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February 2007
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The Elephant of Emotion

If you're looking for an article on the emotions of elephants, see this excellent story: An Elephant Crackup?

How can we understand our feelings when we can't really describe them? Neuroscientists, psychologists, anthropologists don't mean the same thing when they talk about fear or love. When we talk to each other, we borrow from these sciences, and even more from movies, books and music, but each of us has our own inchoate definition of each emotion. We're all of us -- academic and lay person -- blindly describing an elephant.

I'm in Los Angeles for Seven Dimensions of Emotion, a conference put on by the Foundation for Psychocultural Research, and there's a fascinating mix of scientists and academics talking often at cross-purposes about fear, disgust, empathy, grief, anger, love and hope.

I'm here to hear Sue Carter, Helen Fisher and Jaak Panksepp talk about love, and all of them have taken the neuroscience approach to understanding emotion. Their work has been revelatory to me not only because, combining it with Allan Schore's studies of how the brain develops after birth, it provides a framework makes sense of my own experience. Most important, Schore shows how this scientific understanding can be used to heal.

Panksepp's talk was the most exciting so far. He's working to prove that animals and humans share the same emotions. He said, "The nature of affect is the most important scientific question in emotion research." He said that in the 20th century, animals "lost their feelings to behavioral neuroscience." The behaviorists, in an attempt to be ultra-objective, reduce everything to stimulus and response; Panksepp called this an intellectual tragedy.

He studies play behavior in animals as one of the most universal and primary affects (or emotions). He's identified the sound of rats laughing!

Panksepp says his work has potential for helping kids with autistic spectrum disorder or attention deficit or hyperactivity disorder (ADHD). In dogs, blocking the activity of opioids, the brain's natural morphine, makes them more interested in social contact, as evidenced by increased tail-wagging and licking the faces of humans. He says about 40 percent of autistic kids also respond to opioids-blocking by increased social behavior -- but only when they're in a rich social environment.

He thinks that the vast majority of kids diagnosed with ADHD are really play-deprived. "ADHD is largely a cultural disease," he said.

Play needs to be free and self-directed, Panksepp said, and it needs to involve plenty of rough-and-tumble activity. Such play is about pushing limits, and, inevitably, there comes a moment of complaint, when one kid becomes uncomfortable with what's happening. Such moments are opportunities for dramatic social learning, he says, because it forces kids to learn to negotiate on the spot.

"Kids aren't given enough free play," Panksepp said, "and I think many of them don't know how to renegotiate that moment."

Now, think of the modern play date, where kids' activities are closely monitored by moms or nannies. Each monitor is hypervigilant that their kid neither gives cause for complaint nor becomes a target. They're so quick to jump in and deliver controlling commands. "Seth, give the truck back." The children are under a microscope and may feel that they're more of the adults' surrogates than self-directed individuals free to follow their joy.

All this has nothing to do with oxytocin nor with my book. Which brings me back to the elephant of emotion. Panksepp told an illustrative anecdote. Speaking about grief, he said that he himself had experienced great grief, that is very strong when he's alone. When he's with another person, no matter what they talk about, the grief dissipates somewhat. He attributed the lessening of his grief to his shift from activity in the limbic system, the subsystem of the brain that processes emotion, to the cortex, the part of the brain that handles higher reasoning.

But what about the oxytocin response? Social contact, especially but not only with those we trust, causes the brain to release oxytocin, which calms us and makes us feel more at peace. Grief could be defined as pain caused by loss of social contact; social contact can help ease that grief.

Opioids but not oxytocin are part of Panksepp's emotional elephant; both opioids and oxytocin are involved in social bonding, especially that state that we somewhat randomly call love.

See also Prairie Voles and Me (and You),

The Time is Right for "Holding Time"

It's time for another look at an 18-year-old book on repairing the attachment between mother and child.

