Part III of Position Paper

As much as I try to avoid cliches, sometimes like to go a cafe to write.  I like writing at home, but sometimes I need the energy from a different environment to get the words out.  One particular afternoon, at my go-to neighborhood cafe, as I was laying out my books and opening my ipad to write about stress, without thinking, I pressed the wrong button on my screen, accidentally and irreversably deleting about two hours of work I had done the evening prior.  My heart stopped as I leaned forward into my computer screen to understand why the page in front of me looked sparser than I remembered leaving it.  As the reality dawned on me, my body squeezed into a tightly compacted mass of agony.  My mouse-clicking hand clenched into a fist and I closed my eyes, raising my pained face to the cafe ceiling and I whispered, "No, no, no, no, no, no!", grateful that no one was close by to hear the swear words that followed.  I could feel my heart pounding hard in my chest, and the major veins on either side of my neck popped out.  The muscles around my buttox were clenched-- it happens-- from the realization of how well I had tied everything together the night before, knowing I didn't know how to start recreating what I wrote.  At a certain point, I noticed that my breathing was really shallow, and when I tried to take deeper breaths, my body pushed back against my efforts.  Eventually, I started to get annoyed about other things around me, like the fact that my nose was running, Kenny G was playing on the loudspeaker, and my make-up was melting in the heat.  Ten minutes after the fateful moment, I was still grumpy, so I packed everything up and went home to go eat an entire bag of popcorn.

We all experience stress, but it's only been relatively recently that scientists have been systematically studying its effects on our lives.  Before the twentieth century, the word "stress" was applied more often to the force exerted on an object than to emotional pertubation.  The affliction that veterans of World War I were experiencing--shell shock, as it was called-- was understood in terms of brain damage caused by loud, exploding shells.  It wasn't until after World War II that the concept of stress was widened to apply to the veterans' overall emotional life.  Diverting from B. F. Skinner who saw human behavior as simply the outcome of whatever was repeatedly reinforced- be it with a stressor or a reward, Richard Lazarus of the University of California at Berkeley examined a group of subjects' thought processes upon provocation; in other words, he looked at what the thought process best helped people cope when their buttons were pushed.  He defined stress as "a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endagering his or her well-being" (Kabat-Zinn, 292), making him among the first to recognize that stress exists along a continuum of severity.  War and its effects would be at one extreme, and mundane daily annoyances would be at the other end.  By emphasizing the conscious processing between stimulus and response, he paved the way for a more humane discipline within psychology, Cognitive Science, and dignified emotional coping mechanisms as a legitimate subject of scientific study (Lazarus, 1993). 

In her book, Radical Acceptance, American Buddhist teacher Tara Brach tells about her strained relationship with her teenage son who would frequently become so absorbed in his violent video games that he lost awareness of the dimensions of space and time.  When she would ask him to clean his room or meet her at a certain time or start his homework, she'd find him in his room in front of his computer, mesmerized by the game, unable to hear her knocking.  They invariably wound up yelling at each other.

One night as she lay in bed, she became fearful that her son was going to look back someday on his teenage years and only remember the fighting he had with his mom.  She decided that next time she saw him, she would take a meaningful pause when she was provoked by him instead of jumping into a reaction.  

The next evening, about half an hour after the time we had agreed on for starting homework, I arrived outside his room.  Through the closed door, I could hear the muffled sounds of "Everquest", Narayan's favorite computer game.  Anger began mounting inside me as I visualized him with his eyes glued to the glowing screen, fingers nimbly working.  I realized he had been at it for hours, again disregarding our agreements.  I imagined myself heaving a giant boulder into the computer screen.  This had been a recurring fantasy. 

Instead, I simply waited, and in that pause, I began to notice the feelings and sensations in my body.  The anger felt like a mounting pressure in my chest and throat.  My shoulders and hands were tight, my jaw was clenched.  I felt my heart pounding, felt the heat in my face.  This was horribly uncomfortable- it would have been far easier to just play out my anger and barge into his room.

