Born Anxious: The Lifelong Impact of Early Life Adversity - and How to Break the Cycle

Born Anxious: The Lifelong Impact of Early Life Adversity - and How to Break the Cycle

by Daniel P. Keating


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Product Details

ISBN-13: 9781250075048
Publisher: St. Martin's Press
Publication date: 04/11/2017
Pages: 256
Sales rank: 633,832
Product dimensions: 5.30(w) x 7.90(h) x 1.00(d)

About the Author

DANIEL P. KEATING is a professor of psychology at the University of Michigan, and received his Ph.D. at Johns Hopkins. Keating has conducted research at leading North American universities; at Berlin's Max Planck Institute; and with the Canadian Institute for Advanced Research, where he was a fellow for two decades and led the program in human development. He focuses on developmental differences: cognitive, social, emotional, and in physical and mental health. He resides in Ann Arbor, Michigan.

Read an Excerpt

Born Anxious

The Lifelong Impact of Early Life Adversity - and How to Break the Cycle

By Daniel P. Keating

St. Martin's Press

Copyright © 2017 Daniel P. Keating
All rights reserved.
ISBN: 978-1-4668-8648-3



The Biological Impact of Rising Inequality

The battle over nature versus nurture — over the importance of qualities we inherit as a result of genetics versus those that come from things we are exposed to after we are conceived — has raged for more than a century. And at the time I entered the field of psychology, that battle had entered a particularly nasty phase. Little did anyone know that a new science was taking shape that would forever transform this battle — in fact, it would render it obsolete. The result would directly impact my chosen field.

* * *

In the late 1980s and early 1990s, headlines like "Murders Surge As Crack Spreads" and "Race, Genes and IQ" screamed from newsstands. The social safety net was rapidly fraying, with proposals to roll back the Great Society emanating from the White House. The liberal efforts of the 1960s were widely viewed as having failed, and even if this wasn't entirely accurate, the political direction seemed to be taking a different tack. Doubts about the costs of social programs, their effectiveness, and even their fairness were rising fast.

From this swell of anxiety and uncertainty emerged the outspoken University of Chicago political scientist Charles Murray, who argued that welfare and the social safety net had done little more than encourage dependency. Murray launched a project designed to test the idea that racial inequality was based on, as he put, "intractable race differences" in intelligence. With The Bell Curve, the bestselling book he coauthored with Harvard psychology professor Richard Herrnstein, hit the bookstores in 1994, Murray would push this stance even further, claiming that African Americans and the poor could not succeed because "what's holding them back is that they're not bright enough," and that welfare along with remedial education efforts should be tossed overboard. "For many people, there is nothing they can learn that will repay the cost of teaching," was his dire conclusion (New York Times, October 9, 1994, "Daring Research or 'Social Science Pornography'?"). The book took a clear stance on the nature-nurture debate, and it spawned a rancorous public debate, with other scholars attacking the credibility of its statistical analyses, its unstated assumptions, and its failure to consider alternative explanations.

Nurture wouldn't go down without a fight, though. Taking an opposite tack, but with equally dire implications, the "culture of poverty" arguments began to make a comeback to redirect blame away from ineffective antipoverty programs and place it on those who were the most vulnerable. Harking back to Daniel Patrick Moynihan's famous and controversial 1969 report, "The Negro Family: The Case for National Action," there was a resurgent belief that the ills of the "underclass" arose from cultural deficiencies. In Code of the Street, the sociologist Elijah Anderson argued more persuasively that the claim of presumed deficiencies misunderstood the real cultural imperatives at work. Because inner-city youth were blocked from more traditional ways to succeed and achieve a meaningful identity, the violence and criminality that they engaged in were in fact adaptive in their circumstances — even if they ran against mainstream norms.

In part, both of these schools of thought rose in reaction to the claims of the Great Society and War on Poverty initiatives, which implied — or said outright — that increased attention and funding would soon take care of persistent problems by improving the social environment. But with rising rates of violent crime and limited progress on child poverty, clearly they hadn't succeeded in the public eye. The argument that more spending was the answer, that we hadn't done nearly enough to implement promising programs like Head Start, was met with increasing skepticism, even when there was evidence to support this unpopular rebuttal.

So we basically had a replay of the nineteenth century, when the social Darwinist belief in the survival of the fittest — as shown in the "natural superiority" of white Europeans — led directly to the eugenics movement in the early twentieth century. This supremacy of the nature view resonated clearly in the work of Murray and others, like the psychologist Arthur Jensen, who explained the better performance of whites in the United States by claiming that they had a superior genetic endowment. And yet the counterargument — that genes played no role and that good nurturing could conquer all — wasn't viable either, as we uncovered genetic vulnerabilities that created particular challenges for some children — like dyslexia, attention disorders, and other learning disabilities.

