A new study, published in the International Journal of Epidemiology, has found that prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) has a significant association with lower birth weight and gestational length. This was found to be in cases where mothers had taken the drug for two or more trimesters.
Depression in both expectant mothers and fathers increases the risk of premature birth, finds a study published in BJOG: an International Journal of Obstetrics and Gynaecology (BJOG).
Traumatic Childhood Events Can Lead to Mental Health and Behavioral Problems Later in Life
A report by the University of San Diego School of Law found that about 686,000 children were victims of abuse and neglect in 2013. Traumatic childhood events can lead to mental health and behavioral problems later in life, explains psychiatrist and traumatic stress expert Bessel van der Kolk, author of the recently published book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Children’s brains are literally shaped by traumatic experiences, which can lead to problems with anger, addiction, and even criminal activity in adulthood, says van der Kolk. Sound Medicine’s Barbara Lewis spoke with him about his book.
Sound Medicine (SM): Can psychologically traumatic events change the physical structure of the brain?
Dr. Bessel van der Kolk (BK): Yes, they can change the connections and activations in the brain. They shape the brain.
The human brain is a social organ that is shaped by experience, and that is shaped in order to respond to the experience that you’re having. So particularly earlier in life, if you’re in a constant state of terror; your brain is shaped to be on alert for danger, and to try to make those terrible feelings go away.
The brain gets very confused. And that leads to problems with excessive anger, excessive shutting down, and doing things like taking drugs to make yourself feel better. These things are almost always the result of having a brain that is set to feel in danger and fear.
As you grow up and get a more stable brain, these early traumatic events can still cause changes that make you hyper-alert to danger, and hypo-alert to the pleasures of everyday life.
SM: So are you saying that a child’s brain is much more malleable than an adult’s brain?
BK: A child’s brain is virtually nonexistent. It’s being shaped by experience. So yes, it’s extremely malleable.
SM: What is the mechanism by which traumatic events change the brain?
BK: The brain is formed by feedback from the environment. It’s a profoundly relational part of our body.
In a healthy developmental environment, your brain gets to feel a sense of pleasure, engagement, and exploration. Your brain opens up to learn, to see things, to accumulate information, to form friendships.
But if you’re in an orphanage for example, and you’re not touched or seen, whole parts of your brain barely develop; and so you become an adult who is out of it, who cannot connect with other people, who cannot feel a sense of self, a sense of pleasure. If you run into nothing but danger and fear, your brain gets stuck on just protecting itself from danger and fear.
SM: Does trauma have a very different effect on children compared to adults?
BK: Yes, because of developmental issues. If you’re an adult and life’s been good to you, and then something bad happens, that sort of injures a little piece of the whole structure. But toxic stress in childhood from abandonment or chronic violence has pervasive effects on the capacity to pay attention, to learn, to see where other people are coming from, and it really creates havoc with the whole social environment.
And it leads to criminality, and drug addiction, and chronic illness, and people going to prison, and repetition of the trauma on the next generation.
SM: Are there effective solutions to childhood trauma?
BK: It is difficult to deal with but not impossible. One thing we can do — which is not all that well explored because there hasn’t been that much funding for it — is neurofeedback, where you can actually help people to rewire the wiring of their brain structures.
Another method is putting people into safe environments and helping them to create a sense of safety inside themselves. And for that you can go to simple things like holding and rocking.
We just did a study on yoga for people with PTSD. We found that yoga was more effective than any medicine that people have studied up to now. That doesn’t mean that yoga cures it, but yoga makes a substantial difference in the right direction.
SM: What is it about yoga that helps?
BK: It’s about becoming safe to feel what you feel. When you’re traumatized you’re afraid of what you’re feeling, because your feeling is always terror, or fear or helplessness. I think these body-based techniques help you to feel what’s happening in your body, and to breathe into it and not run away from it. So you learn to befriend your experience.
Adverse Childhood Experiences (ACE) Study Pyramid
The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The study is a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego. Adverse Childhood Experiences can include physical, mental, emotional abuse and/or neglect, even at the level of infants and toddlers. Being devalued, ignored, screamed at, shaken, hit, neglected and worse all are contained in ACE.
