influences: The ;9:99G'1000. {. & Simonoff, iew of research P. & Bailey, A. rirical findings. ,rplay and psy- Psychology and s ol cognition: 328. and individual (1996) Attach- rst year of life. ,n: Oxford Uni- in securely and 'ic conditions in attachment. In tonships (Vol. 5, oks. r of separation- Psychiatry, 133'. g on attachment rsiveness among 457-t477. vI.J. (1999) Dis- rsors, concomi- In J. Cassidy & clinical applica- ton, G.G. et al. 0+135r. rsick, R. (2008) r Cummings. c acids. Nature, Chapter 2 Ref ational traum a and the developing right brain The neurobiology of broken attachment bonds Allon N. Schore Over the past two decades I have integrated ongoing sc clinical data in order to construct regulation theory, a ne model of the development, psychopathogenesis, and treatm self. Towards that end, in 2001 I edited an issue of the Inf Journal, and in it I offered an article, 'The effects of early on right brain development, affect regulation, and infant this chapter I build on that work and provide very rece developmental data that allow for a deeper understandi logical and biological effects of early relational trauma. will be on current studies of the early developing right br substrate of the human unconscious and the site of the subcortical regulatory centers. This interpersonal neur explicates the mechanisms by which attachment trauma the developmental trajectory of the right brain/mind/bod course of the lifespan. Also discussed is the etiology of pa ation, the bottomline defense of all early-forming sev psychopathologies. Pierre Janet (1889) defined pathologica phobia of memories, expressed as excessive or inap responses to thought or memories of 'old traumas'. It is n 'old traumas' specifically refer not just to childhood tra relational trauma occurring in infancy, the critical period o theoretical perspective has direct clinical applications fo treatment and prevention. Developmental interpersonal neurobiology o secure attachment The essential task of the first year of human life is the c attachment bond of emotional communication and inte between the infant and primary caregiver. There is now agr ing how to communicate represents perhaps the most im mental process to take place during infancy' (Papousek & I
30
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influences: The;9:99G'1000.{. & Simonoff,iew of research
P. & Bailey, A.rirical findings.
,rplay and psy-
Psychology and
s ol cognition:328.
and individual
(1996) Attach-rst year of life.
,n: Oxford Uni-
in securely and
'ic conditions in
attachment. Intonships (Vol. 5,
oks.
r of separation-Psychiatry, 133'.
g on attachmentrsiveness among457-t477.vI.J. (1999) Dis-rsors, concomi-
In J. Cassidy &clinical applica-
ton, G.G. et al.
0+135r.rsick, R. (2008)
r Cummings.
c acids. Nature,
Chapter 2
Ref ational traum a and thedeveloping right brainThe neurobiology of brokenattachment bonds
Allon N. Schore
Over the past two decades I have integrated ongoing scientific studies andclinical data in order to construct regulation theory, a neuropsychoanalyticmodel of the development, psychopathogenesis, and treatment of the implicitself. Towards that end, in 2001 I edited an issue of the Infant Mental HealthJournal, and in it I offered an article, 'The effects of early relational traumaon right brain development, affect regulation, and infant mental health'. Inthis chapter I build on that work and provide very recent interdisciplinarydevelopmental data that allow for a deeper understanding of the psycho-logical and biological effects of early relational trauma. A particular focuswill be on current studies of the early developing right brain, the biologicalsubstrate of the human unconscious and the site of the highest cortical-subcortical regulatory centers. This interpersonal neurobiological modelexplicates the mechanisms by which attachment trauma negatively impactsthe developmental trajectory of the right brain/mind/body system over thecourse of the lifespan. Also discussed is the etiology of pathological dissoci-ation, the bottomline defense of all early-forming severe developmentalpsychopathologies. Pierre Janet (1889) defined pathological dissociation as aphobia of memories, expressed as excessive or inappropriate physicalresponses to thought or memories of 'old traumas'. It is now clear that these'old traumas' specifically refer not just to childhood traumas but also torelational trauma occurring in infancy, the critical period of attachment. Thistheoretical perspective has direct clinical applications for models of bothtreatment and prevention.
