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Reviewed Publisher: 
New York: The Atlantic Monthly Press,. 364 pages, $25. Hardcover. ISBN: 0871137038
Reviewed Title: 
Ghosts from the Nursery: Tracing the Roots of Violence(1997)
Reviewed Author: 
Publication Date: 
March, 1998
Starting Page: 
Page Count: 

This very important book will advance the mission of APPPAH. Dr. T. Berry Brazelton calls it a "timely classic" and a "call to alarm". Robin Karr-Morse is a marriage and family therapist tapped for statewide leadership in child welfare and child abuse prevention; she advises the Oregon Legislature on child and family issues. Her co-author, attorney Meredith Wiley is chief of staff to the Oregon Speaker of the House. This powerful duo has worked to restructure services to families and children in Oregon.

The central message of the book is that in seeking an explanation for the rising tide of violence in the United States-children being the fastest growing segment of the criminal population-we must look to the first chapter of life, prenatal development, and the first two years following birth. From "gestation and birth, we begin to develop a template of expectations about ourselves and other people, anticipating responsiveness or indifference, success or failure. This is when the foundation of who we become and how we relate to others and to the world around us is built, "(p 4)

During these critical thirty-three months of infancy, the individual forms the core of conscience by developing the ability to trust and relate to others, and lays down the foundation for lifelong learning and thinking. The authors convincingly argue that the majority of complex factors leading to violence take root in the nursery-where few are looking.

The causes of violence are complex, but according to the research cited, maltreatment during the first thirty-three months of life threaten the three factors that protect against violent adult behavior. These protective factors are intelligence, trust, and empathy. Chemical, emotional, and social toxins threaten these protectors and are precursors to violence. These toxins are drugs, alcohol, tobacco, chronic stress, abuse, neglect, parental depression, and loss of primary relationships.

Research is cited throughout the book to enlighten readers how early factors combine to create antisocial outcomes. Except in rare instances (such as certain severe head injuries) one factor alone will not eventuate in antisocial outcomes. Nor does exposure to early violence alone predict adult violence. Psychiatrist Dorothy Lewis has found that "adult criminal violence results from the interaction of two or more internal factors (i.e., cognitive and/or neuropsychiatrie deficits) with early negative family circumstances" (p 10).

In a beautifully organized sequence, the authors demonstrate how internal vulnerabilities combine with certain negative environmental factors to create a "predictably explosive mixture of life circumstances" heralding disaster for a child and society. Prenatal exposure to emotional, social, and chemical toxins, with specific correlations to the effects, are discussed and then summarized in an appendix.

Each chapter begins with a portion of the life story of Jeffrey, a young man on death row who murdered at age sixteen. His story helps us understand how a baby becomes a violent criminal and hopefully will inspire us to act in protecting and preventing others from such a tragic loss of promise.

The authors do a good job of outlining recent discoveries in brain research and apply this to the critical first thirty-three months of life. The structure and function of the brain as well as its biological adjustment to positive and negative forces and how these adjustments affect social behavior are clearly explained. The different origins and pathways of impulsive violence and premeditated violence are described. The authors stress that the nervous system, muscles, and body chemistry are involved in recording experiences from conception on. There is a biological component to every recorded experience. Experiences change the brain and the brain mediates experience.

During the first nine months of life, the brain is built from the matter available and works toward survival within the given environment. It is assessing what to expect, how safe the world is, and whether to trust or to fear. From first relationships develop the strategies that will be reinforced or altered by experiences after birth. By eighteen weeks gestation, all one hundred to two hundred billion basic brain cells, the neurons, are installed for life. By birth, the connecting dendrites and synapses have begun to form. All these creative processes must be protected, stimulated, and nurtured.

An attuned caregiver regulates a baby's physical and emotional states and provides the baby with opportunities to practice self-soothing which will ultimately result in self control and self confidence. Such a baby is on the path to becoming a social adult following the "Platinum Rule": Do unto others as you would have others do unto others. What is done to a baby becomes the internal working model for what to do unto others.

There is something in this book for everyone. Parents will be affirmed in their irreplaceable opportunity to provide a welcoming prenatal and postnatal environment for their child. Teachers will be enlightened in assessing and helping their students become successful. Other concerned adults are encouraged to follow their intuitive sense about a child's first signals for intervention. Medical and academic researchers will be grateful for a fourteen page bibliography, detailed index, five appendices, and 466 footnotes at the end of the 300 page text. Journalists will be able to shape core arguments about the critical importance of advancing the well-being of babies and about the dangers of neglecting it. Social service providers, foundations, community organizers, lobbyists, and legislators will find convincing data to back changes in public policy and improve funding to prevent maltreatment of babies beginning from conception. Even skeptics will find opportunities to replicate and/or challenge the authors' claims and warnings. With the help of this book, perhaps even our prison system, now a major growth industry, will be more capable of assessing a punishment process that replicates and reinforces the original causes of violence and returns persons to society more violent than ever.

Members of APPPAH will find this volume helpful in bringing the Association's mission to their various realms of professional work. They should be able to enthusiastically recommend this book to colleagues, clients, politicians, and students as a way to raise consciousness and influence child rearing. A critical mass is needed to build communities around babies and to shape public policy that incorporates the information that we now have, namely, that conscience formation, brain development, emergence of empathy and clear thinking all originate in the first thirty-three months of life, beginning with conception. Paying attention to this is in everyone's best interest. Chapter One (15 pages) can be used alone as an overview of the entire book and can serve as a handout or as an insert in letters to legislators.