380. Orchid and dandelion children: How sensitivity shapes children’s health, behavior, and resilience with Dr. W. Thomas Boyce

Dr. W. Thomas Boyce (00:00):

It was surprising because we had basically described a psychophysiologic phenotype of high reactivity, and we anticipated that those kids were going to be going to have trouble going to have more illness and injury under conditions of high stress, but we completely missed it, that those kids might have actually better outcomes than the majority of the children when they were in the right kind of conditions.

Dr. Sarah Bren (00:36):

Some children seem to feel everything more deeply. They are more affected by stress, transitions, criticism, and change, and parenting them can feel both beautiful and also overwhelming. On today’s episode of Securely Attached, I have the honor of being joined by Dr. W. Thomas Boyce, a pediatrician, researcher and author of The Orchid and the Dandelion, a book that has reshaped how so many parents and practitioners understand sensitivity in children. In this conversation, we explore why some children are biologically more sensitive than others, and how that sensitivity can become either a vulnerability or a profound strength depending on the environment around them. Dr. Boyce shares decades of groundbreaking research that led to the concepts of orchid and dandelion children, and we unpack what sensitivity really is and how stress and environment shape children’s health and behavior, and why the very kids who struggle the most in difficult conditions are also the ones that often thrive the most in supportive ones. So if you are parenting a child who feels everything or if you were that child yourself, this episode offers a compassionate and science-based lens that replaces fear with understanding and pressure with clarity.

(02:04):

Hello, Dr. Thomas Boyce. I am so thrilled to have you here today. Thank you so much for coming on the show.

Dr. W. Thomas Boyce (02:18):

I’m delighted to be here, Sarah.

Dr. Sarah Bren (02:22):

I’m really nerding out right now getting to talk to you. I love your work. You have, your work has really shaped a tremendous amount of what we understand about children’s sensitivities, children’s unique experiences and development, and I’m just really excited about this conversation. I think it’s going to really resonate with a lot of parents who listen to this show. I think a lot of parents who listen to this show might identify with having an orchid child.

Dr. W. Thomas Boyce (02:50):

Or be one.

Dr. Sarah Bren (02:51):

Or be one. Yeah, absolutely. Maybe we could start out, so first of all, you literally wrote the book on this, but not just the book. This book was a culmination of decades of really rigorous scientific research. So in distilling that all down into a very little bit, could you maybe just explain to families who are listening, what is this work that you’ve done and what is an orchid and a dandelion child?

Dr. W. Thomas Boyce (03:25):

Okay, if I may, I think it’s helpful to back up just a little bit and kind of talk about the origins of the idea at least a little bit.

Dr. Sarah Bren (03:38):

Absolutely.

Dr. W. Thomas Boyce (03:39):

And 50 years ago, it seems unbelievable, but it was 50 years ago, I was a postdoctoral fellow at the University of North Carolina, and I came under the influence of a remarkable South African epidemiologist by the name of John Castle there. And John had spent, he was an md, he had spent a lot of time, a lot of his professional work was done in the Zulu homeland, the homeland of the Zulu people. And he had realized through that work that all of the things that we typically think about as the origins, the determinants of disease, things like pathogens and toxins and exposures of one kind or another, physical exposures, that those were clearly important, but at least for certain populations, far more important, were the kinds of social adversities that people experience. And of course, these Zulu people living in this homeland, isolated on kind of a reserve in South Africa, were subject to tremendous amounts of adversity and a whole variety of different forms.

(05:13):

And he began formulating this theory that these kinds of social adversities were often determinants of health and wellbeing as well. And I listened to what he had to say. It made sense to me. It certainly made sense to me as a pediatrician. I had seen families where there were nothing but healthy kids, and I’d seen families where there were lots and lots of illnesses and injuries and chronic disorders of one kind or another. And it was clear that these kinds of experiences, and in kids, I’m talking about things like being bullied at school or having a parent with a chronic illness or whole variety of kinds of things that families and young children go through. And it became clear to me that in observing these families, that these things were actually etiologic and the kinds of disorders and diseases that their kids were sustaining. But it also became clear that there was a tremendous amount of variability in that it turns out that two thirds of children and youth growing up today experience some kind of major adverse childhood event, so-called ACEs. So it’s a highly prevalent sort of experience, and it’s more prevalent in the lives of certain children relative to other children. But when I began looking at this, it became clear that there was a lot of noise in this connection between adverse childhood events and diseases of one kind or another that children sustained.

