Dr. Miguelina (00:00):

If the adolescent perceived their mother to be warm, there was no relation between harsh discipline in the seventh grade and that adolescent having externalizing problems in the eighth grade.

Dr. Sarah (00:25):

How does culture shape the way we parent and how our children experience and internalize that parenting? Joining me this week to unpack the intersection of attachment security and parenting styles across different cultures is Dr. Miguelina German. Dr. Miguelina is a licensed clinical psychologist who has conducted extensive research on the mental health of Latino children and families and other minority groups. In this episode, we discuss why warmth is a crucial factor in positive child outcomes. Also how a children’s perception of warmth versus strictness is influenced by cultural norms. And finally, we also talk about how generational values shape parenting strategies. We also discuss the impact of attachment ruptures during critical developmental periods and strategies that parents can use with children of any age to repair your parent child bond. By understanding the cultural and psychological influences on our parenting decisions, we can be so much more intentional about the choices that we make. We can have more respect and compassion for other parents who may do things differently than we do, and we can focus on the things that actually matter the most for raising resilient and healthy children. Hi, I’m Dr. Sarah Bren, a clinical psychologist and mom of two. In this podcast, I’ve taken all of my clinical experience, current research on brain science and child psychology, and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights. So you can tune out the noise and tune into your own authentic parenting voice with confidence and calm. This is Securely Attached.

(02:15):

Hello. Welcome back to the securely attached podcast. Dr. Miguelina German is here with us today. Thank you so much for being with us.

Dr. Miguelina (02:28):

Thanks for having me.

Dr. Sarah (02:29):

I’m really excited to have this conversation. This was a very, I sought you out and you were so gracious to come on because I had some questions that they’ve come up on other episodes and repeatedly you kept coming up as the person to talk to about this, to clarify. So today we’re going to be talking about how there’s lots of research on parenting styles and all kinds of things across the way that parents are showing in their relationships with their kids and how that has shown to have an impact on outcomes in children and families wellness. But a lot of these studies are done in a very homogeneous or OneNote population, and we make generalizations about those research results across multicultural groups. And so you’ve done some really interesting research on differences in parenting styles across different cultures. And so I’m just really looking forward to diving into this with you today.

Dr. Miguelina (03:34):

Likewise.

Dr. Sarah (03:36):

So first maybe it’d be helpful if you wanted to share a little bit with our audience on the work you do right now and maybe a little bit of your story of why this was an interesting area for you to dive into.

Dr. Miguelina (03:51):

Sure. So I am bicultural, right? I consider myself to be both American and Dominican. I’m a first generation Dominican American, born in the United States, and from my earliest years I was exposed to Spanish and English. And more than the language, I was really exposed to how parenting could look different. So in my home, there was certain parenting practices that I saw my parents use, and then I would go to a friend’s house who had a different cultural background, and I would notice some differences. I would also notice similarities, but I think I became aware that what is considered normative really could differ, and I realized that from my earliest years. And so I think that probably planted the seed for why I ultimately wanted to study clinical psychology and specifically child and adolescent clinical psychology. So I went to Arizona State University to get my master’s and doctorate, and my mentor, her name is Dr. Nancy Gonzalez, which she really taught me about the literature, is that when it comes to parenting, there’s kind of two main frameworks by which you can research and approach parenting.

(05:48):

So one is really bain’s typologies of authoritarian, authoritative, permissive neglectful versus looking at the individual parenting practices such as parental discipline, parental warmth monitoring. And so in my training, we actually looked at the individual parenting practices and sometimes how they interacted. And the reason my advisor preferred to use that approach is because she believed that it helped us uncover cultural differences if they were present. And sometimes they matched bain’s typologies and sometimes our findings were different.

Dr. Sarah (06:48):

So that’s really interesting. I want to just translate this a little bit. For people who are listening and aren’t familiar with Bain’s parenting styles, although as I described it, you’ll probably be like, oh, yeah, okay, I’ve heard of this. So there’s this sort of classical way that we’ve historically kind of grouped different types of parenting approaches. Authoritative is typically high warmth, high expectation, or high boundaries like clear boundaries. Authoritarian is high expectation, low warmth.

