Your question reflects the both the complexity and the danger of dichotomizing inherent in the theoretical clashes of our field. There is no doubt in the current scientific literature that the first years of life (0-3 in some places, 0-5 or 6 in others) contain the most sensitive and critical periods for human development in a number of areas not least neural and psychological development! An awful lot happened between Freud and Kagan and a lot since Kagan's 2000 book. Do also see the National Academy of the Sciences book Neurons to Neighborhoods which dates back to that time and that presents a very different picture from Kagan. As a trauma researcher, it is clear that children can be resilient to an extent-- but certain traumatic life-events, and the accumulation of such events, coupled with other environmental factors such as caregiving, culture (see our book Formative Experiences: The Interaction of Caregiving, Culture, and Developmental Psychobiology), in interaction with biological factors both genetic and epigenetic and more, make it very unlikely that an individual faced with certain noxious mixes will not suffer a measure of adverse developmental consequences. This is particularly true during specific periods of brain development-- including the first years of life, and transition points thereafter (i.e. puberty, and late adolescence. See the work of Martin Teicher for more on this.

There are many longitudinal studies such as Family Pathways (Lyons-Ruth), Minnesota (Sroufes and Egeland) to support that early childhood experience, while not the be-all and end-all, is extremely important and predictive.

Your question reflects the both the complexity and the danger of dichotomizing inherent in the theoretical clashes of our field. There is no doubt in the current scientific literature that the first years of life (0-3 in some places, 0-5 or 6 in others) contain the most sensitive and critical periods for human development in a number of areas not least neural and psychological development! An awful lot happened between Freud and Kagan and a lot since Kagan's 2000 book. Do also see the National Academy of the Sciences book Neurons to Neighborhoods which dates back to that time and that presents a very different picture from Kagan. As a trauma researcher, it is clear that children can be resilient to an extent-- but certain traumatic life-events, and the accumulation of such events, coupled with other environmental factors such as caregiving, culture (see our book Formative Experiences: The Interaction of Caregiving, Culture, and Developmental Psychobiology), in interaction with biological factors both genetic and epigenetic and more, make it very unlikely that an individual faced with certain noxious mixes will not suffer a measure of adverse developmental consequences. This is particularly true during specific periods of brain development-- including the first years of life, and transition points thereafter (i.e. puberty, and late adolescence. See the work of Martin Teicher for more on this.

There are many longitudinal studies such as Family Pathways (Lyons-Ruth), Minnesota (Sroufes and Egeland) to support that early childhood experience, while not the be-all and end-all, is extremely important and predictive.

Neo-Freudian theory, object relations, was researched extensively by Margaret Mahler that demonstrated a relationship between Harlow's rresearch with monkeys and the application of these results by Ainsworth and Bowlby with attachment theory has clearly demonstrated the connection between childhood (early) experiences and adult emotional problems. Research completed by neuroscientists, especially on neural pathways, supports the accuracy and efficacy of both attachment theory and object relations theory. The application of neuroscience knowledge is slowly becoming an essential part of the practice base of mental health services.

Dear Thomas K, Daniel, Thomas B. and Catarina,

The comparison of behavioral theory and psychoanalysis is an important issue. To define the relationship between the two models of learning is one of the most important theoretical projects if you want to build up a comprehensive model of how embodied mind is working, taking into account also its sociability. As for my work in progress about these themes I consider Charles S. Peircean pragmatic semiotics as the missing link which helps to relate one theoretical approach to the other.

Psychoanalysis does not deny the capability of continuous learning but it centers on specific mechanisms which inhibit further learning in very specific areas.

A deterministic monocausal relationship of psychiatric disorders and childhood experiences is certainly far too simple. Psychoanalysis does not consider isolated symptoms or syndromes but comprehensive personality traits and personal biographies. Psychoanalytic thinkers have discovered a lot more traits that are not healthy although not being really psychiatric or psychological symptoms. These traits are apt to cover defects in deeper strata of personality: alexithymia which imlicit danger to produce psychosomatic symptoms on the one hand, or sexual perversion that balances panic-fueled angst or depersonalization phenomenon on the other.

