Finding blooms amid the ashes

“You don’t grow up as a Southerner without wondering how people come to be who they are. It’s just a part of the culture.” So says Linda C. Mayes, M.D., who ought to know, having grown up in the small town of Winchester, Tenn., at the foot of the Cumberland Plateau.

Mayes has built on this cultural touchstone in her scientific contributions to our knowledge of human development. Now the Arnold Gesell Professor of Child Development in the Child Study Center (CSC), she has conducted seminal studies of how stress-induced disturbances in early brain development affect children’s later ability to recognize and regulate their emotions.

As a young woman, Mayes moved from Winchester to the mountains of Sewanee, Tenn., to attend college at the University of the South. There, she immersed herself in the history and literature of the post-Civil War South and came away impressed by the extraordinary burst of literary creativity that took place in the wake of the region’s wartime trauma and humiliation.

“I’ve always been interested in the idea that when a culture is undergoing tremendous transition, oftentimes you see a great flowering of the arts.” In the field of child development, Mayes explains, researchers “often talk about the capacity to preserve imaginative play. If a child preserves creativity despite horrific trauma, it’s often a sign of adaptability and some spark of health.”

During medical school training and a pediatrics residency at Vanderbilt University School of Medicine, Mayes specialized in neonatology, with a special interest in the work of the intensive-care nursery. At first, she was captivated by the rapid changes seen in sick infants as they struggle toward wellness, but soon found herself drawn to longer-term questions. “What I ultimately found most intriguing about neonatology was what happened to the infants after they left the nursery,” she says, “how their life stories evolved and their long-term outcome after we had done the best we could with medicine.”

Arriving at Yale as a Robert Wood Johnson General Pediatrics Fellow in 1992, Mayes began collaborating with the late William Kessen, Ph.D., who believed that research ties with pediatricians would strengthen developmental psychology, which he saw as in danger of becoming isolated from children’s real-world, day-to-day lives. Other research partnerships with developmental pediatrician Richard H. Granger, M.D., and legendary child psychiatrist and CSC director Donald J. Cohen, M.D., both also now deceased, profoundly shaped her views as well.

Trained as a child and adult psychoanalyst, Mayes maintains a clinical practice at the Child Study Center, using play-centered therapy techniques with children as young as 3 years who suffer from trauma or loss of a loved one. In 2007, she was appointed special advisor to Dean Robert J. Alpern, M.D., a position in which she oversees scientific integrity in research conducted at the School of Medicine.

In her own behavioral neuroscience research, Mayes uses dense-array electroencephalography (EEG) to measure subtle changes in brain function that result from early childhood stress, whether caused by prenatal exposure to cocaine or broader, more all-encompassing stressors such as poverty and violence. In long-term studies at Yale, Mayes has found that early cocaine exposure disrupts the regional specialization of the cortex necessary for efficient learning and effective emotional control. These changes themselves lead to an increased vulnerability to drug addiction, a vicious intergenerational cycle that Mayes hopes her work can help to bring to an end. In partnership with the Anna Freud Centre in London, where she is a member of the directorial team, Mayes and her colleagues have recently developed a parallel EEG lab and they are developing clinical interventions for at-risk families and adolescents.

“The families involved in our longitudinal research let us stay in their lives for such a long time, because that’s the only way to really find anything out,” says Mayes. “We are studying adolescents who are now 15 and 16 years who we have known since they were newborns. It’s a real honor.”