When Martha G. Welch wrote Holding Time in 1989, the idea of attachment -- the bond between mother and baby -- was something intuitively understood, but not scientifically proven. Since then, studies of rodents, mammals and humans using functional MRI have begun to show how early nurturing shapes the brain, and how the lack of it harms brain development.

Welch treats attachment disorder using holding therapy at her treatment centers in New York City, Chautauqua and Greenwich, Conn. She's a psychiatrist at Columbia University's Department of Neuroscience, and she's studying both the role of oxytocin and secretin in autism and possible therapeutics using these two peptides. (Secretin is a gastric hormone that prompts the pancreas, stomach and liver to release digestive enzymes.)

Welch's method aims to repair the bond between mother and child. A baby's nervous system and brain aren't fully formed at birth, and development takes place in response to interactions with her mother.

Holding, nursing and nurturing develop the oxytocin response and they seem to determine the amount and sensitivity of oxytocin receptors in the brain, especially the parts of the brain that deal with social interaction. Oxytocin also is critical in moderating the fight-or-flight response.

If a baby experiences fear or abuse, she develops a strong and oversensitive stress response. If she is neglected, or doesn't get enough holding and attention, her brain won't learn to release oxytocin when she does have physical contact -- and contact, even soft nurturing, may seem intense and scary to her deprived body.

The diagnosis of reactive attachment disorder is a catchall similar to autism spectrum disorder. But, no matter the symptoms, its roots are trauma, neglect and the lack of a secure bond with a mother. (I'm using mother here to describe a role; anyone who is the primary caregiver and nurturer of a baby is acting as her mother.)

In Welch's method, the mother takes the child into her lap and attempts to make and keep eye contact. Welch's holding therapy typically goes through three stages: confrontation, rejection and reconciliation. In the first stage, holding often means restraining the child on her lap. In the second stage, the child may reject not only being held but also his mother, telling her he hates her, she smells, she's bad. The mother may express her own feelings, saying, "It makes me feel bad that you won't look at me," for example.

Finally, all the negative feelings having been expressed, the child and mother feel peaceful and can connect lovingly. According to Welch, this process is a more expressive version of the gentle cycling between arousal and calm that ideally happens when a mother interacts with her newborn. Being restrained on Mommy's lap gets the child's adrenaline going; that leads to the expression of rage, fear and sorrow, leading to release of those feelings and a new kind of arousal, that of pleasure in being close to Mommy.

Welch writes, "As the struggle continues, the child usually experiences a whole range of emotions but in the safety of his mother's arms. This time the state of arousal is associated with being held lovingly, resolutely, and closely."

It's important for the mother to also be able to release some of her frustration and anger, Welch believes. She writes, "Holding time allows both of you to discharge your pent-up aggression in a safe way."

Welch's method has much in common with Theraplay: The child being controlled and kept in therapist's or mother's lap; the therapist or mother taking charge of the interaction (designed to let the child know there is an adult in control); the goal of mutual gazing and intimacy; and the theory of consciously recreating the experiences that lead to healthy brain development in the infant.

While Theraplay uses activities to distract the child from her distress and engage her less directly with therapist or parent, the holding time method asks mother and child to stay with their feelings and work through them.

The book and Welch's treatment have come in for criticism because of the enforced holding, especially in light of the horrible cases where RAD kids have died during different types of holding therapy, when they were covered in blankets of grownups laid on top of them.

But her work makes sense in light of attachment theory. Children who aren't well attached to their mothers may be either anxious -- desperately craving attention -- or avoidant. Avoidant kids have learned that being close to Mommy means being hurt -- either being rejected or being yelled at. So, they've decided the safest course is to cut themselves off from anyone else.

I grew up avoidant. I still remember the moment when I consciously decided, "I'm not going to let them hurt me anymore." I still craved love and connection, but when it was offered to me, I froze. I desperately needed someone to break through the ice, take hold of me and love me. I kept waiting for someone to do that, but of course, since I couldn't reach out or ask for it, no one ever did.

