About Our Guest- Dr. David Hill- Co-Parenting Through Separation & Divorce

David Hill, MD, FAAP is a hospitalist pediatrician at Goldsboro Pediatrics, Adjunct Assistant Professor of Pediatrics at the University Of North Carolina School of Medicine, a member of the American Academy of Pediatrics Council Management Committee, and Associate Editor of Pediatric Care Online Patient Education for the AAP. He writes and lectures nationally and internationally on pediatric topics including media use, fatherhood, and family separation. He is the co-author of the new book “Co-Parenting Through Separation & Divorce“.

Full Podcast Transcription

Dr. David Hill 00:00
I think any parent is going to agree that they want their children to be healthy, safe, happy, successful, right? Okay, now we’re having a conversation starting from a shared goal. And when you start with a shared goal, it’s much easier to get to where you’re trying to go.

Diva Nagula 00:23
Hello, everyone, and welcome to another episode of From Doctor to Patient. Today, I have David Hill joining us. He is a hospitalist pediatrician at Goldsboro Pediatrics, Adjunct Assistant Professor of Pediatrics at the University of North Carolina School of Medicine, a member of the American Academy of Pediatrics Council Management Committee, and Associate Editor of Pediatric Care Online Patient Education for the AAP. He writes and lectures nationally and internationally on pediatric topics, including media use, fatherhood, and family separation. He’s the co-author of the new book, co-parenting through separation and divorce. David, how are you today? Thank you for joining us.

Dr. David Hill 01:21
I am fantastic. Thank you so much for having me on today. I really appreciate it.

Diva Nagula 01:25
And congratulations on this great book. What spawned this publication? Was it personal experience?

Dr. David Hill 01:37
Yeah, absolutely. It was personal experience. My first book Dad to Dad: Parenting like a Pro, not my idea for the title by the way, but it came about when I was in the middle of functioning as a single parent. I had gone through a separation and divorce and was working on a remarriage. And I recognized at that time that there were an awful lot of dads out there, including in my pediatric practice, who were trying to function as a sole parent or as a primary parent, and a lot of people functioning as dads who might not necessarily be traditionally thought of as dads such as grandparents, uncles, you know, two dad, families, etc. And I thought, you know, we really need something that speaks to us, and provides a comprehensive childcare guide in the voice that we understand. And, you know, lets us know, hey, we can do this. And so that was where I started. And then the AAP publishing, folks actually approached me and said, you know, we really liked what you did there, would you be willing to speak directly to families undergoing separation and divorce, and they paired me up with a writer that I had not known. Before that Dr. Jan Blackstone, who is a Psy D. She has worked for 20 years, she just retired in the California family court system as a mediator. And she, like me had undergone separation, divorce, remarriage, trying to blend a family and has written extensively about it. She came up with the bonus families movement and had written about six books about this before, as well as a nationally syndicated column. And so when they said, Hey, you guys need to talk and see if you can put something together. It was fantastic. Because we had so many experiences in common, so many of the same struggles, and then sort of complimentary professional approaches me coming at it as an MD and her Psy.D.

Diva Nagula 03:50
That’s great. It’s a great combination, and actually works really well for this type of topic and experience and knowledge. And I’m glad that the synergies worked out really well, with what you wrote, and let’s get into the nitty gritty of the topic at hand. I mean, How can parents really help their children cope with their new reality? I mean, is there really a good time to discuss this transitional phase?

Dr. David Hill 04:16
You know, as soon as it’s going on is a good time. But there’s also a good way, right? You want to think about the environment. If you are functioning together as a couple well enough to try and have this conversation together. That is a great way to do it. Some people are fortunate enough that they can be in the same room and sort of provide a combined message. That was my personal experience. Sometimes things are too emotional, or somebody is going through a really hard thing in life and they’re not really available at that time. And so it may not work out that way. But you really want to think ahead of time before you drop this on your kids. How is life going to Look for my children, and what do they need at their developmental stage? You know, so a young child just needs to understand, hey, we’re going to live in different houses. And we both love you. And you’re going to see both of us and you’re not going to lose your dog. And you’re still going to see your friends. If that’s, fortunate enough to be the case. An older child may have a lot more detailed questions, a teenager may have many more detailed questions. And you want to sort of think those through – imagine what’s going to be the same? What’s going to be different? How are we going to keep both parents involved with the child’s life? How are we going to get your needs met? And, be ready to answer those questions in the moment. Here, though, is what no child needs to know. Here is everything the other parent did wrong. That is just at no point, at no age, do you need to tell your child what’s wrong with the other parent, how they wronged you what they did, that they shouldn’t have done. Now, if there are cases where the child already knows that, for example, perhaps the parent has been arrested, perhaps you came home to find somebody there who shouldn’t be there, or a parent has gone into rehab for something, well, you’re gonna have to address that, that’s a conversation you’re gonna have to have. But if there are elements of what went wrong in the relationship, because the two of you to end up apart, that you just want the child to know, so they know how bad that other parent is that it wasn’t your fault, save it, just save it, they do not need that, what they need is to be able to trust and love both of their parents. And the fact is, we all have flaws, we all have strengths. And over time, children of separation/divorce, or even children and families that are intact, we’ll figure out what each parent’s flaws and strengths are, they’re going to learn over time, who each parent is and what they can come to them for and what they might not be reliable for. And you don’t have to you don’t have to set that table for him, they’ll find it.