Developmental interpersonal neurobiology ofsecure attachmentThe essential task of the first year of human life is the creation of a secureattachment bond of emotional communication and interactive regulationbetween the infant and primary caregiver. There is now agreement that'learn-ing how to communicate represents perhaps the most important develop-mental process to take place during infancy' (Papousek & Papousek, !997),
I
20 Schore
and that 'In one sense we can consider the whole of child development to be
the enhancement of self-regulation'(Fonagy & Target, 2002).In line with theessential attachment elements of affect communication and affect regulation,Schore and Schore (2008: 10) now suggest that:
In line with Bowlby's fundamental goal of the integration of psycho-logical and biological models of human development, the current clinicaland experimental focus on how affective bodily-based processes are non-consciously interactively regulated . . . has shifted attachment theory to aregulation theory.
Secure attachment depends not on the mother's psychobiological attunementwith the infant's cognition or behavioq but rather on her regulation of theinfant's internal states of arousal, the energetic dimension of the child'saffective state. Through nonverbal visual-facial, tactile-gestural, and auditoryprosodic communication, the caregiver and infant learn the rhythmic struc-ture of the other and modify their behavior to fit that structure, thereby co-creating a specifically fitted interaction. During the bodily based affectivecommunications of mutual gaze, the attuned mother synchronizes the spatio-temporal patterning of her exogenous sensory stimulation with the infant'sspontaneous expressions of endogenous organismic rhythms. Via this contin-gent responsivity, the mother appraises the nonverbal expressions of herinfant's internal arousal and affective states, regulates them, and communi-cates them back to the infant. To accomplish this, the sensitive mothermust successfully modulate nonoptimal high or nonoptimal low levels ofstimulation that would induce supra-heightened or extremely low levels ofarousal in the infant.
In order to enter into this communication, the mother must be psychobio-logically attuned to the dynamic crescendos and decrescendos of the infant'sbodily based internal states of autonomic nervous system (ANS) peripheralarousal. Indeed, the intersubjective dialogue between mother and infant con-sist of signals produced by the autonomic, involuntary nervous system inboth parties. The attachment relationship mediates the dyadic regulation ofemotion, wherein the mother co-regulates the infant's postnatally developingANS, and thereby its internal homeostatic state. Also known as the vegetativenervous system (from the Latin vegetare, to animate or bring to life), it is
responsible for the generation of what Stern (1985) calls vitality affects.
Research now clearly demonstrates that the primary caregiver is not alwaysattuned and optimally mirroring, that there are frequent moments of mis-attunement in the dyad, ruptures of the attachment bond. The disruptionof attachment transactions leads to a regulatory failure and an impairedautonomic homeostasis. In this pattern of interactive repair' followingdyadic misattunement (Tronick, 1989) or 'disruption and repair' (Beebe &Lachmann, 1994), the 'good-enough' caregiver, who induces a stress response
Confirrning this right-brain-to-right-brain interpersonal neurobiologicalmodel, in very recent lunctional magnetic rcsonance imaging studies ofmother-inf'ant emotional communication Lenzi et al. (2009) offer data .sup-
porting the theory that the right hemisphere is more involved than the lefthemisphere in emotional processing and thus, mothering', and Noriuchi et al.(2008) show activation of the mother's right orbitofrontal cortex duringmoments of maternal love triggered by viewing a video of her own infant. Anear-infrared spectroscopy study of inf ant-mother attachmen t ar 12 monthsconcludes, 'our results are in agreement with that of schore (2000) whoaddressed the importance of the right hemisphcre in the attachment system'(Minagawa-Kawai et al., 2009: 289).
