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Monthly Archives: May 2013

Battling PTSD? Well Then, You Must Be a Soldier, Right?

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May 24, 2013
Abuse and Violence, Child Development, Trauma and Resilience
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PTSDFacesRecently in an online community dedicated to the discussion of trauma, I came across a comment that I’ve heard many times before. The gist was, “Whenever people find out I have post-traumatic stress disorder (PTSD), they assume I must be a combat veteran.”

Now, it’s true that way too many soldiers end up with PTSD. And it’s true that we can thank soldiers for the fact that PTSD was ever taken seriously enough to study in the first place. But almost twice as many women succumb to PTSD than men, and only a relatively small number of these women are soldiers. Most, in fact, are survivors of child abuse. And while that might not surprise you, here’s something that might: Even among soldiers, child abuse may lie at the root of PTSD, as this study suggests:

Embattled Childhoods May Be the Real Trauma for Soldiers with PTSD

This makes perfect sense, of course, when we consider how the brain develops. We are born to connect with other people, and it’s through nurturing interactions early in life that our self-regulatory systems—including fear and stress circuitry—are calibrated.

Born to Connect: The Role of Secure Attachment in Resilience to Trauma

Considering the far-reaching effects of our first experiences with caretakers, we can see why neglect counts as trauma alongside physical and sexual abuse, and we can also see why adults who have been abused as children are so much more vulnerable to stress than others.

Child Abuse Changes the Brain

This vulnerability to stress can lead to a host of mental health challenges. But, here’s a duh! moment: The brain controls processes in the body as well as thinking processes, right? So how is it we’ve managed for so long to overlook the fact that harmful effects of abuse in childhood are not confined to mental health issues? We’re only just beginning to acknowledge that we can’t really separate notions of the biological, the psychological, and the social aspects of human well-being. So, what does child abuse do to the body? Not only does developmental stress accelerate aging,

Risk of Accelerated Aging Seen in PTSD Patients with Childhood Trauma

but it also makes us vulnerable to cancer,

Study: Children Abused by Parents Face Increased Cancer Risk

as well as cardiovascular problems. In men who have been abused as children, this tends to be seen in an increased risk for heart attack,

Childhood Sexual Abuse Linked to Later Heart Attacks in Men

while in women, it’s high blood pressure, poor cholesterol levels, and metabolic issues like diabetes.

Middle-Aged Women Survivors of Child Abuse at Increased Risk for Heart Disease, Diabetes

PTSD is a complex disorder, and the costs to human potential and national budgets are equally devastating. And child abuse is a major contributor to PTSD, for soldiers as well as civilians. With that in mind, perhaps when we read studies like the next one, we’ll remember that it isn’t only the soldiering that that led to these findings, but life before soldiering too.

For Combat Veterans with PTSD, Fear Circuitry in the Brain Never Rests

And instead of asking civilians with PTSD whether they’re veterans, maybe we’ll start asking veterans whether they’re survivors of developmental trauma. Or maybe we’ll just offer them the nurturing support and friendship they need to work through the healing process, instead of making assumptions about them. Hey—It could happen! 

On the bright side, good relationships later in life can help repair the effects of abuse.

Marriage, Education Can Help Improve Well-Being of Adults Abused as Children

And while some relationships will certainly have challenges, it is well worth the time to find support for them.

Couple’s Therapy Appears to Decrease PTSD Symptoms, Improve Relationships

Parents and Teachers: Partners in Building Healthy Brains

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May 13, 2013
Child Development, Education, Interpersonal Neurobiology, Mind and Brain
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ClassroomStressTeacher Appreciation Week has passed, along with “Mom Appreciation Day,” but parents and teachers continue the important work of shaping children’s brains all year long.

Unfortunately, there are challenges that can get in the way of this worthy goal, and perhaps the most fundamental of these is the widespread misunderstanding of the conditions children need for learning. Just as a child needs secure attachment with caregivers at home to lay the foundation for healthy brain development, they also need secure attachment with teachers in the classroom if they are to build on that foundation.

However, points out Pepperdine University professor Dr. Lou Cozolino in his book The Social Neuroscience of Education, schools aren’t always constructed with concern for human biology. “Most schools are based on a model of industrial production where raw materials are converted into a predetermined product,” he writes.  But students and teachers aren’t “uniform raw materials or assembly-line workers,”he says. “Relationships are our natural habitat. . . . Our ability to learn is regulated by how we are treated by our teachers, at home and in the classroom.”