(07:27):

And so the question then became, could we fine tune the measures that we were using epidemiologically? Could we fine tune them in a way that would tighten that association? So it was always significant. It was always not likely to be due to the effect of chance alone, but it was always a noisy association. And was there a way that we could tighten that up? And we decided that maybe what was going on was that some children were more reactive or responsive to the effects of these adversities than other children. So we took that idea basically to the lab, and we started testing children under conditions of mild stress, mild adversity, where they were interviewed by a person that they hadn’t known before, or there was a fire alarm that went off in the middle of the interview, or we put a drop of lemon juice on their tongue. All of these things are relatively minor stressors, nothing that would make a child or anything like that. And then during these sessions, we would measure parameters that would tell us about the activity of the autonomic nervous system.

Dr. Sarah Bren (09:06):

The fight or flight response, basically.

Dr. W. Thomas Boyce (09:07):

The fight or flight response. And so we could actually make concrete the measurement of these responses that children were making to these mildly stressful tasks. And lo and behold, we found that while most children had relatively diminished just modest responses in their autonomic nervous systems to these interviewing stressors, that there was a subset of kids that, and usually about 20%, about one in five who had these hyperdynamic really strong neurobiological responses to these things that we were asking them to do. And so then we had a concrete measure that we could then take and under controlled conditions with all the children having the same experience, we could take those measures and transport them into epidemiologic study designs where we looked at naturally occurring adversities in the lives of kids. And we now knew that in the lab what their autonomic responses looked like. So we could then use the combination of these naturally occurring adversities and if you will, naturally occurring reactivity of these kids and look at those things together.

(10:46):

And we found, first of all, that what we had expected, which was that kids growing up in conditions of stress when they were high reactive kids, when they had lots of autonomic responses to these laboratory controlled minor stressors, they had tremendous increases in the rates of their respiratory illnesses, their injuries, their behavior problems, all of these different kinds of pediatric morbidities. So that was really what we had planned to find and really was what got us the funding to be able to do the research. But what we found that was not expected, and that was really highly unexpected, and it was sort of a mystery to us at first, was that some of these kids with high autonomic reactivity when they grew up in families where there was lots of predictability, very low stress, very low adversity experience, they didn’t have just normative levels of pediatric morbidities. They actually had lower.

Dr. Sarah Bren (12:12):

So they did better than everyone else.

Dr. W. Thomas Boyce (12:15):

Yeah. These were kids who had either the worst outcomes or the best outcomes of all the kids that we studied, depending upon the kind of context in which they were being reared. So we puzzled on that for quite a while. And I remember presenting these data down at Stanford one time, and this old Swedish biologist came up with his gnarly cane up to me after I had talked and pointed the cane at me and said, you’re talking about musk crowbar? And I said, I’m talking about what he said, Musk cross barn. And there’s a Swedish word, musk cross barn, which means dandelion child. And by this, the Swedes mean that there are children who dandelions can grow up anywhere. Dandelions do well in fertile mountain fields, they grow in the sidewalk cracks, they grow out of brick walls, they grow anywhere. And he recognized that this Swedish sort of neologism was captured very well, the kids in the middle of this distribution of reactivity that had the same level of illness and injury regardless of the kind of adversity that they had experienced.

(14:03):

So we said, okay, those are dandelion children. Well then who are the kids at the end? And we thought, well, those must then be orchid children following the metaphor. So orchids in contrast to dandelions have their plants of exquisite beauty and have remarkable biological botanical lives, but they have to be very carefully taken care of. So we came up with this dichotomy between orchid and dandelion, and it seemed to us that it was a fitting metaphor to describe these kids who have lots of reactivity to and under conditions of adversity, they have high levels of illness under conditions of low adversity. They have exceptionally low levels of adversity. Very long-winded explanation, but that’s where it came from.

