Kate Anthony: [00:00:00] Hey, everyone. Welcome back. I am so glad you are here for another episode. Something that you guys deal with all the time is that when you get divorced, medical decisions don’t stop. Your children still need vaccines. They need dental appointments, medication decisions, evaluations, therapy, follow-up care, all of the things.

And, on a good day, these are things that we all juggle in parenting. But in high-conflict co-parenting or parallel parenting, even basic healthcare decisions can become a new arena for control, misinformation, sabotage. So in this episode, we’re gonna talk with board-certified pediatrician Dr.

Madeline Ganion about how divorced and separated parents can navigate medical decision-making when they do not agree when they don’t know how to know what [00:01:00] information to trust and what to do when one parent’s fear or misinformation or need for control interferes with a child’s care. Dr. Ganion is a board-certified pediatrician, qualified neutral mediator, and advocate for family communication and conflict resolution.

She’s a graduate of Georgetown University School of Medicine, and she has worked for leading institutions, including Boston Children’s Hospital. Welcome to the show.

Dr. Madeleine Gagnon: Thank you. Welcome. Thanks for having me.

Kate Anthony: Yeah. Thank you so much. This is a really obviously complex dynamic, and you work with families navigating grief, trauma, transition, and medical decision-making.

So what kinds of conflicts do you see most often between either divorced or divorcing co-parents when it comes to children’s healthcare?

Dr. Madeleine Gagnon: Ultimately, just for reference for our listeners, my background is a complex care pediatrician, so not necessarily the pediatrician in a clinic that you’ll go [00:02:00] to when your ears are hurting or your throat is sore, but a pediatrician that has helped families, like you said, at Boston Children’s and other leading hospitals across the country, navigate significant disabilities, life-changing conditions, and traumas.

So maybe that is a set of individuals who had a child with significant disabilities at the time of birth, or perhaps co-parents who are navigating their robust, healthy, 16-year-old son who plays football, who got in a catastrophic car accident and has now a traumatic brain injury and uses a wheelchair.

So my perspective is that of really significant corners that parents have been in, dark corners that hopefully most families don’t venture in. But what I’ve seen from there is that it is entirely independent of the state of the union between two co-parents, whether married, separated, divorced, the leading ingredient for navigating high-conflict medical decisions often comes down to the nature of the ability for parents to work [00:03:00] together.

So certainly, common topics can be involved in those extreme situations of how to navigate a wheelchair or how to feed the child in those extreme situations. But in much more routine options, we see the same level of conflict around to give the flu vaccine or not, or to give the Vyvanse for the ADHD, and ultimately it comes down to parents’ ability to work together.

And we do see in high-conflict situations, those power plays come into p- play, and ultimately we need to keep it about the child. Yes, and you and I know, it’s easy for us to say that. Yes. And for probably for the women or, and men listening to say that, to feel that But what happens when the other parent, when essentially their job is to oppose and counter just for the sake of argument?

Kate Anthony: As a pediatrician are, do you have any sway here? Wh- what’s the… What do you do?

Dr. Madeleine Gagnon: Yes, that’s an excellent [00:04:00] question. This comes up a lot in family mediation. I think for the parent who’s navigating with the desire to be a successful parent and with the desire to be steady- … you are going to feel those frustrations, the absolute irate, hair-pulling, smoke from your head frustration of why your co-parent is coming from a place of power positioning or narcissism or, wanting to thrust energy and decisions just to flex power.

So I think it’s like you said, to address the reality and the practicality of the frustrations you feel as, let’s say, the mother in that position. However, leaning in on the professionals around you, recentering yourself on, “I really believe my son needs ADHD medications. His teachers are telling me he’s telling me it’s hard for him to concentrate and make friends at school.” So you’re that, that kind of mom gut vibe is feeling like, “Okay, I need to recenter into what’s important here, what I’m seeing in front of me about my kid- Yeah … what the teachers are telling me. How can I use [00:05:00] authority that’s in our life?

What kind of pediatrician or family practice providers in our life that can help provide that clinical assessment of what my kid needs, or a therapist, and you’re involved in your child’s life? How can you use your own therapist to check your frustrations that you’re feeling and how to execute this with keeping your eye on the main point, which is trying to get what’s best for your child?

I think where parents- Yeah … not just are power playing, but they also wanna influx what they want to see for their kids. This is a problem in parenting. We all grieve who we want our child to be in our head and who our child ends up being in reality. And I hear this all the time. “I don’t want my kids on ADHD medicine ’cause I don’t want them, on meds.”

Okay, but the reality has it you may not want that- … but the reality is, what is it that your child needs to be successful?

Kate Anthony: Yeah. Yeah,

Dr. Madeleine Gagnon: exactly. Other thing I have to tell families on both sides of that coin, ’cause I do get tapped a lot for medical expertise around some of these topics, is no [00:06:00] decision is often permanent, except some of those really big ones and serious injuries.

So short of those, whether it’s the vaccine or the medications, decisions aren’t permanent. Why not try the medication, see where that gets you?

