CARENurturance and Social Bonding

Although there are other chemistries to be found, the most powerful peptides so far that regulate maternal behavior and social bonding are oxytocin, opioids, and prolactin (Carter, 1998; Nelson and Panksepp, 1998; Uvnas-Moberg, 1998). Whether medicines can be developed to facilitate the arousability of these brain care-taking systems, and whether such agents could find a place in psychiatric practice, remains open for discussion and inquiry. It would seem that when mothers exhibit difficulty attaching emotionally to their infants, and vice versa, it might be worth considering interventions that have the potential to gently facilitate the process of mother-infant bonding. Of course, the amount of difficult clinical human work that would need to be done on such issues, and the variety of ethical concerns that would need to be addressed (see end of this chapter), makes it unlikely that such agents will be available in the foreseeable future.

Another realm of human distress management where such chemistries might find a place is in marriage therapy. A cogent answer has recently been provided for the age-old question "What makes some marriages happy, but others miserable?" The most powerful answer is to be found at an affective level; those couples who have the social-emotional skills to make each other feel better tend to thrive whereas those who facilitate negative feelings get themselves into self-sustaining cycles of misery (Gottman et al., 2002). This immediately raises the issue of how social-skills learning might be utilized in conjunction with agents designed to facilitate the affective endpoints they desire. For instance, oxytocin can facilitate the intensity of natural social reward (Panksepp et al., 1999). Might such stimulants for social-neuropeptide systems be able to facilitate psychotherapeutic interventions that aspire to promote social skills to help solidify affectively positive interactions, and thereby diminish psychological effects that sustain negative affective cycles (Gottman et al., 2002)?

In short, many converging lines of evidence have implicated oxytocin in the beneficial effects of social support on both mental and physical health. Oxytocin is released by prosocial activities and can counteract separation anxiety and stress in general, and thereby promotes development of social contacts and attachments (for a recent overview, see Taylor et al., 2002). One foreseeable problem is the uncertainty whether the relevant steroid-sensitive receptive fields are present in the brains of individuals who might be helped most by such interventions.

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