Bedtime problems?

One of the most frequent referral problems is bedtime.

"My child keeps calling out, coming out of bed, has a hard time falling asleep, can't get up in the morning, is scared to go to bed," goes the litany of woes.

Most mothers are so tired by nighttime that they have little patience for their children's manipulations. They may follow their nightly routines, including time alone with each child, and still the music doesn't end until - hours later - they're ready to collapse.

There might have been threats, yelling and spanking in-between.

It's a song that we don't want to hear. But how do we change the music?

First of all, have you ever noticed that an orchestra, before beginning to play a concert, plays a few notes together? One musician plays a note and the rest follow, tuning their instruments to match the first.

Similarly, one family member often sets the tone for everyone at night. For example, if one child throws a tantrum the others may become whiny. If the children are in a good mood then their parent is happy and vice-versa, if the parent is upbeat then the children are more likely to behave.

The goal is for the parent to "lead the orchestra" through skillful conducting, looking out for members who need individual attention and keeping everyone on the same page. The conductor prompts one section of the orchestra, makes sure another one doesn't dominate, and coaxes those who lag behind. Through consistency, practice and tolerance for mistakes, the parent-conductor can lead the orchestra-family through the entire evening performance.

Bedtime is the coda for the evening. If we want our children to ease peacefully into sleep we need to ensure that the first three movements are performed well. The staccato section should not be at the end but rather in the middle, bordered on either side by legato. There is a time to jump around and a time to relax.

And the conductor, not the musicians, determines when the concert will end. There are no encores.

When Do You Need Help?

Her pain emanated from her face. Sitting forward in her seat, tense and unsmiling, she recounted her childhood to me: Parents in frequent battle, coming home to an empty house and being molested by a neighbor.

Now she battles anxiety and depression.

This is a fictional account that mimics the many stories that I hear in my practice. It typifies either the human tragedy or the human triumph, according to our ability to overcome adversity and move on.

My parents' generation, for example, overcame the worst debacle that can happen to a person - the destruction of their homes, families and society at the hand of the Nazis - to raise a new generation.

Many of us, through determination and hard work, similarly transcend our histories.

But we pay a price. The outside world doesn't see the wounds; there are no external scars to elicit sympathy. So when we break down and cry they admonish us and say, "What's wrong with you?"

We don't know. Often the wounds are so deep and so painful that it takes much sympathetic treatment to help us feel safe enough to explore the site.

So we carry on. We push aside the feelings until one day, maybe after the birth of another child, the move to another city, the death of a parent or loved one, we suddenly find ourselves no longer able to go on.

The burden has become to heavy to bear.

If you have suffered in the past and/or suffering now, don't wait for a crisis to repair the emotional damage. Trust your feelings. They are there for a reason. When they signal unhappiness, fear, confusion or despair seek the support and help you need. You deserve to live.