Kate Anthony: Oh, and as a, as the mother of a child with severe ADHD who, we had to medicate very early on because, I think one of the, one of the difficulties in medicating for ADHD is that there is no specific way of knowing which medication is gonna work, and so it’s often trial and error, and you feel like you’re experimenting on your kid.

And it’s oft- yes, I do not, I did not want to have to medicate my child. And also, my child was essentially non-functional in a school environment. He c- he was not able to be educated without it for a period of time, and it is not forever and all of those things. But I know that I certainly ran into some conflict with my ex around [00:07:00] this, but ultimately he was willing to listen to the medical advice.

He was lis- he was, willing to get him evaluated. He was willing to pay for the eval- evaluations ’cause I certainly couldn’t afford it, and he was willing to listen to the advice. But I hear so many women saying, and/or they say, “Yes, we’re, we’ll do it, but…” But then they don’t medi- they don’t actually dispense the medication when they’re at the other parent’s house, which is dangerous and damaging for the child, right?

Depending on what kind of medication, obviously. A- and this is the kind of stuff that I hear and, with my clients all the time, and I guess what I’m hearing you say is like We try to do what’s best for our children, but there’s no short of going to court and hiring you as a expert witness, there’s not a lot that we can do other than to keep moving forward one step at a time, one conversation at a time, [00:08:00] one medical appointment, right?

I guess I’m hearing my listeners being like, “Okay what’s the answer? So what’s the solution?”

Dr. Madeleine Gagnon: Like- The answer, I think too is having tenacity, right? Like I’m sure you’ve talked about many times, picking your battles. But in theory, if you’re picking a battle that’s gonna leverage your child’s success, to me, that’s worth leveraging, right?

Let’s say we’re tracking back to ADHD and meds. That is probably a huge implication in your child’s academic successes or failures, along with interpersonal relationships at school, both with teachers and friends. That’s 90% of their day right there. Yes. So you’re going to bat for something that potentially can make, a real change in your kid’s life.

And to your point, you’re gonna have to have tenacity, not only through that first brink of that decision of to get them evaluated and to start a med, but we may have to go through three or four medications to figure out what that is. Number one, recognizing that you’re gonna need… this is running the marathon.

This is not a sprint, right? Yeah. And that it’s worth running because, looking at the battles in front of you, [00:09:00] this can have huge implications for your child’s success down the road. So to me, that’s worth going after. Versus, let me just juxtapose your co-parent or ex-spouse is feeding them macaroni and cheese and not serving enough broccoli and, apples.

Yeah. I get a lot of that, too. To me, I’m thinking, “Okay, let’s-“

Kate Anthony: Whatever. “…

Dr. Madeleine Gagnon: let’s weigh the, the, let’s weigh the battles here.”

Kate Anthony: Exactly.

Dr. Madeleine Gagnon: And then really creating a short list of who’s, who are the experts in your child’s life to be leveraged and to help broaden, like you mentioned for your ex, hearing it from other professionals, helped bring credibility.

That this wasn’t just your agenda as mom running, but that this is what his or hers team, your child’s team is saying. And if your co-parent is at all vested in leveraging what’s best for your kid, that’s the leverage you’re playing here, is to try to leverage the experts to b- amplify that volume.

And I also find in high conflict reassuring them that let’s go back to the drawing board. If it [00:10:00] doesn’t work let’s see what else needs to be done. That’s right. And often the parent who’s opposed, particularly on the medication example, is saying that’s not a one-stop fix-all,” and they’re right.

It’s not. Acknowledging, sure, do you think they also need play therapy? Do you think they need some executive functioning coaching? Do they need a reading tutor? It’s usually multiple things, so trying to get buy-in from your co-parent, what’s important to them a- and where can put that into the care plan together.

Kate Anthony: Yeah. And I think one of the things that’s really important, too, is to make sure that in your parenting plan you have a clause that says, “We agree to abide by the recommendations of medical professionals,” agreed-upon medical professionals, right? So if you and I have agreed that, this is our pediatrician or this is our evaluator and this is the recommendation that we’ve, that they make, we are now legally bound collectively to abide by those [00:11:00] recommendations because we have thought about that in advance.

It’s really hard to think about everything in advance with a parenting plan, but that is something that must be in there because then you’re, then it’s like it’s, we’ve, you’ve signed this agreement. So when we go to court, if we have to go to court, we’ve already basically covered this conversation.

Dr. Madeleine Gagnon: Correct. I seem to find a lot of families in that post-decree period where they’re back at mediation or they’re back litigating and are h- having that conflict. And I especially find that if you’re finding that you’re getting divorced or separated at an age or stage and then some years go by, oh, I didn’t think about college, I didn’t think about how we’re gonna handle high school teen-based issues because we separated when they were three.

So I think just leaving space for what you don’t know, leaving space for what you can’t yet predict. Certainly my families who are facing life-changing trauma, near drowning, house fire, car accident- Sure … there’s no way to have predicted that degree of trauma. And to me, the [00:12:00] families who are successful, and I say families, and that could be in multiple different households, are successful when they can navigate that space together despite perhaps hating one another.

