Chiarandini: You're about to be made an honorary member of The American. What does that mean to you?
Brazelton: Well, I have a long acquaintance with psychoanalysis. When I finished my pediatric training back in the late forties, I realized I didn't know anything about children, let alone parents. I went to a psychiatric center, a psychoanalytic center in Boston, where there were figures such as Beata Rank—Otto Rank's first wife—Marian Putnam, some now famous figures then in training, and my own analyst, Gregory Rachlin.
I went through five years of training and had a personal analysis. I've always been, well, attached to psychoanalysis. My thinking is profoundly indebted to analytic thinking, to Freudian thinking. I was greatly inspired by Winnicott—he was one of my heroes. In a way, I fashion myself after him, I suppose. And then, over the years, my former analyst has been an important figure, a sort of family therapist to myself and my wife and four children. Not long ago he asked me if I would write an introduction for a book he is writing, about Freud. I said, “About Freud! I'm not the right person to write that, unless you are writing about his infancy!” I had to make the decision along the way whether or not to pursue psychiatric and analytic training. With the help of my analysis, I was able to decide that I wanted to be a pediatrician. I think all of that is bearing fruit now. I feel that I gained a lot, but I gave something up at that time that now finally I am retrieving. All of my research, you know, is clearly based on psychoanalytic theory about infancy.
I'll tell you what has driven my research, that comes from my experience during the five years I spent at a center in Boston, called the Putnam Child Center, treating preschool children—atypical children, autistic children, what we would call PDD now. They were in treatment for three to five years. I was the first pediatrician the center ever had, and I think they didn't know what to do with me. They put me on the floor, first just to look at the children. The first year they made me a nursery school person, then a teacher, then a social worker and after three years they let me have a case, Skipper. I was so closely identified with that child there was no separation in our minds. In those days I became aware of how in pediatrics there was only a pathological model, just as in psychiatry. I found that so unsatisfying. Mothers got blamed all the time, nobody got better. I kept thinking: this is not working. Why is the baby not making a contribution to the parent-infant unit? Maybe we're not using the right approach. Maybe if we understood the baby better—maybe that's the way. Maybe if we understand the baby better we will help the mother understand the baby and herself. That became a goal I set for myself.
It was in 1955, when I was still at Putnam, that I began to work on what I have become famous for, the Neonatal Behavioral Assessment Scale. I knew there was a temperamental quality to the newborn baby's reaction. That realization and that work gave me the best window into what a baby is going to give to its environment and what the environment is going to have to give that baby for an optimal outcome. I realized our task was to capture those parents for that particular baby.
Chiarandini: You capture others, you know. Over the years you have influenced, through your presentations and films, some of my patients' and students' decisions to have a baby.
Brazelton: Really? What a responsibility! Well, it is really a revelation—it was for me—to see how competent a baby is, and how much parents can rely on their baby. Parents ask, How am I going to know? I say: Watch the baby, the baby will tell you. His behavior, that's his language! We realized that observation gave us the first real window into the parent-infant attachment process. Later I did a lot of cross-cultural studies, to appreciate the differences across cultures. There is great variability in the baby, but then we could study the influence of the different environment and see what changes it produced. When I came back to Boston I had a chance to work with Jerome Bruner, who was a sort of Piaget in this country, and he taught me how to look at cognitive development. So now I had some notion of emotional development and of cognitive development. Now I could look at the interaction: mother, father, and baby and how they learn their job of attachment to each other together. It's a very tight, a very interdependent developmental process of learning about each other. You've seen my films. You see there the development of a process of learning about each other in the first four months, and we described four stages. Dan Stem was doing his work too, and at the very beginning we didn't know about each other. When we learned what the other was doing we got together and became very good friends.
Chiarandini: I have seen what a terrific impact you have on parents. You teach them to observe, you enhance their capability, and thus their enjoyment. They must be terrified of the responsibility and then you relieve them of the anxiety and provide an incredible enjoyment. I remember seeing how you put the baby up on your arms extended between the mother and you, and show the different response of the baby to your voice and to hers.
Brazelton: I do it with fathers too. And when the baby doesn't turn to the father's voice, I tilt my arms a little! Parenting is so hard! I observed my own mother—I grew up in Texas. My mother raised me and my younger brother, working very hard, a very dedicated woman. Very hard, but very liberal. She founded the first abortion clinic in Texas. In 1940. She had to call it Women's Health Clinic something.
Chiarandini: Was she a physician?
