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Modern Attachment Theory: The Central Role of Affect Regulation in Development and Treatment

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Abstract

Over the past decade attachment theory has undergone an intense expansion of both its original scientific foundations as well as its applications to clinical work. Bowlby’s original description occurred during a period of behaviorism and an emphasis on the strange situation and secure base behaviors, which then gave way to a dominance of cognition and an emphasis on attachment narratives and reflective capacities. We will argue that in line with Bowlby’s fundamental goal of the integration of psychological and biological models of human development, the current interest in affective bodily-based processes, interactive regulation, early experience-dependent brain maturation, stress, and nonconscious relational transactions has shifted attachment theory to a regulation theory. This emphasis on the right brain systems that underlie attachment and developmental change has in turn forged deeper connections with clinical models of psychotherapeutic change, all of which are consonant with psychoanalytic understandings. Modern attachment theory can thus be incorporated into the core of social work theory, research, and practice.

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... The answer to this question is, unsurprisingly, not simple. Early interactions between a child and caregiver form the basis of their attachment relationship (Bowlby, 1969) and shape the child's developing capacity for self-regulation (Schore & Schore, 2007). These interactions are rich in sensory information; therefore, the child and caregiver's sensory processing pattern may affect the quality of these interactions (Turner et al., 2012;Whitcomb et al., 2015). ...
... Second, Whitcomb et al. (2015) theorised that the child-caregiver attachment relationship may either support or challenge the child's development of sensory modulation. Attachment research has highlighted that a child's development of selfregulation is promoted by caregivers who respond to their child in a consistent and sensitive manner (Schore & Schore, 2007). Self-regulation refers to one's capacity to regulate emotional states and organise a behavioural response to experiences (Barton, 2000), which includes the regulation of one's emotional and behavioural responses to sensations (i.e., sensory modulation; Taipale, 2016). ...
... Child-caregiver interactions, which are inherently rich in multisensory input (Whitcomb, 2014), form the basis of the attachment relationship and shape the child's development of self-regulation (Schore, 2001;Schore & Schore, 2007). ...
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Clinicians and researchers have increasingly identified that individuals often co-present with sensory processing and attachment difficulties. To understand and support clients with difficulties related to sensory processing and/or attachment, more research is needed to understand how and why these two constructs are related, particularly in the context of contemporary research on psychophysiology and childhood adversity. The purpose of this thesis is to investigate the ways in which sensory processing and attachment patterns are related, the reasons they may be related, and to examine the implications of this relationship for areas of functioning and wellbeing. A scoping review was undertaken to examine evidence for a relationship between sensory processing and attachment patterns across the lifespan. There is emerging evidence in children that attachment security is related to better sensory modulation (i.e., self-regulation in response to sensations). In adults, there is also evidence that having a low sensory threshold (i.e., easily noticing and/or becoming overwhelmed by sensory stimuli) is related to attachment anxiety and, to a lesser extent, attachment avoidance. Findings from this review highlighted a need for further research in this area, including research: (1) examining the impact of childhood experiences on the relationship between sensory processing and attachment patterns; (2) investigating the psychophysiological underpinnings of sensory processing; and (3) exploring the implications for sensory processing and attachment on functioning and wellbeing. Based on the findings of this scoping review and a broader review of relevant research and theories, three cross-sectional studies were designed to address these gaps in the literature and lay the foundation for the proposition of a new model to understand the complex interactions between these factors. The first study was a laboratory-based study with a non-clinical young adult sample. This study aimed to determine whether different sensory processing patterns were associated with differences in autonomic functioning before, during and after a physical stressor. In the study, a low sensory threshold was related to unique patterns of autonomic activity and reactivity, which varied by gender. Previous studies have found that autonomic arousal may underpin patterns of attachment insecurity and explain the behavioural patterns of people who have experience childhood adversity. This study therefore indicates that autonomic arousal may be a potential psychophysiological factor that underpins the relationship between these constructs. The second study was an online survey with a non-clinical adult sample designed to investigate the links between sensory processing patterns, attachment patterns, and childhood experiences. In this study, it was found that childhood adversity predicted more attachment anxiety in adulthood for highly sensitive individuals. However, childhood adversity predicted more attachment avoidance for individuals with low levels of sensitivity. These findings indicate that sensory processing sensitivity interacts with childhood adversity to shape the type of attachment pattern an individual experiences in adulthood. The second study also produced a second paper that investigated the interaction effect between childhood adversity and sensory processing sensitivity on meaningful activity engagement in adulthood. Sensory processing sensitivity was not related to meaningful activity engagement and did not moderate the relationship between childhood adversity and meaningful activity engagement. Childhood adversity did, however, directly affect an individual’s level of meaningful activity engagement in adulthood. This finding supports the involvement of early intervention occupational therapists for individuals who experience childhood adversity as they are more likely to have long-term difficulties with meaningful activity engagement, which has important implications for their health and wellbeing. The third study investigated the implications of sensory processing and attachment patterns for functioning in families of children with persistent pain. Pain is a sensory experience that can trigger an individual’s threat response and activate their attachment system. Children with persistent pain often co-present with sensory processing and attachment difficulties, which impact their wellbeing and functioning. Because it was theorised that a child’s sensory processing and attachment patterns impact the child-caregiver relationship, it was expected that the child’s sensory processing and attachment patterns may also affect caregiver functioning in this context. However, it was found that the children’s sensory processing patterns were not related to parent functioning. Child and parent attachment avoidance were, however, significantly related to poorer parent functioning in a range of domains. Because the study did not investigate parent sensory processing patterns, further research is needed to understand how the interaction between child and caregiver sensory processing patterns may affect the attachment relationship and family functioning. When considering the findings of these studies alongside the contemporary literature, there is growing evidence that sensory processing, attachment patterns, and childhood experiences are interrelated factors that may be underpinned by autonomic arousal. However, it is evident that there is a need for an integrative model that conceptualises sensory processing in the context of attachment, childhood experiences, and autonomic functioning. The Dyadic Model of Sensory Modulation is therefore proposed in the fourth and final section of this thesis. Clinical implications and future areas of study are discussed that may help to further understand this emerging area of research and practice.
... • Emotion regulation: the ability for an individual to regulate his or her own psychobiological emotional states through various means, such as interaction with others and autonomous autoregulation of emotions (Schore & Schore, 2008). The success of such regulation strategies is highly dependent on early interactions with caregivers, which form the basis for one's ability to interact meaningfully with those surrounding the individual. ...
... In essence, this is the classic 'nature versus nurture' debate. In 1994, Schore posited that attachment behaviour is vital for the development of the essential right-brain processes like emotion regulation, stress modulation and self-regulation, all of which are vital for the development of a coherent sense of self, and further claimed that the most important task in early childhood is for a child to learn self-regulation (Schore & Schore, 2008). In particular, attachment is important for the synaptic connections in the right hemisphere, where the individual's sense of self and social connections with others is formed (Schore & Schore, 2008). ...
... In 1994, Schore posited that attachment behaviour is vital for the development of the essential right-brain processes like emotion regulation, stress modulation and self-regulation, all of which are vital for the development of a coherent sense of self, and further claimed that the most important task in early childhood is for a child to learn self-regulation (Schore & Schore, 2008). In particular, attachment is important for the synaptic connections in the right hemisphere, where the individual's sense of self and social connections with others is formed (Schore & Schore, 2008). Hence, development comes from the relationship between mind, brain and body of the caregiver and the infant together, and that this can only take place in an environment that supports them both, in much the same way that Bowlby and Winnicott both described. ...
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The following paper serves as a Masters' dissertation. In 2017, a large proportion of children around the world were placed into alternative care through child protection statutory interventions. Based on the researcher's own experiences as a child protection social worker in South Africa, a number of children who face these interventions have parents who faced similar interventions in their youth, indicating a cycle of violence transmitted across generations. The researcher hypothesised that this cycle may come about as a result of attachment difficulties stemming from infancy, and thus, this paper sought to answer the following research questions: (1) What effects does exposure to family violence have on children? (2) What are the impacts of family violence on child attachment styles? (3) How do these acquired attachment styles affect future childcare? (4) What methods (if any) can be employed to improve or change attachment styles? The three theorists used as a focal point for this research were John Bowlby, Donald W. Winnicott and Alan N. Schore. The study consisted of a systematic review of literature. The dataset consisted of fifty-one peer reviewed journal articles, which was analysed through a thematic analysis of literature. Whilst it seems that this cycle of violence is indeed linked to attachment difficulties and that attachment styles can be transmitted intergenerationally, as was hypothesised by the researcher, it appears that this issue is more complex, with other factors such as mental health, social support and socioeconomic status also playing a role. Key words Attachment security, family violence, child protection, cycle of violence, intergenerational transmission of trauma 3 Acknowledgements This paper would not exist were it not for the contributions of several people. This year has been tumultuous for very many people, as the coronavirus caused lectures and supervision to be cancelled, stranded people, isolated them and tested their resilience to the extreme. I was very lucky that, throughout this time, I had a strong support network that guided me, even though I was not physically present in their lives. Firstly, I would be remiss not to thank my supervisor, Professor Punzi, who gave me guidance and advice, proofread my documents and approached my ideas with an extreme enthusiasm that renewed my own excitement for this project. This paper would be much poorer without your contributions, Professor, and I am grateful. Secondly, to Viktoria Jendmyr, our course administrator, our port of call when we had questions and our link to the university, thank you so much for your tireless work. Next, I have to thank my mother, Margaretha Pankhurst. Firstly, she gave birth to me, raised me and supported me. Secondly, she was my first editor on this document, my main sounding board for my ideas and the person I turned to when I was feeling anxious, nervous or insecure. Thank you always. To my father, Peter Pankhurst and my brother, Christy Pankhurst, thank you for believing in me, supporting me and making me laugh.
... And, although at first glance "attachment theory is deceptively simple on the surface" (Schore & Schore, 2008, p. 9) it is a complex theory of human development. According to Schore and Schore (2008), contemporary interdisciplinary research in the areas of neurobiology and neuropsychology can now explain why "early emotional transactions with the primary object impact the development of psychic structure, that is how affective attachment communications facilitate the maturation of brain systems involved in affect and self-regulation" (p. 9). ...
... Over the course of time, attachment theory has been proven to be an effective framework for examining, organizing, and integrating the interconnected concepts of interpersonal functioning, emotion regulation, developmental relationships, health, mental health, coping, and psychopathology (Mikulincer & Shaver, 2012;Berry & Drake, 2010;Schore & Schore, 2008). ...
... Attunement can also be understood as how reactive a person is to the emotional needs and affective state of another and is critical to the development of affect regulation (Schore & Schore, 2008;Wylie & Turner, 2011). Schore and Schore (2008) further noted the regulation of one's affect is central to optimal human functioning and is often compromised in those who have experienced early relational trauma. ...
Article
The Attuned School Clinician: An Advanced Clinical Practice Curriculum in Attachment Informed School-Based Mental Health for Social Workers Lauren. M. DePinto, MSW, LCSW Dissertation Chair: Joretha Bourjolly, PhD As the educational landscape in our country continues to transform and the mental health needs of our youth increases, so have the domains and demands of school social work practice. One of the most influential advancements impacting school social work has been the expansion of school-based mental health (SBMH) programs and services. This dissertation calls attention to the growing clinical role social workers play in the delivery of direct mental health services in schools. A review of the literature suggests it is timely and necessary to introduce content specific to SBMH into the social work curriculum to adequately meet the requisite needs of current MSW students entering the field. Additionally, this dissertation aims to develop an advanced clinical practice course for second-year MSW students that is grounded in the principles of attachment theory and introduces an empirically supported theoretical framework that extends a developmental and applied way of thinking, observing, examining, and interpreting behaviors in school-based clinical practice settings. This proposed advanced clinical practice course is designed to strengthen clinical practice skills and expand upon the foundations of school social work. The primary educational objectives of this course aim to introduce, broaden, and deepen students' understanding of attachment theory as a developmental framework for relationship-focused clinical school social work practice and is intended to cultivate and shape the reflective professional identity of the attuned school clinician. Course content introduced and discussed will include: the historical context of school-based mental health, the current state of SBMH and the expansion of school social work; attachment theory as a framework for relational and reflective clinical school social work practice; attachment and emotional development in the classroom; reflective practice and the shaping of professional identity; clinician secure base reflection. Keywords: school-based mental health, clinical school social work, attachment theory, relationships, reflective practice, social work education, curriculum development
... Instead, psychopathology is rooted in and continually unfolds from the transactions between child and context. In children and adolescents referred to therapy, core developmental processes such as adequate regulation of attention, arousal, and affect can often present as disturbed, derailed, or halted (Schore and Schore, 2008;Jacobsen and Svendsen, 2010). The same is often true for their important social relationships. ...