But it’s the tenacity of how to navigate those relationships. So I think you’re very wise at the time of separation, divorce, to put some kind of more general language- Yeah … that there will be unforeseen educational and developmental and medical decisions, and that we will look to the experts in our children’s lives, said pediatrician, said teacher, said therapist, to really be the decision maker.

Yes. And that, that has worked well.

Kate Anthony: Yes. I absolutely, and I’m gonna just plug for a second because we’re talking about it, that I have a new parenting plan sort of product, that I’ve recently rolled out, which is so comprehensive, right? And really thinks through all of these eventualities that you may not think through, that your [00:13:00] attorney isn’t gonna think through, right?

Because your attorney looks at a parenting plan, and I think this is a great example of this, right? Which is why I’m mentioning it, not as like a shameless plug. But that your attorneys are looking at what is legally enforceable, right? As a coach, I am looking at all of the conversations that need to be had, whether they’re legally enforceable or not.

I want you guys, before divorce, having this conversation about we’re going to listen to the medical professionals when and if they are… medical issues arise with our children. We have talked through the fact that we don’t think it’s wise for us to introduce a new partner to our children too early on in the relationship or too early on in our separation, right?

I’ve had people try to use things like that, be like we’ve been together for a year.” And it’s yeah, but our, we told [00:14:00] our children three weeks ago. Like-

Dr. Madeleine Gagnon: Let’s be practical about this …

Kate Anthony: let’s be practical, right? But there are so many things, but it- but if you… But an attorney would be like that’s not legally enforceable, so we’re not putting that in a parenting plan.”

And it’s like n- no, we, no, we are, ’cause we’re having this, we’re having this conversation now to mitigate issues later on. Sure, I am not gonna take my spouse to court to be like, “He introduced his girlfriend too soon.” Whatever, but we’ve had a conversation, and now we have a mutual understanding of what’s expected.

And so there are all these things that I put into this really deeply comprehensive parenting plan create- creation tool that I have that I think are so important exactly for this reason, right? That these are-

Dr. Madeleine Gagnon: Absolutely …

Kate Anthony: things that your, like checklists that your attorneys may not give you.

Dr. Madeleine Gagnon: No, I hear that all the time.

We didn’t talk about that.” But when you think about, just forget the divorce for a moment. You’re thinking about raising your [00:15:00] children, albeit you’re now at a new juncture and crossroad of what that’s gonna look like, but ultimately, parenting is parenting. And kids need really two things: safety and structure.

They need the psychological safety. They need emotional and physical safety and that can be… they- they don’t need to be triangulated in a position between two parents over their own vaccine status, for example, right? So you have got to be thinking ahead about these issues, and then the structure piece, right?

They need those pieces of structure to feel safe. And I think just walking through your everyday life at the time of your separation, just for you said in terms of your parenting plan, of what are those realistic potholes that I know I’m gonna hit, and what is it that I know I’m gonna hit that I don’t know I’m gonna hit yet, and how do I leave enough space for that?

Kate Anthony: Yeah. Yeah, absolutely. You mentioned triangulation, and I wanna touch on that or talk about that because I think that’s a really important piece, and it happens so often, right? And it [00:16:00] only takes one parent to do it usually, right? And then your kids are in this position. So triangulation is literally like, one, one parent, the other parent, and then the kids, and pl- pitting one against the other.

And how do you see that from like a trauma perspective affecting children?

Dr. Madeleine Gagnon: Yeah. There’s no doubt that triangulation impacts kids very negatively. So again, to your point, as the parent who may not be doing the triangulation pitching but it’s your co-parent who is, that’s very challenging. Yeah.

I do think you can still be a steady emotionally available resource to your child and provide some mirroring of why that’s not healthy behavior. But the triangulation can be obviously very overt. “Go tell your mother this,” or I… venting about your mother and how terrible she is. But it’s often more subtle than that, and I think that’s even more traumatic for kids because they don’t even initially realize what’s happening.

“Oh, your mother would love to be here today, but apparently she [00:17:00] must have had something more important than your soccer game.” Or, “Oh, what’s your mother up to? Does she have that new boyfriend?” That fishing- … kind of behavior. What did you

Kate Anthony: do at your dad’s this weekend?

Dr. Madeleine Gagnon: Exactly. And I think that is really confusing to kids.

And make no mistake, I’m not just talking about the school-age kids. I’m talking, let’s not forget our teenagers who often think like, oh, they’ve got this down and I think they’re just as impacted if not more. And so it’s a matter of- Helping our kids recognize what that is. So if you’re the parent, hopefully who’s not doing that, and we all screw up, you may do an opportunity where you’ve triangulated and make repair.

“I’m sorry, I shouldn’t have asked that. I hope your weekend at Dad’s was a good time. Let me know if there’s anything you wanna talk about.” At the end of the day, it’s about fostering connection and keeping the door open for good psychologically safe communication. If you’re, if you can keep yourself mostly regulated and emotionally available to your kid, they’re gonna feel that.

