Seeking CARE

Most neuroscientists accept the LUST and RAGE brain systems, because both emotions are manifested in animal behavior and because these emotions are patently essential for survival. But CARE is essential to survival in terms of nurturing of the young. Since the quality of motherly CARE is enhanced by oxytocin, scientists study oxytocin concerning pregnancy and motherhood and so indirectly study CARING.

Of the seven primary-affect systems, perhaps CARING is the least studied but most important. We would not exist unless our brains and bodies were prepared to invest enormous time and energy in the care of offspring who could not survive without such care. The ability of young animals to reach reproductive maturity is linked to the quality of motherly care. You may not have heard of the primal CARE system, but, of course, you have heard of maternal care.

One aspect of the CARE system deserves particular attention. A branch of the CARE system extends through the hypothalamus from the dopamine-producing ventral tegmental area (VTA) to the heart of the SEEKING system, the nucleus accumbens reward center. The CARE system uses the Seeking system to fulfill its action-oriented functions.

Oxytocin and other hormones along with infant contact enhance the CARE system. New therapeutic methods with oxytocin and other hormones will hopefully help parents like mine to experience nurturing affect and display supportive behaviors. Enhanced oxytocin activity may promote accepting, positive, prosocial feelings that continue to affect for a lifetime.

A segment of the CARE system arouses Seeking impulses, which promote goal-driven maternal foraging tendencies. In animals foraging consists of nest building and retrieving pups. In humans, it means preparing for the birth and all the foraging behavior after that. Injections of oxytocin into the VTA promote just such maternal behaviors.

If you compare the SEEKING system with the CARE system, they are almost the same. The only difference is the hypothalamus as part of the CARE system

 

 

Fig.  Seeking – CARE

Maternal care is essential to survival with the nurturing of the young. The ability of young animals to reach reproductive maturity is linked to the quality of motherly care. Fortunately, the investment of maternal attention has not been left to chance. It is grounded in a solid set of instinctual brain urges to nurture newborn infants and to bond with them.

Motherhood has life-long benefits for brain and behavior. Infants who have received loving motherly care are better off emotionally and physically for the rest of their lives. But infants who have not received loving motherly care are in for a rough ride through their lives as I will attest to throughout this book.

How motherly and fatherly care help nurture the brain is of great importance for understanding how altruism, compassion, and empathy become possible. This is true not only for the offspring but for the mother herself. Animal research demonstrates that once a mother has exhibited competent and devoted maternal behavior following the birth of her first offspring, her maternal abilities remain elevated thereafter.

I asked my aunt – my mother’s sister – whether my grandmother kissed her and her sister (my mother) and told her she was loved. She said she did not. And my aunt, caring a person though she was, seemed unable to give or receive affection. Whenever I hugged her she stood with her arms at her sides, staring impassively ahead. Like my mother.

Why was my daughter suddenly eager to protect and sacrifice four months of their lives for this screaming infant? The investment of maternal attention could not be left to chance. It is grounded in a network of instinctual brain urges to nurture the newborn infant and bond with it. And the secret juice that sets it all into motion is oxytocin. Oxytocin transformed my daughter from a playful, sexy lady into a loving mother. Oxytocin, the same lustful chemical that stirred her on to create this infant.  She had an ample supply what my mother had seemingly lacked. 

Oxytocin, one of the main maternal chemicals, is manufactured in greater quantities in female brains than in male brains. Oxytocin, like all chemical messengers of the nervous system, would be useless if it did not bind with specific chemical receptors. Estrogen controls the number of oxytocin receptors throughout the cell fields of the (anterior) hypothalamus. Increasing the number of oxytocin receptors in the hypothalamus where oxytocin is released makes oxytocin effective.

An intranasal spray of oxytocin facilitates the quality of father’s play with their children. But even without the oxytocin spray, most new human fathers experience an increase in oxytocin and other similar hormones of pregnancy and motherhood. Then, infant contact modulates the father’s endocrine systems in a very similar way that infant contact affects mothers. But the effect of oxytocin and infant contact is much more significant with mothers.