Dr. Sarah Bren (15:07):

But I love that so much, and it paints such a beautiful picture. So first I want to just distill some of this. What I took from this, and translated a bit in case people had a hard time following the science piece, but what I’m understanding is you basically were like, Hey, we can tell that really sensitive kids tend to struggle more than kids who aren’t so sensitive, but we need to be able to scientifically isolate those variables so we can really show that it’s a causal effect. So you did this laboratory setup where you were able to isolate those variables, get baseline read, and with all that really careful scientific orchestration, you’re able to show, yes, there is this very scientifically, statistically significant predictive outcome, that high sensitivity kids have higher reactivity and in poor outcomes in highly stressful environments or in response to trauma. But what you didn’t realize was that those same kids, those same subgroup of highly sensitive kids were actually also because the logic there would be oh, so that the kids who are kind of roll with the punches, I’m lower reactivity, I am flexible. I’ve got a higher tolerance for a lot of stuff that those would have the best outcomes.

(16:29):

But really they’re the middle of the bell curve. They have the most predictably fine outcomes in good or bad situations, hence dandelions, they’re cool flowers, they’re awesome. They serve a wonderful purpose, and they are never going to, rarely are going to live in these exquisite extremes. And that these orchid children who are often probably categorized or at least identified by their high sensitivity and poor outcomes, because that’s what gets the red flags. That’s why you got the grants we need to figure out what’s going on with these kids that are struggling, but they’re the same subset or the same kids with that same degree of highly reactive physiological neurobiological sensitivity when in the right context, when cared for with the really good, I’m use words that I would use from an attachment perspective, but a highly attuned environment that meets the needs of the child and can see them and support them in probably somewhat creative and unique way because they need more. They did the best, they had the best health outcomes, they had the best life outcomes.

Dr. W. Thomas Boyce (17:55):

Yes, that’s exactly it. And it was surprising because we had basically described a psychophysiologic phenotype of high reactivity, and we anticipated that those kids were going to be going to have trouble going to have more illness and injury under conditions of high stress, but we completely missed it, that those kids might have actually better outcomes than the majority of the children when they were in the right kind of conditions.

Dr. Sarah Bren (18:28):

And I definitely want to ask you about how do we find those conditions? How do we help make the environment meet the needs of the child, whether they’re a dandelion or an orchid? That’s important, I think, because a good takeaway for parents. But could you talk for a second about why are the orchids so porous? What is it? There’s something about them, they soak up their environment, they’re highly attuned to the world around them. What’s going on there?

Dr. W. Thomas Boyce (18:56):

Yeah, I mean, the other metaphorical way of talking about is they’ve got thin skin. They are more permeable to the environmental experiences that they have. And we don’t know exactly why that is. It’s not likely the autonomic reactivity that we measured because that’s just a sign of it. That’s not the thing in itself. It likely has to do with differences in brain circuitry, maybe in the emotion prefrontal cortex circuitry. We don’t actually know why it is that these kids are more sensitive, but they’re sensitive in all kinds of different modalities. These are kids whose feelings are more easily hurt. So they’ll take the comment of some other child more personally and more sensitively. They have taste aversions, so they taste things more vividly. They sometimes have aversions to bright light. So it’s both psychologically and physically that they have, there’s this sort of sense that they have high sensitivity in all areas of their being.

Dr. Sarah Bren (20:31):

But at the flip of that, I see how it kind of makes sense now that you would think that these kids would be as acutely sensitive as they are, that it could be their kryptonite, but it could also be their superpower. So the kid who’s just so highly sensitive to social hurt might also be profoundly empathic and profoundly have such a high social intelligence because they can just like their emotional, their sensitivities, allow them to be deeply hurt by another person. They also could, their empathic capacity is probably incredibly high as well.

Dr. W. Thomas Boyce (21:14):

Exactly.

Dr. Sarah Bren (21:14):

There’s two sides to that coin.