That’s right. And connection will far outweigh any other influence in their [00:18:00] life. And it’s often important if this triangulation really kind of blossoms from the co-parent that you can’t control- … then putting up a mirror and helping your child see that. I’m sorry Dad said that about me.

At the end of the day, know that I love you very much, and I want you to have a good relationship with Dad. But when Dad says that, that’s not healthy, and I can mention that to him.” Again- Yeah … depending on the safety of the relationship. Trying to provide some boundaries, even if it’s…

often I hear, “I’m not gonna say that. They don’t listen to me. It’s not going anywhere.” I hear you, but you’re not just advocating for your position in that relationship with that former ex-spouse. You’re now advocating for a dependent and a minor. So I do feel that there is some responsibility on the parent’s part to continue to advocate, even if you feel that, quote, “They’re not gonna listen.”

Kate Anthony: Yes, and I also think there’s a way to present it that they might be able to he- [00:19:00] look, you’ve been married to this person. You’ve divorced this person. You know how to speak with, to them in a way that they might be able to hear it. I always tell the story that my ex actually said to me once, he said, “Listen, if you’re gonna say anything,” ’cause he’s so hypersensitive a- about criticism, ironically, “That if you’re gonna say anything that criticizes my parenting, I need you to s- first tell me what a great dad I am to soften it so that I can hear it.”

And while I was like, “Okay, fine. If that’s what you need, whatever,” I did it so that he could actually hear it, right? Because in- Yes … in the interest of my kid, and in the interest of actually saying to him “Hey, you, your rage is terrifying your child and he’s scared of you right now,” I need to als- first say “Hey, you’re a great dad.”

Dr. Madeleine Gagnon: Advocate with strategy. And if that strategy- That’s right … involves, parentheses, sh, manipulation, that’s okay, right?

Kate Anthony: Sure,

Dr. Madeleine Gagnon: especially if [00:20:00] you’re dealing with, because we’re dealing with comorbidities here, what I’m hearing. We’re hearing, I’m hearing narcissism. I’m hearing other mental health needs, potentially.

And so ultimately, ram charging in and saying it how you’re scripting it in your brain isn’t good strategy. Exactly. And again, what’s the eye on the ball? The eye on the prize is your child, and getting him or her what they need. And to your point I think particularly when you’re co-parenting with a narcissistic parent, it is incredibly important to navigate eggshells carefully.

And I don’t mean that in an unhealthy way. I mean in a healthy strategy to leverage success.

Kate Anthony: Absolutely. And so many of us are so concerned that then we’re actually throwing our kid under the bus, or that, our kid’s gonna get in trouble for having told us something, right? And so we do have to do this strategically.

We have to protect our kid in this conversation, but we also have to say it. We have, as you said, we have to [00:21:00] advocate for them. That’s just that’s responsible parenting.

Dr. Madeleine Gagnon: We do. And I do see that shortcoming, we’ll call it, of I’ve divorced them. It’s not, they’re not really my problem anymore.”

And the reality is if you’ve got children and you’ve got children who are either gonna have school-based need decisions or medical-based need decisions, which introduce me to a child that doesn’t. The reality is you are, have to find some sort of way to have a working relationship. And so I think this is important for viewers.

You are gonna have to find a way, short of, of course, if it’s compromising your physical safety, to have a working relationship with your co-parent. And that’s gonna involve strategy and thoughtfulness and not ram charging loosely into the relationship of the conversation just ’cause they’re not my problem anymore.

I don’t have to be filtered. I don’t have to approach them like I did in the late stages of that marriage. I think, in fact, that same tenderness and thoughtfulness needs to be there. And I do see folks- Very- … struggle with that. You’re angry. I get it. There’s unchecked anger. There’s [00:22:00] grief. But how do you put that over here, perhaps in your relationship with your own therapist or your friends or your own confidants?

Kate Anthony: Yeah.

Dr. Madeleine Gagnon: Your children are not your confidants. That’s right. Your children are your responsibility to advocate for- Yeah … and what they need.

Kate Anthony: Absolutely. Absolutely. I’m so glad you said that because we do sometimes feel like- I’m not married to them anymore. And it’s not just like they’re not my responsibility or whatever.

It’s also like I’m not married to them. I don’t have to walk on these fucking eggshells anymore. Amen. I’m fucking done with that, right?

Dr. Madeleine Gagnon: Amen.

Kate Anthony: And then it’s oh, but, oh, but maybe we do for- We do … again, as you said, for strategy in protection of our children. And then we get … We’re like, “God damn it.”

It’s like it’s never-ending. And but it is because it’s conscious, it’s strategic, and you’re … The end goal is not to get them to love me, to get them to stop abusing me, to get … it’s to get your children what they need from their other parent.

Dr. Madeleine Gagnon: And to get your child to [00:23:00] adulthood, and for them to be able to look in the rear view mirror and say, “That couldn’t have been easy for Mom, but I appreciate that Mom always went to bat for me.”

