• Heather

Empathy, Compassion and Connection: Impact on Human Development

Over the course of the last century Developmental Psychology has attempted to explain the development of key characteristics throughout the human life. The aim of developing this body of knowledge has been to provide guidance to support the lives of children and families. In the late 19th century Freud proposed that un-assimilated trauma was the route cause for all psychological maladaption, a change from the previous Darwinian group-thought that attributed healthy human intellectual, behavioural and social development to thriving genetic precursors. Neither the nature nor nurture theory fully explained the delicate balance of interplay between our genetic blue print and environmental exposures and experiences that scientists are beginning to understand in more depth within the speciality of Epigenetics. (Turkheimer E., 2020). The epigenome represents a dynamic adaptation to environmental conditions and therefore plays an important role whilst we evaluate the interplay between nature and nurture in human development. Regulation of the human genome by the epigenome is a profound, inherited, physiologic process and plays a central role in the materialisation of traits that influence human development.

With our global population ever more closely linked on-line in a world united through mandated isolation of 2020, developmental psychologists need to be ever-mindful of socio-economic and geographic cultural nuances within their research and practice. This essay aims to evaluate the progress that has been made to understand the impact of early life experiences on human development and potential remedial approaches within two distinct minority groups: 1. children in care and 2. children living through war-related trauma.

Since the ACE (Adverse Childhood Experiences) study was developed in the USA in the 1990s, the importance of a loving and happy early life on psychological and indeed physiological development has been given more gravitas, however it has taken time for this research to influence policy decision makers for those assisting minority groups such as children in care. A high ACE score is positively correlated with long-term negative effects on development, including increased maladaptive personality traits, a higher risk of mental health disorders such as complex PTSD, learning disabilities and psychiatric disorders (Gescher et al., 2018). Research examining the roots of abnormal development shaped by early life events has shown malfunctioning of the stress response system and hypothalamic pituitary adrenal (HPA) axis activity in children and adults (Tyrka et al., 2016). The most common reason for foster care placement is child maltreatment including neglect and abuse (Kennedy, 2019).

Children and teenagers who are living in care often experience compound developmental and psychosocial disturbances due to adverse occurrences in their lives. This can involve being removed from their natal family or previous care givers (Szilagyi et al., 2015). Research suggests behaviour in teenage years may be more challenging than those experiencing a ‘normal’ family life, due to the impact of their earlier experiences. The adolescent brain is uniquely adaptable until the 20s (Giedd, 2015), with all teens finding emotional regulation more challenging and somewhat more greatly influenced by short-term rewards due to changes in cortical development guiding higher processing and decision making. Since children in care often feel uncertain regarding their future, combined with potentially negative past experiences, researchers argue such children focus more on present events which can encourage higher levels of risk taking behaviours (Morsanyi & Fogarasi, 2014).

One institution ensuring research into best standard of care for children in care is the Rees centre in the UK. Their research shows that risk taking behaviour is more common in teenagers in care. Literature also suggests it is possible to form a new and meaningful attachment during teenage years even if attachment bonds were discontinued earlier in life. However new positive attachment bonds are more likely to be successful the younger the child was when they entered a stable foster-care environment. Teens living in care state that feeling safe, emotionally accepted and building trust with caregivers are of key importance in order to form a new nurturing care-giver bond.

A further minority group for which recent research has provided insight for are children with intellectual disabilities in care. There has been a high prevalence of such disabilities, with 21% observed in children in care, this was two times higher than previous papers. (Aguila-Otero et al., 2018). This research backs up the notion that there is an over‐representation of children with disability in care, the impact of adverse earlier life experiences may account in part for these findings.

Unfortunately research shows that children in care are at risk from a variety of negative developmental outcomes. However interestingly, further papers on post traumatic stress disorder and IQ shows that higher IQ levels appear to help alleviate development of PTSD (Saltzman et al., 2006). Education Outcomes for Looked After Children 2017/18 by the Curriculum for Excellence in Scotland show that children who have more consistent care (with fewer placements and in stable foster care for at least one year) also have higher education outcomes. Results from the University of Ottowa show that academic attainment of children in care can be improved with tutoring, signifying the importance of providing appropriate all-round support for children in care to help them fulfil their fullest potential (Hickey, 2018). These papers illuminate the potential for children who are living in care that may be recovering from traumatic experiences to improve academically and emotionally with befitting care and attention. Du Bois et al., (2006) noted that youth mentoring provides small improvements upon psycho-social, academic and employment measures and that the improvement has a greater effect size for young people from lower socio-economic backgrounds.

When we examine refugee and asylum‐seeking children in care, it’s suggested that these children have better educational outcomes than other children in care but are still not on par with children in the general population (Higgins, 2018). Refugee and asylum‐seeking children were more likely to have lower educational outcomes if they entered care later in life, were not in foster care, or were not in a mainstream schooling. However this study was limited in scope and did not investigate the relationship between the child and their carer, which is likely to be a key influencing factor.

A limitation of such studies focussed on children in care may be that children who complete the full study may reflect care-givers that are highly motivated and committed foster parents. Unfortunately, this is not always a typical representation of a child in care (Hickey, 2018).

