Tuesday, 10 April 2012

Why Love Matters - a book review by Janie Loubser


Janie Loubser writes about the thoughts that are provoked by Sue Gerhardt’s book Why Love Matters

Why Love Matters: How Affection Shapes a Baby's Brain
by Sue Gerhardt
264pp, Routledge

Available on www.amazon.co.uk/exec/obidos/ASIN/1583918175/

Why Love Matters is the title of a book I recently read. It is written by Sue Gerhardt and she explores how the earliest relationships shape the baby’s nervous system. As psychologists and counsellors we know that childhood experiences have a great affect on adult life. We are familiar with John Bowlby’s attachment theory and Margaret Ainsworth’s  “Strange Situation” study that showed how a child’s development is a direct result of the way the child's main carer responded to and engaged with him or her.  Yet it seems that attachment theory has almost been forgotten or is being downplayed. The whole issue of mothering has become sensitive and even politicised.   Sue Gerhardt however goes and uses neuroscience to prove the attachment theory. She provides the scientific explanation for the importance of early experiences. She is very honest about how parents fail their babies and what the consequences can be. But she also describes a mother’s experience of being with her baby with sensitivity and provides insight into why a mother is limited in the way she mothers. She goes further and gives a rich description of psychological disorders such as depression and borderline personality disorder. I say it’s rich because she helps the reader imagine the baby’s experience that possibly contributed to the disorder.  She makes it clear that she believes that prevention is key and that early intervention with mothers and babies are much more effective. But she also explains how psychotherapy with adults can help to repair some of the damage.
 
This quote summarizes Gerhardt’s viewpoint: “The human baby is the most socially influenced creature on earth, open to learning what his own emotions are and how to manage them. This means that our earliest experiences as babies have much more relevance to our adult selves that many of us realise. It is as babies that we first feel and learn what to do with our feelings, when we start to organise our experience in a way that will affect our later behaviour and thinking capacities.” 

The book is divided into three parts. I am going to present some of the key ideas from this book that I have found helpful in my work.

The first part of the book deals with brain development in infants and how this can be influenced by attachments and the corrosive influence of cortisol. Gerhardt sets out the scientific basis for understanding babyhood as a crucial time in emotional development. She uses the concept of “the unfinished baby” and explains that the baby has many systems that are incomplete and will only develop in response to other human input. Babies also rely on adults to manage their emotional states so that discomfort and distress are reduced and comfort and contentment is increased.  If a baby is exposed for too long or too often to stressful situations (such as being left to cry) its brain becomes flooded with cortisol and it will then either over- or under-produce cortisol whenever the child is exposed to stress. Too much is linked to depression and fearfulness; too little to emotional detachment and aggression. 
  
The second part of the book looks in more detail at the links between various adult disorders and their roots in babyhood. Gerhardt highlights the concept that insecure attachments and the consequences can make one more vulnerable to specific psychopathologies. She does not say that the one ‘causes’ the other, but explains how poorly developed emotional systems impair one’s  capacity to manage one’s feelings . The likelihood of finding dysfunctional solutions to emotional problems are increased, such as eating too much or too little, drinking too much alcohol, reacting to others without thinking, failing to have empathy for others, falling ill, making unreasonable emotional demands, become depressed, attack others physically, and so on.  Gerhardt looks at the links between early emotional regulation and the immune system, depression, as well as personality disorders. Her description of the baby’s experience that developed into a borderline personality is a helpful reminder of the baby within the adult. In fact she says, “whether you focus on the parent, the baby or the adult with the mental health difficulties, the core problem remains the same: the insecure baby within.”  Insecure attachments tend to develop because parents find it hard to respond adequately to their babies. This is mostly because of their own limitations in regulating their emotions.

Gerhardt  writes about an emotional framework that is set up and consists of both a physiological and psychological  capacity. If the framework is secure, it gives the individual a confidence in regulating the ups and downs of emotional life, with the help of others when needed. But if the framework is insecure, then the person will find it much harder to cope effectively with stress, and will feel little confidence either in coping as an individual or in relying on others to help. She describes self-esteem as the confidence in oneself as well as in others and says that self-esteem is not just thinking well of oneself in the abstract, but also having the capacity to respond to life’s challenges.

Part three looks at treatment and repairing the damage. Gerhardt acknowledges that this information can leave one feeling heavy with guilt about the parenting one provided and hopeless about the parenting one received. Gerhardt argues that improving the relationship between parents and their babies is a much more cost-effective way to improve mental health than any number of adult therapeutic interventions. She advocates parent-infant psychotherapy as one way to prevent damaging emotional patterns from repeating themselves.  

She does however acknowledge the possibility of development and change extending across a lifetime and not just infancy. She explains that important pathways continue to be established through childhood until the brain is fully fledged at 15 years old. Change and development do continue after that, but as we know from our own work, at a much slower rate. She explains how through psychotherapy an individual can explore the way that he or she regulates himself or herself in relation to others, and can attempt to modify old emotional habits and introduce new ones. She writes, “the therapist’s acceptance allow a mental space to reflect on the feelings and consider how to respond afresh. Whilst the feelings are alive and active, so too are the stress hormones which will assist new (higher brain) cortical synapses to be made in response to the subcortical signals. Together with the therapist, new networks can be developed.”

We can probably all relate to how difficult it is to talk about early experiences. Adults cannot remember their babyhoods even though they have feelings about it. And mothers find it hard to express their intense emotional and physical experience with their babies.  Gerhardt’s writing does not only provoke thoughts and feelings about early childhood experiences, but provides a language to talk about it. It is accessible to not only those involved in mental health, but to parents too.  The book can help create awareness in parents about how much their babies need them.  It can also be helpful for adults in explaining why they have the difficulties they have. It has helped me to teach parents how to respond to their babies; and to teach adults how to respond to the baby inside them in an empathic way.

-          Janie Loubser is a clinical psychologist in private practice, Cape Town. She has a special interest in relationships and helps people to discover and remove the obstacles that keep them from having meaningful relationships. This includes relationships between parents and children.  www.janieloubser.co.za    

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