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Family relationships
Special Article FAMILY RELATIONSHIPS F~SI)EI~IC~: H. ALLEN, M.D. 1 ) H I L A D E L P H I A , PA. HE fact that many volumes have been written on the subject of T family relationships bespeaks the importance of the subject, but also makes difficult the assignment of adding any fresh point of view. But a series of articles on the mental health of the child that omitted this large subject would leave untouched influences which vitally determine the quality of the child's personality. This brief statement will have as its purpose the evaluation of some normal aspects of family life in our present culture and will point the discussion around the needs of a growing child and how they are satisfied. The needs of the child for healthy development are apparent. He needs a sense of belonging and to achieve through living a feeling for his own inner value. How he achieves these and other essentials for health requires a discussion of the balance and interplay between the parents' responsibility and capacity to satisfy these needs and the emerging desire and ability of {:he growing child to be responsible for meeting these needs with his owp developing capacities. As a preamble to the discussion of this subject, I want to draw attention to certain evolutionary aspects of family life and relationships. The child as he grows has not only a relation to his family but to the culture within which his family is a small but integral unit. In different periods of man's history, and in different cultures of each period, there have been many variations of family structure and funetion. So wide have been the variations that the term " f a m i l y " is not easily defined. In one culture it may refer to a small group bound together by the convention of marriage and maintaining a separate unity within a larger social organization. In other groups the term may define a more loosely organized group bound together by economic rather than biological factors. In some cultures there may be the dominant matriarchal influence, and in others the patriarchal influence may be in the foreground. Some family units attain the status of a elan, and the element of kinship binds together a considerable group of people who try to maintain a completeness within their group that in other cultures is :found in the interrelations between the family and the larger social unit within which it functions. O n e of a s e r i e s of a r t i c l e s p r e p a r e d for, a n d a p p r o v e d by, Tile C o m m i t t e e on M e n t a l H y g i e n e , A m e r i c a n A c a d e m y of P e d i a t r i c s . F r o m t h e P h i l a d e l p h i a Child G u i d a n c e Clinic. 130
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During the historical evolution of man and family life there have been many shifts in its form and function. B u t through these shifts there has r u n an important common dilemma. The family constitutes the smallest social unit within a larger unit. There have always existed varying degrees of competitiveness between the family and elan for the prim a r y loyalties of its members. The family has always touched the deepest feelings of mankind because here man and woman live in closest contact with each other. Members of families in their living relations supply each other with a completion of their living selves in a way that is unique. The child is the product of two people and becomes not only a new person, but a symbol of their togetherness. B u t the elan or nation demands some of that loyalty. The safety of the family has required the larger organization which the elan or state provides and that has been maintained through a larger and a different feeling of belonging. As cultures became more complex, the needs of its members required new tools for their satisfaction. The family slowly ceased to be a selfsufficient unit but began to depend upon other resources for a better performance of certain functions. Going" along with these shifts, the clan or state in order to gain more support began to take over many family functions. F a m i l y change has been associated with the growing demands of the larger unit. We have seen, therefore, the family becoming less important as a center for education, for religious instruction, for companionship and recreation. There can be no doubt that in some cultures there have been open attempts to destroy the family and to start the child, almost from birth, with the feeling that he belongs to the state and not to any smaller division. B u t such attempts only serve to focus attention on certain indestructible aspects of family life--influences which have always operated and which have made the family, in one form or another, almost synonymous with human existence. Where there is life, there is a relationship to another; where there is a child, there is