Sunday, March 19, 2006

A Triumph of Heart Over Hypothalamus?

Ever since I was leveled by that bicycle messenger a week or so back, I've been thinking about the sudden outbreak of loveliness that I experienced as I was lying flat on my back on 16th Street. Each person who came by to help suddenly looked lovelier than the last, and the blue of the winter sky was so exquisite that it nearly brought tears to my eyes. How was it that everything and everyone had suddenly become of so unaccountably lovely?

All of this got me thinking about hormones.

While much has been written about the "fight or flight" rush of adrenaline and coritsol that occurs when one encounters a stressful situation that calls for battle or retreat, I don't think much of anything has been written about the flood of chemicals that must be released when one is injured, knocked down, belly-up, wholly incapable of either a fight or flight, and thus completely dependent on the loving kindness of others.

What, I wondered, happens when we're suddenly injured? What happens that inures us to the pain of our injuries and renders our impression of others beneficent?

My thought was oxytocin.

Oxytocin is a hormone secreted by the hypothalamus at the based of the pituitary gland. Associated with the contractions of childbirth, the onset of lactation and the overall success of maternal bonding, oxytocin also seems to be necessary for all sorts of social bonding.

I don't know if anything at all has been written about the biochemistry of surrender. And I've spent a good bit of my professional life discounting biological explanations of social effects, but could it be that oxytocin is the hormone not only of bonding, but also of surrender? Could it be that there is an evolutionary value in having a lovely hormone that makes you loving and trusting when you haven't got even the remotest possibility of fighting or fleeing and quite urgently need the help of others? Perhaps the outbreak of loveliness that I experienced on 16th Street was little more than a flood of oxytocin.

And what about oxytocin and autism?

There is some evidence that dysregulations of oxytocin and vasopressin (the anti-diuretic hormone that helps create nighttime continence and the only other hormone known to be produced by the hypothalamus) may play a role in autism.

So perhaps there is a biomedical, hormonal basis for both Sweet M's overall lack of interest in others and her nighttime incontinence. Perhaps her hypothalamus doesn't do a great job producing either of these peptides.

Oxytocin has even been tested as possible medication to treat repetitive behaviors and lack of social interest in autistic individuals. The hormone was in the news this past summer when a study conducted at the University of Zurich that demonstrated how effective oxytocin is in heightening trust. Researchers even suggest developing a nasal spray to increase levels of trust in individuals with social phobia or autism.

Completely by coincidence, while I'd been doing all this thinking about oxytocin, I've also been reading Susan Senator's powerful memoir of parenting her autistic son and his two brothers. Early on in Making Peace with Autism, Senator is very honest in describing a sense of detachment she felt from and for her eldest son — her autistic son — when she brought him home from the hospital.

I read this segment with the greatest of interest because I, too, remember being puzzled at how I felt when I'd brought Sweet M home from the hospital. While there was something sort of adorable about her, there were, frankly, other moments when I would look at Sweet M and think "who are you, where did you come from, and what are you doing here?" Someone told me I had post-partum depression, or PPD. But frankly, I've been treated for depression, and on a scale of one to ten, the depression I felt postpartum was barely a 4 on my depress-o-meter.

Now I'm wondering if there might not have been some sort of connection between my supposed PPD and Sweet M's subsequent PDD: not necessarily a causal connect where the equation is depressed mom yields developmentally impaired child. But rather that some biochemical deficit in the mother-child dyad that left me somewhat depressed and distant and rendered Sweet M somewhat detached and dysregulated. Perhaps she and I were oxytocin-deficient.

Additional evidence for this hypothesis was that Sweet M and I were also plagued by feeding/nursing problems. No matter how much she nursed, and no matter how much I pumped, she just wasn't getting enough to eat when we were breastfeeding. After three months of frustrating and absurd interactions with "lactation consultants" we gave up and switched to bottle-feeding.