Having become aware of her reactions, she knocked on Naranyan's door, got his attention, and had a heart-to-heart discussion with him.  This Buddhist practice of mindfulness as practiced by Brach-- noticing how our reactions to stress affect our body-- has become increasingly popular in the West since the 1970s, and some neuroscientists say Buddha was a man ahead of his time.

In some ways, scholars see the nearly 2,500-year-old practice of Buddhism as a form of study of the nature of the mind rather than a theistic tradition. "Reading early Buddhist texts will convince the clinician that the Buddha was essentially a psychologist" (Siegel, 2007)

While the medical establishment has traditionally been skeptical about the clinical importance of emotions under stress, social scientist Daniel Goleman brought the discussion into the limelight with his 1995 book, Emotional Intelligence.  His work generated a worldwide discussion about healthy and unhealthy ways of coping under emotional turbulence, dethroning IQ as the number one predictor of life success along the way. It's been shown that our ability to read and regulate our emotions and those of others in the face of difficulty plays an important role on our destiny, along with other important factors like our IQ, the level of wealth we were born into, the quality of attention we got from our caregivers, the quality of education, and simple luck.  In the business realm, the focus of Goleman's research, the importance of EQ translates into success at work where soft skills are important.  While conceding that "hundreds, if not thousands of studies have shown that IQ predicts which career rungs a person can manage", among those with the high IQs, who have risen to the top of an organization, EQ becomes the separating factor."  He quotes the head of research at a global executive search firm who says, "CEOs are hired for their intellect and business expertise-- and fired for a lack of emotional intelligence."

Goleman also highlighted the studies coming out that showed that our EQ greatly affects our physical health (Goleman, 2005).  As long as we allow toxic emotions like worry, anger, cynicism, loneliness, and depression to dominate, we become more susceptible to heart disease, cancer, alzheimers, and ultimately, early death.

Our capacity to handle stress starts with our intrauterine relationship with our mothers.  Studies have been showing for several decades that babies experience their mom's stress in the womb.  Dr. Wadhwa, professor of Obstetrics and Gynacology at the University of California at Irvine explains, "At each stage of development, the organism uses cues from its environment to decide how best to construct itself within the parameters of its genes." As the fetus takes in nutrients from its mother, it also absorbs the cortisol and other stress hormones that she scretes, resulting in the infant being vulnerable to several developmental complications.

Some studies are suggesting that stress in the womb can affect a baby's temperament and neurobehavioral development. Infants whose mothers experienced high levels of stress while pregnant, particularly in the first trimester, show signs of more depression and irritability. In the womb, they also are slower to "habituate" or tune out repeated stimuli -- a skill that, in infants, is an important predictor of IQ.

Studies also show that babies with highly stressed mothers have a greater chance of being born pre-maturely and at a low birth weight [Source].  The medical effects of being born pre-mature are surprisingly far-reaching; babies born before 37 weeks are more susceptible to heart disease, high blood pressure, and diabetes as adults [Source]. 

When the baby comes out of the womb, she experiences the first crisis of her life, having been expulsed from a warm and soft embryonic sac, and squeezed through a narrow cavity into a cold, bright room where they will take probably the most difficult breaths of their lives, exchanging the fluid in their lungs for oxygen. 

Now, on the outside of her mother's body, the baby's amniotic fluid starts evaporating off her body, lowering her body temperature.  Added to that, the bright lights, loud noises, not to mention the loss of the "oceanic feeling" of oneness with her holding environment will make the relief of being placed on mother's chest that much greater.  The baby will now seek to achieve the same level of homeostasis she enjoyed in the womb by finding her mother's nipple to satiate her hunger, and alleviating her body's tension through urinating, defacating, coughing, spitting up and sneezing.  

