Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary developmental science can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Wednesday, August 13, 2014

Epigenetics, Psychoanalysis, and Listening to Parents

Psychoanalysts for over a hundred of years have recognized the significance of early relationships in health and development. Now the exploding science of early childhood offers evidence that early parental care regulates physiology, influences development of the stress response, and even affects the expression of genes and structure and function of the brain.

The latest issue of the journal Neuropsychoanalysis provides an integration of psychoanalytic thought and contemporary developmental and evolutionary science. The article by Myron Hofer, and the accompanying commentary contain an abundance of evidence for the significance of early relationships.

Michael Meaney, a father of the new and rapidly growing field of epigenetics, offers this comment.


As Hofer noted, “maternal- infant interactions ... regulate the basic physiology of developing infants (such as sleep states, body temperature, autonomic balance, level of general motoric activity, and adrenal and growth hormone levels)”. These studies also revealed that these same maternal regulators were a source of information that shaped long-term phenotypic adaptation [gene expression and individual charcteristics.]

But all the science in the world may fall on deaf ears if our culture does not support parents in being present with their infants in the way the research suggests is critically important. 

If we pass laws condoning 8-week maternity leave, how can we take in and apply this abundance of research pointing to the significance of the early weeks, months and years? If, rather than addressing the problem of parents feeling overwhelmed and alone, and offering meanignful support, we are quick to diagnose them (and their children) with ADHD and prescribe medication, opportunities to make use of this wealth of scientific evidence are lost.  

Beatrice Beebe, a leading researcher in infant development whose detailed videotapes of mothers and infants offer elegant evidence for the richness and complexity of early parent-child relationships, praises Hofer's integration of theory and research. But Beebe, in conversation with a colleague of mine who is a general pediatrician, suggested that video be used in every 4-month well child visit. This comment represents a kind of disconnect between science and reality. The science certainly supports this kind of investment in time and attention to parent-child relationships in infancy.  But in today's fast-paced world of primary care, where clinicians are under pressure to see more and more patients in less and less time, such a suggestion is almost laughable.

In his concluding remarks, Meaney points in the right direction:
Developmental psychobiology established the conceptual framework within which to better understand the biology of early experience. The challenge is to now translate the emerging scientific advances into psychiatry and clinical psychology.
It seems like a kind of chicken-egg phenomenon. If as a culture we can place value on parents caring for themselves in order to be present with their children; if we value time for listening to parents and children together in the setting of primary care as well as mental health care, we may be better able to hear what the science is (and has been) telling us. 




2 comments:

  1. Here's a big study of child development going on here in Memphis: http://www.urbanchildinstitute.org/key-initiatives/candle-research-study

    ReplyDelete
  2. About time we rediscovered early childhood...

    ReplyDelete