6. Responsive relationships

RESPONSIVENESS TO NEEDS AND CUES

What to do:

•  Learn the cues your baby gives to signal needs. Skin-to-skin contact is especially good for this in the early hours, days and months of life.

•  Learn to move in with a response before your baby cries—in order to keep baby in optimal arousal. Otherwise your baby will practice becoming distressed as part of his personality. 

Why?

After nine months of gestational synchrony, human mothers and neonates under natural conditions typically move into an interactional synchrony of sound and movement within the first hours after birth (e.g., Condon & Sander, 1974; Papousek & Papousek, 1992). Caregivers act as external regulators of psychological and biological development (Hofer, 1994; Schore, 2001). Optimal human development is thus rooted in social synchrony with others who help the child maintain optimal arousal levels (Reddy, 2008; Schore, 1994; Trevarthen, 2005). 

In early life, the brain is forming its emotional circuitry and structures in collaboration with caregivers (for reviews, see Schore, 1994; 2001). Responsive caregivers, in mutual co-regulation, shape the infant brain for self-regulation within and across multiple sensory systems (e.g., respiratory, hormonal), influencing multiple levels of functioning (Hofer, 1994) and establishing emotional patterns that promote confidence and mental health. 

For example, responsive care with co-regulated communication patterns is related to good vagal tone, which is critical for well functioning digestive, cardiac, respiratory, and immune as well as emotional systems (e.g., Donzella et al., 2000; Propper et al 2008; Stam et al., 1997). Non-responsive parenting leads to poor vagal tone (e.g., Calkins, Smith, Gill & Johnson, 1998; Porter, 2003). Other systems are also affected negatively. For example, having a depressed mother (whose nurturing responses are limited) alters the functioning of the hypothalamic-pituitary-adrenal axis (HPA; e.g., Beatson & Taryan, 2003; see Dawson, Ashman & Carver, 2000, for a review). 

BUT: Isn’t it normal for babies to cry? Not in our ancestral context. That would have been quite unwise. Unfortunately, a common cultural misperception is that letting babies cry themselves to sleep represents adequate parenting (Gethin & MacGregor, 2009). When babies are left to cry, with no parental attempt at timely comforting, their brains are flooded with high levels of potentially neurotoxic stress hormones such as cortisol (Blunt Bugental, Martorell, & Barraza, 2003; Gunnar & Donzella, 2002). 

•  Opioids, which promote feelings of wellbeing, diminish during human sadness (Zubieta et al., 2003) and psychic pain circuits are aroused (Eisenberger et al., 2003; Panksepp, 2003). Stress response systems can be wired permanently for oversensitivity and overreactivity (Anisman et al., 1998), leading to predispositions for clinical depression and anxiety (Barbas et al., 2003; de Kloet et al., 2005; see Watt & Panksepp, 2009, for a review), poor mental and physical health outcomes, and accelerated aging and mortality (for a review, Preston & de Waal, 2003). 

•  Unrelieved distress in early life reduces the expression of GABA genes, leading to anxiety and depression disorders as well as increased use of alcohol for stress relief (Caldji et al., 2000; Hsu et al., 2003). 

•  When emotional dysregulation becomes chronic, it forms the foundation for further psychopathologies (Cole, Michel & Teti, 1994), especially depression. 

•  Infant emotional dysregulation is related to subsequent mental illness, including a propensity for violence (Davidson, Putnam & Larson, 2000). 

•  Stress that leads to “insecure attachment” disrupts emotional functioning, compromises social abilities and can promote a permanent bias towards self-preservation (Henry & Wang, 1998; also see Schore, 2009, for a review).