TT7860 – BAL30Session 1:

Attachment, Emotional Well-being and the Developing Brain

• Go to the Student Introductory Discussion Board and tell a little about yourself (you can find a link in the Session 1 page, or to the left in the navigation bar).

• Go to the Session 1 Blog and answer a few questions about why you are taking this module (you can find a link in the Session 1 page, or to the left in the navigation bar).

Before You Begin…

• Brain development - experience, environment & genetics

• Trauma – Physical, Social, Psychological

• Factors that can influence the attachment process and relationships.

Session Aims

Political Influence

Economic

Policy

Hea

lthP

olic

y

WelfarePolicy

SocialPolicyTechnology

Natio

nal

Wea

lth

Political

Stability

Community Facilities

Physica

l

Environment

Employm

ent

Opportunities

Housing

Cultural

Identity

Biological Microsystem

BehaviouralMicrosystem

PsychosocialMicrosystem

LeisureWork

Lifestylecultural

GeneticsPhysiological Process

Health StatusAge Relationships

Social Support

Temperament

Mesosystem: Immediate Environment

Exosystem: Local Environment

Macrosystem: National Environment

Chronosystem: Changes through time

Action

Reaction

Interaction

The Approach - the Assumptions

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• Neuroscientific evidence

• The Physiology of the physicality

• Social Constructivism

What Informs Understanding of Mental Health and Well-being?

National Institute for Health and Clinical Excellence (NICE) Public health guidance 40, 2012Guidance for social and emotional well-being for LA’s, NHS, community, voluntary & private sectors

Allen Report, 2011The significance of social and emotional intelligence

Marmot Review, 2010The significance of nurturant environments

Field Report, 2010The significance of responsive relationships

Confident Communities/Brighter Futures, 2010 Life course approach which include positive social relationships

Why bother?

Click on the ‘evidence’ box in the section ‘what research tells us’

http://www.education.gov.uk/childrenandyoungpeople/earlylearningandchildcare/early/b0077836/introduction

Research Informing Government Policy: Critical Factors in Early Years

• Prevention and Health Promotion

• Early Intervention

• Targeted Support Services Around the Child and Family

Three Approaches to Mental Health and Well-being

Clip to View:Shonkoff: The Science of Early Childhood Development

What’s today all about?

The Anatomy, Physiology and Biochemistry of our Brains

Clips to View:

Which way?

Solution.

Brain Game

• Dissection, experimentation & observation of behaviour:

• Imaging including:• fMRI- Functional magnetic resonance imaging• CT- Computed tomography • PET- Positron Emission Tomography • EEG- Electroencephalography • MEG- Magnetoencephalography • NRIS- Near infrared spectroscopy

Click Here for a Great Free Resource

Exploring the Brain Through…

You are born with 100 billion brain cells,

neurons, but these are largely unconnected and not networked.

Synapses are produced at the rate of 1.8 million per second between 2 months and

2 years! Each neuron forms about 1,500 synapses.

You have more than 2 million miles of neuronal fibres.

By the age of 2 a child has as many synapses as an adult but

this has doubled by the age of 3.

By late adolescence half the synapses in the brain have

been discarded.

Stress induced neurochemicals lead to

cell death in a tender brain.

Neglect may cause unused regions to atrophy – apopsis.

When signal transmission reaches a certain threshold the synapses

involved become exempt from future elimination.

Myelination begins in the brain stem and cortex and progresses

to higher order regions of thought, memories & feelings.

By the age of 3, the brain has reached 90% of adult

size.

The brain continues to grow & develop until mid

20’s but remember plasticity.

Brain Facts

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Our Brains

Our BrainsYour hand-held

model

(Siegel, 2012)

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• During the first few years of life the brain becomes organised i.e. the brain changes in response to stimulation.

• Neurons which were unconnected at birth become connected

• Neurons which are not stimulated are lost• Lack of stimulation and profound neglect alters

and reduces the brain’s functioning• Assaults and toxins can damage brains cells,

resulting in difficulties associated with the area affected.

