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?

Keywords: autism • Asperger's Syndrome • ADHD • bed wetting • enuresis • oxytocin • postpartum depression