Because if you don’t, if you’re thinking, “F them,” “I’m not … I don’t have to deal with you. I’m not doing this. Do what you want,” and I do see that and hear that a lot, who pays the price? Who then shoulders the burden is the child themself. That’s

Kate Anthony: exactly

Dr. Madeleine Gagnon: right. They then, especially in the teen years, have to go to bat with the other co-parent around their narcissism to get the things they need.

Absolutely. And so ultimately you’re just displacing that decision-making onto your child, who then, invariably can years later have feelings of resentment and mixed emotion towards you. So I think the winning strategy, that’s why I said the marathon game here, is to think, “Okay, by the time I’ve gotten my kid to 40, that they can look back and say, I was a champion or attempting to be a champion for the things they needed even when it was incredibly hard.”

If not, what I often see in kids, sure, we see the things where they’re acting out more in school or having- [00:24:00] Sure … behavioral issues or rise of anxiety. I actually see a, a U-shaped catapult into perfectionism. We see this a- around, ig- eating disorders and anxiety around perfectionism and parentification and wanting to be this just stellar child so that there are no decisions for the parents to make.

And I think that that too has its long-term consequences that adult children look back and see where that came from.

Kate Anthony: Let me ask you this, because I think a lot of people who might be s- like standing on the precipice of making this decision or whatever might think, “If I’m gonna continue to have to go to bat for my kids, if I’m gonna continue to have to get into the trenches if I’m gonna have to… if all this stuff is [00:25:00] on the horizon for me shouldn’t I just stay?”

Shouldn’t I just stay so that I can just keep the peace and be in charge and continue to mitigate these factors that might come up later?

Dr. Madeleine Gagnon: As a pediatrician, divorce or marriage, is not the key ingredient for successfully raising kids. Having a calm, emotionally stable warm, emotionally available home is key.

So I think for, all too often I hear, I- “It’s very chaotic at home, things are very challenging, but I gotta stay for my kids.” And I’m always startled as a pediatrician by that statement because that isn’t what parenting is all about. What being there for your kids and staying for your kids should be about is what environment can you be your most healthy self?

What environment can you be most regulated? Yeah. What environment can you most mirror healthy [00:26:00] relationships and healthy conflict? I certainly am not conflict averse. I think healthy conflict is so important. So if you and your spouse feel that you’re really at an inflection point on the precipice of divorce, but feel that you both have the tools and the shared desire to get into therapy, to exercise good communication, to take opportunities to augment your marriage in ways that you haven’t expanded it before- I think, great. I think the challenge is many women find themselves that they’re not in a marriage where that other party is able to do those things up against perhaps, certainly abuse or addiction mental health needs infidelity, areas where it’s just not… It would be impossible from a human and medical and psychological lens to repair the other person to get the environment you’re looking for.

Yeah. So then the strategy comes down to, you’re right, I’m still gonna have to co-parent with you and through [00:27:00] this, through our child’s life. But what environment can I control that brings the most structure, safety, routine, predictability into our kids’ lives? And yes, is it easier to just sometimes as the one parent to just stay?

I’m not saying it’s easier to leave. I’m just saying it may be healthier and better parenting to be divorced and create a better, more controlled environment.

Kate Anthony: Yeah, and I love what you said about, what, in what environment can I be my best, most regulated self? And I think a lot of women mostly ’cause that’s who my listeners and my clients are mostly women.

But a lot, for a lot of women, they actually don’t know the, they don’t actually know that on the other side, that kind of regulation is possible. They’re so heightened in their trauma responses at this point, and they this is the devil they [00:28:00] know, right? And the other side it’s terrifying. It is absolutely terrifying to know that half of the time you’re gonna have to send your children into an environment that is really toxic or chaotic.

As, we’ve talked about a million times on the show, and what you are here validating is that H- even just having one home that is free of toxicity is enough for children. You give them, as I like to say, the gift of perspective. You allow their nervous systems to regulate- Yeah … even if it’s h- only half of the time, and they get to understand “Oh, I feel this way at this, in, in this environment, and I feel this way in this environment,” and what are the differences?

And they really ultimately learn to appreciate later in life that you created that for them, and how hard that must have been for you to go up [00:29:00] against all the things.

Dr. Madeleine Gagnon: Absolutely. There’s growth opportunity in that, and I don’t, and I, people often question me on the younger kids. I would argue, as soon as your kiddo is in those, early grade school years, they’re very bright.

They’re very perceptive. They internalize a lot. So they can see, feel, and hear conflict even if they can’t identify. That’s trauma. They, their nervous system is feeling that. So just to your point, to be able to decompress and have a harbor of safety where they don’t need to either be fielding those emotions subconsciously and/or performative.

Kids are- Yes … kids wanna please their parents, even in the most, and I have seen some of the rawest, most abusive circumstances that have led to, injury, of course, in a clinical setting. And kids want to please their parents. A- and so how do you ensure that they’re pleasing in a way that’s healthy and appropriate for their age?

Yeah. And like you said, giving them one house to do that is what, as a pediatrician, I would highly recommend. I also think when you’re assessing, where [00:30:00] I also- Yeah … feel that women get stuck is trees from forest, of assessing your ex-partner’s home. Again, I would not get caught up on the mac and cheese, but I would get caught up on, oh, they have a new partner, and that new partner’s been disciplining or yelling your, at your kid, or, there’s been new influxes of relationships.