a mother and a relationship together, usually in a family setting. Thus these shifts in family, structure and function must be viewed as change rather than signs of deterioration. In every period there have been those who have predicted the break up of the family. But it continues, and will always be a part of life. But these shifts which have gone rather rapidly in an age of rapid transit, radios, moving pictures, etc., have made it necessary to redefine the essential function of a family and how it meets some of the basic needs of its members, particularly the child. These shifts have served to focus attention upon the basic unchanging and everlasting function of a family: where people live together, where they experience their most fundamental feelings, and where a child gains his first sense of self in his relations to others. It is the mutual experiencing of feelings that establishes the bonds that make the family
132
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unique a n d s t i r s loyalties that can never be fully t r a n s f e r r e d to a larger a n d less personal relation to a state or clan. I n those cultures which seem to have the most stability, these loyalties are not in competition with others. Rather, they supplement each other and strengthen the individual who can make creative use of his sense of responsibility both to f a m i l y and to state. We live in a culture t h a t still respects the individual as the foundation stone of the social order. A vigorous and healthy individualism is almost a basic requirement of a creative society. I t rests upon a belief and respect for difference which is the essence of individualism. A h e a l t h y individual is one who believes in his own uniqueness and difference, which belief leaves him free to respect difference in others. I f this is a base for a healthy society, it must be the base for a healthy normal family group. So I would place that first as the m a j o r contribution of family life. H e r e individuals with different experiences a n d backgrounds learn to live out their differences in a relationship that is close and binding. They can find their satisfactions in a sharing relation r a t h e r than in one where one self engulfs and submerges the other. Man a n d woman participate in the creation of a child and have the irap o r t a n t and fascinating responsibility of guiding the growth steps of a child as he achieves through living a self t h a t is his own and different f r o m those who create and direct him. The philosophy t h a t people have about difference is the determiner of f a m i l y relations and the influence necessary for mental health. Such a family, whose members have a live and let live attitude, can provide a f r a m e w o r k for the differentiation of its members. B y contrast, this becomes clear when we think of an atmosphere dominated by the drive for self-immortalization, where a person would seek to live forever b y p e r p e t u a t i n g himself in another and t r y i n g to make of a child a rubber s t a m p of himself. W h e n m a n and woman have acquired through their own development a healthy feeling of their own individuality, they are in position to create a child and guide him to m a t u r i t y . They can give all that must be given to the child of their creation without trying to p e r p e t u a t e that feeling of ownership which can block the child in the achievement of his own independence. I t seems worthwhile to devote the balance of this p a p e r to a more careful consideration of those family relationships which are built on a healthy respect of the individuality of its'members' and:h0w this philoso p h y can influence the relationship between :parent,and child. A child needs a g r e a t deal f r o m parents. ]:IiS life depends on what they give. His physical life depends upon the food and shelter they provide and his emotional life is conditioned by the quality of affection and direction they are free to give. I would stress here the freedom to give, because of the need of naturalness and spontaneity in the giv-
ALLEN :
FAMILY
RELATIONSHIPS
133
ing. A parent cannot be told h o w to love a child, nor can he be given the 9rules and regulations of being a good parent. Children need real people for parents and not intellectual artifaets. The parent w h o knows all the answers on h o w to be a parent is sometimes a person w h o cannot trust his eapaeity to live out that knowledge in his everyday relation with the child. Those individuals who have found through their o w n development a feeling that there is value in being what they are will be those who can give freely and naturally to a child. Methods become the expression of their own realness. They can modify method through more knowledge a n d become more real in the living out of t h e i r responsibilities. B u t knowledge alone never made a good parent.