(07:25):

And permissive is high warmth, low expectation. And then neglect is low expectation, low warmth. And it’s been this sort of classical model that’s been used a lot in research in part because it’s so simplified, it really simplifies it down to this essential element of warmth and expectation. But what I’m hearing you say is what you were doing with Dr. Gonzalez was breaking this down even more so that you weren’t necessarily using a grouping. It was like, could you have across different groups, types of disciplines that could be discipline strategies that could be both harsh, but also live in a context of a warm relationship. And so you’re breaking it up. You’re just getting more granular.

Dr. Miguelina (08:23):

We’re getting more granular. Exactly. And we’re not making assumptions that a particular cultural group’s parents and children are going to fit into one of these four.

Dr. Sarah (08:40):

Right. Because your not looking at just two axes on a grid. Right, exactly. You’re saying instead of trying to use a two factor, a two…

Dr. Miguelina (08:52):

A two by two, right?

Dr. Sarah (08:53):

Yeah. You’re saying maybe there’s way more to this, and if we get more detailed and we break these things down into much smaller pieces to measure, we can get way more nuance.

Dr. Miguelina (09:03):

So, so it might be helpful for me to give an example.

Dr. Sarah (09:06):

Yeah.

Dr. Miguelina (09:07):

Okay. So this is a study that I conducted with a Mexican-American population. So this was a study with about 189 adolescents and their mothers. And what we measured was the adolescents perceptions of how warm their mothers were. And then we also measured harsh discipline, and then we studied them a year later. And what we found was if the adolescent perceived their mother to be warm, there was no relation between harsh discipline in the seventh grade. And that adolescent having externalizing problems, which is typically defined aggressive behaviors or the sorts of problems that you don’t want your teen getting into.

Dr. Sarah (10:27):

And past research has shown, other research had shown previously. I would imagine you’re referencing this authoritarian parenting, which is more associated with harsh discipline, has been linked to outcomes of externalization externalizing behaviors in kids later on in life. So you’re basically creating more color to that.

Dr. Miguelina (10:48):

Exactly. However, if the adolescent perceived their mother as being low on warmth, that traditional finding that we find with authoritative parenting was present.

Dr. Sarah (11:05):

That’s interesting. And I guess it shows that our kids’ perceptions of us as being warm more globally, I’m assuming that the measure of, are these kids perceiving their parents as warm? Is it when they’re being disciplined, or is it in life as a general?

Dr. Miguelina (11:26):

It was just in general. Yeah, it was a general questionnaire. So the prompt was like overall, right? How often, which means does your mother engage in these warm behaviors?

Dr. Sarah (11:41):

Which is I think helpful for parents to hear too, because it’s like, okay, I think we get really scared of

Dr. Miguelina (11:47):

Exactly.

Dr. Sarah (11:48):

We feel like we get kind of put in what we can perceive to be a bit of a corner that we’ve gotten painted into where it’s like, well, I know I’ve been told that harsh discipline is really bad, and also my kids have to see me as warm. And sometimes in the moment, I’m sorry, I’m a mom of two kids. There are definitely moments where no matter how warm I want to show up in life, they need to get in the fricking car right now and they need their shoes on, going to pull school out a little bit of harshness to make it to like, Hey, listen to me. I need your attention. This is important. And so I think obviously we can be both. I’m not advocating for harsh discipline, and maybe you could share a little bit about what was defined as harsh, because I also think the definition of harsh discipline has gotten kind of muddy because I think there’s a big difference between raising your voice to your kids and corporal punishment, for example.

Dr. Miguelina (12:55):

So I can give you some examples of the items from our harsh discipline measure. It was my caregiver got so mad at me, he or she called me names. My caregiver spanked me when I did something wrong. Now, of course, the child might’ve put a never response for that particular item, but overall, the measure harsh discipline was a measure of both verbal discipline, and we had one item that was on physical discipline, which I just read to you.

Dr. Sarah (13:46):

Okay. So I guess that’s interesting, right? Would you say, I think that raising your voice, your kids might not be on that measure, right? Maybe it is, but I think there’s a line too, in terms of calling your child names or hitting them that feels counterintuitive to a secure relationship.

Dr. Miguelina (14:13):

And so let’s talk a little bit about that.

Dr. Sarah (14:15):

Yeah.