Diva Nagula 07:08
That’s, that’s actually really good information. I mean, I have to agree with that. That’s the last thing that you want to do, is to dump all your problems and issues on the child that suffering from from this divorce or separation. And I guess there’s, you’re gonna, even though the child’s living in two different homes, there has to be some sort of co-parenting that takes place. I mean, what recommendations do you have for effective ways to co parent?

Dr. David Hill 07:36
You know, the first thing you have to do is figure out some way to communicate. Now I’m very fortunate, Dr. Blackstone was very fortunate in her situation, and that we can sit down in one room and have a conversation with our co parents. In fact, to this very day, I’ve still got an 18 year old and a 15 year old to go back and forth between the houses, I now live with my wife, and three of us usually meet in the driveway since COVID. We used to meet, we used to meet inside sometimes we’d share a glass of wine around the table sort of download, you know, here’s what happened this week, here’s what you need to be looking for in the coming week. Here’s something that we talked about that we might have been upset about, here’s what we did about it. And that because of COVID has turned into an outdoor conversation instead of an indoor conversation, but it’s still something that the three of us can do face to face. And that’s very fortunate. Not everybody has a situation where that’s practical. Sometimes. I mean, I’ve had families in my practice, were handoffs had to occur at the police station to avoid a physical altercation, which is really, really tragic. I think that’s awful, awful for the kids. But some people are having a hard time holding it together. But even if that’s the case, I mean, even if you have to write a letter, and pass it to the other parent or agree it’s going to be an email or a text or, you know, somehow you have to communicate and there are a couple of ways not to communicate. Do not make your child the go between, you know, be sure until you’re dad when you get over there that you need your baseball uniform washed, because kids are kids, maybe they’re gonna forget, maybe the parents not going to hear maybe they don’t get everything right. I know Mom said there was some laundry that needed to be done I forgot what it was right? And now the kid is in the middle, you’re gonna have to be an adult in some fashion and carry this information directly – don’t go through the child to do it, they’ve got enough to worry about just taking care of themselves. So grow up and and you know, communicate in some fashion, if you at all can. Another thing to do is to try and find places where you agree. I think any parent is going to agree that they want their children to Eat healthy, safe, happy, successful, right? So even if the two of you are in a place where you can agree on almost nothing, you can probably start with “boy, we want our kids to be okay.” Right? Now you may have different definitions of what that look like, you know, one of you may think playing video games all night is a great idea and the other may not. So now you can get down to details, right? But if you can start at a place where we say, you know, I want our children to thrive, I want them to be well, I want them to have friends, I want them to do well at school, I want them to explore whatever makes them happy. Okay, now we’re having a conversation starting from a shared goal. And when you start with a shared goal, it’s much easier to get to where you’re trying to go.

Diva Nagula 10:53
Yeah, that brings up another point that I wanted to ask when, obviously, you and your ex wife are in good terms. But when the separation or divorce is new, and it’s filled with emotions, on both sides, how are you able to communicate with each other? In a heightened emotional state? You know, obviously, the child’s best interest is suffering. I mean, how do you like, get rid of those emotions and tap into the logical portion of your mind and move forward in a positive way?