At the end of the first yeaq right cortical subcortical circuits imprint inimplicit-procedural memory, an internal working model ol attachmentwhich encodes strategies of affect regulation that nonconsciously guide theindividual through interpersonal contexts. This working model generatcsunconscious 'procedural expectations' of the emotional availability of othersduring stress (cortina & Liotti. 2007). Although these cxpectations are notexperienced as left-brain conscious thor,rghts, they arc consciously experi-enced as subjective right-brain affectively chargcd, cmbodiecl cognitions('gut feelings'). At all points of the lifespan attachment communicationsare expressed not in lcft-brain secondary process but in right-brain primaryprocess cognitions (Dorpat,2001; Schore & Schore,200g; Schore, in press).
Attachment neurobiology of relational traumaoptimal attachment communications directly affect the maturation of thecentral nervous system (cNS) limbic system that processes an<I regulatessocial emotional stimuli and the autonomic ncrvous system IANS) thatgenerates the somatic aspects of emotion. It is important to stress that agrowth-faciliterting emotional environment is required for a child to developan internal system that can adaptively regulatc arousal and an u.roy ofpsychobiological states (and thercby affect, cognition, and behavior). Thegood-enough mother offers her securely-attachcd infant access to her aftera separation; she tends 1o respond appropriately and promptly to his/heremotional expressions. She also allows high levels of positive affect to begenerated during co-shared play states. Such events scaffold and support anexpansion olthe chiid's right-brain regulatory coping capacities and unclerliethe developmental principle that secure attachment is the primary defenseagainst trauma-induced psychopathology.
In contrast to caregivers who foster secure attachment, an abusive orneglectful caregiver not only plays less but also induces encluring negativeaffect in the child. Such caregivers provide little protection against otherenvironmental impingements, including that of an abusive father. In contextsof relational trauma this carcgiver is emotionally inaccessible, given to
prolongcd dorsal vagal parasympathetic activation explains the lengthy
'voicl' states that are associated with pathological dissociative detachment
(Allen et al.. 1999).
Developmental neuroPsychology of dissociation
How arc the trauma-induced alterations of the developing right brain
expressed in the socioemotional behavior ol a traumatized toddler? Main and
Solomon's (1986) classic study of attachment in traumatized inlants revealed
a new attachment category. Type D, an insecure disorganized/disorientedpattern that occurs in 80,X, of maltreated infants (Carlson et al.. 1989) and is
associated with prenatal and/or postnatal maternal alcohol or cocaine usc
(Espinosa ct al.. 2001). Hesse and Main (1999) note that Type D disorganiza-
tion and disorientation is phenotypically similar to dissociative states. Mainand Solomon (1936) conclude that Type D infants have low stress tolerance
and that their disorganization and disorientation indicate that the infant is
alarmed by the parent. Because infants inevitably seek the parent when
alarmecl, these authors assert that frightening parents places infants in an
irresolvablc bind wherein they cannot approach the mother, shift their atten-
tion, or flee. These infants are utterly unable to -qenerate a coherent strategy
to actively cope with their frightening parents.
Main and Solomon detail the uniquely bizarre behaviors of l2-month-oldType D infants in the Strange Situation procedure. These infants displayed
brief (frequently only 10-30 s) but significant interruptions of organized
behavior. At such times, Type D infants may exhibit a contradictory behaviorpattern such as 'backing' towards the parent rathcr than approaching face to
face. Main and Solomon (1986: I l7) note that:
The impression in each case was that approach movements were continu-
ally being inhibited and held back through simultaneous activation olavoiclant tendencies. In most cases, howcver' proximity-seeking suf-
ficiently'over-rode' avoidance to permit the increase in physical proxim-
ity. Thus, contradictory patterns were activated but were not mutually
inhibited.
