Why Love Matters Why Love Matters explains why loving relationships are essential to brain development in the early years, and how these early inter- actions can have lasting consequences for future emotional and physical health. This second edition follows on from the success of the fi rst, updating the scientifi c research, covering recent fi ndings in genetics and the mind/body connection, and including a new chapter highlighting our growing understanding of the part also played by pregnancy in shaping a baby’s future emotional and physical well- being. Sue Gerhardt focuses in particular on the wide- ranging effects of early stress on a baby’s or toddler’s developing nervous system. When things go wrong with relationships in early life, the depen- dent child has to adapt; what we now know is that his or her brain adapts too. The brain’s emotion and immune systems are particu- larly affected by early stress and can become less effective. This makes the child more vulnerable to a range of later diffi culties such as depression, anti- social behaviour, addictions or anorexia, as well as physical illness. Why Love Matters is an accessible, lively account of the latest fi ndings in neuroscience, developmental psychology and neurobi- ology – research that matters to us all. It is an invaluable and hugely popular guide for parents and professionals alike. Sue Gerhardt has been a psychoanalytic psychotherapist in private practice since 1997. She co- founded the Oxford Parent Infant Project (OXPIP), a pioneering charity that today provides psychotherapeutic help to hundreds of parents and babies in Oxfordshire and is now the prototype of many new ‘PIPs’ around the country. She is also the author of The Selfi sh Society (2010). This page intentionally left blank Why Love Matters How affection shapes a baby’s brain Second edition Sue Gerhardt Second edition published 2015 by Routledge 27 Church Road, Hove, East Sussex, BN3 2FA and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Sue Gerhardt The right of Sue Gerhardt to be identifi ed as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. First edition published by Routledge 2004 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Gerhardt, Sue, 1953- author. Why love matters : how affection shapes a baby’s brain / Sue Gerhardt. — Second edition. p. ; cm. Includes bibliographical references and index. I. Title. [DNLM: 1. Brain—growth & development. 2. Parent-Child Relations. 3. Brain Chemistry. 4. Emotions—physiology. 5. Infant. 6. Love. 7. Mental Disorders—prevention & control. 8. Personality Development. WL 300] RJ134 155.42´2—dc23 2014011544 ISBN: 978-0-415-87052-8 (hbk) ISBN: 978-0-415-87053-5 (pbk) ISBN: 978-1-315-75831-2 (ebk) Typeset in New Century Schoolbook by Refi neCatch Limited, Bungay, Suffolk For my children, Jessica and Laurence This page intentionally left blank Contents Foreword by Steve Biddulph ix Acknowledgements xii Introduction to the second edition 1 PART 1 The foundations: babies and their brains 13 1 Before we meet them 15 2 Back to the beginning 28 3 Building a brain 48 4 Corrosive cortisol 74 Conclusion to Part 1 104 PART 2 Shaky foundations and their consequences 107 5 Trying not to feel: the links between early emotional regulation and the immune system 113 6 Melancholy baby: how early experience can alter brain chemistry, leading to adult depression 134 7 Active harm: the links between trauma in babyhood and trauma in adult life 157 8 Torment: the links between personality disorders and early experience 174 9 Original sin: how babies who are treated harshly may not develop empathy for others 193 viii CONTENTS PART 3 Too much information, not enough solutions: where do we go from here? 219 10 ‘If all else fails, hug your teddybear’: repairing the damage 221 11 Birth of the future 238 Bibliography 251 Index 298 Foreword When our children were little, we once, when they were fi nally asleep in bed, settled down to relax by watching a movie called Parenthood . In this fi lm, Steve Martin’s char- acter, a harassed but caring dad, had two fantasies in rapid succession, triggered by moments with his little boy. In the fi rst fantasy, his now grown- up son is giving the graduation address as the star student, and thanking his wonderful father for all his help. He points to his dad in the audi - torium, and the audience applauds! Then, the dad is jerked back to reality, his little boy is misbehaving. And suddenly he fi nds himself imagining a very different scene – chaos on a campus as students ran from a crazed shooter in a high tower. ‘It’s the “Martin” kid!’ they are screaming. ‘His father was no good!’ We all do this, I think – hope for our kids, and fear for them. But in the last few decades the fearing side of this has reached a kind of fever pitch. It’s as if parents have never felt quite so lost, while at the same time so plagued by so- called experts. It all seems to get more and more complex, and we doubt ourselves more and more. Part of the problem, though it’s almost never admitted, is that the experts themselves have been confused. That happens in science sometimes, when the old models no longer match the data, and a new way of looking is needed. A period of confusion precedes a sudden leap to a new under- standing, and everyone breathes a sigh of relief. Luckily, we have just arrived at one of those times. In the last ten years, helped hugely by the technology that allows us to look inside x FOREWORD the working human brain, neuroscience has transformed what we know about how little children grow. You may be thinking – well, if there’s a revolution in child development, why haven’t I heard about it? And the reason is this: fi rst, it’s made up of thousands of research papers on tiny fragments of the problem, and second, it’s really hard to understand. For example, the very best book in the fi eld is Allan Schore’s Affect Regulation and the Origin of the Self . You can tell from the catchy title that this is a doorstopper of a book. I am a professor of psychology, but I still only made it half way through, before collapsing like Frodo on the slopes of Mount Doom. But Sue Gerhardt is made of sterner stuff. Alongside her work as a psychothera- pist and specialist in mother and baby relationships, Sue set herself the task of reading and absorbing pretty much the whole fi eld of developmental neuroscience, speaking to the researchers, synthesising it all with a view to discovering ‘How does this help real mums and dads, as well as teachers and policy makers and so on?’. She did this because she recog- nised that this knowledge would change everything. And she was right. In short, our problems with kids’ lives and with our own lives have arisen because we have completely missed the importance of affection. We thought it was just something nice that parents did. But in fact, it’s the key to all mental health, intelligence and functioning as a human being. If someone is a great human being, it can only mean one thing. They were loved. Those moments of soothing, playfulness, touching and tickling, hugging and holding that happen between mother and baby, husband and wife, old people walking hand in hand, stimulate the brain and build connections that are the foundations of intelligence, people skills and being a decent and wonderful human being. All the enrichment, education, money and resources, courses and expensive schools won’t make up for having parents who were rushed, tense and had trouble settling with their baby or toddler and having a loving and fun time. There are astonishing new fi ndings in this book . FOREWORD xi That stress on a pregnant mother can already begin to shape her baby’s brain – affecting the volume of its hippocampus (a brain structure involved in memory) or amygdala (another brain structure central to emotional reactions). That a gene called MAOA-L makes some children twice as likely to have trouble holding back emotional impulses. (Yet this gene is in forty per cent of the population, so most of us have learned to get it under control). That money worries, or long working hours during preg- nancy, can affect an enzyme in the placenta, which normally blocks cortisol from the mum going to the baby, allowing stress hormones to fl ood into the baby. The result is a baby who is born already stressed out, who may be much harder to care for. There are clear remedies, too – for society, and for our own parenting. If in early parenthood we can slow down, minimise stress, value kindness and time, fun and playful- ness, and if governments make this possible so that young mums and dads see their work of parenthood as valuable and precious, then the benefi ts in resilient, empathic, good humoured and interpersonally effective adults will be enor- mous.