Since going back to practice after lockdown, I have become acutely aware of the enormous impact on children of the Covid 19 pandemic and the world’s response to it. Although children are some of the least vulnerable to the physical affects of the virus, many have suffered a lot emotionally and psychologically. Next Tuesday, I am taking part in a live webinar, along with fellow paediatric acupuncturists Julian Scott and Robin Ray Green. We will be discussing how the last few months have impacted children from a Chinese medicine perspective, and what we can do to help. Please click here to sign up.
I was really excited to be invited as a guest on Michael Max’s wonderful Qiological podcast. We had a really wide ranging and interesting discussion on all things adolescent – from the Chinese Medicine view of puberty, to the challenges of being a teen and to working with teenagers in the treatment room. We also focussed on possible reasons for the increase in mental/emotional health problems in teens today. Please do have a listen and share with anybody else who might be interested.
Since the coronavirus pandemic began, I have been contacted by parents who are anxious about the impact the situation will have on their child. Many children will be off school for months, unable to see friends or partake in most of their usual activities. There is no getting away from the fact that this time is throwing up enormous challenges, of many different types and to many differing degrees for almost everybody. This is a difficult time, and it is going to continue to be difficult
In the conversations I have had with parents, we have found it helpful to pare things back to basics. What, of their old lives, can our children really not do without? There may be short term, negative impacts from a few months off school, not seeing friends, no extra-curricular activities or normal leisure pursuits. But how many of these effects will last beyond the short term? Providing a few basics are in place, our children can get through this time unscathed and may even develop resilience and learn some other useful life skills along the way. Perhaps a positive outcome of this challenging time is that we will be reminded of how little we really need to remain physically and emotionally healthy. (It is, of course, also important to remember that there are sadly many children around the world who will not even be able to rely on the basics that are described below.)
Over a thousand years ago the Chinese developed a system of medical massage for babies and young children called paediatric tui na. As well as being extremely effective for the treatment of many common childhood problems, one of its advantages is that it is very practical. It is possible to access the five key functional aspects of a child’s physiology on the hand, specifically on each of the fingers. This means the massage can be done while a baby is breastfeeding or without needing to get an older child undressed.
Each finger relates to a different acupuncture channel and function. Looking at these five functions and, crucially, what they need to remain healthy, shows us what the 5 pillars that support a baby or child’s growth and development are.
Thumb – spleen meridian - nourishment
The thumb relates to the digestive system. In order to maintain health, a baby or child needs adequate nourishment. Although what constitutes adequate nourishment is something which could be discussed all day, it can be stripped back to:
Enough food or milk
Gaps between meals or feeds
A good variety of foods
Index finger – liver meridian - movement
The index finger relates to the flow of qi all around the body, which in Chinese medicine is governed by the liver. This enables the emotions to flow freely and for digestion to be rhythmic and comfortable. In order to maintain health in this area, a baby or child needs to be able to move. For a baby this means first kicking their legs, then rolling, sitting up, crawling and finally toddling. For a child, this means having several opportunities a day to be physically active. If, due to lockdown restrictions, this needs to be done in the home rather than outside, it is still beneficial.
For young children, the key is to move little and often. They need to intersperse more sedentary activities with short bursts of movement, for example, a play in the garden (if they are lucky enough to have one) or some star jumps.
Middle finger – heart meridian – connection
The middle finger relates to the Heart meridian which, in Chinese medicine, governs our emotions. In order for this aspect to thrive, the baby or child needs connection and intimacy. This is more than merely being in the presence of other people. It means having an emotional closeness to them, trusting them, receiving physical touch from them, doing activities together and, for verbal children, having conversations with them. Children may deeply miss seeing friends and extended family, but if they remain connected to those they live with, this will sustain them.
Ring finger – lung meridian – fresh air
The ring finger relates to the Lung meridian which, unsurprisingly, is related to breathing. In order to thrive, the Lung meridian needs a source of relatively clean air. For children who live in cities or whose opportunity to go outside is currently limited, this is probably the hardest basic pillar of health to achieve. If this is the case, simply doing some basic breathing exercises with your child (if they are old enough) can be beneficial.
Little finger – Kidney meridian – rest
The little finger relates to the Kidney meridian which, in Chinese medicine, governs our reserves of energy. In order to thrive, the Kidney meridian needs an adequate amount of rest and downtime. Even if they are not currently going to school and their lives are less busy than usual, we should remember that children are always hard at work behind the scenes with the mammoth task of growing and developing. This consumes a lot of their qi. Getting adequate rest is therefore even more important for children than it is for adults.
