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August 2007
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Paul Zak Talks to Hug the Monkey

Download susan_kuchinskas_interviews_paul_zak_for_hug_the_monkey.mp3

Paul J. Zak is director of the Center for Neuroeconomics Studies, Claremont Graduate University; professor of Neurology at Loma Linda University Medical Center; and a senior researcher at UCLA. He has a Ph.D. in economics from University of Pennsylvania and post-doctoral training in neuroimaging from Harvard.

He coined the term "neuroeconomics" to describe the study of how the brain and nervous system affect our behavior in economic exchanges, that is, business and commerce. In 2004, he discovered that oxytocin lets us determine who we can trust. He's using fMRI to understand how oxytocin forms the basis for modern civilizations and modern economies.

His work is exciting to me because it shows that our biological nature is designed to be trusting and reciprocal -- i.e. moral -- even when we do business.

Saving a Troubled Adoption

When I started this blog more than two years ago, the severe behavioral problems that adopted kids and their parents struggle with was really under the radar. Reactive attachment disorder, PTSD and other ills that affect children who were traumatized by, if nothing else, being separated from their mothers, are becoming mainstream concerns, thanks to articles like this one from the Boston Globe.

In "Choices of the Heart," Patricia Wen tells the story of a family that almost relinquished their son when he was 15. Luckily, as a last resort, they found an attachment therapy center that, after months of intensive work, allowed him to heal -- and return to the family.

Deconstructing the Pitocin Label

Brambledoula wrote a long and exceedingly well-informed post about the choices women make for their labor and birth in her blog Hormonal Pregnant Woman. She uses the information provided by the FDA and the manufacturer of Pitocin to show why its wholesale use is such a scary idea.

She discusses the pressure women feel from doctors to have medical interventions, the screwy, lying-down position they recommend in hospital births, and offers many excellent links to more information.

Brambledoula also carefully read ALL the information on Pitocin, the artificial form of oxytocin used to induce labor, that's been published by the FDA and the manufacturer. She notes that Pitocin has never been indicated for elective induction, something that's been omitted from the Physician's Desk Reference!

This is just one alarming quote from her piece:

DELAYED LONG TERM EFFECTS: There have been no adequate and well-controlled studies to determine the delayed, long-term effects of Pitocin on pregnant women, or on the neurologic, as well as general, development of children exposed to Pitocin in utero or during lactation.

Pitocin interferes with -- or eliminates -- the natural pulses of oxytocin that should gently push the infant down the birth canal and out the cervix, while making the mother feel calm, happy and peaceful about the whole process and ready to bond with her newborn.

Easing Labor Along

I came upon this four-year-old article from American Family Physician detailing ways to create cervical ripening if labor seems stalled and for inducing labor.

Along with drugs and invasive procedures like stripping the membranes, it discusses several herbal remedies, including blue and black cohosh and raspberry leaves. Although the article concludes that these methods aren't proven to be effective, it provides references of studies published in respected journals.

It also discusses the mechanism by which sexual intercourse and breast stimulation can induce labor to begin -- although in this case, induce is probably too strong a word:

With penetration, the lower uterine segment is stimulated. This stimulation results in a local release of prostaglandins. Female orgasms have been shown to include uterine contractions, and human semen contains prostaglandins, which are responsible for cervical ripening.

Breast massage and nipple stimulation have been shown to facilitate the release of oxytocin from the posterior pituitary gland. The most commonly prescribed technique involves gently massaging the breasts or applying warm compresses to the breasts for one hour, three times a day.

See the whole article, "Methods for Cervical Ripening and Induction of Labor."

The Foster System Damages Kids' Brains

The CBS affiliate in Miami, Florida, has an excellent story today about the problems created by our foster care system.

Reporter Michelle Gillen writes about  the growing awareness in the Miami court system that efforts to help kids by taking them out of abusive or danger situations can be permanently damaging their brain development, and to conditions such as reactive attachment disorder, or RAD.

Cindy Lederman and Steven Leifman, two Miami court judges, are using new information about brain development and how important connection with the mother or other primary caregiver is, to help kids at risk for this.  According to the story:

Leifman says the latest research is staggering because it means juvenile court systems around the country have unwittingly damaged children in foster care by purposely preventing attachments.

“It is particularly acute in the foster care system and one of the things that we realized, again, the court in advertently contributed to the problem, because we felt that we didn’t want children to become too attached, that it would do more harm than good if they got attached then we’d move them. So for a long time we kept moving the kids around the foster care system.”

Miami is trying to intervene early to help kids at risk that come through the court system with an early intervention center. It's opened the the Linda Ray Intervention Center, a therapeutic home where babies up and toddlers up to three years old can attach to a warm and caring person.

In Miami alone, some 9,000 children enter the foster care system each year.  And 27 percent of the children in foster care are under five years old.  As the article points out, this is many more children than can be helped by the Center but at least it's a start.

How Much Does Breaking Up Hurt?

Psychologists at Northwestern University say that getting dumped doesn't really hurt as much as we  think.

According to this Washington Post article, "Breaking Up Is Not So Hard to Do," people typically expect heartbreak to hurt worse and last longer than it really does. (This article is also seen on Digg.)

The study followed freshmen over a nine-month period, surveying them regularly about their relationship status -- or lack of it -- and how they felt about it. According to Wash Post writer Alan Mozes,

... the researchers found that, on average, the participants' predictions of emotional cataclysm offered just two weeks before a split far exceeded the actual distress they underwent for three months after the split.