From the first moment of skin-to-skin contact, the baby takes in her mother through all the senses.  She loves gazing into her mother's eyes and demonstrates a preference for her mother's smell.  She responds to her soft cooing voice by turning her head in the direction it's coming from.  As the baby learns that her efforts to get the mother's attention are rewarded with warmth, food and a comforting touch, a bond develops between the two.  That bond is the subject of John Bowlby and Mary Ainsworth's Attachment Theory, developped in the mid-twentieth century that the quality of an infant's attachment to their mother sets the stage for their emotional, physical, and intellectual development later in life.  A strong symbiosis that includes plenty of visual and auditory mirroring between mother and the child, creates the conditions whereby the child can begin to feel comfortable separating, exploring, and developping their own relationships.

Influenced by Darwin and increasing secularization, Sigmund Freud was the first psychologist to suggest there was an evolutionary chain reaction of human behavior of one generation to the next, in other words, that a parent's behavior affected their child's development.  Some of the psychologists who accepted the ego, id, and superego framework to personality, but who didn't agree that all neurosis emerged from sexuality developped a model called Attachment Theory.  Their research demonstrated how critical the bonding period was to the child's mental development.  A bond between themselves and a primary caregiver that was affectionate and predictable allowed what psychologists termed "basic trust" to develop, the foundation for their identity as an individual.

The child develops basic trust by moving safely through the phases of symbiosis to differentiation, from the soothing oceanic feeling of boundaryless oneness with mother, in Freud's terms, to learning that they have their own identity and can safely explore the world apart from her.  The journey through the phases, as defined by Dr. Margaret Mahler provides the child with confidence to feel comfortable being apart from mother for increasing periods of time, and ultimately to develop their own unique identity as an adult.  A healthy and successful individuation process begins when the child learns that mother's ministrations and their own expulsion of tension through their bodily functions can relieve their unpleasant sensations.  The child sees, furthermore, that when they make eye contact with their mother, that it is welcomed, and when they make vocal sounds or move their body to imitate their mother, that they are mirrored lovingly.  Having their cries answered teaches the baby that their actions have an impact, and brings positive results that alleviate their discomfort; in other words, it teaches the baby that they have agency.  As individuality consolidates and the baby begins to walk and explore his environment, he needs to see his mother waiting for him or waving at him when he looks back at her.  When he comes back to share what he discovered on one of his "adventures", dumping his findings in her lap, the subsequent cooing and interaction about what he found teaches the child that it's not only safe to explore, but healthy.  Eventually, if the child had a positive enough interaction with his caregivers, he learns to soothe himself in moments of crankiness, and feels more and more comfortable engaging with strangers and exploring new environments.

The best way to understand how a child develops resilience is to look at the role of the nervous system vis-a-vis the rest of their body.  Knowing how the child's brain reacts to stress can help us understand what they need in order to develop empowered and adaptable responses to life's unpredictabilities. 

It is significant at the outset to note that in the embryo stage, the nervous system begins as the ectodermal layer of a three-layer group of cells, developping into a tube shape that migrates inward as the embryo forms.  Neuroscientist and mindfulness researcher Dr. Daniel Siegel points out,

This origin of neurons, the basic cells of the brain, on the "outside" and their journey "inside" the body developmentally reveals a philosophical point that the brain originates at the interface of the inner and outer worlds of our bodily defined selves.  When we think of the mindful brain, it is helpful to keep this inner/outer interface in mind (Siegel, pg. 29, 2007)

Our stressors are all around us- they can be inside us- such as a stomach ache right before going on stage to perform, as well as outside us, like a person we don't like approaching us for a conversation, and just as the nervous system takes in information from both sides and sends it up to the brain, so when we meditate, we scan both the external and interior worlds for tension, soothing the nervous system as we go.

The ability to observe ourselves under stress and have an awareness of our reactions, though, is a skill that is unique to the human pre-frontal cortex. Contrary to most of the animal kingdom, when human babies are born, they still have 70% of their brain to develop [Source], and at birth, the pre-frontal cortex itself is still very much developping and creating synapses.  One important part of the brain that is fully formed at birth, though, is the amygdala, which is the alarm system of the brain that takes in information about danger, and prepares our body for the fight or flight response. 

