Neuroscience and the Parent
The advances in brain imaging technology over the past decade have helped propel the exciting field of neuropsychiatry way beyond what one would ever have thought possible even a generation ago. Mapping the brain is allowing more and more precise diagnoses and treatments for brain disorders and mental illnesses than ever before. Just take a look at these amazing images of the brain, which appear in a new art book titled “Portraits of the Mind: Visualizing the Brain From Antiquity to the 21st Century,” newly published by Abrams, and including short essays by prominent neuroscientists and long captions by Mr. Carl Schoonover, a neuroscientist at Columbia.
http://www.nytimes.com/slideshow/2010/11/29/science/20101130-brain.html?...
The ability to pinpoint exactly what is happening in someone’s brain when they are experiencing trauma, or when they are suffering a delusion, or problems with impulse control, is changing not only the way these conditions get medicated, as we can find precisely which chemical reactions are not happening properly, but also how we can work cognitively, behaviorally, and therapeutically with patients in order to precisely target the issues that are plaguing them. It is beyond exciting that the field is changing so rapidly, being revolutionized really, because we can literally see things working or not working in someone’s brain, even as they receive treatment. We can “read” a patient’s chemistry and physiology, and understand what is disregulated. And we are beginning to be able to teach and treat exactly those parts of a persons’ functioning that are failing them.
A good example of this is ADHD. One of the most researched conditions in mental health history, we know so much about how the brain of ADHD sufferers work, that we can now effectively improve the lives of many patients who just a generation ago would have been considered dunces, incorrigible, or even given lobotomies. There is hope that eventually the same will be true for autism spectrum disorders.
HBO recently re-aired their movie about Temple Grandin, the celebrated autistic researcher who was able to overcome her deficits, and utilize her amazing gifts to advance the field of animal husbandry and create more humane cattle handling systems. One scene in the movie struck me, and made me understand yet another implication of the advances we have made in understanding mental illness.
In one scene, Temple’s mother goes to a doctor to seek help with her daughter’s strange behaviors. The doctor tells her in no uncertain terms that her daughter is autistic, and should be institutionalized. He then states that the cause for autism is attributed to a “cold mother”, who withholds affection and empathy for their child at the developmental stage when they need it the most.
While this seems crazy and insulting by today’s standards, I actually remember this theory being put forth when I was studying psychology in Europe in the late nineties. While new theories were emerging to challenge it at the time, it was still upheld as one possible etiology for the disorder.
It is hard to imagine today that anyone would still think that autism is caused by a cold mother. We now understand that if a mother seems cold towards her autistic child, it’s because the child is not able to respond emotionally and physically to her attempts to make contact, and that over time, without help or a framework by which to understand the child, the mother would become depressed, withdrawn and helpless.
Thankfully research is helping not only to discover the true causes, and effective treatment of, many mental disorders, but in the process, is exonerating mothers who under the old psychodynamic regime have too often been unjustly blamed for their child’s difficulties.
What we know now is that nature and nurture do intersect in many ways, more than I can get into in this single post. But more and more we see how many of the more serious mental disorders have clear chemical, physiological, and neurological causes. The other good news is that, while they do not readily need to take the blame, mothers (and fathers and other caretakers) need not be irrelevant in how a child’s disorder gets played out.
With our growing understanding, we can help teach parents strategies for overcoming difficulties by adjusting their interactions with their child to help compensate for, balance out, and correct behaviors and reactions. Something as simple as how close a mother sits to an autistic child, or the angle at which she holds an infant with sensory integration disorder, to the language she chooses to point out what her ADHD child is doing, can go a long way. And without the guilt of having caused the condition (which, by the way, no advance of scientific rationale will ever completely eradicate!), parents can feel empowered and hopeful that they can be effective and impact their child’s prognosis in a positive way.