Fathers are called to CAREing by an enzyme made in the brain’s hippocampus called aromatase that converts testosterone to estrogen which then mediates production of oxytocin.

A more direct way is with an intranasal spray of oxytocin. Either way facilitates the quality of father’s play and CARE with their children.

CAREing in School

We can counter violence with CAREing. Ideally, that means a secure attachment from birth on. But secure attachment from birth is a poker hand of two kings and three aces. When kids reach school age, teachers can watch for students lacking in secure attachment and do their best to not only teach but to CARE.

I caused teachers GRIEF through elementary school.  So instead of getting CAREing at school, I remember having “Joel Dames” screamed at me pejoratively for at least seven of my eight years of elementary school. As if to rub that in, all of my teachers but two marked shiny bright red Fs for Cooperation and Dependability down the left side of my report cards.

Some schools have been incorporating CARE into their curriculum. The Adverse Childhood Experience Study, now known to most educators, documented the devastating effects of childhood neglect and maltreatment on later-life health and well-being. 

One of the largest CARE or kindness programs called Bucket Fillers is based on a 33 page illustrated children’s book, “Have You Filled a Bucket Today? A Guide to Daily Happiness for Kids.” The idea is “Everyone carries an invisible bucket, and think of what you can say or do to fill it.”

In a program here in Shoreline, WA where I live, the kids who volunteer for the Fill-the Bucket program wear yellow vests. Other kids know that if they are lonely and have no one to play with they will not get rejected if they approach one of these kids wearing a yellow vest ( a kid who receives credit for being in the program).

I was a loner on the playground, but would never have gone up to a “yellow vester.” What would have helped me is for teachers to stop treating me as a disaster. I cannot remember being given any trusted responsibility.

My friend was a police boy who got to stand on a corner and watch kids cross safely. He chose me to be his substitute. If a teacher had bestowed an honor coming even close to this, I would have worshiped her.

CARE and Love are hard to define and hard to get right. CARE school programs are a great idea. Perhaps it might help if some ACE victims were a part of planning a CARE school program. Even include very old ACE survivors like myself.

Now I can no longer find any school Fill-a-Bucket programs on the first ten pages of a Google search.

Clinical Implications

Panksepp predicts in years to come we will learn more about the CARE system. New meds might alter brain CARE chemistry and help parents experience nurturing affect and display supportive behaviors more effectively.

Facilitation of the use of oxytocin may promote the kinds of accepting, positive, prosocial feelings that can increase confidence in one’s capacity for greater emotional openness.

A series of recent studies showed how plasma oxytocin in mothers increases with abundant affectionate contact with their babies. The effect of infant contact, oxytocin and other hormones, and infant contact, enhance the CARE system.

When an infant is separated from Mother it cries in GRIEF or distress. But the feeling of GRIEF, as painful as it is, is essential for its survival. And it keeps on crying for long periods at a time until rescued by Mother or caretaker. Infant distress from a lack of caring sensitizes the child to chronic anxiety and insecurity, and often depression later in life. Without soothing and loving care, an infant will even pine away and die. I am back from the dead – sort of back.

Jaak. Panksepp’s lifetime of research offers a map of chemicals and receptors that need to be stimulated for each of the seven primary affects or emotions. (Universities around the world are beginning to recognize the significance of his work and are starting up Ph.D .programs in Affective Neuroscience.) Hopefully, not very far in the future, it will be possible to medically stimulate the hypothalamus of someone affect-deprived like my mother to generate oxytocin receptors and zap an urge to nourish and cherish her crying, distressed infant.

I don’t think anyone can realize the damage done to an entire life by an affectless mother. My mother never realized it in her lifetime. Her complaint to family and friends was that I was abusing her. I was abusive for sure. Not physically, but as an adult, I was constantly irritated and annoyed by things she said and more by things left unsaid.

I made my mother miserable in her older years. But at that point in my life, I was Dr. Jekyll and Mr. Hyde with no control. The one thing I am grateful for is that I was not physically abusive to my mother. I had lots of other outlets for that.