This is a profound truth. The human brain is a social organ, shaped by our interactions with others. When those interactions are positive, we feel safe and connected, which allows brain chemicals to support new neural growth: the stage is set for learning. On the other hand, Cozolino points out, thinking and feeling are so intertwined that plasticity turns off when anxiety levels are high. “Stressed brains,” he underscores, “are resistant to new learning.”

Is all stress bad? Of course not. But the circuits involved in arousal, stress, and fear operate much like a muscle. They operate well under low levels of intermittent stress, when there is adequate time for repair, but high levels of chronic stress can cause these circuits to malfunction. Anyone who has done weight training can easily understand the concept: a muscle burdened with too much weight for too long will break down rather than grow. In the same way, chronic, high levels of stress flood the brain with cortisol, shutting down all systems but those required to fight or flee. Immune systems are shut down, as are systems involved in neural growth and learning.

On the other hand, when people around us make us feel safe, understood and cared for, these biological processes are reversed. When teachers are aware of the emotional needs of their students as well as tailoring tasks to their abilities, they help regulate children’s stress levels. Even children with poor attachment at home are capable, given time, of responding well to nurturing relationships in the classroom. “Brains grow best in the context of supportive relationships, low levels of stress, and through the creative use of stories,” writes Cozolino. “Secure relationships not only trigger brain growth, but also serve emotional regulation that enhances learning.”

Of course, no parent is attuned to their child at all times and teachers will also have stressors that get in the way of their ability to attune with students. But “good enough” parents supporting and supported by “good enough” teachers are the building blocks of the kind of school communities that are needed to create a fertile ground for learning.

Happy Mother’s Day: And BTW, Here’s ‘Ten Things Every Mom Needs to Know’

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May 12, 2013
Child Development, Parenting
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It’s the American holiday called Mother’s Day, a time to let Mom know how much we appreciate all the little things she does to help us reach our potential. We’ll start with the reminder that “Mom” upside-down is “Wow.”

Of course, as much fun as Mom is, she also helps us in some pretty serious ways. (Keep your shirt on, Dad, we realize parenting isn’t all about Mom. But we’ll get to you next month.)  In any case, maybe the following video will make a point about just how crucial that parent-child bond is to a child’s lifelong mental health:

Attachment is the primary process through which children develop self regulation. Unfortunately, as much as researchers know about the importance of secure attachment, many parents don’t know how to achieve it. Fortunately, it doesn’t need to be all that complicated.

As you’ll hear in the following video, “we are basically genetically programmed  to seek a secure relationship with a caregiver.”

However, with our hectic lives and scattered extended families, we are steeped in a society that may be more “child illiterate” than ever before. Many parents have no clue about what children need most.

“Events that occur during infancy,” says this next  video, “especially transactions with the social environment–much more than with the physical environment–are indelibly imprinted in the structures that are developing in the first year of life.”

“We know more about children and development than anytime in history,” say researchers. “And yet, there is a huge gap between what is known and what is practiced in the culture.”

This might be a good time to point out that no one is expecting mom to be perfect. Even when we try our best to practice what is known, we’re going to fall a bit short some of the time. Maybe even a lot of the time. Fortunately, UCLA Neuroscientist Dan Siegel has some positive perspective:

Children pick up on our positive intentions, even when we fall short, says Siegel. (Whew!) That’s a relief to this less-than-perfect mother.

Here’s to a happy Mother’s Day, moms. Wow.

Three Common Myths about the Teenage Brain

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May 5, 2013
Adolescent Development
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what are they thinkingThe latest issue of Current Directions in Psychological Science came this week and caused me a ‘major’ personal dilemma. My book club meets on Monday, and my Kindle tells me I’m only 2 percent of the way through Major Pettigrew’s Last Stand, which I will be expected to discuss with a modicum of intelligence. But this is a special issue of CDPS, entirely devoted to research about the adolescent brain—a topic I’m going to be writing a 2,500-word article about in the very near future.

To read or not to read was not the question so much as which to read.

I settled on a compromise. I’d allow myself one article about teen brains and then devote myself wholeheartedly to Major Pettigrew. But where to begin among the fifteen research articles in this special issue? Clearly I stand to pick up some valuable personal pointers from the one on decision making. But I focused instead on an article about a skill that forms the foundation for good decision making. I began with B.J. Casey and Kristina Caudle’s research titled “The Teenage Brain: Self Control.”

