Minding the baby
Rebecca Abrams

Saturday July 17, 2004, "The Guardian"

Rebecca Abrams applauds Sue Gerhardt's clear-sighted assessment of child development in Why Love Matters

Why Love Matters: How Affection Shapes a Baby's Brain
by Sue Gerhardt
264pp, Routledge, £9.99

When researchers studied the brains of Romanian orphans - children who had been left to cry in their cots from birth and denied any chance of forming close bonds with an adult - they found a "virtual black hole" where the orbitofrontal cortex should have been. This is the part of the brain that enables us to manage our emotions, to relate sensitively to other people, to experience pleasure and to appreciate beauty. These children's earliest experiences had greatly diminished their capacity ever to be fully human. Sue Gerhardt's book Why Love Matters shows that early experience has effects on the development of both brain and personality that none of us can afford to ignore.
It was Margaret Ainsworth, a Canadian psychologist, who first demonstrated a robust connection between early childhood experience and personality. For a large part of the 1960s Ainsworth sat behind a two-way mirror in Baltimore and watched one-year-olds playing with their mothers. She noted what happened when the mother left the room for a few minutes and how the child responded when she returned. She then took the study a stage further and studied what happened when, instead of the mother, a stranger entered the room and tried to engage with the child.
Ainsworth's "Strange Situation" study, together with John Bowlby's attachment theory, showed that how a child developed was not the result of a general mish-mash of experiences, but the direct result of the way the child's main carer responded to and engaged with him or her. A neglectful, stressed or inconsistent parent gave the kind of care which tended to lead to anxious, insecure or avoidant children. Further studies showed that patterns of attachment behaviour in one-year-olds could accurately predict how those children would behave aged five and eight.
Although attachment theory has been massively influential in many ways, underpinning psychology and psychotherapy ever since, it has never achieved general credibility.
The kind of "proof" provided by psychologists has never quite washed with a sceptical public. Sitting in a room watching babies - what kind of proof is that? How can anyone know what a baby is thinking and feeling? Isn't it all just woolly liberal conjecture? Added to this, an entire generation of feminists hated attachment theory from the word go, accusing Bowlby of being against working women and wanting to shackle women to the home. The whole issue of how babies develop suddenly became highly politicised - and still is. Confusion reigns about the connection between early experience and personality. Parents are blamed when things go wrong, the rest of the time their role is downplayed.
In Why Love Matters, Gerhardt, a psychotherapist, has bravely gone where most in recent years have feared to tread. She takes the hard language of neuroscience and uses it to prove the soft stuff of attachment theory. Picking up your crying baby or ignoring it may be a matter of parental choice, but the effects will be etched on your baby's brain for years to come. Putting your one-year-old in a nursery or leaving them with a childminder may turn out to be a more momentous decision than you thought.
Drawing on the most recent findings from the field of neurochemistry, Gerhardt makes an impressive case that emotional experiences in infancy and early childhood have a measurable effect on how we develop as human beings. Wielding the language and findings of science like a haycutter in a corn field, she scythes through the confusion that normally surrounds this subject to explain how daily interactions between a baby and its main carer have a direct impact on the way the brain develops.
Gerhardt is not interested in cognitive skills - how quickly a child learns to read, write, count to 10. She's interested in the connection between the kind of loving we receive in infancy and the kind of people we turn into. Who we are is neither encoded at birth, she argues, nor gradually assembled over the years, but is inscribed into our brains during the first two years of life in direct response to how we are loved and cared for.
Our earliest experiences are not simply laid down as memories or influences, they are translated into precise physiological patterns of response in the brain that then set the neurological rules for how we deal with our feelings and those of other people for the rest of our lives. It's not nature or nurture, but both. How we are treated as babies and toddlers determines the way in which what we're born with turns into what we are. According to Gerhardt, "There is nothing automatic about it. The kind of brain that each baby develops is the brain that comes out of his or her particular experiences with people."
The key player in this unfolding drama turns out to be a hormone called cortisol. When a baby is upset, the hypothalamus, situated in the subcortex at the centre of the brain, produces cortisol. In normal amounts cortisol is fine, but 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. Children of alcoholics have a raised cortisol level, as do children of very stressed mothers.
The key point is that babies can't regulate their stress response on their own, but learn to do so only through repeated experiences of being rescued, or not, from their distress by others. Through positive interactions, the baby learns that people can be relied upon to respond to its needs, and the baby's brain learns to produce only beneficial amounts of cortisol. Baseline levels of cortisol are pretty much set by six months of age.
Gerhardt's book is a much-needed corrective to writers such as Steven Pinker, who have made too great a claim for the role of inherited genes. Instead, in line with Antonio Damasio and Daniel Goleman, she shows that you can't slide a knife between the heart and the brain. Human babies, like all mammals, are born wired for survival, but uniquely, we are wired to do so through other people. By smiling cutely long before they can walk or talk, babies ensure that the adults in their lives are sufficiently besotted to forgive them the sleepless nights and want to keep them alive. Being smiled at in return teaches the baby the rewards of communication and primes the infant brain for more. Good parenting isn't just nice for the baby; it leads to good development of the baby's prefrontal cortex, which in turn enables the growing child to develop self-control and empathy, and to feel connected to others. Interaction, it turns out, is the high road from merely human to fully humane.
The policy implications of Gerhardt's book are as important as they are bound to be, for many, unpalatable. It's hard to read this book and feel complacent about the conditions in which many children today are raised. Not enough is being done to help parents prioritise and meet their children's needs in the vital first two years of their lives. Gerhardt touches only briefly on the issue of daycare for very young children but this, too, clearly needs far more attention. The government's unbridled enthusiasm for nursery care means that the most vulnerable children in our society end up with the biggest deficit in terms of the quality of their early interactions - precisely the same children most likely to end up with behavioural, educational and social problems later on.
Gerhardt is not the first person to say these things, but research findings in this area have been very slow to filter out to the general public. Precisely because they are so politically sensitive, researchers in this field have been reticent over the years about broadcasting their results. There is a welcome robustness to Gerhardt's book, a willingness to stick her neck out and take the consequences. Why Love Matters is hugely important. It should be mandatory reading for all parents, teachers and politicians.
· Rebecca Abrams's books include Three Shoes, One Sock and No Hairbrush: Everything You Need to Know About Having Your Second Child (Cassell).