Posts made in June 2018

American Heritage and Psychiatry

Common Messages to Help us Navigate the Crisis at the Border

The ideals around which we have founded this nation and raised our families are dear to all of us.  We are fortunate to have been born in a nation where we can raise our children in relatively safe and secure communities and change our situation, station, or life when we choose.  When people around the world long for this freedom for their children they may make the choice to leave their land and journey to the United States of America. History has given us direction and psychiatry has given us understanding about how we can form and maintain a rich and diverse melting-pot as a nation.  

“…Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tossed to me.

I lift my lamp beside the golden door.”

Emma Lazarus 1883

American Heritage

In the 1860s, French anti-slavery activist Edouard de Laboulaye suggested that France gift of the
statue, “Liberty Enlightening the World” to commemorate the alliance between the U.S. and France during the American Revolution and the end of slavery in the U.S. after the Civil War. In order to raise money to construct the monument’s base, the poet, Emma Lazarus wrote the famous sonnet “The New Colossus” for a Statue of Liberty fundraiser in 1883.  Concurrently, the “Great Wave of Immigration” had begun and between 1880 and  1920, 23.5 million persons immigrated to the U.S..  The poet was inspired by her experiences with Russian Jews detained by immigration officials on Ward Island and included a new facet of liberty in her interpretation of what the statue could mean. In the years since, though the statue would take on many additional layers of meaning, the link between it and immigration  solidified. 

America is a nation of immigrants, but we have struggled with our identity.  My own  family came to the United States in 1966 from a small town in Italy, looking for a better life, hoping to find the “American dream”.  Many of you have stories of immigration, renewal, hope, and pride going back just a generation or so. We are the beneficiary of what freedom and opportunity has to offer.   This is the America where we are raising children together with the values we want to uphold. It is hopeful to believe in our commitment to liberty, justice, and freedom for all. It can be difficult to conceptualize that this same invitation is not extended to everyone.    

We have always returned to the vision that the U.S. shall be a place of refuge in the World.  However, in May 2018, the U.S. began  enforcing a “zero-tolerance policy” to prosecute anyone crossing the border, including those who may seek asylum.  This policy determines that families apprehended at the border be separated, with parents being contained by the U.S. Department of Homeland Security (DHS) and children being sent to the U.S. Department of Health and Human Services’ Office of Refugee Resettlement. It is estimated that 658 children were separated from their parents in May.  

We have misinterpreted fundamental concepts of helping others, building alliances, and protecting our future when we do harm to those least able to care for themselves.  Children coming to the United States from Northern Latin America are traumatized, depleted and most vulnerable. They are fleeing a degree of danger and violence that is difficult for U.S citizens to understand, because despite our struggles, most of us can access safety and justice when we need it. It is important to understand the meaning and impact of the policy separating children from their parents.

The Consequences of Separating Children from Parents:

Disrupted Attachments

In psychiatry we use the term attachment to describe the secure structure of a relationship between a child and caregiver. It is the portal through which the child learns to experience him/her self, others, and the world around them. The quality of the attachment translates into how the child relates and reacts to everything in ways that both subtle and overt. When the attachment is disrupted, the ripples into the child’s development and future and significant.

A healthy attachment is described as a reciprocal, enduring, emotional connection between a child and his/her primary caregiver(s). This develops from care that is attuned and responsive to the child’s physical and emotional needs. A secure attachment is an essential building block of cognitive, social, emotional, and physical development. Characteristics such as empathy, capacity to love, and inhibition of aggression are all related to a child’s sense of secure attachment in the world.

When this attachment is disrupted through a variety of circumstances such as the abrupt loss of or extended separation from a parent, child abuse or neglect, the child is at risk of attachment related problems.

Attachment Related Problems:

Problems with Interpersonal Relationships:

  • lack of trust in caregivers or adults in positions of authority
  • resistance to nurturance or guidance
  • difficulty giving and receiving genuine affection or love

Problems with Emotional Functioning:

  • minimal ability to recognize the emotions of others
  • poor emotional regulation (moodiness, extreme fluctuations in emotions, “falling apart” when faced with stress)
  • low self-esteem

Behavior Problems:

  • demanding, clingy, and/or overt or covert over-controlling behavior
  • temper tantrums and poor self-control
  • regressed behavior, problems with speech, problems with eating
  • chronic lying and Stealing
  • property destruction and aggression
  • impulsivity

Problems with Cognitive/Moral Development:

  • lack of understanding of cause and effect
  • decreased abstract thinking
  • limited compassion, empathy, and remorse
  • difficulty concentrating and attending to school related tasks

Currently, The U.S. has enacted a policy with potentially devastating consequences to children.  The types of injuries that we are causing can be permanent, pervasive, and exceptionally difficult to treat.  Repair of early life trauma, particularly the abrupt severing of contact between child and parent, without understanding, without predictability, and without promise of reunion causes irrevocable damage.   The cost to these children and the future that unfolds along with them will be astronomical and beyond any justification for the current policy.

It is important to remember that these children may not demonstrate full signs and symptoms of their injuries at this time.  It is not until they reach a place where safety is more certain that that they begin to demonstrate the full impact of the trauma.  As a nation, we have an opportunity to either begin to heal or to further deepen the psychological wounds this children bring with them across our border. The United States has the capacity to offer a restorative and corrective experience to our neighbors, community, and within this nation.  We can rebuild the trust of these children. We can offer security. We have the opportunity to demonstrate that the world can be more good than bad. 

