Monday, June 21, 2010

Who we are

"Who we are is neither encoded at birth nor gradually assembled over the years, but is inscribed into our brains during the first two years of life in direct response to how we are loved and cared for." ~Sue Gerhardt

Margaret Ainsworth, a Canadian psychologist, was first to demonstrate a significant connection between early childhood experience and development of personality. For a large part of the1960s, Ainsworth sat behind a one-way mirror in Baltimore and watched one-year-olds playing with their mothers. She noted what happened when the mother left the room for a few minutes and how the child responded when she returned. She then studied what happened when, instead of the mother, a stranger entered the room and tried to engage with the child.

Ainsworth's study, together with John Bowlby's attachment theory, showed that how a child developed was not the result of general experiences, but the direct result of the way the child's main care-giver responded to and engaged with him or her. A neglectful, stressed, or inconsistent parent gave the kind of care which led to anxious, insecure or depressed children. Further studies showed that patterns of attachment behavior in one-year-olds could accurately predict how those children would behave at aged five, ten, and fifteen which can further predict the personality of a child when fully grown.

Although the attachment theory has been very influential, underpinning psychology and psychotherapy, the kind of "proof" provided by psychologists has never quite convinced a skeptical public that thinks: Sitting in a room and watching babies – what kind of proof is that? How can anyone know what a baby is thinking and feeling? Isn't it all just liberal conjecture? Added to this, an entire generation of feminists hated the attachment theory from the get go, accusing Bowlby and Ainsworth of being against working women and wanting to shackle women to the home. The whole issue of how babies develop suddenly became highly politicized – and still is. Confusion reigns about the connection between early experience and personality.

Later, when researchers studied the brains of Romanian orphans – children who had been left to cry in their cots from birth and denied any chance of forming close bonds with any adult – they found a "virtual black hole" where the orbitofrontal cortex should have been. This is the part of the brain that enables us to manage our emotions, to relate sensitively to other people, to experience pleasure and to appreciate beauty. The earliest experiences of these children had greatly diminished their capacity ever to be fully human. This gave strong evidence for the attachment theory.

In Why Love Matters, Sue Gerhardt, a psychotherapist, takes the language of neuroscience and uses it to prove the attachment theory. Gerhardt makes an impressive case that emotional experiences in infancy and early childhood have the greatest influence on how we develop as human beings. Drawing on the most recent findings from the field of neurochemistry, she explains how daily interactions between a baby and its main caregiver have a direct impact on the way the brain develops. Picking up a crying baby or ignoring it may be a matter of parental choice, but the effects will be etched on the child’s brain throughout life.

Gerhardt is not interested in cognitive skills – how quickly a child learns to read, write, etc. She is interested in the connection between the kind of loving we receive in infancy and how it influences the kind of people we turn into. According to Gerhardt, "There is nothing automatic about the development of one’s personality. The kind of brain that each baby develops is the brain that comes out of his or her earliest experiences with people." Our earliest experiences are not simply laid down as memories or as influences; they develop into precise physiological patterns of response in the brain that set the neurological rules for how we deal with our feelings for the remainder of our lives.

In other words, how we are treated as babies and toddlers determines exactly who and what we are.

Stress during infancy damages the amygdala, an almond-shaped cluster of nuclei located in the brain's emotional control center that enables us to respond quickly to danger – such as stepping out of the way of a swerving car. Repeated abuse or violence in the home of any type causes the amygdala to signal danger even when there is no apparent threat. Dr. Bruce Perry, a neuroscientist who heads the Child Trauma Academy, a nonprofit research center in Houston, says that a maladaptive amygdala makes a child or an adult survivor of child abuse recoil in fear at the drop of a hat. This negative impact on developing brain structures is associated with changes in brain chemistry.

Overwhelming stress early in life also alters the production of both the stress-regulating hormone cortisol and key neurotransmitters such as epinephrine, dopamine, and serotonin, the chemical messengers in the brain that affect mood and behavior. These biochemical imbalances can have profound implications. For example, constant abuse typically lowers serotonin levels, leading to depression or impulsive aggression.

