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September 2006
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Inside a Circle of Security

The Circle of Security (COS) is a therapy process to designed create or repair the bond between mother and child. The part of our brains responsible for social memory contain both oxytocin and dopamine receptors, which combine to form the almost addicted social preference we call love, this capacity has to be learned after birth. Mothers teach love by example as they nurture babies. But a mother who didn’t get the security and love she needed as an infant won’t be able to teach her own child.

Instead, she becomes part of a cycle of failed attachment that's passed down through the generations.

The oxytocin response is what creates the bond of love between parent and child at the neurochemical level; the infant and toddler must learn this response through her interactions with her primary caregiver, usually the mother.

Their bodies engage in a dance, each responding to the other's gaze, movements, sounds and smells. As they mirror each other, the mother's body teaches the baby's body how to move through different states. Eventually, the baby will learn to"self-regulate."

"Emotional regulation is, basically, a parent being able to join the child in emotional experiences and help them to self-soothe and calm down," says Bert Powell, COS co-founder (with Glen Cooper and Kent Hoffman). "Children come into the world with almost no ability to manage their internal experience. So, early in life, they need someone to manage their emotional experience for them."

But mothers who weren't mothered well themselves can’t teach their kids how to experience ups and downs in a healthy way. Instead, they pass along the dysfunctional behaviors they learned from their moms.

Because we learn what we can expect from our parents emotionally long before we have the ability to form memories or analyze our experiences, these interactions are really hard to understand. COS therapy, based at the Marycliff Institute in Spokane, is designed to uncover these hidden agendas.

"We're focused on teaching parents emotional regulation and what kinds of emotions babies have that literally disregulate the parent's emotions," Powell says.

To do that, the COS staff created an easy to understand model of different styles of attachment, and some intuitive ways to describe what's unconsciously going on between mother and child.

Before a COS group begins, each mother and child pair is videotaped in what's known as a "Strange Situation Assessment." This test, developed by psychologist Mary Ainsworth in the 1970s, was designed to show the style of attachment between mother and child. Mothers also participate in a videotaped COS interview.

Says Powell, "A healthy individual is able to express a full range of emotion, and emotions don’t necessarily have to be threatening. Within that range of emotions, you can hold perspective, self-soothe and keep in the range where you can maintain a reflective self."
Kids who don’t learn these skills from their parents are headed for hurt. "The reason people choose drugs or thrills is as a way to manage different difficult affective states, such as depression, loneliness or isolation," he says.

In the program, mothers meet in groups of six weekly for 20 weeks. In the sessions, they watch videotapes of mother/child interactions edited by COS therapists to illustrate not only the central problem in the relationship, but also times when the mother is successful in giving her child what he needs.

The OS team came up with a way to viscerally illustrate how a mom's emotional baggage can interfere with her ability to see her child for himself.

They show the women a video clip of a beautiful coastal rainforest set to two kinds of music. First, serene, soothing music plays, and the women discuss the pleasant feelings it evokes. Next, the ominous music from "Jaws" plays, and, as the mothers talk about the anxious feelings the same setting evokes, they understand how their own emotional tone colors the way they see their kids.

As they watch the tapes of themselves and the other mother/child pairs in the group, each woman begins to identify when a kid is "miscuing," that is, trying to disguise the need to be mothered so as not to trigger Mommy's pain.

"Shark music" becomes a useful metaphor for moments when a mother is reacting to her own sensitivities. She learns to separate her child's longing from her own, and to give the love she never got. Her baby learns to turn to others for love and comfort.
"When the child is excited and feeling delight, the parent can join in their emotional state," Powell says. "It's up-regulating around delight and down-regulating around stress."

This attunement creates actual changes in the child's physiological state. At the same time, his orbitofrontal cortex, the part of the thinking brain that matches social communication with emotional experience, learns that this interaction is part of the state called "love."
He learns, at the somatic level, that if he can be close to someone, his brain will release soothing, healing oxytocin, and he'll feel better.
COS therapists score each child's attachment style during the Strange Situation Assessment and again after the 20-week COS program is completed. The program can help even the most desperately disconnected kids to being securely attached by the end of the program. In one study of 65 toddlers, the majority shifted to secure attachment.

Powell and his colleagues have worked with babies and kids up to five years old. Powell thinks the sweet spot for intervention is when the baby is two or three months old, so that the mother has time to get to know her, but the negative behavior patterns haven't become entrenched.

While most COS projects involve what are known as "at-risk" women -- homeless mothers, mothers in prison, mothers with a history of violence -- there's a project in Perth, Australia working in a hospital perinatal unit.

"It's fascinating to see the level of disorganization in the middle class," Powell says. "We're so focused on the supposed high-risk population, but I really think the middle class is underserved."