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Brain Region

Age of Greatest

Developmental Activity

Age of Functional

Maturity

Key Functions

Neocortex

(Forebrain)

Childhood Adult

Reasoning, problem-solving, abstraction, secondary

sensory integration

Limbic

(Forebrain)

Early Childhood

Puberty

Memory, emotional regulation, attachment, affect regulation, primary sensory integration

Diencephalon (Forebrain)

Infancy Childhood Motor control, secondary sensory processing

Brainstem

(Mid and Hindbrain) In Utero Infancy

Core physiological reflexes and state regulation, primary

sensory processing

Brain Functions By Region

BRAIN ANDDEVELOPMENT

(Hughes & Baylin, 2013)

STAGE ONE: VERTICAL INTEGRATION FRONTO-LIMBIC CIRCUIT 0-18 MONTHS

STAGE TWO: HORIZONTAL INTEGRATION LEFT AND RIGHT INTERACTION

STAGE THREE: LATERAL INTEGRATIONFRONTAL ORCHESTRATION & MATURATION 17-28 YEARS

ESSENTIAL FOR SELF-REGULATION

AND ADAPTIVE FLEXIBILITY

• Planning ahead• Monitoring• Sustained attention• Goal directional

behaviour• Working memory• Problem solving

Pre-frontal Lobe Functions

•It stimulates or halts the release of neurotransmitters and hormoneshttp://www.psychologytoday.com/blog/the-athletes-way/201309/the-love-hormone-drives-human-urge-social-connection (Oxytocin link)

• Ability to process emotions• Encode, store, and retrieve

memories• Has a role in:

- arousal

- memory,

- emotions,

- feeding,

- sexual behaviours,

- Motivation• It operates by influencing

the endocrine system and the autonomic nervous system

Limbic System Functions

Amygdala is for regulating movement, memory, emotions, immune system etc.

Frontal lobes for regulating impulses, planning, judgement, goal-setting etc.

More connections between amygdala and frontal lobes than any other part of brain

Motivation = Emotion in motion

Clip to View:

Emotions in the Brain

The Double Act

Limbic System

COMPETENT LEARNER

EFFECTIVE COMMUNICATOR

BORN SURVIVOR

ADAPTABLE

Survival by Adoption, Adaption and Maturation

Clips to View:Experiences Build Brain ArchitectureIntro to Brain Structure and Function

Complex Problem Solving Machine

Direction of impulse

AxonDendrites

Axon

Dendrite of receiving neuron

Neurotransmitters

‘Neurons that fire together wire together’

A Neuron

Increased effectiveness – dendrites & synapses

More effective transmission - myelinated axon

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Synaptogenesis & Apoptosis- developing, tuning and pruning our neuronal

networks• We are born with many more neurons

than we will ever need

• Genes, environment & experience effect the density of the neuronal networks

• As we develop and grow some networks are prunede.g. babies are tuned into every human sound

but gradually “prune” out the ones not neededor used for their “mother tongue”

‘Use it or loose it’

What’s New in Neuroscience?

The Connectome - neuronal network linking up the areas of brain

Denser network = quicker, faster, more reliable connections because ‘the sum of the parts is better than the parts

alone’

Plasticity – the ability to adopt and adapt to stimulus

Neuronal networks are continuously shaped by genetic, environmental and experiential stimulus and

strengthened through repetition. Brain plasticity reduces as we age

Mirror Neurones - encode information about the external world and goal-directed

behaviour

They enable humans to emulate others and thereby empathise & understand intent– essential for the

socialization of children

Mirror Neurons Continued• i.e. they help us to process information about the

intentionality of others’ actions and minds• 1 year olds are able to distinguish between goal-directed

behaviour and non-goal directed behaviour by humans

i.e. they don’t just copy mindlessly, they can infer people’s goal-directed actions and will selectively imitate

others’ actions

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Clips to View:Mirror NeuronsMirror Neurons 2Origins of Us, Brains, Mirror Neurones Dr. Siegel Explains Mirror Neurons in DepthEmpathy and MirrorNeuroscientist says we are all one. 'Empathy neurons.'