All of my friends who were cheerfully breastfeeding their children described the maternal bliss they experienced when nursing and shortly afterwards. They felt content, happy, and less driven — even the most professionally successful among them. We jokingly, and politically incorrectly, dubbed this state of mind "milk brain." Some among us were singing the praises of oxytocin and thinking it might be a prescription for world peace. And others among us worried about "losing our edge" — losing our critical acumen. But there was just one thing: I only felt this way once or twice in my daughter's entire infancy. And most of my fellow-mom friends seemed to feel this way much of the time. Hmmmh. Now I'm really wondering. Were Sweet M and I just not making enough oxytocin between the two of us?

I realize, of course, that in thinking about this that I am treading perilously close to the dreaded and discredited "refrigerator mother" hypothesis that was advanced by pseudo-psychiatrist Bruno Bettelheim. Bettelheim and other, actual psychiatrists of his period (Bettelheim turned out to have been an impostor) thought that the autistic child was rendered autistic or schizophrenic by contact with his or her "cold, intellectual" mother. The proposed cure, of course, was to separate the child from the damaging influence of the mother by institutionalizing the child.

In the last few days I've been wonder if there might not be just a tiny kernel of truth in this horrible mischaracterization of the mothers of autistic children. What if there was something biochemical in the mother-child dyad that made it exceptionally difficult for maternal-newborn bonding to flourish? What if the problems in affect were an effect of chemical processes gone awry — the result of an oxytocin deficiency?

And what if the obvious love autism mothers have for their children — the love that anyone can see overflowing in the books of Susan Senator, Valerie Paradiz, Clara Claiborne Park, Eustacia Cutler, Patricia Stacey, Catherine Maurice, Beth Kephart, to name only a few, and in the blogs of so many autism moms — what if this obvious love is evidence of a remarkable triumph of heart over hypothalamus?



kristina said...

Indeed, there has been a lot of investigation into the endrocrine system and hormones--as at this BBC report about Cambridge U studies about testosterone levels. I am very glad you mentioned Bettelheim, whose pseudo-ness always baffles me, especially after reading biographies. I puzzled over the oxytocin research that appeared last summer---Charlie was my daemon from moment 1 and did he eat (nurse), for 13 months, plus, but he had teeth.

The Greeks had it better: Heart, brain, mind, hypothalamus were all one word.

Jannalou said...

Now I want to find out all about oxytocin, especially its role in ADHD. Cuz I only get that kind of happy in response to guinea pigs.

I am so serious here.

Anonymous said...


Interesting. I felt a pretty normally strong bond with my first child, the ASD child. Xe had a really good instinct to nurse and we managed really well, even though my mom was not able to nurse any of her kids... hmmm, maybe that's how I ended up with AS? :-)

I didn't feel as much overflowing love for my second child, who is normal, but I was in a really bad marriage by was only a little shaky when the first one was born. I didn't plan the second one and s/he came when the first one needed me so much.

I cheated the second one out of some of the love that s/he deserved for several years and then started to deliberately try to make things right between us. It worked, as far as I can tell, the second one loves me very much. The second one is much more likely to say, "I love you." I said, "I love you" and meant it to both of my kids, alot.

Still....I think there is something to the oxytocin idea, it's probably very complex, though not a one to one formula.

I think that "broad autism phenotype" moms are naturally inclined to be less "mushy" than normal moms. I think that there is something to the "refrigerator mom" thing, not that the distance causes autism, but that the mom is autistic and perhaps... maybe... less demonstrative to her kids. But less demonstrative moms can be fiercely good mom's, too.

I'd rather have a mom who is distant but who would throw herself in the path of a lion than a mom who is mushy and lovey dovey who is too stupid to keep her kids fed and clothed and safe and/or needs a man above all else. Look at the evil stupid critter who drowned her 3 boys in order to get her man, her boss, who didn't want her anyway. Sorry... off topic.

It would be interesting to know why you felt all at peace and in love with the world when you got hit by the bike. Endorphins? Maybe you were stoned on endogenous opiods?

Bronwyn G said...

This makes sense, I think.

I like Camille's second last paragraph. It shows me a true picture of what motherhood does mean.

Susan Senator said...

This post made me think of what we used to refer to as "too much joy," the way little Nat would look away from us, smiling, when we had made him happy. It is so easy to see it as merely "overstimulation due to his autism," but what, exactly, is that? Maybe a flooding of oxytocin.

