Thumb Sucking: Orthodonture or Psychotherapy?

Thumb Sucking

Thumb Sucking

Thumb sucking can become a heated issue for parents. “How can I get my child to stop sucking her thumb?” is a common question asked by parents. And there are so many “remedies” on the market to help achieve this goal—bitter nail solutions, thumb wraps, children’s books to coax a child away from the act, and parenting books with numerous strategies. I rarely hear the question, “Why is my child sucking her thumb?” As a psychologist, I wish we would start there.

Yes, I too have heard from pediatric dentists that constant thumb sucking may impact the teeth, jaws, or roof of the mouth. But I’ve also read sources (e.g., American Dental Association, 2016) that suggest that we shouldn’t be too worried for a young child. And, as noted by the American Dental Association (2016), excessive pressure to halt thumb-sucking can in fact do more harm than good.

Children can be seen sucking their thumbs even before birth in the womb. It is a natural way to self-soothe and relax, and may build a sense of comfort and security in times of stress. Some children gradually develop other modes of self-soothing by the time they reach 4 years of age, especially when they learn to express themselves and connect to others with words and other activities.

But children are not all built the same. Temperaments differ. Some children are born with more intense feelings that are harder to manage. And environments do not have the same impact on all children. Some children relish being surrounded by activity and sounds, while these can overwhelm others. Of course, an especially stressful environment can cause problems for a child, but even a normal level of stress may overwhelm the coping mechanisms of some children.

If a child is over 4 and still wishing to suck her thumb, rather than jumping to eliminate this potentially important source of comfort, I would encourage parents to consider the needs of their individual child.

• Is the thumb sucking merely a habit which is no longer important as a source of calming?
• Is there something they can modify in the child’s environment to reduce stress?
• Can they help her develop other coping strategies?
• Or should they allow the child to continue sucking the thumb until she is ready to move on?

In some cases, future orthodonture may be a more desirable alternative than years of psychotherapy as an adult.

APA Approved SponsorThe Institute of Advanced Psychological Studies is approved by the American Psychological Association to sponsor continuing education for psychologists. The Institute of Advanced Psychological Studies maintains responsibility for this program and its content.

What a T-Shirt and Ticklish Gorilla Can Teach a Psychotherapist About Building a Life That’s True to the Self


Identity Development

Identity DevelopmentI’ve learned much from both my favorite t-shirt and a ticklish gorilla about identity development, self-awareness, and building a life that’s likely to be fulfilling.

First, for the t-shirt.  My favorite t-shirt has a little label sewn on it that says, “Do what you like, like what you do.”  I’ve thought a lot about this.  How is it that we can come to know what we’ll like to do?  It’s a question that I believe is related to identity development and self-awareness—areas that I’ve long been interested in as a psychologist, psychotherapist, and college professor.

How can we come to know who we are and what we’ll like? 

Can we think our way there?  Can we read about options on the internet, consider our intellectual strengths and temperament, select a path, and live happily ever after?  Or is there benefit to meandering along unplanned trails, getting dusty and sweaty, and feeling the warm sun on our face?  Which approach will provide us with a more fulfilling journey as we proceed through life?

I spent the entire summer after graduating from high school, thinking about exactly what college would be like.  I read about it, dreamed about it, and had long discussions about it with my dog Louis, until I thought I had it all planned out.  I would be a French major and then go on to Law School.  And I would establish a law practice in Paris.  It all made perfect sense.  I loved French poetry and had taken French since the 3rd grade—something not uncommon on the east coast—and so was pretty good with the language.  I was analytical.  And I thought Paris was a beautiful city.  And so, here I am, today, a lawyer in Paris…  My point is that I really had no idea what would be in store for me over the next few years.

So, I began my first year in college as a language major.  The only field I’d ruled out was psychology—I thought that psychologists must be, by and large, strange people and kind of scary.  But then, one day as I was stumbling through the halls on my way to a class, a psychology professor stopped me and asked if I’d like to run a study with him.  What kind of study could one run in psychology anyway, I thought?  Fortunately, I said, “Sure,” thinking of it as an opportunity to try something strange—strange, like eating chocolate-covered ants might be strange.  But he soon had me researching in the library, constructing questionnaires, running all across campus to collect participants, learning about stats so I could analyze the findings…  If I’d stopped and reflected on what he’d have me doing before I jumped in, I never would have said yes.  I never would have considered psychology—a field that I’ve now been very happily working in for most of my life—if a professor hadn’t encouraged me to “try it on.”