The Brain: “You get out what you put in”…

The more a pathway is used .. the more established it becomes .. the easier it

is the use .. and the more it will become the chosen route.

The Early Years - Windows of Opportunity

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Development arises from the interplay - over a lifetime - of:

Genetic make up & maturation processesAutonomic nervous system response Learnt response ExperiencesEnvironmentsAttachmentsKnowledge and understanding

Gene- environment interaction

Environment of relationships

Physical, chemical and built environments

Nutrition

Cumulative effects over time

Biological embedding during sensitive periods

Physiological adaptations & disruptions*

Health related behaviours

Educational achievement & economic productivity

Physical and mental health

Adult outcomes Lifelong outcomes

Foundations for healthy development & sources of early adversity

Biodevelopmental Framework: How early experiences get into our Body: (Shonkoff, 2010,pg.358)

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What do you think we need to develop and grow?

• Time• Teaching• Opportunity• Knowledge and

understanding • Security

Birth to 12 months old Brain growth is unmatched.

The most critical windows during this stage are:

Emotional Development as the foundations for governing emotions are established through attachments

Vision Vocabulary

12 to 24 months old At no other time is the brain so receptive

and responsive. Many of the neurological connections that

govern a lifetime of skill and potential are beginning to take shape.

Children in this stage are gaining more control of their bodies, and their motor skills are developing.

They are becoming more aware of other people’s feelings and beginning to

learn to share. Language and vocabulary remain

important. Attention should be given to maths and logic skills as well-holistic

2 to 5 years oldBy the age of three, much of a child’s brain

growth and density is almost complete-physical.The brain connections that will guide a child’s

development are already well established. There appears to be a connection between the

brain patterns stimulated by music and the part of the brain used to understand spatial concepts in math.

5-10 yearsLearning from parents, peers and

educational settings- cultural influences

Gender awareness establishedDevelopment of friendship groupRecognition of rulesDevelopment of social skills to

accommodate difference and diversityDevelopment and articulation of logicAbility to combine knowledge sources

to create new

11 to late teens• Moral maturation- Nb of changes

in frontal lobes• Selective/exclusive in friendships• Peer influence/ parental control

balance• Recognition of roles and rights• Puberty- hormonal fluctuations• Emotionally labile & exploration• Personal/group identity issues• Conform/ individuality

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Emotional Neglect

Windows of Vulnerability

Toxins can alter patterns of Neuron proliferation.

Many intrauterine and perinatal ‘insults’ can alter the migration of neurons and have a profound impact on functioning.

Examples include infection, lack of oxygen, malnutrition, psychotropic drugs, lead poisoning, ionising radiation and alcohol.

Clips to View:Foetal (Fetal) Alcohol SyndromeFASD Resource Page Link

The neurobiological impact of abuse

Epigenetic effect.“When abuse occurs during the critical formative time when thebrain is being physically sculpted by experience, the impact ofsevere stress can leave an indelible imprint on its structure andfunction. Such abuse, it seems, induces a cascade of molecularand neurobiological effects that irreversibly alter neuraldevelopment.” (Teicher,2002:54-61).

It can alter the function of genes for the following hormones: STRESS HORMONES OXYTOCIN RECEPTOR SEROTONIN RECEPTORS OESTROGEN RECEPTOR BRAIN GROWTH FACTOR

Epigenetics Continued• Genes are programmed to respond to external

environment• Epigenetics = changes in gene activity that do not involve

alterations to the genetic code but can still get passed down to at least one successive generation

• These patterns of gene expression are governed by the cellular material — the epigenome — that sits on top of the genome

• Epigenome can tell your genes to switch on or off (gene expression) depending on the experiences we have

• Environment can make ‘imprint’ on epigenome

Clip to View:

The Epigenome at a Glance

The First Relationships are Important

• Positive predictable interactions with nurturing caregivers profoundly stimulate and organize young brains.