As Daniel put it, « there is no doubt in the current scientific literature that the first years of life (0-3 in some places, 0-5 or 6 in others) contain the most sensitive and critical periods for human development ». In my therapeutic work as intercultural therapist I often asked myself if the ideal mother-baby-relationship that we have in mind is not too culture-bound and normative. Wouldn’t it be fairer to measure a child’s development and experiences according to the average childhood of his brothers, sisters, neighbors and schoolmates? There are many cultural norms within the relationship of mother and baby. F.e. there are African cultures where they consider too much talking with a child as very dangerous, producing eventually madness in the child.

Although countless individuals with severe deprivation during early childhood seem « normal » and with notable little neurotic disorders, many of them show low resilience after accidents, illness or loss. During therapy these patients often cannot overcome their grief, they stuck in a demanding oral position without being able to recover and use crisis to their advantage (Krise als Chance) which is one of the mottos of psychoanalytic treatment.

Dear Vera,

thank you for your differentiated statement. I think there is a lot of work to do. Easy explanations in this field suffer a lot from reductionism. There are dangers in exaggerating early childhood experiences or refusing them. My experience is that there are a lot advocates and opponents but critical disputes are rare.

Examples for dangers in exaggerating the relevance of childhood experience:

• Underestimation of plasticity in the rest of life

• Therapeutic strategies that focus too much on problems in the past.

• Blaming parents (behavior) too much to be responsible for psychopathological developments.

• Problems to explain effects of mindfulness oriented therapies, which rather focus on here and now.

Examples for dangers in exaggerating the perspective that childhood experiences are irrelevant:

• Underestimation of the sensitivity of early life periods.

• Underestimation of the responsibility of parents and relations during childhood.

• Exaggeration of the influence of situation.

• Problems to explain biographic characteristics of psychopathological developments.

I absolutely agree, that an integrative approach is needed, that integrates results of both perspectives.

To stay honest what we need is not conviction but critical research.

And critical points are not answered yet or stay unproven.

1. Concluding that any stress (or consequences of stress reactions) is more severe in childhood is only possible to test with a design that compares childhood stress experiences to adulthood stress experiences by estimating severity and respecting a long period of time. If for example adults that were stressed (stress reaction) the same way are compared to children.

2. I do not know any study that predicts depression or other psychiatric disorders in adulthood only from childhood experiences. At least not one that does the same in a comparable way with an older cohort and tries to predict psychiatric symptoms or mental disorders over a comparable time span.

3. Results that underpin, that early experiences change brain mechanisms or physiological parameters, suffer from 1. too. And observed changes of physiological factors may be seen as mediators but are not really dependent variables (psychiatric symptoms, mental disorders).

So in a critical few, if someone suffers from severe stress as an adult it as well is possible that his brain mechanisms, physiological reactions etc. change severely in a short term or long term perspective. The difference of adult to child reactions (or better in a longitudinal perspective) over a long period of time is the crucial point. Because it is trivial to conclude that stress has severe consequences to human bodies and minds.

A differential theory should be developed that integrates research findings and that allows us to develop a concept of differential resilience and vulnerability stages or coping mechanisms over the life span (children, adolescents, young adults, adults, older people).

Some examples:

Probably a war has more severe consequences for the cohort of 20 to 30 year old people compared to younger and older cohorts. And a severe winter is more dangerous for older adults in western cultures. But young children suffer most from famine in active zones. Adolescents are vulnerable for influences of peer groups but peer groups also teach them a lot. …

I am also aware that this discussion is not a new one, but it seems to me that it is still full of irrational conflicts. Some early theories (e.g. Erik H. Erikson) as well as modern developmental psychology contain interesting approaches too.

This motivated me to present the question here.

What do you think?

Regards Thomas

This is a very important topic and I thank you for raising it. Daniel Schechter framed the issue very well and provides a few good references (I think that Sroufe's carefully designed longitudinal studies are very compelling). I think that Felitti and Anda's research on Adverse Childhood Experiences (http://acestudy.org/) is very relevant to the topic. Their studies show a very strong relationship between adverse childhood experiences and later serious health and behavioral problems. Thanks again for starting this discussion here.