From my own experience, I think holding therapy may be just what an avoidant kid needs.
Holding Time explains how to use this method; however, I'm not so sure parents should try it without training. The key to holding therapy is that the mother accept the child's rage, letting him know she loves him no matter what. This is easier said than done.

In the examples in the book, the mothers always respond by expressing their needs or feelings in non-judgmental ways. "I know you are angry at me, but I still love you." "I feel upset when you scream and fight. I am going to hold you until we both feel better."

This kind of response is tough for any of us to do; and, to be brutally honest, if this kind of interaction comes naturally to a mom, her kid is not likely to be in need of holding time. (In the book, Welch doesn't discuss the special needs of adopted children, who may have been traumatized or deprived before being adopted; this was before adoption became as widespread as it is today.)

A parent who hasn't been trained in how to respond could end up damaging the child more. As one reviewer, a self-described survivor of forced hugging, put it, "I found it punitive and abhorred it. Who wants to be yelled at and told to look at somebody while being subdued by force?! Who wants to be the recipient of false accusations with no recourse or defense?!"

If the mother hasn't learned how to give love, if she uses holding time to express herself in ways that frighten or hurt her kid, it will damage the bond even worse, by denying the child the one defense he has: withdrawal.

But if mother and child learn to do this with the support and guidance of a therapist, it could be that revelation that Welch promises: "a closer, more satisfying and truly wonderful relationship with your child."

Theraplay to Shape a Child's Brain

Interview: Dafna Lender, Theraplay Institute

Tips for Orgasmic Birth

This article from The Independent is the most complete I've seen from a mainstream publication on the still-touchy subject of orgasmic birth.

The writer talked to several midwives and a birth center in the UK that encourage and support women in designing the birth process to be pleasurable.

"... the approach is capable of transforming birth - perceived by most women to be terrifyingly painful - into a pleasurable, even, ecstatic experience."

I recently spoke to someone from a pharmaceutical company who described labor and birth as "one of the most painful and traumatic events in a woman's life." This is an incredibly sad view of giving birth, and one that's endemic to medicine.

According to the article:

Part of the problem, it seems, is the way sexuality around childbirth has been denied. In her book, Ina May's Guide To Childbirth, Gaskin points out that doctors had to downplay female sexuality for medical men to be admitted to the birth chambers of women in the 18th and 19th centuries. This " denial" was later institutionalised when hospital births became routine.

Even today, it's a pretty taboo subject. "Lots of women would worry they'd be seen as abnormal or deviant if they admitted to feeling sexual at birth," says Carolyn Cowan, a yoga teacher and doula based in south London, who herself had an ecstatic birth.

The article also gives eight tips for achieving an ecstatic -- or at least relaxed -- birth.

See also: Labor Like a Cat, Orgasmic Birth, the Interview and  Birth, Oxytocin and Ecstasy

Monkey Hugs

Sam_cp_1 My blog title, Hug the Monkey, is a metaphor about how we need to give and get cuddling and hugs to grow and stay healthy and happy.

But the Touch Ambassador points to a story from last month's Nature magazine about how Mexican spider monkeys use hugging as a way to defuse intra-clan tension. (I think she is part of the Cuddle Party crew in the UK.)

From the article,

The small gangs bumps into one another frequently. If the other monkeys are seen as rivals, there is a danger that fighting will erupt. Hugging seems to be a way to ease the tension — aggressive encounters such as chases are more likely to happen among monkeys that do not embrace first.

This hugging presumably releases oxytocin, which calms the amygdala. The amygdala is a control center for the fight-or-flight reflexes; it sometimes causes animals (including the human variety) to lash out before the prefrontal cortex can make a judgment about whether aggression is called for.

Oxytocin also is involved in social memory -- recognizing who is a friend or member of the social group. So this hugging likely reinforces the "friend" relationship between huggers.