Evolutionarily, the limbic brain, made up of the amygdala, the hippocampus, the thalamus, and other structures, was the first part of the mammalian brain to develop.  Its alarm system came in useful if ever we found ourselves to be stalked by predators or other such dangers, upon which occasion, the sensory information traveled from the ears or eyes to the thalamus, and then to the amygdala.  The small, bilateral set of structures equidistant between the ears then secretes a course of stress hormones that put the body on high alert.  The pupils dilate to let in more light, the hearing becomes more acute, the heart pumps more blood to the limbs to prepare them for fighting or fleeing, while restricting blood flow to the digestive system, a superfluous mechanism in a life-or-death scenario. [Source]

As babies, when we experience distress like having a wet diaper, for example, our amygdala goes through the same procedure, flooding our bodies with stress hormones like the catecholamines [epinephrine (adrenaline) and norepinephrine (noradrenalines)] and eventually cortisol (Kabat-Zinn, pg. 312, 2013).  In response, we begin to fuss or cry to attract the attention of our caregiver, another mechanism evolutionarily designed to ensure the survival of our species. 

It turns out that evolution has made the work relatively easy to come up with an appropriate response to the cry of a baby.  Eradicating the need for all others, all we typically have to do to calm a baby is to change their diaper, feed them, or pick them up and hold them.  Babies are biologically programmed to calm down when they're picked up [Source] as it stimulates a parasympathetic response from the vagus nerve, a major nerve runs from the cerebellum to the belly, impacting all organs of the body along the way.  This is the same relaxation response we get when we meditate, we are relaxing the cerebellum, which signals to the vagus nerve to relax our internal organs. 

Babies show a ingrained tendecy to want to connect with their mothers.  Loving eye contact with the mother is a highly satisfactory experience for the baby, and it does double duty by spilling synapse-building chemicals into their system. 

From the earliest moments of life, parental nurturance shapes the child’s emotional make-up, literally altering the course of brain-growth. One of the key elements of secure parent-child attachment is affectionate eye-contact. A parent’s sustained, loving gaze and smile suffuses infants with indescribable joy. What ensues is a cascade of dopamine, endogenous opioids, enkephalins and endorphins in the baby’s brain- all feel-good
chemicals associated with loving relations. This joy-precipitated surge of brain chemicals promotes the maturation of precise regions of the cortex, which are concerned with healthy regulation of emotion later in life. Every baby requires this kind of nourishing
experience regularly and frequently, for healthy brain development [Source].

Daniel Goleman provides a very clear example of two different interactions a baby might have with their mother, which predict the two paths their lives will take. 

Say a two-month-old baby wakes up at 3 A.M. and starts crying.  Her mother comes in and, for the next half hour, the baby contentedly nurses in her mother's arms while her mother gazes at her affectionately, telling her that she's happy to see her, even in the middle of the night.  The baby, content in her mother's love, drifts back to sleep.

Now say another two-month-old baby, who also awoke crying in the wee hours, is met instead by a mother who is tense and irritable, having fallen asleep just an hour before after a fight with her husband.  The baby starts to tense up the moment his mother aburptly picks him up, telling him, "Just be quiet-- I can't stand one more thing!  Come on, let's get it over with."  As the baby nurses his mother stares stonily ahead, not looking at him, reviewing her fight with his father, getting more agitated herself as she mulls it over.  The baby, sensing her tension, squirms, stiffens, and stops nursing.  "That's all you want?" his mother says.  "Then don't eat."  With the same abruptness she puts him back in his crib and stalks out, letting him cry until he falls back to sleep, exhausted." 

As we all know, this is not to say that mothers are always successful at calming their baby, but as long as one interaction happens much more frequently that the other, their development is duly influenced.  Studies show that the child in the first example tends to grow up to develop what researchers call "basic trust"- an innate belief that the world is basically a good place, and their needs will be met if they ask. 

The first baby is learning that people can be trusted to notice her needs and counted on to help, and that she can be effective in getting help; the second is finding that no one really cares, that people can't be counted on, and that his efforts to get solace will meet with failure (Goleman, 2005).