Also -- wasn't there research a while back that tried to link autism incidence to women who had pitocin (artificial oxytocin, I think?) during labor? Very interesting to connect all the dots.

And thanks for the link, BTW. Please try to come see me in NYC tomorrow night!

MothersVox said...

No doubt it's much more complicated than just a single chemical . . . however powerful oxytocin may be, it can't account from the total lack of pain that I felt when smashed by the bicycle. My bruises suggest that, had I had any access to pain sensation, that I wouldn't have been lying around in an aesthetic delirium cracking jokes with the EMTs as the hauled me off. So there must be some handy opiate-like endorphins that kick in at those moments. And maybe some oxytocin as well.

I didn't read the oxytocin/pitocin research yet . . . but since pitocin is synthetic oxytocin, maybe there is a link there.

All of this, of course, makes me wish I'd studied molecular biology, but fortunately Candace Pert and other neuroscientists are at work on this.

Susan, I will try to get over to your talk tomorrow night! It's Barnes and Noble, Union Square, right?

Mary said...

Fascinating. I'm sorry that you had an accident, but am pleased that if you HAD to have one, at least it resulted in some VERY interesting hypotheses.

Wendy said...

There was an article (cover story actually) in the February National Geographic magazine about love and the effects of oxytocin. They mention the autism research in the article stating that autistic individuals are deficient in oxytocin.

I've never admitted this to anyone (and can't believe I'm doing so now) but when the twins were born, I didn't bond at all with my daughter who was in the NICU for 2 weeks. When I was finally able to bring her home, I felt like I was bringing home a stranger. I felt like she was intruding on the extremely strong bond and fierce love that I immediately felt for my son. My daughter is "normal". My son is autistic. (It took me a very long time to forge a bond with my daughter and I'm not sure why. I'm glad that time has passed.)

I hope more research is done on oxytocin and it's connection (or lack thereof) in autistic people. Great post.

Julia said...

Wow, lots of stuff here, both in the post and in the comments.

1) I'm self-diagnosed with Asperger's Syndrome.

2) I have 3 children, a singleton and twins.

3) I had a pitocin drip both times I gave birth.

4) Additionally, my oldest had to be helped through the birth canal by vacuum extraction. (He got stuck too far down for a C-section to be possible.)

5) My oldest was really snuggly as a baby, loved being carried in a sling once he got used to it, was breastfed exclusively for 6 months and not entirely weaned until 18 months.

6) The twins were not carried in slings as much, but were both pretty snuggly, breastfed exclusively past 6 months, weaned at 19 months.

7) Breastfeeding went very well with all of them, aside from Mommy having to learn a few things the first time around, and one twin needing a few days to really get the hang of it; with the twins, there were supply issues at first, but lots and lots of sucking + "mothers milk" tea took care of that.

8) Oldest has been diagnosed with autism; an autism spectrum diagnosis on one or both twins would not entirely surprise me. (On one of the twins, the one who took to nursing the most easly of my kids, it would surprise me more than the other.)

9) I absolutely enjoy lactating. That's the thing I miss most about any of them not being a baby anymore.

I don't know what that does for anyone's theory, but there's what I have to offer in response to the various ideas being thrown about.

kristina said...

I was induced with pitocyn somewhere during 21 1/2 hours of labor with Charlie, who looked me right in the eye when he was born as he did tonight and who I'm as joined to as Foua to Lia Lee in The Spirit Catches You

I always wonder if we are flirting with disaster to bring up the ghosts of Bettelheim?

MothersVox said...

I know I know I know Kristina. I was somewhat reluctant to go there . . . Maybe some things are best left unsaid . . . but I was so struck by Susan Senator's description of her postpartum experience . . . how similar it felt to my own . . . and what an enormous relief it was to read about someone else who had a similar set of feelings.

I think my point is that the refrigerator mom thesis is completely obviated by the obvious love, commitment and determination of the moms (and dads) of kids in the spectrum. Lionesses and mama bears alike, the stories one reads from all of these blogs are ample counterpoint to the Bettelheim nonsense.

And from so many of the posts here, it seems that there may be no correlation at all between the detachment I experience and oxytocin/pitocin. Wendy and Julia seems to have had a quite opposite experience . . . feeling more attached to her child in the spectrum than to her NT child.