Or you took them on a trip and I didn’t know about it, or, pick your battles here, right? And it’s always centered around safety and structure. If it’s not a violation to safety and structure, but it annoys you, I would hold space that it annoys you and process that, but not go after every battle, because there’ll be plenty of real battles where your kids will need you to advocate for, because again, if you don’t, they’ll find themselves advocating for their own needs in that home.

Kate Anthony: Absolutely. And helping them triage that list. I think that’s the other thing.

Helping the children.

Dr. Madeleine Gagnon: Helping the children triage the… They c- I hear this all the time. They came back to me Friday morning or Friday after school. Wow, they were so dysregulated. They were all [00:31:00] over. The behaviors were this.

The moodiness was that. Okay, maybe by Saturday morning, get their favorite donuts. Sugar’s not gonna hurt them. And say, “Hey-” Tell me, how’s it going? You’re not fishing in a triangulation session. You’re just like, “How are you doing? How are you feeling? Tell me something good. Tell me something bad.”

That’s my favorite question. Very open-ended. Okay, and that’s when, “Oh, hey, I was at dad’s house, but he went out and I was left home alone, and I was watching the ki- other siblings, and it made me feel, anxious and a little bit nervous, and I wanted to call you, but, I couldn’t ’cause I didn’t have a, watch or phone.”

And “Oh, okay. Tell me a little bit more.” Then that’s when you’re gonna start to parse out, are you age-appropriate enough to be home alone? Are you age-appropriate- Yeah … to be watching your siblings? If you are, then that may not be a battle to fight. That might have been an age-appropriate decision your co-parent made.

Sure. But now helping your child, tell me why that felt chaotic. What can we do to help you feel more in control? Your child is gonna need that processing space, even if they have, a great therapist and great [00:32:00] teachers. You’re their mother. You’re the one who they’re gonna look to the most, and that connection with that primary parent is the number one protective factor in life from risky decisions, value-based decisions, married or not.

Yeah. So having that connection and communication is key.

Kate Anthony: Yeah, and I think so many people find it so hard to work in the sort of the narrow margin of helping your kid process without going into mama bear protection. Yeah. “Are you kidding me? I can’t believe he did that.” Or like calling him or calling the therapist or, “I’m gonna, I’m gonna call DCFS,” or you know- Yes

whatever, right? We, our mama bear gets really triggered, and it can… we have to, we gotta regulate ourselves.

Dr. Madeleine Gagnon: You have to pause, take a breath. Yeah. Mouth shut

Kate Anthony: Right.

Dr. Madeleine Gagnon: Because how you react is key. Because if you react mama bear-

Kate Anthony: Yeah …

Dr. Madeleine Gagnon: that mama bear is [00:33:00] also gonna be felt by your child and cause some shutting down as well.

Even though you think you’re coming to their rescue and their defense- … th- we need to foster them to have a loving, connected relationship. Doesn’t need to be perfectly balanced, but a loving, connected relationship with both parents ideally. And so mama bearing it will cause a almost a recoil of, “Maybe I shouldn’t have told you,” or, Right

You wanna r- respond in a way that promotes safety. “I hear you. Let me think on this.” You don’t have to have the perfect answer. You can always say, “Let me think on this.” And not every answer needs an immediate solution, and not every question needs a solution at all. Maybe the individual’s 14, the child’s 14 years old, and she was babysitting the little sister who’s eight.

Dad was gone for two hours. That, to me, clinically sounds like a very safe situation. There’s nothing to report. There’s nothing to call on. Tell me more. Why’d you feel that way? How can I help you feel more successful? Y- maybe getting a iPhone Watch or, a phone, that we could figure out would make you feel [00:34:00] more safe so you’d call me.

Just little things like that. I think, like you said, though, controlling your reaction and controlling the words that come out of your mouth are absolutely key to not double down on kind of a traumatic response. You’ll shut them down, and they may not come to you next time.

Kate Anthony: And also, I think it does two things, right?

It shuts them down, ’cause they’re like, “Oh, wait, I shouldn’t have told mom because now she’s and by the way I was so guilty of this so many times. Just, I was so full of rage really, ultimately- Yes … about some of the things that were going on in the other home. Or just what? Ex- aghast at that, those parenting decisions sometimes, right?

Not only did it make my son “Oh, okay, lady, calm down. I don’t… it’s not that big a deal.” But also, I think it makes them more scared. They’re like, “Oh, it was that… Oh that’s that bad?” It makes it heightens their anxiety around the things that are happening as opposed to “Oh, okay, let’s troubleshoot this, let’s solve this.

How can we talk to dad about it?” “What do you think [00:35:00] you can say to dad about it?” Help them advocate for them to be using their own voice. And but if we’re like, “What?” Then their response is “Oh, it’s… oh God, I really was as unsafe as I felt.”