Even the most vulnerable of mothers seem to be able to make the subtle changes that can turn a tormented child into one who knows she's loved. "I never cease to be surprised by the resiliency of people," Powell says, "and, given the right circumstances, what people are capable of doing. A child calls forth in every parent this innate, primitive desire to provide proper care. The baby calls the parent out, and all we have to do is help her see the road."

Orgasmic Birth -- the Interview

How do you get people to take seriously the importance of labor and birth? Unfortunately, in our hedonistic culture, you have to sell it with some sizzle.

Childbirth educator Debra Pascali-Bonaro aims to change the image of birth from an unpleasant chore to a profound and sensual experience.

Pascali-Bonaro is Lamaze International Development Chair, a Lamaze certified childbirth educator and teacher trainer with Passion for Birth, as well as the International co-chairperson for the Coalition for Improving Maternity Services. (The list of her accomplishments is much longer; see her complete bio here.)

She says, "Working so many years as an educator, I've seen birth getting more medicalized. But this information was not getting out in a format that the public was taking hold of. There are many films that present a wonderful look at birth and midwives. They seem to be used a lot by the 'choir,' but I didn't think a lot of these messages had successfully crossed over into the broader population. I wanted to find a way that would reach people who aren't even interested in birth."

As she traveled the world, she brought a video camera along and asked women if she could film their births, a project intended to show birth as a sensuous, powerful part of a woman's life.

She realized that a focus on orgasmic birth could fire people's imaginations. The result is a documentary film, "Orgasmic Birth," to be released next year.

Pascali-Bonaro says that this is an aspect of birth that's been almost forgotten in our day, while TV shows portray labor and birth as medical emergencies.

"It's something maybe our great-grandmothers knew," she says. "They birthed at home and felt the continuity of birth as part of their sexuality. When we medicalized birth, we took it out of that context. While the concept of orgasmic birth is not known, when people get the information about how the hormones of love and intimacy are present in elevated forms at birth and in the first moments between mother and baby, and during breastfeeding, the light bulbs go off in their heads."

Pascali-Bonaro has done focus groups as she works on the project. She finds that if she asks people if they want to look at a film about birth, they're not interested. But when she says it's about orgasmic birth, they get enthusiastic.

"The age group I'm hoping to target is young people who are not pregnant, and we hope get them hooked into watching it because it’s called 'Orgasmic Birth.' They say, 'I never thought of birth like this.'"

Sure, the project is controversial in our sex-negative culture. Pascali-Bonaro says that she's gotten very mixed reactions even from her colleagues.

But controversy can stimulate debate, and that's healthy. "I hope it might wake a lot of people up to not only think about birth in new ways but also to explore their choices in new ways. We need to gain confidence in our bodies -- and in our ability to listen to our bodies -- and move through this process in a more humanized way."

The film also will affirm the experiences of the lucky women who have had ecstatic births, whether or not they have a physiological orgasm. Women have told Pascali-Bonaro that they'd never before told anyone this had happened to them, fearing it was inappropriate or even perverted.

I think that "Orgasmic Birth" has the potential to create not only a shift in how we look at birth, but also in the ability of future generations to love completely. If we're not born into the world in love -- deep, physical love -- we have a very hard time learning to love.

When doctors interrupt the natural neurochemical processes of labor and birth with anesthetic or surgery, they can create an attachment gap, a lack of connection between mother and baby. The baby's still-developing brain doesn't learn the oxytocin response, leaving her emotionally disabled.

This disability informs today's culture and society: The violence, anger and disconnection expressed in war, crime and entertainment are, I believe, evidence of the harm done by pervasive birth trauma and painful child-rearing practices.

"Organic Birth" is about to go into post-production, with the goal of releasing it at the end of 2007. Pascali-Bonetti needs to raise funds to finish her project. If you, too, think this is important work, visit her website and make a tax-deductible contribution.

Visit the Orgasmic Birth website!


Oxytocin as Marketing Hook

Mauritian Kittens
Originally uploaded by mira_o.

Allerca has bred hypoallergenic cats. By changing one of the proteins produced by cats, the company was able to breed kitties that look normal but don't cause sneezes -- at a cost of $3950.

To justify this expense, the press release mentions the health benefits of pets:

"Some of the well documented scientifically demonstrated benefits of pet ownership* include: increased sense of well being, reduced anxiety and stress, decreased feelings of loneliness and isolation. Pets lower blood pressure, while increasing oxytocin (happiness hormone), increasing phenyl ethylamine (attention hormone), and increasing endorphin (warm feeling hormone). Pets also increase levels of serotonin, a natural anti-depression chemical."

(This outstanding photo does not show the Allerca cats, but rather some seen on Mauritius. Thanks, Mira!)