Dr. Miguelina (14:16):

Because what we know from research is that normativeness can really play a role in perception, and psychology is nothing but the study of perception in many instances. And so the theory goes that in a lot of Latino cultures, there’s this expression called bapa, right? Which if your child isn’t listening to you, you give them a little slap on the hand. That might be very normative in your community where you’re raising your child. Your child may see other parents do that to their kids. And so they may not interpret that behavior as a rejection, as a personal rejection.

Dr. Sarah (15:14):

Right, or as scary.

Dr. Miguelina (15:16):

That my mother doesn’t love me. So perception is one of the theoretical moderators of why we may not find these links between harsh parenting and maternal warmth. It’s almost, you have to ask yourself, what allows an adolescent to view their parent as warm? Is it that they’re taking care of them in other ways? And then when they are giving them this harsh discipline, it’s either not happening very often, or if it happens, they interpret it in a particular context. So theoretically, that’s what a lot of researchers believe is another moderator. It’s this idea of normativeness. So on the other side, if you’re in a culture where that is not normative and you as a child are experiencing that and perceiving that as rejection, then I would predict that would be particularly harmful that child’s like…

Dr. Sarah (16:35):

And I’m curious what you think I would add a different, I guess, add an additional variable to that. If you have a perception, if you are making sense of a type of discipline that you’re receiving as rejection, yes, I think that could be damaging to the attachment relationship and then subsequently other outcomes.

(16:58):

I would also think fear. Am I feeling afraid? Because if this is a culturally standard practice that I’ve seen around me regularly, whether it’s directed at me or directed at other children, and it’s just part of the way that we are all collectively being raised, then receiving it might also, one, to your point, not feel like a rejection because it’s expected or there’s a context for it, but it also might not feel scary as scary because again, for that context, I think a lot of times what makes certain types of parenting discipline, harsh parenting discipline, particularly damaging is the fear that it elicits in the child. I think going back to sort of Dan Siegel’s four S’s, like safe, soothed, seen and secure, our ability to not be frightened by a parenting intervention, I think has a big impact if we feel safe.

Dr. Miguelina (18:08):

You know what, Sarah? I kind of go back to what you mentioned before. I think it’s in the repair. I don’t know how a child is not a little afraid if their parent gives them a powow or any type of harsh discipline. It feels like, like you’re getting yelled at…

Dr. Sarah (18:30):

Yeah, but on that scale of ugh. Right? To be able to say, I’m a little scared that they’re mad at me, or I’m a little scared that I’m going to get in trouble, versus I am terrified right now for my safety.

Dr. Miguelina (18:40):

Yeah, no, that’s very different.

Dr. Sarah (18:42):

That threshold, because fear is the spectrum. We all get a little in cultures where it’s not normative to do a pow, pow, but you give your kid the look.

Dr. Miguelina (18:52):

Exactly. They get scared.

Dr. Sarah (18:53):

But they’re not terrified of you. And I think that’s a very important distinction.

Dr. Miguelina (18:59):

Yes. I appreciate you bringing up that distinction. And I should say for the study that I just referenced, it was a normal population. So we did not have any families who were kind of in the system or involved with, in New York, we call it administration for child services, ECS, every state has a different name.

Dr. Sarah (19:25):

This was a non-abuse. We’re not talking about abuse at all in this population, right?

Dr. Miguelina (19:29):

No. This is not.

Dr. Sarah (19:31):

You’re controlling for all of that, which is I think an important thing to validate these findings, right?

Dr. Miguelina (19:37):

Yes.

Dr. Sarah (19:38):

Yeah, that’s really, it’s very interesting. I like digging into this. I hope that the listeners are equally as into the nerd stuff as we are.

Dr. Miguelina (19:46):

Yeah, no, I, and I understand that what I’m saying may feel provocative for some of your listeners, but this research exists.

Dr. Sarah (19:56):

And I think, and it’s important, I think we talk a lot about parenting styles on the podcast, and I think it is important to remember that there’s so many layers that go into how we show up as parents. And a lot of it, especially when you are starting to look at other cultures, especially other cultures in the US because then you’re layering on not just completely organic evolution of culture, of parenting practices within a culture that’s just been able to evolve on its own. We’re looking at generational trauma as a big piece that goes into what has formed different cultures, parenting strategies. Like I’m mindful of the fact that in certain groups in the us, if your kid is at the grocery store and they’re screaming, you might not feel like you have the safety or that your child has the safety in that moment to get down on the ground and validate their feelings and let them release and do all the things. You might actually be in an absolute threat response. And you need to know on some level or believe or fear on some level that this is absolutely not safe for either of you to be in this spotlight, and you need to stop your child from behaving this way now, and you need to get out of there because the graciousness is not extended to all groups equally.