Now for the ticklish gorilla.  A delightful article by Bering (2010) was published in Scientific American several years ago.  It was about evidence that animals have a sense of humor.  I’d like to share this excerpt from the article:

When I was 20, and he was 27, I spent much of the summer of 1996 with my toothless friend King (a 450-pound Western Lowland gorilla, with calcified gums), listening to Frank Sinatra…, playing chase from one side of his exhibit to the other, and tickling his toes.  He’d lean back…, stick out one huge ashen grey foot through the bars of his cage and leave it dangling there in anticipation, erupting in shoulder-heaving guttural “laughter” as I’d grab hold of one of his toes and gently give it a palpable squeeze.  He almost couldn’t control himself when, one day, I leaned down to act as though I was going to bite on that plump digit.  If you’ve never seen a gorilla in a fit of laughter, I’d recommend searching out such a sight before you pass from this world. (para. 2)

Now, a lot has been written in the field of psychology about identity development.  And, with the help of neuroscience, a helpful distinction is starting to be made between identity and self, putting words to elements that are related but actually quite distinct (Gerson, 2014).  Identity refers to a self-reflective third-person understanding of oneself, whereas self is a more primitive and core first-person sense or experience of oneself.  Early on, we move from a purely personal experience as and become more reflective, as we become socialized and develop language (Gerson, 2014).  We no longer merely experience with our senses, as we develop tools to reflect on and think about our experiences.  We become our own observers.  This development represents identity (me), as opposed to self, which involves our personal experience as an I.  Our gorilla friend probably experienced more self-ness than clarity about his identity—but that’s for ethologists to verify.  Human adults, on the other hand, often lose touch with their basic self.

If I asked you who you are, I might get a variety of answers.  You might say “an adult,” “a generous person,” “a teacher,” “a psychotherapist,” and so on.  These would tell me a little bit about your identity—descriptions that derive from observations of or reflections about yourself.  But, now take a moment, and think back to your earliest remembered experiences.  Try to experience what it felt like being you at the time, not as an observer, but as a participant.  Did you feel excited, timid, curious?  Now, you could probably tell me something about your self.  Probably something our gorilla friend was acutely aware of during the play experience. 

My experiences with my psychology professor had transformed both elements.  They had changed not only how I thought about who I was, but also how I experienced my self, in the first person—I.  And redirected me down a path that has allowed me to build a life doing what I really love.

Erikson (1959) (who did not distinguish in his writings between self and identity) wrote about the value of moratoria in identity development.  I believe first-hand experiences are important for becoming aware of the paths that will be consistent with the self and lead to an optimally satisfying life.


Bering, J. (August, 2010). Laughing rats and ticklish gorillas: Joy and mirth in humans and other animals. Scientific American

Erikson, E. H. (1959). Identity and the life cycle: Selected papers. Psychological Issues, 1, 1-171.

Gerson, M. J. (2014). Reconsidering self and identity through a dialogue between neuroscience and psychoanalytic theory. Psychoanalytic Dialogues, 24(2).

Facing Dreaded Projects (How to Make a Mole Hill Out of a Mountain)

Facing Big Projects

Facing Big ProjectsWe’ve all had to face that project that we’ve dreaded.  A paper, a speech, preparing an event.  Maybe we don’t feel that we have enough background or the skills needed to do the project well or even to do it at all.  Or maybe it’s just that it’s so big—like a mountain we’ll have to climb, with its peak so tall that it’s obscured by the clouds.  Or maybe both—we’ll have to climb it barefoot and it could erupt with lava at any moment… Clearly, I have personal experience with such trepidations.

To be efficient in tackling such projects, we need to consider both the emotions that may be involved and how to tackle the project in a problem-solving mode.

Diffusing or Managing the Emotions

Over a century of research shows that it’s really hard to think and plan when our emotions are intense.  Some degree of anxiety can be motivating, but when we’re too aroused, our minds shut down (Yerkes & Dodson, 1908).  Even trauma research supports the importance of moving beyond an emotion-focused coping style to one that works on problem solving (Penley, Tomaka, & Wiebe, 2002). 

