6

Tea for Two
THE ROLE OF TEMPERAMENT

“What is REAL?” asked the Rabbit. . . . “Does it mean having things that buzz inside you and a stick-out handle?”

“Real isn’t just how you are made,” said the Skin Horse. “It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become real.”

“Does it hurt?” asked the Rabbit.

“Sometimes,” said the Skin Horse, for he was always truthful. “When you are Real you don’t mind being hurt.”

“Does it happen all at once, like being wound up,” he asked, “or bit by bit?”

“It doesn’t happen all at once,” said the Skin Horse. “You become. It takes a long time. That’s why it doesn’t happen often to people who break easily, or have sharp edges, or who have to be carefully kept.”

—MARGERY WILLIAMS,
The Velveteen Rabbit

The main difference that I see between me and John is that John was always one to stand back from a situation. He would detach himself and evaluate whatever circumstances in our environment that life brought our way. Whereas me—I wouldn’t take that time, that, you know, maybe split second, you know, to stand back from a distance and look at the situation and assess it and figure out what would be the most effective way of going about things. I would just kind of jump in with both feet, just deal with it at the moment and take whatever consequences came—whatever hit me—instead of stopping like John did and looking.

—JEFFREY, AUGUST 1996

We could all go out and do this one thing and we could talk about it later, and Jeffrey and my grandma, well actually my grandma, would say something about how it was, and it didn’t actually happen that way . . . I’d see it a different way. And I would ask someone else, like one of my friends or whatever, and they’d say, “Yeah, that’s exactly the way I saw it.” And I’d say, “Well, did you see it the way my grandma saw it?” And they’d be like, “Well, no, I didn’t see it like that.” ’Cause you know they [the family] have this funny thing. It’s like when we do things or we experience things or when certain things happen, it’s like they twist it around to being something either better or sometimes they even make it worse than what it really was, you know. And a lot of times I just try, I’ve always tried, to keep an open mind and see what I see. It was like most of the time I had to agree with them. I’d just say okay because I didn’t want to get in a long argument with them. But I’d be like, “That’s wrong. That’s not the way it was. But have it your way or whatever.”

—JOHN, AUGUST 1996

A personal opinion on me and my brother. . . . See, the way I look back on things, I look back on it and remember the feelings that I had. I remember it like it’s happening again when I remember it. But the way John remembers things is that he detached himself from everything that was going on and he just kind of took it like, “Oh well—that’s just some more bull shit.” There was just so much chaos. . . . The way that he dealt with it and the way he accepted being bounced around was to distance himself. We’re like total opposites. John all his life has known what he wanted in life, and he can tell you. The way he puts it really makes a lot of sense. He thinks it goes back to Walt and Bev [foster parents when John was five]. He’s seen a functional family, and they took really good care of us. He’s seen a lot of love—we hated being taken from there.

—JEFFREY, AUGUST 1996

Any of us who have stood and really looked at a nursery of newborn babies or have parented more than one infant or observed other families with more than one baby knows that babies are not alike. In spite of some basic physical likenesses, newborns are almost as different from each other as are individuals of all ages. One baby will cry ceaselessly at being bathed or dressed. Another sleeps through it all. Researchers studying this reality have confirmed that babies vary markedly in their dispositions from the beginning and that a number of their characteristics remain stable over time.1

Differences in behavioral style or temperament have captured people’s attention since ancient times. Dr. Jerome Kagan drew on this history to name and frame his fascinating book on child temperament: Galen’s Prophecy. In this volume, Kagan explains that the Greeks and Romans framed human behavior as falling into types that stemmed from varying balances among the four humors: blood, phlegm, and yellow and black bile. Observed differences in human rationality, emotionality, and behavior were accounted for in terms of the relative distribution of the humors in interaction with the bodily qualities of temperature and moisture. In the second century, a philosopher named Galen outlined a behavioral typology that remained influential until the end of the nineteenth century, when philosophers reframed Galen’s “choleric” as “bilious,” “phlegmatic” as “lymphatic,” and “melancholic” as “nervous,” while “sanguine” held its own. Remarkably, however, throughout the centuries of evolving thought, individual physiology was seen as responsive to environmental forces such as climate and diet. Although the early typologies sound prosaic in light of current thinking, they have a lot in common with current biosocial views of human behavior. The interaction of biology with the environment is at the heart of current explanations of human behavior, and several schools of thought have opened windows of knowledge onto how this process works. Chapter 5 looked at the roots of violent behavior through the window of the disruptive behavioral disorders first appearing in childhood: ADHD, ODD, and CD. Another group of researchers, studying these and the whole range of nondisordered children, are examining temperament. Though the terminology and orientations are different in these two branches of research, both groups appear to converge with strong interest on children who are aggressive, impulsive, and difficult to discipline from early in life.