• The quality of early care giving has a long lasting impact on how people develop, their ability to learn, and their capacity to both regulate their own emotions and form satisfying relationships

Clip to View:

Harvard Serve and Return

Stresses that Impact upon the Care- giving Relationship- Socio-demographic Factors

Chronic unemployment Inadequate income/housing Frequent moves/no telephone Low educational achievement Single teenage mother without

family support Violence reported in the family Severe family dysfunction Lack of support/isolation Recent life stress (e.g. bereavement,

job loss, immigration)

Effects of Maternal Anxiety During Pregnancy

• This doubles the risk of behavioural problems in both boys & girls at 4 & 7 years of age

• The chemical changes associated with even mild anxiety leads to raised maternal cortisol levels- which are passed through the placenta → raised cortisol in foetus.

• Cortisol in baby’s bloodstream is a trigger for premature delivery & causes intrauterine growth retardation

• Analysis of stress hormone levels in 10-year-old children whose mothers suffered stress during pregnancy has provided evidence that prenatal anxiety may affect the baby in the womb in a way that carries long-term implications for well-being.

• The study suggests that foetal exposure to prenatal

maternal stress or anxiety affects a key part of their babies' developing nervous system; leaving them more vulnerable to psychological and perhaps medical illness in later life.

(O'Connor et al., 2005)

Effects of Maternal Anxiety During Pregnancy Continued

The Context of Parental Depression and Effect on Infant Security

Economichardship

Less sensitive interactions

Relationshipstress

Increase infrequency of

child punishment

Infantattachment

security

• In high-risk, low socio-economic status families, the rate of disorganised attachment in young children with depressed mothers has been estimated to be as high as 60%.

(Lyons-Ruth et al.,1990)

• Rates of insecure-disorganised attachment are higher in chronically depressed mothers than in those who are not chronically depressed.

(Teti et al., 1995)

Effects of Maternal Mental Illness on Attachment Patterns in Their Children.

It is IMPORTANT TO REMEMBER that when few other risk factors are present the compromising effect of maternal depression can be minimized

When young children of mentally ill mothers are compared to index groups of children of non mentally ill mothers they have been found to have higher rates of disorganised / controlling attachment.

(DeMulder, & Radke-Yarrow, 1991)

Lack of Touch and Interaction on the Brain

These are PET scans of two three year olds.Note the reduction in brain volume as a result of neglect.

Global Neglect & Reduced Brain activity.

The temporal lobes receive and integrate inputs from the senses, and combine them with deep primitive drives from the limbic system and brain stem. They deal with hearing, learning, memory skills and emotions.

P.E.T. scan of a typical two year old.

PET scan of the brain of a Romanian orphan, who was institutionalised shortly after birth. It shows the effects of extreme deprivation in infancy.

‘Global neglect’ has resulted in atrophy of the unused and therefore ‘unnecessary’ areas.

NB: Use /abuse of scans

The infant has no comparisons and family relationships are their world.

“You must be careful how you walk and where you go, for

there are those following you who will set their feet

where yours are set”

(Lee, no date, cited in Brodie, 2009: 14)

Clip to View:Children Copy

Attachment Related Trauma

Severe traumatic attachments in the first two years of life results in structural limitations of the early developing right brain. This is the hemisphere that is dominant for:

Unconscious processing of social and emotional information,

The regulation of bodily states, The capacity to cope with emotional stress, The ability to understand the emotional states of

others (empathy)The sense of a bodily and emotional

self.

Any experiences of prolonged and frequent episodes of intense and unregulated stress in babies and toddlers have devastating effects on the establishment of psycho-physiological regulation, (Vagal Tone) and the establishment of trusting, stable and relationships in the first year of life is important.

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What Happens

When Attachment

Doesn’t happen?

Emotional Responses

Distress Fear Surprise Joy Disgust Anger

We are all born with them and we all feel them.