Touch Heals

This article by Roger Dodson of The Independent outlines many studies showing that touch lowers blood pressure and stress hormones while promoting healing.

In the most recent study by neuroscientist Jim Coan of the Affective Neuroscience Laboratory of the University of Virginia, brain scans of women showed less stress when they were touched.

"As soon as the women touched the hands of their husbands, there was an instant drop in activity in the areas of the brains involved in fear, danger, and threat. The women, who had been exposed to experimental pain while they were scanned, were calmer and less stressed, and a similar, but smaller, effect was triggered by the touch of strangers.

The story only mentions oxytocin in passing at the end, but clearly, it's the release of oxytocin in response to touch that provides these benefits. Dodson writes,

Some believe the power of touch is all down to the placebo effect. "If you touch your partner they feel relaxed, but if someone else touches they may not feel as relaxed," said Professor Edzard Ernst, a professor of complementary medicine at the University of Exeter. "That is very much mind over matter. It has nothing to with the sensations of being touched, it is the expectation and the context of the intervention, rather than the specific effect of that intervention."

I think Dr. Ernst is wrong about the placebo effect. If you touch your partner and he or she feels relaxed, it's a combination of the physical sensation of being touched and the context of being touched by someone you trust.

The oxytocin response isn't automatic. The brain of someone who grew up in an extended, loving family may release oxytocin easily at almost any friendly touch. At the other extreme, people whose early nurturing included anxiety, anger or abuse may not be able to release oxytocin in response to touch at all. Most people's brains release oxytocin in response to touch in situations where they feel safe, with people they trust. Such as their mates.

This is why married people tend to live longer and be healthier; they have ongoing, safe touch relationships that promote the regular release of healing, calming oxytocin.

The Pregnancy Blog Carnival

Jackie of the Nerd Family blog published a Pregnancy Blog Carnival. This is a wrap-up with links to a variety of blogs and posts all about the months when a new baby's body and brain are being formed. Healthy development of the oxytocin response and secure attachment between mother and baby begin in the womb; this is the time when the new person's limbic responses begin to take shape.

You'll find links to posts about baby names, gadgets, expenses and personal accounts of in vitro fertilization and what it's like to see the first sonogram.

Thanks, Jackie, for including my post, Home-Made Oxytocin Therapy for Pregnant Moms! Jackie plans to publish a new Pregnancy Carnival every two weeks or so, so bookmark that site.

The Mother/Baby Attachment Gap

A mother's feeling of deep love and connection with the newborn doesn’t always happen immediately. In 1978, 97 mothers in the UK were asked, "When did you first feel love for your baby?" More than half felt the love during pregnancy or at birth: 41 percent during pregnancy and 24 percent at birth. Another 27 percent felt love during the first week, and 8 percent felt it later than that.

In a 1980 study of first-time mothers, 40 percent said their predominant emotional reaction when first holding their babies was one of indifference. Indifferent mothers were more likely to have had their membranes ruptured artificially, endured a painful labor or taken a dose of Demerol.

The studies on when mothers fall in love with their babies are discussed in "Bonding: The Beginnings of Parent-Infant Attachment," by Marshall Klaus and John Kennell.

If a new mother doesn’t fall in love with her baby, she may nurse him less, spend less time gazing into his eyes and keeping him close to her. She may experience his cries of need as demanding and unreasonable, and respond to them less readily. Her baby soon learns to see the world as a place of insufficient resources and human attachment as fraught with uncertainty and discomfort.

There are many reasons why new mothers don't bond with their babies. Even a baby that isn’t "pretty" can put the mother off, while birth defects or the skinny, wrinkly look of a preemie can fail to evoke the maternal instinct.

But there's one special culprit: c-section delivery. Studies have confirmed that cesarean births can create a mother-baby attachment gap. Women who give birth vaginally produce significantly more oxytocin pulses when they begin breastfeeding than do women who had cesareans, and this pattern can set the stage for the entire breastfeeding period.

Mothers who undergo c-sections feel less positive about the experience and have less physical and emotional energy for mothering.  They often feel less confident about their mothering. Mothers who give birth vaginally, on the other hand, tend to be more emotionally involved in taking care of their babies and more attached to them.

Cesarean mothers were less satisfied with their birth experiences and remained so over time. They're less likely ever to breast-feed, take longer to begin to interact with their babies, have less positive reactions to them after birth, and interact less with them at home.  In one study, a month after cesarean birth, the mothers had much less eye-to-eye contact with their babies.

This attachment gap is not only on the mother's side. The infant brain is not fully developed; it must learn the oxytocin response through interactions with the mother. As she loves and nurtures the baby, he learns to love back.

The indifferent mother, the anxious mother, the frightened one, teachers her baby something very different. She teaches him that it's frightening to be close, that other people won't care for him and cherish him. He'll remember these lessons all his life.