Dr. David Hill 11:27
You know, I’m a huge fan of mindfulness meditation and other meditative practices. But one of the keys to all mindfulness is recognizing that you really don’t have that much attentional bandwidth, right? So if I’m really going to focus on my breathing, or the way it feels to sit in this chair, or the sounds in the room around me, or, or what I smell right now, it doesn’t actually leave a lot of room to focus on what I’m worried about, or what I’m angry about. That’s really, you know, that’s the magic of mindfulness is you just don’t have enough mental bandwidth to think of 20 things at once. So you can be selective in what you pay attention to. And I encourage parents, we do in the book, to pay attention to your vision for that child. Now, other things are going to come into your head, right, that’s what happens when you meditate stuff comes in, I have bills to pay, I haven’t figured out what to eat for dinner yet, I’m uncomfortable in this position, whatever, and things are gonna come into your head, you’re gonna be like God, that jerk, I can’t believe what he did. Or he’s out there having fun, and I’m working so hard or, you know, you’re going to have those thoughts. And the key is to give those away for a little while and just focus on – this is what our child needs to be well – right now, you know, our child needs some books for school, we’re gonna have to figure out how to get those. You know, right now, with a lot of people not going to school in school, maybe our child needs a tablet computer that she can use to study or maybe she needs a quiet place. So let’s just focus on solving the problem. And when you get tempted to move off of the problem at hand, and into everything else that you want to say, you just have to bring it back to the problem. For example, you know, we agreed on a drop off at five. And now it’s 520. And now my dinner is going to be late. You can be all about you know, I really hope that we can get our drop offs on time. Tell me what happened over there. Did you? Did you need to gather the stuff was was there laundry that needed to be dried? You know, did you forget a shoe? Did somebody call? Or you can go to oh my gosh, you’re always late. This is something I hate about you, I always have you never get anywhere on time. You’re not going to solve a problem by going to that second place.

Diva Nagula 13:59
Yeah, so you’re not reactive, and can be proactive. Right?

Dr. David Hill 14:02
Exactly. So stick with the thing. And leave that other stuff aside for another day.

Diva Nagula 14:09
Yeah, I think that’s probably also good advice for just in general. Oh, yeah. When we’re having constant conversations or arguments with other people, I mean, it’s just a great way to, to live life. And also with these situations, you know, we tend to think the worst, right? So we don’t know what condition or, you know, what experiences the child has at the exes home, you know, you want to know, and make sure that that child is safe at your exes. I mean, how do you go about doing so without being so you know, over the top about it?

Dr. David Hill 14:47
Yeah. This is back to communicating in a common direct way with the other parent and find out what happened. Jan tells this amazing story. Just a hilarious story in the book of a patient, that she was counseling, a couple who came to her for mediation. And the mother was incredibly upset because the child came back and said that she caught dad sleeping with his girlfriend. And mom’s like, Oh, my gosh, she’s sleeping, we’re there right in front of my child, you know, she immediately mandated that they’re probably naked, they’re probably having intercourse, right. And when she went to the drop off and addressed it, dad’s like, oh, yeah, we fall asleep on the couch watching television. And, you know, she walked in, in the morning, and we were still asleep on the couch. So that’s not at all what she thought was going on. Right. So before you, run to the worst case scenario, go to the other parent and say, you know, my child, our child, told me something that concern me a little bit, you know, what was really going on? Now, it may be that what was really going on was something that was very concerning. And if that’s the case, well, you’re going to have to address that. But be aware that the story you get from the child, is you know, it’s a game of telephone. And before you absolutely hit the ceiling and lose it, and you know, start to call your lawyer and the cops and DSS on the other parent, first, go and try to find out what that parent side of the story is. And it may not be nearly as upsetting as you thought.

Diva Nagula 16:27
That’s a good point. And another thing, I wanted to share an experience, actually, I have a really good friend of mine, who is recently separating from his wife. And they’ve been married for, I don’t know, 17-18 years or so. And they have a daughter. She’s, I think she’s 12 or 13ish. And so they have 50/50 custody. So it’s split equally. But the issue that came out recently, when the joint custody was awarded, was, how do you split vacations in time? You know, there was an argument about my friend who had her for a week during the summer vacation. And it was around the same time that his ex wife’s birthday was, and there was an argument about who gets the child when, you know, what’s the best way to go about this discussion? Because it can also trigger some emotions.

