Erica Komisar never expected to become “a bit of a pariah,” as she puts it, in her own liberal, educated Manhattan world. A Freudian psychoanalyst who lives and works on New York’s Upper West Side, Ms. Komisar is a political liberal who has presented at Aspen Institute workshops and moves in intellectually elite circles. Yet, in 2017 Ms. Komisar found herself in hot water with these very people. The reason? It’s summed up in the title of her book: “Being There: Why Prioritizing Motherhood in the First Three Years Matters.” If Sheryl Sandberg is the avatar of working mothers “leaning in” to seize professional opportunities, Komisar became the not always popular prophet of staying home or prioritizing motherhood in the early years of a child’s life.

“Spending more time with your child during this critical period of development means she will have a greater chance of being emotionally secure and resilient to stress,” Komisar wrote, “as well as being better able to regulate her emotions throughout life, read others’ social cues, achieve a higher emotional intelligence, and connect with others intimately.”

When Komisar was invited onto ABC’s “Good Morning America” to talk about the book, the interviewer said, just before the camera went live, “I don’t believe in the premise of your book at all. I don’t like your book.” Things went downhill from there. That Komisar was guilt-tripping working mothers was a common theme of her critics. “Komisar wants working mothers to feel guilty so they will do as biology (allegedly) dictates and stay home with their infants,” the liberal Slate sneered. A guest at a dinner party confronted Komisar with the accusation that she is anti-feminist.

“The reaction was interesting,” Ms. Komisar told IWF, “because I got an incredibly positive reactionfrom a very large group of people who said, ‘Thank you for recognizing this work that we do that society seems to not value. And even our husbands don’t value, and our friends don’t value.’

When Komisar was invited onto ABC’s “Good Morning America” to talk about the book, the interviewer said, just before the camera went live, “I don’t believe in the premise of your book at all. I don’t like your book.” Things went downhill from there. That Komisar was guilt-tripping working mothers was a common theme of her critics. “Komisar wants working mothers to feel guilty so they will do as biology (allegedly) dictates and stay home with their infants,” the liberal Slate sneered.

“But I also got a lot of people politicizing the book and saying, ‘You are an anti-feminist, or you are a misogynist.’ I’m not an anti-feminist because I believe in women having choices with their lives and their careers, but I also don’t think that our choices can usurp or overshadow what is good for children. As an analyst who specializes is parent guidance, I have to think of the welfare of children first, as we all should.”

Komisar is a graduate of Columbia and Georgetown Universities and The New York Freudian Society. She is married to Dr. Jordan Kassalow, a prominent eye doctor, who founded VisionSpring and cofounded EYEAlliance, both of which provide eyeglasses to people around the world who could not otherwise afford them. Under the auspices of the Council on Foreign Relations, Dr. Kassalow established the Global Health Policy Program. He is author of “Dare to Matter: Your Path to Making a Difference Now,” blurbed by author and former Aspen Institute head Walter Isaacson as “a beautiful, timely book.” The couple, who have three children, met in an unusual way.

“He was an eye doctor in the practice that I went to as a patient. It was his father’s practice,” Komisar recalls, “and his father pulled out a picture of my husband and said ‘Would you date my son?’ And, of course I said, ‘Well, if he calls me.’ And he didn’t call me because, who wants to be set up by their father? But then we happened to bump into each other another time when I came to pick up some contact lenses. And we started to chat and then, one thing led to another and we started to date.”

Komisar has been practicing for 25 years. At some point, she began to observe something troubling. “I was seeing an increase in mental disorders and also children being diagnosed and medicated at an earlier and earlier age with things like ADHD and depression and anxiety and aggressive behavior,” she says.

“And so, I was connecting it in my practice to the families where mothers weren’t that physically and emotionally available to the children,” Komisar continues. And so, then for 13 years, I just basically looked at all the neuroscience research and the attachment research and the epigenetics research to see if what I was seeing in my practice was verifiable. And it was. And so, I wrote a book really to help people, educate people really, to make more informed choices.”

Komisar maintains that daycare is a poor substitute for the presence of a mother. “Mothers are unique biologically to baby,” Komisar tells IWF. “They are not interchangeable like socks, like you can put your right sock on your left foot. For a baby, the mother is the go-to person for that baby’s sense of emotional security. When the mother separates from that baby, particularly before the first year, and the baby is put into a group setting with many babies and very few caregivers who are strangers to that baby, you’ve automatically raised that baby’s level of cortisol, or the stress hormone,” says Komisar

Komisar cites the work of Columbia University neuroscientist Nom Tottenham, who says that “babies are born without a central nervous system” and that “mothers are the central nervous system to babies in the first year.” Komisar has explained, “Every time a mother comforts a baby in distress, she’s actually regulating the baby’s emotions from the outside in. After three years, the baby internalizes that ability to regulate their emotions, but not until then.”

Making herself even more unpopular in some circles, Komisar maintains that daycare is a poor substitute for the presence of a mother. “Mothers are unique biologically to baby,” Komisar tells IWF. “They are not interchangeable like socks, like you can put your right sock on your left foot, but mothers are not interchangeable with other people. For a baby, the mother is the go-to person for that baby’s sense of emotional security. When the mother separates from that baby, particularly before the first year, and the baby is put into a group setting with many babies and very few caregivers who are strangers to that baby, you’ve automatically raised that baby’s level of cortisol, or the stress hormone,” says Komisar.

“A mother has the unique function of regulating a baby’s emotions and buffering her from stress,” she explains. “Now imagine a daycare situation, which is usually no fewer than five children to one caregiver. Sometimes, if you’re lucky under the age of one, you get four children to one caregiver. I say to mothers, if you had quadruplets or quintuplets, how do you think you would do in terms of buffering those children from stress, soothing them and helping to regulate their emotions?

