21 minute read
Viewpoints
Beyond the Oedipus Complex:
What we know about parent-infant relations and why research on the paternal brain may have lagged behind
Advertisement
By Iciar Iturmendi Sabater
Trapped in myth
In Greek mythology, the king of Thebes is warned by an oracle that his son, Oedipus, will slay him, take over the throne, and marry the queen, Jocasta (Oedipus’ own mother). Interestingly, the impact of this omen has reached beyond the ending of Sophocles’ Oedipus Rex, and has continued to inspire thinkers until today.
In The Interpretation of Dreams (1899)1 , Sigmund Freud (1886-1939) referred to this myth to represent a child’s unconscious desire to get rid of his father to remain merged to his loving mother, naming it the “Oedipus Complex”. From the start of the 20th century, psychology has carried the weight of the negative connotation of father-infant relations introduced by Freud.
It may be time neuroscientific and psychological research on fathers raises its voice over this myth.
A Nobel Prize drawing attention to mothers
Ten years after the publication of Freud’s The Interpretation of Dreams (1899)1, oxytocin was discovered by Sir Henry H. Dale (190 9). He found that this hormone, produced in the brain’s hypothalamus and released by the posterior pituitary gland, induced uterus contractions in a pregnant cat.
Oxytocin is produced in higher concentrations in women than men. It was the first polypeptide hormone to be synthesised, which earned Vincent du Vigneaud the Nobel Prize for Chemistry in 1955. The discovery drew world-wide of emotion (let that be ceaseless crying and screaming), but she further works through these in her own mind and reflects them back to the infant in a digestible, more tolerable way. For example, the mother opens her eyes widely and slowly says: “I know why you are crying: you are hungry! Food is coming soon”.
In this way, Winnicott argued, the mother provides ‘holding’ for the infant’s mental states, or a secure psychological base from which to make sense of one’s intense emotions and to begin exploring the outside world.⁵
It is possible to draw parallels from Winnicott’s work with later findings from neurobiological research.
attention and recognition to the power of medical research in unveiling the mechanisms of the maternal brain.
Oxytocin (from Greek, meaning “sudden delivery”) is now used to induce labour, known to control lactation and to be involved in diverse reproductive functions in women, including the regulation of the menstrual cycle.2, 3
While knowledge on the functions of oxytocin in mothers kept growing throughout the second half of the 20th century, interest remained limited in understanding to what extent fathers shared oxytocin-related parental functions with mothers, or what alternative mechanisms may underlie the fatherinfant relationship.⁴
Parents as mirrors
As the positivist emphasis of the 20th century propelled neurobiological research on the maternal brain, the development of psychological theories on the mother-infant relationship silently advanced in parallel.
Freud’s differentiation of the role of the mother and father in the psychological upbringing of their infant is arguably sexist as seen through today’s lens. Yet his work lit the spark for others to reflect upon the psychological processes through which the mother introduces a newborn infant to the world. British paediatrician Donald Winnicott (1896-1971) dedicated his life’s work to this matter.
Winnicott studied in detail how the mother acts as a mirror for her infant’s intense emotions: not only is she receptive to the infant’s manifestations
Metaphors for brain function
Emotion regulation (provided by a mirroring and holding mother) is known to be mediated by top-down control of the brain’s highly evolved prefrontal cortex, which is in charge of executive control, over more primitive structures like the amygdala, a region highly reactive to emotional triggers.
Neuroimaging research finds that functional brain connectivity between the prefrontal cortex and amygdala is not yet established in infants and young children. However, when young children are exposed to the same stressful situation in the presence of their mother, connectivity between these regions is boosted, as if the mother was providing some type of stress buffering or holding their child’s emotions.⁶
Children drawn by Winnicott. Winnicott resorted to drawings during his therapy sessions and to illustrate his theories on the mother-infant relationship. He called the drawings produced in the therapeutic process “squiggles”.8
Source: Thinking About Children (R.Shepherd, J.Johns, H. Taylor Robinson (Eds.). 1996).
known to be triggered by social stimuli. In young children, this occurs especially in the presence of the mother. Over time, oxytocin further promotes the formation of social preferences and modulates attachment behaviours.⁶
Interestingly, prefrontal-amygdala connectivity increases with age. Adolescents can regulate their own emotions when the mother is absent, as oxytocin release becomes less specifically sensitive to mothers’ presence and generalizes to other social stimuli. Maternal presence no longer affects amygdala-prefrontal connectivity, and the individual becomes independent to regulate and hold their own mental states.⁷ mirroring functions? Current and future research is aiming to target this gap in the psychological and neuroscience literature.