If you are aware that your child is struggling in one of these areas (for example, your toddler is going through a fussy phase and refusing to eat anything other than pasta), you can support that function by doing a simple massage on the relevant finger. Simply rub the pad of that finger in a circular motion (it doesn’t matter which direction) for between 1 -2 minutes, twice a day. You don’t need to use great force – just firm contact is enough. As well as supporting that function, the massage can also enable your child to support it better themselves. For example, with the case given above, by massaging the pad of the thumb on a fussy eater, you may well find that by improving their spleen qi, they then start to eat a wider range of foods.
As parents, we are hard-wired to want the absolute best for our children and it can induce anxiety if we feel we are not able to provide that. This extraordinary time, when the fabric of our children’s lives has been temporarily entirely changed, may stir those anxieties. So it is worth reflecting on these 5 pillars of health and reassuring ourselves that if our children have them in their lives, at least to a large degree even if not completely, then they will be getting what they need. Everything else, that is temporarily missing from their lives, is icing on the cake.
I hear the same story time and time again in my paediatric clinic. The basic theme is – one moment a parent felt connected to their child, needed and loved. Suddenly, they feel as if their child hates them, doesn’t want to be around them and that they have lost their connection with them. When listening to heartbroken and concerned parents, I have found it usually helps if I explain, from a Chinese medicine perspective, the underlying process that is causing the change in their child.
Adolescence is an in between phase, when the young person is no longer a child but not yet an adult. It marks a transition between one stage of life and the next. A caterpillar does not become a butterfly with the click of a finger. They build a chrysalis around themselves, retreat inside it, dissolve their previous form and, sooner or later, emerge as a butterfly. There are many similarities between this process and the human one. Young people in the height of the adolescent change are akin to the chrysalis stage. They often build a protective shell around them and retreat from loved ones, before emerging as a beautiful butterfly and spreading their wings!
One of the ways in which this analogy stops being helpful, however, is that in humans the change from child to adult tends to be a much less smooth and linear process. Most young people go back and forth a few times – one minute retreating into a childlike state, the next leaping forwards to ‘test out’ being an adult. Parents can become easily bewildered by a child who one minute is screaming at them to get off their back and the next is not wanting to go to sleep without them at night. It is reassuring and useful to be able to remind parents that this is absolutely normal and, in itself, does not indicate any kind of pathology.
So, how on earth do we explain what underpins this massive process of transformation? I have found the Chinese medical perspective is a really helpful way to understand it, even for those without any prior knowledge.
In order for young people at this age to grow and develop as fast as they do , to start breaking free from their parents and become more independent, there is an enormous surge of yang in the body. Yang is powerful, transformative, hot and volatile qi. It is resonant with the energy of the Spring – when all of a sudden plants and trees begin to shoot up, blossom and sprout green leaves. It is yang which initiates and drives the internal processes of a young person so that they gradually leave behind childhood and head towards being an adult.
Imagine what it must feel like to suddenly have this surge of yang within you. It is as if a small flame has fuel poured on it and suddenly flares up into a roaring fire. It is the feeling you would get if you were put behind the wheel of a powerful sports car when you had been used to driving an old banger. It feels powerful, at times frightening, at times out of control and at times hugely exciting. It can feel to the young person like surfing a big wave.
Moreover, if you have constraints put on you when this powerful yang is roaring inside, you will feel them incredibly strongly. This is why young teenagers often act as if they have just been put in prison when you ask them to be home for supper! Yang also surges up towards the Heart (which, in Chinese medicine, is the seat of emotions). This is why teenagers feel things so strongly. It intensifies and brings to the surface feelings that were previously lurking around in the background.
In order to counterbalance this surge of yang, there is also a strengthening and consolidation of yin that goes on at the same time. Yin encourages retreat, sleep and calm. It explains why teenagers need so much sleep, and why they have a tendency to want to spend so much time in their bedrooms and are often less willing to interact with the family. This is the equivalent of the chrysalis stage for the caterpillar. In order for any change to take place, there has to be a period of retreat. Explaining this to the parent of a teenager who may be feeling hurt by their child’s disinclination to engage, can help them to understand it’s an important part of the process and not a personal rejection.
There are numerous books and articles for parents offering advice about how to manage living with teenagers. I am not going to add more advice, too much of which can estrange a parent from their instinctual, natural parenting instincts. But I urge parents to just bear in mind this explanation of what is going on, in order to better understand their child. There are three key points to remember:
Your teenager has not suddenly stopped loving you
They are fulfilling their job description if they are beginning to separate from you
This time will pass and, if you let them spread their wings, they will fly back to you as a loving adult when they are through the transition!