Maltreated infants cxhibit apprehension, conlusion, and very rapid shifts ofstate during the Strange Situation. Main and Solomon (1986: 119) describe
the child's entrance into a dissociated state:
One infant hunched her upper body and shoulders at hearing her
mother's call, then broke into extravagant laugh-like screeches with an
excited fbrward movemcnt. Her braying laughter became a cry and
distress-face without a new intake of breath as the infant hunched
forward. Then suddenly she became silent, blank and dazed'
ltoiiicr'. Irrcic;ci. tirc intcn:,i',1' oi tirc lleb1''s ci1'slcltiiilicci afl'cclir c .t:,lc i.olicu hci3hicncci u'hcir thc illl:r1 is o.irosccl io tirc uciciccl :,ti,:-.s cli' lilriiliiiii.itilitil-i)Jisoit. Ai l: stirilrg"'r': ,';l'.r'.rirc... tu'o inilirls nroveci lI., ltV llOti.i
Lroili ll-roihet'ilncl s'r.r'ani:cr-1o iircc lirc iiali: uiroillct"lcitncci iil'chcati .li:.lr:t.1iire ri'lli 1b;' scvcl'ui scconcls. iooi.iiirg blicir in allirli'.lli icnor". I hc:c inllil.ii:;crltibit 'bchaviol'ai stiiillg" thai is. 'cl:rzcri' ir..iravio;' ur.ii-l crcllcsst-ti r,iti'et"bchuvioral ntanil-cstutions ot'ciissociililou. Onc iiriitnt 'irccllrrtt iiti' lt ltro!itL-lttcrccssit,cly s'.i11. stuling inio :;oac"' a\ iirougir coiirirlcicll oiii oi-eoir:ltcl ti'itliscil-. cnviloiuncnt. ilnti paicni". Anoillci' sitou'eci 'a ciltz,--ii 1l:cilll ltrlitcal'il;re.l... uccolllltinlco b1'll siiliill: oi'lril 'bo<lf novt'ncnt^ iii.ici s,ol'tctit',tcs u il'ccz-ini: o1'linbs u'iricli i'racl becir in rnotion". Yci unoihcr''icii lacc-ciott'lt ott ilic1'looi iu ir clclrrcsscci il():tiLlc 1-rliol itr srir::r'.rtio'r^ stiliinri lill bociy lttovciltcitis'Gr-rcrtcircl'uncl I--cl'nlinian (200i)olicr an ulliLt-l ciisirc,ss sc:l1e tltitl tlsscssr.ts
thc siistainecl x,itircl'ar-,'iii that is u:sociatecl with ciisor!ri:nizecl attitclltitciti.'l'iris u'itircilarval statc is crirr.essccl ir lloz:en" ubseut iitcirii c:'irr'.':siort. l.rrtli
bchlivior'.Furthclilorc^ tiris bcirai'ioL is uccomi.xrniccl by a 'clisslpiltion oi'thc lltllint's
siaic o1'cousciousr.rcss^ aiicl u cilrinisirnrclit oL scil'-orlranizing altiliiict 1ha:
lcllcct 'clisorqunizaiiorr of iiranl' o1- ihe lorvct' 1n'cl ns;'cirobioiogical .il:tcs.sricir as nciiibolic s),stcrrs'. l{cciiil that ciissociution. li ii5'ltol.t.tctabolic stltic.irirs irccr.r ciciinccl in thc Amcr'icun Psychilltlic As;ociiition^s .1)ragrio,stit' uttrl
aclopi a ct'rr.nrrtuiricution stylc oi'"stay rnvit1,. clon'i conncct". l-hi: cL-tcrtsivc
staltcc is u vcly r'aiiv-ir.riiriil'rg" yct alrcacil,chi'oiiic. nrthoiogical clis:ttcilliiotr
34 Schore
that is associated with loss ol ventral vagal activation and dominance ofdorsal vagal parasympathetic states.
The strange Situation and Still-Face biphasic induction of arousal andaffect dysregulation occurs in face-to-face communications with the mother.The mother's face is the most potent visual stimulus in the child's worlcl. butit is well known that direct gaze can mediate not only loving but also aggres-sive messages. Hesse and Main (1999: 5l l) describe the mother's frighteningbehavior: 'in non-play contexts, stiff-legged "stalking" of inlant on all foursin a hunting posture; exposure of canine tooth accompanied by hissing; deepgrowls directed at infant'. Thus, during the trauma, the infant is presentedwith an aggressive expression on the mother's face. The image of this aggres-sive face and the associated alterations in the infant's bodily state are indel-ibly imprinted into limbic circuits.
