Why Love Matters: How affection shapes a baby's brain - Sue Gerhardt - Book Summary

Securing our child’s life starts in the womb. A baby begins to collect data from the outside by the nutrition from his mother and her stress levels. Research shows that when the mothers’ diet is poor a baby is likely to have ‘thrifty phenotype’ which causes overweight later on, and the levels of omega-3 in the blood at the time of delivery predicts attention span. Mother’s stress has a lot of impact on different aspects of the developing fetus - from ‘pot belly’ (fat is concentrated around the belly), through lower birth weight to emotional regulation difficulties and even depression. Research even showed that babies that experienced more prenatal stress, are more likely to be fussier. Hence it is recommended for pregnant women to rest more - especially at the last two months of pregnancy, although our industrial culture doesn’t support that. When a mother is depressed during pregnancy, the chances of the baby to suffer from depression later on increases.

Even when children lacked the optimal environment in the womb - it’s not too late to fix after they are born. Human babies’ brains continue to develop and collect data in their first year of life. This data is unmemorable but unforgettable in the sense that our first experiences as infants shape our personality. When caregivers help children express their emotions and regulate them back to normal, children learn to do it themselves. When caregivers are not emotionally available, like in the case of depressed mothers that neglect or disrupt (by resenting the baby and handling him forcefully) or parents with their own regulation problems - that have problems noticing feelings of themselves or others, usually can’t help their children identify their feelings and regulate themselves.

Children that are neglected, and are not consistently regulated get insecurely-attached or avoiding-attached and are unable to regulate their own emotions, and hence suppresses strong feelings while still keeping the physical symptoms of stress (like elevated heart rate and blood pressure which in turn causes physical illness).  Parents that are inconsistent may cause their children to be resistant-attached - exaggerating their feelings to be noticed. Attentive caregivers, that reflects their children emotions, echos them or name them, and helps calm the child down (optimal social biofeedback) creates secure attachment - allowing the child eventually regulate his own emotions and his different body systems (nervous system, breathing, heart rate, blood pressure, etc), and allowing him to be more confident and have a better sense of self.

Research shows that emotionally secure children can also control themselves better, control their food intake, and notices his own feelings and those of the people around him - facilitating better relationships and prevents destructive behaviors.

Human beings are starting with the basic functions of mammals - allowing them to breathe, suck and so on, but unlike mammal human beings are very social, and from day 1 babies are looking around them, and empathizing with their surrounding people’s facial expressions, voices, and actions.

The orbitofrontal cortex is the part of the brain that interprets emotions and controls them. We are not born with it (and hence babies can’t control themselves in the first few years of life), and it develops through social stimulation: through play, and touch, and interaction. When there is no one-to-one interaction with a caregiver, the orbitofrontal cortex is unlikely to develop well, pruning anxieties and fears and depression. If a mother is enjoying spending time with her baby, usually this is a good sign that his social brain is developing properly. If not, sometimes it helps to follow the baby lead, and fulfill his needs as he communicates them. Lovingly being held is even more important than breastfeeding - as the baby feels warm and secure and can relax, deepen his breath and lower his heart rate. This effect of touch remains throughout our lives.

Parents smiling at their baby is another way to help the brain grow, and in general - lots of positive experiences early on produce brains with more neuronal connections – more richly networked brains. The growing of the brain becomes less rapid at the age of 1 year and almost stops at the age of 3, although it can continue growing as long as you use it throughout your life. At the age of 1 year though, a pruning process beings - and unused neurons start to die - so social intelligence is particularly sensitive to experiences between 6 and 18 months.

It is the repeated and typical experiences that structure the brain – generating basic emotional categories much like ‘dog’ or ‘table’, but in a highly sensory form. Unless they are highly traumatic, one-off experiences leave little trace. The exception to this rule is that very highly charged and arousing experiences will be registered in the amygdala which is responsible for instant reactions to situations of danger like faces with fear or anger that will register as an emergency and require an automatic “fight or flight” response. Those responses can later be changed by consciously inspecting them.

At the age of 12-18 month babies start to make memories in the form of images. The repeating “happy” images of faces and experiences will float in memory without time or place but will be an emotional compass in the future - to help interpret future experiences, and help self-regulate in the absence of the caregiver, providing the tools given to soothe oneself. Unfortunately, also the bad experiences and negative facial expressions will be stored as well, such as a disapproval look from a parent, that in turn can cause a stress reaction in infants and toddlers. This stress (or shame from our actions) is positive in the sense that it is needed for toddlers to learn which behaviors are unacceptable and help mature the orbitofrontal cortex, as long as there is a proper recovery afterward.

In a child's’ second and third year, verbal communication starts to take part in addition to the previous visual one. Left brain starts to develop and organize our thoughts and emotions, and the consciousness of our emotions allows a wider range of possible responses, as long as the emotions are recognized and labeled.

When babies are born - they are not capable dealing with stress, and high cortisol levels caused by stress. When a baby consistently left to ‘cry it out’, without a supportive caregiver to help soothe him and buffer the stress - the cortisol levels are high enough to become toxic and they can shrink and reduce connections in the orbitofrontal cortex, damage the hippocampus leading to less self-control, intense stress response for low provocation, he may be easily depressed, easily panicked and prone to overeating. He might display a facade that everything is ok but have occasional outbursts of aggression.

