Parents

Dr. M’s SPA Newsletter Volume 16 Issue 22 – Technology and Kids

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The Hardest Part of Medicine Isn’t Making the Diagnosis

Last week I wrote that one of the most healing words in the English language may be “no.” I believed it when I wrote it.

After today, I believe it even more.

Today was one of the hardest days I’ve experienced in medicine in a long time.

I drove home with a heaviness that is difficult to describe. Not because a child died. Not because I faced an impossible diagnosis. Not because science failed me. Not because of the many reasons medicine offers for struggle.

I drove home grieving.

Grieving for children who have no idea what is quietly happening inside their own bodies.

Grieving for my own pain at being unable to convince certain parents to see this problem.

Grieving because I can already see a future they cannot.

Today marked the one-year follow-up for many of the children enrolled in our asthma pilot program. We built this program around hope. We invested time that most medical practices simply don’t have. We spent hours educating families. We provided healthy food. We offered gift cards to encourage participation. We discussed sleep, movement, nutrition, inflammation, insulin resistance, and the remarkable ability of the human body to heal when given the right environment….. and a literature review.

Enjoy,

Dr. M

Dr. M’s Women and Children First Podcast #111: Duey Freeman, MA – Attachment


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Welcome back to Dr. M’s Women and Children First. Today’s conversation moves into one of the deepest layers of human development: attachment, relationship, and the way early experiences shape the architecture of our emotional lives.

My guest today is Duey Freeman, a licensed therapist, teacher, mentor, and internationally respected voice in attachment theory, human development, and relational psychology. Duey has spent decades teaching therapists, graduate students, and helping professionals around the world, developing a practical framework for understanding how connection, or the absence of it, shapes the nervous system, identity, and the capacity for intimacy.

He has logged nearly 80,000 direct clinical hours and co-founded both the Gestalt Equine Institute and the Gestalt Institute of the Rockies.

What makes Duey’s work unique, and it is unique, is that he does not approach attachment as a sterile academic theory. He approaches it as lived human experience. His work centers on a simple but profound truth: what is injured in relationship is often only healed in relationship.

In this episode, we explore how attachment patterns emerge in childhood, how they quietly shape adult relationships, parenting, stress physiology, and even our sense of safety in the world. We discuss the roots of attachment theory through the work of John Bowlby and Mary Ainsworth, and we move into modern concepts involving trauma, nervous system regulation, emotional attunement, and relational repair.

We also touch on an uncomfortable reality in modern culture: many people are surrounded by communication yet starving for authentic connection. Children especially do not simply need instruction or behavioral management. They need co-regulation, attunement, eye contact, emotional presence, and secure relational anchors.

This conversation is not just for therapists. It is for parents, physicians, educators, coaches, and anyone trying to understand why humans behave the way they do under stress, conflict, intimacy, or loss.

Duey brings an unusual combination of wisdom, groundedness, tenderness, and clinical depth to this discussion. I have heard him frequently called Yoda, and if you knew him, you would immediately understand and agree with that moniker. You can feel that he has spent a lifetime studying not just psychology, but people.

So sit back and enjoy this remarkable conversation with Duey Freeman on attachment, psychology, and the relational foundations of being human.

Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 9 – Leadership


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Brene Brown – Leadership

Tools to Teach Your Children and SELF

“Stand firmly enough to lead, loosely enough to listen.”

Strong Ground by Brené Brown published in 2025

Breaking down this new book by the excellent Brene Brown, we find that strong leaders don’t eliminate tension or risk. They hold it. And this is key! What does the hold look like? How does it show up to the team?

The theme in my mind is “toughness with tenderness”

Clarity is kindness. Vagueness is avoidance dressed as politeness.
You can be both confident and uncertain. That’s not weakness, it’s reality.
Values are not what you believe. They’re what you do under pressure.
Most leadership failures are emotional avoidance, not strategic failure.
Accountability without empathy is cruelty. Empathy without accountability is chaos.
People don’t disengage because work is hard, they disengage because trust erodes.
The goal is not control. The goal is grounded presence in uncertainty.
You can’t build brave cultures with armored leaders.
Paradox is not a problem to solve, it’s a condition to manage.
If you’re always comfortable, you’re not leading. You’re maintaining.

I especially, like the last one. Discomfort is the path to growth in all things. Think euthermia for temperature, not a recipe for human cellular health or plants for that matter. Temperature through environmental swings are keys to protein elaboration for handling the cold and the heat. The lack of swing equates to a lack of adaptability…. and a piece on the Stakeholder.

Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 1 – Beyond Behaviors Part 3, Mona Delahooke, PhD

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Chapter 3 – Individual Differences

Dr. Delahooke starts Chapter 3 by allowing Margaret Mead to remind us that each child is absolutely unique: “Always remember that you are absolutely unique. Just like everyone else.” This is more than a witty paradox, it is the hinge upon which all effective pediatric care swings. When we take individual differences seriously as neurobiological fact, we can finally stop confusing adaptive survival responses with defiance, stop labeling children as problems, and begin the real work of supporting the mind body systems that shape behavior from the inside out.