The future of research on the paternal brain
The present theoretical and evidence-based research on the maternal brain clearly outweighs that of the paternal brain. Yet, promising lines of research are building to understand the brains of fathers.
Research on hormones and neurotransmitters beyond oxytocin (i.e., vasopressin, testosterone, endogenous opioids, norepinephrine, prolactin, GABA, serotonin) is providing novel insights into the parental brain. Neuroimaging studies are finding that fathers’ responses to their own infants’ stimuli are not as different from that of mothers as previously thought. From a theoretical perspective, psychologists have proposed that fathers promote interactions with the outside world and provide their children with discipline that sets limits to keep them safe.3
Neurobiological discoveries about the maternal brain have historically advanced in parallel to the development of psychological theories on the motherinfant relationship. Perhaps, using psychological theories to guide medical research on father’s brains can accelerate our current understanding of the fatherchild relationship, and let it finally break free from the Oedipus Complex myth.
References
1. Freud S, Strachey J. The interpretation of dreams. New York: Avon
Books. 1965. 2. Dumais KM, Veenema AH. Vasopressin and oxytocin receptor systems in the brain: Sex differences and sex-specific regulation of social behavior. Front Neuroendocrinol. 2016 Jan 1;40:1–23. 3. Marazziti D, Baroni S, Mucci F, Piccinni A, Moroni I, Giannaccini
G, et al. Sex-Related Differences in Plasma Oxytocin Levels in Humans. Clin Pract Epidemiol Ment Health 2019 Mar 27;15(1):58. 4. Swain JE, Dayton CJ, Kim P, Tolman RM, Volling BL. Progress on the paternal brain: theory, animal models, human brain research, and mental health implications. Infant Ment Health J. 2014 Sep 1;35(5):394–408. 5. Winnicott DW. The theory of the parent-infant relationship. Int. J.
Psycho-Analysis. 1960;41:585–95 6. Gee DG, Gabard-Durnam L, Telzer EH, Humphreys KL, Goff B,
Shapiro M, et al. Maternal buffering of human amygdala–prefrontal circuitry during childhood but not adolescence. Psychol Sci. 2014
Nov 20;25(11):2067. 7. Nelson EE, Panksepp J. Brain Substrates of Infant–Mother Attachment: Contributions of Opioids, Oxytocin, and Norepinephrine.
Neurosci Biobehav Rev. 1998 May 1;22(3):437–52. 8. Winnicott DW. Selected Drawings. Collect Work D W Winnicott. 2016 Oct;279–88. 9. Winnicott, DW. A child psychiatry case illustrating delayed reaction to loss. Drives, Affects, Behavior. 1965; 2:341-368.
By FirstName LastName
The Big T
Is Testosterone a Key Player in Illness Disparities Seen Across Sex?
By Shu‘ayb Simmons
Introduction: Disparities in Illness Across Sex
Disparities in disease incidence across males and females are well established. Here, the word ‘disparity’ serves to denote the unequal incidence of illness manifestation across sex. In general, males are more susceptible to infectious diseases whereas females are more prone to autoimmune diseases.1 There equally exist illnesses that affect only one sex or one sex in the majority. For example, only females attain certain autoimmune diseases, such as Turner Syndrome, and are more likely to manifest conditions such as Chronic Fatigue Syndrome (CFS).2 Males, on the other hand, are more likely to attain illnesses such as stomach cancer, abdominal aortic aneurysms, tuberculosis, esophageal cancer, and liver cancer. So why do these disparities in illness incidence occur across sex exist? They can be attributed mainly to variations in the immune system across sex due to factors like high testosterone levels and chromosomal differences.
