Why Love Matters: Review

Why Love Matters

How affection shapes a baby's brain

Sue Gerhardt

Routledge 2004 246pp

Sue Gerhardt is a psychoanalytic psychotherapist and co-founder of the Oxford Parent Infant Project which provides therapeutic help to parents with their babies.

'Babies are like the raw material for a self. Each one comes with a genetic blueprint and a unique range of possibilities... Each baby can be 'customised' or tailored to the circumstances and surroundings in which he or she finds him or herself. A baby born into an ancient hill tribe in Nepal will have different needs from a baby born in urban Manhattan.'

Eloquent that the 'unfinished baby' is not a mistake but a triumph of evolution, Gerhardt likens the infant to a plant seedling which has all the genetic potential of its kind but needs the right conditions in order to flourish. The rapid growth of the brain in the first 18 months allows the child to make meaning of the world as patterns emerge: what to expect, how to respond, whether to push people away or draw them closer.

The interaction between mother and child regulates the baby's heart rate, immune systen, growth hormones and muscle development. Touch and feeding disperse stress and keep the baby alive. The mother tunes in with face and voice, mirroring the baby's distress and leading him to a calmer state, holding and rocking him to sooth him. If caregivers have difficulty noticing and regulating their own feelings this process can be hard to carry out.

Sue Gerhardt marries psychotherapeutic theory and neurobiology, linking in advances in neuroscience to show how attachment affects the nervous system, hormones and brain development and that the parents' emotional states shape the child into adulthood. The goal, says Gerhardt, is that feeling become respected as valuable guides to the state of oneself and others, rather than enemies to be feared or impulses to be instantly gratified.

She goes on to describe the origins of different psychological disorders in terms of infant/parent inter-relationships, suggesting that unattuned, unpredictable or withdrawn parents created problems in emotional regulation which persist to adulthood, causing a range of disorders from anxiety and depression to personality disorders. She calls persistent early patterns 'set points'. These chapters appear to be too generalised as there are multiple factors in the development of these disorders, including genetics and influences outside the family, and it is drawing a rather long bow to lay all of the blame at the door of the parents, mainly the mother, as Gerhardt appears to do. She does state that we can all be caregivers and that both mothers and fathers are parents, but the emphasis seems to be on mothering.

What should be done to change these unadaptive patterns? The plasticity of the brain means that changes can happen and new connections will be made in response to new behaviours and new environments. Medication can help, as can diet and lifestyle. A chance to grow up again, using words to support each other, is another means of change and while Gerhardt no doubt is referring to her profession of psychotherapy, this can also be done by loving partners and friends. Childhood messages can be reworked, but in an ideal childhood, if there is ever such a thing, the messages would be positive and adaptive, providing a safe platform for moving on into the adult world.

With the growth in knowledge about child development and neuroscience one would hope that modern societies understand how to give children the best possible start in life, but is this so? Gerhardt asks whether, in reaction to the 1960s when Betty Friedan pointed out the oppression young mothers suffered, the times have changed so that the children are now paying the price.

'If we continue to insist on the primacy of production, drawing all adults including the parents of young children, relentlessly into the pursuit of material goals and careers, then we may have to bear the eventual fallout.'

However, this does not take into account the fact that many families need both parents to work to provide the means of support. This can be true in Western societies as well as in subsistence farm economies such as in Nepal where childcare is often left to children too young to offer much stimulation, or babies are left alone in their cribs while their mothers are in the fields. Parents are not necessarily pursuing luxuries at the price of their infants' well-being but merely doing what they can to survive.

Gerhardt concludes that overcoming the isolation and inexperience that plague parents will take radical social change but it is necessary in order to stop the cycle of poor regulation of emotions and the interpersonal problems they create.