... A developmental view of psychopathology also means that therapy with children and young people should be viewed as a developmental process rather than a repair process with a one-sided focus on symptom relief (Johns and Svendsen, 2016). Specifically, this view of psychotherapy includes a focus on influencing core developmental abilities and processes underlying developmentally supportive transactions (Jacobsen and Svendsen, 2010), such as the capacity for joint attention (Mundy and Jarrold, 2010;Hansen, 2012), implicit beliefs around oneself as a causal agent (self-agency) (Stern, 1985(Stern, /2000Kögler, 2012), and regulation of arousal and affect (Sørensen, 2006;Schore and Schore, 2008). Affect integration (Solbakken et al., 2011a), defined as the ability to attend to, tolerate, regulate, and express affect both nonverbally and conceptually, is particularly important because of the central role of affect in both communication and creation of meaning and significance around internal and external events (Saarni et al., 1998;Campos et al., 2004). ...
... Furthermore, as parents are a large part of a child's context and day-to-day transactions, parents' ability to see, meet, and reflect on the child's developmental needs is vital for healthy development (Sørensen, 2006;Schore and Schore, 2008). Importantly, transactions and transactional effects can be positive or negative (Sameroff, 2009). ...
Article
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Psychopathology in children cannot be understood without considering developmental processes and transactional relationships, particularly the relationship with caregivers. Time-limited intersubjective child psychotherapy (TIC) is a developmental and transactional approach aimed at helping children and caregivers get back on healthier developmental trajectories. Core developmental processes, such as self-other-regulation and affect integration, are considered particularly important for healthy function and transactions with caregivers and contexts. Therefore, TIC seeks to strengthen core developmental processes in the child and the caregivers’ ability to scaffold the child’s development. This is achieved through parallel child therapy and parent sessions. The current study is a qualitative study of parents’ experiences of change after TIC. The study explores parents’ perception of change in their child, themselves, and their transactions, and what they experienced as helpful in therapy. Materials and Methods Nine semi-structured qualitative interviews were conducted with parents ( n = 13) of nine children aged 9–12 years with internalizing difficulties after completing TIC. The data were analyzed with thematic analysis. Results The parents described positive changes in the children’s ability to understand, regulate and express themselves. The parents also described positive changes in their parenting, and for all nine children the parents reported positive changes in the transactions between themselves and the child. Most parents saw the parallel child and parental sessions as particularly important, while several parents mentioned play and the therapeutic focus. Discussion Parents’ description of changes after TIC indicate that the parents perceived their children as strengthened in core developmental processes important for intersubjective exchanges such as self-regulation and affect integration. In addition, parents saw their children and their own contributions more clearly, and their transactions were described as more supportive and positive. Conclusion The results from this study give support to TIC as a developmentally supportive approach to therapy, with potential effects on children’s core developmental processes, their parents’ ability to both see and scaffold the child’s development and positive effects on the transactions between children and parents. The positive effects likely result from the integration of the different parts of TIC and the synergies taking place between them, rather than any one component by itself.
... Diese Konzeption soll in Abschnitt 1.1 in Kürze dargestellt werden. Auch aus phänomenologischer Perspektive gibt es einige sehr weit fortgeschrittene Ansätze, die sich besonders auf zeitlichdynamische Aspekte von Bewegungen und Schwingungen beziehen (Siegel, 1999;Fuchs, 2016Fuchs, , 2014 (Powers & Trevarthen, 2009) oder emotionaler Resonanz (Schore, 2003;Stern, 2004;Schore & Schore, 2008) deutlich auf diese intersubjektive Feldabhängigkeit emotionaler Prozesse hinzuweisen (Steffens 2020a, S. 120ff). Auch ließe sich erklären, dass sich bei Menschen, die sich unbeobachtet fühlen, nachweislich der emotionale Ausdruck in seiner Intensität verändert und emotionale Reaktionen auf Ereignisse im Durchschnitt weniger expressiv sind (Holodynski, 2006). ...
... Die Fähigkeit, sich in andere Personen ‚hineinzuversetzen' ist nicht nur für gelingende zwischenmenschliche Interaktion, sondern auch für die eigene emotionale Entwicklung von elementarer Bedeutung. "Unsere Entwicklung beruht weitgehend darauf, dass sich ein Großteil der neuronalen Netzwerke unseres Gehirns der Aufgabe widmet, sich in den inneren Zustand einer anderen Person einzufühlen" (Siegel, 2012b, S. 71 (Stern, 1985;Stern, 2010;Trevarthen, 2012;Fuchs, 2016 (Trevarthen, 2012, S. 112) Dimensionen gemeinsam geteilter Emotionen werden besonders deutlich innerhalb von Momenten einer gleichzeitig auftretenden Koppelung von inneren Erregungszuständen (Schore, 2003;Schore & Schore, 2008). Bei einer synchronen Abstimmung des äußeren Verhaltens synchronisieren sich auch physiologische Prozesse innerhalb der beteiligten Personen. ...
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Emotionen sind im Leben allgegenwärtig. Sie bestimmen, wie wir uns fühlen, beeinflussen unsere Gedankenwelt und wirken durchgehend in allen Situationen des Lebens auf unsere Entscheidungen und unser Verhalten. Ob allein oder in sozialen Interaktionen, ob in der Schule, bei der Arbeit oder im Privatleben: Emotionen sind bewusst oder unbewusst integraler Bestandteil des Lebens und bestimmen Sein und Bewusstsein des Menschen. So ließe sich ein Leben ohne Emotionen mit einem Tanzen ohne Musik vergleichen. In diesem Beitrag soll im Sinne einer synthetischen Humanwissenschaft (Jantzen, 2018, 2019) eine interdisziplinäre Perspektive entwickelt werden, die entsprechend diese Bildes versucht aufzuzeigen, dass menschliche Tätigkeit und soziale Gemeinschaft von Beginn an nur auf das Engste verflochten mit der Funktion und der Entwicklung von Emotionen denkbar sind (Jantzen, 2014; Vygotskij, 2001). Dies gilt in besonderer Weise auch für Lernprozesse, die, obgleich in klassischen Lerntheorien traditionell als intellektueller oder kognitiver Vorgang gefasst, nicht ohne eine formgebende Beteiligung der Emotionen verlaufen. Mehr noch, mit Lev Vygotskij ließe sich sagen, dass das emotionale Erleben sowohl am Anfang kognitiven Lernens, so wie, in neuer und veränderter Form am Ende jedes Erkenntnisprozesses steht. Vygotskij hat dieses sich ständig weiterentwickelnde Verhältnis von Affekt und Intellekt mit einem Satz, dem der Titel dieses Beitrags geschuldet ist, besonders prägnant beschrieben. Die Emotionen "öffnen und schließen das Gehirn, sie sind die aller niedrigsten uralte, primäre Systeme des Gehirns und die aller höchste, spätesten, in ihrer Ausbildung nur dem Menschen eigenen“ (Vygotskij, 2001, S. 162). Auch die Neurowissenschaften beschäftigen sich intensiv mit den Wechselwirkungen zwischen Fühlen und Denken (Damasio, 2009, 2011). Mittlerweile gilt es als bestätigt, dass eine funktionale Einheit zwischen Emotionen und Kognitionen besteht, in der die Emotionen nicht einfach nur die gefühlsatmosphärische Begleitsituation eines Lernprozesses ausmachen, sondern buchstäblich formgebend auf Wahrnehmungs-, Aufmerksamkeits- und Gedächtnisprozesse wirken (Pessoa, 2013; Tyng et al., 2017). Eine analytische Trennung von Emotionen und Kognitionen in der Untersuchung von Lernprozessen erscheint somit problematisch. Umso dringlicher, dass die Bedeutung von Emotionen für das Lernen innerhalb der Bildungswissenschaften einen größeren Stellenwert einnimmt (Huber, 2018). Dies besonders auch, da Forschungen zum Verhältnis von Emotionen und Schule feststellen, dass die Freude am Lernen in der Schule bei Kindern mit dem Eintritt in die Grundschule kontinuierlich abnimmt (Hascher et al., 2011). Dies hat entsprechend Auswirkungen auf die Qualität von Lernprozessen (Hagenauer & Hascher, 2011). Es drängt sich also die Frage danach auf, was diesbezüglich falsch läuft in der Schule.
... Sensory channels, such as the visual pathway, function as an interpersonal communication channel that allows Frontiers in Psychology | www.frontiersin.org for the transmission of reciprocal influences (Schore and Schore, 2008). The interaction between the child and his caregiver develops as a kind of speechless dialog (Spitz, 1958), characterized by mutual affective mirroring modulated by a continuous synchronization of affects in which the two members of the dyad engage each other through the coordination of affective responses. ...
... If the caregiver is well adjusted, he or she can understand what is happening and allows the child the necessary space to self-regulate by withdrawing and waiting for the signals that indicate the child's readiness for new involvement. Mirroring is characterized by interactions with continuous regulatory mechanisms (autonomous and relational); thus, emotional regulation develops within this synchronized mode of interaction (Schore and Schore, 2008). ...
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Eating disorders (EDs) can be viewed as “embodied acts” that help to cope with internal and external demands that are perceived as overwhelming. The maintenance of EDs affects the entire identity of the person; the lack of a defined; or valid sense of self is expressed in terms of both physical body and personal identity. According to attachment theory, primary relationships characterized by insecurity, traumatic experiences, poor mirroring, and emotional attunement lead to the development of dysfunctional regulatory strategies. Although the literature shows an association between attachment style or states of mind, trauma, behavioral strategies, and various EDs, the debate is still ongoing and the results are still conflicting. Therefore, we believe it is important to examine and treat EDs by understanding which narrative trajectory intercepts distress in relation to narrative and embodied self-concept. Drawing on clinical observation and a narrative review of the literature, we focus on the construction and organization of bodily and narrative identity. Because bodily representations are the primary tools for generating meaning, organizing experience, and shaping social identity from the earliest stages of life, we focus on the role that bodily interactions and sensorimotor and proprioceptive patterns have played in the development of EDs. We consider the role that lack of attunement, insecure attachment, and relational trauma play in mentalizing, affecting self-representation and emotion regulation strategies. The paper also considers a semantic mode of trauma in EDs that involves a top-down pathway through beliefs and narratives about oneself based on lack of amiability, on devaluation, and on humiliation memories. Finally, we would like to highlight the proposal of an integrated model with multiple access model to psychotherapy that takes into account the complexity of ED patients in whom aspects related to dysregulation, body image disintegration, and post-traumatic symptoms are associated with a suffering sense of self and a retraumatizing narrative.
... Consistently responding positively to the early needs of a child not only provides insight about how relationships should work, but also provides the foundations for later mental health, self-regulation and optimal brain development. Schore & Schore [6] underscore the importance of these early developmental interactions, "At the most fundamental level, attachment represents the evolutionary mechanism by which we are sociophysiologically connected to others and reveals how nonconscious implicit interactive regulation is the central strategy that underlies all essential survival functions of the human self-system" [6]. ...