A Key Distinction: Sex vs. Gender
The operative words in this article are female and male (i.e., sex) and not woman and man (i.e., gender). Sex and gender are not analogous nor interchangeable. Sex denotes one’s biological chromosome makeup (male = XY, female = XX, etc.). Contrarily, gender refers to the social role one chooses to adopt. This is an important distinction to highlight as the crux of this article focuses on sex.
The Immune System & Sex
Threats to one’s health are not few and far between; bacteria, toxins, and viruses can all cause illness and potentially death. So how exactly do we humans defend ourselves from these serious threats? The immune system is the first common biological defence that pathogens (i.e., illness-causing substances) meet. The immune system is incredibly complicated. In simplified terms, it is a series of cells that aim to conquer the threat (i.e., the antigen) to maintain the host’s health (i.e., the human). The immune system is capable and consists of two components. The first is innate immunity, which can be considered the general immune response. The second is adaptive immunity and mounts a pre-programmed immune response to similar antigens that once invaded the host body, providing the host with a more specific immune defence. The immune system, however, is not infallible and proves virtually useless against specific predators like Naegleria fowleri (the braineating parasite). The immune system is also not universal, and its efficacy can be largely determined by the environment and the individual in question. Additionally, the human immune system is ‘sexually dimorphic,’ a million-dollar phrase meaning that the immune response is different across sex.
Hormones are chemical signals of the endocrine system and are secreted by the endocrine glands. Hormones can be divided into two broad classes: steroid or peptide hormones.3 Hormones and behaviour are bidirectional; hormones influence behaviour, and, in turn, behaviour influences hormones. Testosterone (The Big T) is a cholesterolderived steroid hormone and is one of four androgens. It is synthesized by the ovaries and adrenal glands in females and by the Leydig cells and adrenal glands in males.4 Testosterone is present in both females and males, although at a much higher quantity in males, and is critical for developing male characteristics.4 Testosterone also boasts immunosuppressive (i.e., immune system weakening)1 and analgesic (i.e., pain-relieving) qualities, indicating that it can lower the immune system’s efficacy and make pain more bearable. Granted, not all research supports this theory. Nowak and colleagues (2018) did not find a positive relationship between testosterone and immunosuppression.5 However, this finding was only significant when considering body mass index (BMI) and age as covariates in their model, suggesting that these are potential confounders. There has been an equal query as to whether testosterone promotes aggressive behaviour since it is marginally beneficial in bouts of human aggression,6 however, further research is
The Big T: Testosterone
required to assess the robustness of this relationship due to the paucity of research on the matter.
Testosterone is not the only key player in the sexual dimorphism of the immune response and its consequent effect on the immune system. Factors such as one’s genetic makeup also play a role. Males possess XY chromosomes, whereas females have XX chromosomes. The haploidy (i.e., the singular appearance of X) of the male chromosome is costly; it renders males more susceptible to infectious diseases and diminishes immune system efficacy. Experimental studies in autoimmune encephalitis mice assessing the effect of sex chromosomes on illness have found that mice with XX chromosomes experienced worsened disease progression compared to XY mice.1 Difference in lifestyles across sex (e.g.., differences in engaged behaviour, thus changing one’s environment) is another potential key player in the disparities of the immune system between sex. Although–immunologically speaking–the Big T may sometimes cost the win, it’s a fascinating hormone with a fascinating immune system interplay. I doubt anyone could imagine a world without testosterone.
Additional Key Players & Conclusion
References
1. Klein, S. L., & Flanagan, K. L. (2016). Sex differences in immune responses. Nature Reviews. Immunology, 16(10), 626–638. https:// doi.org/10.1038/nri.2016.90 2. Faro, S. et al. (2016). Gender Differences in Chronic Fatigue Syndrome. Reumatología Clinica (Barcelona), 12(2), 72–77. https://doi. org/10.1016/j.reumae.2015.05.009 3. Simmons, S. (2021). Diurnal Variation in Male White-Faced
Capuchin (Cebus imitator) Faecal Glucocorticoids, Testosterone and Dihydrotestosterone [Unpublished Undergraduate Thesis].