LOVE

Love is what drove me into therapy. I could not fall in love. I was sexually turned on, but I could not love. Psychoanalysis was about the worst place I could have turned to, but that is where I ended up for four years. It opened up Pandora’s box and all the ruminations stored there. I got deeper and deeper into spiraling ruminations that ended with a series of electroshock treatments.

Recently I received an email that contained a Chasidic talk on love and marriage by Rabbi Mannis Friedman. This might have helped way back then.

He asked about loving the person you’re marrying. Ask anyone in the west whether love is the most important thing and virtually everyone will say, yes, a relationship is all about love. But Mannis says that is not true. It is just Madison Avenue. It’s good for a sale, a lot of sales.

You fall in love. You marry the person you love. Love is an object. You enjoy the relationship because it feels so good for a year, maybe five or six years. But if love becomes the most important thing, it eventually, in most cases, ruins the relationship. Because it is not about him or her, it is about love. Love is more important than him or her. But love is a feeling. Anything blocking the feeling, for example, money, looks, health can get in the way and ruin the relationship. Love that is dependent on something will not last.

Mannis says when asking for someone’s hand in marriage, the question is not will you love me. It is will you be mine. It is about I am yours and you are mine. This will last when the passion is gone. It is deeper than love. If you didn’t get love from your mother, he says, don’t think you are going to get it from your husband or wife as a substitute. You get married because you don’t need love. If you need love, don’t get married. Marriage is not because I want your love, not because I need your love, but because I need you.

Mannis goes on to say, you don’t need love from your husband. You don’t need love from your wife. If you really need love, go back to your mother. That’s where you get love. “I don’t need you to give me love. I don’t need you to give me security. I need you to be my wife. With you, I have a life. Without you, I can manage.” Ask the person you go out with how do you feel about marriage. If either of you does not love marriage, don’t get married. 

Replace the concept of love with three pillars of a relationship, kindness, respect, and sanctity.  A relationship has to stand on these three pillars. Kindness means generosity. You have to be not only generous with possessions and money, but with time and space. 

Marriage does not mean finding a person with who you can just be yourself. It does not mean dropping all attempts at being considerate and respectful. It does not mean letting your hair down and being your ugliest self. You can’t live long with a person if you have lost respect and being your ugliest selves means losing respect for each other. So the second pillar on which every relationship rests is respect for dignity.

Mannis feels the third pillar, sanctity is the hardest to define. He sums it up, though, as respect for marriage.  This might be in a holy sense, but it can mean a very special union. Another relationship can be a very workable one, but it doesn’t have the awesome power of a marriage that makes it different than any other relationship. 

Mannis compares and contrasts two different relationships. The first is a friendship of forty years. The two friends went to school together and were in military service together. And they go for a vacation on the Titanic. And in a panic when the ship is sinking, one of them spots a space on a lifeboat and climbs aboard and saves his life. Half an hour later he thinks, oh, where’s my friend. He will never forgive himself. But everyone else will say they understand. It was panic, it was every man for himself. You panicked, we understand.

On the Titanic on the same voyage, there’s a young couple, newlyweds, they met two weeks ago. And the ship is going down and the husband sees a spot on a lifeboat and climbs aboard, then thinks ten minutes later, oh where’s my wife? “You forgot your wife?” “Well, wife barely.” Nobody will forgive him. Why is it we can forget a friend of forty years, but we can’t forgive a guy who forgets his wife of one week? It is because marriage is special. It involves sanctity – inviolability. You should treat it as sacred and spend the time to make it work.

Love is a Skill

Besides kindness, generosity, respect, and sanctity, there is the paradoxical balancing of intimacy and independence. We get married to have an intimate relationship with our partner, but at the same time, we need solitude and self-transcendence. Both partners have their ideal balance and at times, if not often, there is disagreement between partners. 

While in Japan a friend came over to teach a class on the army post where I was employed. He was single and I introduced him to a lovely Japanese woman. But they spent a weekend together and he decided not to see her again. He liked to read the New York Times on Sunday mornings and she interrupted him while he was reading. He needed solitude that could not be violated. But he lacked the skill of being flexible and attempting to work problems out.