Brazelton: No, just a housewife. She was very active, a very dominant woman. I used to watch her with me and my younger brother—I was only five years old. She ruined my brother. She would make him sit for two hours at every meal to make him eat, and I used to think, how can someone who cares so much go so astray? I knew right away I wanted to be the kind of doctor who could change that, to give back to parents a feeling that parenting is all right, it's not horrible.
Chiarandini: What has been your own experience as a parent? Was being a parent hard for you? How did it affect you in your thinking as a researcher?
Brazelton: Oh! deeply. I learned a lot from my own experience as a parent. In Infants and Mothers I describe three different kinds of babies: very quiet babies, watchful calm babies, and hyperactive babies. You know, I knew how difficult a hyperactive baby is; parents need a lot of help. But until I had this first baby I did not realize how hard it was to have a baby that just looked at you. Nobody realizes how hard it is to have a very quiet baby, one who doesn't give you anything but critically, just this cool gaze follows you quietly—one of my children was like that. My own children mobilized me to realize how much backup parents need. From my private practice I learned about all kinds of babies, but without my own children to learn from I would never have had the courage to write, to really get into this, to popularize the psychodynamics of child development.
Chiarandini: You have taken some unpopular positions: on family leave, on the deterioration of family values, on many social issues. You think we have to give a new priority to the family, and are not afraid to say it.
Brazelton: I would be afraid not to say it! Of course, I don't know if I would have had the courage to enter the political arena if Ben Spock
had not done it first. I was critical at first, when he started speaking out. I thought he should not speak against the war—a pediatrician in my view didn't have that right. I feel we are in deep crisis: I see it with everybody, I see it on television. I felt I had a responsibility to do something political. My research has shown me how critical the first four months are, how critical to bonding. We know that from our face-to-face research. So I felt we had to go to Washington and demand parental leave, decent child care, hunger relief, family support. I just came back from Washington. On the National Commission for Children, with Jay Rockefeller, we have laid down a wonderful book, We outline existing conditions, but everybody has hope. During the Reagan/Bush years we missed so many chances.
Chiarandini: I can see how people might be unresponsive to you, but it is hard for meto imagine that you could be attacked, as I know you have been. Can we talk about that?
Brazelton: Oh, yes, I have been attacked a lot. Not just ignored, as I was by the past Administration, but attacked too, a lot! I do write for the media and for sure I get mail.
Chiarandini: On what issues for instance?
Brazelton: Well, the most recent one is, I came out against corporal punishment. I got flooded with mail, saying such things as “That's the trouble with our children, they don't get spanked enough.” I had laid out my thinking, saying that to spank a child today, with all the violence around, is to say it's all right to pass that message.
Chiarandini: It is so complicated when, for instance, all presidential candidates believe in the death penalty. It is a complicated system of values for children to sort out.
Brazelton: All over the country people don't think we have any values, that is the problem. What does the U.S. stand for? War, aggression, money, power. People don't want to leave those to their children. Ethnic hatreds are ready to boil up; the struggle that women go through to establish their identity, the lack of values, of community, the lack of any systems of support, those concern me.
Chiarandini: Do people, young people, your children's generation, ask you what they can do? Beyond the simple individual level, where people can teach, write, talk, I think there is such a visible problem for people in trying to balance what they can do individually and what they demand society to do. What are your thoughts on that? Do you have any advice?
Brazelton: Sure! We have a grassroots organization called Parent Action, attempting to do for children what AARP does for the elderly. We established it last year in an attempt to fight for what we need. In our meetings at the National Commission for Children we are trying to establish four things: (1) health care for everybody, outreach programs, preventive care; (2) income support; (3) changing the educational system; and (4) changing the workplace to become more oriented to family issues. On a personal level, we have to make the workplace not only family friendly but also geared to men as well as to women. We have to pay attention to spending special time for children, time to cuddle, to rock, to chat. Special time like weekends. We have to pay attention to the things that mitigate stress.
Chiarandini: The people who write you angry letters, who are distraught, are they reachable? Those people are not going to join your grassroots organization. Is there a danger in abandoning them? Do you try to keep a dialogue going?
Brazelton: I think it would be a great danger to abandon them. But you see, I grew up in Texas, where there are a lot of those people.
Chiarandini: How do you engage them? I imagine people saying, What was good for me must be good for my children. That's not easy to change.