York University. 4. Jordan-Young, R., & Karkazis, K. (2019). Testosterone: An Unauthorized Biography (pp.1-23). Harvard University Press, https://doi. org/10.4159/9780674242647 5. Nowak, P. et al. (2018). No evidence for the immunocompetence handicap hypothesis in male humans. Scientific Reports, 8(1), 7392–11. https://doi.org/10.1038/s41598-018-25694-0 6. Book, S. et al. (2001). The relationship between testosterone and aggression: a meta-analysis. Aggression and Violent Behavior, 6(6), 579–599. https://doi.org/10.1016/S1359-1789(00)00032-X
By S. Hussain Ather
Men are less likely than women to wear face masks and find themselves at greater risk of being infected with COVID-19, but for what reasons? According to a recent study, it is not socially desirable to be seen wearing a face mask.1 Being conditioned not to show fear in light of the pandemic, these men have embraced a form of masculinity that can interfere with their personal health. These tough, “macho” behaviors rely on never showing weakness, suppressing one’s emotions, and remaining self-reliant. Through “Stoicism,” a philosophical school of thought for dealing with distress and anxiety, these men find answers.
With the popularity of websites like “Daily Stoic” and books like “Meditations,” a series of personal writings in which Stoic philosopher Marcus Aurelius journaled his own self-improvement as he sought peace, Stoicism has offered insights into behavior, attitudes, and lifestyles that could influence to this day. These new attitudes towards life could also bring differences in health outcomes. The ideas and beliefs of Stoicism could lie at the root of many mental health issues men face. Indeed, upon examining the attitudes of Stoic philosophers, it is evident how the philosophy might encourage men to deny or minimize health-related issues.
A Doctrine against Disaster
When Greek philosopher Zeno of Citium founded Stoicism, it was a school of thought that emphasized wholesomeness and peace of mind. Upon finding himself in the disastrous face of a shipwreck, Zeno needed to find the answers to some of life’s deepest questions. By studying the works of Socrates and Marcus Aurelius, he conceptualized Stoicism, a term borrowed from the Greek phrase “stoa poikile”, meaning “The Painted Porch,” where Zeno taught his students. At the heart of the system of belief lies an aversion to fear and pleasure, alongside an emphasis on reason (i.e., logic), sometimes described using the Greek word logos. Stoics used the phrase seminal logos (“logos spermatikos’’) to refer to the law of generation in the universe. As in, by the divine law of logos, reason had the power to work and create all things in the universe. If the universe were a computer, then logos would be its operating system.
Orthodox stoicism comprised a set of principles that embodied features commonly used to describe “harmful masculinity”. These include, but are not limited to, behaviours such as hypersexuality, aggression, homophobia, and limited expression of one’s emotional range. In the 17th century, Neostoicism emerged as an amalgam of Stoic and Christian ideas and principles. When upholding this ideology, one can overcome unwanted emotions through reason while also maintaining the Christian ideal that God’s suffering should be endured. This form of Stoicism still retained the ideas or methods of how, through analyzing one’s own judgements, one could find peace from any sort of negativity. This would later evolve into contemporary Stoicism.
Men vs. Reason
What ties the toxic, harmful forms of masculinity that prevents men from seeking treatment to the ideals and principles of contemporary Stoicism? Professor Emerita of Sociology and gender theorist Raewyn Connell describes that when practicing or embracing ideals of emotional restraint and hiding vulnerability, men may refuse or remain averse to seeking treatment for mental health issues.2,3,4 And, in some ways, Stoicism was meant to be a philosophy for men. As the Historian of Medicine Ludwig Edelstein described, “The difference between the Stoics and other philosophers, Seneca says, is the difference between men and women; those who have chosen the Stoa have chosen the manly, the heroic
“Man is not worried by real problems so much as by his imagined anxieties about real problems. “
- Epictetus
Can we improve our health through reason alone? Stoicism offers a tough solution to men’s problems.