Parents will always have a sense of responsibility for a child they have created. W h a t he is at birth is what they have made him. Truly, a child is an extension of themselves, a feeling that has more living significance for the mother. But growth necessarily begins to change this feeling because through each experience the child has he learns his own separateness and gradually acquires a feeling of being responsible for what he is and what he can become. Through these changes the parents begin to experience a change in their earlier feeling of complete responsibility. _ks they can let that feeling-be broken up, they are allowing the child opportunities to :feel responsible for himself. This is the process of differentiation, the success of which is so basic for mental health. This feeling of responsibility that one human has for another has been stressed in such a way in literature that many parents have been overwhehned by the seriousness of their task. Certain unhealthy sequences have followed when the parent tries too consciously and too purposely to live out this responsibility and be a good parent. Certain common problems illustrate the dilelnmas c r e a t e d by the overintensity set in motion. F o r example, affection is a feeling that needs a spontaneous and natural expression. Children need t h a t . But when a mother, aware of the powerful influence of affection, begins to parcel it out in carefully measured doses to prevent a"mother fixation" or to avoid the horrors of a "spoiled child," she is i n t r o d u c i n g m~ u n n a t u r a l element into the child's life. She is taking' her responsibility too literally and too completely. It is probably true that just as many children are confused and disturbed by the parent's fear of spoiling as are upset by the possessive'and controlling use of "affection," which does create a spoiled child. The p a r e n t who tries too hard to reduce his affeetional expressions to rules and techniques fails to appreciate the capacity of a growing child to make responsible use of the natural and spontaneous expression of feeling' which characterizes the healthy parent. Parents who can give such real expressions of their feeling can be equally free to main tain a growing feeling of separateness to the child of their creation. They can continue to build their own adult life and interests and still maintain their p a r t in the life of a growing child. This is the natural
134
THE JOURNAL OF PEDIATRICS
breaking up of the more complete feeling of responsibility during infancy, but necessary in a different and less complete way as the child gains, through the use of what a p a r e n t has given, the courage and capacity to move toward separate living. Parents who can accept the responsibility of being persons in their own rights can encourage the necessary separation and differences which growth requires. They can feel increasingly that the life they were responsible in creating can continue through the g r a d u a l breaking up of that more complete feeling of being necessary for all that a child is and does. They can use their relation to encourage a child to find the self that will be his a n d which will have the i m p o r t a n t qualities of difference. A growing child needs not only affection and a feeling of belonging in his relation with p a r e n t s ; he needs also the comfort of authority. H e needs a person who, in being real, can limit the emerging power a child comes to feel as his own. The child needs limits to this emerging strength in order that he can acquire an organization t h a t allows for its creative use. Here again there has been a good deal of confusion, made more articulate by some well-intentioned but not always wise efforts t o " t r a i n " p a r e n t s for the great responsibility of their task. Discipline is a word that has a slightly old-fashioned connotation in an age that always seeks to be reasonable about everything. The doctrine that states that a p a r e n t should always explain requirements to a child is a doctrine that is sometimes as confusing to a child as it is to a parent. growing child needs not only affection and a sense of belonging in his relation with a p a r e n t ; he needs, and even craves, the comfort of authority. He needs a person who, in being real, can define limits to his emerging s t r e n g t h - - l i m i t s that are not designed to crush and overcome this strength but to give direction and creative value to it. I f every limit has to be explained and its purpose defined, it frequently ceases to have a n y realness because of the discussions set up. A child can struggle against the p a r e n t s ' conceptions of reasonableness m o r e effectively sometimes than against the original requirement. I f he is in a struggling mood, he can find as m a n y arguments against going to bed as the p a r e n t can find for it. P r o b a b l y the more i m p o r t a n t force in this area of discipline is the p a r e n t ' s feeling of the right to be direct and to require some conf o r m i t y to a world that requires both assertion and yielding. Where there is a basic respect for the individual being directed, some things can be required without lengthy explanations and because a p a r e n t wants something done. A child has the right to rebel and a p a r e n t has the right to stand firm. B u t it does take more courage to be that direct. I t does require belief in one's self tempered and colored by belief and respect in the child who is being helped to live in a world t h a t does not give way to rebellion and whim.