And the mothers go ‘Oh my God I’d have a breakdown.’ I say, ‘Well that’s what you’re doing, when you put your child in a daycare.’

She continues, “The other issue that daycare has is it is group care. So, automatically the environment is overstimulating. It’s louder. It’s brighter. There are more people walking around. There are more babies crying. And babies again are supposed to be against their mother’s body buffered from stress in the first year. So, you can see that already it’s problematic.

“So, in fact, what’s best for children neurologically in the first year is one-to-one caregiving. One child to one caregiver. And in the second and third year no more than three to one. And you are never going to find that in daycare because it’s not cost-effective. It would never be cost-effective.”

If a mother can’t afford to stay home with a child, Komisar suggests an old-fashioned solution: having a member of the extended family, perhaps a grandmother or an aunt, take care of the baby. Another possibility may be going in with another family and pooling resources to hire a caregiver.

Still, there will be mothers who can’t swing either of these solutions. Komisar is an advocate of government-mandated expansion of paid leave. She and IWF have both common ground and a fundamental disagreement. Both advocate for paid leave but IWF insists that it should be voluntary, rather than required by government. IWF has put forward a plan to use the Social Security program to provide paid leave.

She is critical of Senator Elizabeth Warren’s plan for daycare. “It would be institutional daycare where your children are going to be in a stressful environment with strangers who are transient. That is going to cause a lot of stress and impact the child’s mental health. I’m not against the government helping parents with childcare. That $10,000 [that might be allocated per child for institutional daycare] might be used instead to enable a mother to stay home part time so she only has to be away from her baby part time.”

“I know your organization stands for paid leave,” Komisar says. “And I’ve often said in interviews that I’ve done on TV and radio, that I backed the idea of Social Security being used to offer families paid leave. So, I support the idea.” But Komisar sees a larger role for government. “We’re the only country other than I think Papua New Guinea that doesn’t offer paid maternity leave. There are countries in the former Soviet bloc that offer three years of full pay maternity leave. We are a country that says we value family and we’re family-oriented, and I’m like ‘baloney!’ If you value family, you have a lot of poor and working class and middle-class families who cannot afford to take off because they are relying on two incomes unless there is a paid maternity leave. It’s always your actions that show how family oriented you are. Three months is not enough leave. At three months, a baby is just waking up after birth.”

One thing Dr. Komisar and IWF can agree upon is that Senator Elizabeth Warren’s daycare plan is not the way to address the problem. Warren proposes the creation of federally subsidized and regulated daycare centers. It is part of Warren’s Universal Child Care and Early Learning Act.

Komisar says of the Warren plan, “It would be institutional daycare where your children are going to be in a stressful environment with strangers who are transient. That is going to cause a lot of stress and impact the child’s mental health. I’m not against the government helping parents with childcare. I advocate that we have a choice as families about how we want to allot money, how we want to assign money for what’s best for our child and what’s best for our family. That $10,000 [that might be allocated per child for institutional daycare] might be used instead to enable a mother to stay home part time so she only has to be away from her baby part time. So, universal daycare that is subsidized by the government, I don’t agree with. So, I don’t agree with Elizabeth Warren.”

Enquiring minds what to know: How did a busy psychoanalyst manage to be emotionally and physically available for her three children?

“I’m a psychoanalyst,” she replies. “I picked the profession. It was very intentional. There was nothing unintentional about it. I considered being a lawyer at some point. I was thinking about going to law school. I knew I wanted to have children, and I looked at the life that I would lead as a lawyer, and it was very clear that that was not a life that someone who wants to have children and be with her children can have.

What Komisar urges is that women make informed choices. She praises retiring New York Congresswoman Nita Lowrey. Lowrey’s choice was to raise her children before entering politics. When Komisar’s critics claim that she wants to stymie women, she has a reply. “We can do many, many things in life; we can even do everything in life,” she says. “We just can’t do it all at the same time.”

“So, I switched my thinking to a profession where I could have flexibility and control, which includes being a therapist or any service profession. Or any of the professions that were considered ‘women’s’ professions that the feminist movement kind of laughed at and poo-pooed and said women should go out and do men’s work. Well, the bottom line is a lot of those careers that are ‘in male environments’ and considered men’s work, don’t offer flexibility and control and aren’t great professions for women who want to be available to their children. Whereas professions that give you some flexibility and control, whether it’s teaching or nursing or physical therapist or speech therapist or psychotherapist or, you know, any of those professions offer flexibility and can offer flexibility and control.”

“I have a lot of flexibility and control,” she continues, “and when I had my children I took off six to eight months with each of my three children, depending on the child, and then I went back to work just two patients a day in the beginning until they were a year old. So that meant an hour and a half I was away from them each day. And so that way what I did is I incrementally worked-in separation.

“So, what I say to parents is, it’s not that children can never be separate from you, in fact they need some separateness and they need to feel that little bits of time they can be separate from you. What we do to children, however, that causes them stress, is we overload them with separateness.”

But there were tradeoffs and, yes, even sacrifices. Komisar began thinking about her book 13 years ago, but she knew she could not write it just then. She was raising children. What Komisar urges is that women make informed choices. She praises retiring New York Congresswoman Nita Lowrey. Lowrey’s choice was to raise her children before entering politics. When her critics claim that she wants to stymie women, she has a reply. “We can do many, many things in life; we can even do everything in life,” she says. “We just can’t do it all at the same time.”

In terms of the heat she got for her book Komisar says “as a psychoanalyst I was uniquely qualified to deal with others guilt, aggression and attacks. I understood that the defensiveness of so many mothers and fathers came from a place of fear that they may be making or may have made poor choices and not from a place of hatred.” My family was also very supportive, particularly my husband who believes wholeheartedly in the power and strength of motherhood.