Dr. W. Thomas Boyce (21:16):

So they become wonderful friends. They become peacemakers within social groups. They’re remarkable children who are both vulnerable and exceptionally resilient.

Dr. Sarah Bren (21:33):

Yeah.

(21:33):

I hope you’ve been enjoying my conversation with Dr. Boyce. I wanted to jump in quickly because if this episode is resonating with you and you are parenting an orchid type child, you’ve probably already noticed that generic parenting advice often falls flat with your unique kid. And that’s exactly why I created Parenting By Design, my guided program for helping parents support emotional and behavioral regulation in their sensitive children. In the program, I walk you through how to understand your child’s unique nervous system so you can recognize what’s happening for them before, during, and after their most dysregulated moments. You’ll learn how to adjust your responses and expectations based on your child’s temperament, sensitivity, and stress response instead of trying to force strategies that don’t fit or just end up making things worse. So if you’re interested in getting step-by-step support for parenting your unique child, you can learn more about parenting by design in the episode description, wherever you’re listening, or by heading to drsarahbren.com/parentingbydesign. That’s drsarahbren.com/parentingbydesign. Okay. Now, back to my conversation with Dr. Boyce.

(22:54):

I mean, there’s research obviously on the highly sensitive child, there’s the explosive child. Are these all the same kid in different names or are there differences across these sort of taxonomies, if you will?

Dr. W. Thomas Boyce (23:19):

Well, I suspect that Elaine Aaron’s work on the highly sensitive child. I suspect that she was coming at exactly the same phenomenon from a psychological viewpoint that we were coming at from a more of a psychophysiologic biological standpoint. So I’m not sure that those two constructs describe actually different phenotypes, but the highly sensitive child, the orchid child in our metaphorical way of referring to them, they also have characteristics that overlap with other kinds of phenotypes and if you will, diagnoses. So for example, I was in contact with a mom the other day, actually, a grandmom who has a grandchild who is autistic, has been diagnosed with autism spectrum disorder. And there are certain characteristics of autistic children sometimes that overlap with our view of orchid children, this kind of high sensitivity to taste and to certain kinds of experiences, their sensitivity on the positive side to things like family routines, which are kind of the predictable aspects of family life. Those are true of autistic kids, and they’re also true of our so-called orchid kits. So there are ways in which these are overlapping circles in various ways, but a good way of referring to our orchid children is a highly sensitive child.

Dr. Sarah Bren (25:18):

And I find this helpful in my work because I’m often trying, I mean, I have a self-selecting group of people who come to me for therapy. They don’t tend to come to me when things are going just super smooth and fine. They usually come when there’s something that’s starting to interrupt the flow of family life and people are having distress. And so a lot of the kids I tend to see in my practice are probably orchid kids, but I also probably see a good amount of dandelion kids that are just dealing with a tremendous amount of stuff happening or just developmental hiccups. But do you think that most kids who might carry a neurodiversity diagnosis like, we talked about autism spectrum disorder, but even ADHD or kids who have anxiety disorders, we know that maybe kids who are orchids are more likely to have those diagnoses. But I mean, dandelions can have those diagnoses too. So how do we make sense of that?

Dr. W. Thomas Boyce (26:29):

Yeah. Well, I think one distinction that it’s important to make is that orchid and dandelion are not diagnoses. These are not found in the DSM five. But having said that, there are certain characteristics of kids with other diagnoses that overlap with the characteristics of work at children or dandelion children.

Dr. Sarah Bren (27:00):

In my practice, I have kids who diagnostically present incredibly different. For example, I’ll have a kid who has ADHD and maybe really struggles with keeping their body under control and impulsivity. So they’re like, they just have this, I call it a Ferrari motor with tricycle brakes. Everything’s really intense for them. And the way I see a lot of those kids is in terms of nervous system regulation, I really look at a lot of my treatment with families, whether I’m seeing you for dysregulated behavior or I’m seeing you with a kid, for example, who has really intense separation anxiety, and they’re actually really inhibited totally different from that super rambunctious kid that can’t sit still. But both of those kids often struggle with regulating their physiological experiences. And the anxious child is disinhibited in part because they’re so flooded with a fight or flight response. And the behavior we see looks different because the inhibition is actually locking them in, whereas the kid who’s disinhibited looks explosive, looks like they’re all over the place, but they’re also dysregulated. They’re super sensitive to this really intense idea or feeling anger or frustration. But I do often see, even though these kids diagnostically look different, behaviorally look different, I’m still looking at nervous system regulation as how do I understand this kid? How do I help a parent understand how to support that kid?