Dr. David Hill 17:20
Yeah, you know, there are so many ways to address that, so that it’s a win-win. And, you know, I love negotiation, I think it’s fascinating. And so when you come to the negotiating table, what this is, it’s a negotiation, right? I have a thing that I want, it’s important to me to have my child with me this entire week, during the summer, I made plans, I was excited about it. And I see that your birthday is coming up, and you really want her with you on your birthday, because you’re going to be sad if she’s not. So what else can you bring to the table? If you bring it down to a zero sum game, you know, you lose, I win? Or vice versa? It’s gonna be really hard to find a way around it. Right? I mean, you just say, look, this is what our custody agreement says, We signed it. We both agreed to this. That’s that, right? I mean, that’s one way. Usually there’s a custody agreement in place for these things. But there are other ways there is saying, you know, I know how important it is free to have her on your birthday. And I really want to make that happen for you. I noticed that we didn’t really address Father’s Day, and I’m going to be really sad if she’s not with me on Father’s Day. Can we talk about that, right? I mean, there are a lot of other things you can bring to the table if you’re going to get creative. And as you do that you sort of build a stronger working relationship. And you know, you may be really upset with what happened and really upset with the other person. But you might still find a place where you can come to this as a business relationship really. and say, Okay, how do we enlarge the pie? How do you get more you want more of what you want, and I get more of what I want. And, you know, if you’re a good negotiator, you should be able to come away from the table with something that makes you pretty happy.

Diva Nagula 19:11
And then I guess that would hold true for making preparations for the holidays.

Dr. David Hill 19:16
Yeah, and usually holidays are addressed in a custody agreement. So that’s part of what custody agreements are for are to hash out who’s where when is it practical for kids just spend a half day in one home and a half day in another home? Or do you switch off holidays? Or, you know, maybe if you celebrate different holidays, you know, you’re like, Look, I’m gonna have the kids for Hanukkah and Rosh Hashanah, and you know, whatever, whatever other holiday you want to name and you get Christmas because what do I care, right? There are different ways to look at that but that’s when the attorneys or attorney or mediator gets to and you sort of decide what’s important to you, and also what’s important to the child. Right? Again, you want what you want. But sometimes you have to say, you know, this child has always woken up in this house on Christmas, and you’re going to have that house. So you know what, you always get Christmas morning and I’m okay with that. Right. You know, think about the child.

Diva Nagula 20:42
And I guess the most difficult question, but the most pressing question, to you, in this discussion that we’re having, is essentially, what do you really advise in terms of acclimating your child if there’s someone new in your ex’s life?

Dr. David Hill 21:51
right, so that acclamation really needs to happen on the ex’s side. But that’s the thing that you can talk about, hopefully, with the ex, but if you are the person bringing a new person into your child’s life, I think the first thing to know is that this really should not be a revolving door. Children in separation/divorce have two hopes that are opposing, but coexisting, one is that their parents are going to reunite. They never give up hope that somehow things are going to go back to the way they were, even if in your mind, they were really awful. They were what the child knew is normal. So children are going to want you to get back together. At the same time. They want a family. So if somebody new comes in, they’re going to be wondering, is this going to be my new mom, is just going to be my new Dad? How am I going to relate to them? Are they going to be nice? Are they going to be mean? Are they going to care for me? Are they not going to like me?And that bonding experience that kids go through naturally, if you bring a new significant other into the home, is really powerful. And if they have to go through mourning, again, because that relationship doesn’t work, you really want to minimize the number of times you put them through that. Now, it may be inevitable a couple of times, you may have a couple of very serious relationships that still don’t end up working out. That happens. But what you don’t want is to introduce your child to every single person that you meet on Tinder, and comes over to pick you up for a date, right? They’re gonna be like; Who is this? Are they important? Try and figure out outside of the home and outside of the family, how important this person is going to be before you introduce them to the child. And that includes having a really frank discussion about what parenting looks like to you. Some examples as a pediatrician, if I were dating somebody, and I found out that they smoked, I might have real problems with that person being around my children because they’re going to expose them to third hand smoke. If I had a discussion about parenting with somebody I was dating, and they’re like, ‘Oh, yeah, if you don’t smack a kid, sometimes they’re gonna get mouthy.’ That’d be an enormous red flag to me. I’d be like, you know what, I’m a pediatrician. I cannot raise my children in a household where they’re going to be spanked. We think that that’s really counterproductive. You know, so you need to talk about those values ahead of time and really find those red flags and either address them or move on, and only introduce your children to people that you think have a very high likelihood of becoming really important in all of your lives. And then, when you do that, give them some time to figure out how they feel about that. And give that person some time to figure out how they feel about it because those dynamics are going to evolve. That person is going to be on their best behavior for weeks or a month or two, Oh, I love kids, I love your kids until one of your kids, you know, vomits on their shoes. And then you’re going to see how they feel about a child vomiting on their shoes, or throwing a fit in the grocery store, you know, you’re gonna have to let things get rough, before you really know how that other person is going to respond. And so give that time.

