Australia’s Largest Christian News Site

Erica Komisar is a clinical social worker, author, psychoanalyst, psychological consultant and parent guidance expert who has been in private practice in New York City for over 30 years.

In her address to the Alliance for Responsible Citizenship (ARC) conference in Sydney on October 22, 2024, Komisar discussed the negative mental-health outcomes of institutional childcare in the early years, specifically from zero to three years of age. In her 14-point solution, Komisar echoes many themes that the NCC and AFA have been highlighting for decades.

~~~

I want to thank John Anderson, Philippa Stroud and everyone at ARC for asking me to speak today on the mental health crisis in children and adolescents, both its origins and solutions. The causes of this crisis are multi-variable, however, today I would like to focus on what I consider the most important and underlying cause and its solution.

The foundation for one’s personality and their mental health occurs from zero to three years of age. When this critical period of brain development goes well and children get their irreducible needs met, they have a fighting chance at mental health.

However, when children do not receive what they need emotionally and physically in this period, they will be more inclined towards mental illness.

The mental health crisis in children and adolescents is very real. The Australian Institute of Health and Welfare reports that in 2022, one in seven children in Australia had a mental-health disorder under the age of 18, many of them diagnosed with ADHD, depression, anxiety and suicidality, and only half are being treated.

According to the Australian Psychological Association, the most shocking increase has been amongst the youngest in Australia, from 18 months to five years of age.

There are economic consequences to this mental-health crisis as well. Since 2013, the Australian Government’s investment in mental health and suicide prevention has more than doubled, growing from $3.3 billion to an estimated $6.8 billion in 2023.

Long-Term Consequences

Mental illness is not something children are born with, nor are they born resilient. Children are born neurologically, emotionally and physically fragile. They’re born dependent and in need of sensitive empathic nurturing and attachment security, which is critical to their healthy development.

There is a push in Australia for universal institutional daycare under the age of three to get more women into the workforce as quickly as possible after having a child, and I am here today to tell you why this is a very bad idea for families and that the long-term consequences of this push will harm not only families, but the economy as well.

I want you all to imagine what it’s like to be an infant – you are the size of a loaf of bread, physically and emotionally helpless and cannot even lift your own head or move your own limbs intentionally.

The world you are born into is big and you are small and frightened; you are completely dependent upon your mother or primary attachment figure to provide you with a feeling of safety and security.

Every noise, every new face, every new object is frightening. The world is a scary place, and yet the skin-to-skin contact with your mother – her smell, the soothing tone of her voice and her beautiful eyes – are what keeps you feeling safe.

In fact, infants do not even experience their mothers as separate until around eight months of age – until then, they believe they are the centre of the universe and that their mothers are extensions of themselves who carry them, care for them and protect them.

When a mother leaves a baby in institutional care during this period, it challenges the baby’s necessary belief in omnipotence, which helps them to feel safe. The part of the infant’s brain that regulates stress and adversity is not supposed to be up and running until around a year.

The amygdala, a primitive, almond-shaped part of the limbic system of the brain, helps to regulate stress throughout our lives and helps us to cope with adversity in the future. It is meant to remain offline for the first year and again only meant to experience small, incremental amounts of stress until three years of age.

In most parts of the world, babies are worn on their mothers’ bodies to buffer infants from stress and keep the amygdala quiet until the baby can handle small amounts of stress.

Then, for the next two years, toddlers are kept at their mother’s heels so they can practise independence and explore the world, taking risks while remaining in proximity to their mother.

This period is called the rapprochement period, or emotional refuelling – it allows the baby to explore and develop confidence, practising independence while being able to return to the mother to get a hug or get a glance, to help them to feel secure and continue with their exploration.

At three years of age, children are more capable of being separated from their mothers, which allows them to go to preschool for a limited amount of time each day where they can learn to interact with other children socially. Until three years of age, it is a mother’s presence which shapes the foundation of that child’s sense of security and future mental health.

Fight or Flight

Children who are prematurely separated from their mothers are experiencing high levels of stress, which send their developing brains into the evolutionary fight-or-flight response to danger.

Children as young as two years of age are becoming aggressive, hitting and biting at daycare and at home, as a result of the fight response to fear. They are also being diagnosed at an alarming rate with attentional issues or ADHD, which is the flight response to danger.

According to recent estimates, approximately 10 per cent of Australian children and adolescents have been diagnosed with ADHD and the figure is actually now much higher.

Instead of looking at societal causes of this phenomenon, we’re accepting the symptoms as a sign of modernity and silencing our children’s pain by medicating it away.

The long-term impact of the stimulants used to treat ADHD on children’s brain development is still unknown – what we do know is that stimulants are addictive, can cause growth and other metabolism issues, anxiety, panic disorders, heart issues and insomnia.

We have created a myth in Western society that I call gaslighting – that babies need to be in group or institutional care that society and governments call school and propose is good for children under the age of three, rather than being home with their primary attachment figure.

This myth has damaged many children who develop attachment disorders and pathological defences to cope with being exposed to excessive amounts of stress. They develop learned helplessness and defensive independence, which makes them more fragile and susceptible to breakdown.

Their defences may hold for days, weeks, months and even years, but it is almost inevitable that at some point in childhood or adulthood, they will break down and develop behavioural problems, anxiety, depression, attentional issues, or even worse, personality disorders.

Case Study

Let me tell you a quick story. Jane and George came to see me because their son Max, 18 months old, was aggressive with other children in daycare. He was hitting and biting and often distracted, and had been labelled a problem in the classroom.

Jane and George, who both had intense careers, insisted they could not survive on a single income and spent an average of 90 minutes a day with Max.

I observed Max in his classroom – the first thing I observed was that when his mother dropped him off, he was inconsolable at separation. The teachers and parents colluded to believe that Max will be just fine once you leave.

Max was not just fine. I found Max to be the most vulnerable and sensitive boy who would alternate between the fight-or-flight mode of defence: fight, the hitting and biting, or flight, the distractibility as the evolutionary way we protect ourselves as humans from danger.

Max was too young to be separated from Jane and to be in a group environment with five children to one caregiver. He clearly felt frightened and under attack and his protective response was to attack other children.

Once I established with the parents that Max should not be in a group care situation and that the stress of being separated too early from his mother was causing Max to go into fight-or-flight, I warned them that if he stayed on this current path he could end up suffering long-term from stress disorders such as anxiety, depression and ADHD, or worse, a personality disorder that could lead to self-harm.

His parents found a way to adjust their economic reality to accommodate having one parent at home.