... Consistently responding positively to the early needs of a child not only provides insight about how relationships should work, but also provides the foundations for later mental health, self-regulation and optimal brain development. Schore & Schore [6] underscore the importance of these early developmental interactions, "At the most fundamental level, attachment represents the evolutionary mechanism by which we are sociophysiologically connected to others and reveals how nonconscious implicit interactive regulation is the central strategy that underlies all essential survival functions of the human self-system" [6]. ...
... Child-Psychotherapy as a Right-Brain Psychotherapy Approach Targeting Implicit Processes and Common Factors Schore (2019) differentiates between predominantly left-brain oriented psychotherapy approaches targeting language-based or cognitive processes and predominantly right-brain oriented approaches targeting emotional and implicit processes. Schore's concept of right-brain psychotherapy builds on work by Trevarthen on intersubjective exchanges and developmental laterality (Trevarthen, 1993(Trevarthen, , 1996Trevarthen and Aitken, 2001), attachment theory (Schore and Schore, 2008), and psychodynamic theory (Schore, 2019). So far, much of psychotherapy research has focused on pre-dominantly left-brain oriented therapies trying to affect change through language and cognitive processes. ...
... Importantly, the intersubjective sharing provides the patient with new corrective experiences of feeling seen, met, and functioning in a state of higher self-organization and regulation possible than when alone. These new corrective experiences may include experiences of regularity and safety, implicit affective sharing, and repair of relational rupture, all processes important for development (Sørensen, 2006;Schore and Schore, 2008). Based on TIC's explicit focus on implicit and affective intersubjective processes within a regulating and regular framework, we argue that TIC is a prime example of right-brain psychotherapy consistent with Trevarthen's (Trevarthen, 1993;Trevarthen and Aitken, 2001) and Schore's work (Schore, 2019(Schore, , 2021. ...
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Time-limited intersubjective child-psychotherapy (TIC) is an intensive, structured right-brain oriented therapeutic approach for children and caregivers aimed at both symptom reduction and strengthening core developmental processes such as affect integration. This is the first study to investigate changes in internalizing symptoms and affect integration after TIC. Thirty-three children between 9 and 13 years with internalizing difficulties were assessed after 10 h of TIC. Internalizing symptoms were assessed through the child behavior checklist and affect integration with the affect consciousness interview (ACI). Scores from the children with internalizing difficulties were modeled in a mixed linear model along with data from a control group without internalizing difficulties (n = 24) to control for effects of time and learning. Affect integration increased significantly from time 1 to time 2 in the children with internalizing problems, but not in the control children. Internalizing symptoms were also significantly reduced in the children with internalizing difficulties from time 1 to time 2. The results indicate that TIC may contribute to a decrease in symptoms along with an increase in affect integration in children with internalizing difficulties, making the children better able to notice, tolerate and communicate affective states. This can, in turn, aid development and day-to-day regulation and interactions. The article explores key elements of TIC, such as affective attunement, relational repair, and work with caregivers using one of the individual therapies in the study as an example. The article argues that TIC represents a right-hemisphere to right-hemisphere therapeutic approach to healing that can both enhance important common therapeutic factors such a relation and alliance and bring about growth-promoting change.
... Social bonds strongly support emotional balance and promote wellbeing, mental and physical health throughout the life span of mammals and birds (74)(75)(76). ...
... According to Schore (76,77), the attachment theory is essentially a regulation theory. Interactive emotional regulation implies that emotions are regulated through interaction. ...
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The Integrative Model of Human-Animal Interactions (IMHAI) described herewith provides a conceptual framework for the study of interspecies interactions and aims to model the primary emotional processes involved in human-animal interactions. This model was developed from theoretical inputs from three fundamental disciplines for understanding interspecies interactions: neuroscience, psychology and ethology, with the objective of providing a transdisciplinary approach on which field professionals and researchers can build and collaborate. Seminal works in affective neuroscience offer a common basis between humans and animals and, as such, can be applied to the study of interspecies interactions from a One Health-One Welfare perspective. On the one hand, Jaak Panksepp's research revealed that primary/basic emotions originate in the deep subcortical regions of the brain and are shared by all mammals, including humans. On the other hand, several works in the field of neuroscience show that the basic physiological state is largely determined by the perception of safety. Thus, emotional expression reflects the state of an individual's permanent adaptation to ever-changing environmental demands. Based on this evidence and over 5 years of action research using grounded theory, alternating between research and practice, the IMHAI proposes a systemic approach to the study of primary-process emotional affects during interspecies social interactions, through the processes of emotional transfer, embodied communication and interactive emotional regulation. IMHAI aims to generate new hypotheses and predictions on affective behavior and interspecies communication. Application of such a model should promote risk prevention and the establishment of positive links between humans and animals thereby contributing to their respective wellbeing.
... These supportive others are the parents and immediate caregivers of the children. The responsiveness of these attachment figures leads to a sense of security amongst children, whereas non-responsiveness causes anxiety and stress (Schore and Schore, 2008;Richards and Schat, 2011). These experiences have an ever-lasting impact on the child's personality, further impacting the adulthood of the children (Mitroff et al., 2009;Schore and Schore, 2008). ...
... The responsiveness of these attachment figures leads to a sense of security amongst children, whereas non-responsiveness causes anxiety and stress (Schore and Schore, 2008;Richards and Schat, 2011). These experiences have an ever-lasting impact on the child's personality, further impacting the adulthood of the children (Mitroff et al., 2009;Schore and Schore, 2008). The theory goes on to highlight four kinds of personalities: (1) fearful avoidants, (2) avoidants, (3) anxious and (4) secure (Mitroff et al., 2009). ...
Article
Purpose The purpose of this study is to conduct a systematic review of the extant literature of workplace spirituality (WPS) in a manner that helps us trace its emergence in management practices in the past twelve years and to identify the gaps to be addressed by researchers in near future. Design/methodology/approach A two-step screening process was followed to extract the papers from various databases. The paper reviews one hundred fifty-nine conceptual and empirical articles published in more than fifty journals from 2010 to 2021. Leading databases like EBSCO, Scopus and ProQuest were extensively searched. The papers were analysed and grouped to arrive at the themes and classification criteria. Findings Despite numerous studies and extensive research in the past decade, the construct of WPS lacks a conclusive definition and has overlapping dimensions. It is a multidimensional concept having personal, psychological and social aspects. It is a dominant field in organisational behaviour domain. Research limitations/implications The review explains the multidisciplinary nature of WPS, having roots in organisational behaviour, psychology and theology. Further, the paper provides a clear picture of the present state of literature and enumerates future research avenues which will enable the researchers to further expand the area of WPS. Practical implications The review highlights multiple positive attitudinal outcomes that managers can attain through WPS-related initiatives. Various techniques like prayer breaks, meditation and yoga can be used by the managers for spiritual incorporation process. Originality/value This study acquires significance, for, unlike previous studies, it does not propose that inclusion of WPS will always be gainful, rather it also broaches its potential harm, if incorporated sans due caution. Considering the complexity of spiritual beliefs, it will enable managers to weigh the pros-cons of such inclusion. The research gaps identified in the review will help future researchers in furthering the field of WPS.
... In 2008 my wife Judith and I published an article "Modern Attachment Theory", where we suggested a body of experimental and clinical data on how affective bodily-based processes are nonconsciously interactively regulated had shifted attachment theory to a regulation theory [25]. I use the term regulation theory in order to explicitly denote that I am offering a theory, a systematic exposition of the general principles of a science. ...
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This article overviews my recent acceptance of a Lifetime Achievement Award from Sapienza University of Rome, in which I discussed three decades of my work on the right brain in development, psychopathogenesis, and psychotherapy. In the following, I offer current brain laterality and hemispheric asymmetry research indicating that right brain emotional and relational processes operate beneath conscious awareness not only in early human development, but over the lifespan. I discuss recent interdisciplinary studies on the central role of ultrarapid right brain-to-right brain intersubjective communications of face, voice, and gesture and the implicit regulation of emotion in nonverbal attachment dynamics. Special emphasis is on the fundamental psychobiological process of interpersonal synchrony, and on the evolutionary mechanism of attachment, the interactive regulation of biological synchrony within and between organisms. I then present some clinical applications, suggesting that effective therapeutic work with “primitive” nonverbal emotional attachment dynamics focuses not on conscious verbal insight but on the formation of an unconscious emotion-communicating and regulating bond within the therapeutic relationship. Lastly, I review recent hyperscanning research of the patient’s and therapist’s brains during a face-to-face, emotionally focused psychotherapy session that supports the right brain-to-right brain communication model. I end suggesting that the right brain is dominant in both short-term symptom-reducing and long-term growth-promoting deep psychotherapy.
... It is well established that positive carer-child interactions serve to build children's emotional regulation and secure attachment (Fonagy et al., 2007;Schore & Schore, 2008;Siegel, 2015). Best practice for children with trauma history centres on enhancing the child-carer relationship (Shonkoff et al., 2012) as it aims at reducing the impact of trauma (van der Kolk, 2015). ...
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Foster carers require high-quality training to support them in caring for children with trauma-related difficulties. This paper describes a mixed methods approach that was applied to evaluate the complex intervention Fostering Connections: The Trauma-Informed Foster Care Programme, a recently developed trauma-informed psychoeducational intervention for foster carers in Ireland. A quantitative outcome evaluation and a qualitative process evaluation were integrated to capture a comprehensive understanding of the effects of this complex intervention. A convergent mixed methods model with data integration was used. Coding matrix methods were employed to integrate data. There was convergence among component studies for: programme acceptability, increased trauma-informed foster caring, improvement in child regulation and peer problems, and the need for ongoing support for foster carers. This research provides support for the intervention suggesting the importance of its implementation in Ireland. The integrative findings are discussed in relation to effects and future implementation.
... The caregiver is able to achieve this synchrony through psychobiologically attuning to the child's bodily-based internal states through mutual gaze, activity level, body tone, and vocalizations (Beebe & Lachman, 2020;Feldman, 2007;Gottlieb, 1976;Levine, 2002;Richter, 1995;Sanders, Bor, & Dadds, 1984). This interactive regulation serves as a primary regulator for the infant's own developing central and autonomic nervous systems (Schore & Schore, 2008). Dyadic synchrony (Feldman, 2007) is a major component of co-regulation in parent-child dyads. ...
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The development of fidelity and quality measures for the dissemination of evidence-based practices is an often-neglected, vital step in the implementation of psychological interventions, especially within parent-infant mental health. The current study aims to address this gap by developing a competency-based measure for clinicians delivering the Group Attachment Based Intervention (GABI). GABI is an intervention aimed at supporting family preservation in parents who have experienced disparities across multiple systems of care. After observing over 100 hours of clinical video, the research team, comprised of clinicians and academic researchers, developed a competency coding system to measure clinician efficacy titled the REARING Coding System (RCS). This paper outlines the development and structure of the measure, including a detailed discussion of the model of therapeutic action (i.e., REARING: Reflective Functioning, Emotional Attunement, Affect Regulation, Reticence, Intergenerational transmission of attachment, Nurturance, and Group therapy context), as well as provides a clinical case study to illustrate the utility, flexibility, and depth of the measure. The case study details a family session consisting of a mother, father, and two children (one infant, one toddler), and how RCS can be used in supervision to foster clinical competency and effectiveness in the GABI model. RCS seeks to address the dissemination gap in EBPs by contributing to the limited number of existing fidelity and competency measures in infant mental health and psychodynamic dyadic psychotherapy. RCS is an important tool for monitoring clinical competency in the dissemination of GABI and gives supervisors the ability to provide fidelity-focused supervisions.
... Although the normative aspect and universal claims of attachment theory have been under some debate (Röttger-Rössler, 2014;Keller, 2018), there are good reasons to postulate that the quality and the extent to which children interact with their caregivers (often family members) will have some effect on their psychology as they grow up. Traditionally, attachment theory centers around the interaction between an infant/child and her caregiver as well as the cognitive and developmental consequences of such interaction or lack thereof (Schore and Schore, 2008), and cross-cultural studies usually focus on the relevance and applicability of attachment theory in non-western societies (Röttger-Rössler, 2014). In comparison, relatively little attention has been paid to the underlying social and family structures that produce various styles of attachment. ...