Touch is an important part, not only of emotional development, but brain development.  Studies on rats [source] found a correlation between being licked or groomed by the mother and learning and memory, as well as willingness to explore their environment.  When it comes to humans, Insitutionalized babies who were held an extra 20 minutes per day for ten weeks scored higher on a developmental assessment rubrick [source] than those who are not.  On the other hand,

... We do know that babies left to "cry it out" are flooded with "stress hormones" (cortisol, adrenaline, ACTH) which destabilize their immune systems, so we know that it is bad for them biologically, at the very least. We also know that when the brain is flooded with stress hormones, we are forming panic memories. Those memories don't vanish just because the child is preverbal; researchers now suspect that such memories are instrumental in later anxiety and mood issues for some people [Source].

A 2013 study conducted at Stanford University showed that children with childhood anxiety showed larger amygdalae in fMRIs, as well as more connections to other parts of the brain, evidently an indication of the amount of time they spend stressed compared to other children [Source]. 

Babies are great imitators and can pick up on their mother's depression by showing more depressed symptoms themselves [Source] and [Source].  Stress also negatively affects language learning; a 2008 study from Rutgers University found that babies with larger amydalae had more problems with language ability [Source]. 

Stress wears down babies' organs as well, for example, when parents expect too much independence of the baby too soon.

"The theory holds that emotionally sound infants learn to soothe themselves by treating themselves as their caretakers have treated them, leaving them less vulnerable to the upheavals of the emotional brain." Emotional Intelligence, Daniel Goleman.  Image from bebepost.com.

"The theory holds that emotionally sound infants learn to soothe themselves by treating themselves as their caretakers have treated them, leaving them less vulnerable to the upheavals of the emotional brain." Emotional Intelligence, Daniel Goleman.  Image from bebepost.com.

Extended stress destroys tissues in mammals, impairing organ function and health (Kumar et al., 2013). Isolation is distressful for rat and mouse babies and has all sorts of ill effects like disorganizing stress response systems and undermining the expression of genes that control anxiety (McEwen, 2003; Meaney, 2001). The effects are much greater for humans. Leaving babies to cry unaided is highly distressful and physically and psychologically toxic [Source].

On the other hand, as Daniel Goleman points out in a study on protective mothers who picked up their six-month old babies and held them every time they cried, versus loving, yet firmer mothers who helped their six-month olds try to understand what was happening and how to overcome their stress, the babies who were helped to make small steps toward emotional mastery were less fearful and more willing to explore than babies who were simply held and comforted.  Babies who are soothed and reassured when they fuss are more able to soothe themselves later in life because they've learned that their emotional reactions aren't an emergency- they've learned that their internal reactions to stress are not emergencies, and can be brought under control.

These findings don't minimize the overall wisdom that carrying babies (or "wearing" them) has great overall health benefits for the child because it encourages independence earlier than babies who are more frequently left to ther own devices. 

Babies who are carried actually demand less attention than babies who are made to sit by themselves in strollers, seats and playpens, probably because their needs for companionship and stimulation are met at the same time....  We fill our children’s dependency needs so that, filled, they can go on to other things, like exploring the world. We acknowledge that children are children, and need our tending as they grow. Kids who’ve been attachment-parented are age-appropriate in their relationship with their parents, moving from dependency to inter-dependence, and able to form fulfilling intimate relationships as adults. When kids’ attachment needs aren’t filled, those needs eventually get focused on their peer group, often with disastrous results as they get older [Source].

The point of bonding is not that a particular practice is routinely instituted, as if raising healthy children is a matter of going through particular motions.  It's not that mothers have to be constantly imitating their child's actions back to them, or they never should put them down; the point is to be present to what they're experiencing, helping babies work through their fussy moments in little increments, and nurturing the connection no matter if mother needs her hands free to work while baby watches, or if they're playing pattycake.   Being present in the moment to the baby's needs helps build a foundation of trust and courage for the baby's future development.

As we shall see, children who feel that they have a connection with their parents grow up to be healthier all around.  They are less prone to heart disease, alzheimers, and loneliness, and they tend to be more popular than their peers.