Higher cognitive emotions

‘Softwired’, appear from toddlerhood, dependent on context, related to cognitive development

Envy Guilt Pride Shame

What happens in and to our bodies ?Fight- Flight- Freeze

Response

To Fear, Excitement and Effort – it is a natural hormonal response to stress

Vagus Nerve Response It acts as a ‘brake’ on bodily

functions - it slows down the heart beat and helps return ‘all systems’ to ‘normal’

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Short term: Essential Long term: Damaging

The vagusNerve

When you need to

concentrate it has to be inhibited

The Vagal response

Vagal Tone is how well our fight/flight response and vagus nerve are balanced

and work together.

How is the Vagal Tone Activated?Via Soothing, Compassion and

Physical comfort

Empathy

We learn to self- soothe and

self- regulate from our

relationships with parents and

significant others -attachments

Vagal tone is partly genetic but

also a result of experiences and

environmental stimulus.

Vagal Tone

Good Vagal Tone

• Highly responsive:• Respond quicker,

process information faster, concentrate better

• More appropriate and effective responses to stimuli

• Return faster to a normal‘resting state’

Poor Vagal Tone

• Low responsiveness:• Responds and

process information not as quickly, less able to concentrate.

• Less appropriate and effective responses to stimuli

• Difficulty returning to normal ‘resting state

Good Vagal Tone is linked to…

Better emotional balance

Clear thinking

Improved attention

More efficient immune system

Greater resilience

To support the development of a child’s Vagal Tone we need to provide…

Secure attachments and bases

Enabling environments Repeated opportunities to

share and learn Repeated opportunity to

recognise, practice and adapt behaviour

Stress: Positive, Tolerable & ToxicPositive/Healthy Stress Some stress is a normal part of life. Learning how to cope with stress is an important part of development.

Tolerable/Manageable StressMore serious and prolonged, but is buffered by supportive relationships, human capital and supportive environments

The extent to which stressful events have lasting adverse effects is determined by:

• Individual’s biological response mediated by both genetic predispositions

•Availability of supportive relationships

•The duration, intensity, timing, and context of the stressful experience.

Toxic Stress Constant activation of the body’s stress response

systems due to chronic or traumatic experiences in the absence of caring, stable relationships with adults, especially during sensitive periods of early development, can be toxic to brain architecture and other developing organ systems.

Connections in the brain are reduced and lost through toxic stress.

Less connections means it is more difficult to utilize the brain capacity and learn effectively

Clip to View:

Toxic Stress Derails Healthy Development

Toxic Stress: Fact Sheet Reference Link

Detrimental Early Experiences can lead to … Learning difficulties Language delay Lack of empathy Hyperactivity/disruptive behaviour Distractibility Hypervigilence Poor impulse control Lack of compassion Correlation to adult borderline personality disorder,

multiple personality disorder (Balbernie, 2001, pg. 242)

Clips to View:Negative ImpactsToxic Stress of Early Childhood Adversity

Resiliency

For Pro-social Behaviour…

• There needs to be many opportunities to share in empathetic and nurturing environments and experiences

• There needs to be opportunities to feel good about yourself, it’s not just not feeling bad about yourself that matters

Children learn what they liveIf children live with criticism, they learn to condemn.

If children live with hostility, they learn to fight.If children live with fear, they learn to be apprehensive.

If children live with pity, they learn to feel sorry for themselves.

If children live with ridicule, they learn to feel shy.If children live with jealousy, they learn to feel envy.If children live with shame, they learn to feel guilty.

If children live with encouragement, they learn confidence.If children live with tolerance, they learn patience.If children live with praise, they learn appreciation.If children live with acceptance, they learn to love.

If children live with approval, they learn to like themselves.If children live with recognition, they learn it is good to have

a goal.If children live with sharing, they learn generosity.

If children live with honesty, they learn truthfulness.If children live with fairness, they learn justice.

If children live with kindness and consideration, they learn respect.

If children live with security, they learn to have faith in themselves and in those about them.

If children live with friendliness, they learn the world is a nice place in which to live.