Let us review what we have learned in Beyond Behaviors so far – We are invited to descend below the waterline of the behavioral iceberg. What we see at the surface: the tantrum, withdrawal, rigidity, hyperactivity, the refusal to transition is merely a set of observable outputs from deeply personal internal variables. The sensory wiring, physiological states, immune triggers, thoughts, feelings, memories, and the child’s moment-to-moment sense of safety. Without diving into these subterranean layers, we risk treating smoke while ignoring the fire, which is the general state of current pediatric psychiatric medical therapeutics. We mostly treat the smoke. We don’t often ask about the fire. Her central thesis is simple, clinically robust, and profoundly humane:

Children behave according to the state of their nervous system, and their nervous system is shaped by individual biological, emotional, and sensory differences.

Once we understand this, behavior becomes not a moral test but a window into the child’s internal world…..

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 31 – Poly Vagal Theory, Stephen Porges, PhD

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I think that this is an important time to pause and relook at Polyvagal Theory before continuing with Beyond Behaviors.

Polyvagal Theory: Current Status, Clinical Applications, and Future Directions (Porges, S. 2025)

“Social behavior and the capacity to manage challenge are dependent on the neural regulation of physiological state.” S. Porges


When I dove into Stephen Porges’s 2025 review of the Polyvagal Theory (PVT), I felt like I’d stepped into a crossroads where neurobiology, clinical practice, trauma science, and human experience collide. This paper isn’t merely a summary of three decades of work (all of which I have read); it’s a spirited defense of a paradigm that’s been both celebrated (by me) and contested (by others). What follows is an honest appraisal of what the article teaches us, where it sparks real insight, and where it may fall short, especially through the lens of evidence-based medicine and developmental neurophysiology. (I also went deeper into his 2022 paper in Frontiers in Integrative Neuroscience for the biophysiology of the ANS)

At its heart, the article argues that the autonomic nervous system (ANS), through a set of hierarchically organized circuits centered on the vagus nerve, is not just a background player in stress and homeostasis, but a core regulator of social engagement, physiological flexibility, and behavior. Dr. Porges situates his theory as an alternative and expansion to classical views that treat sympathetic (fight/flight) and parasympathetic (rest/digest) branches as functional opposites. Instead, he proposes a three-component hierarchy: the ventral vagal complex (VVC) supporting social engagement, a mobilization circuit mediated by the sympathetic nervous system or fight or flight state, and a dorsal vagal circuit that facilitates shutdown or immobilization under extreme threat…..

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 30 – Beyond Behaviors Part 2, Mona Delahooke, PhD

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Review of Chapter 2 of Beyond Behaviors
by Mona Delahooke, PhD


“Social behavior and the capacity to manage challenge are dependent on the neural regulation of physiological state.” S. Porges

Top Down or Bottom Up?

“Before We Respond to Behavior, We Need to Understand Its Origin.”

With a deceptively simple observation, Dr. Delahooke reshapes the entire field of behavioral intervention: children’s actions come from two very different places in the brain. Some behaviors are top-down, intentional, planned, thoughtful. But many, especially the ones adults find most perplexing, arise bottom-up from stress responses generated by the body’s autonomic nervous system. We often think of this state in terms of fight or flight, however, it is not that simplistic. It is truly any significant response to the outside environment that leads to a neuroceptive reaction that is not governed by the neocortex, top down. If we don’t distinguish the source, our interventions are guesswork at best and often counterproductive at worst.

She illustrates this through a case, a child whose impulsive, disruptive behaviors were treated as failures of will or desire. School teachers and teams repeatedly urged him to “use his words,” as though language were a faucet he simply refused to turn on. What no one stopped to ask was the foundational question: Was his nervous system regulated enough to access language at all? Was he gated at the level of the amygdala blocking the ability to use his mind consciously and even have the opportunity to respond to a meaningful request? Is he capable of the ask, not in terms of willingness, but in terms of physiological access to the skill itself?
….. and more

Enjoy,
Dr. M

Dr. M’s Women and Children First Podcast #102: Jeremy Goldberg – Life Begins


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This weeks Guest is Dr. Jeremy Goldberg. He styles himself as a compassion cultivating day making change agent/empathy collecting not quitting word wizard/chief burrito appreciator aspiring to inspire/struggle overcoming ranter in charge/ferocious idealist/never giver upper/a love bombing kindness pirate. What he really does, in my mind, is write and teach the world to project love and kindness where it is not layered enough. On his website he writes: My mission is to make kindness cool, empathy popular, and compassion commonplace. As part of that purpose, I write articles, send emails, host retreats and workshops, give TEDx talks, coach clients, host a podcast, write books, and make spoken word poetry videos. My name is Jeremy, I founded Long Distance Love Bombs, and I am fucking stoked to meet you. Send me an email and let’s get going: LongDistanceLoveBombs at gmail dot com. We breakdown words, relationship, connection and being happy in a world of silly tribal divisiveness!

In this conversation we discuss his experience as a new father and the initiation of fatherhood. “I have been wiped out and annihilated by parenting and the initiation of fatherhood. Hands down, brutally, face dragged along the hot coals of the initiation….” There are so many real, honest, open truths dropped along the winding road of this discussion. If you are young and ready to understand the world of fatherhood, this is a conversation for you!

Dr. M

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