Within a few weeks, Max’s symptoms went away for the most part – he no longer was overtly aggressive and although he wouldn’t let his mother out of his sight for some time, his behavioural issues subsided.

Jane and George were fortunate to be able to accommodate their financial reality, but other families are not so fortunate.

We have traded in our value system, which understood and valued the bond and relationship between a mother and a baby in the first three years, for idealising and fetishising economic growth, career achievement and materialism over the most critical relationship a child will ever have in their lifetime – that of their attachment to their mothers.

When did the GDP become more important than the physical and mental health of its citizens?

In Australia, there is a push to become like the rest of the Western world and neglect your children, just as we do in America. I can tell you it’s a mistake.

Much of the damage we have done to our children is irreparable and will last their lifetime and for generations to come.

Some may be reparable, but because our mental healthcare system is broken, overwhelmed and mistaken in its approach, most of our children will not get the proper care they need and will go on either to opt out of having children themselves, or will have children and neglect them just as their own mothers did.

14 Solutions

So, what’s to be done? This is ARC after all, the organisation that provides solutions to the problems of the world and has a more hopeful and optimistic approach. So, here is what you can do as a government, as a country but more importantly as parents to prevent your children from developing mental health issues.

One: On a personal and individual level, prioritise your time with your children above all else. Don’t rush back to your ‘important’ careers, don’t choose to go out to business dinners and travel for work – rush back to your children and give them your bodies and minds. Be emotionally and physically present as much as possible in the first three years, but also throughout their childhood if you want them to be healthy.

Two: Resist the narrative that work outside the home is more important than family. Educate your own children that education and career are important before you have children, but when you have children, the most important thing is the responsibility you bear for the lives you have brought into this world. Teach adolescents in school about the importance of family through adulting classes that focus on raising healthy children and the importance of relationships over work.

Three: If you as a parent struggle with attachment and can’t wait to get away from your children to go to your ‘important’ jobs outside the home, get help. It is normal to be bored with other people’s children, but not your own. See a therapist who can help you to understand and repair the emotional damage done by your own parents, so you too can be more joyful in your attachment to your own children.

Four: Avoid institutional care for children under the age of three, period. Teach others in your community about the dangers of daycare and the importance of maternal presence and attachment security.

Five: Support a government or party that pushes for a lengthy paid leave for a primary attachment figure for the first three years. Do not support a government that is pushing for daycare or institutional care for children under the age of three as they are contributing to the mental health crisis.

Six: Provide tax credits, childcare credits and family stipends to families that give them the choice to care for their own children or to have a trusted family member care for their children at home under three. Family stipends allow families to choose what kind of childcare is best for their children when they must work. Do not make institutional care, which is quite expensive for the Australian Government and harmful to families, the only choice.

Seven: Create off-ramping and on-ramping for women who choose to take time off, work part-time or work from home when they have young children, to give them the support to do what is best for families. When mothers need to work to provide for their families, we need to create small business loans, entrepreneurial mentoring and work opportunities that give mothers the choice to raise their own children.

Eight: The private sector has to play their part as well and not only create extensive paid leave policies that meet the needs of families, but also create a corporate culture where parents must take paid leave after the birth of their children. Too many companies offer generous paid leave, but in reality, there is a culture where executives don’t take the full extent of their leave and are poor models for their employees.

Nine: Create financial safety nets for women in caretaking roles who stay at home to take time away from their careers to care for their children or their sick and elderly parents. Governments and employers can continue to put money into pensions and social security while a mother is caring for her child or her parents.

Ten: Make it financially possible for couples to live on one income in the early years while they’re raising young children. Make housing, healthcare and education more affordable to allow one parent to stay at home or for a primary attachment figure to work part-time.

Eleven: Provide mental healthcare services for new parents from pregnancy throughout the first three years, through a home visitors or community-based program that continues to evaluate and provide care for those suffering from postpartum depression and anxiety. Parenting education begins with a nurturing, helping professional who can support new mothers, but also refer them to other mental health professionals when necessary. Parenting classes can continue in healthcare clinics, community centres or even online.

Twelve: Choose trust over fear. Women who have been neglected or abandoned by their own mothers or fathers do not trust in others to care for them, whether it is trusting men to financially support them while they’re raising young children or trusting women to care for their children individually rather than in group care.

We are and always have been teams when we raise children – women and men are equal in intelligence and ambition, and yet raising children is a sacrifice, where instead of working as an individual, you work as a member of a team. That means that having one parent primarily provide financially while the other raises the children remains ideal for children. There is a reason why this model worked for a millennium and was best for children in the early years.

Thirteen: Create advertising campaigns and public service announcements on the importance of marriage, two-parent families and mothering and fathering for the future mental health of children.

Fourteen: Caring for your own elderly is another way that society shows they are a caring society with a value on trusting and secure attachments. Daycare and elder care outside the home have something important in common – they are symptoms of a more detached and self-centred society. Give families financial incentive to care for their own sick and elderly parents at home.

Remember, if your own parents abandoned you to institutions when you were an infant, you are more likely to put them in institutions, and further, when you put your own parents in an old-age home, it is more likely that your children will do the same to you – and on and on the cycle of neglect goes.

It is not too late to turn this mental health epidemic in children and young adults around, but only if we can look at ourselves in the mirror and take responsibility for behaviour as parents and our government and private sector policies, rather than blame our children or other external aspects of society.

Of course, technology, academic pressure and global warming are environmental stressors for children and there is a great deal to be frightened of in this world, but children who are resilient to adversity and stress are children whose beginnings have given them the foundation on which to build trusting relationships and emotional stability.

When we grow up fearful, emotionally neglected and forced to become emotionally independent too early, it backfires and leaves our children defensively independent, distrustful of attachments, fearful of future losses and without the solid internal resources they need to become successful, mentally healthy, loving and useful members of society who then raise healthy children of their own.

The generations are before us. In Judaism, we use an expression, “l’dor vador” – from generation to generation. We have a choice to make the future better than the present. The responsibility for our children’s mental health rests upon us.

