AAP Voices Blog

Recent examples of police brutality have re-opened deep and long-festering wounds caused by racism. These horrific images come as we struggle with fear, uncertainty and grief due to the COVID-19 pandemic. Like other medical professionals, I am mortified by the violence and perplexed by accounts of citizens angrily refusing to wear a mask in public.

At times, it seems as though the entire country is suffering from a case of “compassion deficit disorder.”

As a primary care pediatrician, I worry about the impact of these turbulent times on the social and emotional functioning of children and their families. When our brains are in “survival mode,” they are typically not in “relational mode.”

But the healthy development of children requires adults who are in relational mode and able to provide a safe, stable and nurturing environment in which to grow and learn.

Even as an adult professional, I lean heavily on a supportive network of relationships to cope with stress. Colleagues, friends and family regularly show me – and in doing so remind me – that kindness trumps anger, and compassion is more powerful than hate. Our children and families need those same sort of supportive relationships, perhaps now more than ever.

The capacity to develop and sustain these safe, stable and nurturing relationships is “relational health.” By meeting our most basic needs (to feel safe, understood and valued), relational health turns off our body’s stress response and limits the long-term biological, behavioral, educational and economic consequences of significant adversity. Relational health is also the platform for learning the skills to cope with future adversity. This is the power of relational health: It not only heals old wounds but teaches us how to deal with whatever the future may bring.

“As a primary care pediatrician, I worry about the impact of these turbulent times on the social and emotional functioning of children and their families.”

To build relational health, children and their parents need certain skills, including an effective way to communicate, the ability to understand and regulate their emotions, and a capacity to empathize and respond to the emotions of others. These social-emotional skills are difficult, but the good news is that they can be learned.

As the pandemic and unconscionable inequities challenge us to change our ways, perhaps we should build our “new normal” around relational health by encouraging the following activities among our parents, patients, family and friends: 

• Reconnect with self: Find activities that get you out of your head and back into your body. Breathing, exercising and making art or music are potent antidotes to information overload, and they discourage the dissociation or numbness linked with unremitting stress. Being present in the moment helps us to forget, even temporarily, about past pains and future fears. Moreover, a mindful focus on this moment may promote calmness, instill a broader perspective, and allow you to be a better role model for others in distress.
• Reconnect one-on-one: Embrace opportunities to be entirely present with others. The public health need for physical distancing does not preclude the biological need to feel connected. This is particularly true for children, because they will synchronize their heart rates and brain waves with loved ones. Try to find developmentally appropriate ways to play with younger children. For older children and adults, engage in activities that bring mutual joy. These moments of shared connection are the building blocks of relational health.
• Reconnect collectively: Find innovative ways to connect with a small group in a responsible manner. Connecting with a few family members around the dinner table and meeting with team members through videoconferences are important ways to share highs and lows, accomplishments and frustrations, or hopes and fears. Camaraderie reminds us that we are all in this together.
• Reconnect with those in need: Look for opportunities to connect with those who might benefit from your support. Delivering food to the elderly, sewing masks, and calling out racism and inequities when you see them may increase your sense of control in a situation that may seem out of control. Most of us are not in a position to develop a vaccine or to dismantle structural racism, but we are each an integral part of society’s response to these collective traumas.

Building our new normal around relational health will not only sustain us through turbulent times, it will make us a healthier, more compassionate and resilient society moving forward.