Temperament is often confused with personality, but the two are not the same. Personality consists of the combination of temperament and learned experience, especially as it relates to habitual behavior and ways of coping with the world, along with ideas about what the self and others are like. Temperament, a subset of personality, refers to children’s basic orientations to emotion and arousal. These orientations are woven into our genetic endowment, underlie personality, and shape how we respond to learning experiences. At the core of temperament is central nervous system circuitry and chemistry that determine our most fundamental emotional and behavioral responses to life situations. Temperament traits include biologically rooted predispositions to respond to situations of danger or challenges, positive opportunities, and impediments with a given emotional style. They also describe our sensitivity to stimulation and our attentional responses. Temperament appears early in life and is greatly influenced by environmental experiences even before birth.

MARCHING TO THE BEAT
OF A DIFFERENT DRUMMER

This concept of the interactive nature of temperament with the environment, especially for infants with their parents, was a difficult concept to sell in the human sciences in the 1950s. Following a long period of belief in genetic determinism, the influence of the nurture side of the nature-nurture argument was in full swing. When it came to babies, it was commonly accepted that environmental factors made all the difference in who they became. Any variation in infant behavior was attributed to the child’s treatment at the hands of caregivers. Mothers, who were generally the primary caregivers, were assigned the burden of guilt for a child’s behaviors. This was the milieu in which Drs. Stella Chess and Alexander Thomas, married psychiatrists, began their own family. In bringing up their children, they began to question whether the development of a child’s behavior was solely a one-way process. The child’s experiences in the home did not seem to be inscribing personality on a blank slate. Drs. Chess and Thomas noticed that often parents with good skills had difficult children and that competent children sometimes emerged from families with multiple problems. They began a lifelong search for explanations for these developmental disparities.

Beginning in 1956, Chess and Thomas undertook the New York Longitudinal Study to investigate whether and how a baby’s inherent characteristics influence his or her developmental outcome. Starting with babies at the age of three to six months, Chess and Thomas and their associates observed and interviewed 133 parents and their children in standardized contexts and at regular intervals into the children’s late teen years. They continued periodic follow-up interviews with the children into their late thirties and early forties. The original research findings from this study have influenced hundreds of studies including a temperament study done by Kaiser Permanente on 8,000 children in Northern California.2

Dr. Chess and Dr. Thomas identified nine characteristics that appear to underlie the variability in infants’ responses. The nine ­dimensions—still used today—are: activity adaptability, approach/­withdrawal, rhythmicity, threshold, intensity, mood, persistence, distractibility, and sensory threshold. Every child has all of the nine specific traits in varying degrees. Temperament characteristics, while influenced by caregiving, are not caused by the quality of caregiving. Based on an assessment of variations in these traits, Drs. Chess and Thomas grouped characteristics into three categories of temperament, which describe most but not all children: easy, difficult, and slow to warm up.

“Easy” children are characterized by regularity, high adaptability, a preponderantly positive mood of mild or moderate intensity, and regularity of sleep and feeding patterns. They are adaptable, pleasant, smile at strangers, and are easy to be around. Forty percent of the children in the study sample fit within this temperament category. On the other end of the spectrum were the “difficult” children, about 10 percent of the children studied. These are the children who are irritable and withdraw at exposure to new people or situations, who are slow to adapt to change, display a frequently negative mood, and have irregular sleeping and eating patterns. They cry more frequently and may throw tantrums with little provocation. In the middle are children who have a mild positive or negative response to new stimuli, but who can be engaged with extra effort. These “slow to warm up” children comprised about 15 percent of the New York Longitudinal sample. The remaining 35 percent fell into none of the three temperament groups designated by the researchers.

Chess and Thomas assert that each child has a characteristic style and relatively predictable orientation in response to new people, situations, and events. The researchers are careful not to assign a positive or negative value to a particular temperament style. No one style is predestined for aggression, violence, or any other particular outcome. The focus of this body of research is the degree to which there is an alignment between the child’s temperament and the traits valued or called for in his or her environment, particularly by the parents. Drs. Chess and Thomas call this match between the child’s traits and the parenting environment “goodness of fit.”3 How any of us become who we are is not a result of just genetics or just environment. Rather, it is the result of the interaction of both variables—especially temperament with parental responses.

