I met Judith when her son, Adam, was about 12 years old and was first diagnosed with a psychotic disorder. He had been very hard to deal with for some time but she and her husband had found it difficult to acknowledge there was something medically wrong with him. They had spent many years trying a variety of behavioral approaches, diets, exercise plans, and the like. When he began to hallucinate and developed clearly delusional thinking, they blamed themselves. Judith was especially hard on herself. It seemed impossible to her that her son could be so ill and she could not somehow be responsible. Judith became obsessed with parenting “perfectly,” with finding the right treatments and doctors, with behaving correctly in the complex situations that confronted her family daily. She wanted to be sure she was handling these situations correctly at home, responding to her son in ways that were most helpful to him, and providing the best type of environment possible. The standards she set for herself were high, very high. She felt overwhelmed with guilt at times for not being able to live up to them.
On one particular afternoon when Adam was fifteen, Judith called me very upset. She had lost her temper with Adam and screamed at him in the car. She had picked him up from school and told him “No, she would not take him to the video store to buy a new video game”. He attacked her verbally from the backseat, calling her names, accusing her of all sorts of evil intent. Likely, harboring paranoid thoughts that included his mother, Adam was behaving in an entitled, demanding, and vicious manner. Judith was exhausted and really angry. She just lost it. She turned around over her shoulder and told him to “SHUT UP” and then said a few more words, out of character for her. Judith was stricken with guilt over the episode. She wondered if Adam would be traumatized if he would forgive her. She was plagued with thoughts that her words might cause a full psychotic episode. I let her know that one episode of “losing it” was highly unlikely to cause a psychotic episode. Nor was it likely to cause Adam to think his mother didn’t love him or traumatize him for life. As we talked Judith came to understand that her behavior was really OK. Parents are, after all, only human. We are not perfect and we are not required to be perfect for our kids. We are only required to be good enough. There might even be some benefit to being `imperfect’ and only ‘good enough.’ For example, Adam needs to have his extremely inappropriate outburst responded to negatively. The rest of the world will not respond well when he behaves in that manner. Why should his mother? Granted, it is certainly not therapeutic to scream or curse at a 15-year-old psychotic person but, on the other hand, it is not helpful to beat oneself up for doing it after it has happened. We take responsibility, apologize, for our part, resolve to do better, and move on.
Donald Winnicott (1896-1971), a London Pediatrician and psychoanalyst wrote that the infant required only the “good enough parent” to develop its own sense of self as an independent being. He believed that the imperfect parent allowed the baby space to adapt. Winnicott wrote:
“The good-enough mother…starts off with an almost complete adaptation to her infant’s needs, and as time proceeds she adapts less and less completely, gradually, according to the infant’s growing ability to deal with her failure” (Winnicott, 1953)”
It is important to note that Winnicott’s work was based on infant/parent relationships and so we are borrowing and applying albeit loosely here but the comparison is helpful. We will fail sometimes. It’s inevitable. But, failing in small doses (like the Winnicott ‘good enough’ parent) is OK. Better than OK, it’s good. The child with a psychiatric illness may not have attained the same level of independence as another child the same age. They may lack coping skills, struggle with frustration tolerance, require more, and need more from us. We may, therefore, find ourselves with more opportunities to fail. The road can be hard at times. It is helpful to keep in mind that we do not have to do everything perfectly. The concept of “good enough” can get complicated and wordy. Suffice it to say:
The Rules for Good Enough Are:
1. We are not meant to be perfect parents but only Good Enough.
2. Good Enough means failure in small doses.
3. Failure is inevitable because we are human.
(Note: All of the people described in this article are fictional, created by the author for illustration purposes only.)
This text will be published in sections over the next several months on this blog in the hopes that it will provide ongoing support and information for families in need.
WA Schwartz, MD Board Certified Psychiatrist, Child and Adolescent Psychiatrist and Psychopharmacologist