By the way, I went to a Cuddle Party in the San Francisco Bay Area, and thoroughly enjoyed it. I think they're dying out in the U.S., but here's my report: How I Cuddled

Film: Pregnant in America

A new film, "Pregnant in America," uncovers the big business of pregnancy, labor and birth -- and how hospitals have a stake in making birth more dangerous than it has to be. Filmmaker Steve Buonaugurio talks to experts and advocates for natural, home births, women who've experienced such, and angry mothers and fathers who didn't have such great experiences.

From the site:

Pregnant in America examines the betrayal of humanity's greatest gift--birth--by the greed of U.S. corporations. Hospitals, insurance companies and other members of the healthcare industry have all pushed aside the best care of our infants and mothers to play the power game of raking in huge profits.

His wife pregnant, first-time filmmaker Steve Buonaugurio sets out to create a film that will expose the underside of the U.S. childbirth industry and help end its neglectful exploitation of pregnancy and birth.

It's not so clear whether the film is out and where you can see it, but it sounds like this would be an excellent thing to show in high school health classes, just for starters.

You can see a trailer on the website. I found this through the Lamaze Institute's Giving Birth With Confidence blog, a great source of information on natural birth and breastfeeding.

Insight into the Basis of Insight

A new study  showed that men did a lot better at reading facial expressions after they'd inhaled some oxytocin.

The researchers used a test called "Reading the Mind in the Eyes," developed by Simon Baron-Cohen, a professor of developmental psychopathology at the University of Cambridge. (I hear he's related to Sasha Baron-Cohen, btw.)

Baron-Cohen got actors to portray different emotions, such as jealous and arrogant, and photographed their eyes. The eyes really are windows into the soul, because it's quite possible to understand what someone else is feeling simply by looking at the photos. In fact, we do it every day, some of us better than others.

The researchers didn't say how much better their subjects did. But they suggest that oxytocin improves the ability to infer the emotional state of others from social cues of the eye region.

Thanks to BrainEthics for snagging this off ScienceDirect on the very day it was published.

By the way, the Reading the Mind in the Eyes test is interesting and fun, and you can do it online.

Reading the Mind in the Eyes

Paul Zak: Oxytocin, Trust and Greed

Paul Zak is director of the Center for Neuroeconomics Studies at Claremont Graduate University. He's one of the researchers studying trust in economic exchanges.

Zak recently looked at oxytocin release while people played a money-transfer game.

In this game, two subjects who can't see each other are assigned the role of investor or trustee. Both start the game with a bankroll, say $12.00. The investor can choose to share some money with the trustee or keep it all. If the investor transfers some money to the trustee, the experimenter will triple that amount.

For example, if the investor gave the trustee $12, the trustee then has $48: the original $12, plus the tripled transfer amount of $36. Giving the trustee some money is a trusting decision. The transfer increases the total amount of money in the game but, if the trustee doesn't return the favor, the investor ends up with less than she started with, while the trustee makes out better.

Zak and his colleagues Robert Kurzban and William Matzner found that when someone got a signal of trust, his or her oxytocin levels rose, while people with higher oxytocin levels were more likely to reciprocate trust.

Zak also has written about the growing lack of trustworthy behavior in business.

HUG: Oxytocin makes it feel good to cooperate. But, as you pointed out in your op-ed piece, more and more businesses are run by bosses who've abandoned human values.

Zak: We all have these predisposition toward being cooperative, and if you look at the long run, cooperation is important. It maintains employee morale, and it improves customer support. If you're a greedy bastard type, you may extract more resources in the short term.

But business schools train people to be self-centered and selfish -- and they don't understand that it's counter to human nature and people don't like it.

HUG: According to one article, you've found that some people are chronic "non-reciprocators," and their character traits are similar to those of sociopaths: They simply do not care about others the way most people do. Can you explain what's different about the way these people's brains use oxytocin?