Main and Solomon (1986) document that Type D infants often encountera second kind of disturbing maternal behavior: a maternal expression offear terror. This occurs when the mother withdraws from the infant asthough the infant were frightening. Indeed, studies show that the caregiver ofType D infants exhibits dissociated, trancelike, and fearlul behavior. currentresearch underscores a link between frightening maternal behavioq dissoci-ation, and disorganized inlant attachment (Schuengel et al., 1999). In recentwork, Hesse and Main (2006: 320) observe that when the mother enters adissociative state, a fear alarm state is triggered in the infant. The caregiver'sentrance into the dissociative state is expressed as 'parent suddenly com-pletely "freezes" with eyes unmoving, half-lidded, despite nearby movement;parent addresses infant in an "altered" tone with simultaneous voicing anddevoicing'. In describing the mother as she submits to the iieeze state, theynote (321):
Here the parent appears to have become completely unresponsive to.or even [un]aware of, the external surround, including the physical andverbal behavior of their infant . . . we observed one mother whoremained seated in an immobilized and uncomfortable position with herhand in the air, blankly staring into space for 50 sec.
In an early history of traumatic attachment the developing infant/toddler istoo frequently exposed to a massively misattuning primary caregiver whotriggers and does not repair long-lasting intensely dysregulated states. Thegrowth-inhibiting environment of relational trauma generates dense and pro-longed levels of negative affect associated with extremely stressful states ofhyperarousal and hypoarousal. And so for self-protective purposes it severelyrestricts its overt expressions of an attachment need for dyadic regulation.The child thus significantly reduces the output of its right-rateralizedemotion-processing, limbic-autonomic attachment system. When one isstressed, defensive functions are rapidly initiated that quickly shift the brain
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Ncurobiology oi attachmcnt 35
irotn inlcractivc i'egLrlatoly rrocics into long-clciut'ittg. iess conpicr alttoicgtt-latot'l,r'nocles. l'ircsc pattet'ns arc plimitivc stratcgiics fbi st"il'vivai thiit t'r'tt.lltinonlinc lbr longi iutcrvals oltimc. pcliods in rvhicli thc det'clopirtg brairl is lu ithypornctabolic statc. detrimcntal to tlic suirstat.rtiiil aii-iottttts of ctlct'91'
ol thc clcvcloping right blain. anci tirc lusting irnpailrlcnt is an immatr.tt'c aucl
lunctionally lirnitecl right-brain capacii)' to rcgriiatc latcr iil-'^ strcsstlt's thal
gcncratc intensc all'cct siates. Rclational trautnrtlic L'\p!-l'icnces at'c stot'ccl in
imagistic proccclr,rral lncmory of ihe visuospatiai rigirt hcmisphcrc (Schil]'cr
ct a1.. 1995). the locr-rs of'irnplicit (Ilu.gciairl. 1995) and ar-rtobioglaphical(Marliorvitsch ct al.. 2000) ircmory. 'l'ltcsc psychological and biological pct'-
spcctiv!-s cou!cIgc on a basic dcvclgDmcntal u'irlciplc of'rcgulation thcorl'that carly trautnatic sunclcrinli of attachu-rcnt trotrcls is critical to tlic- g,--trcsis
36 Schore
ol an enduring predisposition to a varicty of early forming severe psycho-pathologies that characterologically acccss the auto-regulating, affect-deadening defense of pathological dissociation.
Enduring effect of relational trauma on right braindevelopment: lmpaired emotion processing andpathological dissociationNeuropsychoanalytic authors now contend that 'If children grow up withdominant experiences of separation. distress, fear and rage. then they willgo dorvn a bad pathogenic developmental pathway, and it's not just a badpsychological pathway but a bad neurological pathway' (Watt, 2003: 109).