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Where the relationship rests upon a healthy respect for difference, which follows when one is oriented to a relative set of values about responsibility, a discipline that has creative values will usually follow. A child is being brought up in a world that is not always going to be reasonable; therefore, a parent who feels so responsible for a child that he tries to protect him from any discomforts is really saying that he cannot believe the child has anything in himself to deal with uncomfortable realities. This is not a defense of unreasonableness in direction. I t is more an a t t e m p t to say that reasonableness and fairness become a p a r t of a living relation when there is not a too conscious and p u r p o s e f u l a t t e m p t to achieve it. H e l p i n g parents to a n a t u r a l belief in their own convictions usually allows reasonableness to be a p a r t of their relation with a child. Their ability to be real in their relationships allows for realness to emerge in those who are dependent upon them. I n s u m m a r y , pediatricians and psychiatrists, who have the professional responsibility of clarifying for parents and children the nature of their relationship, can be more effective as they are clearer about the basic nature of the relationships involved. This statement has sought to emphasize t h a t healthy human relationships grow f r o m a respect for the individual differences. A healthy p a r e n t is one who has gained through living the courage to be himself, which allows the emergence of a feeling of u n i t y with others whose differences he accepts. He respects the value of what he has to give to a child and, at the same time, believes in the capacity of the child to make use of what is given as he moves toward a more complete feeling of his own separate individuality.
ALLEN :
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RELATIONSHIPS
131
During the historical evolution of man and family life there have been many shifts in its form and function. B u t through these shifts there has r u n an important common dilemma. The family constitutes the smallest social unit within a larger unit. There have always existed varying degrees of competitiveness between the family and elan for the prim a r y loyalties of its members. The family has always touched the deepest feelings of mankind because here man and woman live in closest contact with each other. Members of families in their living relations supply each other with a completion of their living selves in a way that is unique. The child is the product of two people and becomes not only a new person, but a symbol of their togetherness. B u t the elan or nation demands some of that loyalty. The safety of the family has required the larger organization which the elan or state provides and that has been maintained through a larger and a different feeling of belonging. As cultures became more complex, the needs of its members required new tools for their satisfaction. The family slowly ceased to be a selfsufficient unit but began to depend upon other resources for a better performance of certain functions. Going" along with these shifts, the clan or state in order to gain more support began to take over many family functions. F a m i l y change has been associated with the growing demands of the larger unit. We have seen, therefore, the family becoming less important as a center for education, for religious instruction, for companionship and recreation. There can be no doubt that in some cultures there have been open attempts to destroy the family and to start the child, almost from birth, with the feeling that he belongs to the state and not to any smaller division. B u t such attempts only serve to focus attention on certain indestructible aspects of family life--influences which have always operated and which have made the family, in one form or another, almost synonymous with human existence. Where there is life, there is a relationship to another; where there is a child, there is a mother and a relationship together, usually in a family setting. Thus these shifts in family, structure and function must be viewed as change rather than signs of deterioration. In every period there have been those who have predicted the break up of the family. But it continues, and will always be a part of life. But these shifts which have gone rather rapidly in an age of rapid transit, radios, moving pictures, etc., have made it necessary to redefine the essential function of a family and how it meets some of the basic needs of its members, particularly the child. These shifts have served to focus attention upon the basic unchanging and everlasting function of a family: where people live together, where they experience their most fundamental feelings, and where a child gains his first sense of self in his relations to others. It is the mutual experiencing of feelings that establishes the bonds that make the family
132
THE
J O U R N A L OF P E D I A T R I C S
