Komisar: Why early presence shapes lifelong mental health

Komisar says 85% of the right (social/emotional) brain is built by age three, driven heavily by the caregiving environment. Frequent soothing, skin‑to‑skin contact, eye contact, and parental responsiveness during this period shape a child’s capacity for emotional regulation, trust, and resilience. While adolescence (9–25) offers a “second chance” to repair some damage, you cannot fully recreate the neurodevelopmental conditions of the 0–3 window.

Longitudinal attachment research cited by Komisar shows that infants who are securely attached at 12 months are overwhelmingly more likely to be secure and mentally healthy 20 years later, while those insecure at 12 months are far more likely to develop anxiety, depression, ADHD‑like behaviors, and personality disorders. Security comes from a consistently present, sensitive, empathic primary caregiver—not from brief “quality time” layered onto extensive separations.

Komisar frames ADHD behaviors (hyperactivity, impulsivity, distractibility) as manifestations of fight‑or‑flight: “fight” yields aggression and acting out; “flight” yields distraction and inattention. Early separation, daycare, sleep‑training and other practices can prematurely activate the amygdala, enlarge it under chronic cortisol exposure, and then burn it out, leaving an overactive “on” switch and an underdeveloped “off” switch (hippocampus). She calls current medication‑first treatment for many children “malpractice” when underlying stressors and relational factors have not been assessed and addressed.

Drawing on hormone research, she argues that oxytocin in mothers promotes vigilant, sensitive, empathic nurturing and buffering from stress, especially in infancy. In fathers, oxytocin is linked more to playful physical stimulation, risk‑taking, and teaching regulation of excitement and aggression, supported by higher vasopressin. She contends that children raised without either a robust “mother figure” or “father figure” are missing key developmental inputs, even in same‑sex or single‑parent families, and that these roles must be consciously filled rather than assumed to be neutral or interchangeable.

Komisar strongly criticizes early daycare, saying research shows it elevates salivary cortisol in infants and toddlers, and correlates with increased aggression, anxiety, behavioral issues, and attachment disturbances later. She insists that babies under three do not need peer “socialization”; they need one‑to‑one attachment with a consistent caregiver. When childcare is unavoidable, she recommends a hierarchy: (1) primary attachment figure, (2) extended family/kinship caregivers, and only then (3) institutional daycare as a last resort.