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The relationship between children and their maternal uncles in contemporary Mosuo culture reveals a unique parenting mode in a matrilineal society. This study compared the responses of Mosuo and Han participants from questionnaires on the parent–child and maternal uncle–child relationship. More specifically, Study 1 used Inventory of Parent and Peer Attachment (IPPA) to assess the reactions of the two groups to the relationship between children and their mothers, fathers, and maternal uncles. The results show that while Han people display a higher level of attachment toward their fathers than their maternal uncles, Mosuo people do not exhibit a significant difference in this aspect. Study 2 used a scenario-based method to compare how adults and teenagers perceive the rights and responsibilities of fathers/maternal uncles toward their children/nephews or nieces. The results show that Han adults attribute more rights and responsibilities to their own children than nephews/nieces, while their Mosuo counterparts have the reverse pattern and assign stronger responsibilities to their nephews/nieces than their own children. Both groups perceive the fathers to be the bearer of rights and responsibilities, although this perception was weaker among Mosuo. This paper concludes that in the Mosuo society, fathers have a relatively weak social role as a result of their unique matrilineal social structure.
... Second, Whitcomb et al. (2015) theorized that the childcaregiver attachment relationship may either support or challenge the child's development of sensory modulation. Attachment research has highlighted that a child's development of self-regulation is promoted by caregivers who respond to their child in a consistent and sensitive manner (Schore & Schore, 2007). Self-regulation refers to one's capacity to regulate emotional states and organize a behavioral response to experiences (Barton & Robins, 2000), which includes the regulation of one's emotional and behavioral responses to sensations (i.e., sensory modulation; Taipale, 2016). ...
Article
Background. Clinicians and researchers have observed that sensory processing and attachment difficulties frequently co-occur; however, little is known about which sensory processing and attachment patterns are interrelated across populations. Purpose. To review evidence of empirical relationships between sensory processing and attachment patterns across the life span. Method. Using the Arksey and O’Malley framework, four databases were searched up to June 2021 for studies that investigated relationships between sensory processing and attachment patterns. Findings. Twenty-two studies met inclusion criteria: nine considered sensory and attachment patterns in children/adolescents and thirteen in adults. In children, sensory modulation was positively associated with attachment security. In adults, more extreme patterns of sensory modulation (e.g., higher sensory sensitivity) were generally associated with attachment insecurity. Implications. Findings indicate empirical relationships between sensory processing and attachment constructs in children and adults that warrant further investigation. Occupational therapists should consider both sensory processing and attachment patterns when planning interventions.
... Dem Modell liegt ein Verständnis des Bindungskonzepts zugrunde, welches Bindungsrepräsentationen als Kombination aus frühkindlich geprägten und situationsspezifisch aktivierbaren Anteilen begreift, in deren Folge durch die situationale Auslösung von Affektregulationsstrategien spezifische sozioemotionale Fähigkeiten befördert oder eingeschränkt werden können (vgl. Schore u.Schore, 2008;Verhees et al., 2020). ...
Chapter
Recently, an increasing interest has been evolved in extending the mentalization model to social and cultural contexts. In this article, by using mentalization- based concepts in this broader sense, the psychosocial background of anti-democratic prejudices is analyzed and strategies for communicating with young people expressing right-wing populist attitudes are developed. For this purpose, the spread of right-wing populist prejudices in contemporary German population is shown based on current large-scale findings. Then, a model based on mentalization theory is presented, which helps to understand the socio-emotional emergence of anti-democratic prejudices. In this framework, research results regarding pedagogical contexts are shown, investigating prejudice reduction through intergroup processes in schools and supporting the effectiveness of promoting mentalizing processes. Finally, concrete strategies are discussed in detail showing how (social) educational professionals can react to right-wing populist statements through mentalization- based communication.
... Using music enables the family to try out and explore different communication patterns aiming to break inappropriate patterns, and here non-verbal communication skills are thus essential in the development of self-regulation. Supporting the child to become emotionally stable and emotionally self-regulated is one of the key aspects of parenting and parenting skills [32]. Stern further describes how intersubjective experiences and affect attunement between parent and child are necessary for the child to develop a robust emotional self [33]. ...
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Background General mental health and interpersonal skills of families are crucial to children's development and future. Research suggests a link between participation in music activities and individuals' own sense of mental health, as well as an effect in objective measures of health such as quality of life, social skills, and rehabilitation of various kinds. However, in Denmark there are not many services for families with school-aged children (7–12 years) that focus on prevention and strengthening family interaction hereby minimising the risk of children not thriving and developing optimally in terms of social and emotional skills and competences. The purpose of this study is to investigate the effect of shared music activities on family interaction, parental stress, and child well-being. Methods The study is a controlled effect study where 40 family dyads from Aalborg and Aarhus are randomized into 4 different groups including music therapy activities, community music, family concerts and a control group. Measurements of family interaction (Assessment of Parent Child Interaction, APCI) and mental health (Parental Stress Scale, PSS, and the Strengths and Difficulties Questionnaire, SDQ) will be made at baseline/pre intervention, at post intervention and a follow-up measurement 12 month after baseline (month 1, 3 and 12) 3 times in total. Furthermore, data about the family dyad’s regular participation in music events as part of every-day life at the same measure points (month 1, 3 and 12). Since this is a planned prospective study, results are not yet available, but clinical experience from a feasibility study in 2021 were promising and expected challenges and changes are discussed in the article. Discussion Findings of this study will be relevant for all fields where music is applied for families, such as education, mental health, social work and for basic research on the study of music and interaction. Music used as a resource for families is crucial in understanding how different modalities can influence the family interaction including emotional communication and attachment. Trial registration: ISRCTN, ISRCTN17290015, Registered 03 March 2022, https://www.isrctn.com/ISRCTN17290015 Date and protocol version July 2022, version 1. Protocol is planned to be updated after finalized recruitment during second data collection point and again after the third and last data collection point (see Additional file 1: SPIRIT Checklist).
... Thus, they were able to provide evidence that the changes were due to treatment and differed to what might be expected in ordinary development. How the change in internal representations comes about (mechanism of change) is not addressed by the studies, although others suggest that new relational experiences challenge working models of attachment and help develop affect regulation and reflective functioning (Brandell & Ringel, 2007;Fonagy & Target, 2002;Schore & Schore, 2007). ...
Thesis
We now know that psychodynamic psychotherapy is an effective treatment for a range of mental health problems. Far less however is known about how it works. Whilst there has been much progress in this area in relation to adults, process research regarding children and adolescents has lagged behind. In recent years, there has been some effort to begin to redress this balance. This paper provides an overview of psychotherapy process-outcome studies with adolescents (aged 11-18 years) to date. Results suggest a combination of moderators and mediators impacting therapy process and outcome. These include: the therapeutic relationship; main attachment style at the start of treatment; length of treatment; and therapeutic technique. Themes appear interlinked, suggesting that different aspects of the therapy process cannot be separated, and instead the process is complex and nuanced. Review findings may be beneficial to therapists working with adolescent patients in thinking about the treatment setting, treatment length, and model fidelity.
... Similarly, clients' interactions with their therapists can facilitate their internalization of more positive ways of relating to themselves and their emotional experiences (Alexander & French, 1946;Riess, 2012;Schore & Schore, 2008;Travis et al., 2001). Therapists' soothing presence, empathic affirmations, and validation of emotions and needs can help reduce clients' isolation and distress, as well as mistrust in and fear of their internal experience. ...
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The aim of this study was to develop and preliminarily validate a transdiagnostic model of how clients overcome Aversion to Emotion/ Self-Interruption (AESI) over the course of a session of emotion-focused therapy. The study employed task analytic methodology and consisted of two phases: a Discovery Phase and a Validation Phase. In the Discovery Phase of the study, a model of the resolution of AESI was developed through the intensive analysis of 5 cases (3 Resolved, 2 Unresolved). The model identified 7 component processes involved in this task: Marker of AESI, Awareness of How Interrupting, Awareness of Purpose of Interruption, Realization of Negative Impact of Interruption, Reduction of Fear of Emotion, Desire to Allow Emotion, and Resolution of AESI. Rating scales were developed to measure each component, so that they could be used to verify the model in the Validation Phase of the study. These rating scales consisted of the Marker of AESI Rating Scale (MARS), the Components of Resolution of AESI Rating Scale (CRARS), and the Resolution of AESI Rating Scale (RARS). In the Validation Phase of the study, segments of therapy sessions from a sample of 24 clients (13 Resolved, 11 Unresolved) were rated for the presence of model components, using the MARS, CRARS and RARS. Significant inter-rater reliability was obtained on each scale. Preliminary support for the validity of the model of resolution was established. The two early mid-model components (Awareness of How Interrupting and Awareness of Purpose of Interruption) were present among all clients, while the three late mid-model components (Realization of Negative Impact of Interruption, Reduction of Fear of Emotion, and Desire to Allow Emotion) occurred more frequently among Resolved clients, compared to Unresolved clients. Resolution of AESI had a perfect positive relationship with Reduction of Fear of Emotion, a fairly strong positive relationship with Desire to Allow Emotion, and a moderate positive relationship with Realization of Negative Impact of Interruption. Support for the structure of the model was mixed. Clinical and theoretical implications of these findings are discussed and contextualized within current psychotherapy research literature.
... Au contraire, la co-régulation promeut la sécurité affective et mène au renforcement des liens (J. R. Schore & Schore, 2008). ...
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Ce projet de thèse vise à étudier la pertinence d’utiliser la médiation équine en thérapie, auprès de personnes ayant des troubles addictifs. Dans un premier temps, il s’agira d’étudier l’influence du style d’attachement des patients sur leur niveau d’autonomie ; en s’appuyant sur des modèles théoriques tels que la théorie de l’attachement (Bowlby, 1969-82 ; Hazan, 1987) et la théorie de la motivation autonome (Decy et Ryan, 2000). Dans un deuxième temps, l’objectif sera d’explorer, de décrire et d’évaluer les processus à l’œuvre durant l’intervention à visée thérapeutique avec le cheval. Cette recherche s’inscrit dans le cadre de la compréhension et de l’évaluation des interventions complexes, axe fort de recherche du laboratoire APEMAC. Le questionnement principal de ce projet de thèse est d'interroger la place de la théorie de l’attachement dans les interventions en psychologie de la santé, notamment dans les programmes de prévention de la reconsommation et de la rechute. Quels liens la motivation et l’attachement entretiennent-ils ? En quoi les troubles de l’attachement peuvent-ils entraver le processus de guérison et la tenue de l’abstinence chez ces patients ? L’utilisation du cheval en thérapie peut-elle permettre d’augmenter le sentiment de sécurité interne des personnes et favoriser le développement de leurs compétences d’auto-régulation et de la motivation autonome ? En somme, peut-on augmenter l’autonomie des patients en leur proposant une intervention qui cible les troubles de l’attachement ? Le recueil des données sera réalisé au Centre de Soins de Suite et de Réadaptation en Addictologie « la Fontenelle ». Tout au long de cette recherche, nous prévoyons d’effectuer différentes évaluations quantitatives à l’aide d’outils psychométriques. Nous utiliserons également des méthodes qualitatives en réalisant des entretiens cliniques.
... Dies führt jedoch scheinbar nicht dazu, dass die mit den Emotionen verbundenen negativen Kognitionen wirksam verändert, sondern stattdessen sogar verstärkt werden. Darüber hinaus unterstützen die Befunde die Annahme, dass frühe Bindungserfahrungen und daraus hervorgehende Bindungsrepräsentationen eine Grundlage der Entwicklung von Emotionsregulationsfähigkeit bilden(Mikulincer & Shaver, 2012;Schore & Schore, 2008;Zimmermann, 2000). Wie Erkenntnisse der Entwicklungspsychologie verdeutlichen, geraten erlernte Emotionsregulationsstrategien im Verlauf der Entwicklung zunehmend in den Vordergrund und die darunter liegenden Bindungsdimensionen sind nur schwer zu erfassen(Solomon & George, 2018). ...
