This is a very ambitious book. The
author, a psychoanalytic psychotherapist, sets out to show that, although our
genetic inheritance may predispose us towards a range of physical characteristics
and may increase our likelihood of having some and avoiding other illnesses, it
is the way we are brought up, especially in our earliest years, which is likely
to influence our ability to form and maintain loving relationships when we are
adults.

In the first chapter the author
lays emphasis on the now well-known theories of attachment especially as
proposed by Bowlby. This is mainly covering old ground but what the author then
does is to raise the argument to a different plane by going into considerable
detail about how the human brain develops and which part of the brain controls
the various functions we undertake. This is heady stuff! That chapter leads
neatly on to the next which is about the role that cortisol plays. Cortisol is
a hormone released naturally by the body at times of stress. However, too much
stress produces too much cortisol which then goes on to close down other
systems and, if the situation persists for too long, even the body’s immune
system can be adversely affected. The author’s contention is that babies are
not able to regulate their own stress levels and are reliant on their parents
to help them maintain an emotional equilibrium where cortisol levels are kept
within bounds. The author adduces evidence to suggest that "too much cortisol
can affect the development of the orbito-frontal part of the prefrontal cortex
— an area which as we have seen is responsible for reading social cues and
adapting behavior to social norms." (p.66) The author goes one stage
further still by indicating that there is also some evidence that high levels
of cortisol in the mother can pass through the placenta and affect the fetus.
The implications of this are enormous as it means that heavily stressed mothers
are likely to be adversely affecting their unborn baby and this is in addition
to the problems of nicotine and alcohol which can also harm the fetus. The
author is not arguing that temporary periods of stress are particularly
problematic. Rather, the picture she is trying to paint is that it is prolonged
and uncontrollable periods of stress that are particularly damaging for the
baby. This is the point where the author now reintroduces the concept of
attachment. It is the stress caused by long separation from (normally) the
mother or the stress caused by utterly unpredictable behavior on the mother’s
part that causes the damagingly high levels of cortisol. The brains of certain
people who sustain long periods of high cortisol production, as a defense
mechanism, close down the cortisol receptors. This is also a damaging procedure
since these people can become emotionally numb and withdrawn.

The author then links the levels of
cortisol with the stages of the development of the brain and further links
these with the behavioral consequences of normal or abnormal development. When
she applies these to an analysis of child behavior at school and especially in
the playground, we the readers gain a clear picture of the consequences of good
or bad child-rearing practices and we have that niggling worry that it all
starts nine months earlier than the child’s birth. The author provides some
moving case-studies including one of two child-murderers. Poor parenting
certainly does appear to be the culprit. Again, she is not saying that no-one
who has suffered from poor parenting will ever be able to escape the
consequences. She adamantly rejects these ultra-deterministic views. However,
she is saying that poor parenting will cause problems that the child will have
to try to overcome as an adolescent and as an adult. She again provides moving
case-studies to prove her point.

The author ends her book with a
plea for people to be educated about the awesome but wonderful responsibilities
of parenthood. It is certainly frightening that rejection, lack of love and
unpredictable parenting (let alone physical or sexual abuse) will almost
certainly cause problems for the growing child. The upbeat message, however, is
that good parenting, on the other hand, will almost certainly produce children
who will themselves become good parents.

The book has been beautifully
proof-read. It is written in a highly readable style even when dealing with the
complex description of the growth of the brain. It has an excellent index and a
superb bibliography making the book useful for the professional as well as the
lay reader. The book should be prescribed reading for parenthood classes but it
would also be very useful reading in psychology child development courses and,
of course, for all parents and parents-to-be. It is actually a very important
book and a valuable contribution to the discussion about how to ensure a more
mentally healthy future for our society.

© 2006 Kevin M. Purday

Kevin Purday
works at The Modern English School, Cairo, Egypt, and has a Master’s degree in
the Philosophy & Ethics of Mental Health from the Philosophy Dept. at the
University of Warwick.

Categories: Psychology