More than 17, 000 Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination chose to provide detailed information about their childhood experience of abuse, neglect, and family dysfunction. To date, more than 50 scientific articles have been published and more than100 conference and workshop presentations have been made.
The ACE Study findings suggest that traumatic experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States. It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences. Realizing these connections is likely to improve efforts towards prevention and recovery.
In their early to mid-30s, Extreme Low BirthWeight survivors may be at greater risk for other psychiatric problems.
Pediatrician William Sears has claimed that, “babies who are ’trained’ not to express their needs may appear to be docile, compliant or ‘good’ babies. Yet, these babies could be depressed babies who are shutting down the expression of their needs.”
“Parenting and stress often go together, and stepfathers who fill multiple roles are among the most affected, according to a study by Brigham Young University and Princeton researchers.”
I Massaged and Carried My Baby, and Continued My Research
I began massaging my baby shortly after he was born. I started with the traditional massage I had learned in India, and due to my research and my observations, I gradually added and subtracted elements that were backed up by professional research and because of my yoga teaching, my knowledge of the lymph system and the importance of including massage and movements to stimulate it. Lymph carries toxins through its own system and helps push the toxins out through the gastrointestinal system. It has no innate way to circulate on its own — movement of some kind helps circulate the lymph. The circulation of lymph is one of the foundations of yoga postures.
After my first baby was born, I continued studying bonding and its elements, strapping him to my chest (in a new product, invented by an acquaintance of mind, called a “Snugli”) and heading off to the medical library several times a week. By that time I massaged my baby daily and, as much as possible, carried him in a front pack on my chest.
A Massage Routine that Could be Taught
After massaging my baby every day for three months and continuing my research, I developed a massage routine that could be taught. My baby was “colicky” and so I used massage and yoga postures to help mature his gastrointestinal system. The routine I developed was always successful in reducing, then eliminating, the cries of colic. The massage helped move fecal matter and gas through the intestines and down through the colon, easily eliminated by the baby’s natural system. Using the strokes and movements I developed, a baby’s colic is relieved within two weeks. I included my Colic Relief Routine in the curriculum I was developing.
Massage Speeds Myelination of the Brain and Nervous System
The natural sensory stimulation of massage speeds myelination of the brain and the nervous system. The myelin sheath is a fatty covering around each nerve, like insulation around electrical wire. It protects the nervous system and speeds the transmission of impulses from the brain to the rest of the body. The process of coating the nerves is not complete at birth, but skin stimulation speeds the process, thus enhancing rapid neural-cell firing and improving brain-body communication.
Research Finds Infants Sensitive to “Pleasant Touch”
There are two studies whose results are that “pleasant touch” is good for babies. They say that a gentle touch or caress, deemed “pleasant touch,” stimulates a baby’s senses and induces a response indicative of parent-infant bonding. New research into the matter now finds that these interactions are not only important for bonding, but that they also build on the child’s social and physiological development.
One article says, “Our results provide physiological and behavioral evidence that sensitivity to pleasant touch emerges early in development and therefore plays an important role in regulating human social interactions.” The findings are important because they show that the implicit meaning of pleasant touch — to stimulate bonding — develops as early as infancy. In turn, these social interactions carry on into adulthood, as many adults lightly caress, or pet, their partner to express love and affection.
An article in Scientific American reported that children lacking this kind of interaction (“pleasant touch”) — often those who end up in foster care or orphanages — tend to have increased levels of the stress hormone cortisol as they grow older. High levels of cortisol are present in depression and anxiety disorders. “This lack of affection,” say the researchers, “can result in a child who develops emotional, behavioral, and social problems later in life.”
Cognitive neuroscientist Merle Fairhurst and colleagues of the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany, knew that previous studies with adults show that a specific type of touch receptor is activated in response to a particular stroking velocity, leading to the sensation of “pleasant” touch. They hypothesized that this type of response emerges as early as infancy.