The value of the temperament perspective lies in its capacity to identify children who may be seen as difficult by their caregivers, so that parents can be provided with the emotional support and education necessary to establish goodness of fit. While temperament theory would not identify difficult children as posing increased risk of violent behavior, there is evidence that babies perceived by their caregivers as having difficult temperaments are at higher risk of child abuse and the resulting behavioral problems arising from conflict between parent and child that can precede violent behavior. This is especially true when such difficult children are born into chaotic and unstable environments in which their parents are stressed by multiple problems and are uneducated about how to best work with their children. Temperament can be one ingredient in a compromised beginning that in turn sets the stage for performance and self-image problems. Early assessment and guidance can make major differences.

Consider the story of Anthony, born into a middle-class environment, a first baby for Elizabeth, an outgoing young lawyer, and her boyfriend. Anthony had a difficult time from the beginning. Following a normal and drug-free birth, he was unsuccessful at nursing, even after weeks of effort by both his mother and a lactation specialist. A series of bottle-fed formulas seemed to disagree with him, and he spit up frequently. He was irritable and had an intense, high-pitched, “angry-sounding” cry, which seemed to his mother to be his primary effort to communicate. He had difficulty sleeping, and even small noises awakened him. He was interested in watching the family dog and things around him but did not want to “talk” with or look at his mother. He would not cuddle or mold to her body when she held him, and he felt rigid to her—“like a board.” His sleep patterns were irregular, and he reversed night and day for his first four months after birth. He responded erratically to Elizabeth’s attempts to comfort him. When he cried, he often could not be comforted by holding. When she put him down, he would scream until he was picked up, quiet for a few seconds, and then suddenly arch his back to be put down. Elizabeth said she never knew what to do to please him. New situations like a trip to the grocery store sent him into his angry cry. Elizabeth increasingly felt herself a failure as a mother, a perception validated by her critical and sleep-deprived partner.

Having anticipated a loving baby who would provide the affection she longed for from her boyfriend, Elizabeth was constantly anxious and distraught. Her pediatrician, perceiving nothing unusual in the baby’s behavior during office examinations, encouraged her to try antidepressants. Attributing all the problems to herself, she felt even less self-confident. Her irritability with Anthony began to mirror his. Finally, a long-pursued referral to a pediatric development specialist turned the tide. The doctor found that Anthony had digestive difficulties (reflux) combined with an irritable and reactive temperament. She helped Elizabeth to better understand Anthony, to appreciate his high need for motor activity, and to better interpret his cues. Instead of seeing Anthony as a baby who didn’t have much interest in verbal exchanges with her, Elizabeth began to view him as a baby who was extraordinarily curious about the big world and determined to use his limbs to get there. As a result of this new, non-blaming, and value-neutral information, Elizabeth shifted her perception of Anthony and shifted her self-blame to an understanding of her baby’s needs and a constructive course of action. Anthony was intensely sensitive to sights and sounds and required a subdued level of stimulation. Elizabeth adapted his environment, lowering the stimulation level by limiting visitors, using a blanket to reduce visual stimulation in new places, and using gentle music to provide “white noise” during naps. She continued to take him to new places in order to stretch his capacity for tolerance but learned to do so at a pace that Anthony could manage without becoming overloaded.

Anthony and Elizabeth began to enjoy each other. At six months, they showed little resemblance to the mutually frustrated dyad they had been just a few weeks before. Anthony was still a challenging baby. At eighteen months, he was very active and still became overloaded easily by too much stimulation. But by the time Anthony was seven months old, Elizabeth perceived him and herself as competent and well matched in intensity and intelligence. She took great pride in his progress and his unique personality. Babies with easy temperaments now appeared to Elizabeth to be somewhat “sluggish” when she compared them with her own little boy’s “high-spirited” approach to the world.

Because negative patterns of interaction are often difficult to change once they are established, the temperament research presents another powerful example of the opportunities for maximizing positive outcomes present in the first two years of life. It provides a way to help parents understand their child’s unique qualities and defuses the tendency for parents either to blame their own failings or to see their child’s temperament traits as deliberate misbehavior. The ability to prevent a continuing cycle of parent-child conflict at the outset or to derail it before negative patterns are well established depends on getting to difficult children and their parents as soon as possible after birth.