Current workers in the field of developmental traumatology now agree thatthe overwhelming strcss of maltreatment in childhood is associated withadverse influences on not just behavior, but also brain developnent (dc Belliset a1.. 1999), espccially the right brain which is dominant for coping withnegative affects (Davidson et al., 1990) and for 'regulating stress- andernotion-related processes' (Sullivan & Dufresne. 2006). Describing the essen-
tial survival lunctions of this lateralized system, Schutz (2005: 15) notes:
The right hemisphere operates a distributed network lbr rapid respond-ing to dangcr and other urgent problems. It preferentially processes
environmental challenge. stress and pain and manages self-protectiveresponses such as avoidance and escape. Emotionality is thus the rightbrain's 'red phone,' cornpclling the mind to handle urgent matterswithout delay.
In states of pathological dissociation the right brain's 'red phone iine'is dcad.The right brain is fundamentally involved in an avoidant defensive mechan-ism for coping with emotional stress. including the passive survival stratcgyof dissociation. Thcsc adaptive right brain functions are impaired in historiesof early relational trauma. A large body of psychiatric. psychological.and neurological studies supports the link between childhood trauma andpathological dissociation (e.g.. Dikel et al., 2003; Diseth, 2005; Liotti. 2004;Merckelbach & Muris.2001; Macfie et al.,2001).
Recent neurobiological data can also be utilized to create models of thepsychopathogcnctic mechanism by which attachment trauma negativelyimpacts right brain development. Adamec and colleagues (2003) reportexperimental data that 'implicate neuroplasticity in right hemispheric limbiccircuitry in mediating long-lasting changes in negative affect following briefbut severe stress'. According to Gadea et al. (2005), mild to moderatenegative affective experiences activate the right hemisphere, but an intenseexperience 'might interfere with right hemisphere processing, with eventualdamage if some critical point is reached'. Tliis damage is specifically
IO-
0t-
Ncurobiolcgy of attachment 37
hyoclalor-rsal-inciuccci alloptoiic ccli clcatii ir-r thc li1'pct'titciaboiic i'igirt blain.'firu-.^ via u switcir in.io li irypoaroi-l-qai. a h1'potnciaboiic stilic aliorvs tbr ccll
sLilvival at titnes of intensc crcitotoric sti'cs:j (Scliol'c. 200 l.2002).I{ccali tliat light coilical arcas anri thcil cot.incctiot.ts rvi'iir light sribcorticill
Col.rgt'itcui u'itli this cicr,clopl"r.rcirtai uocici. Spitzcr ci lii. rci.rot't a iralls-cilinial i.nagnclic stimLtiirtiorL stucil' o1'uclulis anci cc'rttcl,-tclt-, 'lti ciiss,rc:irrlion-
pl'rxtc incliviciLtals" li trarilna that is pei'ccivcd lttlci pt-c.rc.-sseci b1' the liglit|cltisphclc q,iil lcacl to a 'clisintrtion in tltc '.rstritlh' iiiiL-grated lttnctions of'
as rvcii us rvirh subcoltical arcas lhat l'cncraic botit tlic at'ortsai atlcl auto-
nomic boclily-basccl aspccts ol cn'rotions. I{ccall. SNS aclivit)' is illaniftsi intigfit cngilgcll.rcr.rt rvith thc crtelnai cil'iioument ar"rc1 a high l*,cl ol cilcrgy
components of t'notio'ili 'i"-'"t-tstriore' 1994;' Kalsched (2005) describes