unique a n d s t i r s loyalties that can never be fully t r a n s f e r r e d to a larger a n d less personal relation to a state or clan. I n those cultures which seem to have the most stability, these loyalties are not in competition with others. Rather, they supplement each other and strengthen the individual who can make creative use of his sense of responsibility both to f a m i l y and to state. We live in a culture t h a t still respects the individual as the foundation stone of the social order. A vigorous and healthy individualism is almost a basic requirement of a creative society. I t rests upon a belief and respect for difference which is the essence of individualism. A h e a l t h y individual is one who believes in his own uniqueness and difference, which belief leaves him free to respect difference in others. I f this is a base for a healthy society, it must be the base for a healthy normal family group. So I would place that first as the m a j o r contribution of family life. H e r e individuals with different experiences a n d backgrounds learn to live out their differences in a relationship that is close and binding. They can find their satisfactions in a sharing relation r a t h e r than in one where one self engulfs and submerges the other. Man a n d woman participate in the creation of a child and have the irap o r t a n t and fascinating responsibility of guiding the growth steps of a child as he achieves through living a self t h a t is his own and different f r o m those who create and direct him. The philosophy t h a t people have about difference is the determiner of f a m i l y relations and the influence necessary for mental health. Such a family, whose members have a live and let live attitude, can provide a f r a m e w o r k for the differentiation of its members. B y contrast, this becomes clear when we think of an atmosphere dominated by the drive for self-immortalization, where a person would seek to live forever b y p e r p e t u a t i n g himself in another and t r y i n g to make of a child a rubber s t a m p of himself. W h e n m a n and woman have acquired through their own development a healthy feeling of their own individuality, they are in position to create a child and guide him to m a t u r i t y . They can give all that must be given to the child of their creation without trying to p e r p e t u a t e that feeling of ownership which can block the child in the achievement of his own independence. I t seems worthwhile to devote the balance of this p a p e r to a more careful consideration of those family relationships which are built on a healthy respect of the individuality of its'members' and:h0w this philoso p h y can influence the relationship between :parent,and child. A child needs a g r e a t deal f r o m parents. ]:IiS life depends on what they give. His physical life depends upon the food and shelter they provide and his emotional life is conditioned by the quality of affection and direction they are free to give. I would stress here the freedom to give, because of the need of naturalness and spontaneity in the giv-
ALLEN :
FAMILY
RELATIONSHIPS
133
ing. A parent cannot be told h o w to love a child, nor can he be given the 9rules and regulations of being a good parent. Children need real people for parents and not intellectual artifaets. The parent w h o knows all the answers on h o w to be a parent is sometimes a person w h o cannot trust his eapaeity to live out that knowledge in his everyday relation with the child. Those individuals who have found through their o w n development a feeling that there is value in being what they are will be those who can give freely and naturally to a child. Methods become the expression of their own realness. They can modify method through more knowledge a n d become more real in the living out of t h e i r responsibilities. B u t knowledge alone never made a good parent.
Parents will always have a sense of responsibility for a child they have created. W h a t he is at birth is what they have made him. Truly, a child is an extension of themselves, a feeling that has more living significance for the mother. But growth necessarily begins to change this feeling because through each experience the child has he learns his own separateness and gradually acquires a feeling of being responsible for what he is and what he can become. Through these changes the parents begin to experience a change in their earlier feeling of complete responsibility. _ks they can let that feeling-be broken up, they are allowing the child opportunities to :feel responsible for himself. This is the process of differentiation, the success of which is so basic for mental health. This feeling of responsibility that one human has for another has been stressed in such a way in literature that many parents have been overwhehned by the seriousness of their task. Certain unhealthy sequences have followed when the parent tries too consciously and too purposely to live out this responsibility and be a good parent. Certain common problems illustrate the dilelnmas c r e a t e d by the overintensity set in motion. F o r example, affection is a feeling that needs a spontaneous and natural expression. Children need t h a t . But when a mother, aware of the powerful influence of affection, begins to parcel it out in carefully measured doses to prevent a"mother fixation" or to avoid the horrors of a "spoiled child," she is i n t r o d u c i n g m~ u n n a t u r a l element into the child's life. She is taking' her responsibility too literally and too completely. It is probably true that just as many children are confused and disturbed by the parent's fear of spoiling as are upset by the possessive'and controlling use of "affection," which does create a spoiled child. The p a r e n t who tries too hard to reduce his affeetional expressions to rules and techniques fails to appreciate the capacity of a growing child to make responsible use of the natural and spontaneous expression of feeling' which characterizes the healthy parent. Parents who can give such real expressions of their feeling can be equally free to main tain a growing feeling of separateness to the child of their creation. They can continue to build their own adult life and interests and still maintain their p a r t in the life of a growing child. This is the natural