 Adolescents grow faster than at any other time of life, with the exception of the first year.
It was Tolstoy who wrote that ‘Happy families are all alike; every unhappy family is unhappy in its own way’. Much as I hate to argue with one of my literary heroes, I would say that no two families are alike, whether happy or not, even if they appear to be on the surface. The dynamics within a family are as unique as the individuals who make up that family. If it is true that no two snowflakes ever have been or ever will be exactly the same, that seems a better metaphor for families!
Members of a family are inextricably linked emotionally and energetically. The health and happiness of all the members is interdependent. In Chinese medicine theory, we understand that every individual contains each of the 5 Elements and that each of the Elements is connected. When we treat somebody with acupuncture, treating one Element has an impact on the other four too. It is the same in a family. If one member is ill, stressed or unhappy, it will affect all the other members, even in ways that are often too subtle to immediately notice.
Robyn Skinner and John Cleese, in their book Families and How To Survive Them describe the concept of the family scapegoat. This is the idea that difficult feelings within the family (e.g anger, frustration, anxiety or sadness) may be subconsciously taken on and carried by one member of the family. If these feelings are very strong, this person, who may be a parent or child, may manifest this burden by becoming ill, either physically, mentally or emotionally.
Have you ever heard someone describe a member of the family as being ‘the one with the problems’? Or to say something like ‘The rest of us are fine but little Johnnie is just always so angry all the time – it’s hard to be around and I just don’t know why he is that way’? when it’s obvious that a family think of one member as being ‘the difficult/different/sensitive/withdrawn one’, this is a clue that this person may be carrying the burden of feelings on behalf of everybody else.
Of course, no parent ever sets out for things to be this way. Families create scapegoats, however, because of subtle dynamics that arise as a result of other family members struggling to resolve their own emotional difficulties. People are not islands, and when they are all thrown together, they ‘land’ in a certain way and each one takes on a role within the group that comes most naturally to them. The longer each person is stuck in their role, the harder it is to break out of it. People often resist change and each family member will (unconsciously again) have something invested in each of the other family members playing their particular role.
So, during lockdown, when the pace of most of our lives has slowed down (apart from the heroic key workers to whom we owe so much), we have the perfect opportunity to bring some of these subtle dynamics into awareness and see if we can transcend them. Here are a few suggestions of how you might do this:
Identify which one of your family is struggling the most, either psychologically or physically
Do you have any insights about what emotional load they might be carrying? Think about when their suffering began, what was going on in their life and in the family at that time? (For example, did your child’s headaches begin around the time you and your partner were going through a difficult patch?)
Even if everyone in your family is essentially ‘ok’, reflect on where the tensions are. Do you have higher expectations of one child than another? Do you find yourself always blaming one sibling rather than another when they argue? Does your partner focus all their worry on one child?
Becoming aware of these dynamics is the most important step. Next time you find yourself cross with one of your children at the end of the day for ‘ruining the atmosphere’, take a few deep breaths and try to see if perhaps the dynamic was not that straightforward. For example, did one child start acting up because they sensed your easier bond with a sibling?
Watch, notice and take the time to put on a new pair of glasses and understand your family dynamic from a different perspective. It doesn’t matter that you can’t instantly change everything, and there is no place for becoming overly self-critical either. But there is great value in taking the time to understand things in a different way.
There is a renowned living practitioner of Chinese medicine called Liu Yousheng. He summed it up beautifully when he said:
Don’t talk of mysteries, don’t talk of subtlety! Focus your teaching on the Dao of being human. And where does this Dao of being human start? It starts with the Five Relationships, it starts with the family. Family relationships are the crucial step in the Dao!”
Net of Knowledge have put together a fantastic resource for practitioners during lockdown. They have organised a free webinar a day throughout April. I am delighted to be giving one of them on Wednesday 15th April, entitled Supporting Teenagers During An Extraordinary Time. Please click on the link to register:
Many parents have told me recently that their babies and children are not sleeping as well as usual. This might be due to a combination of heightened anxiety in the household due to the effects of the Covid 19 pandemic, the longer days and the rising yangqi which is resonant of the arrival of spring.
There are as many reasons why babies and children do not sleep well as there are suggestions of how to get them to sleep better. However, these simple, easy-to-learn massages can be used on babies and children of all ages, whatever the cause of their bad sleep. They derive from a system of medical massage called paediatric tui na (xiao er tui na) which has been used in China for approximately 1200 years.
