Article

Relational Trauma and the Developing Right Brain

Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Annals of the New York Academy of Sciences (Impact Factor: 4.38). 05/2009; 1159(1):189-203. DOI: 10.1111/j.1749-6632.2009.04474.x
Source: PubMed
ABSTRACT
Psychoanalysis, the science of unconscious processes, has recently undergone a significant transformation. Self psychology, derived from the work of Heinz Kohut, represents perhaps the most important revision of Freud's theory as it has shifted its basic core concepts from an intrapsychic to a relational unconscious and from a cognitive ego to an emotion-processing self. As a result of a common interest in the essential, rapid, bodily based, affective processes that lie beneath conscious awareness, a productive dialogue is now occurring between psychoanalysis and neuroscience. Here I apply this interdisciplinary perspective to a deeper understanding of the nonconscious brain/mind/body mechanisms that lie at the core of self psychology. I offer a neuropsychoanalytic conception of the development and structuralization of the self, focusing on the experience-dependent maturation of the emotion-processing right brain in infancy. I then articulate an interdisciplinary model of attachment trauma and pathological dissociation, an early forming defense against overwhelming affect that is a cardinal feature of self-psychopathologies. I end with some thoughts on the mechanism of the psychotherapeutic change process and suggest that self psychology is, in essence, a psychology of the unique functions of the right brain and that a rapprochement between psychoanalysis and neuroscience is now at hand.