Thesis
Die Gestaltung einer tragfähigen Schüler*innen-Lehrer*innen-Beziehung ist eine wesentliche Voraussetzung für wirkungsvolles pädagogisches Handeln im Förderschwerpunkt emotionale und soziale Entwicklung (KMK, 2000). Die Grundannahmen der Bindungstheorie sowie die Erkenntnisse aus der empirischen Bindungsforschung ermöglichen es, unterschiedliche Ausprägungen von Verhaltensweisen zu analysieren sowie bindungsrelevante Aspekte bei der Beziehungsgestaltung und zielgerichteten Förderung zu berücksichtigen. International deuten empirische Studien auf Zusammenhänge zwischen unsicheren Bindungsrepräsentationen sowie externalisierenden und internalisierenden Verhaltensproblemen hin (z. B. Fearon, et al., 2010; Groh et al., 2012; Madigan et al., 2016). Des Weiteren liegen internationale Befunde zum Zusammenhang zwischen der Qualität der Schüler*innen-Lehrer*innen-Beziehung und sozialer sowie emotionaler Beeinträchtigungen vor (z. B. Hamre & Pianta, 2001; Roorda et al., 2011; Curby, Brock & Hamre, 2013; Obsuth et al., 2017). Im deutschen Sprachraum und insbesondere im sonderpädagogischen Handlungsfeld des Förderschwerpunktes der emotionalen und sozialen Entwicklung bleibt eine empirische Analyse dieser Zusammenhänge bislang weitestgehend aus. Übergeordnetes Ziel dieser Forschungsarbeit ist es, auf Basis bindungstheoretisch fundierter und empirischer Erkenntnisse einen wissenschaftlichen Beitrag zum Wissensstand des Konstrukts der Schüler*innen-Lehrer*innen-Beziehung im Förderschwerpunkt der emotionalen und soziale Entwicklung zu leisten. Datenbasis für die eigene empirische Analyse sind Fragebogenerhebungen mit N = 141 Schüler*innen mit diagnostiziertem Förderbedarf in der emotionalen und sozialen Entwicklung (im Alter von 7 bis 15 Jahren) sowie deren Eltern bzw. Sorgeberechtigten und Lehrkräften. Es werden Zusammenhänge zwischen unsicheren Bindungsrepräsentationen, Emotionsregulationsstrategien und externalisierenden sowie internalisierenden Verhaltensproblemen untersucht. Neben der Analyse einzelner Zusammenhänge werden ebenfalls Unterschiede zwischen unsicheren Bindungsrepräsentationen und Verhaltensproblemen bei Schüler*innen an Regelschulen und Schüler*innen von Förderschulen mit dem Schwerpunkt in der emotionalen und sozialen Entwicklung untersucht. Darüber hinaus werden mittels Pfadanalyse direkte und indirekte Effekte von emotionaler Unterstützung auf Emotionsregulationsstrategien sowie Verhaltensprobleme überprüft. Dazu wurden in N = 26 Klassen an Förderschulen mit dem Förderschwerpunkt der emotionalen und sozialen Entwicklung standardisierte Beobachtungen im Unterricht zur Erfassung emotionaler Unterstützung von Lehrkräften durchgeführt. Da für den deutschen Sprachraum wenig standardisierte Verfahren vorliegen, die Bindungsrepräsentationen und Beziehungsdimensionen im schulischen Handlungsfeld systematisch erfassen, werden das Verfahren ECR-RC und das CLASS-S adaptiert und psychometrisch überprüft. Die Ergebnisse der Studie legen Zusammenhänge zwischen bindungsbezogener Angst und einzelnen Komponenten aggressiven Verhaltens nahe. Mediationsanalysen verdeutlichen, dass der Zusammenhang zwischen bindungsbezogener Angst und aggressivem Verhalten über internal-dysfunktionale Emotionsregulationsstrategien vermittelt wird. Schüler*innen der Förderschulstichprobe zeigen höhere Ausprägungen bei den unsicheren Bindungsrepräsentationen als Schüler*innen der Regelschulstichprobe. Darüber hinaus bestehen mehr und stärkere Zusammenhänge zwischen den unsicheren Bindungsrepräsentationen und externalisierenden und internalisierenden Verhaltensproblemen bei Schüler*innen der Förderschule mit dem Schwerpunkt der emotionalen und sozialen Entwicklung. Die Befunde der Pfadanalysen zeigen einen direkten negativen Zusammenhang zwischen emotionaler Unterstützung und externalisierenden Verhaltensproblemen auf. Des Weiteren lassen sich indirekte Effekte von emotionaler Unterrichtsunterstützung über external-funktionale Emotionsregulationsstrategien auf externalisierende Verhaltensprobleme feststellen. Die Ergebnisse deuten auf die Relevanz der Dimensionen von Bindungsrepräsentationen sowie emotionaler Unterrichtsunterstützung im schulischen Kontext für den Umgang mit emotionalen und sozialen Beeinträchtigungen hin. Die Ergebnisse liefern darüber hinaus erstmals für den deutschen Sprachraum und insbesondere für den sonderpädagogischen Bildungsbereich empirische Aussagen zur psychometrischen Güte des ECR-RC sowie des CLASS-S. Sie unterstreichen die Nutzbarkeit der Verfahren für die Forschung und Diagnostik im deutschen Schulkontext. Die empirischen Befunde indizieren darüber hinaus, dass Emotionsregulation in Präventions- und Interventionsansätzen wesentlich berücksichtigt werden sollte. Zukünftige Untersuchungen sollten sowohl auf längsschnittliche Untersuchungen über den Entwicklungsverlauf der Kinder und Jugendlichen als auch auf eine verstärkte Grundlagenforschung zu bindungs- und beziehungsrelevanten Dimensionen in sonderpädagogischen Handlungsfeldern sowie auf eine gezielte Überprüfung von Erhebungsinstrumenten abzielen.
... Neuroscience demonstrates how early experiences affect adults [72][73][74][75]. Attachment theory describes childhood attachment patterns to caregivers and positive or negative effects on subsequent relationships [76]. ...
Article
This narrative review presents key concepts from neurophysiology, phenomenology, psychology, and narrative medicine which underpin a developing enactive-ecological framework for osteopathic practice. This framework aims to provide a coherent theoretical basis for understanding healthcare processes and outcomes, based on the neuroscience principles of active inference and enactivism. It offers insights into factors that influence patients’ pain perception and behaviour and foster or inhibit the development of effective therapeutic relationships. Although this approach offers promising opportunities to increase the scope of care by harnessing potential in the unique embodied ecological niches created between patients and osteopaths, it raises challenges to traditional treatment agendas. Healthcare which frames the patient-as-a person, and acknowledges the multidimensional nature of the self, requires practitioners to be collaborative and self-aware, and be able to elicit patients’ lived experiences and body stories. Phenomenological and psychological studies into enactivism emphasise the complex, dynamic nature of therapeutic relationships and the need to understand each person’s unique lifeworld context. The new framework represents an important step forward, but further research is now needed to explore ways of integrating active and enactive inference into practice, of developing psychological or mindful self- and body-awareness, and narrative communication skills for shared sense-making.
... Trauma researchers agree that traumatic memories are primarily stored in the nonverbal part of the right hemisphere of the brain [15,[52][53][54]. In addition, contemporary studies have found that talking about trauma can be a difficult experience at best; at worst, it reactivates the traumatic experience [55]. ...
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The open studio art therapy model offers a space for free creation; in this space, the art therapist supports the participants’ art process. According to this model, the creative process is the central component of the therapeutic work. This qualitative study seeks to learn, through an analysis of interviews and artwork, about the subjective experiences of at-risk children living in a foster-care village who participated in an open studio. In addition, it seeks to identify changes in the artwork over time. This study involves a qualitative thematic analysis, while the analysis of visual data is based on the phenomenological approach to art therapy. The data include interviews and 82 artworks of five participants, aged 7–10 years. Five main themes emerged from the analysis of the visual and verbal data: (a) engaging in relationships; (b) moving along the continuum from basic, primary, art expressions (e.g., smearing, scribbling, etc.) to controlled expressions; (c) visibility, on a range between disclosure and concealment; (d) holding versus falling/instability; and (e) experiencing and expressions of change. The discussion expands on the themes in relation to key concepts in the field of psychodynamic psychotherapy and art therapy. It also examines the unique characteristics of this population in reference to empirical studies on developmental trauma and challenges of out-of-home placement. Finally, it discusses the study’s limitations and presents recommendations for further research.
... Recent research on early experiencedependent brain maturation highlights the importance of the relationship between primary caregivers and the infant for normal brain development and the ability to self-regulate (Schore & Schore, 2008). The provision of 'good-enough' care-giving enables a child to develop neural pathways that allow the child to be in relationship and to be a member of a group (Cozolino, 2014). ...
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Psychotherapy Editorial
... It contributes to the internal working models that the child will use in the future, including the mental images of the self, others, and relationships (8,9). Attachment contributes to creating affect regulation strategies (10). Studies have shown that prenatal attachment may also be directly related to the future mother-child relationship (11). ...
Article
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Objective: This study examined the relationship between coronavirus 2019 (COVID-19) pandemic-related psychiatric symptoms and prenatal attachment in pregnant women, a group particularly vulnerable to the psychological, social, and economic effects of the pandemic. Method: The study group consisted of 68 pregnant women with a healthy pregnancy with no reported psychiatric or other illness. The participants were grouped as those who were pregnant with low COVID-19 anxiety and obsession (Cluster 1) and those who were pregnant with high COVID-19 anxiety and obsession (Cluster 2) based on online scale scores. Results: The prenatal attachment scores of Cluster 1 were significantly higher than those of Cluster 2. The parameter of financial difficulties due to COVID-19 circumstances was significantly different between the groups. Conclusion: The results of this study indicated that anxiety, obsessions, and financial difficulties due to the pandemic might have negatively affected mothers' attachment to the child. Due to the possible effects of weak maternal attachment on the child’s mental health, prenatal attachment may be a point for exploration of the psychological effects of the pandemic on future generations.
... Cozolino (2014) explains that this stage of human development is defined by sensitive periods that leave infants vulnerable to being shaped by negative social, emotional, and environmental impacts. Indeed, forms of emotional, physical, and sexual abuse perpetrated by caregivers to their infant children can preclude the development of crucial emotional regulation centers in the human brain, leading to avoidant, anxious, and disorganized attachment behaviors in adolescence and adulthood (National Scientific Council on the Developing Child, 2007;Feldman & Eidelman, 2007;Nelson, 2017;Vanderwert et al., 2010;Schore, 2008;Schore & Schore, 2010;Fox et al., 2010;Sampaio & Lifter, 2014). Other studies show how these abuse stressors negatively impact the infantile stress response system, from hyperarousal of the hypothalamic-pituitary-adrenal (HPA) axis to the overproduction of morning cortisol levels, often leading to the development of PTSD symptoms in adolescence and adulthood (Gunnar & Quevedo, 2007;Gunnar & Vasquez, 2006;McLaughlin, Sheridan, et al., 2015;Fisher et al., 2011;Cutuli et al., 2011;Lupien et al., 2009). ...
Article
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This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as ‘childhood trauma’, ‘adolescent trauma’, and ‘adulthood trauma’, to ‘PTSD’, ‘fMRI’, and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)—areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.
Article
Persons experiencing schizophrenia and substance use disorders as coexisting conditions report significant expressions of disconnectedness. The lack of ability to relate to oneself and others as described by individuals living with these conditions, both neurobiologically and intersubjectively, is generally accepted in the literature. To support persons in establishing and maintaining co-occurring recovery, specific pharmacological and therapeutic interventions are discussed. Intersubjective connectedness is explored in aim to help individuals, families, and healthcare professionals to better understand the experience of disconnectedness that stems from both disorders. When neurobiological and intersubjective features are viewed as interrelated constructs, integrated treatment and recovery approaches become optimally aligned with the phenomenon of connectedness.