While education and emotional support for parents do not change a child’s temperament, they can help reduce the early rage so likely to occur when a pattern of escalating negative interactions is triggered as a result of a poor match between child temperament and the environment, particularly caregiver expectations, perceptions, and skills. Several clinical sites around the country are finding that such an approach is effective and that the cost of assessing temperament and following up on difficult infants is a fraction of the cost of waiting until entrenched problems result in child abuse or school problems.4

Since the early research by Drs. Chess and Thomas, several ­branches of temperament research have developed, each varying somewhat in the names and numbers of temperament dimensions identified and some preferring to group dimensions into two or more typologies. Dr. Jerome Kagan, who has written extensively on this subject, focuses on two primary dimensions: reactivity and inhibition. Several other researchers, such as Drs. C. Robert Cloninger and Felton Earls, have outlined slightly more elaborate systems, each with three or four dimensions. While there are some variations among these systems of temperament classification, each includes a basic response style to new situations and a measurement of the degree of emotional reactivity or intensity the child experiences in those situations. In Kagan’s typology, children are essentially viewed as responding positively (eagerly, exuberantly) or negatively (fearfully) to new people, events, situations, or things. Fearfully oriented children are viewed as “inhibited” or cautious. Those children comprise about 15 percent of all children. On the other end of the continuum are fearless children, who are viewed as “uninhibited” or bold. Those children, who are mostly boys, comprise about 30 percent of all children. Most children fall somewhere in the middle. Dr. Kagan introduces his book Galen’s Prophecy with the examples of Walter Matthau and Jack Lemmon in The Odd Couple.5 Lemmon’s character, Felix, typifies the sensitive, carefully restrained individual, cautious to the point of neurotic, while Matthau, as Oscar, is gregarious and constantly at risk of behaving like the proverbial bull in the china shop. Oscar and Felix clearly represent the extremes in temperament differences—most of us fall somewhere in the middle—but they illustrate the concept of the basic inborn emotional orientations that are with each of us from the beginning.

Dr. Kagan attributes our propensity toward cautiousness or boldness to inherited biology, particularly brain neurochemistry. Researchers suspect that children like Anthony who are easily overwhelmed have an “excitable limbic physiology.”6 This biology is actively influenced by environmental conditions, interacts with experience over time, and can shift. The key in the beginning is our relationship with our primary caregiver.7 The child’s temperamental profile at any given time is the result of the interactive process between innate, physiologically determined tendencies and the responses the child experiences in the environment.

While we know that infants enter the world constitutionally predisposed to certain temperament qualities, the pivotal role of the home in shaping those qualities can hardly be overemphasized. In one study by Doreen Arcus, approximately 60 percent of infants assessed to be highly reactive at four months of age did in fact become very fearful toddlers at fourteen months. The remaining 40 percent of the babies had experiences with their caregivers that the researchers believe balanced or offset fearful temperaments.8 Arcus observed that maternal holding and limit setting had key roles in sustaining or discouraging fearful behavior. Children who developed relatively less fearfulness were those whose mothers held them less frequently when their babies didn’t require it for comfort. These mothers also used firm and direct limit setting, clearly stated commands, and followed through to enforce their baby’s compliance by redirecting, distracting, or removing the baby from an undesired situation. The researchers’ interpretation of these observations was that parents who created challenges by setting limits and allowing children some opportunity to console themselves actually stretched the children’s ability to cope with unfamiliar situations.

Research with rhesus monkeys has shown very similar outcomes. When little monkeys who were bred for fearlessness or less reactive temperaments were placed with mother monkeys who were inhibited by nature, the young monkeys showed little change in behavior or in neurochemistry as measured by norepinephrine levels and electroencephalogram (EEG) tests. The inhibited behavior of the mothers had minimal influence—her fearfulness rolled off the backs of the bold babies. But when little inhibited or fearful monkeys were placed with uninhibited mothers, both their biology and their behavior shifted over time to reflect that of their foster mother’s. They became less fearful, and their levels of norepinephrine decreased.9

Tracing the developmental path to aggression or violence through the lens afforded by the temperament theorists is a complex process. This branch of psychology is relatively young and there is much disagreement about terms, definitions, and constructs. Some temperament theorists, such as Dr. Kagan, identify typologies (e.g., “inhibited/uninhibited”) that describe behavioral extremes for the purpose of study and providing parental support. Others, finding typologies too limiting, prefer to study dimensions such as “irritability” or “fearfulness.”

