening. Let’s work through this. What have you tried?

Mandy: (sobbing and desperate) Everything. We’ve walked, we’ve rocked, we’ve gone outside, we’ve strolled, I’ve wrapped him up, I’ve unwrapped him, I’ve tried baths…I’ve done everything that’s worked before. I’ve tried everything you recommended.

Me: Yes you have and you’re still doing it. When was the last time you slept?

Mandy: I dunno. A few hours when he passes out from exhaustion and crying.

Mandy’s husband, Terry, was a sweet man. He was involved as a dad as much as possible. But, he was a long-haul truck driver and she was often parenting as a single mom.

Me: Where’s Terry? Is he on the road?

Mandy: He’s sleeping. He just got in from California last night.

Me: You have to wake him up. He needs to help us right now.

Mandy: I feel horrible. He’s been driving for hours and he came home, helped with the other kids and I was with Eric all night.

Me: I get it, but Eric knows how overwhelmed you are too, right now. We need more adult helpers. And you need a break.

Terry, a 6’4” tree-of-a-man, joined the phone call, ragged voice. Eric was still crying in Mandy’s arms.

Me: Terry, it’s Dr. Amy. I need you to follow my instructions very carefully. Mandy, take off all of Eric’s clothes except his diaper. Terry, take off your shirt, please. You’re already warm and in a sleepy state, this will be good for Eric.

I could hear rustling through the crying.

Terry, put the baby against you, skin to skin. Mandy go find a big sheet.

Terry: I don’t think he wants me.

Me: He desperately wants you. He just doesn’t know how to ask. And he’s in pain. His body is distressed and he doesn’t know how to manage his feelings. He needs to CO-REGULATE with someone who’s not overwhelmed. He needs you to help him with his body and feelings.

Terry: OK…

Me: Mandy, wrap the sheet super tight around Terry and Eric, making sure his little nose and mouth are peaking out. Put a hat on Eric too.

Eric is screeching in the background, now super upset to be cold on top of everything else. But Terry and Mandy oblige and Mandy begins to wrap tiny Eric against Terry’s naked chest in a king-size sheet – round and round she goes.

Me: Good, all set? Terry – walk around now with Eric bound to you and hum, very, very low and quiet.

Terry: I don’t sing.

Me: Eric doesn’t care. The vibrations in your chest will add another source of input and your voice is deep, low and calming. Just hum, anything at all. And Mandy, walk away for a bit. Just go outside and breathe.

Eric’s screeching slowed but still seemed desperate. He would stop and cough and then cry again. His voice was raspy from all of the crying. Then the humming began. Now, tiny Eric had this big body, warm and cozy, head wrapped. Terry’s heart rate was slow from recent slumber. He was warm and his body was moving. He hummed “Sweet Child of Mine” by Guns and Roses. It was out of tune and perfectly imperfect. I heard the front door close as Mandy walked out to breathe in fresh air.

Terry: He’s calming down. Wow. Thank goodness. Do you hear him?

Me: Barely. Take some big deep breaths and keep humming.

Terry: Mandy’s standing outside crying.

Me: She’s ok. She’s been doing amazing things with Eric. They’re both simply exhausted. She hasn’t done anything wrong, they both just needed a little help today. Thank goodness, you came home at just the right time.

After about 7 minutes of Terry humming, walking, bouncing and holding Eric tight against him, Eric calmed and dozed off to sleep. Mandy came inside and looked at the two of them in disbelief. She walked over and wrapped her arms around the two of them. Terry wrapped her in his arms, making a sandwich of Eric between he and his wife.

Terry: How long do we do this?

Me: As often as he needs it. Mandy can do it too once she gets some sleep, some food and a break.

Friends, this is what I mean by co-regulation. While this example might seem extreme, it’s not really. Think of the big feelings your children have every day. They get overwhelmed, catastrophic and dysregulated. Sometimes, about big things and sometimes about the tiniest things. When they can’t manage their big feelings, they need your help. They organize their feelings and emotional state WITH YOU.

When you do things like getting down on their level, using a calm voice, softening your eyes towards them and offering help, they regulate with you. They learn to manage their emotions through you.

One sweet exercise to try? Try a 20 second hug with your child. See what happens to their body and yours as you hold them and breathe together. Pull them close and take big, deep breaths. Yes, this works for teens too. Yes, they might think you’re weird. Do it anyway. See what the two of you co-create.

With compassion,

Dr. Amy

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