As we look for solutions for families at our border it becomes increasingly important that we remember the lessons from the past. In medicine and psychiatry, not all things are certain; however, there are concepts that are universally accepted and foundational to healthy development. Supporting attachments between parents and children honors who we are as a people and builds upon the original principals of our nation.


Theresa Randazzo-Burton, MD
Child, Adolescent, and Adult Psychiatrist



American Academy of Child and Adolescent Psychiatry

Quick Facts:Disrupted Attachment. An Information Booklet For Parents/Guardians and Child Serving Professionals in Chittenden County, Vermont

Posted. June 1, 2018. They Are (Still) Refugees: People Continue to Flee Violence in Latin American Countries.  

PEW Research Center:

August 2, 2017. TIME Magazine. Author: OLIVIA B. WAXMAN:The Poem on the Statue of Liberty Was ‘Added Later’ But There’s More to That Story

Family on Cliffside

Listening to the Little Things

Let’s Put an End to Bullying

“How did I miss this?  Why didn’t he tell me what was happening?  If I had known sooner, I could have done something! “ As parents, we try hard to avoid getting out of sync with our family.  We have all found ourselves wondering how to encourage our kids to talk to us about the issues they face.  While we may feel helpless or even unwanted at times, the good news is children really do look to parents and caregivers for advice and help with tough decisions. Getting them to talk is probably easier than you think, it’s just a matter of creating some time and space to connect.  Spending 10-15 minutes a day talking with your kids reassures them that you are available and attentive. If you want to hear about the big things happening in your child’s life, you have to listen to the little things.  

For some families, conversation about daily life, classes, activities, friends, and hobbies comes easily and the topics flow.  Other families may feel out of practice, uncomfortable, or artificial when they try to communicate. Breaking the ice, or getting back to face-to-face communication is worth trying.  Chances are your child (yes, even your teenager) has also been longing to connect with you.

Here are some ideas to help start conversations about your child’s daily life and feelings: 

  • What was one good thing that happened today? Any bad things?
  • What is lunch time like at your school? Who do you sit with? What do you talk about?
  • What is it like to ride the school bus?
  • What are you good at? What would do you like best about yourself?
  • How does your teacher handle problems in the classroom?  Do you think those methods are effective?

When It comes to bullying, having a foundation of good communication and a feeling of security at home can literally be life saving!  Talking about bullying directly is an important step in understanding how this issue might be affecting your child or the school your child attends. Even if your child is not directly involved in bullying, an environment where bullying thrives can put everyone at risk.  The solutions to bullying depend largely on the bystanders deciding their school should be a place where every student feels safe. We can teach our children this message both directly and indirectly when we talk with them. There are no right or wrong ways to address these topics, but it is important to encourage kids to speak honestly. Assure kids they are not alone in addressing any problems that arise.

You can start having conversations at home with questions like these:

  • What does “bullying” mean to you?
  • Describe what kids who bully are like. Why do you think people bully?
  • Who are the adults you trust most when it comes to things like bullying?
  • Have you ever felt scared to go to school because you were afraid of bullying? What ways have you tried to change it?
  • What do you think parents can do to help stop bullying?
  • Have you or your friends left other kids out on purpose? Do you think that was bullying? Why or why not?
  • What do you usually do when you see bullying going on?
  • Do you ever see kids at your school being bullied by other kids? How does it make you feel?
  • Have you ever tried to help someone who is being bullied? What happened? What would you do if it happens again?

Expert Tip: Try listening without planning a reply.  Instead, focus on trying to understand how your child is processing and feeling. If you don’t know how to reply, ask your child how you can help.  You may be surprised by the answer. Finding out what would feel helpful goes a long way towards encouraging them to continue talking.

We tune into our children when we listen to answers from questions like the ones above.  We show our children that they have valuable thoughts in their mind and those thoughts can turn into words and actions, which have the power to impact others.  A child who believes in their own ability is not likely to bully others or tolerate bullying around them.

We spend so much time away from our children that it’s important to continually learn about how teachers, friends, social media and other influences are shaping and changing who they are.  When we listen, we stay tuned into the person they are becoming and we send them the message that they are worth knowing. A child who believes that they are worth knowing, worth our time, worth out effort, worth our support is as bullyproof as can be.

There are simple ways to keep up-to-date with kids’ lives.  This is especially important for parents who split time with another caregiver or who travel and are away from home often.

Tips for staying up-to-date with your child’s life:

  • Read class newsletters and school flyers. Talk about them at home.
  • Check out the school website
  • Attend school events and parent nights
  • Greet the bus driver
  • Meet teachers and counselors or reach out by email

When we take time to talk with our children, we provide an example of how to listen, solve problems, and consider others.  The antidote to bullying is building kids who feel capable, confident, and worthwhile. Kids who receive this message at home share it with others.  

Theresa Randazzo-Burton, MD
Child, Adolescent, and Adult Psychiatrist

Follow our Blog for more on this series.  Dr. Burton will visit topics related to bullying in more detail in weeks to come.  She will tackle the topics of cyberbullying, helping your child form a peer group, identifying bullying at home, bully proofing, bouncing back from bullying, and more.  Check with the Retreat at Ponte Vedra Beach this fall to join our Bouncing Back Group for kids to have experienced bullying.  

Additional Resources: logoNational Anti Bullying Logo Anti-Bullying Logo