This nature-nurture game had been going on for so long, and so fiercely, it almost required picking a team — Team Nature or Team Nurture — not only among culture critics, but among researchers as well. Even those who acknowledged that both nature and nurture mattered couldn't move the ball much — no one could say exactly how they mattered or what to do about it.

Meanwhile, these extreme positions exerted powerful influences on key policy decisions that were being made based on faulty science — sharp reductions in education for low-income populations, deep cuts in the social safety net, "superpredator" laws that removed judicial discretion in favor of harsh mandatory sentencing — all of which created consequences that bedevil us to this day, like mass incarceration, which rose dramatically over twenty years, from an already shockingly high rate in 1990 (1,860 out of every 100,000) to over 2,200 in 2010 — and almost twice that for African American men. The statistics alone fail to capture the disruption created in individual lives, families, and entire communities. Although most striking for African Americans, the pattern was similar for white Americans, as the overall rate of imprisonment continued to rise, long after the drop in the violent-crime rate that began in the mid-1990s and still continues.

In short, we were stuck. We were stuck in policy debates based on stubbornly misguided science. Researchers, including me, were stuck in the middle of an either-or dichotomy that was increasingly sterile. And we were all stuck in a nature-nurture debate that had gone nowhere for more than a century.


In the spring of 1992, out of the blue, I got a call from someone asking if I might have time to speak with a man named Fraser Mustard. I had no reason to suspect that this call would not only change my research career dramatically but also lead to a new way of looking at nature and nurture, eventually breaking us out of the box we'd been mired in for decades — and in the process offering insights that would affect not just the debate on poverty but other social ills, including chronic stress, social inequality, health and health care, and mortality.

I'd heard the name before — I knew his team had played a significant role in the discovery that aspirin could help to prevent heart attacks and strokes. As I soon learned, Fraser Mustard was nothing if not ambitious in his goals. Just like the work leading to the now-common use of low-dose aspirin to prevent initial or subsequent heart attacks that have extended the lives of thousands, he was deeply interested in new areas of science that could make a difference for society as a whole. Quite soon, this man with the unusual name would come to mean much more to me, drawing me into the heated nature-nurture dispute in an entirely unexpected way, leading me to a completely new way of looking at why some kids struggle while others thrive.

* * *

A decade earlier, Mustard had founded the Canadian Institute for Advanced Research, an international think tank that was driven by the simple insight that the best way to tackle really complex problems with multiple causes was to assemble a diverse team of the very best experts capable of addressing each cause. With very little by way of introduction, and no explanation of why he was calling, Mustard asked me if I'd heard about three recent studies that, he said in his probing way, had intriguing implications individually and perhaps even more intriguing implications when considered together.

He started by talking about something called the Whitehall Study. This now-famous study of the health of British civil service employees in the Whitehall district of London, led by British epidemiologist Michael Marmot, was conducted twice, once in the 1960s and again starting in the late 1980s. Marmot found that lower-ranking employees were four times as likely to suffer serious illness (such as heart disease, chronic lung problems, and depression) and earlier deaths than higher-level administrators. Interestingly, because researchers had narrowed their observation to these British civil servants, they were able to exempt the usual reasons offered to explain such a phenomenon: the physical demands of a job (pushing paper is, after all, not arduous labor), limited access to health care (there is universal health care in England) and lifestyle (smoking, diet, and exercise), which they measured through questionnaires filled out by participants. And yet, even with these factors removed from the equation, between 65 percent and 75 percent of the health differences associated with social status were left unexplained. This mystery caught Fraser's interest — what else could be causing those lower on the totem pole to fall ill? But he was also taken by the fact that these weren't the usual victims either. Until this point, research had been centered on the health impacts of being poor, but here, the sufferers were clerks in the British civil service. They were lower on the pecking order, to be sure — but they were hardly poverty-stricken.

Fraser then moved on to the work of an American psychologist named Emmy Werner, who focused on resilience — the reality that some children who experience early life adversity, indexed by various risk factors like economic or social disadvantages, nevertheless enjoy substantial success in later life. She had recently published a book, Overcoming the Odds: High Risk Children from Birth to Adulthood, which followed a group of 505 men and women on the Hawaiian island of Kauai — many of whom didn't graduate from high school and went on to work as unskilled laborers — and tracked risk and stress as it played out in their lives. Ultimately, Werner found that those who were able to rebound from setbacks and troubles in early life had benefitted from a close nurturing relationship in childhood or adolescence–either with a parent or with someone who stepped in to fill that role. This success against the odds set by early life adversity was not a widespread phenomenon — it benefitted around 10 percent of those she'd followed — but it suggested an intriguing possibility: that the right kind of nurturing might repeal some of the damage low social status could inflict.