Dr. Miguelina (21:18):

Yes. So many of my African-American and black parents that I work with express a need to teach their children, particularly their boys, to be more in control, particularly in public. And how do you achieve that as a parent if you have a rambunctious five-year-old with a DHD who’s bouncing off the walls in public or having a meltdown, and it might be okay when they’re five, but what about when they’re 15, right? And so that control dimension of parenting, which is manifested in different ways, but discipline might be one of them, monitoring might be another. It might look a little different in those families, as you mentioned, because they have higher stakes. Another example I can share from maybe a younger age, we’ll think about maybe toddlers, is in Japan versus the United States, for example. So let’s just say babies, baby’s attached. Nine months is typically when they have decided you’re my adult or adults. And soon after they start walking in Japan, what research has found is that when their babies start walking, their toddlers start walking, Japanese mothers really orient their babies to them. Whereas in the United States, we tend to orient our babies and toddlers to objects in the environment. And the theory behind that is that in Japan, the value of interdependence is much higher than in the United States where the value of independence is rated more highly. And so that’s a difference that is found. It has been found pretty consistently.

Dr. Sarah (23:38):

That’s so interesting, isn’t it? It’s so unconscious. Like we were talking about this idea of generational trauma informing some types of way we’re showing up in parenting, but also generational values.

Dr. Miguelina (23:55):

Yes.

Dr. Sarah (23:56):

And so it almost gets passed down. I don’t know if we would call it passed down in our DNA, but it’s definitely passed down in our collective unconscious.

Dr. Miguelina (24:07):

I agree. No, I agree a hundred percent. I think parenting at the end of the day is meant to be adaptive. We are trying consciously end unconsciously to help our children succeed in the environment in which, and they find themselves. And sometimes that is conscious, we’re consciously doing that and picking parenting behaviors that engender that goal. And sometimes it’s unconscious because it has been happening for so many generations.

Dr. Sarah (24:47):

And I think to some degree, we have to give a lot of space for those things to be more acceptable. And I also think there’s, there’s value in understanding what our unconscious autopilot stuff is so that we have just an opportunity to decide, is this as adaptive today as it was two or three generations ago? Is it just happening because it’s what my body wants to do as a parent? Or is it because I’m responding to something that’s not a threat anymore or isn’t a value anymore, or isn’t as adaptive anymore? The idea of Ghosts in the Nursery, that article, yes.

Dr. Miguelina (25:34):

Of course, Alicia Lieberman.

Dr. Sarah (25:36):

Yeah. I just feel like there’s this idea of we all bring these ghosts, these internalized previous generations, fears and griefs and…

Dr. Miguelina (25:53):

Anxieties.

Dr. Sarah (25:54):

Anxieties and hopes and values. It’s not all negative, but we bring it all with us. And so the idea is like you’re in this nursery with your baby and there’s so many other people in there with you from your past or your generation’s past.

Dr. Miguelina (26:11):

Sarah, she’s also written Angels in the Nursery now.

Dr. Sarah (26:14):

Ohh.

Dr. Miguelina (26:15):

Yeah. It’s more recent of course. But it’s also to hope, right? There’s also these angels that we can bring with us into the nursery.

Dr. Sarah (26:31):

But I think, and we talked about this a while back, you and me, but this idea, why is it important to break this information down for people and how we actually use this? And a lot of it is you’ve done a lot of work with definitely populations that are at higher risk, that are less well-served and need more support because they’re vulnerable populations at healthy steps. And maybe you could talk a little bit about healthy steps and what that program is, but also just when we can inform parents about the science, they become more agent full in their ability to make choices and also feel validated in certain ways that they choose to parent already.

Dr. Miguelina (27:24):

Yes. So I was the director of Healthy Steps at Montefiore Medical Center, which is a large medical center in the Bronx. And it really is, it’s a program which exists in your pediatrician’s office, and we place what we call a healthy step specialist who’s trained in child development. And in our particular program, we also made sure that our healthy subspecialists had mental health backgrounds because of the particular needs, like you said, of our population in the Bronx. But basically the healthy subspecialists works with the pediatricians and the other staff to help identify families who may need that extra support to manage parenting challenges like feeding behavior, sleep development. But I think one of the examples that always stays with me with respect to attachment is among immigrant families who come to the United States, it’s actually a very common practice to leave your infant or toddler in your country of origin, typically with the baby’s grandmother or grandparents.