I've published a study that suggests potential long term effects of infancy parenting on adult externalizing psychopathology (Lorber & Egeland, 2009). However, "potential" is the key word there, since it couldn't rule out child or genetic effects. There isn't much evidence of child effects in that data set (Lorber & Egeland, 2011), but there is plenty of evidence for child and genetic effects in the literature (see Moore & Neiderhiser, 2014; a great conceptual piece). See also Haltigan et al. (2013) for a good example of enduring effects of early experiences; though it only goes up to adolescence.

Lorber, M. F., & Egeland, B. (2009). Infancy parenting and externalizing psychopathology from childhood through adulthood: Developmental trends. Developmental Psychology, 45, 909-912.

Lorber, M. F., & Egeland, B. (2011). Parenting and temperament in infancy: Testing a mutual exacerbation hypothesis to predict conduct problems. Child Development, 82, 2006–2020.

Moore, G. A., & Neiderhiser, J. M. (2014). Behavioral Genetic Approaches and Family Theory. Journal of Family Theory & Review, 6(1), 18-30.

Haltigan, J. D., Roisman, G. I., & Fraley, R. C. (2013). The predictive significance of early caregiving experiences for symptoms of psychopathology through midadolescence: Enduring or transient effects?. Development and psychopathology, 25(01), 209-221.

Thanks for the new contributions and literature,

These statements mean to me, that a lot of work has to be done and uncritical believing in naïve relations of early experience and adult mental illness or psychiatric symptoms does not really help, despite it seems obvious. By doing so in my opinion following aspects have to be respected:

• The danger of confounding long term effects over the live span with early childhood effects.

• Dynamics of human organism changes during ontogenetic development.

• Differential vulnerability (organism and mind) over live span.

• Cultural and envirionmental context of human development.

• Resilience, coping and adaption capacities of children, adolescents and adults.

• Therapeutic potential to treat if specific adult symptoms and disorder are seen too much as determined by early childhood experiences (and genetics).

And there are also some philosophical problems in this question. One is the possibility of personal freedom in the light of early childhood determination or specific interpretations of the (relative) strength of the influence of early childhood experiences on adults.

I agree with Michael that ‘potential’ is a key word. So perhaps it is possible to estimate this potential and to identify relevant course parameters (moderators, mediators) that influence the relation (during the time period) between childhood and adulthood.

Regards Thomas

Die Bedeutung frühester Erfahrungen für die spätere Entwicklung von Beziehungen und Bindungsfähigkeit war auch neulich Thema eines Vortrages von Fr. Dr. med. Katharina Kruppa aus Sicht einer psychotherapeutisch tätigen Kinderärztin (Baby Care Ambulanz in Wien) anlässlich der 29. Arbeitstagung des Wildunger Arbeitskreises für Psychotherapie e. V. - zur Frage der therapeutischen Herangehensweise diskutierten wir dort in einem Seminar über die Möglichkeiten, mit Hilfe eines Genogramms früh gestörten PatientInnen einerseits eine konstruktive Beziehungserfahrung zu ermöglichen und zum anderen durch Rekonstruktion der Bedingungen, unter denen das Leben des/der Pat. begann, die bisher erzählte Geschichte um eine zusätzliche Dimension zu erweitern, nämlich die (heilsame) Vorstellung, was dem Kind damals gut getan hätte.

There are so many good points raised by everyone who has responded thus far. I think that there are a few very basic theoretical perspectives and empirical realities that suggest at least some early experiences are really quite important to the development of later psychopathology. For instance:

- Bowlby was one of the first to suggest that the young child quite early on develops attachment styles in relation to caregivers and other important figures that drive relational expectations and subsequent behaviors. While not every aspect of attachment theory is indisputable, there's a lot of research that suggests this is a bona fide developmental construct that does have implications in dysfunctional relationship behavior into adulthood.