Lastly, Mustard brought up a theory put forward by the British medical researcher David Barker suggesting that a baby's nourishment in utero was a crucial factor in predicting aspects of adult health decades later, including blood pressure and heart disease. This so-called Barker hypothesis, which had emerged two years earlier, in 1990, represented a revolution in the way we thought about how social factors impact adult health. Until this work appeared, most of the focus was on stressors that happened during adulthood, like difficult working conditions. This research showed that the more important link was between prenatal conditions in utero and later adult health. Barker had examined the detailed medical records of 449 men and women born in Preston, England, between 1935 and 1943, following them from birth until their late forties and early fifties. Those most likely to suffer heart disease were the group whose birth weight was substantially less than expected based on placental weight — indicating the fetus had not grown to optimum weight. Although Barker made the link between fetal growth and adult heart disease clear, he did not offer the cause.

After reeling these three studies off, rat-a-tat-tat, Mustard now paused for breath. And then: did I see the connection? He could see from Marmot's study that there was clearly something else — something linked to our socioeconomic circumstances — affecting our health that had not yet been revealed. Werner's work on resilience offered the glimpse of a solution, or at least a way to ease the harm our early life circumstances might inflict on us. And yet Barker raised the disquieting possibility that there might be factors, in addition to the social elements Marmot had introduced, influencing our health before we'd even entered the world.

What was really at the heart of these seemingly disparate studies, however, was the notion that one could not simply point a finger at nature or nurture. These findings were beacons signaling that there was something larger and more complicated going on than the intellectual leaders of our day would have us believe. Mustard didn't yet know what that something was, but it seemed clear that venturing further down this road might offer an alternative argument to the sterile debate raging around us.

I was intrigued. My own work to that point had focused on trying to find the hidden forces driving otherwise bright kids — the Jasons and Davids of the world — to lose control when push came to shove in the classroom or at home. And I, too, had been working to escape the confines of the national conversation. In speaking with Mustard, I saw that by closely studying the interplay between the two — nature and nurture — we might uncover just how they influence our lives. And perhaps this would offer real help for those whose fates were being inexplicably altered by their circumstances and their genes.

Within days, Mustard and I were meeting in his CIFAR office in Toronto. (I was working as a professor of applied cognitive science at the University of Toronto at the time.) When I encountered him in person, I glimpsed the U of T football player he'd been long ago — he was a towering figure with a sturdy build. And yet his white ring of hair, like a halo around his otherwise bald head, combined with his frank open-mindedness, made him seem more like a Benedictine abbot from the tenth century.

He got right to the point: he wanted to launch a new CIFAR program that would examine the developmental reasons behind why some people remain healthy while others do not. He had an instinct that the research we'd discussed was only the beginning of a larger conversation. Clearly, the classic accounts for the ways in which social status — whether measured as income, school achievement, or career standing — affected our health were not enough. He wanted to find the missing piece. He also believed that more than just our cardiovascular health could be determined in our early lives. Barker's work may have only opened a door. In the end, it boiled down to this question: what else could be radically affecting the health of certain adults — and when did it take hold?


A year later, we launched a new program — the Human Development Program (HDP) — with me at the helm. We assembled a diverse group of experts, which included an epidemiologist, a couple of neuroscientists, a child psychiatrist, two developmental psychologists, and a primatologist, who worked with monkeys exploring the behavioral and physiological consequences of early nurturing deprivation. The studies that Mustard had cited — by Marmot, Werner, and Barker — were like three pieces of a puzzle, offering an early, albeit incomplete, picture, and now we had to fill in the rest.

We decided to start at the beginning — that is, the beginning of life. We would seek out research expanding on Barker's theory that our experience in utero affected our adult health. Barker's work had been very specific, looking mainly at heart disease; we wanted to explore other problems that might have their origins in utero. And we also wanted to follow through on how environment might continue to affect a person after birth.


Excerpted from Born Anxious by Daniel P. Keating. Copyright © 2017 Daniel P. Keating. Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents



Chapter 1

A Story of Human Development

Chapter 2

Destined to Thrive, Destined to Struggle:

The Critical Period of Baby’s First Year

Chapter 3

Into the Arena:

The Social World of Schools and Peers

Chapter 4

Onto the Stage:

Stress and Coping in Adolescence

Chapter 5

The Stress Tests of Adulthood:

Maximizing Family, Work and Relationships

Chapter 6

The Stress Epidemic:

The Hidden Cost of Social Inequality

Chapter 7

Inequality is not Destiny:

How We Can Break the Cycle


Research Background: A Primer

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