Dr Gregor Kowal
Senior Consultant
in Psychiatry and Psychotherapy,
German Board Certified,
Medical Director,
Clinic for Health and Medical Care
Phone: 00971-4-4574240

This text is an excerpt from an interview which Dr. Kowal wrote for a “Gulf News” related to the topic of parenthood.

BackgroundParenthood is no longer a simple case of yes or no. An increasing number of couples are choosing not to be parents with significant social repercussions and a significant chunk are caught in the middle unable to decide whether it is a good decision to start a family or not. The reasons range from personal to societal – where expectations, traditions and personal freedoms clash. Modern women and men both young and mature will continue to grapple with the concept of parenthood more so now than before.

The main question of the article is: Does being a good parent mean taking stock of whether you can or are cut out for parenthood in the first place? And if so, what are the important aspects to consider before taking the plunge?

G.N. Based on the above background and your own thoughts, could you share your first thoughts that come to mind on this topic?

Dr.K. When I think of parenthood and children, the first thing that comes to my mind is the big challenge which takes place in the modern world. The richest societies are facing a slow or even a negative demographic growth, whilst the populations in developing nations are exploding.

The main question is: what influenced the rich nations, who theoretically would be capable of creating a perfect environment for families and children, this way? What are the common characteristics of these societies?

I would like to point out some crucial socioeconomic developments common for them:

– The rapid technological development, increasing materialistic orientation of the societies and a crisis of traditional values including religion.

– The model of multigenerational family consisting of parents, grandparents, uncles, aunts and so on, a network which supports the young parents vanished.

– The creation of a certain social status requires a long period of education including some work experience. This shifts the decision to create a family to a later period of life (in the Western nations the average age of the first pregnancy lies between 27-30 years).

– The dynamics of industrialized nations force individuals to change their workplace often.

– In most of the cases the woman takes on the primary caregiver role and is more affected than the man. She is often forced to reduce or abandon her aspirations concerning her professional plans.

Individuals can´t be blamed for this development. They are only the product of a changing environment.

Due to my experience the central problem in the soul of modern, well educated women is the conflict arising from the tension between two opposite tendencies: on the one side the necessity to perform “the masculine role” in society, having a career and maintaining her autonomy this way, and on the other side the need to be a mother and a wife.

Of course, the decision to create a family and to have children has a big impact on the personal lives of the parents. The psychological structure of a man/ women didn’t change that much during the last millennia. The creation of a family, birth and upbringing of children is still a central psychological need and goal of human development.

G.N. What advice would you give to women / men who are at the crossroads of parenthood / looking to start a family / confused about whether they want to be parents?

Dr.K. I consider children to be of great personal value to the parents. Since I am also a pragmatic person, my advice will be:

– Find the reliable partner. Family life is a “job” which is best performed in teamwork. You need someone on your side whom you can trust, and who will go through thick and thin with you.

– Be aware of the responsibility resting on your shoulders. Giving a birth to a child means to be on his/her side for at least two decades! Furthermore, the child needs both parents.

– First create a stable environment, having a steady job and reliable income to support your family. The rent, the daily expenses should be paid; later, the education of the children.

– Having small, crying individuals who totally depend on you will influence you private life. It is not uncommon that after the birth of a child the personal relationship will suffer even to such extent that the parents separate.

G.N. Do you have any regional (locals and expatriates) perspectives based on the clientele you have? Any specific insights you could share?

Dr.K. My work in the U.A.E, as a psychiatrist and psychotherapist, confronts me daily with all the problems a multicultural society generates. On the one side you can see a model of multigenerational family of the Emiratis, or of people from the subcontinent. In such families the individual is supported by the family network. To be a member of a traditional family means to have this support, but it also reduces the family member’s freedom of choice. Unfortunately, you can’t have your cake and eat it too! One the other side are the nuclear Western families consisting of parents and their children. In this case there is a high degree of differentiation as the children mature, which essentially leads to them to distance themselves from their parents, so that they can make their own personal choices. As a result of this, you have fragmented families, perhaps spread over various countries, and a separation of the young and old. The family might only come together on special holidays. Elder care in such a family system becomes institutionalized which is unheard of in many traditional multigenerational families.