Please click on the link below to learn how to do the massages.
For most kids in the UK, this is the start of the second week when they would have been in school. There are, most likely, many weeks ahead. So, as parents, how can we best help them to adapt to this time?
Primary school children are, developmentally, still very much focussed on their parents and family. The world of what is important to them is generally quite small. This means that whatever is going on in their immediate family and in their home will determine how they feel, much more than what is going on in the wider world.
There are two main components to this. One the one hand, the daily rhythm of life in the family has an impact. Young children, to differing degrees, are often unable to create their own structure, so they rely on that created by others. It is as if their own internal scaffolding is not yet constructed. So, simple things like getting up at roughly the same time each day, having regular meals and routines will help them cope with this extended time without the normal rhythm of school. It supports them in the way that scaffolding supports a building.
The other key component, however, is a little more complex. This involves what is going on underneath the surface of family life. It concerns the emotional vibrations. Children are like sponges. They soak up everything that is in their surrounding environment. Whilst they may hear their parents’ words, they sense the emotion underlying them. We all know that on a day when we are especially stressed and irritable, our toddlers will be more fractious. Children are a mirror of the internal state of their parents.
I am aware that, for many parents, reading something like that evokes feelings of guilt and inadequacy. It can feel like too much of a responsibility and a burden, and we can too easily criticise ourselves for not doing our parenting job well enough. One of the best things we can do for our children, however, is to let go of those self-critical inner voices. The labels of ‘good parent/bad parent’ are unhelpful because they don’t describe the complex reality of parenting. It is an absolute impossibility for a parent to get it ‘right’ the whole time. The key thing is that, when we do get it wrong (which we all will, repeatedly) we try to recognise it and then make it right if we can. The psychotherapist Philippa Perry calls this ‘rupture and repair’. It’s not ideal but it’s OK that things rupture, as long as we try our best to repair them afterwards.
So, returning to the idea that our children are a mirror of our own internal state, one of the best ways to help our primary school kids at this time is to do whatever we can to get ourselves into the best internal state possible. I do not say this lightly. I understand that this is a time of enormous anxiety – about health, finances, work, the future. But it is also an opportunity. An opportunity to model to our children that we can weather difficult times. An opportunity to show our children that, when life does not go according to plan, we can adapt and find another way through.
Chinese medicine explains why children are so susceptible to picking up what is going on in their emotional environment. The ‘protective’ qi at the surface of the body, which helps to create a filter between the child and the environment, is not yet fully formedThe spirit/emotions (shen) are not yet fully ‘rooted’ because the child’s qi is being consumed by the process of growth and development. So there is less available to ground the emotions. Like a boat without an anchor, a child will more easily get swept away by a strong wave of emotion.
If you, the parent, are feeling anxious, frustrated and sad, here are some suggestions of how to manage this in a way which is helpful for both you and your primary school children:
Acknowledge the feelings. Feelings are not the enemy – it’s OK to have them. By acknowledging them, they are less likely to cause you get into an emotional ‘funk’.
Find a time each day to do something that you know helps you maintain an emotional even keel – whether that be yoga, going for a walk, meditating or beating up a pillow. Even if you are juggling home schooling and work, prioritise this. Put the kids in front of the TV for half an hour if you have to in order to find the time. They will benefit from having you in a better place more than they will lose out from having a bit of extra TV.
Avoid telling your kids that you are fine if you are not. This is deeply confusing for them because they will hear the word ‘fine’ and, in their sponge-like way, pick up that you are not. You can say to them something like ‘I am feeling sad at the moment because we can’t visit Granddad, but it’s great that we can chat to him on the phone and this time will pass.’
Dig deep. This truly is an exceptionally difficult time, and each family is affected in a unique and complex way. But as parents it is up to us to dig deep and steer the ship (our family) through the turbulence to calmer waters.
Arrange Zoom calls with friends or family that you know help you to feel supported, in lieu of being able to see them.
The hardest thing for primary school children at this time will be the impact it has on the adults around them. Most will not have the cognitive capacity to understand the magnitude of what is going on in the world. We are their rocks and, despite many of us not feeling solid, they will take their cues from us. So, dig deep and remember that this time will pass. And remember, you and your children can come out of this experience with increased strength and resilience. There is a Chinese proverb which sums this up brilliantly:
The gem cannot be polished without friction, nor man perfected without trials.
