Clinical social worker and psychoanalyst Erica Komisar‘s deep interview contains her analysis of “why modern children are so anxious, depressed, and diagnosed with ADHD.” Core messages: 0-3 years attachment forms the ’emotional core’ of lifelong mental health, modern parenting, daycare, and parental absence leads to chronic stress, cortisol elevation, brain development abnormalities resulting in anxiety, depression, ADHD, behavioral problems, and attachment disorders. She also presents practical health actions parents can take right now.
1. Erica Komisar – “Attachment Expert”
- Specialty: Infant mental health, attachment theory, parent-child relationships
- Experience: 30+ years clinical practice
- Book: “Being There: Why Prioritizing Presence in the First Three Years Matters”
- Core argument: 0-3 years attachment determines lifelong mental health
2. The 3P Mission
② Prioritisation: Children over career and consumption during critical windows
③ Prevention: Prevention over symptom management
“1 in 5” Statistics
- US: 1 in 5 children experience serious mental illness
- UK: 1 in 6 children
- Conditions: Anxiety, depression, ADHD, behavioral disorders, suicidal thoughts
- Komisar: “Current systems focus only on symptom management. Root causes—attachment and environment—are ignored.”
3. The ‘Emotional Core’ Formed in 0-3 Years
– Neurologically and emotionally very fragile
– Cannot self-regulate emotions
– Learn stability only through caregiver’s sensitive empathy and soothing
Brain Development and 85%
- 0-3 years: Right brain (emotion, intuition, relationships) primarily develops
- Age 3: About 85% of right-brain network is formed
- Mechanism: Repeated experiences of “crying, being held, eye contact, soft voice soothing”
- Result: Stress and emotion circuits organize, forming foundation for self-regulation
4. Four Attachment Styles
5. ADHD, Anxiety, Behavioral Problems – Stress Perspective
“ADHD diagnosis explosion is not just genetics. Many cases are expressions of chronic early stress and attachment anxiety.”
Mechanism:
– Repeated cortisol exposure
– Amygdala and alert systems overgrow
– Hypervigilance, hyperactivity, attention difficulties solidify
“Turning Off Warning Lights” Metaphor
- Current system: Manage symptoms with ADHD medication and behavioral therapy
- Problem: Just “turning off the warning light” that signals the child’s distress
- Needed: Explore root causes – family conflict, frequent separations, caregiver changes, excessive screens, overscheduling
6. Daycare Debate
“Long hours in institutional care during the first year, especially 0-12 months:
– Significantly raises infant salivary cortisol (stress marker)
– Increases risk of aggression, anxiety, behavioral problems, attachment disorders
Daycare is not the best choice except when unavoidable.”
Important: This is Controversial
Komisar’s claims face strong counterarguments from other experts:
- High-quality daycare can coexist with secure attachment
- Not all families can afford full-time parenting
- Risk of inducing guilt and anxiety
- Consider each family’s reality, support network, and child’s temperament
7. Mother and Father Roles
– Oxytocin strengthens empathy, soothing, sensitive nurturing
– Primarily regulates sadness, fear, anxiety
– “Safe base” function
– Oxytocin/vasopressin linked to rough play, exploration encouragement
– Regulates excitement, aggression, risk-taking
– “Courage to go into the world”
“Same-sex parents and single parents can also compensate significantly if they ‘learn and practice attachment principles and sensitive care.’ What matters is not who, but ‘how consistently sensitive and trustworthy the primary caregiver is.'”
8. Practical Health Actions for Parents
– One primary caregiver consistently emotionally present
– Respond sensitively to child’s signals (crying, expressions, movements)
– Lots of eye contact, soft voice, physical touch
– Secure slow time (play, reading, walks, simple routines)
❌ Avoid
– Ignoring child while absorbed in screens/SNS
– Overloading child with excessive schedules
– Verbal abuse, domestic violence, chronic tension
– Frequent caregiver changes
– Long separations (minimize if unavoidable)
If ADHD is Suspected
- First explore environmental/relational factors with family therapist
- Reduce stressors at home
- Drastically reduce screen time
- Create regular, predictable routines
- Ensure sufficient sleep and physical activity
- If no improvement, discuss medication with specialist
9. Recovery Possible After 30?
“Brain and attachment circuits can change even after age 30.”
Possible Methods:
– Psychoanalysis, attachment-based therapy
– EMDR (trauma treatment)
– Group therapy, support groups
– Healthy partnership experiences
Recognizing childhood patterns and readjusting to more secure attachment styles is possible.
5 Core Principles
- 0-3 years is critical: Emotional core forms during this period
- Presence is key: Physical presence + emotional response = real presence
- Attachment is default setting: Without awareness, patterns repeat lifelong
- ADHD/anxiety/behavioral issues may be stress signals: Check environment before medication
- Change possible after 30: Attachment patterns can change with awareness and therapy
Conclusion – “Listen to Your Child’s Signals”
Erica Komisar‘s message is sometimes uncomfortable, but the core is simple: “Children’s mental health crisis is something we created, and something we can change.”
The 0-3 year brain is structured through experience. “Someone comes when I cry” creates neural circuits of “the world is safe.” “No one comes when I cry” creates circuits of “I’m alone.”
ADHD, anxiety, depression, behavioral problems – all of these may be the child’s signal saying “help me.” Before turning off the signal with medication, we must ask why that signal is appearing.
The most important health investment may not be gym membership. It may be putting down the smartphone, looking into your child’s eyes, and saying “I’m here, I’m listening to you.”