(28:58):

And the idea is, I’m going to come here. I’m going to work really hard, I’m going to save money, and then I’ll bring my child back to the states when it’s time for them to go to kindergarten. Many of these parents don’t realize that attachment happens within that critical first year of life. And I cannot tell you, I mean just generations of parents and children who had difficulties with their bond because the young child got very attached to their grandparents as attachment theory would predict and didn’t really spend a lot of time with their own parent. And then they were brought here and it was like they lost their primary attachment figure. And all of this was done with the best of intentions, but I have seen this cause problems for really over the child’s lifespan. And the parent also feels kind of bewildered and unappreciated. Why is this taking so long? I understand we didn’t know each other that well, but it’s been a few years now. And so now what we do is we try to explain to immigrant parents about that first year of life and how important that attachment timing is in an effort to just help them make a decision that hopefully they can take that information into account because they are trying to do what’s best for their children.

Dr. Sarah (31:00):

It’s really interesting because that was a lot of what I wrote in my, so I wrote my dissertation on a very similar topic. So my dissertation looked at the migration experience among first and second generation and Puerto Puerto Rican migrants to the US and then had a control group of Puerto Ricans that didn’t leave. But I was looking specifically at does the process of separating from significant caregivers or I would say the process of migration, which puts you more at risk for separating from significant caregivers. And certainly in what you’re describing too, there’s serial migration where you actually potentially have multiple separations. If your parent leaves, that’s the first separation, and then you attach to the grandparent and then you leave to go be with the parent. And now you’ve separated twice. You’ve had two significant attachment ruptures.

(31:57):

So I mean, that makes total sense to me. And I’ve always been very interested in the sort of this idea of ambiguous loss. A lot of times we don’t necessarily think of moving to a different country as a loss or grief, but just because nobody’s died. But when you separate from a significant person in your life, there’s so much grief attached to that, and it can really impact attachment and the blueprints that we make and then use later on.

Dr. Miguelina (32:38):

I mean, I think one of the, and you and I are really nerding out today, but I was so pleased that the DSM five, which for your listeners, that’s how we diagnose the folks we work with, that when it came to post-traumatic stress disorder, they have now a section that is separate for young children. And being abruptly separated from your caregiver puts a child at risk for developing trauma. And just that recognition in our field, I think speaks to how attachment has finally been recognized and is being acknowledged and respected in terms of its power for young children.

Dr. Sarah (33:37):

And I think educating families that you work with, for example, that okay, my guess is a lot of the time you’re not catching them before they’ve made the decision to separate. You’re catching them after they’ve reunited with their kid who’s now three or four years old. And so that attachment rupture has already occurred. And to be informed about this after the fact can be really difficult, I would imagine to hear that like, oh no, I made this decision and in the moment was to help my family and to support my child’s future. And in the course of actions I took, I actually set them up for something really challenging. And I wonder if you could talk a little bit about how we support families after that, not the end. We know this is a huge misunderstanding about attachment, which is that it’s fixed, and if it’s broken, it can’t be repaired.

(34:30):

And so when you have a mother who’s been reunited with a 4-year-old child who’s having a really hard time connecting with this mother, and the mother is, then that creates that dance of if she doesn’t understand why she’s expecting this warm welcome because she’s an adult, she’s already able to hold that child in mind for the last four years, but they haven’t been able to do the same. And so there’s this mismatch of needs in this moment, and that can also make things way more messy. But in helping a family kind of repair those bonds, what are some of things that families can do that’s been successful?

Dr. Miguelina (35:08):

Well, I think the first thing is to help the mother understand that everybody’s feeling rejected right now, right? You’re feeling rejected by your child. Your child is feeling rejected by whoever they left behind. Your child is also feeling incredibly confused and angry, and you did not do anything wrong on purpose. So it’s almost like the typical response I’ve seen from parents is anger and frustration with their child. And once I’m able to provide that education that often those feelings morph into guilt. So then it’s really about holding this parent’s guilt and reminding them, you did not do this on purpose. You really did this to really try to give your child a better life and your family a better life. And then working on self-soothing for the parent, helping them regulate. And then it’s really about, okay, how do we create the bond now? And so much of that again, is what we would counsel parents with young kids to do. It’s through play one-on-one time, the physical touch. Many of the interventions that we would counsel at the time of attachment are what we would want a parent with an older child to do. But I think that the challenge first is just orienting the parent as to why your child is behaving this way.