Regardless of these differences, the temperament literature offers some valuable insights in discerning children at risk of behavioral problems. Children at greatest risk of later aggression may be those who begin life with high degrees of irritability, are persistent, are low in their responsivity to caregiver feedback, and show marked levels of early distress to limitations, such as dressing and diapering.10 The rating of children on these dimensions has been done primarily through standardized parent ratings. Parent ratings are key in temperament research because it is the parents’ perception of the child together with the parents’ own temperamental traits, values, and expectations that may, in fact, edge the child’s developmental course toward later aggression or other negative behaviors. When such children are perceived by their parents as angry or naughty, the result can be a high degree of conflict or “poorness of fit” between the child and his or her parents. The child’s irritability elicits an irritable response from the parents, which in turn increases the child’s irritability. This increases the parents’ perception of difficulty and their own irritability. In an environment without social or emotional support for parents encumbered by additional stressors, such as poverty or mental illness, this early pattern of negative interactions is the beginning of what can develop into a path to chronic anger, frustration, and later aggression. So while certain inborn characteristics may begin the cycle, specific parental responses that also begin at birth lead the child to emphasize some behaviors more than others.11 The interpretation of the child’s behavior and the contingent responses by the parents to the child’s behavior greatly influence the progression toward expressing prosocial or antisocial behaviors.12 According to Kagan, aggressive children are bold children who are indulged, abused, or poorly socialized so that they become bullies.13

A central lesson being learned during infancy and earliest childhood is how to soothe oneself or to self-regulate strong emotions. This begins with the model provided by the parent. When the baby gets upset and her mother responds by going to the child, picking her up, verbally soothing, holding, and rocking until she calms, the child begins to learn how to do this for herself.14 During a specific window of time, between ten and eighteen months, the orbitofrontal area of the prefrontal cortex is creating connections with the limbic system that will enable the child to modulate distress. Norepinephrine is a key ingredient in activating the limbic system. In addition, parental behaviors have a direct impact on the maturing vagus nerve, which regulates the heart, sends signals to the amygdala from the adrenal glands, and prompts the fight-or-flight response.15 When the baby is initially alarmed, her brain is generating stress responses with strong signals from the limbic brain to the cortex. A host of stress-related neurochemicals surges in the child’s central nervous system. The child feels upset. When the mother soothes the child quickly and sensitively, the chemistry of alarm in her brain subsides and is brought back into balance. The baby feels better and connects this feeling with the presence of the mother. A repeated course of soothing interactions creates a “map” or model in the child’s brain that anticipates similar interactions in the future and will later enable the baby to generate soothing for herself. But for the child who is left to cry, or whose distress is followed by unpredictable or abusive responses—a blow, an angry voice, or rough handling—no such connections are made. Rather than associating the presence of the caregiver with a positive or soothing experience, the child remains fearful or experiences mixed feelings such as anger combined with some relief from physical distress (e.g., hunger). The baby does not experience regular and immediate release from the chemistry of fear and does not learn a smooth and immediate route to modulating these strong feelings of fear or anger. Such a baby may be left flooded with strong emotions she can act out only by screaming or flailing.16

Learning changes the brain. The brain directs behavior. When these basic processes—such as the ability to regulate strong emotion—are learned from negative models and are built into an individual’s personality, learning, as well as relationships, can be impaired. The child who continues to throw tantrums and is aggressive with other children in response to wanting his way and the child who freezes, withdraws, and becomes mute in the face of perceived conflict are both reflecting learned models of what has worked with their early caregivers. These models build patterns, which, if not interrupted, can jeopardize future relationships and—if strong enough—steal the child’s attention from a focus on school. The foundation for our primary patterns of coping with strong emotions is laid early in life. As Daniel Goleman says in his book Emotional Intelligence:

Each period represents a window for helping that child install beneficial emotional habits or, if missed, to make it that much harder to offer corrective lessons later in life. The massive sculpting and pruning of neural circuits in childhood may be an underlying reason why early emotional hardships and trauma have such enduring and pervasive effects in adulthood. It may explain, too, why psychotherapy can often take so long to affect some of these patterns—and why, as we’ve seen, even after therapy those patterns tend to remain as underlying propensities, though with an overlay of new insights and relearned responses.17

By preschool, all children are experiencing anger, and displays of aggressive behavior are normal. But, depending on the child’s temperament and the responses of early caregivers, many children who have not learned to put strong negative feelings into words have developed a characteristic pattern of either “internalizing” or “externalizing” these strong emotions, especially anger. Internalizing children are those who hold or repress the negative feelings. They feel powerless to act, may be quiet or tearful in the face of conflict, and may unknowingly turn their fury toward themselves. Temperamentally cautious, fearful, or highly sensitive children are the most likely to develop this pattern. In an abusive environment in which a caregiver is emotionally unavailable to help such a child with the regulation of strong negative emotions, internalizing children may develop generalized anxiety and later depression or panic disorders. These are often the children who seem the easiest to socialize because they comply to avoid negative consequences, to which they are particularly sensitive. They may more readily internalize self-discipline and show earlier signs of conscience.18 But, like little pressure cookers, they also may repress negative feelings and then explode in aggressive behavior.19 In an overly punitive or critical environment, the price to children who internalize is self-directed emotional violence resulting, at a minimum, in the erosion of confidence and competence and, in the worst cases, in suicide.