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Attachment Theory has the potential to broaden our understanding of the ways in which we can work with systems-impacted youth, regardless of their age. This chapter provides a review of Attachment Theory, including its origins and basic principles, as well as its psychological, social, and biological underpinnings. A summary of the human nervous system and the context in which attachment develops, including secure and insecure attachment styles, are reviewed. Finally, clinical application and tools for working with youth from an attachment perspective are offered.
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Attachment theorists have recently become more interested in how bodily-based processes and interventions can contribute to their interest in the emotional regulation of arousal levels. A review of current concepts and techniques in integrative regulation therapy, including their value for Bioenergetics, will be examined. The literature of recent writings on attachment within Bioenergetics will be provided, along with a clinical vignette utilizing both approaches. The paper proposes that the Bioenergetic community answer the call to promote a somatic-energetic approach to the larger psychotherapeutic world.
Article
This article offers a synthesis of practice; a conceptual integration of theory-informed right brain (RB) to RB (Schore, 2012), body-to-body, somatic and relational practice, interfaced with affect regulation theory and attachment repair. It exemplifies the diverse potential of right hemispheric processing and explores and explains the theoretical underpinnings of this body-centered or somatic practice, showcasing the body as a portal to the unconscious, and to the immobilized relational material that hinders the psyche and dysregulates the body. Through a composite clinical excerpt, I present an in-session experience of my integrative practice, a multi-layered rendering of the therapist's internal clinical experience, which identifies layers of tracking the body in practice. Keywords: somatic; affect regulation; right hemisphere; attachment repair; body-centered psychotherapy.
Article
COVID-19 pandemic has caused a tidal wave of anxiety and stress among Iranians, especially pregnant women. This study aimed to assess the association between knowledge, perceived severity, and controllability of COVID-19 with self-care and health anxiety specially in pregnancy. This cross-sectional study was performed on 440 pregnant women. Data were collected using demographic-obstetrics characteristics, as well as the questionnaires of knowledge, perceived severity, and perceived controllability of the COVID-19, health anxiety, and self-care. Self-care was positively correlated with knowledge, perceived severity, and perceived controllability of the COVID-19. Nonetheless, health anxiety had a significant and inverse association with knowledge and perceived controllability, while there was a positive and significant correlation between perceived severity and health anxiety. Based on linear regression, three variables of knowledge, perceived severity, and perceived controllability of the COVID-19 could explain 46.3 and 17.5% of variations in self-care and health anxiety, respectively. It is suggested that due to the critical importance of prenatal care, managers, and health-care providers promote the use of such methods as telehealth and home-based caregivers, especially in areas with inadequate access to health care. So, the pregnant women can be followed up and receive medical care devoid of any stress and anxiety.
Chapter
Parenthood can be a joy for some and a daunting challenge for others. Many of us are thrown into the deep end and learn to stay afloat while facing the demands and expectations placed on us to be perfect parents. The truth is, though, that there is no such thing as a perfect parent. We can only do our best. This chapter shares how understanding our attachment styles can impact how we relate to others, including our children. It introduces key child development theories to help parents understand children’s physical, cognitive, emotional and social growth at different stages of development. It also discusses various parenting styles and how they affect children’s emotional growth and regulation, and highlights how parents who have endured traumatic childhood experiences can learn to heal their childhood wounds and become positive, loving and emotionally intelligent parents.
Article
Existing literature broadly demonstrates that a therapist’s tone of voice affects interpersonal and therapy outcomes, and qualities of human voice tone (pitch, volume, rhythm, speed and intensity) influence human interaction and attachment. However, little empirical and systematic evidence surrounds the use of voice in Guided Imagery and Music (GIM) and other psychotherapeutic practices. This exploratory study investigates the use of acoustic analysis to report on ways in which therapists’ and clients’ voices attune with each other and the music in GIM practice. Seven volunteer university student participants each attended a single GIM session with a qualified GIM therapist. Audio recordings of the session were made using a multi-channel recording device and 61 excerpts of the recording were then analysed using the MIRToolbox for Matlab. It was found that acoustic features of the client’s voice predicted acoustic features of the therapist’s voice more commonly than the other way round (therapist predicting client). Furthermore, both such predictions occurred more commonly than they did for acoustic features of the music predicting acoustic features of either the therapist or client. These results suggest the client’s voice influences the therapist’s voice more than the therapist’s voice influences the client’s, and the music is the least influential. This study developed a reliable methodology for data collection and analysis to examine interactions between the client and therapist voices and music in GIM practice and provides further insights for clinical practice and training, enhancing sensitivity to vocal interactions and attunement.
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Una revisión integrativa sobre Lactancia materna y programa Madre Canguro: una simbiosis necesaria en tiempo de COVID-19
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The psychological evaluation of children should always take into account their history and stage of life, both from the emotional and physical points of view. Considering all the complexity of child development, a look that takes into consideration all the processes and peculiarities of each phase, supported by several areas of knowledge, becomes necessary. The authors of this chapter defend the line that prioritizes the interdisciplinary approach in children’s clinical practice. In addition to the therapist and psychiatrist, other health professionals may be invited to join the interdisciplinary team. Various neurodevelopmental disorders (autism, ADHD, learning disabilities), as well as other conditions such as obesity, eating disorders, mood disorders, and various traumas, require the presence of professionals from different areas for the treatment to be effective. The advantages, difficulties, and limits of teamwork are discussed in this chapter.KeywordsInterdisciplinarityInterdisciplinary interventionMultidisciplinary interventionTeam workingChildhood psychiatric disorders
Article
Antecedentes: Los trastornos alimentarios (TCA) presentan entre sus síntomas disfunciones psicosociales como ansiedad social, alexitimia y falta de asertividad. Objetivo: Se propone un modelo explicativo/comprensivo que integra aspectos de psiconeurobiología y comportamiento útil para la clínica. Método: Se evaluó una revisión de la literatura en Medline / PubMed, SciELO y bases de datos de textos especializados con criterios de calidad. Fueron seleccionados conceptos centrales para construir una coherencia que permitiera la lectura psiconeurobiológica del fenómeno y su aplicación clínica. Resultados: Cuatro factores fueron dispuestos a significar: 1- sistema de alarma; 2- sistema de recompensa 3- cerebro social; 4-mecanismos de control (inhibición/excitación). Se dispusieron mostrando la complejidad de su interacción psicofisiológica. Se sugiere que la ingesta de alimentos podría funcionar como una forma primaria de equilibrio cuando hay fallas en alguno de los sistemas expuestos. Conclusión: Se presenta un modelo de integración psiconeurobiológico útil para explicar la dificultad interpersonal en TCA. Esta forma de comprensión facilita: la conexión entre las investigaciones emergentes en TCA y DI; la toma de decisiones clínicas y orientan el pronóstico y las alternativas de tratamiento.
Chapter
This chapter explores the relationship between animal-assisted interventions (AAI) and veterinary social work. AAI has historical roots in aligned helping professions, such as nursing and psychology; social work has embraced the challenges associated with preparing students and professionals to engage in this work, including its ethical, educational, and practical dimensions. AAI rests on a strong theoretical foundation, drawing from the biophilia hypothesis, attachment theory, and the biopsychosocial framework. The inclusion of animals in the therapeutic process decreases treatment resistance, increases social rapport, and helps promote favorable treatment outcomes. The chapter concludes with suggestions for future opportunities. An appendix provides a listing of resources for continued learning.
Chapter
In everyday life we actively react to the emotion expressions of others, responding by showing matching, or sometimes contrasting, expressions. Emotional mimicry has important social functions such as signalling affiliative intent and fostering rapport and is considered one of the cornerstones of successful interactions. This book provides a multidisciplinary overview of research into emotional mimicry and empathy and explores when, how and why emotional mimicry occurs. Focusing on recent developments in the field, the chapters cover a variety of approaches and research questions, such as the role of literature in empathy and emotional mimicry, the most important brain areas involved in the mimicry of emotions, the effects of specific psychopathologies on mimicry, why smiling may be a special case in mimicry, whether we can also mimic vocal emotional expressions, individual differences in mimicry and the role of social contexts in mimicry.
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Parental Psychiatric Disorder presents an innovative approach to thinking about and working with families where a parent has a mental illness. With 30 new chapters from an internationally renowned author team, this new edition presents the current state of knowledge in this critically important field. Issues around prevalence, stigma and systems theory provide a foundation for the book, which offers new paradigms for understanding mental illness in families. The impact of various parental psychiatric disorders on children and family relationships are summarized, including coverage of schizophrenia, depression, anxiety, substance abuse disorders, eating disorders, personality disorders and trauma. Multiple innovative interventions are outlined, targeting children, parents and families, as well as strategies that foster workforce and organisational development. Incorporating different theoretical frameworks, the book enhances understanding of the dimensions of psychiatric disorders from a multigenerational perspective, making this an invaluable text for students, researchers and clinicians from many mental health disciplines.
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The concepts of multiple code theory and the referential process are examined in relation to levels of awareness and the sense of self as characterized in recent work in neuropsychology by Damasio. The juxtaposition of subsymbolic and symbolic systems in working memory, as this operates in the referential process, is central to both consciousness and the sense of self. The roots of pathology lie in dissociation within emotion schemas; this applies at different levels for all forms of neurosis. The goal of psychoanalytic treatment is integration of dissociated schemas; this requires activation of subsymbolic, including bodily experience, in the session itself, in relation to symbolic representations of present and past experience. Implications concerning repression, resistance, the primary process, the role of language in therapeutic change, and other psychoanalytic concepts are discussed.
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Private Practice This study explores psychotherapists' somatic experiences during the therapeutic encounter, linking these to ideas from the phenomenological school of philosophy, in particular the notion of the lived-body paradigm in relation to therapists' physical reactions to clients. The methodology for this research evolved from 3 discussion groups, which led to a series of 14 in-depth interviews and 2 professional scrutiny discussion groups. All the participants were experienced psychotherapists. A grounded-theory analysis generated a set of first-order themes that were clustered into the second-order themes of body empathy, body as receiver, and body management. The final grounded theory of psychotherapist embodiment emerged after an analysis of the permeative themes of professional and personal discourse and researchers' bodily responses. The grounded theory of psychotherapist embodiment has revealed the importance of the therapist's body within the therapeutic encounter. Psychotherapy can be considered a way of constructing meaning out of an encounter between two bodies: that of the client and that of the therapist. The principle of this article is that psychotherapy is an inherently embodied process. If psychotherapy is an investigation into the intersubjective space between client and therapist, then as a profession we need to take our bodily reactions much more seriously than we have so far because, as some authors have noted, the body is "the very basis of human subjectivity" (Crossley, 1995, pp. 44–45). This study explores how psycho-therapists experience their bodies during their work with clients. The research begins with a question addressing how the body in psychotherapy had become marginalized and somehow ignored, or as Boadella suggests (1997, p. 31), "the body which became symbolically banned from psychotherapy with the political expulsion of Wilhelm Reich from the psychoanalytic movement . . .
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Nonverbal behavior and sensitivity to a relationship partner’s nonverbal behavior importantly influence the quality of interpersonal interactions and relationships, including attachment relationships. The abilities to encode, or express, and to decode, or understand, nonverbal cues are crucial to effective communication of emotions and are associated with social adjustment and relationship satisfaction. One important social context for the development and use of nonverbal encodingand decoding abilities is what Bowlby (1969/1982, Attachment and loss: Vol.1.Attachment (2nd ed.). New York: Basic Books) called attachment relationships—interpersonal relationships in which one person’s emotional security depends on another person’s sensitive, responsive caregiving and support. In this paper, we present theoretical ideas, review relevant research, and propose new avenues of research dealing with associations between attachment-related processes and patterns of nonverbal behavior and sensitivity in adulthood, two domains of research that have not previously been adequately connected.