(36:50):

And then helping them through their own feelings of guilt and grief. Because you’re right, they’re kind of expecting like, Hey, I work so hard and look, you have your own room and you’re going, you’re going to have this amazing life. And then they don’t get the warm welcome that they were hoping for.

Dr. Sarah (37:16):

And they have to grieve that. And it’s so interesting because I think attunement and really truly being able to, Dan Segel calls it mind sight, but your ability to hold in mind what another person is truly experiencing that is so critical for attachment to occur.

(37:42):

And so it’s so interesting. I think, yes, we can give parents all these strategies for creating this positive experience with one another and these pleasurable, delightful moments. We know that delight in your child is actually a very big predictor of a secure attachment, but before you can get to delight and play and special fill time, you have to really rewrite the narrative because when a parent’s narrative is, I did all this for my kid and they’re ungrateful or they won’t listen or they just won’t do what I want them to be doing right now, and I had this fantasy of them coming back to be with me and it’s being ruined, that meaning that they’re making of this experience is a massive barrier to attunement and to mine site. They can’t hold their child’s experience and mind. It’s not accurate. So getting those dials synced back up with the right story, I think is the most important thing.

Dr. Miguelina (38:51):

It goes back to perception, right? This is like we are nothing if not the study of perception, and we know how powerful one’s perception of another’s, especially our children’s and behavior can impact our parenting. And so that’s in part what I meant about helping the parent grieve, acknowledge their guilt and be able to process their grief. Because if not, if you don’t help the parent do that, they will not be able to develop the skill.

Dr. Sarah (39:33):

No. Or they could do the skills, but it won’t do anything. You can practice these skills, but if you internally hold that narrative still to be true, the skills fall flat.

Dr. Miguelina (39:49):

Yes, it’s you won’t

Dr. Sarah (39:51):

Really delight in the one-on-one time with your kid, and they’ll feel it and you’ll get frustrated and they’ll feel it and they’ll get frustrated and you’ll get more frustrated. It’ll just be icky. It doesn’t work. We have to repair that core connection first and the story of the relationship first, which I think is like, yeah, it’s so amazing that you do that piece that I feel like is it’s step one, but it’s like everything has to follow that, and that’s where you stay until it’s done. And once that part’s actually effectively been done where the story has been rewritten, then all these other tools and strategies can work. But if you skip that step, it will never work.

Dr. Miguelina (40:36):

Correct It, it would be a huge barrier to the healing process. You’re reminding me of how when I first applied to graduate school and I knew I wanted to work with children, and then I quickly, once I started realized, oh, I’m actually going to be working with adults, they’re just called parents. You can’t be effective in working with kids if you don’t work with parents as well.

Dr. Sarah (41:08):

Yes. And just to tie this back to our original topic of cultural differences, if you are working with a child or a parent and you aren’t looking at the larger family system and then placing that family system within a larger cultural context that it exists inside of our field has had historically a slightly bad habit of taking a single individual and trying to heal them, but individuals do not heal as a silo. Even adults who are supposedly grown up and out of their family system, everything comes back to centering it in inside of a relationship.

Dr. Miguelina (41:58):

Yes.

Dr. Sarah (41:58):

And that relationship lives within a family system, and that family system lives within a cultural system. And you cannot disentangle that. You cannot, can’t sever that reality.

Dr. Miguelina (42:09):

We live in a context, and I think it’s just easier when you work with children to understand that because you would never leave a child by themselves. You just instinctively understand that children are greatly influenced by their parents, and then they’re greatly influenced by their friends as they become older. It’s just instinctive to know that and understand that. So to really be able to help a child who is struggling, you have to make the effort to understand that context and that context comes with a particular culture.

Dr. Sarah (42:56):

And bringing that into the room, the therapy room, either bringing in the parents, having family sessions or figuratively, but bringing it in by having it be part of what we’re thinking about and understanding in the room in real time. I don’t know. I just think it’s so important.