I think the Japanese woman would have learned to protect my friend’s solitude if he worked to learn the skill of patience.

Deprived of Love

Harlow was an experimental psychologist and John Bowlby a clinical child psychiatrist. The publication of Harlow’s research with monkeys helped John Bowlby’s Attachment Theory gain acceptance. The two were introduced to each other by British ethnologist Robert Hind who realized how close the men were in their views and willingness to challenge prevailing Zeitgeist. They corresponded and attended some of the same scientific meetings from about 1957 through the mid-1970s when Harlow retired. Harlow provided the experimental research, the controlled laboratory studies that Bowlby needed to document his theories. 

Their exchange of ideas led to a break from Freud and to an understanding of developmental psychology that strongly influences therapists and researchers today. Harlow and Bowlby’s work center about the premise that much of present resentment, anger, and hostility stem from past mistreatment at the hands of a significant other, most often the mother, very early on. 

By the nineteen-forties, some psychologists were conducting studies and writing about the ill effects of children neglected under institutional care, but Bowlby was the most influential. In 1949 the Chief of the Mental Health Section of the World Health Organization (WHO) asked Bowlby to report on the needs of homeless children. Bowlby spent six months researching and meeting with clinicians in the field.

His report, published in 1951 in the form of a WHO monograph entitled “Maternal Care and Mental Health,” chronicled the adverse effects of inadequate maternal care during early childhood on personality development. During the next few years, his report was translated into twelve languages and gave birth to the field of Attachment Theory. Bowlby’s report was not well received by clinicians, but the publication of Harlow’s work helped to authenticate his findings.

Like Harlow, Bowlby concluded that what is essential for mental health is that the infant and young child experience a warm, intimate, and continuous relationship with her/his mother (and/or permanent mother-substitute) in which both find satisfaction and enjoyment. Bowlby called this “secure attachment,” the first of his three basic attachment patterns

And the corollary, that even limited deprivation of three to six months during the first three or four years can produce “affectionless and psychopathic character.” He reported that early maternal deprivation results in dramatically lower IQ scores and poor physical development. Infants observed in institutional studies showed listlessness, emaciation, immobility, unresponsiveness, failure to gain weight properly, poor sleep, an appearance of unhappiness, and an inability to love or enter into relationships.

Not only do threats of abandonment create intense anxiety, but they also arouse anger, often of an intense degree. Acute anxiety and powerful feelings of revenge result even from partial maternal deprivation. But the most violently angry and dysfunctional responses of all are elicited in children and adolescents who not only experience repeated separations but are constantly subjected to the threat of being abandoned.

Maternal deprivation is any situation where the mother or permanent mother-substitute is unable to offer the loving care small children need. Of course, maternal deprivation exists when the mother or mother-substitute is absent. At age seven, Bowlby was sent off to boarding school. He later said, “I wouldn’t send a dog away to a boarding school at age seven.”

Bowlby’s development of Attachment Theory began soon after he graduated from Cambridge University when he was employed in a home for maladjusted boys. He observed that boys who were separated from their mothers suffered intense distress, though they were adequately fed and cared for. And what followed this distress were angry protests and then despair.

After leaving the boys home, he conducted a study with forty-four adolescents in a child guidance program in London who were convicted of stealing. As a control group, he selected the same number of children who had not committed crimes. He interviewed the parents from both groups about whether their children had been separated from them. The conclusions were published in his seminal work, “Forty-Four Juvenile Thieves: Their Characters and Home Life” (Bowlby, 1944). More than half of the children convicted of theft had been separated from their mothers for longer than six months during the first five years of their lives.

The belief at the time of his work was that the bond between mother and infant emerges because of the feeding relationship. Bowlby believed in a primal need for the infant to emotionally bond with the mother. This rational concept was challenged by the psychoanalytic community predominant at the time. It was not until the publication of Harlow’s rigorous controlled experimental studies that Bowlby’s Attachment Theory gained wide acceptance within the scientific community.