Zak: Most people are conditional reciprocators; the more money you send them, the more they tend to send back. About 2 percent of our test subjects were non-reciprocators. Oxytocin typically has an off/on sequence. It's released within seconds in response to a social cue, and then production switches off again. But in about 2 percent of my subjects, the ones who never cooperated, their brains appear not to be turning off their oxytocin production. They are way off the curve for their peripheral oxytocin levels.

In addition, they don't seem to respond to oxytocin like other subjects, who reciprocate more strongly the more oxytocin they have. This suggests, although it doesn't prove, that they have a dysfunction in the oxytocin receptors -- the wrong location or inhibited binding -- that causes them to behave like "bastards."

HUG: You also found that women who take part in the trust game while they are ovulating send back substantially less money to their fellow player than other women or than men -- crudely, they are less trustworthy.

Zak: There are caveats to this study, because it was based on half the sample size of our later paper. After you start ovulation, your progesterone is high and, in animals, progesterone inhibits binding oxytocin to its receptor. If oxytocin facilitates social intercourse and social intercourse leads to sexual intercourse, progesterone acts as a bit of a brake to the oxytocin system when you've got an egg on board.

HUG: In "Building Trust," you calculate that a 15 percent increase in the proportion of people who think their compatriots are trustworthy raises per capita output growth by 1 percent for every year thereafter. Would this be true within a single business? In other words, do you think trust is important to corporate culture?

Zak: It's the human beings that make a business; a business organization is itself a small society. When you understand that a society's biggest aspect is its people, you realize that you need to run the business as a society. I think oxytocin has potential part to play in the organization of the workplace.

HUG: What can a business do to create a more oxytocin-rich environment?

Zak: First, something I was so skeptical of as a practicing economist: morale building. Going out to the mountain for the day, helping people bond as a team in a stressful situation.

Second, they should create a much more horizontal female structure. Nowadays, the biggest assets a company has are human assets. People want to feel part of a team.

Give your employees this gift: Letting them know you care about their happiness and how they feel. You will get returns far beyond the small amount of money you spend.

Phase 2 Trial of Oxytocin for Autism within 12 Mos.

Nastech, the biotech company that has proprietary technology for intranasal drug delivery,  plans to launch phase 2 clinical trials of  a synthetic oxytocin treatment for autism within 12 months.

The plan is to use carbetocin, a synthetic used to control bleeding after  labor and delivery, to control the core  symptoms  of autism, such as repetitive behavior and lack of sociability.

The company uses what it calls "tight junction biology" to squeeze molecules through cells in order to deliver larger molecules, such as the peptide oxytocin, and deliver them to the central nervous system via the epithelial membranes inside the nose.

In the company's earnings call today, CEO Steven Quay said Nastech has entered into an exclusive license of the intellectual property of Eric Hollander of the Seaver and New York Autism Center of Excellence. Hollander recently reported that he and colleague Jennifer Bartz had reduced some of the symptoms in adults with autism spectrum disorder with intravenous oxytocin.

Nastech's inhalant technology removes the needle barrier in oxytocin therapy.

Quay said, "We think current the scientific evidence provides useful insights: Autistic children have lower levels of oxytocin than normal children. In theory, we may be able to overcome this deficit through a nasal spray that uses our tight junction technology."

Nastech will work with Hollander on clinical trials. The plan is to conduct studies on dosage this year, and then, in 12 months, move into stage 2 trials with adults with ASD. Hollander will conduct the studies.

I recently spoke to Sue Carter of the University of Illinois' Brain Body Center. She is one of the foremost oxytocin researchers, and she's written extensively about the possible role of oxytocin and vasopressin in ASD.

She thinks we're moving too fast with oxytocin therapies. She pointed out several issues with dosing humans with oxytocin. First, it's not clear how much relation there is between serum levels of oxytocin and levels in the central nervous system. Second, it's possible that the problem with ASD is related to vasopressin rather than oxytocin. Finally, she said that with any hormone, there is an optimal level and a balance with other chemicals in the body. We don't know whether increasing the level of oxytocin will throw other things out of balance, or cause a shut-down in the body's natural production.

