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Column: New Neuroscience of Childhood Stresses Strong Attachments

Saturday, May 16, 2015
Doctors see disease and they think about genes and germs, molecules and chemicals. But there’s a new recommendation from the neuroscience lab: Think about human relationships too. It’s turning out that babies’ earliest attachment relationships help set their lives’ paths toward disease or health.

Lifelong health, as it turns out, is powerfully shaped during a critical 1,000 days. These are the days of the third trimester of pregnancy and the next two years. During this time, brain growth is exploding. And the brain needs social experience in order to grow. In fact, social experiences — especially in intimate relationships like mother and baby — actually turn genes on and off. The last three decades of neuroscience research have built solid evidence for this. Many of these genes activate and organize brain growth in the regions responsible for regulating emotion, energy and arousal states.

According to neuroscientist Dr. Allan Schore, from UCLA’s David Geffen School of Medicine, disruptions in these processes lead to most psychiatric disorders — including depression and anxiety. And social interactions that teach emotional flexibility lay the foundation for a lifetime of well-being.

The critical 1,000 days also influence physical health. Substantial research shows that an infant’s early attachment experiences — those first lessons of trust — set the pattern for the body’s future ability to handle stress. For example, in a study of children genetically at risk for asthma (because one parent had asthma), those with strained attachments were more likely to develop asthma than those with secure attachments. This underscores the complex and dynamic relationships between genes, experience and the development of disease.

New developments in neuroscience are also indicating that early childhood stress is linked to coping strategies in adults of substance abuse, poor eating and lack of exercise; these then make us sick. Likewise, childhood adversity (like emotional and physical abuse, divorce and domestic violence) is associated with chronic health problems like diabetes and cardiovascular disease. The new neuroscience is a holistic, integrated view of the developmental origins of health.

The news is spreading throughout New England. Vermont wants to address childhood adversity as part of health care reform. In 2014, the Legislature mandated a report on preventing, identifying and treating adverse childhood experiences (ACE). The study, “Integrating ACE-Informed Practice into the Blueprint for Health,” was completed this January. New Hampshire’s private sector is also showing interest in this new vision. The Endowment for Health, the state’s largest health care foundation, has prioritized early child development, and, as part of its public education mission, is funding a day of community education in the Upper Valley with Schore, internationally-recognized expert in the neuroscience of attachment.

Schore reminds us that infants need lots of high-quality time with trusted caregivers. He also encourages us to intervene during the earliest years, when treatments have the greatest effect because of brain plasticity. This would mean that when doctors can’t find medical answers to an infant’s digestive problems, they’ll be more likely to recommend infant-parent psychotherapy. This would also mean that infants showing early signs of autism could get relationship-focused help. Finally, health care providers who are helping a parent under strain — from a crumbling marriage or cancer or homelessness — might find help for the stressed baby too.

According to Schore, infants are not, as we have been used to saying, resilient; they are malleable. Babies are exquisitely sensitive to the emotional experiences that shape their rapidly developing brains. Not just gross abuse and neglect, but even subtle, chronic failures to understand a baby can constrain brain development.

All these new understandings can be good news, but they could make parents feel overburdened. Schore reminds us that we’re all in the same boat. From studies of infant-parent interactions, we know that two-thirds of the time, we can’t understand exactly what our infants need. What matters is that we recognize the mismatch that’s underway, and then adjust, so that infants also feel some moments of connection. And we have to remember that misunderstandings are not just problems; they also give infants valuable practice in stress tolerance.

Schore will discuss these and other issues at his public lecture on Wednesday, May 20, from 7:30-9 p.m., in the Moore Hall Filene Auditorium on the Dartmouth College campus. His visit is sponsored by the Early Childhood Mental Health Network of the Upper Valley, in partnership with Let’s Grow Kids, The Child Care Project at Dartmouth College, and Children’s Hospital at Dartmouth-Hitchcock. Additional funding is provided by the Endowment for Health, the Byrne Foundation, and the Dwinell Charitable Trust. For more information, visit www.ecmhn.org or call 603-448-6311.

The new neuroscience is telling us to look for the essential ingredients for lifelong health in the timeless joys of parents playing peek-a-boo and mothers soothing their crying babies. It’s reminding us of the old forgotten wisdom about human connection and love.

Miriam Voran, Ph.D., is a member of the Early Childhood Mental Health Network of the Upper Valley, and has a psychotherapy practice in West Lebanon and Montpelier.

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