Following on from yesterday’s blog on The Emotional Brain…
TRAUMA AND THE BRAIN
“When human connections go awry, especially early in life, brain circuitry can be impacted. Chronic misattunement, neglect, or abuse on the parent’s part can severely affect the baby’s brain, impairing the corpus callosum, the main connecting pathway between right and left hemispheres (Siegel, 2003); the hippocampus, central to memory function (Sapolsky, 2004); neural integration (Siegel, 2003); overall brain size; and growth of GABA fibers that calm limbic structures (Siegel & Hartzell, 2003). With trauma and its accompanying high level of cortisol release, the amygdala overfunctions, holding emotional traumatic memories, whereas the OFC underfunctions. We are wired to respond to threat with a readiness for action or flight; the amygdala sends alarms throughout the body, stress hormones are released, and muscles are tensed for action. With traumatic experiences in which the person is blocked from fight or flight, as in sexual abuse, the brain and the body are unable to do their work in response to threat (van der Kolk, 2006).
Posttraumatic stress disorder (PTSD) is considered a physical reliving of the trauma, with all the attendant hormonal activation. In flashbacks, the amygdala is overactive, and the prefrontal cortex is temporarily disabled. Bessel van der Kolk (2001), a major writer in the trauma field, notes that individuals with PTSD ‘‘are very sensitively tuned to pick up threat and respond to minor stimuli as if their life were in danger.’’ Neuroscientists have identified two different types of memory: explicit and implicit. The hippocampus, the seat of explicit memory, is not developed until 18 months. However, the implicit memory system, involving limbic processes, is available from birth. Many of our emotional memories are laid down before we have words or explicit recall, yet they influence our lives without our awareness. Although a traumatized person may not explicitly remember the traumatic event(s), the memory is held in the body: ‘‘What the mind forgets, the body remembers in the form of fear, pain, or physical illness’’ (Cozolino, 2006, p. 131; Van der Kolk, 1994).
A woman may not remember that she was sexually abused repeatedly by her father as a girl but may panic when her husband approaches her for sex. These emotional memories may never be erased: ‘‘Unconscious fear memories established through the amygdala appear to be indelibly burned into the brain. They are probably with us for life’’ (LeDoux, 1996, p. 252).
LeDoux, the neuroscientist who has been a major contributor to our understanding of fear and the role of the amygdala, observes that perhaps trauma, . . . in some persons, biases the brain in such a way that the thalamic pathways to the amygdala predominate over the cortical ones. . . . Later exposure to stimuli that even remotely resemble those occurring during the trauma would then pass, like greased lightning, over the potentiated pathways to the amygdala, unleashing the fear reaction. (pp. 257–258)
ATTACHMENT: THE TIES THAT BIND
The fields of neuroscience and attachment converge in the work of Siegel and Schore, among others. The healthy development of the child’s right brainFespecially the limbic system and orbitofrontal cortex, which are involved in emotional functioning and affect regulationFdepends on a secure early environment with caregivers. Attachment researchers, building on Bowlby’s attachment theory, identify secure attachment as the child seeking proximity to the parent, the parent offering a safe haven in times of distress, and the parent-child bond offering a secure base from which the child can explore the world (Siegel & Hartzell, 2003).
Insecure attachments can take the form of anxious, avoidant, or disorganized patterns. Research has identified the intricate dance between parents and baby that facilitates the baby’s brain development. Part of the mechanism is the eye gaze: ‘‘Seeking proximity to a caregiver and attaining face-to-face communication with eye gaze contact is hardwired into the brain from birth. It is not learned’’ (Siegel, 1999, p. 138). This contact is deeply pleasurable: ‘‘In mutual gaze the mother’s face is triggering high levels of endogenous opiates in the child’s growing brain’’ (Schore, 2003, p. 14). The infant is an active participant in this dance: Virtually from birth, babies are not mere passive lumps but active communicators seeking their own intensely urgent goals. . . . Babies need to be tiny masters at managing their caretakers through an elaborate, built-in system of eye contact, smiles and cries. . . . The emotions of the infant direct what the mother does as much as the mother directs the infant. . . . Their loop operates in both directions, a primal emotional highway. (Goleman, 2006, pp. 163–164)
This ‘‘lyrical duet’’ (Cozolino, 2006, p. 97) between infant and parent shapes and changes the brains of both. Not only are the bonding and pleasure chemicals of oxytocin and endorphins released in this process, but the infant’s brain structure is changing as well: Early in life, infants need connections to caregivers in order to organize their brain’s function in the moment, and to allow it to develop properly over time.
This is called ‘‘dyadic regulation’’. . . Interactions with caregivers allow the child’s brain to develop the neural structures necessary to move from dyadic regulation to more autonomous forms of self regulation.” (Siegel & Hartzell, 2003, p. 215)
Our need for secure attachments and our vulnerability to the ups and downs of our relational lives continue throughout adulthood. Whereas distressed adult relationships are correlated with increased secretion of stress hormones and lowered immune functioning, nurturing relationships are correlated with better physical health, including heart and immune function, and resistance to stress (Cozolino, 2006). As Lewis, Amini, and Lannon (2000) put it, ‘‘Stability means finding people who regulate you well and staying near them’’ (p. 86). Healthy interdependence in adulthood entails a balance between self-regulation and looking to others for resonance and soothing in intimate relationships. Most studies of attachment look at the mother-infant pair bond. As systemic therapists, we look as well at the father-infant bond, the nuclear family system, and the larger context, considering the couple’s relationship and the family’s network of support and resources. What happens to a securely attached parent and child, or a securely attached couple, if they experience overwhelming trauma, poverty, racism, or other contextual stresses? A breakdown in the contextual support system or other stressors could override a parent’s or spouse’s ability to attune to and bond with the child or partner. Indeed, a study was done with well-attached baby monkeys and their mothers, who were subjected to an uncertain supply of food. The mother monkeys, normally attuned to and facilitative of an attachment bond in their offspring, became preoccupied and anxious. Their offspring turned into adult monkeys with difficulty in social behavior and in bonding with a mate. These offspring could not self-regulate when they were not in the physical presence of their mothers (Lewis et al., 2000).
In addition to considering the attachment style of the individual, it is important to consider the larger context in which our clients are embedded. We need to take into account the potentially detrimental impact of poverty and violence on the growing brains of young children. And yet poor families do not necessarily lead to damaged attachment systems; through extended family kinship networks, ‘‘alloparents’’ (Hrdy, 1999), and faith-based support, many families are resilient despite the odds.