Yesterday I watched the excitement and elation of five pre-teens and young teens as they heard the news that school was going to be out for the next few weeks at least. One of the first things they did was to download apps to make sure they could easily communicate as a group if they were not able to see each other. They then began writing their ‘No school bucket lists’, and top of all of them was the resolution to ‘make sure not to become distant from my friends’.
Even in extraordinary times, teenagers are still teenagers. And there is nothing more important to most teens than their friendships. Whilst as parents, we may look forward to being able to spend more time with our teenage children and to deepen our connection with them, no doubt their main concern will be how they are going to cope with being stuck at home with their parents. It is natural for a teenager to increasingly separate from their parents, to go out and find their own tribe. It’s a time when they need to explore their identity, and to find out who they are outside of their family. So, any enforced isolation is likely to jar with their deep drive and instinct to go outwards into the world.
In Chinese medicine, adolescence is resonant with the Fire Element. The Fire Element governs how we manage our relationships with other people and ourselves. The qi of the Fire Element intensifies during adolescence, which is why children of this age tend to feel things very passionately! This intensity also drives teens to fulfil their developmental role of this time – ie. to make strong connections with others outside the family.
Whilst those of you who regularly read my blog will know that I have written a lot about the potential negatives of screen time and social media, this is one time when the benefits of it will come into their own. If technology allows our teens to keep those connections with their new-found tribes, it will make this time of uncertainty and disruption a lot easier for them than it otherwise would have been.
At the same time, although teenagers would rather do just about anything than admit to needing their parents, they really do still need us! They are in a state of huge internal flux. Put that together with the enormous external changes they are currently experiencing, and it makes for a potentially anxious time. The more as parents we can work on managing our own anxieties and fears (which may be great at the moment), the more our teens will benefit. What they need from us at the moment, more than ever, is to feel that we are solid and stable. That is not to say we need to pretend that ‘everything is ok’ when it is patently not, but that we need to let them know that, despite all the difficulties, we as a family will come through it.
So, as well as recognising that over the next few weeks or months, our teens will have a strong need to connect with their peers, it might also be beneficial to ringfence some time each day to put away screens and to connect as a family.
Here are some other potential benefits for teens of an enforced, prolonged period out of school:
Time to catch up on some sleep: teens are growing and changing so fast and good sleep is crucial for this process.
Time to slow down and lean in to a more yin lifestyle: most teens have crazily chaotic lives with little downtime. Learning how to be still and have downtime at this age will serve them well for the rest of their lives. Have a look at this blog post – ‘How does a child get real downtime in the 21st century’ – for more thoughts on what actually constitutes ‘downtime’.
Time to reframe what is important: there is a lot of talk about rising anxiety levels at the moment. But I believe, if dealt with appropriately, this time of crisis could actually help teens to reduce their level of anxiety. Through conversation, we can help them to see that a lot of things they may worry about, are actually of very little consequence. One teen, who is prone to huge amounts of anxiety, and who has just found out she won’t be able to take her A levels said to me ‘I was gutted at first but now I’m OK. It’s made me realise there are more important things in the world. We will get through this and I trust that my life will work out – maybe just differently to how I expected’.
William Arthur Ward wrote ‘The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.’ I wish you and your teens, and indeed all your loved ones, all good wishes in adjusting your sails over the coming weeks.
Yesterday, I went to a parliamentary reception at the Houses of Parliament, for the launch of the British Acupuncture Council's To the Point film and the Scope of Acupuncture 2020 report. This is to raise awareness of acupuncture as an effective treatment for a variety of health conditions. I am delighted that paediatric acupuncture played such a prominent role and was given the place it deserves. The last 8 minutes of the film are of my work with children in The Panda Clinic. If you don't have time to watch it all, you can fast forward to 27 minutes and 40 seconds! Enjoy!
I have been practising acupuncture for 15 years. As well as practising in Oxford, I am both a senior lecturer and clinical supervisor at the College of Integrated Chinese Medicine (www.cicm.org.uk) which is the biggest acupuncture training centre in Europe.
I have treated both adults and children and whilst the benefits of acupuncture for adults are well-known and well-documented, fewer people are aware of how it can benefit children.
I decided that I wanted more children to experience the benefits of acupuncture, and so decided to set up The Panda Clinic. I have to admit to having another motivation - I love being around children and derive great satisfaction when I see children recover from ill health.
I am mother to 2 primary school age children. As well as being an experienced acupuncturist, as a parent I have a good understanding of the stress and anxiety that an ill child can induce. I will always do my best to communicate with the parent(s) of a child I am treating as thoroughly and clearly as I can.