Dr. Jerry Yager, PsyD, Director of Training and Education at Denver Children's Advocacy Center, is a Clinical Psychologist with more than 25 years of experience in the assessment and treatment of traumatized children and adolescents. He specializes in working with adolescents who exhibit self-destructive behavior and have severe mental illness such as clinical depression, bipolar mood disorder, post-traumatic distress disorder and psychosis.
Friday, October 26, 2012
The Changing Needs of the Developing Child
During early development many of the children and adolescents seen in the mental health system have been exposed to chaotic, unstable and threatening environments without the soothing presence of attentive, attuned, nurturing and responsive caregivers. These overwhelming experiences occur during the period of time when the brain’s massive neural networks are being formed. Unlike neuron births (neurogenesis) and migrations that occur while the fetus is still in the womb, the creation of neural connections continues at an explosive pace into the second year of postnatal life. At its peak 15,000 synapses are produced on almost every cortical neuron. This production is taking place at a rate of 1.8 million synapses per second. In order to accommodate this growth new connecting branches are grown. The neural signals transmitted during this period of time and later in life not only influence the functioning of the brain, but actually direct and orchestrate the structure and organization of the brain’s architecture. The most powerful signals impinging on the immature brain of an infant are the sensory signals being communicated by its caregivers. Facial expressions, voices, smells and touch all get converted to patterned neural signals that serve to facilitate this incredible developmental process.
When caring adults are present and attuned to the changing needs of the developing child the balance between stimulation and soothing is maintained within a developmentally appropriate level. This creates the relational arena for the child to grow and express his or her genetic potential. However, when the relational environment is chaotic, unresponsive, violent, or dangerous the immature brain of the infant begins to adapt to these painful circumstances.
There is both good and bad news concerning our development as a species. The good news is that we are born with the capacity to respond to danger in a patterned, automatic, behavioral, and hormonal manner that increases the likelihood that we can survive. Newborn infants have the capacity to sense internal distress and then communicate that distress to a caretaker to engage their protection. Their cries are designed to initiate an emotional response in the caretaker that serves to motivate that person’s attention and response. When a caregiver can sense, tolerate, and modulate their own internal distress, they are able to process this information and make a decision about how best to respond. When a caregiver effectively and accurately reads and responds to an infant’s needs both the child and the caregiver are rewarded with an internal sense of pleasure. Through these relational interactions the developing child learns that it is capable of impacting its world and the caregiver develops a sense of competency as a provider and protector.
Now for the bad news: this stress response system works in a reciprocally related manner with the consciously thinking parts of the brain. When we are reacting out of fear and anxiety the thinking parts of our brains shut down and the automatic, emotionally reactive part takes the lead. If a caregiver is already overwhelmed and coping resources are taxed or a baby’s cries activate unresolved past painful memories, the infant’s communication is ineffective in eliciting the response it needs. The caregiver is motivated to protect him or herself and is at risk of unintentionally neglecting the needs of the young, vulnerable child. For the child the relational experience gets encoded in the neural circuits as a potential sign of danger and the child’s fragile sense of self gets embedded in shame. Young children have limited ability to separate how they feel from who they are. Their core sense of identity gets associated with a painful internal state. It wasn’t just that they had bad experiences in the past; they come to feel that they are those bad experiences. Compounding this, their behavior and other’s responses to their behavior often tend to reinforce those perceptions.
I don’t want to end this with bad news so here is some more good news. Science has discovered that the brain is capable of changing throughout a person’s life. In particular, neurons are specially designed to change in response to experiences. However, not all regions of our brains are equally capable of making these changes. The lower regions, which mediate the unconscious automatic functions of regulating the physiological milieu and the body’s arousal levels, are harder to change than the higher regions that mediate conscious thinking and memory functions. Therefore, interventions designed to influence functions mediated by the lower regions of the brain have to occur in a patterned, repetitive fashion with enough frequency to effectively facilitate growth.
Protection and safety always trump new learning experiences, so physical and psychological safety must always be a priority. In addition, we cannot hope to make significant progress in facilitating growth in our children, students, or clients by simply sharing cognitive information without also activating and regulating lower brain regions with sensory somatic stimulation and developmentally sensitive relational interactions. In the protective presence of an attentive, attuned, nurturing and responsive care provider a child will naturally begin to explore its external and internal world. This will facilitate the child developing a range of capabilities, such as regulation of its body and emotions, modulation of fears and anxieties, empathy for others, response flexibility, and insight. The acquisition of these new competencies will result in the child having a more positive sense of self, others, and the world at large.
As a species we are endowed with the potential to develop the capacity to sense our own and other’s emotional states, to compare our current experience with similar experiences from our past, and to envision our anticipated future so as to make choices about how to effectively respond. These capacities can either be expressed or inhibited by the experiences and opportunities to which we are exposed along our developmental pathway. Prevention is about increasing opportunities for growth while decreasing risk factors that inhibit growth so that all children have a chance to express their potential.
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Your comments and questions are welcome. Please feel free to post below or to contact me directly at jerry@denvercac.org
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