~~~

The following is an excerpt from an ARC panel with Paul Kelly, Virginia Tapscott, Peter Costello and Erica Komisar. Komisar rejected the notions that women do not want to stay home with their children and that childcare is good for children.

Paul Kelly: The Albanese Government is planning to go to the national election next year with the policy of universal childcare … To what extent does that conceal and disguise what a lot of women want?

Erica Komisar: I think it’s a little bit of a case of the minority tyrannising the majority. What I mean by that, is that the feminist movement is very good for society in many ways, but a small portion of that movement is very extreme and has the loudest voice – as they say, the squeaky wheel. Statistics in the UK show that 66 per cent of women, if they were offered paid leave, would stay home with their children in the early years. It’s 60 per cent in America and I imagine it’s quite high here, too. So, what that suggests is that the majority of women, if offered paid leave, would stay home with their young children.

I do want to say that women were always admired for their role as mothers, and what we’ve lost in society is the admiration and respect for women to stay home with their children in the early years. that we can have it all; we just can’t have it all at the same time. That lack of admiration has influenced women who would otherwise say, “I feel maternal preoccupation; I want to stay with my young children; I may go back to work a little bit later”, but because society really denigrates, deprioritises and devalues mothering and no longer admires women as mothers, it has influenced many women.
But let me say that the majority of women would stay home with their children if given the opportunity.

Paul Kelly: How do we contradict – how do we summon the evidence and get the evidence onto the public table to challenge what seems to be unorthodoxy?

Erica Komisar: Well, there is very clear research that shows that when children are put in daycare, universal childcare, at a very early age they have increased aggression, distractibility and more behavioural problems. That’s very clear evidence and it’s been around for quite some time, so it’s a distortion of the actual research to say that it’s good for children. As a therapist – and I’m thinking about the low birth rate too – it really comes down to relationships. If you destroy relationships at their foundation, at their core, you cannot expect mothers and fathers to want to parent. You cannot expect them to take joy in the relationship of raising a child because raising a child is challenging, hard and frustrating. So, you cannot destroy the relationships at the foundation and then expect people will want children.

___

Republished with thanks to News Weekly. Image courtesy of Pexels.