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Severe aphasia, adult left hemispherectomy, Gilles de la Tourette syndrome (GTS), and other neurological disorders have in common an increased use of swearwords. There are shared linguistic features in common across these language behaviors, as well as important differences. We explore the nature of swearing in normal human communication, and then compare the clinical presentations of selectively preserved, impaired and augmented swearing. These neurolinguistic observations, considered along with related neuroanatomical and neurochemical information, provide the basis for considering the neurobiological foundation of various types of swearing behaviors.
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Von Economo neurons (VENs) are a recently evolved cell type which may be involved in the fast intuitive assessment of complex situations. As such, they could be part of the circuitry supporting human social networks. We propose that the VENs relay an output of fronto-insular and anterior cingulate cortex to the parts of frontal and temporal cortex associated with theory-of-mind, where fast intuitions are melded with slower, deliberative judgments. The VENs emerge mainly after birth and increase in number until age 4 yrs. We propose that in autism spectrum disorders the VENs fail to develop normally, and that this failure might be partially responsible for the associated social disabilities that result from faulty intuition.
Article
The development of functional brain asymmetry during childhood is confirmed by changes in cerebral blood flow measured at rest using dynamic single photon emission computed tomography. Between 1 and 3 years of age, the blood flow shows a right hemispheric predominance, mainly due to the activity in the posterior associative area. Asymmetry shifts to the left after 3 years. The subsequent time course of changes appear to follow the emergence of functions localized initially on the right, but later on the left hemisphere (i.e. visuospatial and later language abilities). These findings support the hypothesis that, in man, the right hemisphere develops its functions earlier than the left.
Article
The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005
Article
In our commentary, we show how Hofer's work alters the traditional perspective on human attachment in important ways. Hofer describes 2 components of attachment: one that does not develop and one that does. Drawing on work with rodents and primates, Hofer suggests that one component of attachment that does not develop is the sensorimotor or homeostatic regulation between members of a dyad, a stable aspect of all intimate relations throughout the life span. We suggest that this component of attachment in humans may be especially important in the first 6 months of life, a period for which no current theory of attachment provides adequate explanation. Second, Hofer has shown that some components of homeostatic regulation change with development through physiological maturation of organs, internalization of function, and distribution of regulation. We suggest that, in humans, the development of an internal working model can lead to increasing internalization of these functions as well as distribution of regulation among a number of close relationships.
Article
In October 2004 it was my pleasure to present at a cutting-edge conference entitled The Interplay of Implicit and Explicit Processes in Psychoanalysis. In addition to offering an address (“The Essential Role of the Right Brain in the Implicit Self: Development, Psychopathogenesis, and Psychotherapy”), I also provided a commentary to Steven Knoblauch's excellent paper, “Body Rhythms and the Unconscious: Toward an Expanding of Clinical Attention.” In the following, I briefly summarize these presentations, with the purpose of showing how current advances in developmental and neuropsychoanalysis are being incorporated into the practice of clinical psychoanalysis. This work is part of an ongoing effort to expand regulation theory, an overarching theoretical model of the development, psychopathogenesis, and treatment of the implicit self.
Article
Studies of adult attachment indicate that intimacy avoidance is associated with general negative emotionality and withdrawal from potentially positive aspects of social relations. Such emotional negativity and withdrawal motivation have been connected in psychophysiological studies with the right frontal lobe of the brain, whereas the left frontal lobe specialises in emotional positivity and approach behaviour. In the present study we used a divided visual field task to investigate hemispheric asymmetries in making decisions about the positivity or negativity of attachment‐ and emotion‐related words, as well as various kinds of control words. We found that more avoidant individuals made more errors when judging positive attachment‐related words presented to the right hemisphere. The findings are discussed in terms of possible effects of attachment history on the way attachment‐related information is processed in the brain.
Article
Self-regulation is the key mediator between genetic predisposition, early experience, and adult functioning. This paper argues that all the key mechanisms underpinning the enduring effects of early relationship experiences interface with individuals' capacity to control (a) their reaction to stress, (b) their capacity to maintain focused attention, and (c) their capacity to interpret mental states in themselves and others. These three mechanisms together function to assist the individual to work closely and collaboratively with other minds. The paper proposes a reformulation of attachment theory constructs in terms of the quality of interpersonal interpretive functioning and the interpersonal strategies adopted by individuals to maintain optimal psychological distance between themselves and others, given their particular level of interpretive capacity.
Article
Reviews the book, The art of the psychotherapist by James F. T. Bugental (see record 1987-97347-000). Those who are fortunate enough to read this book are in for a treat. James Bugental shares with us a sensitivity, an artistry, and a professionalism that encompasses 40 years of his life as a psychotherapist. This book is well written, clear in style and presentation. It is a book that may be viewed by those of us who have practiced for many years as a way of reviewing and rethinking what we have been doing and the manner in which we have been functioning. For the young therapist it gives much food for thought. For the supervisor it offers an opportunity to formulate ways of thinking and approaching students in a novel and creative manner. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Several aspects of developmental change that are dependent on interactions between parent and infant are examined for their value in casting light on the processes of change in adult psychotherapies. First, the domain of implicit knowledge (where changes necessarily occur in nonverbal infants) is identified. The vast majority of therapeutic change is found to occur in this domain. We then examine the improvised, largely unpredictable, nonlinear movements toward mutual goals that characterize the processes of parent–infant and therapist–patient interactions. Finally, we provide a microdescription of these processes and provide a terminology for the “moments” that make up their flow. Of particular importance is the “moment of meeting,” in which the participants interact in a way that creates a new implicit, intersubjective understanding of their relationship and permits a new “way-of-being-with-the-other.” We view “moments of meeting” as the key element in bringing about change in implicit knowledge, just as interpretations are thought to be the key element in bringing about change in explicit knowledge. © 1998 Michigan Association for Infant Mental Health
Article
Over the last ten years the basic knowledge of brain structure and function has vastly ex- panded, and its incorporation into the developmental sciences is now allowing for more complex and heuristic models of human infancy. In a continuation of this effort, in this two-part work I integrate current interdisciplinary data from attachment studies on dyadic affective communications, neuroscience on the early developing right brain, psychophysiology on stress systems, and psychiatry on psychopath- ogenesis to provide a deeper understanding of the psychoneurobiological mechanisms that underlie infant mental health. In this article I detail the neurobiology of a secure attachment, an exemplar of adaptive infant mental health, and focus upon the primary caregiver's psychobiological regulation of the infant's maturing limbic system, the brain areas specialized for adapting to a rapidly changing environment. The infant's early developing right hemisphere has deep connections into the limbic and autonomic nervous systems and is dominant for the human stress response, and in this manner the attachment relationship facilitates the expansion of the child's coping capcities. This model suggests that adaptive infant mental health can be fundamentally defined as the earliest expression of flexible strategies for coping with the novelty and stress that is inherent in human interactions. This efficient right brain function is a resilience factor for optimal development over the later stages of the life cycle.
Article
An unorthodox view of the function of primary process is presented with a view to enlarge, rather than diminish Freudian assumptions. One of the basic tenets of Freudian hypothesis was the supposed lack of influence of outside experience upon primary process functions. Yet we see demonstrated on a daily basis that primary process cognition is at work in any human interaction or experience. The mental structures of the self in interaction with the nonself is constantly monitored, added to, or subtracted from during contact with others. It is a prereflective mode that does not immediately rise into awareness. We give meaning to all interactions without necessarily reflecting upon them or even clarifying them to ourselves. Without allowing for such meaning to be integrated, we would lose or misinterpret large portions of our daily interactions. Flaws in communication occur every day and are demonstrable particularly in therapy when therapists are not attuned to their patients' emotional needs. It is demonstrated that nonverbal avoidance behavior of disturbed infants is the precursor for disturbed object relations of adults. Therefore, it makes no sense to interpret unconscious meanings—there are none. The difficulty lies in the inter-subjective realm and serves defensive modes. However, if patients present an inauthentic self, it is often difficult to decide if one is indeed in the presence of such a maimed self. The therapist's countertransference aids in detecting inauthenticity. Ever-present, unconscious meaning analysis must be brought into consciousness by the therapist in order to further the therapeutic process.
Article
In 1971, Heinz Kohut, trained in neurology and then psychoanalysis, published The Analysis of the Self, a detailed exposition of the central role of the self in human existence. This classic volume of both twentieth century psychoanalysis and psychology was more than a collection of various clinical observations—rather it represented an overarching integrated theory of the development, structuralization, psychopathogenesis, and psychotherapy of disorders of the self. Although some of these ideas were elaborations of previous psychoanalytic principles, a large number of his concepts, including an emphasis on self rather than ego, signified an innovative departure from mainstream psychoanalysis and yet a truly creative addition to Freud’s theory.
Article
“Knowing one's patient inside out” is a metaphor that is intended to capture the paradoxical quality of the intersubjective field that we call the analytic relationship. The interface among trauma, dissociation, and regression is discussed in the context of unconscious communication as a transferential enactment of unsymbolized experience.The view is offered that for certain patients in particular, past experience is not so much unconscious as “frozen in time” and that a key element of the psychoanalytic relationship is bridging dissociated aspects of self through the creation of a dyadic experiential field that is both “inside” and “outside.” The writings of Michael Balint, D. W. Winnicott, and several other British object relational theorists are explored in the context of a contemporary interpersonal psychoanalytic perspective.
Article
The papers assembled here represent selections from the author's scientific writings, some published here for the first time, spanning a period of more than 40 yr. He has on the whole left the papers as they were originally written. Most of the papers stem from the treatment of neurotic patients who tended to have certain problems in common. The book reflects the author's most abiding interests: emotions - their development and their aberrations, sexuality and gender identity, and problems of psychoanalytic technique.
Article
A review of the empirical literature on implicit (i.e., unconscious) perception and memory reveals that S. Freud's (1910/1955, 1914/1956) hypotheses in this area were remarkably prescient in some respects. The implications of experimental research for psychodynamic models of symptom formation, transference analysis, and the curative components of insight-oriented therapy are discussed. Changes in terminology that can help bridge the gap between cognitive science and psychodynamics are outlined, and the heuristic value of strengthening existing connections between these disciplines is emphasized. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
the concepts of emotional meaning and the referential cycle are defined in the theoretical context of a multiple code model [i.e., verbal, nonverbal, and referential systems] of mental representation, derived from current work in cognitive experimental psychology and neurophysiology / briefly describe the multiple code theory and the concept of the referential cycle / describe the evolution of emotional meaning through the three stages of this cycle and place this characterization of the therapeutic discourse in the context of current empirical research / the development of emotional meaning in the referential cycle [is also discussed] as a process with some epigenetic characteristics [free association is described] as following the tracks of the nonverbal schemata without the connections necessarily being apparent in the hierarchical organization of the verbal system (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Book
PREFACE TO THIRD EDITION The sense of a life going on within us, its flux and feeling, its images, “shape,” and vicissitudes, is the main subject of this book. William James called this experience the “stream of consciousness.” It was what he understood as “self.” This central element of human existence was neglected by the scientific community for much of the twentieth century. It barely features in the mainstream psychotherapeutic systems. “The Metaphor of Play” is part of an ongoing endeavour, begun in the 1960’s, to build a model of psychotherapy around the fundamental experience of what William James had called the “duplex self,” a form of double consciousness which is only one of the various forms of consciousness of which we are capable. In 1985 Robert Hobson called this approach the “Conversational Model.” Its central idea is that we are not born with a “self.” Nor does it inevitably develop in the way that our bones and other physical features grow. Rather, the peculiarly human experience of personal being emerges in the context of a particular kind of conversation. Outcome studies which validate the effectiveness of the model have appeared in recent years.1 “The Metaphor of Play,” is complementary to my other recent work, “Intimacy & Alienation.” Both books have the same central theme but each volume develops the elements in differing ways and degrees. The first edition of this book was written during the period 1989 – 1991. This edition is considerably enlarged and revised. Eight more chapters have been added (8, 12, 14, 15, 16, 17, 22, & 23) and three removed, with some aspects incorporated into the new chapters. Much of what is new in this book concerns trauma, a subject which became a major field of inquiry only about 15 years ago. The notion of self as a self-organising system is also introduced. The opening chapters are largely untouched. The book is addressed to three main audiences. First, those who have a general interest in mind and consciousness; secondly, those beginning psychotherapy; thirdly, experienced therapists who, it is hoped, will find in this story things that are new and of interest.