operations of defensive dissociative processes used by thc child during
traumatic expe'encc ;;;i;lRn^ttt in the hoclv is severed from its corrcs-
oonding images in tht'tinJ onJ tn"'"uy un unbto'ubly painlul meaning is
tbliterated,. Nijenhui"s ?ffi.; ;r;;,, ,r.ru, 'somatoform dissociation' is an
outcome of early or"o i'uu-atization t*p^'*J as a lack of integration of
sensorimoto, .^p"ri.l..;, ;ii;;;, ana'frrr,"tior.ts of the inclividual's self-
representatiot. Di";;;;;i"^ttt-;;dta nii"iJ"uls are not onlv detached
rrom the .nulron*tn'l;;;;i'"-r; 11 '3ii - in"ir bodv' their actions' and
their sense ot ra.nt,tyi,iit.n'"i ur , r999t- This is expressed as a deficit in the
right hemispt,eric .coli'or".;i;;ii to."intr.y 2000t. crucian ct al' (2000)
describe 'a dissocratronlt'*ttn rhe emotional evaluation of an event and the
ohvsiologicat ,"u"ti#^tlo'itui-"u.n,, with the process being dependent on
iniol, tigit hemisphere lunction"
In a numbe, "f *;;k;^i-r1uu. or.r.o interdisciplinary evidence that the
implicit selt, equated *lti'' pttt'a's system
-U"' i' iocated in the right brain
(Schore, 1gg4,200.3;,ZOoll Thg.lSwer tuU*ititut levels of the right brain
(the deep .tn"on'"toJ"i"o"tuin all the major motivational systems (including
attachment, r.ur, ,.i*iiiy, uggr.rrro',,.etc.) and generate the somatic auto-
nomic expressions "r;^"""rr"r intensities of aliemotional states' on the
other hand. high";';;i;iror.,*r-ri-uic levels of the right hemisphere
senerate a conscious emotional state tlrat t^p""t' the affective output of
ihesemotivationalsystems.Inanopttmalaitachmentscenario.thisrightlateralized niera'ct'ical prefrontal system' the system Pt's performs an essen-
tial adaptive nlrti"uillriJi,rn.tion - trr. t.iutiu.rv fluid switching of internal
bodily based states;;;;""" to changes in the external environment that
are nonconsciously upp'oit"a to be.p.ersonallv meaningful'
In contrast, '"rutillt'uiiiuuma elicits more-than'a di::'p1t^"^1''"f conscrous
cognition and a. Oil"'g""i"tion .of overt behavior; it negatively impacts
the early o'run"uiiJ'i oilignt brain-survival mechanisms that operate
beneath levels of t"""i*t uiu"n""' raihological dissociation is manifest
in a maladaptive highly defensive 'igla' tfotti self system' one that responds
to even to* t.u"tr'oi intersubjectiu. ,ir.tt with parasympathetic dorsal
vagal parasvmpatieiic ;;;;;;;;;!1.1"" rate deceleration' and passlve
disengagement' This fragite ""ton'"io"'!.tvtlt- is susceptible to relational
stress-induced #;i;?f metabolic :;i6;t and therebv a loss of
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Ncurobiology of attachment 39
cnergl'-clcpcnclcnt synaptic conucctivity rvithin thc right brain. erprcsscd in asr-rcidcr.r irnpiosior.r ol thc in-rplicit scll and a rupiulc o1' sclf-continuity. 'l hiscollapsc o1'thc implicrt sclf is -.ignalccl by the ampiiflcation ol the ltaritsyrnpa-thetic aficcts of' sharrc ancl disgust. ancl by tlic cognitions ol' hopclcssncssilnd ltclplcssucss. Bccaltsc thc light hcrnisplic-r'c incciiates tho cornn'runicatiouancl rcgr.ilatiot.t oicutoiioiral siatr-s. thc ruirttilc of intcrsuLrjcctivity is acconr,ilir-ricr1 by an instant dissiltaiior-r o1'sai'ct1, uncl tiust.