Diva Nagula 25:24
Right. And talking from, you know, doctor to doctor here. A lot of these kids who are going through this transitional phase, they may act out, some kids, depending on their personality may just keep everything internally. But yet, both sides, they could manifest some sort of diagnoses, if we will, or health issues could be manifesting. What are some things that parents should look out for in their kids? If they’re acting out? Or if they’re, you know, suddenly they see their children not eating? I mean, are these common conditions that the parents should be looking out for?

Dr. David Hill 26:03
Well, I think they are common, but they also deserve to be addressed in a really proactive way. To begin with, you know, I’m both a doctor and a dad, which means I’d love to fix, right, you’re like that we, we do this because we want to make things better. We want to fix things, we want to fix people. And for that reason, I find it especially hard to give my kids space to be upset. That’s why it’s so difficult, especially when you feel like maybe it was your fault. You know, maybe I contributed to this separation or divorce in some way. And now I have caused my child to go through one of the worst things they could possibly endure. And I want to make it better now. I want to hug them and kiss them and let them know that they’re okay, and let them know that I love them and see them smile, and I want them to give me a hug and say, Dad, it’s okay, I’m going to be fine, right? Well, I may not get that. I may not get that that’s really probably unrealistic, they’re going to be upset, and they’re going to be upset for a while. And they’re going to be upset with me for a while. And I’m gonna have to allow space for that. I’m just gonna have to let that be the case and say, Hey, I love you, I see that you’re upset, I get why you would be upset. That makes sense to me. I see what you’re expressing here. And I don’t blame you, you know, if you could not kick the door in that would be really good to stores are expensive. Yeah, we’re, we’re not going to throw things. But I please, you know, if you need to scream and you know, stomp around, screaming stomp around, I get that. That said, you do want to be on the lookout for flares of mental health problems, because this is a tremendous stress. So you want to look for signs of depression of anxiety, and really seek help if you see those, grades are falling off. You know, as a pediatrician, one of the things that I treat in the outpatient setting very frequently is ADHD. But that presents as this kids not doing great at school. And before I just look at the scores on the sheet of paper, mom filled out teacher filled out, say, Oh, yeah, look, you got the score, you have ADHD, here’s your medicine. I really owe it to everybody to say, Tell me what’s going on at home? What are the stresses, because you know, if parents just separated, or divorced, I’m not going to expect a kid to be totally tuned in to school, they’re going to be upset, they’re going to be distracted. And, you know, they did great until fifth grade, and all of a sudden they fell off a cliff and the parents separated, that doesn’t want a stimulant medication that wants counseling, that wants therapy, I’m not treating the right thing. If I just say, here’s your stimulants, you know, talk to me in 30 days. So we have to be aware of those signs and go get help go get you know, if you can find any sort of therapy, there’s more and more online options in this time of COVID. Start with your pediatrician. They usually they have dealt with this before they know what the resources are. Really try and find somebody who can help your child be okay. And ask how are you feeling? What’s going on? And don’t be afraid to ask scary questions, scary for you. How are you angry with me? Because it would make sense if you were? Do you feel like you cause this? Because most children do regardless of how silly that seems for you as a parent. You know, you didn’t do this. There’s nothing that you could have done. This is not your fault. Repeat that. You know, do you feel okay being alive? Are there times you don’t want to be alive? Ask some scary questions? And if the answers are scary, get help.

Diva Nagula 29:35
Wonderful information and advice. I appreciate you coming on to this show. David, for our listeners, how can they find your book online? And if they wanted to reach out and find more information about you and or had any questions? What’s the best way of doing that?

Dr. David Hill 29:51
Yeah, so for the book, it is widely available, they can go to Amazon, Barnes and Noble or the American Academy of Pediatrics books a million and look for Co-Parenting through Separation and Divorce: Putting your Children First. I do all sorts of things in addition to that, so if they would like to learn more about what I’m up to, they can start with Dr. David Hill, doctordavidhill.com and see about speaking engagements, other writing, podcasting, etc.

Diva Nagula 30:23 Awesome, David, thanks again.

Dr. David Hill 30:25
Thank you so much, Diva. I really appreciate this conversation and thanks for dressing this
difficult subject today.

Diva Nagula 30:32 You’re welcome.