Laura Joyce-hubbard

overwhelming situations; for a baby, “fight or flight” works only if someone comes to fight for or flee with them. ³⁹ Hence, leaving them to cry only increases their stress levels, teaches them they cannot rely on their caregivers for assistance, and opens them to the cycle of hyperarousal and dissociation.

When babies experience this sort of persistent or intense stress, they enter the cycle of hyperarousal and dissociation that accompanies stressful events. The

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initial stage of the stress cycle is one of hyperarousal, the “startle” reaction to a threat. This engages the sympathetic nervous system, which increases the heart rate, blood pressure, and respiration.

Distress at this stage is usually expressed by crying, which progresses to screaming. The brain attempts to mediate this by increasing levels of major stress hormones, elevating the brain’s levels of adrenaline, noradrenaline, and dopamine. This triggers in the developing brain a hypermetabolic state—a state of hyperarousal in which the metabolism is speeded up and other functions are slowed or halted. ⁴¹

However, stress hormones are protective mechanisms intended to be used only for short periods of time, to assist the body in surviving a dangerous situation. Prolonged periods spent in this state of heightened stress are damaging. Additionally, prolonged exposure to stress induces increased levels of thyroid hormones and vasopressin, ⁴² a hypothalamic neuropeptide that is activated in response to unsafe or challenging environments. ⁴³ It is also associated with nausea and vomiting, which may explain why many babies throw up after extended crying.

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The second, later-forming reaction to stress is dissociation. At this point, the baby disengages from external stimuli and retreats to an internal world. This involves numbing, avoidance, compliance, and lack of reaction. ⁴⁵ This second phase occurs in the face of a stressful situation in which the baby feels both hopeless and helpless. The infant tries to repair

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the disequilibrium but cannot, and so disengages, becomes inhibited, and strives to avoid attention in an effort to become “unseen.” ⁴⁷ This metabolic shutting-down is a passive state in response to an unbearable

situation and is the opposite of hyperarousal. In biological terms, it is the same process that allows us to retreat from overwhelming situations in order to heal wounds and fill depleted resources. However, as a response to caregiver misattunement and nonresponsiveness, it is devastating, and the effects of even short periods of dissociation can be profound. ⁴⁸ In this state, pain-numbing endogenous opiates and behavior-inhibiting stress hormones such as cortisol are elevated. Blood pressure decreases, as does heart rate, despite the continued circulation of adrenaline.

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This ultimate survival strategy allows the baby to maintain basic homeostasis.

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When babies are in distress, their brains are at the mercy of these states. This means that all their regulatory resources must be devoted to trying to reorganize and regain equilibrium.⁵¹ These kinds of biochemical alterations in a rapidly developing brain can have lasting consequences. In the infant, “states become traits”; in other words, the effects of early relational traumas become part of the structure of the forming personality. ⁵² This is all taking place at a time when the brain is at its maximum vulnerability to influences and