At the other extreme are the children who externalize their angry feelings, who act out their anger in aggressive ways against other people and things. These are the hitters, yellers, biters, kickers, and destroyers of property. Externalizing preschoolers present a challenge to their classrooms. They may be viewed as leaders or troublemakers or both. What such children usually have in common is a bold temperament, relatively less fearfulness, and less sensitivity to potential negative consequences of their behavior. Neurochemically they may have relatively lower rates of norepinephrine, allowing them to proceed undaunted by a reactive nervous system.20 They set their own course. Such children, when growing up in homes where parents are skilled at setting limits and use praise rather than punishment, are more likely to develop prosocial behaviors. Bold children allowed to run over others or who meet with harsh punishment may become aggressive bullies. When this pattern of externalizing feelings is accompanied by poor impulse control and an inability to focus attention, it may trigger an assessment of attention-deficit/hyperactivity disorder in the average preschool or grade school.

The information arising from temperament research is particularly useful in infancy and toddlerhood when it enables the early identification of children with challenging characteristics who may be experienced by their parents as seriously difficult. If a child with these temperament qualities can be supported by parents during infancy, especially when parents are experiencing multiple additional stressors (divorce, single parenting, poverty, physical or mental illness), the provision of information (especially around how to discipline, together with emotional support for both the parents’ and child’s needs) can offset or moderate children’s tendencies to externalize or internalize.

When this early opportunity is missed, and when externalizing or aggressive behaviors become chronic, the stage is set for the more serious behavioral disorders of ODD and CD. At ages two and three years, even when early parent-child patterns have been negative, a great deal can still be done to change this path.21 But if allowed to persist to ages four and five, chronic noncompliance, restlessness, and aggression with peers can become strongly entrenched. These are strong predictors of antisocial behavior problems during adolescence and adulthood.22

Researchers are exploring several theories that may explain the biological basis of temperamental differences. Biosocial researchers hypothesize that, since norepinephrine is involved in the loop between the limbic system and the cortex, which is the seat of control, children who have very high norepinephrine levels are more reactive to extremely low doses of stimulation. These are the children who, like little Anthony, are reactive to small changes and subtle levels of stimulation and respond irritably by fussing or crying. These babies are likely to be more cautious, though not necessarily shy.23 Conversely, children with low norepinephrine levels experience very low levels of arousal, so that they require higher levels of stimulation to achieve responsiveness to external cues such as parental warnings.24

Another theory about the biological basis of temperament points to structural differences in the brain. Asymmetries between the right and left hemispheres of the brain account for predominant moods that affect all of us. Emotional development appears to be inextricably linked with brain development—both inherited and environmentally shaped. Temperamental tendencies to be outgoing or shy, joyful or melancholy, appear to be associated with differing degrees of activity in the right and left frontal lobes. Work by Dr. Richard Davidson at the University of Wisconsin and Dr. Nathan Fox at the University of Maryland has confirmed that the left frontal region is activated during experiences of emotions such as joy, interest, and anger, while the right frontal region is activated during the experience of sadness, distress, or disgust. Drs. Davidson and Fox hypothesize that these differences in frontal lobe activation, as measured primarily by EEG testing, are due to innate biological differences that reflect a predisposition to experience certain emotions in certain situations.25

Dr. Davidson found that the activity of the frontal lobes predicted whether ten-month-old infants would cry when their mothers left the room. The correlation was 100 percent. Every baby who responded by crying had more brain activity on the right side, while those who didn’t cry had more on the left.26 Davidson has also found that adults who have a history of depression have lower levels of brain activity in the left frontal lobe. He believes that people who have overcome depression have learned to increase their levels of activity in the left frontal lobe, a hypothesis as yet untested.27 Where the researchers seem to have little disagreement is on the fact that basic temperamental orientations are clearly affected by experience over time, as was the case with Anthony and Elizabeth.