Dr. W. Thomas Boyce (28:51):

Yeah, it is a nice illustration of how the same neurobiological phenomenon can express itself in very different ways depending upon other aspects of the child’s personality and neurobiology. It can be the same fundamental issue that is down deep in there that expresses itself both as behavioral inhibition and as an externalizing kind of kid. It’s also, I think, important to say, Sarah, that there are no invulnerable children. So while we talk about this broad group of kids in the middle of the reactivity spectrum as dandelion children, in fact, if any of those children are subjected to a sufficient amount of adversity and stress and awful things in life, they’re going to have brokenness in one way or another. So it’s important that we don’t think of those kids as having a kind of invulnerability because they don’t.

Dr. Sarah Bren (30:16):

Yeah, I think that’s so important. And it’s also, you make this point at the end of your book too, where you’re like, listen, the things that help the orchid kids that in fact they must have in order to thrive, benefit all kids. So we as a society could do well to just raise the bar to meet the needs of these more sensitive children a little bit more and increase their access to environments that fit. So trauma informed care, highly trained educators, paid family leave, so parents can be with their kids and do that attuning and be helping them through these life’s ups and downs. These are all like, everyone’s going to benefit from this.

Dr. W. Thomas Boyce (31:08):

Or federal policies that don’t assault children, which is where we are now.

Dr. Sarah Bren (31:15):

Yes. I mean, it does. On one hand, it can be very, I could see a parent reading this book or realizing all my kids a dandelion or an orchid I should say, and thinking, okay, so I think on the one hand, it can be kind of stressful to be like, oh gosh, is every single thing I do make or break for this kid? What about all the things I can’t control? They can’t control if they get bullied in school, I can’t control if they have a really horrible boss one day. I can’t control a lot of the stuff. Or we also don’t want, we know that parents play a role in creating a healthy and supportive environment for their kids, but the kid is the kid. And so how do we give parents a sense of agency? What can parents do to support their orchid child without feeling like everything rests on them? We don’t want to encourage parents to hover and enclose them in glass either, because we know that’s not great.

Dr. W. Thomas Boyce (32:37):

Right. And it’s a fine line to walk, isn’t it? As a parent, I’m the father of two grown up kids, one of whom was a dandelion, one was an orchid. And there’s both the difficulty of everything that you need to do for one child, you don’t need to do for the other. But there’s also the issue of you don’t want to insulate this kid from the world. And so the example that I use is the orchid child who decides at the last minute that she doesn’t want to go to a party, a sleepover party at a friend’s house, because it’s just too fraught. It’s going to be too much. So you’re confronted as a parent with the issue of, do I exceed to that? Do I say, I understand you don’t have to go, it’s fine. You can stay home. Or do you say, this is something that, these are the kinds of challenges that the world presents us, and you need to go ahead and do this and prove to yourself that you can do it. And often those experiences are experiences of victory, of finding that I can do something that I didn’t think I could do. So that’s a tough decision as well.

Dr. Sarah Bren (34:23):

It is, and I think you make an important point, and I very much agree with it that it’s this sweet spot, and I am not sure if you’re familiar with space, the supportive parenting for anxious childhood emotions. It’s a therapeutic modality that came out of the Yale Child Study Center by Ali Liebowitz, but it is specifically about child anxiety and OCD, but I think it is very useful in lots of different types of cases of childhood rigidity, usually because of a sensitive system. But this idea of if we over accommodate the desire to avoid something, we can inadvertently maintain the fear.

Dr. W. Thomas Boyce (35:14):

Exactly.