Brazelton: It certainly will not change over one generation, though it might change over time. But I always write them back. I tell them I respect their thinking, but I expand on mine. Discipline, not punishment. Corporal punishment is one issue, abortion is another. I say, it's not a woman's choice, it's the baby's choice. Every baby has the right to be born into a family that's passionately in love with him! I have seen too much child abuse and failure to thrive not to want to take that side, the position that such babies want to be aborted. When I write back I say, I am expressing my strong views and I expect you to express yours. Somehow, standing up for what you believe, not backing down, is important, while not ignoring the other person. Someone wrote me who was both a mother and a teacher. She wrote me a furious letter, and I answered her. After a while I received a letter back. She told me she had started to think. “Do I really have to spank these kids?” She was taking care of a whole bunch of children, and she said she tried some of the things I had suggested—picking them up, taking time out, and it worked.
Chiarandini: How rewarding! As a fatigued fighter, I appreciate and am encouraged by your answer. Next I'd like to ask you about Bosnia—why you went and what you saw—and about a totally different topic: in these days of surrogate parents, of homosexual couples adopting children, or having children by artificial insemination, what are your thoughts about all that?
Brazelton: Well, about Bosnia, you know that I didn't go into Sarajevo, because my own children made me promise I wouldn't. I stayed in Zagreb. I was exposed to the children though, and saw horrors of that war that don't seem possible for humans to inflict or endure. What goes on there does not seem possible, it has no rationality to it. But similar things happen in Cambodia and in Africa.
Chiarandini: I remember you were at first reluctant to go.
Brazelton: James Grant, the head of UNICEF, asked me. He wanted me to go to make it visible that we ought to go and try to stop this war, but I really didn't have the energy to divert from my task here, my work with poverty, with the nightmares we have in this country. Plus I thought we were really in danger of being used as a political opportunity. I did not want the trip to be used by the Bush administration. Grant eventually convinced me by saying, “I need your eyes.” That made me go. You know, he did need my eyes! I also saw it as a chance to get UNICEF to pay more attention to quality of life, not just life itself. They have been wonderful with their fluid replacement programs and their shots, they are saving lives all over the world, but I think they have to go the next step. Is it worth it to go on saving lives when there is no life to go back to? So I did go to Bosnia, basically to advise on ways in which these kids could recover. It made me much more sensitive to the horrors. I learned a lot about violence, much more than I expected. But we have violence in this country too—in the ghettos of New York, and in Boston. In this country, black infant mortality is beginning to level off, but Spanish-American infant mortality is twice what it is for blacks, which in turn is twice what it is for whites. We are not reaching Spanish-Americans at all, or only in a way that destroys their value system, their intergenerational relation to one another. So we have a difficult task ahead.
As to your other question, about diversity. Diversity is here to stay. We better make it work because we have no other choice. If a homosexual couple can nurture children, that ought to be an asset. Can they offer children stability, nurture, from the two people involved? Those are the questions. I would never, however, give a child to people because they want “to fulfill themselves.” I would tell a single parent, it's awfully difficult with two people, I would not want to see anyone having a child for mainly narcissistic reasons.
Chiarandini: Wouldn't you say, though, that that would be a difficult judgment to arrive at even with heterosexual, legally married couples? Wouldn't others feel that they were being treated unfairly, that such a test is discriminatory?
Brazelton: Yes, but the instability and stress that is inherent in all those situations ought to be considered. It makes it harder. We ought to be child-oriented, not adult-oriented.
Chiarandini: It's so nice how unafraid you are to say these things.
Brazelton: I have struggled with some of the issues myself, waited a long time to get married, had to define my own sexuality. I know what people go through, and I know how much passion is behind these issues. But I guess raising a child is the biggest responsibility we have, and I think given enough sympathetic understanding a lot of people make the right choice. A young couple called me. The judge had decided after their divorce to award them joint custody of their child. One was in San Francisco and the other in Chicago, and the baby would have to be flown back and forth every week. They didn't want that, so they came to Boston to consult. It took two weeks, but finally everybody reached the same conclusion: it would be best for the baby to stay with the father, because his mother was at home and could care for the child. The mother worked and would have to look for outside help. So they decided the mother would get the baby on vacations. It was tough, but they both had the intention to do what was right for the baby. Sometimes we know what is right but it is very hard to do. We have a national organization, Zero to Three, in which many of us are involved; Sally Provence was in it, Al Solnit, Stan Greenspan, Reginald Lourie, many from psychoanalysis, myself. We are trying to be a voice for small children. I need more people to be involved, psychoanalysts as well.
Chiarandini: I'll be sure to publish that. It has been such a pleasure. Thank you.