Dr. Mary Rothbart, a developmental psychologist working with Dr. Michael Posner at the University of Oregon, looks at constructs within temperament research to examine factors, or what she calls “systems,” that are protective against or negatively correlated with aggressive behavior. It is here that the temperament research seems to have the greatest value of all—in discerning temperament traits early and in supporting and educating parents with such information and skills as to enhance each child’s temperamental strengths and to counterbalance liabilities. Dr. Rothbart and her colleagues delineate three systems discernible in very young children that she believes are key to the development—or not—of later aggressive behaviors. The first of these she calls the “fear system,” a child’s tendency toward caution or timidity versus impulsive behavior. Children who are naturally constrained upon exposure to new people or experiences seem to be less likely to engage in aggressive behavior than a child whose reactions to a novel person, toy, or situation are unrestrained. This is a temperament quality that can be measured as early as ten months of age.

Confirming Rothbart’s observations, one study found that even children diagnosed with ADHD who also have anxiety disorders or high fearfulness do not perform poorly on measures of impulsivity or response inhibition. This group of children, by contrast to those with aggressive behavior disorders (ODD and CD), did not go on to develop criminality in adolescence and adulthood.28 Fearfulness appears to serve as a protective factor against impulsivity and mitigates against later aggressive behavior.29 In a study by Dr. David Farrington of Cambridge University, seven-year-olds with shy or inhibited temperaments living in neighborhoods with high crime rates were less likely to become delinquents in adolescence than bold, uninhibited boys.30 According to Rothbart, fearfulness helps regulate impulsivity due to a higher sensitivity to negative consequences. Children who respond intensely negatively to new people, places, things, and situations often begin to demonstrate fearful behavior between the age of ten and thirty-six months. This same sensitivity to unfamiliar conditions later acts to inhibit negative or aggressive behavior when there is a perceived possibility of punishment in connection with an action. Dr. Grazyna Kochanska at the University of Iowa has found that fearfulness in young children is associated with early development of conscience, especially when their mothers use gentle rather than forceful strategies for their socialization. While it is neither constructive nor realistic to attempt to teach bold children to be fearful, parents can work with these children to teach clear limits, provide firm and consistent guidance, and emphasize praise for honoring limits. The development of conscience in more fearless children is also associated with their early attachment to their mothers. And for children generally, positive experiences with their mothers are related to later cooperation and development of conscience. Fearful children also can be encouraged to stretch a bit beyond their self-imposed limitations. Both groups can work to learn to put negative feelings into words, to empathize with other children, and to solve problems.

A second system discernible at a very early age that appears to be involved in later aggressive behavior is what Dr. Rothbart calls the executive attentional system or the child’s ability to choose one behavior while inhibiting another. Rothbart calls this system “effortful control.” In measuring this capacity, Dr. Rothbart’s research staff uses an adapted version of a traditional cognitive learning exercise called the Stroop task. For adults, the Stroop task amounts to answering questions about the color of ink used to spell a word. The word might be “blue” and the color of ink on the computer screen red. In order to answer the question accurately, the subject must inhibit the strong tendency to read the word and instead respond with the color of the ink. For little children ages two to three, this task is adapted by showing them a picture of an animal or other object on the screen and asking them to match it with a picture on one of two keys, one to the right and one to the left. If the animal appears on the right side of the screen and the key with the animal’s picture is on the left, the tendency to respond incorrectly on the same side must be inhibited. This ability to inhibit one response while choosing another seems to be involved in the ability to inhibit impulsive aggression.31 Dr. Kochanska has found that children with higher inhibitory control show greater evidence of conscience development.32 Here is a skill that parents can teach and reward with simple focusing games that can be played at home.

A third system that may be protective against aggressive behavior is the capacity for what Rothbart calls “affiliativeness.” Affiliativeness encompasses the concept of sociability and the ability to get along well with other people. Closely related to the concept of agreeableness, this system typically describes the child whom people enjoy. Here there is convergence between temperament theorists and attachment theorists who assert that the primary bond between the infant and the caregiver, if established in a normal and healthy manner, lays the foundation for empathy, or the sense of connection with other people as a part of one’s self. Some researchers believe that affiliativeness is better framed as warmth, or an openness to the experience of love. There is some speculation about whether this is an inborn or an environmentally created trait. Regardless of its source, the capacity to connect with other people is clearly a factor that protects against aggression and can be taught in the earliest months and years and, as found by Kochanska, may be especially important for relatively fearless children. All of these systems—fearfulness versus impulsivity; effortful control, or the ability to choose one behavior while inhibiting another more obvious one; and the capacity for affiliativeness or connecting with others—are capacities that appear to be protective against the development of aggression. These qualities may also be assessed and enhanced by parents prior to age three.