When we talk about stress in babies - it’s not the same as the one adults feel (i.e. when a deadline is about to arrive), It’s more about sheer physical survival. Babies cannot sustain themselves, so it is very stressful for them if the mother is not there or does not respond quickly, providing the milk, warmth or feeling of safety they need. Stress for babies may even have the quality of trauma. Such stress that an adult may feel when he is attacked by a tiger. The tool babies possess - the cry - in turn, creates stress for the parent, to gain attention and ensure a response. As adults or young children - Cortisol - the by-product of stress seems to reduce the more socially accepted one is and become higher the less socially accepted he is.

Being stressed every now and then is just part of life, it’s even stimulating, and once the crisis is over you restore yourself.  It becomes dangerous and physically and mentally impairing when the one experiences persistent powerlessness and unrelieved, chronic stress. To a large extent, stress is generated by what is unpredictable or uncontrollable. If you spend months or years worrying about your pension or example - that can undermine your health with high levels of cortisol, and the same applies for babies, but with a network of support, stress may be manageable, whether in infancy or in adulthood. Researchers have shown that children with secure attachments do not release high levels of cortisol under stress, whereas insecure children do. The key feature of insecure attachment is a lack of confidence in others’ emotional availability and support.

There is strong evidence that separation from those on whom we depend raises cortisol. Social conflict and threats from predators also raised cortisol levels. A study also found that children of 3 and 4 years old were stressed when they were in an all-day nursery, if there was no figure to attach to that was really paying attention to the child.

Sometimes, children that are raised at home with their biological parents still are not regulated. This can happen in case the parents are depressed, under a lot of stress themselves, neglecting or abusive, or unregulated themselves and find it hard to identify their own feelings or those of their baby.

Early stress (such as repeated brief separations from the mother), before age 6 months on the infant’s developing systems, when cortisol response is still variable, can have severe effects, such as a highly reactive stress response, together with a lifelong tendency towards anxiety, depression, and loss of pleasure, but after that age it seems to stabilise and remain consistent.

When parents are inconsistently emotionally available, their babies feel unpredictability, which in turn causes high cortisol levels, and research shows they tend to be the most fearful  during infancy and toddlerhood, and many emotional dysfunctions such as depression, anxiety and suicidal tendencies in adulthood, as well as with eating disorders, alcoholism, obesity and sexual abuse.ֿ

fear is ‘metabolically costly’ - It can damage the hippocampus and capacity to retrieve information (perhaps making an ‘absent-minded’ or ‘scatty’ child), as well as affecting the ability of the prefrontal cortex to think and manage behavior. It compromises wound healing and the immune responses, making the individual vulnerable to infection; in some cases, it even leads to decrease in muscle mass and to osteoporosis. It may play a part in diabetes and hypertension through increased blood glucose and insulin levels (which can also lead to overweight and fat tummies)

High levels of cortisol in early childhood can also have an effect of low cortisol levels, which can produce a state of emotional numbness and even dissociation.

This (unconscious) strategy of low cortisol has been associated with low grade, frequent emotional (and sometimes physical) abuse and neglect, as well as with unresponsive parenting or very early neglect.

Children who experience negative attitudes towards them or experience intrusive parenting which does not respect their boundaries tend to adopt an emotionally avoidant style of relating. They feel angry, but their families do not tolerate the child’s self-expression so they suppress the feelings. suppressing feelings doesn’t make them go away; in fact, it may actually increase arousal and burst out uncontrollably and unpredictably with peers.

Good emotional ‘immunity’ comes out of the experience of feeling safely held, touched, seen and helped to recover from stress, while the stress response is undermined by separation, uncertainty, lack of contact and lack of regulation.

Sensitive stress response, or a difficulty in regulating emotions, along with insecure attachments to others, can make individuals vulnerable to various psychopathologies. This does not imply that one ‘causes’ another, but simply that the likelihood of finding dysfunctional solutions to emotional dilemmas is increased. There are many well-trodden pathways to misery. People may choose to eat too much or too little, drink too much alcohol, react to other people without thinking, fail to have empathy for others, fall ill, make unreasonable emotional demands, become depressed, attack others physically, and so on, largely because their capacity to manage their own feelings has been impaired by their poorly developed emotion systems. Those who lack self-esteem and the capacity to regulate themselves well may become very self-centred adults.

People without effective and well-resourced emotional systems, cannot behave flexibly or respond to others’ needs. They tend to be rather rigid, either attempting not to need others at all, or needing them too much. Because they have not had enough experience of being well cared for and well regulated, their original baby needs remain active within.

Emotions can also affect the immune system more directly. Psychosocial stress itself can trigger the release of pro-inflammatory cytokines. One study shows that social rejection increased inflammatory activity in the body. It seems that we feel not only with our brain - but with all our body.

It was found that people who lack social support or who are under acute psychological stress have low natural killer cells, which is the main tool that prevents cancer. Chronic stress is also responsible to kills of lymphocytes, including natural killer cells, and stopping new ones from being produced. That’s why sometimes it is inferred that people who suppress their feelings and have high levels of stress have “cancer personality”.

Handicapped by insecure relationship patterns, which prevent them from drawing comfort from others or problem solving with other people, many people turn to alternative sources to make themselves feel better. Their choice of addiction may be influenced by their parents’ preferences.

Sometimes suppression of feelings happens in happy families in which children are afraid their parents cannot cope with their negative feelings and although they are constantly in the presence of the parent, they do not necessarily feel safely cared for by her.