A further institution that has pioneered research examining human development within a minority group of children living in a war torn environment, is the Ruth Feldman laboratory in Israel. A longitudinal study published in 2020 investigating the impact of a close attachment bond with maternal safety signals found stress-buffering to be exhibited in a trauma-exposed group compared to a control group. The trauma-exposed group included a group of families living in an Israeli town close to the Gaza border. Inhabitants were exposed to terror-related trauma since 2001 consisting of major military operations, and daily missile attacks for week long periods. Dozens of citizens were killed, more than two thousand injured and properties damaged. Inhabitants were advised to take shelter when sirens were heard when families had between seven and fifteen seconds before potential explosions. These circumstances were a massive trigger for psychological distress and a “trauma reminder”. Whilst such research in diverse populations out-with ‘the norm’ is applaud-able, it does bring the question to mind if research funds may have been better spent as donations toward peace keeping efforts. The study also serves as a reminder that public research findings being adopted by those who wish to cause harm is an uncomfortable possibility.

The study demonstrated that the presence of maternal safety signals can attenuate stress responses even in trauma-inducing environments throughout childhood and into adolescence (participants were followed from age 2 to 11). Stress buffering was defined based on the three step outline by Hostinar et al. (2014), including supportive early relationships that establish a care giver as a “safety signal”; which forms physiological mediators of support, such as oxytocin, ultimately fine-tuning an individual’s lifetime reactivity to stress. The study backed up the theory that human attachments require inner security evolving over time based on caregiver support to trigger stress buffering.

As discussed, adolescence is a period of delicate neuroplasticity associated with a higher risk for psychopathology (Gunnar et al., 2009). Understanding how attachment relationships can buffer stress at this stage may be important for understanding how relationships including a loving care-giver can influence stress response and may hinder abnormal development of stress-related disorders.

Support throughout parenthood is therefore of vital importance, particularly in niche environments such as single parents, foster care and children with early life trauma. Scientists globally are researching biological and psychological correlates of compassion and empathy, traits at the centrepiece of humanity (Levy et al., 2019). Compassion based therapy and meditation can bring a positive influence, associated with reduced stress hormones, increased social closeness, positive emotions and brain plasticity (Singer, 2014), it has also been shown to increase 'relative telomere length' (RTL) with shorter RTL linked to chronic stress and lower life expectancy. Further, Kaliman (2019) notes that regular mediation practice results in the down regulation of certain genes predicting better cortisol recovery after acute stress and down regulation of pro-inflammatory genes. In a socially distant world at the end of 2020, this research is of utmost importance for appropriate cognitive, social and physiological development and human health.

Not since the 1600s in the UK, have such sweeping societal infringements been mandated. It therefore could be argued that we are living through times that are ‘beyond the norm’, normal social functioning of human beings has certainly been compromised and therefore potentially, development. Complex post-traumatic stress disorder is known to be associated with prolonged and repetitive trauma, often in childhood. It is therefore important to consider stressors at play in the lives of some children through current global events and policy.

Chronic social stress has been long studied in pre-clinical laboratories inducing animals into disease through separation from social groups or threats from larger, more empowered animals (Fuchs, 2014). Behaviour is observed and microscopic analysis conducted on brain tissues. Countless studies demonstrate that these animals typically suffer from major depressive disorder, neuronal depletion within the hippocampus reducing learning and memory and further, that DNA replication is hindered therefore encumbering optimal cellular processes underpinning physiological and psychological health. Whilst, generalisations cannot be made between animal studies and humans, ‘chronic social stress’ is known to impinge upon mental and physical well-being in a variety of different ways (Smirni, 2020). It will be important to examine the effects of social distancing and isolation upon human development across all age groups in future months if neuronal health is considered to be enhanced through positive social interaction. Comparatively high incidences of anxiety, depression and stress have been reported in a global sample of study participants during the COVID-19 pandemic (Xiong et al., 2020). Associated risk factors included female gender, age less than 40 years, psychiatric illnesses, unemployment, student status, and regular exposure to social media/news concerning COVID-19 (Xiong et al., 2020). As examined above, appropriate stress-axis functioning is considered necessary for appropriate development, therefore these findings are concerning.

Females under forty are in prime, child bearing age and with maternal depression increasing child vulnerability to psycho-social maladaption (Pratt et al., 2019), the current need for parental support, especially for mother’s at risk from depression is heightened. Researchers recommend early interventions for mothers that boost sensitivity and physiological synchrony (mirrored brain waves and heart waves) through methods such as skin to skin kangaroo care in order to prevent the long-lasting effects of maternal depression on the developing infant’s brain potentially impacting cognitive and social development. Introducing early intervention programmes for mental illness will have important consequences on appropriate development for future generations.

Behavioural genetics has demonstrated that both genes and the environment are crucial for the development of psychological traits. As our scientific sophistication evolves, so too do the core questions on the influence of nature and nurture upon development. How development shapes adolescent and adult lives and may influence the appearance of psychopathology through life can be further assessed by the review of populations living out-with normal socio-economic environments. Early childhood experiences have long-term effects on development, including increased incidence of cognitive and psycho-social disorders through direct physiological impact of stress hormones upon the epigenome. Further studies are now required to show the positive epigenetic influences certain therapies and environments may solicit to assist reducing the incidence of such dysfunction, especially in children and adolescents that have experienced a far from perfect childhood. In order to assist children in overcoming early life difficulties, research must examine methods that can alleviate suffering in minority populations such as those in foster care or recovering from traumatic experiences. Empathy, compassion and connection are underlying facets for typical human development and must be taken into consideration as we rise to the challenge through psychological research and practice in preserving our ‘true state of being’.

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