ONE FLEW OVER

Even in the most difficult families, where child abuse or alcohol or poverty and neglect have taken their toll, it is not unusual to observe that one child will somehow emerge relatively more competent or successful than the rest. The stories of Jeffrey, John, and Julie, though they are siblings, provide a study in contrasts. (Jeffrey and Julie are full siblings; John is a half brother.) At nineteen, Jeffrey was on death row; at seventeen, Julie was embarking on her third pregnancy; and at twenty-one, John was in college and gainfully employed by his “dad” (foster father). Their stories reveal very different temperaments, aptitudes, and coping mechanisms. While all three children were bounced through several foster homes, only John had the capacity to engage emotionally with two different sets of foster parents. He attributes his abilities to hope for more, to visualize a different life, and to actually create that life for himself to his closeness to those foster parents, one family at age five, another during adolescence. There is growing evidence that John’s insights may be valid.

The theory of resiliency is based on the observation that certain individuals manage to succeed in spite of the odds. The resilient child is the child who emerges competent and confident from a family when everyone else seems to be a victim of “risk factors” or negative circumstances such as chronic poverty, alcoholism, criminality, community violence, or child abuse. With the exception perhaps of the fear system, Dr. Rothbart’s emphasis on the systems of effortful control and affiliativeness as protective factors against development of aggression or violence coincides with concepts emerging from the resiliency studies that are asking why some children do not succumb to negative environments. It is notable that the systems viewed by the temperament researchers as those most protective against later violence are “higher” cortical functions attributed to the frontal lobes, the adequate development of which is seen by neurobiologists as key to protection against later violent behavior. In effortful control, the ability to focus on relevant information in school (similar to the ability to focus attention and to delay action) is a key resiliency factor.33 The ability to perform successfully in school allows a child otherwise at high risk to succeed in this arena, gain prosocial employment, and avoid a criminal lifestyle.34

An agreeable and affiliative or social personality is a second factor cited in the studies of resiliency.35 Such children are optimistic, positive in their responses to others, get along well with their peers, and engage adults outside their families, such as teachers and neighbors who provide alternate role models and opportunities in addition to affection and validation. Resilient children are somehow capable of generating relationships and collecting glimpses of a different sort of world, which they integrate into a very different life for themselves than that from which they are emerging. They are empathetic and their connections with people enable them to internalize socially constructive behavior. For example, Jeffrey’s brother, John, still consciously treasures the kindness of the foster parents he and Jeffrey lived with for seven months when John was five and Jeffrey four. In talking about Bev and Walt, John says:

It made a difference. It made all the difference. I don’t know how to explain. It was like that seven months of time is when I got all of my morals. It’s when I learned every single thing as far as basics. And it’s so strange, I mean, because I’ve thought of this a lot. . . . It’s been a long time and I think about them almost every day of my life. I think about what they did for me. I wish I could talk to them right now.

John, similar to many resilient children, internalized a social compass early that proceeded to guide him beyond his original risk-laden environment. Like Dr. Rothbart’s three protective systems, resilience can be made as well as born. Resilience is a concept best viewed as more environmentally than biologically generated. Like risk, it seems to occur as a consequence of the interplay between the child’s basic traits and the environment. Risk for behavioral problems is created by the combination of a child’s innate vulnerability (e.g., Jeffrey’s ADHD) with negative environmental factors (e.g., his mother’s depression and consequent abuse and neglect). John is an example of this process in reverse. His strengths were key to reducing the negative effects of difficult circumstances such as his placement in foster care. When a child is exposed to risk factors that challenge but don’t overwhelm his strengths, when his experience results in feelings of competence and confidence, he can actually become stronger. When the risks overwhelm the child’s strengths, the outcome is most often destructive.

Taken together, temperament research and resiliency research corroborate what we know through commonsense observations—that the capacity for connecting and getting along with other people, the capacity for focused thinking and problem solving mitigate against impulsive violence in human society. These capacities are fundamentally sown and nurtured in the earliest months of life.

POSTSCRIPT

As we acquire more and more information on brain development in the womb and the role of chronic maternal stress in that process, it appears that what we refer to as “temperament,” and have viewed as an entirely genetic reality, is in fact highly influenced by the chemical intake of the mother—drugs, alcohol, prescription medications—and by her own emotional state, particularly the impact of chronic fear. While we have formerly viewed a very “sensitive” or “fussy” baby as an aspect of temperament, it may be that these early traits are the infant brain’s response to chemical or hormonal influences in the womb. Historical wisdom in many cultures informed families that pregnancy should be a time of peaceful and exceptional nurturing of the mother. While old wives’ tales—such as the belief that a pregnant woman exposed to a rabbit might give birth to a child with a harelip—are simply superstitious, the general idea that maternal experience can influence a baby’s temperament is no longer merely in the realm of myth.