Dr. Sarah Bren (35:15):

The example he’ll often give is, if your kid is afraid of the monsters under the bed and you look under the bed to prove there are no monsters, you are inadvertently showing them there could be monsters under that bed. So the more we accommodate, the more we might be transmitting indirectly a message to our kid, you can’t handle this. This is too scary. I can’t handle you trying it. It could be dangerous. But then on the other extreme, when we sort of push further than their, I often say parents, it’s like the goal is to bend, not break. If we push them past where they can comfortably stretch or bend outside of that tolerable window and say, kind of disregard their heightened sensitivities or their unique needs and say, your brother could do it, so you need to do it, or You never do this, so you have to do it today.

(36:16):

I’m not doing this anymore. It’s sort of more, and it comes from a well-meaning place of you got to go to the sleepover, it’s good for you, and you just need to go that sort of more demanding side of things. And that this sort of sweet spot is, I can validate that it’s really hard. I can name for you that you want to avoid this, and it makes sense because it’s hard to do something that feels scary and confidence that you can handle that feeling. And doing both of that is the sweet spot, and that seems like that middle path tends to be.

Dr. W. Thomas Boyce (36:55):

Yeah, and I think part of that sweet spot is also when an orchid child has tried that has gone to the sleepover party and comes back and has done it to celebrate the victory, to make notice of the fact that this was something that you didn’t think you could do, but you’ve done it.

Dr. Sarah Bren (37:21):

Yes. I always say, you got to log it, help them log it so that it changes the narrative on the inside from, I can’t do this to, oh, well, sometimes I can do this.

Dr. W. Thomas Boyce (37:33):

Yeah. Yeah. One of the surprises from the book has been, I’ve gotten a number of wonderful responses, people writing about their kids and their grandkids and so on. What I hadn’t expected was how many people would write, having read the book about themselves and their own struggles with their sensitivities over decades of life and how they’re still struggling with when do I push myself and when do I withdraw? So this is something that doesn’t go away when you graduate from high school.

Dr. Sarah Bren (38:25):

Yeah. Yeah. I had one question I wanted to ask you too. Is there a sensitive period? Is there a window, you talk in the book a lot about epigenetics. We could get into a little bit here, but there’s this other layer that’s not just like, oh, their sensitive nervous systems in certain kids make them more vulnerable to having really strong reactions to the goodness of fit of their environment, but that it’s not just their nervous system. There’s this sort of very, very cellular level like encoding that’s happening in utero in early years of life. Maybe you could explain epigenetics a little bit, but specifically by question right now, is there a sensitive window or does that sensitivity to changes in the environment changing the genetic coding or the expression of the genetic coding, can that happen throughout life? Or is it kind of like it’s really the early first maybe five years?

Dr. W. Thomas Boyce (39:35):

Yeah, there seems to be, use the developmental psychology term for it. There seems to be a kind of canalizing, a kind of deepening that happens over time. So in our work, and I’m now thinking of some of the studies of my colleague Abby Alcon, also at UCSF, who’s a nursing professor who studied kids reactivity very early in life in the first year and then in the second and third year. And basically what we found was that as kids go through those first few years, their predisposition to reacting in a certain way becomes deeper. It is, it becomes more predictable. So an infant’s reactivity may be quite different a year from now than it was today, whereas a five-year-old’s reactivity, if we test them again in a year is likely to look pretty much the same. So I don’t know that there’s a bookends kind of critical period, but there are certainly aspects of early development that seem to move children in certain ways toward these reactive phenotypes.