Plan A: Consider what you might be so worried about.  What meanings do the project, its accomplishment, or its failure have for you?  They may be as simple as concerns about increased expectations for the future or not wanting to appear foolish to one’s peers.  Sometimes the meanings are less apparent.  In helping doctoral students, I’ve been struck by the number of times a student couldn’t complete their dissertation until a revered parent passed away.  Only then did it become clear that the resistance had been rooted in less obvious fears, stemming from prohibitions against competing with the parent, anxiety about incurring the parent’s envy, or symbolically becoming an independent adult

If you’re stumped about the meanings, it may be helpful to ask yourself the question immediately before going to sleep: “What meanings does this project have for me?”  I’m a big believer in our problem-solving abilities during sleep.  With the decreased censoring by the prefrontal cortex during sleep, you may gain some insights (Barrett, 1993).  Hopefully, you’ll discover some meanings that you can recognize as survivable and so will no longer be incapacitating. 

But if you can’t figure the meanings out or otherwise diffuse them, go to Plan B: work around them by delving full-force into the next step.  

Tackling the Problem

From here, no more keeping things in your head—put everything on paper (or its technological equivalent).  This will not only help with constructing a reasonable plan and monitoring its progress, but can also reduce the emotionality of the task.

Get out or access a calendar.  When must you reach the top of the mountain?  How much time does that give you?  Be very concrete — “3 weeks,” rather than “frighteningly little.” 

Say you have 3 weeks.  Is there an event (e.g., Thanksgiving, your daughter’s 16th birthday, etc.) that will interfere?  How many days does that now leave?  How much can you reasonably expect yourself to accomplish each week?  Each day?

Now, chop the project up into do-able pieces.  Small pieces–pieces that can be accomplished within no more than 1-2 hours each.  Do you need to consult with someone for guidance to help you know what all of the pieces are?  Include that as a piece.  Don’t freeze in fear; problem-solve.

List all of the pieces in an order.  If some must follow others, number these (1, 2, 3, …).  If some are interchangeable, follow their numbers by letters (e.g., 1a, 1b, 1c, …).  Allow yourself to move between the letters.  For example, if you don’t feel like working on 1a at the moment, you can start with 1c.  I find that this flexibility helps give at least an illusion of choice.  You may not have a choice about whether to do the project, but you may have some in freedom in how to proceed from hour to hour.  This can relieve boredom (and any rebellion that may be lurking in the wings).

All aspects of your life probably can’t be put on hold during this period.  Make a list of any other noteworthy things that must also get done during this period—appointments to keep, classes to teach or attend, bills to pay.  Put off nonessentials until after the 3 weeks are over (or do them during breaks of non-thinking down-time)—polishing shoes, looking into new window treatments or car detailing, a monthly call to Aunt Sue, bills not due for a while, etc.

Consider what windows of time may be least disruptive to your life and/or best for a clear mind.  Early morning before others are awake?  Late at night when things are quiet?

Also consider how you work best.  Short bursts interspersed by other activities?  Long, uninterrupted periods of focus?  Schedule your day so it works most efficiently for you. 

But, however you plan your day, be sure to schedule periods of sacred time dedicated only to the project.  Do NOT just tell yourself that you’ll “work some time in” for the project—chances are, other obligations will edge it out.  Years ago, a colleague said something that had, oddly, never occurred to me but has worked out well—a person can always get up earlier.  I was never an “early bird,” but I’m also not a “night owl” (if you are, this may not work for you).  But I find it best for me to hobble over to my desk every morning, before I’m awake enough to talk myself out of it, to put some time into a project I’m needing to accomplish.  Of course, my desk must be ready for me so I can plunge right in (Achor, 2011).

Each morning (or evening), reevaluate your schedule, check the number of remaining days, and modify your list accordingly.  Modifications are part of the process. 

Happy mountain climbing!


 Achor, S. (2011). The happiness advantage: The seven principles of positive psychology that fuel success and performance at work. Virgin Books. ISBN-13:9780753539477

Barrett, D. (1993). The “committee of sleep”: A study of dream incubation for problem-solving.  Dreaming, 3(2), 115-123.

Penley, J. A., Tomaka, J., & Wiebe, J. S. (2002). The association of coping to physical and psychological health outcomes: A meta-analytic review. Journal of Behavioral Medicine, 25(6), 551-603.

Yerkes, R. M., & Dodson, J. D. (1908). The relation of strength of stimulus to rapidity of habit-formation. Journal of Comparative Neurology and Psychology18, 459–482. doi:10.1002/cne.920180503.

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