Basic Attachment Patterns

Understanding the three basic patterns of attachment are necessary for the treatment of infants and toddlers, but also for the treatment of youth and adults. Bowlby details both the evidence base and treatment for Attachment Theory in a trilogy of books: “Attachment” 1969, “Separation: Anxiety and Anger” (1972,) and “Loss: Sadness and Depression” (1980). 

The second pattern, anxious-resistant attachment, is when the mother is available and helpful only some of the time, and the parents threaten the child with abandonment as a means of control. There are some separations of parent and child. The child prone to separation anxiety tends to be clinging and is anxious about exploring the world.

Third and worst of the three patterns, anxious-avoidant attachment, is when the mother rebuffs the child whenever she/he approaches for comfort or protection. The child has no confidence at all that the parent will be there for her/him. In severe cases, the child is constantly rejected, ill-treated, or institutionalized. The child has no confidence he can get help from anyone, and attempts to live his life without the love and support of others. Needless to say, this results in personality disorders and suffering. And today we are aware of the physical, neurological, and even genetic damage.

An unhappy past cannot be changed however understandable the suffering may be. Bowlby would say that to continue fighting old battles is unproductive. Even with attachment so dependent on early years, Bowlby broke from Freudian therapy with its roots in the patient’s past. As with Cognitive Therapy, Attachment Therapy focuses on the here and now and only brings up past events when the events might shed light on the patient’s present way of dealing with her/his current life. 

Attachment Therapy

In clinical practice, as set forth by Bowlby, the therapist attempts to establish a secure attachment the patient never had. The therapist provides the patient with a secure base by taking the role of a parent providing the child with a secure base from which to explore the world. The therapist strives to be reliable, attentive, and sympathetically responsive. She/he tries to see the world through the patient’s eyes and be empathic.

Patients are helped to understand that much of their present resentment, anger, and hostility stems from past mistreatment at the hands of others. But however understandable their anger may be, the therapist now helps to see that to continue fighting old battles is unproductive.

Patients consider the ways they engage in relationships with significant others in their lives. What are the expectations of their feelings and behavior? What are their expectations for the feelings and behavior of others? What unconscious biases do they bring to a relationship? What are those biases concerning why and when things go badly?

The overlaying ongoing relationship with the therapist will be influenced by the perception and expectation of how an attachment figure is likely to feel and behave towards them, which is influenced by the models they hold of their parents and themselves. The patient considers how his/her current expectations, feelings, and behavior may be the product of events, situations, and what he/she has been told about him/her self during childhood and adolescence.

They are encouraged to recognize that their image of themselves and others that often emanates from a parent, may not be appropriate or justified. They can work on imagining and developing a more positive and helpful alternative image to replace the unreasonable image of their past experiences, to stop being a slave to old and unconscious stereotypes, and to feel, to think, and to act in new ways.

Bowlby’s goal for the therapist to provide the patient with a secure base is not an easy task and Bowlby acknowledged this. The therapist must be aware that the patient’s adverse experiences may make it difficult for him to believe the therapist can be trusted to behave kindly or understand his situation. On the other hand, the unexpectedly attentive and sympathetic responses the patient receives may lead him to think the therapist can provide more than is realistic. And the therapist comes to the relationship with her/his views of herself/himself and others, developed during her/his childhood and adolescence.

Bowlby has left us with both an understanding of Attachment Theory and the ingredients of a good therapist. In his last book, “Secure Attachment,” he presents both Attachment Theory and attachment therapy. That makes it possible to design a cognitive self-therapy with mental scripts constructed with an understanding of the unhealthy messages constructed during childhood and adolescence. 

Many beliefs about ourselves and the world are formed during the first thousand days of our lives and are truly hard to shake. John Bowlby spent a lifetime researching and developing Attachment Theory that deals with beliefs formed during these early years as a result of mother-child relationships. Many therapies today have roots in Attachment Theory and it has become a pop psychology buzzword.

Self-help books that help:

Total Self-Renewal through Attention Therapies and Open Focus

The Open-Focus Brain: Harnessing the Power of Attention to Heal Mind and Body