The crux of their study was why teens are subject to a 200 percent higher risk of harm during this time of their lives compared to childhood, even though they actually have a much higher reasoning capacity and are faster, stronger, and more resistant to disease.

Before they focus on the answer to this question, Casey and Caudle suggest that many of us may already think we know it. But if we’ve been getting most of our information from oversimplified media reports or from pop-psych books, we may have fallen victim to one of the following myths about the teenage brain:

1. Myth: Adolescent behavior is by nature irrational or deviant.

You’ve heard the pat analogies about teen thinking. “Teen brains are like a race car with no brakes or steering wheel,” the saying goes.

Casey and Caudle have performed some of the research that may have led to popular overgeneralizations like this one. However they write, “To suggest that this period of development is one of no brakes or steering wheel is to greatly oversimplify it.” In fact, under certain circumstances adolescents can actually outperform adults in regulating impulses. Which circumstances? Those in which emotional information is absent.

Adolescence is a phase during which we need to practice independence in preparation for adulthood. Perhaps in part to prompt us toward independence, we also become increasingly sensitive to social cues during this time. Sometimes these social cues are powerful enough to exert an emotional pull. Thus, explain Casey and Caudle, “when decisions are required in the heat of the moment (ie., in the presence of emotional cues), performance falters.”

In other words, the “race car with no brakes or steering” analogy is only accurate in some “heat-of-the-moment” situations. In cooler, less emotionally-charged situations, teens are perfectly capable of acting rationally.

That said, this common adolescent “emotional hijack” condition is not the fault of an overactive amygdala as it is sometimes portrayed in popular media. The “amygdala hijack” described by psychologist Daniel Goleman is a very real phenomenon that can occur in children and adults alike, but it isn’t the same situation we see commonly in teen decision making. And neither is this adolescent hijack the fault of a “defective” prefrontal cortex, as we’ll see next.

2.  Myth: Adolescents can’t make rational decisions because of their immature prefrontal cortex.

It’s true that the prefrontal cortex is still developing in teens, but it is not defective. Teens can make rational decisions. Just before puberty, research has found, the brain experiences a burst of neuronal growth to provide for a period of pruning before adulthood. During the important adolescent stage of development, prefrontal connections are far from absent. Rather, as Casey and Caudle point out, they have been there since birth and are continually being strengthened through adolescence by the teen’s daily experiences.

“What is changing during this period of development is the strength of connections within prefrontal circuitry as individuals learn to adapt to changing environmental demands,” the researchers write. Specifically, they observe enhanced activity in the ventrolateral prefrontal cortex when teens are successful in suppressing “heat of the moment” responses, an ability that increases with age. But when teens were unsuccessful in depressing “heat of the moment” responses, the researchers saw increased activity in the ventral striatum, “a region critical for detecting and learning about novel and rewarding cues in the environment.”

You might call it a “ventral-striatal” hijack, in a sense. But this tension between reward circuitry and control circuitry doesn’t indicate an irrational or deviant brain. Rather it’s a natural step on the way to achieving the control and independence necessary to prepare for adulthood.

3. Myth: All adolescents go through a perod of “sturm and drang,” or emotional rebellion.

Simply put, some teens go through a stormy period and some teens don’t, and like all other behavior, the difference seems to involve both genetic and environmental influences on self regulation.

A 40-year followup to the famous “marshmallow study” showed that the same people who had shown difficulty in delaying gratification as children still had difficulty with self regulation as adults in their mid 40s. Clearly, individual differences in self-control can persist. But we also know that self control is a skill that can be strengthened with practice.

Adolescence is a time when the brain is more capable than ever before and is being fine-tuned. It’s a period ripe with opportunity for parents to contribute to the process without taking full control over it. After all, teens need opportunities to practice, which includes being allowed the opportunity to fail as well as to succeed. “Indeed,” write Casey and Caudle, “if the objective of adolescence is to gain independence from the family unit, then providing opportunities for adolescents to engage in new responsibilities is essential. Without opportunities and experiences to help optimally shape the adolescent’s brain and behavior, the objectives of this developmental phase will not easily be met.”

Much like the objectives of my book club if I don’t return to Major Pettigrew immediately.