See also: Falling in Love with the Baby

Oxytocin, Vasopressin and Autism

Sue Carter, one of the world's top oxytocin researchers, published a new paper examining the link between oxytocin, vasopressin and autism. The paper, "Sex differences in oxytocin and vasopressin: Implications for autism spectrum disorders?," reviews the scientific literature

There are two reasons why many researchers are looking for a connection between oxytocin and autism. First, five times as many boys as girls are diagnosed with autism, and oxytocin is normally more abundant in women's bodies. Second, most of the behaviors people with autism spectrum disorder aren’t so good at are the very behaviors that oxytocin influences: picking up social cues, affection, making friends, giving and receiving physical affection.

Carter is head of the University of Illinois' Brain Body Center, and the researcher who demonstrated the link between oxytocin and bonding. She was able to switch monogamous behavior on and off by blocking oxytocin in monogamous prairie voles or injecting it into the brains of promiscuous montane voles.

She looked at not only oxytocin but also vasopressin, a related neurochemical that's less understood. While estrogen increases the effects of oxytocin, vasopressin is androgen-dependent, and males have more receptors for it in the paraventricular nucleus, a part of the brain involved in coping with stress. In animals, vasopressin influences male behaviors including reacting to challenges, protecting the nest and offspring and some parenting activities. (The assumption is that mechanisms are similar in humans.)

One hypothesis is that there are optimal vasopressin levels needed for protection against ASD. Males might be more sensitive to stress while their brains and nervous systems are under development, both in the womb and after birth. Disrupting their neurochemical balance may make them more vulnerable to ASD.

Another hypothesis is that the oxytocin-enriched female nervous system has better protection against whatever stressors cause ASD.

Carter's review of the literature found support for the connection between disruption of the vasopressin system and autism.

One interesting idea Carter floats at the end is that female coping mechanisms may keep ASD-like behaviors from becoming full-blown. She writes, "Sexually dimorphic differences in coping mechanisms, including the willingness to use social interactions to down-regulate anxiety, could be another mechanism through which males and females might differ in the expression of the features of ASD. Knowledge of natural ways to stimulate the release of endogenous oxytocin or to inhibit 'excess' vasopressin might be protective."

In other words, females naturally seek support and comfort from others (a behavior psychologist Shelley Taylor dubbed "tend and befriend" in her book, "The Tending Instinct"). Women are better at giving themselves a natural oxytocin boost, and this ability may form while they’re young enough to compensate for autistic tendencies.

Oxytocin: The Book

It may seem almost unbelievable, but a single hormone called oxytocin is responsible for life's most fulfilling emotions: love, trust and commitment.

Oxytocin is a neuropeptide that helps regulate many of the body's functions, including hunger, thirst and blood pressure. But it plays a special role in bonding with other people. When we're touched by someone we trust, when we make love and orgasm, when we simply spend time with someone we like, our brains release pulses of oxytocin that make us feel deep bonds with that person.

But we're not born with this response. Our newborn bodies enter the world knowing how to breathe, how to digest food, how to pump blood. But they don't know how to love.

The most profound human experience there is must be learned after we're born.

The brain begins to learn the oxytocin response during labor, when oxytocin stimulates the mother's uterus to contract. At the same time, it floods mother's and baby's bloodstreams, priming their bodies for their first experience of connection.

If the baby is breastfed, the same oxytocin that lets down the milk increases the feelings of safety, trust and love. Every time the baby is touched, held and nursed by its mother -- or another primary caregiver -- its brain learns to release its own oxytocin pulses, soothing the system and deepening the love.

But many things can interfere with the development of the oxytocin response. If the nursing mother is anxious, angry or afraid, her brain will release fight-or-flight neurochemicals, teaching her baby's body that being close to someone is frightening. Abuse, harshness, neglect and indifference all take their toll on the brain's ability to release oxytocin.

When we grow up without learning the oxytocin response, we can't truly bond with others. Other people are speaking a secret chemical language that we can't hear. Our relationships may get stuck at romance and sex, then fall apart when the excitement dwindles. Friendships may be filled with hurt feelings and anger. We can only feel bonded with people who hurt us or reject us. We wander through life feeling deeply alone. Our "hearts" -- the body's loving responses -- are truly broken.

But there's one more amazing thing to know about the oxytocin response: Our brains can learn it at any age. It's never too late to heal these broken hearts.

The Chemistry of Connection: How the Oxytocin Response Can Help You FInd Trust, Intimacy and Love, to be published by New Harbinger in spring 2009, will show you how to birth and nurture your children and heal yourself, so you can give and get the love you need.

Read all about oxytocin in my blog, Hug the Monkey.

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