Dr. Sarah Bren (41:17):

Got it. And so I guess that makes me think, I’m a big fan of early intervention, and I’m also a really good supporter and proponent of helping parents learn how to really, one, have the bandwidth because they’re taking care of their own mental and physical health and getting their needs met to have the bandwidth to be able to attune to their children and really be able to accurately decode the cues their kid’s giving them, regardless of whether the kid is a dandelion or orchid, we got to be able to read our kid. And that attunement our capacity to attune to our child, get what they’re needing, which usually is expressed in very convoluted ways when they’re little hard to necessarily understand. But that is going to be predictive of more secure attachment relationship. And we know that that is like a child’s, the quality of a child’s attachment with their parent is sort of identifiable as early as 10 to 12 months of age, and it doesn’t really tend to change that much over time. But of course, there’s all these sensitive periods of development, I always call it, it’s a blueprint, right? And the blueprint, what goes on that blueprint is information from these early relationships with our parents, but then also there’s Mylar sheets that go back on top of the blueprint, and a new edit goes when your kid goes to kindergarten or starts to school and new information gets added to this blueprint. And when they going into adolescence having their first romantic relationship, all these relational experiences can change the attachment system. I’m assuming it’s similar for this.

Dr. W. Thomas Boyce (43:14):

I think it is. And actually what you just described is a beautiful way of talking about genetics and epigenetics genetics.

Dr. Sarah Bren (43:25):

Well, thank you. I do not presume to be an expert on epigenetics, although the way you would describe it in your book really helps me understand it better.

Dr. W. Thomas Boyce (43:34):

Yeah. I mean, epigenetic epi means on top of, and you just described a blueprint with a Mylar sheet that goes on top of it, and that’s exactly what happens with the genome. There is this underlying blueprint that changes very little over time, but what does change over time is the set of overlays of things that go on top of the genome that regulate how often and how extensively a certain gene is expressed. So if the blueprint, I don’t want to carry this metaphor too far, but if it’s a five bedroom house and the occludes two of those rooms, you’ve got a three bedroom house. So the epigenome is what allows there to be variability in the expression of the blueprint of the genome that underlies a lot of who we are. I like to think of it as the place where the external world touches the internal self. The DNA is touched by the experiences that kids have in early life, and those get translated into epigenetic changes that regulate the expression or non expression of genes.

Dr. Sarah Bren (45:18):

That is so interesting. So in terms of how that relates to whether a child shows orchid qualities or dandelion qualities, how can we use this description of epigenetics, this idea of this overlay that basically tells a child’s DNA, which is decided the second those cells started replicating into a baby way, oversimplifying that process. But that DNA, that’s really hardwired and not changing the experience of that embryo and utero or that child from birth onward interacting with touching the environment in these moments, it’s changing. It’s editing the overlay on top of that genetic structure that determines how reactive they are or other types of things.

Dr. W. Thomas Boyce (46:22):

Yeah. That’s what we think is that these experiences of early life, along with the kind of underlying structure of the genome itself are the things that together affect the sensitivity and the reactivity of a given child now. But it’s important, as you pointed out 30 minutes ago, that we don’t actually know what it is that creates the sensitivity. We know that it’s in the brain and it has to do with these genome epigenome interactions in the neurons of the brain. But we don’t know precisely where that actually happens and how it happens.

Dr. Sarah Bren (47:12):

But we probably have certain environmental patterns that are either protective or maybe less protective. So what are some of the things, obviously there’s going to be things like trauma, things like really, really intense scary events or chronic illness or things that are just like capital T traumas that we know are going to be epigenetically informing the expression of that child’s sensitivities later in life.

Dr. W. Thomas Boyce (47:52):

Yes.

Dr. Sarah Bren (47:54):

Are there subtler ones?

Dr. W. Thomas Boyce (47:55):

I think there, are.

Dr. Sarah Bren (47:56):

Are there things that parents might want to be aware of that might be more or less in their control?

Dr. W. Thomas Boyce (48:01):

Yeah. One of the things that we have been able to do in our own research is to really study in depth the characteristics of families where they have an orchid child, a child who’s highly sensitive, highly reactive to the environmental experiences that he or she has, and to study what are the characteristics of families where the outcome for those kids are very positive versus circumstances in which they’re not positive, where they’re having lots of illness. And I describe in the book a sort of mnemonic that arose from these really kind of descriptive studies of families where orchid children have grown up and flourished, and there are six sort of characteristics of these families that we organize into this mnemonic orchid, O-R-C-H-I-D, conveniently enough. But those are, the O is for one’s true self families, where there is a predisposition to let the child’s expression of himself flourish and to be open to that self, allowing the child to become who he or she wants to be.

