Fighting Fear

Confronting phobias and other fears

The Effect of a Bellowing Child

Nature vs. nurture: an extreme case.

Everyone agrees that individual personality and behavior grows out of a combination of genetic influences and the influence of different aspects of the environment. This is a theoretical point of view. It is hard to imagine how it could be otherwise. In trying to understand the particular individual, however, it becomes almost impossible to tease out the effects of each discrete influence. For example, is a criminal driven to his actions more by a genetic vulnerability or by having grown up in a family of criminals? That issue is brought up frequently in criminal trials. You’ve heard it all before. This criminal grew up in deprived circumstances; therefore, his sentence should be diminished as his responsibility was diminished. If he is a murderer with a sufficiently low I.Q., the Supreme Court has ruled that he cannot be executed. Substitute neurological defects for genetic influences and the dispute takes on its modern formulation. In some sense, if a psychopath is driven by abnormal neural pathways, presumably beyond his control, should he be held responsible for his actions?

Anyway, the debate between nature and nurture has played out in all sorts of issues, including, for example, the anxiety disorders. Are they hereditary or are they learned? Most people think they are both, but, once again, it is hard to know how much each factor contributes and exactly in what way. Perhaps it is more a philosophical question, rather than scientific. In any case, I have been struck by that debate more as it applies to the very beginnings of life than later on, when everything becomes too complicated to understand clearly.

Babies are seen to be different as soon as they are born. Part of the Apgar score, which measures a baby’s viability, is a test of the baby’s reactivity. You clap your hands loudly in front of the baby, or shake the baby’s bassinet, to see how much the baby reacts. A sick baby might not react at all, but healthy babies vary a great deal. Some babies cry briefly, others bounce so forcibly, you have to catch them. My theory of the anxiety disorders is that the very reactive babies are more inclined to be influenced by nervous parents, so that the effects of nature and nurture intertwine from the very beginnings of life. But every once in a while I have seen an otherwise normal child who reacts so distinctively to his environment, I have wondered how much he influenced that environment rather than the other way around.

The Case of the Bellowing Baby

Of course, babies vary in familiar ways. They are described initially as being of a certain sex, and of a certain weight. They are more, or less, active and more, or less, inclined to suck. And so on. Some babies cry more than others. Some cry louder. And a very few cry really loud. A child at the extreme of one behavior or another cannot automatically be said to be abnormal; and the child I have in mind was normal by all the usual ways of measuring a child. But it had a really loud cry. It is hard to describe in print just how loud he was, but when I saw him last, at the age of three days, it was the only time I ever saw an obstetrical nurse cover her ears.

I don’t know what happened to that particular child. I could only imagine. But a few years later, when I was doing research on very young children, I saw a two year old boy whose parents described him, sighing, as having a similar voice. They joked about his future career being in the opera, or, perhaps, if he did not sing on key—there was no way of knowing yet—he could make a living as a foghorn. I think there can be no question that he started off in life with a huge cry, and that that sound did not stem from environmental influences, but was inborn just as much as his sex or his size. But his environment was different from that of his siblings—because he made it different.

According to his parents: his cry was intolerable at night. He woke up his older brother and sister. They were afraid to take him on vacation, as they had taken his siblings, because he could be heard through the walls of the hotel. They could not allow him to cry himself to sleep since in the meantime no one else could sleep. Of course, he could not be taken to restaurants. Both parents were inclined to hurry to calm him when he was upset. Both admitted to becoming exasperated with him. His father got out and out angry. They were not inclined to deny him anything he wanted; but they often became irritable when responding to him. His siblings gave him a wide berth.

Who knows what effect there was on him from parents who always treated him gingerly and yet were impatient and irritable? He got his way more often than other children, but was shunned to some extent even at the age of two. So, how could we tease out the effect of his inborn inclinations from that of his environment? The fact is, every child, by virtue of the particular qualities he or she has, defines that environment just as much as the environment determines who that child will become. So, there is an intertwining of cause and effect. Children construct an environment which affect them in such a way that they become different and have a still different effect on their environment. This is why the nature and nurture debate is never settled.(c) Fredric Neuman Author of "Detroit Tom and His Gang." Follow Dr. Neuman's blog at fredricneumanmd.com/blog/ or ask advice at fredricneumanmd.com/blog/ask-dr-neuman-advice-column/

Fredric Neuman, M.D. is the Director of the Anxiety and Phobia Center at White Plains Hospital.

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