I guess I like to float ideas that are speculative -- and possibly way off -- but it is true that with certain horrible characterization that the risk may be too great. Even when this feels like a private email or list serv, of course it isn't . . . it's a blog!

Ah well. I will think about whether to be self-censorious in the future when my mind wanders toward biological determinism/essentialist hypotheses. Still I like to allow for postings that admit the fullness and complexity of our experiences. It's not an easy call.

kuchinskas said...

I've been researching oxytocin for about a year, and some researchers do think that the administration of pitocin may interfere with the natural oxytocin response between mother and child. (That's may interfere,not always does interfere.) Sue Carter, the most noted oxytocin researcher, told me she thinks there might be a link.

Moreover, it is possible to experience a biochemical deficit in the mother-child dyad. On a biochemical basis, love can be defined as the consistent release of oxytocin in response to interaction with another, leading to feelings of calm, pleasure and connection. Although we're born knowing how to digest our food and breathe air, we're not born knowing how to love. The not fully developed infant brain must be trained by caregivers to regulate itself, in part by releasing oxytocin.

Typically, when a baby nurses at the breast, the mother's body releases oxytocin, which goes into her milk as well as her bloodstream, making both mother and baby feel connected and joyful. Eventually, the baby learns to produce oxytocin in situations of safe intimacy with others.

Sometimes, for many many reasons, this doesn't happen.

Bettelheim was kind of onto something, with three very important caveats:

1. It's not to blame the mother. Many physical, cultural and social factors may thwart the oxytocin response.

2. We are not determined by our biology.

3. What's amazing is that we can actually retrain the oxytocin response. For a very scholarly explanation of all this, read Daniel Schor, "Affect Regulation and Repair of the Self."

Christy said...

Okay - I've just been looking up the hypothalamus as my little girl has had wetting problems and been put on medicine to help. As I've been reading I've come across a link to autism - my eldest was diagnosed add and aspergers and also had wetting problems. There was also a mention of it regulating temperature and hormones - two of mine (and myself) get cold easily, and I'm having major problems with the drastic responses I get to fluctuating hormone levels. Blood pressure was another one - low in a couple of us and weight - we're not overweight but have to work really hard to not become so. Oh and growth - I'm quite little as are the two of my four who have had the wetting problems (one with aspergers) - IS THIS REALLY ALL LINKED???? and what does it mean - the hypothalamus doesn't pick up on things or works too quickly? Oh and I'm really maternal - go into labour bang on time and spit them out!!!

Anonymous said...

I know this is 6 years too late; what you are describing is 'Savant Syndrome' not Autism/Aspergers; that is to say you may be describing the Hypothalamus of a mind with a spectrum memory, but unlikely that Oxytocin or Vasopressin can fully explain spectrum minds: Note as someone who was born with Aspergers and now displays signs of Savant Syndrome I am a bit biased.

MothersVox said...

Hi anonymous, It's never too late to comment as we're reviewing everything all the time! What do you think is Savant Syndrome in the above post? I'm not sure which part you're referring to . . .

bruce said...

So I'm diagnosed ASD, Aspie. 60 yrs old, having experienced strong anxiety most of my life including as a small child. I find my body temp regulation doesn't work, and often feel chilled. All other causes have been tested, it must be neurological. I see the hypothalamus is involved in both fight-or-flight and body temp. Someone should look into this.

Lately I see that autism is treated with Oxytocin. OK if it helps those with difficulties, but I think "social" issues are symptoms, not the core ASD issue which is sensual and neuro processing. So, not a "cure". I follow Baron-Cohen who suggest that Psychopathic and Borderline problems are also ASD. Note our definition of "Psychopath" is highly social zero empathy. So administer Oxytocin to an Aspie, create a Psychopath? Sure enough a study found exactly that" Psychopaths have increased Oxytocin! OK I feel for parents with non-communicative kids, I've worked with them. If the nasal spray helps that family I support it. But the bigger picture is something else. Back to sensory processing as cause. And to me, looking at a stranger's face is like a bomb going off in my face. Fight or flight! I'd rather study the ground on which I walk, I also stumble if I don't. And when people all talk at once I switch off, it's just noise.