Article
The maturation of corticolimbic systems that neurobiologically mediate essential affective and social regulatory functions is experience dependent. During the first and second years of life, the infant's affective experiences, especially those embedded in the relationship with the primary caregiver, elicit patterns of psychobiological alterations that influence the activity of subcortically produced trophic bioamines, peptides, and steroids that regulate the critical period growth and organization of the developing neocortex. Interactive attachment experiences of psychobiological attunemcnt, stressful misattunement, and stress-regulating repair and reattunement that maximize positive and minimize negative affect are imprinted into the orbitofrontal cortex — the hierarchical apex of the limbic system that is expanded in the early developing right hemisphere. During the critical period of maturation of this system, prolonged episodes of intense and unregulated interactive stress are manifest in disorganizing experiences of heightened negative affect and altered levels of stress hormones, and this chaotic biochemical alteration of the internal environment triggers an extensive apoptotic panellation of corticolimbic circuitries. In this manner less than optimal affect-regulating experiences with the primary caregiver are imprinted into the circuits of this frontolimbic system that is instrumental to attachment functions, thereby producing orbitofrontal organizations that neurobiologically express different patterns of insecure attachments. Such pathomorphogenetic outcomes result in structurally defective systems that, under stress, inefficiently regulate subcortical mechanisms that mediate the physiological processes that underlie emotion. The functional impairments of the cortical-subcortical circuitries of this prefrontal system are implicated in an enduring vulnerability to and the pathophysiology of various later forming psychiatric disorders.
Article
The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud's thinking, and links it with the ideas of Ferenczi and post-Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post-traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non-declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue, psychoanalysis can be receptive to and be enriched by the contributions of other disciplines, just as it enriches them with its own contributions.
Article
Attachment theory (J. Bowlby, 1982/1969, 1973) is one of the most useful and generative frameworks for understanding both normative and individual-differences aspects of the process of affect regulation. In this article we focus mainly on the different attachment-related strategies of affect regulation that result from different patterns of interactions with significant others. Specifically, we pursue 3 main goals: First, we elaborate the dynamics and functioning of these affect-regulation strategies using a recent integrative model of attachment-system activation and dynamics (P. R. Shaver & M. Mikulincer, 2002). Second, we review recent findings concerning the cognitive consequences of attachment-related strategies following the arousal of positive and negative affect. Third, we propose some integrative ideas concerning the formation and development of the different attachment-related strategies.
Article
In response to a growing diversity of opinion regarding educational models and essential content in clinical social work education, this paper offers a perspective concerning graduate clinical curricula. Part I, the foundational piece of the paper, discusses the definition of clinical social work, social work’s core orientation and values, and influential contextual issues. The interrelated core orientations guiding knowledge and skill development are identified as the person-in-situation perspective and the concept of relationship. Based on this foundation, Part II identifies elements of a contemporary biopsychosocial knowledge base and essential clinical skills. This paper is intended to stimulate dialogue about a topic of importance to the profession and the clients it serves.
In addition to repeated reexperiencing of the event, the delayed effects of severe psychological trauma, i.e., post traumatic stress disorder (PTSD), present a paradoxical mix of symptoms. There is enhancement of the self-preservative catecholamine states; anger and fear with a contrasting sense of meaninglessness and a blunting of the emotional responses of the attachment behavior so critical for species preservation. Hormonally, there is a striking separation of the catecholamine response, which stays elevated and that of the hypothalamo-pituitary-adrenal (HPA) axis, which may remain at normal levels. Pathophysiologically, the reexperiencing of the trauma and the arousal may be associated with dysfunction of the locus coeruleus, amygdala and hippocampal systems. This article explores the consequences of an additional dysfunction: a dissociation of the hemispheres that appears to be responsible for the alexithymic avoidance and failure of the cortisol response that so often follow severe psychological trauma. There is neurophysiological evidence that the left and right hemispheres subserve different emotional sets that correspond to “control” and “appraisal,” i.e., very approximately to the self and species preservative behavioral complexes, respectively. Several studies point to physiological dissociation of hemispheric functions during alexithymia. This raises the question: What has been lost if in this condition the right side no longer fully contributes to integrated cerebral function? Right hemispheric damaged children lose critical social skills and in adults the related sense of familiarity critical for bonding is lost. Such losses of social sensibilities may account for the lack of empathy and difficulties with bonding found in sociopathy and borderline personality: conditions now believed to result from repeated psychological trauma during development. On the other hand, systems that promote right hemispheric contributions provide solacing access to a “Higher Power.” They also appear to protect against socially disordered behavior, substance abuse, the failure of the HPA axis and some aspects of the pathophysiology of chronic disease.
Article
Several lines of evidence suggest that the right cerebral hemisphere is dominant for sense of physical and emotional self, specifically, for an individual's awareness of his or her own corporeal being and its relation to the environment and affective state. Right parietal lesions impair body image. Left-sided neglect, anosognosia, and anosodiaphoria can arise from destruction of the hemispheric module controlling body image and the physical relation of self to the environment. Right parietotemporal lesions impair topographic orientation, the relation of the body to environmental location. Right frontotemporal lesions impair impulse control. Right temporal disorders affect the sense of the familiar and unfamiliar, evoke fear and mania, and evoke experiential phenomena. Right frontal lesions impair social behavior, impairing the relation of self to others, the social self. Whereas linguistic consciousness is a function of the left hemisphere, consciousness of the corporeal and emotional self and aspects of the social self may be a right hemisphere-dominant function.
Article
3 theoretical approaches to the origin and development of the infant-mother relationship are reviewed: psychoanalytic theories of object relations, social learning theories of dependency (and attachment), and an ethologically oriented theory of attachment. "Object relations," "dependency," and "attachment," although overlapping, are seen to differ substantially. Among the concepts in regard to which there are significant intertheoretical differences, the following are discussed: genetic "biases," reinforcement as compared with activation and termination of behavioral systems and with feedback, strength of attachment behavior versus strength of attachment, inner representation of the object, intraorganismic and environmental conditions of behavioral activation, and the role of intraorganismic organization and structure. Finally, the relation between theory and research methods is considered.
Article
Only a few analysts (Deutsch, 1947, 1952; Braatøy, 1954) have systematically tried to investigate how nonverbal behavior may be derived from events and experiences from the preverbal phase of development. Their approaches to the analysis of such behavior differ. Extracts of an analysis are used to illustrate basic technical and theoretical questions with regard to the possibility of making use of nonverbal material to reconstruct preverbal experiences. It is inferred that the analyst's visual observations of the patient's nonverbal behavior may be a cue to significant events and trauma from the preverbal period. Besides, the specific visual imagery of the patient that, in this case, emerged just after the appearance of nonverbal behavior, may be a valuable source of data for analytic reconstruction.
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This paper focuses on the phenomenon of nonverbal behavior and its role in analytic practice and in the teaching of technique. The idea is presented that data arising from the nonverbal realm are underutilized both in the clinical situation and in supervision. Some possible reasons for the development of this situation are presented, illustrated by several clinical examples drawn from the author's experiences as a candidate.
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The author presents vignettes of a type of experience that is familiar to many analysts. He suggests that analysts and analysands know much more about each other than is generally recognized and that much of the important communication is subliminal, out of conscious awareness. Evidence of our unconscious knowledge surfaces in the form of emotion, fantasy, images, intrusive thoughts, and physical feelings. Often it seems uncanny. Recent experimental evidence and neurobiological research seem to explain and validate these analytic experiences.
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The development of functional brain asymmetry during childhood is confirmed by changes in cerebral blood flow measured at rest using dynamic single photon emission computed tomography. Between 1 and 3 years of age, the blood flow shows a right hemispheric predominance, mainly due to the activity in the posterior associative area. Asymmetry shifts to the left after 3 years. The subsequent time course of changes appear to follow the emergence of functions localized initially on the right, but later on the left hemisphere (i.e. visuospatial and later language abilities). These findings support the hypothesis that, in man, the right hemisphere develops its functions earlier than the left.
Article
In his 1895 "Project for a Scientific Psychology" Freud attempted to construct a model of the human mind in terms of its underlying neurobiological mechanisms. In this endeavor "to furnish a psychology which shall be a natural science," Freud introduced the concepts that to this day serve as the theoretical foundation and scaffolding of psychoanalysis. As a result, however, of his ensuing disavowal of the Project, these speculations about the fundamental mechanisms that regulate affect, motivation, attention, and consciousness were relegated to the shadowy realm of "metapsychology." Nonetheless, Freud subsequently predicted that at some future date "we shall have to find a contact point with biology." It is argued that recent advances in the interdisciplinary study of emotion show that the central role played by regulatory structures and functions represents such a contact point, and that the time is right for a rapprochement between psychoanalysis and neuroscience. Current knowledge of the psychobiological mechanisms by which the right hemisphere processes social and emotional information at levels beneath conscious awareness, and by which the orbital prefrontal areas regulate affect, motivation, and bodily state, allows for a deeper understanding of the "psychic structure" described by psychoanalytic metapsychology. The dynamic properties and ontogenetic characteristics of this neurobiological system have important implications for both theoretical and clinical psychoanalysis.
In addition to repeated reexperiencing of the event, the delayed effects of severe psychological trauma, i.e., post traumatic stress disorder (PTSD), present a paradoxical mix of symptoms. There is enhancement of the self-preservative catecholamine states; anger and fear with a contrasting sense of meaninglessness and blunting of the emotional responses of the attachment behavior so critical for species preservation. Hormonally, there is a striking separation of the catecholamine response, which stays elevated and that of the hypothalamo-pituitary-adrenal (HPA) axis, which may remain at normal levels. Pathophysiologically, the reexperienceing of the trauma and the arousal may be associated with dysfunction of the locus coeruleus, amygdala and hippocampal systems. This article explores the consequences of an additional dysfunction: a dissociation of the hemispheres that appears to be responsible for the alexithymic avoidance and failure of the cortisol response that so often follow severe psychological trauma. There is neurophysiological evidence that the left the right hemispheres subserve different emotional sets that correspond to "control" and "appraisal," i.e., very approximately to the self and species preservative behavioral complexes, respectively. Several studies point to physiological dissociation of hemispheric functions during alexithymia. This raises the question: What has been lost if in this condition the right side no longer fully contributes to integrated cerebral function? Right hemispheric damaged children lose critical social skills and in adults the related sense of familiarity critical for bonding is lost. Such losses of social sensibilities may account for the lack of empathy and difficulties with bonding found in sociopathy and borderline personality: conditions now believed to result from repeated psychological trauma during development. On the other hand, systems that promote right hemispheric contributions provide solacing access to a "Higher Power." They also appear to protect against socially disordered behavior, substance abuse, the failure of the HPA axis and some aspects of the pathophysiology of chronic disease.
Article
Cytoarchitecture of speech areas 44 and 45 of human brain was studied on frontal series of sections of brain of a newborn, 6 months, 1 year and 2 years old child. Sections were stained with cresyl violet after Nissl. Density of neurons and gliocytes location as well as fraction of satellite gliocytes and surrounded by the latter, glia index were determined by quantitative methods. General principles of cortical areas 44 and 45 were distinguished as well as peculiarities of their formation if left and right hemispheres of human brain in postnatal ontogenesis. Heterochronia of postnatal development of areas 44 and 45 was demonstrated. A hypothesis on different activity of right and left hemispheres speech areas in different periods of speech development of the child was discussed.