Dr. Miguelina (43:20):

It is. And so in my, sometimes families seek me out because they know I speak Spanish or they know I’m Latina. Sometimes what can come up is I’ll talk about a cultur of stress, which is this idea that you had a particular set of parenting norms in your country of origin, and then you moved to the United States, and we have different norms than your country of origin’s, norms sometimes. Sometimes they’re the same, sometimes they’re different. And that creates stress for parents. And I name that. I give that a name. Let’s talk about that. Because we know the higher the parenting stress, the more likely they are to struggle with parenting overall. So I’m always conceptualizing how to help reduce parental stress.

Dr. Sarah (44:30):

Yeah, because if you can support a parent, you’re supporting the health of the family system.

Dr. Miguelina (44:37):

Absolutely.

Dr. Sarah (44:39):

It’s all connected.

Dr. Miguelina (44:40):

So really, I work with parents. I know once in a while I see the kid, but it’s really about working with parents.

Dr. Sarah (44:47):

It’s funny, I started out, I went through so many phases of this where I was, at first I would work with kids and I’d be like, just give me the parents, let me work with the parents and this will be so much easier. And then I went through a phase of only working with parents, and then I was like, there’s a missing piece. I got to get the kid in here. I got to, I need the kid. And now I’m actually a kind of come full circle and I’m like, I actually really need, I’m enjoying so much more working with kids in the room because I flipped it. I don’t know. I mean, I still love doing parenting support, but I’m finding more joy in working with the child and the parent together, diadic like parent child and more family systems work. It’s just been moving into that space more and it’s been really cool. I used to be like, nah, just give me the parents. We could do so much just if we could just talk it through together in our minds, because we can intellectually go there together and say things we’re not be able to say in front of the child. And I still need those parenting sessions to be able to do the parent child dyadic work that I like to do. But it’s like when you’re really in there together with a kid and you’re just following them in real time, so much magic happens.

Dr. Miguelina (46:14):

Agreed. No, it’s ideal, I think to be able to do both types and the dyadic piece, plus working with the parents alone as needed. And like we’re saying, every family’s unique and different and has different needs and also has different availability.

Dr. Sarah (46:33):

Right. No, it’s true. I mean, tend to kind of do whatever works with the particular family I’m working with, but it’s just interesting. I used to say I would much prefer to work exclusively with the parents and now I’m changing all over again.

Dr. Miguelina (46:50):

Yes, yes. And I’ll also say if you’ve ever had an experience with your own parenting where maybe you just did something that the pediatrician had not recommended and you just felt a little alone and maybe unsafe to ask that question. And I’ll give you a really good example.

Dr. Sarah (47:16):

Oh yes.

Dr. Miguelina (47:17):

Every pediatrician is like, and I’ve had actual pediatricians who are from other countries or other parents just say, my mother will kill me if I try to put the baby in the crib alone. So there’s real cultural differences that sometimes parents, I think feel ashamed to bring up and talk about and discuss. And that doesn’t mean I’m endorsing co-sleeping, I’m just saying I don’t like shaming parents from asking these types of questions when it relates to cultural differences. And I think that can happen very easily when you feel like a minority.

Dr. Sarah (48:15):

Yeah, I think there’s a lot of fear when you’re a minority, because even if your doctor is also, even if you went to a pediatrician who is the same cultural identity is you, they are participating in a different system where I know a lot of pediatricians who on the books will say, I cannot recommend co-sleeping, but off the books will be like, well, there’s lots of ways to do it safely. I just am not allowed to say you can do it. Exactly. And so I think that’s a huge disservice to parents, and I understand the limitations and the liability, and nobody wants to be responsible for something awful happening. And there are safe ways to co-sleep. There are unsafe ways to co-sleep.

Dr. Miguelina (48:54):

As well, right.

Dr. Sarah (48:54):

And I think that’s really a good point. This was so fun talking with you. If people want to connect with you, learn more about, because you have a private practice, if they want to learn more about working with you, how can they connect with you?

Dr. Miguelina (49:11):

Oh, they can check me out on my website, which is just drmiguelinagerman.com.

Dr. Sarah (49:21):

Okay, awesome. We’ll link that too in the show notes so people can easily find it. And thank you so much.

Dr. Miguelina (49:28):

Thank you. This was wonderful. So wonderful. I appreciate you having me on.

Dr. Sarah (49:38):

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