Full-text preview

Available from: ahealthymind.org
  • Source
    • "Psychoanalytic and relational therapists tend to feel the most uneasy about technology's presence because the idea of digital media conflicts more with underlying theories and trends. The current analytic focus on nonverbal communication that consists of gestures, facial expressions, and important moments of face-to-face affective regulation (Beebe and Lachmann 2003; Fonagy et al. 2002; Schore 2009; Stern 2004) renders cybertechnology a somewhat suspect form of communication. However, the recognition also exists that technology's sheer cultural popularity and widespread use all but guarantees its inevitable creep into the therapist's office (Brottman 2012; Hartman 2011; Mishna et al. 2012). "
    [Show abstract] [Hide abstract] ABSTRACT: The increasing popularity of the Internet and social media has generated concerns and disputes about their effects on brain, behavior, and relationships. While many positive outcomes are associated with cybercommunication, some individuals experience negative consequences. This, in turn, has roused theoretical and clinical debates about the impact of technology on psychotherapy and the stances therapists should take in their own work with clients. Understanding the emerging digital culture, which includes how the Internet, social media, video games, reality, identity, relationships, and the self are experienced and managed, is thus important if clinicians are to carefully consider and understand the modern relevancy, patterns, and meanings of clients’ communications with and about technology, as well as the possible use of social media as a therapeutic tool. This paper considers those questions by evaluating research on the effects of technology use and the implications of that research for psychotherapeutic practice and theory, with a particular emphasis on how psychoanalytic therapists have approached the topic.
    Full-text · Article · Jun 2015 · Clinical Social Work Journal
  • Source
    • "Tal hecho subraya la importancia de entender los trastornos de la personalidad, y la salud mental en general como una combinación inextricable de factores ambientales, psicológicos y físicos (Braun & Bock, 2011; Teicher et al., 2002).Gabbard, 2005; Hall, Olabi, Lawrie, & McIntosh, 2010; Ruocco, Amirthavasagam, & Zakzanis, 2012; Weniger, Lange, Sachsse, & Irle, 2009). Los traumas interpersonales promueven la lateralización de los hemisferios cerebrales, afectando su integración temprana (Miskovic, Schmidt, Georgiades, Boyle, & Macmillan, 2010; Schore, 2009). Esto tiene como consecuencia que las experiencias afectivas, que son procesadas y almacenadas en el lóbulo frontal derecho, se escinden de las funciones cognitivas del hemisferio izquierdo, lo que da cuenta en parte de la desregulación emocional presente en pacientes límite (Fonagy et al., 2011; Gabbard, 2005 Gabbard, , 2012 Miskovic et al., 2010; Pally, 2002). "
    [Show abstract] [Hide abstract] ABSTRACT: La teoría del apego es un modelo biopsicosocial para describir y explicar la forma en que un individuo se relaciona con otros cercanos: como sus padres, hijos y parejas sexuales. Esta forma de relacionarse es aprendida durante la infancia temprana y sirve de molde para todas las relaciones íntimas durante la vida del sujeto. Un adulto con un apego seguro ha internalizado una relación de confianza con sus padres o cuidadores durante la infancia y es por lo tanto capaz de adaptarse a distintos contextos sociales, y de mantener un equilibrio adecuado entre autonomía y dependencia para la regulación del estrés. Los estilos inseguros de apego se dividen en 1) Ansioso (el individuo es hipersensible al rechazo e intenta llamar la atención de los otros de manera compulsiva); 2) Evitativo (el individuo es hiposensible a las interacciones sociales, por lo que tiende a aislarse); y 3) Desorganizado (el sujeto es incapaz de controlar sus reacciones de estrés, por lo que tiende a sufrir desregulaciones afectivas generalizadas). El presente artículo revisa los elementos teóricos, psicológicos, neurocientíficos y del desarrollo del apego desde una perspectiva basada en la evidencia. Otorgamos un reporte actualizado del estudio del apego y de su relevancia para la comprensión de la etiología, el diagnostico y tratamiento de los trastornos mentales. Este artículo examina la relación privilegiada entre apego y trastornos de la personalidad desde diversos ángulos, con el objetivo de introducir los avances psicoterapéuticos más recientes para el tratamiento de los trastornos de la personalidad, especialmente del trastorno límite, basados en el estudio científico del apego. Describimos tres intervenciones terapéuticas cuya efectividad ha sido demostrada por evidencia científica: el Tratamiento Basado en la Mentalización, la Psicoterapia Centrada en la Transferencia y la Terapia de Esquemas.
    Full-text · Article · Apr 2014
  • Source
    • "Moreover, the lateral tegmental limbic forebrain–midbrain circuit has been found to be involved in the negative regulation of affect and to be associated with avoidance behavior and with the passive coping style.72,73 "
    [Show abstract] [Hide abstract] ABSTRACT: In recent years, great attention has been given to the presence of psychological problems and psychiatric comorbidity that are also present in children affected by primary headaches. The relationship between pain and attachment has been identified, and it may be that pain perception may change in relation with specific attachment styles. The aim of the present study was to assess the prevalent attachment style and verify its putative relationship and correlation with the main characteristics of migraine attacks, in school-aged children affected by migraine without aura (MoA). The study population consisted of 219 children (103 males, 116 females) aged between 6 and 11 years (mean 8.96 ± 2.14 years), consecutively referred for MoA compared with 381 healthy controls (174 males, 207 females; mean age 9.01 ± 1.75 years) randomly selected from schools. All the children were classified according to the attachment typologies of the Italian modified version of the Separation Anxiety Test; monthly headache frequency and mean headache duration were assessed from daily headache diaries kept by all the children. Headache intensity was assessed on a visual analog scale. The chi-square test and t-test, where appropriate, were applied, and the Spearman rank correlation test was applied to explore the relationship between the types of attachment style and clinical aspects of MoA. The MoA group showed a significantly higher prevalence of type A (avoidant) attachment (P<0.001) and a significantly lower prevalence of type B (secure) attachment (P<0.001) compared with the control group. Moreover, the Spearman rank correlation analysis showed a significant relationship between MoA characteristics and the attachment style of MoA children. The main findings of the present study were the higher prevalence among MoA children of the avoidant attachment style (type A) and the significantly lower prevalence of the secure style attachment (type B) compared with the normal controls, suggesting that the study of psychiatric comorbidity in pediatric headache may be enriched by this new aspect of analysis.
    Full-text · Article · Oct 2013 · Neuropsychiatric Disease and Treatment
Show more