5 June 2000
Dear Readers: Sincerely,
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that
advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physican who knows you and cares about you.
Dr. Warren
Thank You,
-LB
Dear LB: With so little to go on, it's hard for me to make a suggestion. My one thought would be for your daughter to be seen by an orthopedist since they deal with bones and joints and there's little else in a finger. A less likely consideration is that your daughter should be evaluated by a rheumatologist. The only tests I could suggest would be a blood count, sedimentation rate, and maybe, down the road, a bone scan, but evaluation by a specialist first would be more appropriate.
Sincerely,
Dr. Warren
Could this fractured skull be from the fall 5 days earlier? Why were there no symptoms before this? And what can they do for a one year old with a fractured skull? Can this cause brain damage?
Please e-mail me back as soon as possible.
Thank You
-Johnny
Dear Johnny: Sometimes a fracture doesn't swell right away. If your sister's baby hasn't fallen since April 18, and has a fractured skull, the fracture apparently happened at that time. The purpose of the CAT scan is to look at the fracture but also to see if there is any injury to the brain or bleeding inside the head. If there is bleeding, it will require neurosurgery. If the fracture is linear and not depressed, there is nothing to do for it except let it heal. Since heads have no moving parts they heal without casting.
There is always the possibility that a serious head injury which results in a brain contusion could cause seizures or subtle neurological deficits at some later date, but most head injuries that cause brain damage cause serious symptoms very quickly. Since the baby had no symptoms, it is unlikely that any serious brain injury could have occurred.
Sincerely,
Dr. Warren
If you could tell me anything, I would greatly appreciate it.
Thank you.
-Chris
Dear Chris: A lot depends on where you are in puberty. If your body is fully developed and you haven't grown in a year, then you are finished growing and there isn't anything you can do about it. Many adolescents continue to grow until they are 18 to 21 years of age, but some are fully mature and have finished growing by 15 or 16. If your body is not yet mature and you haven't grown in the past year, then you should see an endocrinologist to determine why you have stopped growing, and what should be done.
If you have finished growing, you should not be distressed about being below average height. Genetics plays a large role. If your parents are short, you shouldn't expect to be tall. My grandfather was 62 inches. I am 66 inches. My son, who is finished growing, is 64 inches. It's what he inherited from me and his mother who is 60 inches.
Sincerely,
Dr. Warren
-TS
Dear TS: I suspect that your little one's have come to see being cared for by Daddy as being treated special. This happens in many households where Mommy is the main caretaker. Because Mommy is dealing with daily care and discipline the children learn to tune her out and take her for granted. Often, Daddy can get a better response on disciplinary issues, and as a result, doesn't have to spend as much time in negative interaction. In fact, Daddy's distance from the daily struggles may make it easier for him to be playful and distract the children from mischief, while at the same time getting a more immediate response to his commands. I can understand the distress you're feeling when the children request Daddy instead of you. It's fine to point out that your feelings get hurt when they reject you, but a 2 year old and 4 year old are too young to be dealing with your feelings while they're dealing with heir own needs. You mustn't allow this to become an issue between you and the little ones. They need your love, even though they take it for granted. There are several things you can try that might make a difference.
Sincerely,
Dr. Warren
Thank you
-Julie
Dear Julie: I need more information to answer your question properly. I have never heard of "emotional incest." Is the term "emotional incest" your own term for the situation, or is it something your read about? If you read about it, perhaps you can refer me to the article or source so that I'm sure we're talking about the same thing.
The age of the daughter is a crucial piece of information. If she is an adolescent, my advice and interpretation of the situation would be different than if she is 5 years old.
Sincerely,
Dr. Warren
Sincerely,
-Julie
Dear Julie: The situation you describe is much different and in some ways more complex than the situation you refer to as "emotional incest" where the daughter becomes a surrogate wife to fill the father's emotional needs. First, the father and mother were separated for some time at the time of the mother's death, and second, the father is already having relationships with adult women, such as the one he has with you. In fact, your relationship with the girl's father may be a significant dynamic, in the current situation.
Father is dealing with guilt about his separation from his wife and "abandonment" of his daughter. As is typical in many such situations, he overcompensates by trying to give her special treatment and perhaps material things. Daughter responds by equating this treatment and the things with lost love. She comes to believe she needs and is entitled to this relationship. Like any child, in fact any person, she would rather be in control and have whatever she wants, with no understanding that parental control would provide her security. Neither Daughter nor Father realize that the father's being in control and making a life for himself would NOT be another "abandonment." The daughter's lack of tears for her mother is not so unusual. Due to the separation of her parents the event may have been sufficiently traumatic for her that she may not find the tears until many years from now. These emotions can become suppressed in the struggle to survive.