Dr. Madeleine Gagnon: Correct. Correct. Yeah, I think that calm response, just like we talked about strategy and manipulation with the ex- Yeah

we have to have that same strategy and thoughtfulness with our children. I- if your goal is succeeding, if your goal is, “Hey, I wanna hit this mothering thing out of the park,” then being thoughtful and not reactive is so key. And I, I do find, I’m gonna echo it again for a third time here really pick your list, what is really worth going to bat for, and what’s not? And that’s why I come back to some of the families I’ve worked with who have experienced some of life’s worst and horrific traumas to their children, because it’s such a humbling event, right? And all of a sudden, what you fed them and where you took them and who you introduced them to seems so insignificant.

And so I like to infuse some of [00:36:00] that perspective. Again, we don’t want bad things to happen to any children, but the reality is, keep it in perspective. Is this really gonna impact my kid? Does this really matter? Or am I trying to flex control ’cause like you said, I’m just pissed? And so really I encourage people to write it down and cross-check it with safety and structure, and is this a really a major infraction?

And if it’s not- Let it go. Take it elsewhere. Not from your children, but take it elsewhere if it’s just bothering you, but not an actionable item.

Kate Anthony: Yes, and this might, and it might be cause for documentation because- … we want, I don’t wanna, I don’t want them, I don’t want people listening to be like, “Oh, none of it matters.”

That, that may not be true, right? We wanna document it. You wanna put it somewhere so that over time, if a pattern emerges that is really n- damaging, you have the information and the evidence to support [00:37:00] whatever action you take. But each time is not, may not necessarily be the appropriate time for action.

Dr. Madeleine Gagnon: Correct. Correct. And often, I think a good litmus test for that of what’s actionable or not, and I’m with you, write everything down if it’s bothering you. Journaling’s never a bad idea, and records are never a bad idea. And patterns are where it’s at, unless there’s key signature safety events, is how it’s feeling for your child.

Maybe they said, “Oh, so great at Dad’s. We got to go to the amusement park, and then we got to stay up till 11:00, and then we got to watch our favorite movie, and we ate, three packs of Kit Kats.” Okay. Now, that’s irritating, but your kids sounded like they had a good time. It wasn’t the same degree of structure you’d like.

It was more sugar than you’d like. But again-

Kate Anthony: Your kids

Dr. Madeleine Gagnon: had a blast … this is the k- stuff, though, that I do hear a lot of what bothered them versus if your child’s telling you something. The litmus test here is how your kid’s feeling about it. If your kid is [00:38:00] describing something that they feel validated, that they feel uncomfortable, that they feel queasy about, right?

And, but they’re not sure what the right words are for that-

Kate Anthony: Yes …

Dr. Madeleine Gagnon: then that’s really important. “Dad was acting funny when he was driving. I didn’t know what that was all about.” Oh, whoops, these are big now kind of- That’s big … magenta flags going off. So I think it, that’s what I mean in terms of- I find some women really get triggered by the violation of the structure that they want for their kids of they went to bed at 11:00 and they hate Kit Kats versus your kids telling you that they just feel weird about something, and what is that really getting at?

Kate Anthony: Yeah, totally. Absolutely. Absolutely. Like gauging your child’s ex- right? If they’re like, “We had this great time, and it was, like, and it was crazy, and it was rough and tumble,” or it was whatever, but they’re, but they felt safe, and they felt fine about it, and they had a good time, you know what? Okay. Right?

Dr. Madeleine Gagnon: And I think here’s where your reaction’s really key, too, [00:39:00] if you don’t wanna infuse microtraumas on your kid. “I’m really glad you had a good time at Dan’s house.” I, not hammering, “You went to bed when? You ate what? You went where?” Yeah … but, even though you’re th- picking all these thought clouds, right?

And you can take it up with your girlfriend over a glass of Chardonnay later, but for now you need to be saying Pause. That sounds like he had a really nice time with Dad. Yeah. Sounds like he had a fun day. I’m glad.

Kate Anthony: Yeah. Yeah, exactly.

Dr. Madeleine Gagnon: I’m not saying that’s easy, I’m just saying that’s what should be said as a pediatrician.

And,

Kate Anthony: no, I totally, I exactly. You bite your tongue.

Is there anything else, like final words of wisdom? This has been such an, a great conversation. When, just when talking about sort of medical decision-making or the safety of our children in these high-conflict situations, any final words of wisdom to the mama bears out there who are struggling to know what, w- what’s important, what matters, what [00:40:00] doesn’t or trying to take care of their children’s medical needs and it’s an uphill battle that th- they just can’t seem to get ahold of?

Dr. Madeleine Gagnon: The number one mantra that I feel as a pediatrician who’s been exposed to a lot of really harsh and challenging family dynamics is the mama bears need to be the healthiest mama bears they can be. I need you to take care of yourself. And I know everyone says that, but truly feel and find your own self-regulation.

Feel and find tenets of moments where you can be calm and feel calm throughout the day, because that’s what your kids are gonna not only see and hear, but really feel. They can feel your frenzy and frenetic energy, or they can feel your calmness.