Strokes of Medium Velocity Work Best
Babies show unique physiological and behavioral responses to pleasant touch, which helps to cement the bonds between parent and child. For this study, Fairhurst and colleagues had infants sit in their parents’ laps while the experimenter stroked the back of the infant’s arm with a paintbrush. The results showed that the babies’ heart rate slowed in response to the brushstrokes when the strokes were of medium velocity; in other words, the touch of the medium-velocity brush helped to decrease their physiological arousal. The infants’ slower heart rate during medium-velocity brushstrokes was uniquely correlated with the primary caregivers’ own self-reported sensitivity to touch. The more sensitive the caregiver was to touch, the more the infant’s heart rate slowed in response to medium-velocity touch.
The most engaging response came with the medium-velocity strokes, which not only lowered the babies’ heart rate, but also caused them to become more curious about the brush as it stroked them. Further strengthening the relationship between pleasant touch and parent-child bonding, the researchers found that parents whose self-reported sensitivity to touch was higher were more likely to have children who responded more to the pleasant touch of the paintbrush.
Pleasant Touch Plays a Vital Role in Human Social Interactions
The researchers noted that this link between caregiver and infant could be supported by both “nurture” and “nature” explanations. “Social touch is genetically heritable and therefore correlated between caregiver and infants,” Fairhurst said. According to the researchers, the findings “support the notion that pleasant touch plays a vital role in human social interactions by demonstrating that the sensitivity to pleasant touch emerges early in human development.”
With Massage, Babies Experience Bonding in their DNA
This study indicates that a baby who is massaged regularly, receiving “pleasant” touch, will experience bonding in the infant’s very DNA, and is therefore more likely to naturally bond with his/her own children later in life. It also reminds us to teach the strokes in a way that is “medium velocity”; that is, not too light, not too heavy. In my experience, most parents err on the side of too light a stroke, and often need to be encouraged to be a little more firm in their massage. When they know that their baby responds better to a firmer stroke, they gain confidence. I often asked them to think of a cat licking her kittens; the “stroke” is just right; the kittens rely on the mother’s strength to feel grounded and cared-for.
Research Suggests that Touch is as Important to Infants and Children as Eating and Sleeping
Dr. Tiffany Field has said, “Our research suggests that touch is as important to infants and children as eating and sleeping.” She notes that loving touch triggers physiological changes that help infants grow and develop, stimulating nerves in the brain that facilitate food absorption and lowing stress hormone levels, resulting in improved immune system functioning. A report by the Families and Work Institutes states that during the first three years of life, the vast majority of connections between brain cells are formed They conclude that loving interaction such as massage can directly affect a child’s emotional development and ability to handle stress as an adult.
Premature Babies Benefit Tremendously from Massage
Studies with premature babies using the massage and holding methods in my book have demonstrated that daily massage is of tremendous benefit. In 1984, an instructor from my organization did an in-service talk at the University of Miami Medical Center. Dr. Tiffany Field became very interested in the effects of touch and massage on premature infants. She founded the Touch Research Institute after a groundbreaking study on premature babies and massage. Her research has shown remarkable results and eventually earned her the “Golden Goose Award,” which honors scientists whose federally funded research may not have seemed to have significant practical applications at the time it was conducted but has resulted in major benefits to society.
The key discovery — that touch, in the form of infant massage, can vastly improve the outcome for babies born prematurely — has affected millions of lives around the world and saved billions of dollars in healthcare costs in the United States alone. In one study, twenty premature babies were massaged three times daily for fifteen minutes each. They averaged forty-seven percent greater weight gain per day, were more active and alert, and showed more mature neurological development than infants who did not receive massage. In addition, their hospital stay averaged six days less — a long time for parents, and thousands of dollars of care.
I included a chapter on premature babies in the manuscript for my book. Because of the support of a noted pediatrician, I was able to work in the Neonatal Intensive Care Unit (NICU) of a prominent Denver hospital. I did not touch or massage the babies myself, feeling it is important for parents to bond with their newborns, even in the NICU, with their babies often attached to cords, tubes, etc. I taught parents one-to-one how to use Touch Relaxation and Resting Hands, methods I developed to begin a skin-to-skin bond preceding massage. The experience I had with these parents and babies was amazing. Regardless of their age or the amount of care they needed, every baby responded remarkably well to parents’ touch.
© 2014 Vimala McClure