G.N. What steps would you recommend to parents who have children and are grappling with the realities of parenthood and family and finding it hard to adjust?

Dr.K. There is no simple advice. In our clinic I often see broken relationships after the spouses decided to have children. A type of personality with some compulsive obsessive characteristics exists.  Mothers with such a personality are prone to develop the idea to be a “perfect mother” while completely neglecting their own needs and rights to be an individual. These women often develop a depression. The English pediatrician and psychoanalyst Donald Winnicott created a term: “a mother good enough”. He said: “The good-enough mother…starts off with an almost complete adaptation to her infant´s needs, and as time proceeds she adapts less and less completely, gradually, according to the infant´s growing ability to deal with her failure…” To make it a simple: you can’t be a perfect mother. Try to do your best, love your child and relax.

G.N. There are many children who face rejection from their parents in many ways and develop so many psychological problems ranging from low self-esteem, anger, withdrawal, inability to cope with interpersonal relationships, depression. What can parents who unwittingly inflict this on their children do to right some of the wrongs?

Dr.K. I believe that there are only a small number of psychopathic personalities who are a priori not predestined to have children. Very often the inner crises of the parents (not always related to poverty) influence the whole family system.  Let´s suppose: you have a person stuck in a boring and stressful job with an angry superior. It is very probable that this person will develop some aggressive behavior (or the opposite of that: a depression) in his/her private life. In the Western countries alcohol is the most common used “remedy.” You can imagine how such circumstances influence family life.

For growing children a stable parent-child-relationship and love experienced in the family will be the most important life asset. This experience underlies the attachment theory of another British psychiatrist, John Bowlby. The most important statement of attachment theory is that the quality of the bond between a child and his/her primary caretaker (parents, other members of the family) basically impresses reactions, feelings, thoughts and expectations during adulthood. How can you give love to others if, as a child, you were not loved at all or only somewhat? From the love of the parents the trust in oneself, in other human beings and in society is skimmed.

G.N. A growing number of expatriate parents leave their children with nannies or grandparents to be reared while they work and try to provide for their family? What are the issues that could result in this arrangement? For example, pathological cycles of behavior learned from a completely different generation or cultures that then clash with the biological parents own; children who do not identify with their parents after they attain a sense of self (toddlers, teenagers, etc.)

Dr.K. From a psychological point of view, a stable relationship with the mother is the most important issue for the development of a sound personality in an individual. The first years of childhood (at least until the 3rd year) are crucial for this development. It is important that the mother is present for the child. It doesn´t mean that she has to be with the child 24 hours per day. She can certainly enlist additional support from the father, other family members, or a trusted nanny.  The first year of a child’s life is critical and it is highly recommended that the mother is at home.

It is not uncommon in the U.A.E. to see a family constellation in which the child is in the home country and the mother, due to economic reasons, works abroad. If the grandparents or other family members are capable of creating a secure bond with the child, there is nothing to worry about. The child will develop normally. They serve as “real parents.” The emotional bond is proportional to the number of days spent with the child, to the amount of sleepless nights and worries about its health, and sometimes even anger related to its upbringing. The fact of biological parenthood, or genes is less important.

G.N. How can one ascertain if they are ready to be a parent or start a family? Are there a set of steps or tips couples can keep in mind to help them make an informed choice?

Dr.K. I´m convinced that the best prerequisite for a balanced marriage and good parenthood is a certain degree of maturity. You are more conscious of your role as a wife/husband as well as a mother/father at 25-30 than at 15-17. It is better to give a birth to a child who is welcome and expected with joy, having on your site a reliable partner and some financial stability.