Copyright © 1972 by Dorothy Law Nolte (1924-1985) http://www.nytimes.com/2005/11/20/arts/20nolte.html

Reference and Research• Balbernie, R. (2001) Circuits and circumstances: the neurobiological consequences of early relationship

experiences and how they shape later behaviour. Journal of Child Psychotherapy, 27 930, pp.237-255• Barnes, J. and Lagevardi-Freude, A. (2002) From pregnancy to early childhood: early intervention to

enhance the mental health of children and families. Mental Health Foundation Vol1 • Blaffer Hardy, S. (2000) Mother Nature. London: Vintage• DeMulder, E. K., & Radke-Yarrow, M. (1991) Attachment with affectively ill and well-mothers:

Concurrent behavioral correlates. Development and Psychopathology, 3, 227-249• Fonagy, P. & Target, M. (2003) Psychoanalytic Theories: Perspectives from Developmental

Psychopathlogy. London: Whurr Publications• Gutman, L.M., Brown, J., Akerman, R. and Obolenskaya, P. (2010). Change in wellbeing from childhood

to adolescence: risk and resilience. http://www.dcsf.gov.uk/research/data/uploadfiles/DCSF-WBL1001-Brief.pdf

• http://www.learningbenefits.net/Publications/ResRepIntros/ResRep34intro.htm• Hughes,D. & Baylin, J. (2013) Woburn brain based parenting and attachment focused therapy,

powerpoint delivered at fostering conference• Infants and Toddlers and the California Mental Health Services Act : Zero to Three Policy Center Fact

Sheet Available at: http://main.zerotothree.org/site/DocServer/Infants_and_Toddlers_and_MHSA_AS.pdf?docID=3861 (Accessed January 23rd 2013)

References and Research Contined

• Lyons-Ruth, K., et al. (1990) Infants at social risk: Maternal depression and family support services as mediators of infant development and security of attachment. Infant Mental Health Journal., 17, 257-275

• Michigan Association For Infant mental Health (2000) Guidelines for Infant Mental Health Practice. Michigan: The Michigan Association for Infant Mental Health

• National Research Council and Institute of Medicine (2000) From Neurons to Neighbourhoods: The Science of Early Childhood Development. Committee on Integrating the Science of Early Childhood Development. Jack P. Shonkoff and Deborah A. Phillips, eds. Board on Children, Youth and Families, Commission on Behavioral and Social Sciences and Education. Washington D. C. :National Academy Press

• O'Connor, T. G., Ben-Shlomo, Y., Heron,J., Golding, J., Adams, D., & Glover, V. (2005) Prenatal Anxiety Predicts Individual Differences in Cortisol in Pre-Adolescent Children. Biological Psychiatry; 58:211-217

• Pomeleau, A., Succimarri, C. & Malcut, G. (2003) Mother-infant behavioral interactions in teenage and adult mothers during the first six months postpartum: relations with infant development. Infant Mental Health Journal, 24 (5), 495-509

• Rees, G., Bradshaw, J., Goswami, H., Keung, A. (2009) Understanding Children’s Well-Being: A national survey of young people’s well-being. London, The Children’s Society

• Shonkoff, J. (2010) Building a new biodevelopmental framework to guide the future of Early Childhood Policy, Child Development, 81(1), pp. 357-367 http://ehis.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=6&hid=101&sid=29ff5ce0-e997-463e-bcdf-98ceafaf9961%40sessionmgr113

• Teicher, M.H. (2002) Scars that won’t heal: the neurobiology of child abuse. Scientific American, March pp.54-61)

• Teti,D., et al. (1995) Maternal depression and the quality of early attachment: An examination of infants, pre-schoolers and their mothers. Developmental Psychology 31, 364-376.

Additional Video Resources

Dr. Clyde Hertzman Attachment Related Trauma and Mental Health Teens and Family Attachment

Additional Readings:

Carter,R.(2010) Mapping the mind. London: Phoenix Conzolino,L. (2013) The social neuroscience of education.

New York: W.W. Norton & Company Siegel,D. (2012) The developing mind 2nd ed. New York:

The Guildford Press. Seung, S.(2012) Connectome. London: Allen Lane