Listen to thisThis is my first column for CYC-Net. First experiences are important; they provide the template for subsequent similar experiences. The power of first experiences to shape – for better or worse – future perceptions, interactions and behaviors is pervasive in our work with maltreated children. To better understand that power, one must know a little bit about how the brain develops and works. Which is the reason I am writing this column. I hope to add a tiny bit to your toolkit; I hope to share some new findings, thoughts, hopeful moments and failures, all through the lens of neurobiology, to help shift – even just a fraction – the frame of reference from which to do your work.
That shift in perspective has helped in our work. For the last twenty years, my colleagues and I have been living and working with maltreated and traumatized children. We have struggled to understand the impact of developmental trauma, neglect, chaos and a host of adverse experiences on the child and, when we could, help in the healing process. We are an interdisciplinary group; we have a variety of strengths and, Lord knows, limitations. Each of us started this long process with a frame of reference based upon our individual experiences and education. We quickly realized that each of our views was too narrow, limited and, while often useful for some specific problem in a given child, not capable of adequately explaining or dealing with the diverse range of problems related to developmental trauma and maltreatment. Over time we found that one of the most useful exercises clinically was to begin to think about what was actually happening in the brain of the child “during development, during the actual moment-to-moment interactions in the foster home, school or therapy. And as we folded a healthy dose of neurobiology and neurodevelopment into our clinical mix, we gained new insights about origins of symptoms, reasons that some clinical or educational efforts were inefficient and, most important, clarity about what would be more effective therapeutic activities. The results have been promising. But I digress, more of that in future columns.
Back to first experiences. To understand the power of first experiences we need to review a couple of simple but important neural principles. The first is that the brain has the capacity to “pair” or connect patterns of neural activity that co-occur. Two or more incoming sensory signals taking place at the same time with sufficient frequency or intensity become “associated” (e.g., the sight of mother’s face, the sensation of sucking and the feeling of becoming satiated). This association “or connection “is created by making and then reinforcing new synaptic connections; essentially creating a new memory. For a newborn with an attentive, attuned and nurturing mother, a complex set of associations is created. This is the infant’s first “memory” of the nature and quality of what a human being is. This first memory is unique. And, as the infant grows, this first memory acts as a template for all future human interactions.
Why? Well, simply because the human brain “despite all its complexies “is limited in the number of unique neural networks it can create. Even with the 100 billion neurons and multiple thousand times more synaptic connections, the brain can not possibly make a new neural network “a new memory “for every single aspect of every single moment of experience. The solution the brain uses is to make new associations, new synaptic connections, new memory only when the experience is sufficiently unique. If a given experience is similar to other experiences, the brain will essentially process the new interaction as a current version of something already experienced and essentially reinforce the existing memory template.
Let me give some examples; each day we get up, brush our teeth, get ready for work and, for most of us, do a set of activities all day long that are very similar to what we have done many times before. And, because of the familiarity, we really do not create a unique memory for every single aspect of every single day; we don’t remember days. Some of us don’t remember unique details of whole years! These routine day-to-day experiences are “categorized” as today’s version of memory templates and just provide more repetitive stimulation of these existing neural networks.
By the time a child is four years old, the majority of these “template” memories have been created. We have experienced some version of most of the sensory, motor, emotional and even cognitive elements of life and, therefore, created the working templates for our life. The child's template for what a caregiver is; for how reliable and trustworthy people are; for whether the world is predictable or chaotic; for what touch “means” have all been created in those first years of life.
And sadly, maltreated children with early histories of overwhelmed, disorganized, absent or abusive caregivers have created a catalogue of templates about humans, relationships and the world that reflect their abusive backgrounds. And they carry that into their interactions with us; where we intend to give a reassuring hug, their template may categorize that as “seductive and sexualized–; where we mean to be firm and clear their templates may categorize that as “yelling–; where we mean to establish eye-contact for relational respect and intimacy their template may interpret “threat.” It is a sad reality that the first experiences of these children distort future interactions and lead to behaviors and feelings that make sense to their brain “but are confusing, frustrating and very sad to those of us working to help them.
Their current style of interaction with a foster parent is based upon their history with caregivers and previous foster parents. Their views about therapists are shaped by their experiences with their first therapists; and on and on with teachers, peers, with the world.
It is our greatest battle with these children; to shift their worldview. To alter and replace the inaccurate, distorted and destructive memory templates created by a maltreated child's first experiences is our greatest challenge. Yet it can happen; you have seen it, we have seen it. But all too infrequently.
Yet there is hope. By
better understanding how the brain works and how it changes we can
become more efficient and effective in our therapeutic work. But that
will have to wait for future columns.