When a baby is upset, the hypothalamus, situated in the subcortex at the center of the brain, produces cortisol. In normal amounts, cortisol is good, but if a baby is exposed for too long or too often to stressful situations its brain becomes flooded with cortisol and it will then either over- or under-produce cortisol for the remainder of its life when exposed to stress. Too much cortisol is linked to depression, anxiety, and fearfulness; too little cortisol is linked to emotional detachment and aggression. Children of alcoholics have a raised cortisol level. Baby girls of abusive parents tend to develop high cortisol levels while boys tend to do the opposite, and produce too little, becoming aggressive and/or detached.

If abuse or stress continued into the early childhood years, triggers and cues act as reminders of the trauma and can cause further anxiety and depression. Often the person can be completely unaware of the triggers. In many cases this may lead a person suffering from a traumatic disorder, engaging in disruptive or self-destructive coping mechanisms, without being fully aware of the nature or causes of their own actions. Panic attacks are an example of a response to such emotional triggers. Consequently, intense feelings of anger may surface frequently, sometimes in very inappropriate or unexpected situations, as danger may always seem to be present. Upsetting memories such as images, thoughts, flashbacks, and/or nightmares may haunt the person. Insomnia may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night. Chronic depression and/or Post-Traumatic Stress Disorder (PTSD) more likely than not plagues the person throughout their life.

The point is that babies cannot regulate their stress response on their own, but learn to do so only through repeated experiences of being shown consistent love, unconditionally, or not being shown love, by its parents. Through positive interactions, the baby learns that people can be relied upon to respond to its needs, and the baby's brain learns to produce only beneficial amounts of cortisol. Through a lack of love, or through physical or emotional abuse, babies become highly stressed causing cortisol production to run amok throughout its life, leading to a plethora of physical and psychological problems. Baseline levels of cortisol are pretty much set by six months of age. Too much cortisol, and the child is set up for a lifetime of struggle with depression and physical health problems such as fibromyalgia, IBS, asthma, weight gain, and high blood pressure.

Timely interventions – by 7 years of age – can help rewire the brain and put psychological development back on track up to a point. A loving, understanding adult can come along during the child’s early years and somewhat correct the problem; but if the child is removed from its rescuer any time before full adulthood and once again put in a situation where love and nurture is not provided (as with an unloving stepparent), then the “repair” is all but undone.

Sue Gerhardt's book, Why Love Matters: How Affection Shapes a Baby's Brain, is a much-needed corrective to those who have made too great a claim for the role of inherited genes. Instead, she shows that you can't slide a knife between the heart and the brain. Human babies, like all mammals, are born wired for survival, but uniquely, we are wired to do so through other people. By smiling cutely long before they can walk or talk, babies ensure that the adults in their lives forgive them the sleepless nights and want to keep them alive. Being smiled at in return teaches the baby the rewards of communication and primes the infant brain for more.

Good parenting during the early years leads to good development of the baby's prefrontal cortex, which in turn enables the growing child to develop self-control, empathy, and to feel connected to others. Bad parenting (neglect, abuse, violence in the home) during those early years leads to a damaged amygdala (the brain's emotional control center) setting the child up for a lifetime of sorrow.

Gerhardt is not the first person to say these things, but research findings in this area have been very slow to filter out to the general public because they are so politically sensitive. It is because of this that researchers in this field have been reticent over the years about broadcasting their results. It's hard to read this book and feel complacent about the conditions in which many children today are raised. Too many parents are not meeting their children's need for love in the vital first two years of their lives.

Who we are really goes back to those early years spent with loving or unloving parents. Those who say that the grown-up child should forget and forgive, that at some point she is completely responsible for her own emotions, is ignorant of brain development and the long-term consequences of abuse and/or neglect. Years of therapy and love from a good-hearted spouse can rewire the brain to an extent; but, even so, the personality that we developed as a young child is always there, ready to subconsciously respond to any trigger or reminder of those early years.

Who we are is neither encoded at birth nor gradually assembled over the years, but is inscribed into our brains during the first two years of life in direct response to how we are loved and cared for.