Medical Tuesday Blog
Erica Komisar’s book on the science of early childhood development
The Politicization of Motherhood Conservatives cheer and liberals jeer New York psychoanalyst Erica Komisar’s book By James Taranto | Oct. 27, 2017 | New York Motherhood used to be as American as apple pie. Nowadays it can be as antagonistic as American politics. Ask Erica Komisar. Ms. Komisar, 53, is a Jewish psychoanalyst who lives and practices on the Upper West Side of Manhattan. If that biographical thumbnail leads you to stereotype her as a political liberal, you’re right. But she tells me she has become “a bit of a pariah” on the left because of the book she published this year, “Being There: Why Prioritizing Motherhood in the First Three Years Matters.” Christian radio stations “interviewed me and loved me,” she says. She went on “Fox & Friends,” and “the host was like, your book is the best thing since the invention of the refrigerator.” But “I couldn’t get on NPR,” and “I was rejected wholesale—particularly in New York—by the liberal press.” She did appear on ABC’s “Good Morning America,” but seconds before the camera went live, she says, the interviewer told her: “I don’t believe in the premise of your book at all. I don’t like your book.” The premise of Ms. Komisar’s book—backed by research in psychology, neuroscience and epigenetics—is that “mothers are biologically necessary for babies,” and not only for the obvious reasons of pregnancy and birth. “Babies are much more neurologically fragile than we’ve ever understood,” Ms. Komisar says. She cites the view of one neuroscientist, Nim Tottenham of Columbia University, “that babies are born without a central nervous system” and “mothers are the central nervous system to babies,” especially for the first nine months after birth. What does that mean? “Every time a mother comforts a baby in distress, she’s actually regulating that baby’s emotions from the outside in. After three years, the baby internalizes that ability to regulate their emotions, but not until then.” For that reason, mothers “need to be there as much as possible, both physically and emotionally, for children in the first 1,000 days.” The regulatory mechanism is oxytocin, a neurotransmitter popularly known as the “love hormone.” Oxytocin, Ms. Komisar explains, “is a buffer against stress.” Mothers produce it when they give birth, breastfeed or otherwise nurture their children. “The more oxytocin the mother produces, the more she produces it in the baby” by communicating via eye contact, touch and gentle talk. The baby’s brain in turn develops oxytocin receptors, which allow for self-regulation at a later age. Women produce more oxytocin than men do, which answers the obvious question of why fathers aren’t as well-suited as mothers for this sort of “sensitive, empathetic nurturing.” People “want to feel that men and women are fungible,” observes Ms. Komisar—but they aren’t, at least not when it comes to parental roles. Fathers produce a “different nurturing hormone” known as vasopressin, “what we call the protective, aggressive hormone.” Whereas a mother of a crying baby will “lean into the pain and say, ‘Oh, honey!’” a father is more apt to tell the child: “C’mon, you’re OK. Brush yourself off; let’s go back to play.” Children, especially boys, need that paternal nurturing to learn to control their aggression and become self-sufficient. But during the first stages of childhood, motherly love is more vital. Ms. Komisar’s interest in early childhood development grew out of her three decades’ experience treating families, first as a clinical social worker and later as an analyst. “What I was seeing was an increase in children being diagnosed with ADHD and an increase in aggression in children, particularly in little boys, and an increase in depression in little girls.” More youngsters were also being diagnosed with “social disorders” whose symptoms resembled those of autism—having difficulty relating to other children, having difficulty with empathy.” As Ms. Komisar “started to put the pieces together,” she found that “the absence of mothers in children’s lives on a daily basis was what I saw to be one of the triggers for these mental disorders.” She began to devour the scientific literature and found that it reinforced her intuition. Her interest became a preoccupation: “My husband would say I was a one-note Charlie,” she recalls. “I would come home, and I would rant and I would say, ‘Oh my God, I’m seeing these things. I’ve got to write a book about it.’” That was 12 years ago. She followed her own advice and held off working on the book because her own young children, two sons and a daughter, still needed her to be “emotionally and physically present.” She uses that experience as a rejoinder to critics who accuse her of trying to limit women’s choices. “You can do everything in life,” she says, “but you can’t do it all at the same time.” Another example is Nita Lowey, a 15-term U.S. representative from New York’s northern suburbs: “She started her career when she was in her 40s, and she said to me she wished she’d waited longer. She said her youngest was 9.” Ms. Lowey is a liberal Democrat, but she was born in 1937 and thus may have more traditional inclinations than women of the baby boom and later generations. Ms. Komisar tells of hosting a charity gathering for millennials at her apartment. One young woman “asked me what my book was about. I told her, and she got so angry. She almost had fire coming out of her eyes, she was so angry at my message. She said, ‘You are going to set women back 50 years.’ I said, ‘Gosh, I wouldn’t want to do that.’” Male attitudes have changed as well, Ms. Komisar says: “A lot of young men, particularly millennials, have been raised to believe that it’s even-steven; that women are to bring in as much money, and they’re always going to work.” Young women “make promises to their partners, these young men: ‘I’m going to work forever, I’m going to make as much money as you; maybe I’ll make more than you.’ It’s almost like a testosterone kind of competition.” The needs of children get lost in all this—and Ms. Komisar hears repeatedly that the hostility to her message is born of guilt. When she was shopping for a literary agent, she tells me, “a number of the agents said, ‘No, we couldn’t touch that. That would make women feel guilty.’” Another time she was rejected for a speaking gig at a health conference. She quotes the head of the host institution as telling her: “You are going to make women feel badly. How dare you?” In Ms. Komisar’s view, guilt isn’t necessarily bad. “My best patient is a patient who comes to me feeling guilty,” she says. “Women who feel guilty—it’s a ‘signal’ feeling, that something’s wrong, that they’re in conflict. If they go talk to a therapist or deal with the conflict head-on, they often make different choices and better choices.” That’s “better,” not “perfect,” and Ms. Komisar is at pains to emphasize that “mothering is not about perfection.” She acknowledges, too, that staying at home isn’t right for all new mothers: Some lack the wherewithal to take time off work; some are depressed or distracted and “not really emotionally present.” When the mother can’t be there, Ms. Komisar says, the best alternative is a “single surrogate caregiver,” optimally a relative. “The thing I dislike the most is day care,” she says. “It’s really not appropriate for children under the age of 3,” because it is “overstimulating” given their neurological undevelopment. She cites the “Strange Situation experiments,” devised in 1969 by developmental psychologist Mary Ainsworth, a pioneer of attachment theory: “A mother and the baby are on the floor playing. The mother gets up and leaves the baby in the room alone. The baby has a separation-anxiety response. A stranger walks in; the baby has a stressed reaction to the stranger.” Researchers sample the infant’s saliva and test it for cortisol, a hormone associated with stress (and inversely correlated with oxytocin). In a series of such experiments in which Ms. Komisar herself participated, “the levels were so high in the babies that the anticipation was that it would . . . in the end, cause disorders and problems.” In a more recent variant of the experiment, scientists use functional magnetic resonance imaging to look directly at the brain of an infant reacting to photos of the mother and of a stranger. You can see why tradition-minded conservatives welcome Ms. Komisar so warmly. Think about how they are stereotyped—as backward, superstitious, hostile to science. She shows that science validates what they know as common sense. But although she returns their affection, she doesn’t share their distaste for contemporary mores. “We don’t want the ’50s to come back,” she tells me. “Women had children who didn’t want to have children. Women didn’t have other choices than having children, and women were ostracized if they didn’t have children. And women were ostracized if they went out into the world and worked.” . . . . . . To read the entire review in the WSJ . . . Mr. Taranto is the Journal’s editorial features editor. This book review is found at To read more book reviews . . . To read book reviews topically . . . Feedback . . . The Book Review Section Is an Insider’s View of What Doctors are Reading about. |
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