134
THE JOURNAL OF PEDIATRICS
breaking up of the more complete feeling of responsibility during infancy, but necessary in a different and less complete way as the child gains, through the use of what a p a r e n t has given, the courage and capacity to move toward separate living. Parents who can accept the responsibility of being persons in their own rights can encourage the necessary separation and differences which growth requires. They can feel increasingly that the life they were responsible in creating can continue through the g r a d u a l breaking up of that more complete feeling of being necessary for all that a child is and does. They can use their relation to encourage a child to find the self that will be his a n d which will have the i m p o r t a n t qualities of difference. A growing child needs not only affection and a feeling of belonging in his relation with p a r e n t s ; he needs also the comfort of authority. H e needs a person who, in being real, can limit the emerging power a child comes to feel as his own. The child needs limits to this emerging strength in order that he can acquire an organization t h a t allows for its creative use. Here again there has been a good deal of confusion, made more articulate by some well-intentioned but not always wise efforts t o " t r a i n " p a r e n t s for the great responsibility of their task. Discipline is a word that has a slightly old-fashioned connotation in an age that always seeks to be reasonable about everything. The doctrine that states that a p a r e n t should always explain requirements to a child is a doctrine that is sometimes as confusing to a child as it is to a parent. growing child needs not only affection and a sense of belonging in his relation with a p a r e n t ; he needs, and even craves, the comfort of authority. He needs a person who, in being real, can define limits to his emerging s t r e n g t h - - l i m i t s that are not designed to crush and overcome this strength but to give direction and creative value to it. I f every limit has to be explained and its purpose defined, it frequently ceases to have a n y realness because of the discussions set up. A child can struggle against the p a r e n t s ' conceptions of reasonableness m o r e effectively sometimes than against the original requirement. I f he is in a struggling mood, he can find as m a n y arguments against going to bed as the p a r e n t can find for it. P r o b a b l y the more i m p o r t a n t force in this area of discipline is the p a r e n t ' s feeling of the right to be direct and to require some conf o r m i t y to a world that requires both assertion and yielding. Where there is a basic respect for the individual being directed, some things can be required without lengthy explanations and because a p a r e n t wants something done. A child has the right to rebel and a p a r e n t has the right to stand firm. B u t it does take more courage to be that direct. I t does require belief in one's self tempered and colored by belief and respect in the child who is being helped to live in a world t h a t does not give way to rebellion and whim.
ALLEN :
FAMILY
RELATIONSHIPS
135
Where the relationship rests upon a healthy respect for difference, which follows when one is oriented to a relative set of values about responsibility, a discipline that has creative values will usually follow. A child is being brought up in a world that is not always going to be reasonable; therefore, a parent who feels so responsible for a child that he tries to protect him from any discomforts is really saying that he cannot believe the child has anything in himself to deal with uncomfortable realities. This is not a defense of unreasonableness in direction. I t is more an a t t e m p t to say that reasonableness and fairness become a p a r t of a living relation when there is not a too conscious and p u r p o s e f u l a t t e m p t to achieve it. H e l p i n g parents to a n a t u r a l belief in their own convictions usually allows reasonableness to be a p a r t of their relation with a child. Their ability to be real in their relationships allows for realness to emerge in those who are dependent upon them. I n s u m m a r y , pediatricians and psychiatrists, who have the professional responsibility of clarifying for parents and children the nature of their relationship, can be more effective as they are clearer about the basic nature of the relationships involved. This statement has sought to emphasize t h a t healthy human relationships grow f r o m a respect for the individual differences. A healthy p a r e n t is one who has gained through living the courage to be himself, which allows the emergence of a feeling of u n i t y with others whose differences he accepts. He respects the value of what he has to give to a child and, at the same time, believes in the capacity of the child to make use of what is given as he moves toward a more complete feeling of his own separate individuality.