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Psychiatric Times. Vol. 25 No. 4
 

Adult Experiences, Genetic Activity, and Maturation

April 1, 2008
Dr Lewis is chairman emeritus of the Timberlawn Psychiatric Research Foundation and clinical professor of psychiatry at the University of Texas Southwestern Medical School. He is also in private practice of individual, marital, and family therapies in Dallas.

For some, the new relationship or crisis is a positive turning point and the apparent impetus for psychological maturation. For others, however, the result is not positive—rather, their adjustment patterns remain dysfunctional or worsen.

The assumption that has dominated clinical thinking about this question is that the answer involves preexisting personality strengths. It is those fortunate persons who are most apt to profit from new relationships or to cope with adversity. That assumption has not been systematically validated, and recent developments concerning the role of gene-environment interactions in psychopathology offer another way of looking at the different outcomes experienced by persons who encounter the same or similar life experiences. It is, perhaps, in the genes. The premise would be that the multiple genes involved in personality characteristics such as autonomy and relational ability are turned on in some but not all persons by certain life experiences. But where do we learn about the life experiences?

The most obvious sources for such leads are careful longitudinal studies that follow persons from early childhood well into adulthood using state-of-the-art measurements. Even the most accomplished of these studies, however, have, at best, only measures of the amount of variance due to genetic factors.1 We simply do not know which genes (combinations of such) play a role in important developmental propensities like autonomy and relatedness. Thus, in assuming the gene-environment interactional perspective, we infer that certain experiences turn on or off the as yet unknown genes that produce the proteins that influence the brain circuits involved in such maturational outcomes.

The same dilemma holds for the second source of clues about adult experiences that reverse or modify the adult consequences of childhood trauma—the autobiographical narratives of nonclinical subjects. During the past 50 years I have had the opportunity to be involved with more than 800 nonclinical subjects in exploratory interviews. These persons were applicants for a residency training program, research volunteers for studies exploring family health and dysfunction, and, more recently, aspirants for the priesthood or diaconate in the Episcopal church. The average interview time ranged from 1 to 4 hours, and the interviews had several objectives. One was essentially categorical: Did the subject describe symptoms that when grouped together are considered descriptive of psychiatric syndromes? The other objective, more pertinent to this essay, involved the development of a subject's autobiographical story, its coherence, underlying themes, turning points, and other identifying characteristics.

Only a handful of adult experiences of these nonclinical persons were described as major life-turning events that appeared to undo or modify the psychological consequences of childhood trauma. The most common was a new relationship with a loving other. These new relationships often follow years of unsuccessful relationships, many of which appear to have been of the same pattern as the original painful childhood relationships. Although we do not know how they occur, the new relationships are described in ways that suggest the characteristics of well-functioning marriages in the research accomplished over many years at the Timberlawn Research Foundation.2 The relationship structure is clear, affection is openly expressed, and power (particularly in defining the relationship) is mostly shared. There is a high level of commitment to the relationship, joint problem solving is well developed, and psychological intimacy (the sharing of vulnerabilities) is often present. In such a relationship, partners develop an increased ability to function with autonomy and to feel a newfound safety in closeness. As a consequence, they appear to have matured psychologically.

Many of these nonclinical persons with dysfunctional families of origin and prior relationship failures ascribe their new and positive experiences to their partners' characteristics. "He [or she] is so loving, stable, and sensitive that I finally grew in my ability to trust, express myself, and change old, destructive behaviors," was said in different ways. What is not known, however, is how such healing relationships come to be. Luck may play a role, but there are likely other factors that influence how a person with traumatic childhood experiences and adult relationship failures finally selects a different type of partner and co-constructs a transforming relationship.

Although a new romantic relationship (usually marital) was the most common, other relationships with psychotherapists, close friends, ministers, and important others were also described. The shared characteristics in all of these "healing" relationships included emotional intensity, reciprocity (ie, the relationship was seen as important to both participants), and sufficient time—usually several years. It is also apparent that deeply spiritual experiences can also be associated with evidence of personal growth. These are usually gradual and are often described as a new and more intense relationship with a loving God.

Another type of adult experience that appeared to promote psychological growth involved the resolution of a severe crisis. Many of the crises fit the description of major depression; a small number involved alcohol(Drug information on alcohol) abuse, but a substantial minority did not fit any syndromal pattern. Many of the subjects describing the crisis pattern received psychiatric care (psychotherapy most often, but psychotropic drugs as well). There remains some debate about what has been called the posttraumatic growth syndrome. Some students believe that the reported growth is real and others emphasize that believing one has been positively changed by struggling with adversity is but a part of coping with that adversity and does not necessarily reflect objectifiable psychological growth. I have discussed this intriguing issue in an earlier column.3

Changes in systems of meaning were the most common change mechanism described for the group by those who appeared to mature as a result of resolution of crises. Almost all these subjects described a movement away from self-interests (eg, accomplishments) to the search for meaning in relationships with others (eg, generativity).

A small number of nonclinical subjects did not describe a new and healing relationship or the resolution of a serious crisis. Rather, they found it difficult to account for their maturation. "I guess I finally grew up," was said in one way or another by these subjects.

The current thinking about adult maturation is almost exclusively psychological. Psychoanalytic theory emphasizes the internalization of important others and the replacement of earlier internal object representations with new and more positive ones. Attachment theory describes changes in internal working models of relationships brought about by new and secure adult attachments that replace or modify insecure attachment styles learned in childhood. Cognitive theory emphasizes much the same processes that result in revised internal relationship schemata.

Although there is growing appreciation that sustained behavioral changes must involve synaptogenesis and changed brain circuitry, there has been little attention paid to how the types of experiences described in this essay can operate through their impact on the genetic activity required for those brain changes. It seems reasonable to speculate that as the genes that influence the propensity for complex traits like autonomy and relatedness are identified, we will be able to better understand why the same adult experiences that appear to facilitate growth in some, fail to do so in others. It may well turn out that, as has been demonstrated for certain forms of psychopathology, healthy adult development requires both certain types of experiences and the presence of certain combinations of genes.

 

 

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References
1. Reiss D, Neiderhiser JM, Hetherington EM, Plomin R. The Relationship Code: Deciphering Genetic and Social Influences on Adolescent Development. Cambridge, Mass: Harvard University Press; 2000.
2. Lewis JM. Marriage as a Search for Healing: Theory, Assessment, and Therapy. New York: Bernel Books; 1997.3. Lewis JM. The post-traumatic growth syndrome: fact or fiction? Psychiatr Times. 2007;XXIV(14):18-19.


 
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