I cannot say whether there is a risk in this situation of an incestuous relationship, but I suspect that the seductive behavior you have seen Daughter display is more related to your relationship with Father than with Daughter's relationship with Father. It does not sound like you and Daughter have become friends. Under the circumstances, Daughter can only see Father's relationship with you as risky to her relationship with the only parent she has. You are both in competition for the affection of the same man, and even though the relationship cannot and should not be the same, Daughter evens the playing field by competing with you in this provocative way.
While I do believe you have a genuine concern about the health of the relationship between Father and Daughter, my sense is that your biggest concern is where you fit in to this picture. That's by no means an illegitimate concern, but your seizing on the term "emotional incest" (incest being one of the remaining major societal taboos) as the perfect description of the relationship between Father and Daughter, expresses as much of an opinion as a concern about their relationship. If you were to use this term in discussing your feelings and concerns with Father, you would find it would immediately set a hostile tone which would preclude real communication.
If you see your relationship with father going any place, you need to deal with your feelings about the relationship between Father and Daughter. You need to deal positively with your feelings about Daughter. If there is a chance you will become a family, you need to become friends. Father can never be in a position of having to choose between you and Daughter, and any disagreements you have about Father's handling of Daughter cannot be discussed from the point of view of choosing. Father and Daughter clearly have a need for counseling to deal with parenting and unresolved guilt, but your involvement in the situation makes it just as important for you to join them in counseling. Father and Daughter's relationship is likely to continue, no matter how pathological. As I see it, if you want to be in the picture, you need to establish a place inside that relationship, not outside it. You all need joint counseling. Since I don't know if Father thinks there's a problem, it looks like the ball's in your court. Handle it carefully and gently.
Sincerely,
Dr. Warren
I am taking care of Xxxx while her dad is away visiting the 2 children from his ex-wife. He is gone from Thursday-Monday afternoon. Xxxx and I had lots of "girl talk" and I have assured her that I never want to take the place of her mother.. but that I am always available when she needs a female to talk to, and she has many times, taken advantage of that.
Actually, the only problem that we all encounter is that I'm divorced with a 14-year-old son..I have total custody, and the two kids are both "only children", although Xxxx has a half-brother and half- sister that have never lived with her. Also, Xxxx's father is an "only child".. perhaps the "only child" thing has some bearing on the relationship too. I'm not sure though. All I know is what I am seeing. . and it's made me worry about things. My son, at age 14, is going through the "typical" teen thing of not wanting to associate with parents..wanting to go in his room, listen to music, talk to his friends on the phone.. etc. I am okay with that.. as I have been reading books on Teenagers and the "phases" of growing up. His psychologist told me the same things, and we address those issues at his last visit.
I don't know what else to tell you.. except that the father and I have discussed "emotional incest" and he told me that is what his mother did to him. He is reading "The Flying Boy".. which I read first, and he says, it is very much like his own life.
There are alot of "issues". He is going to a psychiatrist and psychologist and was DX'd as OC-personality a couple months ago. He is taking Luvox now.. perhaps he should make some appointments and include his daughter in them.. I might make that suggestion, as we have talked about counseling for her before. We have a very open communication about most things.. and yes, I have discussed just about everything with him. It doesn't seem to hurt our relationship, because we do it in a loving-type manner.. not just "blurt" it out. If you have more suggestions.. please let me know, and thank you very much for replying.
-Julie
Dear Julie: When answering e-mail questions I have to try to get as complete a picture as possible from very little information. This often requires reading between the lines when dealing with questions about interpersonal relationships. In trying to construct an answer I try to consider the most likely situations that my readers would find themselves in. If an important detail is missing, I could easily make the wrong assumptions, making my answer useful, perhaps to most of my readers, but off the mark for the person who sent the question.
It isn't that anything in your e-mail suggested that you weren't friends with Daughter, but that your fairly detailed explanation gave no clue that you had any relationship with her. And the term "emotional incest" implies a fairly negative view of the father-daughter relationship, even though the term didn't originate from you. So, I assumed, apparently incorrectly, that the relationship between you and Daughter was at best cool or nonexistent. I apologize for my misinterpretation of the situation. Nonetheless, I find that the most salient points of my previous advice hold true and would like to reemphasize them.
Sincerely,
Dr. Warren
-R
Dear R: Until the cord falls off, it should be kept dry, therefore, newborns should only be bathed with a sponge or cloth. After the cord falls off, which usually happens within two weeks, you can put the baby in a tub for bathing.
Sincerely,
Dr. Warren
-LL
Dear LL: Eating dirt or other nonfood items is known as pica. In young children it may be just an unusual habit, but it may also result from nutritional deficiencies. Iron deficiency can cause pica.
Sincerely,
Dr. Warren
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