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The Trump Administration policy of forced family separation at the US border has been almost universally condemned by scientific and professional organizations representing pediatricians, psychologists, and developmental scientists. I have written and spoken about why this should in fact be regarded as torture, in that it is intentionally inflicting long term biological, psychological, and emotional damage on third parties – in this case, innocent children – to advance policy goals. These actions violate two different UN Conventions, the Convention Against Torture and the Convention on the Rights of the Child. The new Executive Order apparently ending this policy likely will not undo much of the damage. The plans for reunification of several thousand families remain vague, and current judicial rulings prohibit housing families together for more than 20 days – unless the adults are released from custody to present themselves at a later date to an immigration court, which is not an option the administration is considering, thus likely leading to a further round of forced family separations.
The strong scientific consensus on the harm this does to children is clear. What is less well understood are the ways that the toxic stress and trauma from forced separation causes this biological and psychological damage. One pathway is through the rewiring of neural circuits that are involved with how we react to stress, how we relate to others, and how we form emotional attachments. A less familiar but increasingly understood pathway is through epigenetic changes that alter how genes function without affecting the DNA. Both of these pathways for how toxic stress “gets under the skin” – brain wiring and gene function – can and do lead to lifelong impacts affecting thinking, behavior, emotional life, later health, and even early mortality.
Some observers may wonder how such major impacts could result from relatively brief events (compared to a full lifespan). In this Q&A drawn largely from my recent book, I describe the basic story on how epigenetics play a crucial role.
What is epigenetics?
Epigenetics includes biological mechanisms that can change the way a gene functions. These epigenetic changes do not alter the DNA. Rather, they change what the gene actually does, also known as gene expression. These epigenetic changes can happen for a number of reasons, including exposure to various toxins, especially during pregnancy, or from social experiences like highly stressful environments.
What is social epigenetics?
Although aspects of epigenetic processes have been understood for some time, the field of social epigenetics has been growing rapidly for just over a decade. The key discovery – first in animal studies, and later in humans – is that social experiences can “get under the skin” to alter our core biology.
What kinds of social experiences matter for epigenetics?
There are many, and more are being discovered as the field expands. Among the most studied are high levels of stress in an expectant mother, leading to epigenetic changes in the fetus, and absent or poor nurturing during infancy, leading to similar epigenetic changes. For humans, parents experiencing high levels of stress are at higher risk for providing inadequate nurturing. High levels of stress on parents is basically a double risk, both in utero and early in infancy. Clearly, forced separation is among the most toxic of stressors that parents and children can experience.
Why is early life critical when determining stress dysregulation (SDR)?
We do know that the basic physiology of the stress response system is established early, and that it has a strong tendency to maintain that basic response style throughout later development. Toxic stress in early life (in utero or in early nurturing) sends a signal that “amping up” the stress system is the best defense against danger – in other words, it is a chance for the genes to “listen to the environment” in terms of what that young life is likely to encounter.
But wait – that sounds like a good thing, getting ready for the environment that is actually out there. Why call it stress dysregulation (SDR)?
It can be a good thing, especially at an earlier period when predators may have invaded the territory, or even now in dangerous situations – for example, war zones, or high violence neighborhoods – when being constantly on full alert can help survival. In more settled environments in modern societies where this is less likely to be encountered, the downside of is that SDR’s excess cortisol, which is not essential to confronting survival threats, is that it has negative effects on development, behavior, and health. Reunification after the toxic stress of forced separation is important, but not all the damage can be undone.
Are epigenetic changes heritable?
Yes, but not always. There is good evidence for some epigenetic changes being passed down to subsequent generations, and emerging evidence for this in the case of the stress gene. But even without epigenetic inheritance, the problems can pass down to later generations: children who have stress dysregulation will, as parents, be more likely to have challenges in providing a strong nurturing environment to their children.
Is stress “contagious”?
We’ve known for some time, from both research and everyday observation, that when emotions run high, everyone in the group or family can be drawn in. What the recent research shows is that the physiological stress response becomes coordinated between or among individuals.