But, as Quay said during the call, so far there is no drug approved to treat the core symptoms of autism -- and one that worked could be a blockbuster. The CDC recently announced that the rate of autism in children was higher than its previous estimate: One in 150 kids will be diagnosed as on the spectrum.

For more on Drs. Hollander and Bartz's work, see "Oxytocin Therapy for Autism Gets Closer." See also "Love in a Whiff" and "Another Oxytocin Patent."

Are We an Autistic Society?

Donna Williams, a self-described "mad, autistic artist" -- as well as a teacher, author and consultant -- wrote an article for American Chronicle that boldly questions whether our technology-oriented, individualistic society is creating more infants with reactive attachment disorder and autism.

She writes,

Is possible that we’re living in an age where some pregnant mothers being so busy with cerebral, passive interactions with technology and its related increase in time use that they don’t have the range of movements, emotional experience, that it’d be conceivable some don’t develop the same full prenatal bonding with their child that may have been more common before the 80s and 90s?

I'd answer yes to that. But I don't think that technology, and specifically our reliance on computers, is completely to blame. I think that the medicalization of childbirth, cutting mothers off from the biggest oxytocin rush a human will ever get and from the opportunity to bond immediately and bodily with their newborn babies, may be the biggest factor.

Add to that the necessity for most mothers to work, being away from their children for most of the day, and our reliance on television as a surrogate for human interaction, and you have a recipe for isolation and thwarted empathy.

Williams asks,

what if society is improving upon detachment, passivity, being more cerebral than emotional and physical, and progressively then mistrusting and fearing unexercised real interaction with ’strangers out there’?

We are all, already, becoming more ‘autistic’ and the ‘geek syndrome’ generally associated with Asperger’s Syndrome is so widespread that mild cases are not even worth diagnosing lest we end up losing sight of any measuring stick of ‘normality’ (which is all relative anyway).

Williams raises the spectre of the "refrigerator mother," the idea in the 1940s that some women were intrinsically not motherly enough, thereby causing their kids' autism. The pendulum has swung away from blaming the parents -- which is a very good thing. But it may have swung too far.

Mothering matters more than anything else in our lives. Without mother love when we're babies, our brains don't develop the oxytocin response -- as well as many other systems and responses we need to successfully navigate the world.

Williams writes,

If so, if today’s generation benefit from, enjoy or are addicted to those causes, and if voracious consumer economy feeds, encourages and entrenches those addictions through increasingly consumed media, will we ever wake up? Will we be ‘allowed’ to? And in a dog-eat dog society of stone throwing tabloid press, witch hunts and bitching public forums, can we ever calmly look at even hints of the refrigerator mother yet empathically envision ourselves in their shoes?

Mothering Affects DNA -- after birth!

Mental Floss has a breezy article about how a mother's actions can affect her baby, before birth and afterward.

The article says,

Just because you’ve exited the womb doesn’t mean your mother stops having power over your DNA expression. ... if a female baby rat didn’t get licked enough then her body turned off a series of genes that should have produced certain “mothering” and “love” hormones, like estrogen and oxytocin. Deprived of those, the female rat grew up to exhibit the exact same insufficiently nurturing behavior her mother had shown her—thus continuing on the cycle for another generation. On the other hand, when a baby girl rat got an extraordinary amount of lick-based attention from her mommy, she went on to actually have higher-than-average levels of estrogen and oxytocin.

She's referencing work done by  Frances Champagne, Josie Diorio, Shakti Sharma, and Michael J. Meaney showing that how a mother rat treats her babies may directly -- and permanently -- influence  the receptivity of oxytocin receptors in their brains.

The researchers said,

"These findings suggest that maternal licking/grooming influences the development of estrogen sensitivity in brain regions that regulate maternal behavior, providing a potential mechanism for the intergenerational transmission of individual differences in maternal behavior."

That's in rats, of course. Oxytocin researchers are still way leery of saying the same thing goes on in humans.