Kate Anthony: That’s right.

Dr. Madeleine Gagnon: The second tenet I would say to this is be willing to see your kid for who they really are, and that is not easy.

That’s not easy for us who say, “I thought you were gonna be a, all-star athlete. I thought you weren’t gonna need Vyvanse ADHD [00:41:00] medication to… How did you end up in a wheelchair and y- not play football anymore?” You don’t know what’s coming, but you have to open your brain up to say, “I’m gonna love and experience this child no matter who the universe wills them to be.”

That’s right. And that may feel in conflict with what I want, but I’m gonna have the emotional maturity To reconcile that over time. That’s not an immediate acceptance, but that’s an over time aspect. And number three, I’m gonna have the energy to really determine what are the key issues around safety and structure that are core values for raising my children- and I’m gonna go to bat for those issues even when it feels easier to say, “Not my problem anymore.” Because when you do that, you place that burden on your children. So I think it’s just, you- I’m not saying fight every battle. We’re saying be strategic, think about what needs to be done [00:42:00] for your kids that really represents important values, instrumental aspects of their emotional development, and navigate that.

Because again, healthy conflict is a key tenet of pediatric development. So think of this as a really good opportunity to model that.

Kate Anthony: That’s right. That’s right.

Dr. Madeleine Gagnon: Teachable moment. What…

Kate Anthony: Okay, I know that wa- I said that was like a last, the last-minute words of wisdom, but now I wanna ask you also what do you see as healthy conflict?

What does that mean to you? No, I think conflict’s great. I- I think chronic exposure to chaotic, coercive, unbalanced conflict, no good. Yeah. And that’s often what’s happening in the late stages of that marriage, right? If it was a perfectly balanced conflict ballgame you

probably- You probably wouldn’t be getting divorced

Dr. Madeleine Gagnon: you probably wouldn’t get a divorce. Exactly. So I- I think conflict gets a bad rap because it’s positioned in lack of equity of power, and usually under some sort of corrosive corrosion and coercive angles- … and that’s not healthy. So I [00:43:00] think if you can not only get divorced and have your own growth opportunities as mom to figure out how to do conflict well for your kid- parent or mother father or mother, what a win. That’s a win. Absolutely, yeah. And that can look like, how do you approach challenging topics calmly? How do you keep it about the topic of the issue, not about the character of the person you’re in conflict with? Yes. How do you not put your child in the middle?

They told you something, you’re concerned about that. You wanna go to bat for them. They’re 10 years old, they shouldn’t have been left home alone. Okay, now we need to talk about that, but you’re not gonna put your child “Bobby told me,” never mind what Bobby told you.

Yeah. “Hey, we need to talk. Remember that clause we made in the parenting agreement about when they can, issues we hadn’t thought of? Here’s one. What, how old can they be when they’re left home alone? Let’s work through that.” Modeling that because, again, having good conflict resolution skills for your kids to see which won’t come overnight, but I strongly believe even in some of the most [00:44:00] extreme cases of violence and control in the marriage, there are ways to exercise ability to demonstrate good conflict.

It doesn’t mean it will be received and reciprocated But that’s not what you can control. That’s right. What you can control is what you’re putting out- That’s right … and across the net, and this is what your kids are seeing. That’s right. And they will remember that when they’re entering their own, adult relationships.

Kate Anthony: Amen. Amen. Thank you so much, Maddie. This has been a really great, insightful conversation. I’m so glad we have it. Where can everybody find you? And it- do you work with… I know you’re in Minneapolis. W- how do you work with people? What’s your deal?

Dr. Madeleine Gagnon: Great. Wonderful. I own Bridge Health Consulting, which can be found at bridgehealthconsulting.com. And exclusive for your listeners at bridgehealthconsulting.com/podcast parents can join me for a free 15 to 20 minute parent strategy call. I do kind of parent coaching and mediation for families or a [00:45:00] single parent who just wanna talk strategy.

And parents often call with kind of, “Hey, these two things are on my mind as it relates to pediatric development, or what’s healthy for a child, or, what’s worth going after, or to medicate or not.” And so that can be usually helpful conversations that people tap in and out of. Certainly, like I mentioned, I also do, medical expertise in cases that are real high conflict and reach areas of litigation, but we hope that for, especially for the kids’ sake, that we can reach areas of conflict resolution before that point.

I also do a lot of work in the teen space. So pulse.teens, pulse.parents, one is for teens, one is for parents, on Instagram, is a great community where we’re doing a lot of different conversation around what’s it like to parent teens today. Parenting today’s teens is really intimidating. We’re facing topics and stakes much higher than we faced in the ’80s and ’90s when we were kids.

77% of parents are reporting feeling insecure in raising their teens. So I do a [00:46:00] lot of work in that space around helping parents who are raising teens and wanna just drop in and connect, either on social media or through coaching virtually. We have… I h- work with folks like yourself, predominantly women all over the country.

Kate Anthony: Awesome. I love it. Thank you so much. All of those links will be in the show notes, ’cause those are super important. Maddie, thank you so much for being here. This has been really great.