Illustration by: Amy Assabgui
cause.”5 In response to these stiff, rigid norms, men don’t reach out for help, much like a Stoic might refuse to do so as well.6
When performing research, four quantities (stoic taciturnity, stoic endurance, stoic serenity, and stoic death indifference) can be measured to determine how “stoic” one is.7 Although, from here, it is still not clear how differently men and women score in terms of stoicism. While one study showed that about 30% of men had “strongly endorsed stoicism” compared to about 20% of women, another study showed similar scores for both men and women.8 For men of color, emotional stoicism within cultures can also disrupt health outcomes. For example, the high-effort masculinity-informed method of coping observed among Black men, known as John Henryism, hinges wholly on emotional stoicism. While this form of “high effort” coping in response to the psychosocial stressors of racism may provide relief for certain psychological distresses in temporary contexts, in the long-run, health outcomes vary by socioeconomic status.9 The risk for hypertension, for example, goes down with increasing levels of education.
There’s an irony in how a philosophical doctrine meant to guide men to peace through a reason-derived approach to their emotions may serve as a detriment to their health. Could a healthier, more positive form of Stoicism emerge from the struggles men face? Stoic emotional repression, as it plays out, can’t be ignored.
Expressions among Ethnic Groups
References
1. Capraro V, Barcelo H. The effect of messaging and gender on intentions to wear a face covering to slow down COVID-19 transmission.
PsyArXiv. Preprint posted online May. 2020;11. 2. Connell, R. W. Masculinities. Polity, 2005. 3. Connell, R. W., and James W. Messerschmidt. “Hegemonic Masculinity.” Gender & Society, vol. 19, no. 6, 2005, pp. 829-859. 4. Javaid, Aliraza. “Hegemonic Masculinity, Heteronormativity, and
Male Rape.” Male Rape, Masculinities, and Sexualities, 2018, pp. 155-193. 5. Edelstein L. The meaning of stoicism. Harvard University Press; 1966. 6. Moore, Andrew, et al. “Troubling stoicism: Sociocultural influences and applications to health and illness behaviour.” Health: An
Interdisciplinary Journal for the Social Study of Health, Illness and
Medicine, vol. 17, no. 2, 2012, pp. 159-173. 7. Pathak, Elizabeth B., et al. “Stoic beliefs and health: development and preliminary validation of the Pathak-Wieten Stoicism Ideology
Scale.” BMJ Open, vol. 7, no. 11, 2017, p. e015137. 8. Murray, Greg, et al. “Big boys don’t cry: An investigation of stoicism and its mental health outcomes.” Personality and Individual Differences, vol. 44, no. 6, 2008, pp. 1369-1381. 9. James S.A. John Henryism and the health of African-Americans.
We need to do more to promote diversity in science
By Madhumitha Rabindranath
As part of my graduate seminar series, I recently attended a lecture on “diversity, equity and inclusion (DEI) in scientific research”. It was refreshing to see the issue tackled directly but I could not help but think that it is about time! With increasing public pressure catalyzed by the Black Lives Matter movement, various academic institutions are taking more active approaches to show their support.1 Some recent examples include land acknowledgments during presentations, department-specific DEI committees and representatives, new initiatives to attract diverse talent through fellowships, and scholarships. Although these measures are a step forward, the question remains if they are effective or merely tokenistic.