Can the body counteract SDR at the biological level?
There are several pathways, some healthy and others less so. One comes from social connections, which can produce neurohormones (serotonin, oxytocin) that not only “feel good” but are also counter-agents to cortisol. Another comes from exercise, which also burns up cortisol and helps the body regulate itself. A third comes from effective mindfulness, which allows our own awareness to intervene in the automatic stress response. Finally, and less healthy, consumption of high fat/high calorie foods, which do counteract excess cortisol, increases the risk for eventual diabetes and metabolic disorders and diseases; and drugs and alcohol also relieve stress, but at risk for substance abuse and addiction.
What are current social sources that lead to SDR?
Most people in advanced societies today do not confront the predator or similar threats of our ancient ancestors. So what causes the level of stress required to trigger this damage to the stress system today? In some situations – war zones or highly dangerous neighborhoods, for example – the stress is similar, namely, threats to survival. But we also see evidence of it in individuals who experience economic deprivation and uncertainty, leading to early life adversity in their children. And the extreme stress of forced family separation clearly rises above the threshold for causing this damage.
How much stress does an expectant mom need to experience to trigger this?
We don’t have (yet) a dose-response curve – we don’t know exactly how much stress is too much. In part, this is because research is just beginning to look at this in the population as a whole. But also, there is not a direct translation from external circumstances to the experience of stress – the perception of threats plays a major role in how stressed one feels. Everyday hassles and moderate stressors are likely not enough, but sustained levels of worry or stress at a significant level are. Again, forced family separation experienced by an expectant mother is highly likely to generate this level of toxic stress.
How does adversity and stress in early life fundamentally alter the life course, making it harder for a child or teen to learn and to make friends, or for adults to establish relationships with a partner, to enjoy a stable family life, or to find secure employment, and keep healthy?
Because one core issue is a dysregulated stress response system – easy to trigger, hard to turn off – the basic pattern repeats as we have seen above. Although it shows up in a bit different guise at different points in development, what is constant is the person’s experience of feeling highly agitated, often for no obvious reason, and with no effective means of self-regulating to bring oneself to a calmer, more functional state. Problems then begin to pile up in many areas: school performance; fraught relationships; career difficulties; and eventually physical and/or mental health issues.
It is easy to see how early life adversity from poverty, disadvantage, or the toxic stress of forced separation matter, but can it affect middle or upper class families and individuals?
As societies become highly unequal, such as we are experiencing today, being in the middle or even upper classes is no guarantee of maintaining that position. Significant downturns in employment or financial status, as in the Great Recession beginning in 2008, can make most anyone feel vulnerable. And if not for oneself, the worries for one’s children, in a decreasingly mobile society, can generate stress in terms of them “sliding down” the social ladder. We can easily see how an extreme stressor like forced separation could cause this biological and psychological cascade, but we should also take note how the increasing stressors of everyday life are having similar effects, as shown in a well documented, and worsening, stress epidemic.
What about resilience? Won't these children just bounce back after they get back with their families?
In general, resilience – “bouncing back” – is a term used to describe successful and healthy outcomes despite early adversity. One strong research finding across many studies is that a strong social connection with a supportive individual is the most common way for resilience to happen. This can come from other family members, teachers, coaches, mentors, and in adolescence and beyond, a romantic partner. For SDR individuals, this can provide the support needed to reduce the heavy toll from stress dysregulation. But it’s not always available, either because a supportive person is not available for a variety of reasons, or because the SDR individual has great difficulty in forming or sustaining meaningful relationships. Even under favorable circumstances, it's not successful in many cases. And for families that have been through this ordeal, it is very likely that stress will remain at toxic levels for some time to come – with the implication that a quick and supportive program for reunification and stress reduction is essential.
References
Keating, D. P. (2017). Born Anxious: The Lifelong Impact of Early Life Adversity – and How to Break the Cycle. New York: St. Martin’s Press.