-While several psychological disorders occurring in adulthood have high heritability and appear to unfold naturally and without a lot of influence from the environment in terms of buffers or risk, others-- notably the personality disorders but also certain anxiety disorders (e.g., social anxiety, PTSD) have very strong or even fundamental environmental risk factors involved with them. While EARLY childhood experiences (e.g., traumas) may not be widely established as risk factors for adult disorders, it seems like there is reason to believe that there may be some influence, and certainly middle childhood stressors and learning experiences can be linked to some issues that persist into adulthood.

- On the obvious end of the spectrum, fetal and early childhood exposure to certain toxic biological stressors (e.g., lead, malnutrition, maternal drug use) has been linked to risk for disorders that persist across the lifespan.

I think it is shortsighted, in light of these and many other lines of evidence, to believe that early childhood experience cannot impact the expression of psychopathology in adulthood. The real question that may never fully be answered is "how much?"

Dear Thomas,

The question you raised reminds me the older discussion of the role of nature vs. nurture in development. Today we know that it is not one or the other but gene-environment interaction that determines development, and that this interaction is slightly different in each individual case, based on the specific genes and the specific environment s/he was exposed to.

Coming from a biological perspective and considering the psychic as reflecting what happens in the brain, I believe that because the brain develops during childhood there is a large effect of what happens to us during that time, on our psychic. Nevertheless, we know today that the brain is plastic and to some extent constantly changing, even in adulthood, in response to our experiences (and this is why therapy can be successful and effective). Thus, similar to the first question I mentioned above, I believe that both perspectives are correct, and that it is the interaction between the effects of both early childhood experiences and later experiences (as well as genetic vulnerability) that determines mental health status and symptoms.

Dear colleagues,

thanks for the ongoing discussion.

I agree with Will that one important question is ‘how much’. I also agree with Tal, that both perspectives are in a way correct. But as I pointed out above to exaggerate one perspective can lead to severe problems. I also think that the three laws of behavioral genetics should be taken into account (Turkheimer E.: Three laws of behavioral genetics and what they mean. Current Directions in Psychological Science 2000, 9 (5) 160)

1. ‘All human behavioral traits are heritable.

2. The effect of being raised in the same family is smaller than the effect of genes.

3. A substantial portion of the variation in complex human behavioral traits is not accounted for by the effects of genes or families.’

The role of environment is relevant during the whole lifespan, not only in childhood. And I believe it plays a differential role in different stages of life. But as a lot of you argued there are some measurable perhaps long lasting brain changes after childhood stress too. Additionally humans and brains seem to be plastic or able to adapt to new situations until old age. Additionally single very severe experiences can have long lasting effects in every age and long lasting stress enhances the vulnerability in every stage of life.

In consequence for psychotherapy it means that,

• early experiences can be relevant but are not significant in every case.

• psychotherapeutic treatment can lead to effects in every age because of law 3 and plasticity.

But the concrete correlations of genetics (also gene expression), brain mechanisms and environment should be studied more into depth to come to more specific answers and conclusions.

Regards Thomas

It seems to me, there might be a connection between this question an an answer to another one:

George M Tarabusly asked "Can anyone help me find work ... that addresses child cortisol response....." and

especially the studies named by  Joan Warmbold Boggs lead to interesting publications,  for example

Gunnar MR, Tout K. de Haan M, Pierce S, Stansbury K: Dev Psychobiol. 1997 Jul;31(1):65-85. Temperament, social competence, and adrenocortical activity in preschoolers.  

I think that this article cited by Dr. Kopka is a good example of work by a scientist who quite rigorously has shown that early experience is extremely important-- but it is not determinant in and of itself of later outcomes.  Fortunately, with a good enough basis in early development, there is sufficient plasticity.  That being said, at this point, there is far too much solid research on the importance of early attachment experiences on the psychology and biology (i.e. down to the level of  gene expression) of the individual to downplay their role   (see: Roth et al., 2013 in Genes Brain Behav. 2013 Oct;12(7):673-80. doi: 10.1111/gbb.12067. Epub 2013 Aug 23. Neurobiology of secure infant attachment and attachment despite adversity: a mouse model.).