Current policies tend to re-affirm the universities’ commitment to diversity which often includes trying to increase representation in their faculty and student body.1 This is crucial since representation greatly matters in any form. Whether it is providing funding for under-represented students or hiring professors with diverse backgrounds and identities, these measures reinforce a sense of belonging. A recent study showed that approximately 54% of minority individuals comprised of mostly female respondents stated that interacting with gender and ethnicitymatched STEM professionals provided sufficient encouragement to pursue the associated professions.2 The exposure does not necessarily have to be direct interaction, as 56% of participants in the same study stated that increased media exposure of gender and ethnicity-matched STEM professionals (e.g., Instagram influencers) also provide a similar effect. This supports the policies that universities are enacting in hiring diverse role models in high academic positions and starting mentoring opportunities which can foster recruitment to academia. Newly hired academics from an ethnic minority, in turn, can become mentors themselves, continually increasing the representation of minority groups in science.3 Ultimately, increasing the number of individuals from various backgrounds in academia through institution-led DEI policies can help attract minority populations to these fields. safeguarding DEI. Although dismantling the barriers to academia should be a priority for every member of an institution, the few minority professors or scientists hired at universities are often expected to tackle this behemoth alone.4 Known as “cultural taxation”, these professors are often asked to participate in DEI committees, mentoring upcoming scientists with similar backgrounds or any DEI-related commitments. Interestingly, most of these responsibilities are often under-recognized and uncompensated even though many universities proclaim their commitment to DEI.4 This “tax” infringes on the paid protected time that is required to complete research-related activities, including publishing articles especially in high-impact journals, which are particularly important for acquiring funding. This issue may further exacerbate the discrepancies in research funding awarded to minority-ethnic scientists. For example, African-American scientists are 10% less likely to receive funding from the US National Institute of Health.4 This disparity shifts the efforts of promoting DEI to tokenism as minority faculty members are seen as “representatives” of their associated ethnicity, gender, sexual orientation, and disabilities. These individuals should not be expected to carry the sole responsibility for changing the current scholarly climate which requires the collaboration of privileged allies and a conscious effort by institutions to tackle structural biases.
Although some of the challenges faced by academic minorities can be overcome by increasing numbers, the promotion of DEI in academia should not be confined to this objective. Surprisingly, increasing exposure and individuals from a particular background may not lead to significant changes in the culture of their respective fields. A study published in JAMA Surgery found that male physicians tend to refer their patients to male surgeons while this effect was not seen with female physicians.5 The authors present a harsh reality that even with increasing females in this field, these biases will continue to exist as their results show no changes in over-referrals to males during the study period. This example further supports the idea that we cannot simply increase the number of individuals from a particular group; institutions need to do more. Some of these biases are so entrenched in academia that certain groups are often excluded such as scientists with medical conditions or disabilities.6,7 Ranging from inaccessible lab spaces and equipment to lack of support and mentoring, upcoming scientists with disabilities feel discouraged from pursuing graduate work or often fail to complete their degrees.7 This again illustrates that issues with DEI in science are not primarily about representation; tailored support systems need to be in place to adequately help minority students, faculty, and scientists. These past two years have shown that biases perpetuate systemically, and thus, to promote DEI in academia, sufficient time and effort must be invested to create a truly inclusive environment. Universities, professors, scientists, and students must play an active role, which can include participating in DEI training and advocating for their peers.
Ultimately, the current DEI policies and measures put forth by various institutions are a starting point. They seem to predominantly focus on increasing the number of diverse faculty and mentors but as illustrated, it is not enough. Measures need to be put in place to ensure that all individuals are well supported. Primarily allocating seats at the academic table for individuals from minority backgrounds is insufficient; institutions are also responsible for ensuring they thrive.
References
1. Forrester N. Diversity in science: next steps for research group leaders. Nature. 2020;585:S65–7. 2. Kricorian K, Seu M, Lopez D, et al. Factors influencing participation of underrepresented students in STEM fields: matched mentors and mindsets. Int J STEM Educ. 2020;7:16. 3. Fadeyi OO, Heffern MC, Johnson SS, et al. What Comes Next?
Simple Practices to Improve Diversity in Science. ACS Cent Sci. 2020;6:1231–40. 4. Gewin V. The time tax put on scientists of colour. Nature. 2020;583:479–81. 5. Dossa F, Zeltzer D, Sutradhar R, et al. Sex Differences in the Pattern of Patient Referrals to Male and Female Surgeons. JAMA Surg [Internet]. 2021 [cited 2021 Nov 23]; Available from: https://doi. org/10.1001/jamasurg.2021.5784 6. Brown E. Disability awareness: The fight for accessibility. Nature. 2016;532:137–9. 7. Bayer GSM Skylar. Our Disabilities Have Made Us Better Scientists [Internet]. Scientific American Blog Network. [cited 2021 Nov 27].
Available from: https://blogs.scientificamerican.com/voices/our-disabilities-have-made-us-better-scientists/