(49:37):

The R is for routines, and we talked about this earlier, that family routines kind of the stable structure of day-to-day, week-to-week life seems to be helpful to kids. The C is for the Latin term caritas, which means attentiveness and love, the degree to which the parents just express their deep love for that individual child. The H is for human differences, how parents celebrate and honor the differences between kids. There are families that I’ve seen in pediatric practice where the interest is in making all the kids the same, basically homogenizing the temperaments and personalities of the children, and that’s not as good. It’s better to let kids express these human differences. The eye is for imagination, imaginative play, the degree to which the child is allowed to imagine and to have fanciful play as a way of expressing himself or herself. In the last letter, danger is this thing that we talked about of the approach avoidance of dangerous situations like going to an overnight party that feels aversive to you. So that little mnemonic of O-R-C-H-I-D is a way of thinking about the categories of mundane experience within families that pull for positive outcomes among highly sensitive kids.

Dr. Sarah Bren (51:33):

And just like we were saying, if we can raise the bar to the needs of the most sensitive, what kid is not going to thrive if those things that you just described are compasses inside of a family, you do not have to get it right all the time. But if you have this guiding or a star of these values and these orientations, I guess, to try to do that when you can.

Dr. W. Thomas Boyce (52:02):

Exactly. Yeah.

Dr. Sarah Bren (52:03):

It’s going to be good for every kid.

Dr. W. Thomas Boyce (52:05):

Yeah.

Dr. Sarah Bren (52:08):

This is amazing. Thank you so much. I feel like I could keep you forever. I would if I could and just ask you more questions, but I mean, everyone really needs to read this book. It’s called The Orchid and the Dandelion: Why Sensitive Children Face Challenges and How All Can Thrive. It’s so good. It’s so beautifully written. It’s just like you’re a pediatrician and a researcher, but you could have been like a poet.

Dr. W. Thomas Boyce (52:38):

Well, I wish.

Dr. Sarah Bren (52:41):

If people want to follow your work, get this book, where can we send them?

Dr. W. Thomas Boyce (52:48):

You mean to get the book?

Dr. Sarah Bren (52:50):

Do you have a website or any sort of place where you publish or keep sort of like?

Dr. W. Thomas Boyce (52:57):

No, Sarah, I wish I did. I don’t have a podcast. I don’t have a blog. It’s interesting you say I could be a poet because what I’m doing now is writing fiction.

Dr. Sarah Bren (53:15):

Really?

Dr. W. Thomas Boyce (53:15):

I retired for seven years and doing that kind of writing instead. So stay tuned. That stuff.

Dr. Sarah Bren (53:26):

Yes. Oh, let us know. We’ll share it with our audience because I mean, I feel like the people who really can understand and get inside the experience of a child must write the most incredible characters, so I bet your nonfiction is just really deep.

Dr. W. Thomas Boyce (53:45):

Yeah. Well, I hope that’s true.

Dr. Sarah Bren (53:50):

Well, thank you so much.

Dr. W. Thomas Boyce (53:52):

Thank you. It was a delight,

Dr. Sarah Bren (53:55):

A true delight.

Dr. W. Thomas Boyce (53:56):

Much pleasure.

Dr. Sarah Bren (54:03):

Thanks so much for listening. In today’s episode, we talked about children who are biologically more sensitive to their environments. Kids who feel things deeply react strongly to stress and can struggle more than others when the fit between them and their environment isn’t quite right. And if that sounds like your kid, I wanted to remind you about Parenting by Design, my research-based framework for parents of sensitive, spicy, and strong-willed children. This guided program teaches you to parent your unique child in a way that increases cooperation, diffuses power, struggles, and rebuilds their trust in your authority, all while supporting your child’s mental health and your own. You can learn more and get started by visiting drsarah.com/parentingbydesign or by checking the link in the episode description. I’ll see you back here on Thursday for a q and a Beyond the Sessions episode. And until then, don’t be a stranger.