How Neglect Can Impact Brain Development – with Bessel van der Kolk, MD

Summary

In this insightful interview, the speaker discusses the critical yet often overlooked role of attachment in psychological development. They emphasize the importance of early nurturing and the development of brain capacity during critical periods. The lack of pleasure and vitality in neglected individuals is highlighted, suggesting that traditional therapeutic approaches may fall short. The speaker advocates for innovative methods like Tango dancing and music-making to foster engagement and pleasure, urging therapists to be patient and creative in enhancing the vitality of their interactions.

Takeaways

• 🧠 The importance of understanding attachment in psychiatry is highlighted, as it is often overlooked in core psychiatric formulations and the DSM.
• 🚫 Neglect in early childhood is a significant issue that is difficult to treat, as it can lead to the development of a brain that accommodates to neglect and doesn't expect more than it receives.
• 👶 The concept of critical periods in brain development is emphasized, where the right input at the right time is crucial for the development of certain brain capacities.
• 🌱 The lack of attention and pleasure from caregivers during childhood can hinder the development of the capacity to feel and give pleasure in social interactions.
• 👵 The speaker's personal observation of grandchildren shows the importance of being seen and acknowledged, which contributes to the development of pleasure centers in the brain.
• 💃 Engaging in activities like tango dancing and making music can be beneficial in developing a sense of pleasure from social engagement and vitality.
• 🤔 Clinically, there is often a lack of vitality and pleasure in interactions for those who have not experienced positive social engagement during their formative years.
• 🔍 Traditional therapeutic methods may not be effective in addressing the lack of pleasure and vitality, as they do not stimulate the development of underdeveloped social pleasure systems.
• 👩‍⚕️ The burden is on the therapist to be patient and to focus on increasing the vitality of interactions with clients who are passive and struggle with social engagement.
• 🤝 The importance of physical engagement with others is underscored as a way to cultivate the habit of deriving pleasure from social interactions.
• 🎶 The script concludes with the suggestion that music and dance can serve as therapeutic tools to enhance the pleasure of social engagement.

Q & A

What is the main issue discussed in the interview with the BBC?

The main issue discussed is the lack of understanding and recognition of attachment and neglect in core psychiatric formulations, particularly in the DSM, and the challenges it poses in clinical practice.

How does neglect affect brain development according to the speaker?

Neglect affects brain development by causing the brain to adapt to the lack of care, leading to an expectation of minimal engagement and potentially underdeveloped capacities for pleasure and vitality in social interactions.

What is the significance of critical periods in brain development mentioned in the script?

Critical periods in brain development are significant because if the right input is not received at the right time, certain brain capacities may not develop properly, affecting one's ability to feel pleasure and engage with others.

How does the speaker describe the impact of being ignored during childhood on a person's development?

The speaker suggests that being ignored during childhood can lead to underdevelopment of the capacity to feel pleasure from being noticed or appreciated by others, which is a crucial aspect of social and emotional development.

What role do grandchildren play in the speaker's understanding of the importance of being seen and acknowledged?

The speaker uses the example of their grandchildren to illustrate the natural human desire to be seen and acknowledged, and how this contributes to the development of pleasure centers in the brain.

What clinical observation does the speaker make about individuals who have experienced neglect?

The speaker observes a lack of vitality and pleasure in interactions among individuals who have experienced neglect, suggesting that their capacity for social engagement and enjoyment may be underdeveloped.

What traditional methods does the speaker believe are insufficient in addressing the issues stemming from neglect?

The speaker believes that traditional methods such as talking, analyzing, and figuring things out are not effective in resolving the feelings and issues related to neglect and underdeveloped social capacities.

What is the speaker's advice for clinicians dealing with patients who have experienced neglect?

The speaker advises clinicians to lower their expectations, be patient, and focus on increasing the vitality of their interactions with patients who may be passive and struggle to derive pleasure from engagement.

What activities does the speaker suggest might help in developing or enhancing social engagement and pleasure centers in the brain?

The speaker suggests activities such as Tango dancing and making music with others, which involve physical engagement and can help develop the habit of deriving pleasure from social interactions.

How does the speaker relate the issue of attachment and neglect to the broader field of psychiatry?

The speaker implies that the field of psychiatry has largely overlooked the importance of attachment and the impact of neglect, which they believe are critical factors in understanding and treating certain psychological conditions.

What is the speaker's view on the importance of being engaged with others for personal development?

The speaker views being engaged with others as essential for personal development, particularly in developing a sense of pleasure and vitality, which can be compromised in individuals who have experienced neglect.