I)issociatiou thus icllccts thc inability of iirc i'ight bliiin corticalsubcoitical intplicit sclf s1'51g111 io adaptivcly rcco-rnizc rincl ploccss extcrluistirrruli (crtcrocclttivc infbrrratiou coning Il-out tirc rclational cnvilonrlcnt)iiud ot't a lrlolrcltt*to-11-lomcl.]t basis intcgratc tircrr rvith inlcrnill stimuli(inteloccptivc inforn.ration fl'oi.i-r thc bod;,. somlir,ic uralkcls^ thc 'tclt expcri-cncc'). I'his lailurc ol itttcgratioir of thc highcr right hcmisphcrc rvitir thclolet' r'ight bt'ain inch-iccs an instant collalrsc ol both subjcctivity anci intcr-sr-rbjcctivtty. Stiesshtl allccts. cspccially thosc associatccl rvith ernotionaipaitt. arc thlrs not cxpcricnccci in cousciousncss. l)issociatcd affcct is thusitttcot'tsciotts allcct. clcsct'ibccl by l;r'ei-rd: 'Unconscious ideas cclntinuc tcl cxisraiicl rcprcssion as actual structriles ir.r thc systcrn Lc'1. rvirclcas all thatcoircspotlcls itr that s)'slcnl to t-rtrcouscior"rs allects is a ltotcntial bcginnintlvhicli is pr*'entecl 1r'orn clcr.'clopin-s' (1915: 178).
,/\t ali poinls <t1'thc lil-cspan. although clissocilition rcprL'sct.rts un clllctivcsitorL-tct't.t-l strate g1," ii is detrincntal to iong-tclrl functioning. spccilicaiiy byptcvcntin!: cxposurc to potcntial ligirt-brain sociocrnotional attachmentobjcct lcarning cxpcricnccs cmbcddccl iu intirlaic inicrsubjcctivc contcxtsthat arc ncccssal')/ lbl cmotional glorvth. 'rlie cndpoint of clrloirically cxpcri-ct.tcir.tg catastrophic statcs o1-rclational iritLrna in car:ly lifc is a progrcssir'c.iupairlnctrt of thc ability to acijust. taiic clcl-cnsivc action. or oct on oirc's owllbcltalf" ancl a blockingi o1'lhc capacit;'to rcgistcl ulicct ancl irain. a1l criiical tosut'viva1. Clinical rcscarcli sirou's palhological dissociation. a priuritii,,-.clef'cnsc auainst ol'cllr'ircin.rirrg allccts. is a Lcy 1'calure ol not only lcactivcatiachl.t-tcIlt clisorcler of inliurts and pcdiatric maltreatntr-nt clisordcr. br-rtaiso dissociutivc idcntity clisordcr, posttnnu.natic stlcss disorder. psychoticclisortlcls. e'ating ciisoldcrs. substiir.rcc abusc and alcohoiism. sontatolormdisorders auci socioltathic uncl bordcllinc pcrsonality disordcr.s.
Ps;,cirothcrapy ll,ith sucir patietris ncccls to littcnd to tlorc thau thcsigniiicar-rt clysrcguiatiou of allcct that chalactc-ri;ucs thcsc s*,crc sclf irath-ologics. It tlltst also acldrcss the carly lbi'miug clcfcnsc that blclcks tlicscovclrvhclmirrg a{Tccts from rcacliins consciousncss. thclcby dcnying thepossibility ol intct'activc rcgulation anci lhc organizatior.r ol rlorc complcxlighi-blain stl'css rc-cLrlation. Ilrombcrg (2006) obscrvcs tliat in tiic clinicalcncoLlutcr pathological clissociation acts lis an 'caily rvalnir.r-9 system" thatarticipatcs potcntiai alicct ciyslceLrlation bclorc thc traurna alrivcs. 'l hccurrenl paracligm shilt from cognition to aiiect also inch;dcs a shift lrornt'cpt'essiott to tlic sitt'vivai stt'atcgy of'clissociation as thc n-rajol mcchar.ristrl ril'
40 Schore
psychopathogenesis. It thus rcpresents a major obstacle to the intersubjective
change process in all all-ectively lbcused psychotherapies (Schore,200l , inpress), and to the effectiveness of early intervention programs. a major theme
of this book.
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