And, although both real and imagined distress diminished as time went on, the spread between actual and predicted anguish stayed constant throughout -- with predicted distress far exceeding actual distress even months after a relationship had ended.

But wait!

What kind of "love" did these researchers look at? The study participants, all Northwestern students, had to have been in relationships for just two months. While overall, participants were in relationships for an average of 14 months, 38 percent, more than one third, ended their relationships in the first six months.

Two months into a relationship is a very different emotion from that of committed, long-term love. The prevailing wisdom among neuroscientists is that romantic passion lasts for 18 months to two years; then, it becomes the less passionate but deeper committed love.

The neurochemicals of romantic love are dopamine and norepinephrine. They're  the brain chemicals that drive us toward a reward They ebb and flow normally throughout the day, as we strive and achieve goals large and small.

The chemical of committed love is oxytocin. This is also the neurochemical of social interaction, and an anti-stress hormone that facilitates relaxation and healing. This relationship between social interaction and stress reduction is the reason married people seem to stay healthier and live longer.

In fact, social isolation of any kind seems to involve the same brain systems that handle physical pain. In "Adding Insult to Injury," Geoff MacDonald, Rachall Kingsbury and Stephanie Shaw of the University of Queensland posit that we evolved a pain-like response to social exclusion because, if we were outcast from the tribe, we'd starve.

The Northwestern's lead author, Paul Eastwick, told the newspaper that he wouldn't be surprised if his findings didn't hold true for older people, as well. But I don't think so. Or at least, I don't think they'd hold true for people in longer-term relationships, no matter what their age.

Being dumped from a shorter-term, dopamine-based relationship may not be as bad as we think. But I think that breaking a deep oxytocin-based bond would be much more painful and the pain would last much longer.

Just ask a widow.

How to Avoid Cesarean Birth

One of the most mainstream media outlets in the United States has come out against the indiscriminate use of cesarean section and labor induction. In addition to putting mother and baby at risk with unnecessary surgery, C-sections can disrupt the bond between them. It eliminates the mother's natural release of oxytocin during labor, birth and the first contact with the newborn, and it makes both of them too sick to enjoy that natural connection that occurs when the baby, left to her own instincts, makes her way to her mother's breast for the first time.

In this column on CNN, Elizabeth Cohen suggests Five Ways to Avoid a C-Section. More important, she begins this good advice with information about how C-sections can harm the health of mother and baby. And, she touches on the bonding problems that can result from interfering with the natural release of oxytocin during labor, birth and immediately afterwards.

Cohen quotes a mom who's angry that she had an unnecessary C-section: "It affected the quality of my mothering. I had trouble bonding with my son."

This anecdote is backed by scientific studies:

Women who undergo cesareans feel less positive about the experience and have less physical and emotional energy for mothering.[i]

They're less likely ever to breast-feed. They take longer to begin to interact with their babies, and tend to interact less with them once they're back home. In fact, they don't feel as positive about their newborns at all.[ii]

This negativity lingers. In one study, a month after cesarean birth, the mothers had much less eye-to-eye contact with their babies.[iii]

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.[iv]

See also, The Mother/Baby Attachment Gap.

[i] Marut J.S., Mercer R.T., The cesarean birth experience: implications for nursing. Birth Defects Orig Artic Ser. 1981;17(6):129-52.

[ii] DiMatteo, M. Robin; Morton, Sally C.; Lepper, Heidi S.; Damush, Teresa M.; et al., Cesarean childbirth and psychosocial outcomes: A meta-analysis. Health Psychology. 15(4), Jul 1996, 303-314.

[iii] Trowell J., Possible effects of emergency caesarian section on the mother--child relationship. Early Hum Dev. 1982 Oct;7(1):41-51.

[iv] Gathwala G, Narayanan I., Influence of cesarean section on mother-baby interaction. Indian Pediatr. 1991 Jan;28(1):45-50.

More Cuddles for Better Babies

Bounty, maker of paper products for babies and grown-ups, ran a story today saying that cuddling your baby longer can reduce her crying.

No references are given, but a study supposedly found that babies who are cuddled, cooed over and generally offered bonding activities cry 50 percent less. But to make them this much happier, you have to coddle them for five hours a day. How many babies in the developed world get that, unless they co-sleep?

My Appearance on Dr. Mike's Radio Show

It was a thrill and a great honor for me to have been interviewed by Mike Roizen, the co-author of You: The Owners Manual and several other books in this series.

His show, "You The Owner's Manual with Dr. Mike," is broadcast in several markets and available online.

Roizenand co-author Mehmet Oz are MDs and leaders in their fields. Roizen is a professor of anesthesiology and internal medicine at Case Western Reserve Medical School and chair of the Division of Anesthesiology, Critical Care Medicine, and Comprehensive Pain Management at the Cleveland Clinic. Oz is professor and vice chairman of surgery, New York Presbyterian-Columbia University. Dr. Oz is also medical director of the Integrated Medical Center and director of the Heart Institute, New York Presbyterian/Columbia Medical Center.

Despite their heavy-duty credentials, their books are highly digestible, while being packed with scientific information you can use to improve your health.

It was exciting to go on the show and discuss what I've found about oxytocin's role in life and love.

Here's how to find the show; my segment starts at about 35:00.

HealthRadio.Net - Compelling Talk Radio for every-Body!
Show Title: You The Owner's Manual w/ Dr. Mike: Hour 2 (2007-08-25)
Guest: Susan Kuchinskas
Host: Dr. Mike Roizen
(Click to listen or find out more)