++SCHORE ON PROJECTIVE IDENTIFICATION

Schore/ar chp 3

Projective identification

12-25-06

WINDOWS OF TOLERANCE:

WHAT THEY ARE AND WHAT THEY DO

Who can give words to the unspeakable?  Is that what writers do?

massive missatunements, malattunement

“…Defensive projective identification, an early-forming right-brain survival mechanism for coping with interactively generated overwhelming traumatic stress, is activated in response to subjectively perceived social stimuli that potentially trigger imminent dysregulation.  (schore/ar/

p 59 –

primitive mental states are psychobiological states

“Thus, those of us with a developmental framework are exploring not primitive states of mind, but primitive states of “mind-body.  (schore/ar/59)”

p 60 –

“…affective states are transacted within the mother-infant dyad (Feldman, Greenbaum, & Yirmiya, 1999), and that this highly efficient system of somatically driven, fast-acting emotional communication is essentially nonverbal (Schore, 1997c)….the state in which the therapist receives the projective identification is identical to maternal receptivity [is referring to work of Grotstein 1981].  (schore/ar/60)”

“…critical role of the communication of internal affective states and process, rather than cognitions and content….”intense affective engagements” ….preconscious communication….Ryle pointed out that this mechanism [projective identification] is essentially concerned with “the relationship between intrapsychic and interpersonal phenomena and with indirect forms of communication and influence” (1994, p. 107) (schore/ar/60).”

PI is “a process that mediates…transmission of “intrapsychic externalizations” …. (schore/ar/60)”

Developmental affective neuroscience — neurobiology of emotional development = “mutuality of emotional response” (Migone, 1995; italics added) (schore/ar/60)”

developmental affective neuroscience and neuropsychoanalysis (schore/ar/63)

Neurobiology of the emotion-processing right brain

P 61 –

Copy this para into 9 postnotes right brain

“The early-maturing right hemisphere is dominant for the first 3 years of life (Chiron et al., 1997) and is specialized for the processing of emotional information (…bunch of schore article refs)…. This is due to the fact that this cortex, more so than the left, is anatomically connected into the limbic system, the brain network that “derives subjective information in terms of emotional feelings that guide behavior” (MacLean, 1985, p.220).  In fact, this hemisphere plays an essential role in the nonconscious appraisal of the positive or negative emotional significance of social stimuli via a mechanism similar to Freud’s pleasure-unpleasure principle (schore, 199b).  The right hemisphere is dominant for the perception of nonverbal emotional expressions embedded in facial and prosodic stimuli (bunch of refs)…, even at unconscious levels, (bunch of refs)… for nonverbal communication (ref)…, and for implicit learning (Hugdahl, 1995).  (schore/ar/61)”

++++

psychophysiological studies

“This “automatic emotion” operates in infancy and beyond at nonconscious levels (Hansen & Hansen, 1994), and such early automatic reactions shape the subsequent conscious emotional processing of stimulus (Dinberg & Ohman, 1996).

++ implicit perception of affective information transmitted by faces

++ distinct dynamic properties of “nonconscious” affect

++ relatively diffuse

++ more readily displaced

++ yields stronger or less adulterated effect

“I suggest that projective identification is a prime example of the “transmission of nonconscious affect” (Murphy et al., 195, p. 600  (schore/ar/61)”

++++

“…right-brain-to-right-brain communications embedded within the attachment bond represent what Bion (1959) called “links” between mother and infant.  Ornstein (1997) termed the unconscious right brain “the right mind,” and so Bianchedi’s assertion that “the mother’s mind functions as a link” (Vergopoulo, 1996) described the link provided by the mother’s right mind. (schore/ar/61)”

++++

normal emotional development

“…disorganizing forces in the early social environment can interfere with maturational processes.  (schore/ar/61)”

“The early social environment can positively and negatively influence the emergence of the early developing “primitive” (Tucker, 1992) right brain.  Indeed, this hemisphere is dominant for affect regulation, and for generating coping strategies that support survival and enable the individual to cope with stresses and challenges (Schore, 1994; Sullivan & Gratton, (schore/ar/61) 199; Whittling & Schweiger, 1993).  [this is copied into 9 postnotes right brain]

“Specifically, I am proposing that knowledge of the experience-dependent maturation of the right brain (“right mind”) offers us a chance to more deeply understand not just the contents of the unconscious, but its origin, structure, and dynamics.”  (schore/ar/63)”

“…early-developing yet enduring defense mechanisms that are mobilized by relational stress. Depending upon attachment history, these coping strategies can be both adaptive and maladaptive, and therefore critical elements of psychopathogenesis…. Therapeutic regulation and not interpretation and insight is the key to the treatment of developmentally disordered patients who are not “psychologically minded.”  (schore/ar/63)”

++++

the self is bodily based

“…I describe projective identification as an early organizing unconscious coping strategy for regulating right-brain-to-right-brain communications, especially of intense affective states.  Because affects are psychobiological phenomena and the self is bodily based, the coping strategy of projective identification represent not conscious verbal-linguistic behaviors but instead unconscious nonverbal mind-body communications. This information from developmental affective neuroscience and neuropsychoanalysis describes (schore/ar/63) the fundamental psychoneurobiological mechanisms that mediate the therapist’s capacity to access unconscious communications in order to know the patient “from the inside out” (Bromberg, 1991).  (schore/ar/64)”

We don’t teach people this, that the self is bodily based.  I would suppose this in part is the link to suicide – that when people are experiencing intense affects they do not understand that they are primary and primitive, stored normally in the unconscious – but that they have a direct link to the body – in fact are inseparable from it.  So if these people cannot tolerate the affects, they seek to eliminate the body that “feels” them.

p 64 –

CCURRENT UPDATINGS OF CLINICAL CONCEPTIONS OF PROJECTIVE IDENTIFICATION

P 65 –

“A conception of mother and infant adjusting to each other’s communications describes a model of mutual reciprocal influence.  This clearly suggests that projective identification is not a unidirectional but a bi-directional, interactive process…..Ryle (1994) referred to projective identification as a particular form of “reciprocal role procedures” that organize interactions with others, predict the role of the other, and combine action with affect, expectation, and communication.  Again, the concept moves from a monadic, one-way ejection of intrapsychic contents to a dyadic, intersubjective communicative process (schore/ar/65).”

Interactional principle

“,,,psychobiologically regulated affect transactions that maximize positive and minimize negative affect cocreate a secure attachment bond between mother and infant (refs to lots of his own work here).  They also are concordant with attachment researchers who are now defining the central role of the attachment relationship, a mechanism that continues in dyadic interactions throughout the lifespan, as the dyadic regulation of emotion (Sroufe, 1996)….  (schore/ar/65).”

“…projective identification…is not a unidirectional but instead is a bi-directional process in which both members of an emotionally communicating dyad act in a context of mutual reciprocal influence.  Although projective identification arises in the emotional communications within the mother-infant dyad, this “primitive” process plays an essential role in “the communication of affective experiences” in all later periods of development (Modell, 1994).  These communications, however, have unique operational properties and occur in specified contexts.  Authors emphasize that projective identification constitutes a mode of “primitive joint action” mediated by nonverbal signs (Leiman, 1994).  (schore/ar/65).”

P 66 –

DEVELOPMENTAL STUDIES AND THE ORIGIN OF DISSOCIATION AND DEFENSIVE PROJECTIVE IDENTIFICATION

“The ontogeny of both adaptive and defensive projective identification is deeply influenced by the events of the first year of life.  Developmentally, “realistic” or “adaptive” projective identification is expressed in the “split-second world” (Stern, 1985) of the mother-infant dyad in the securely attached infant’s expression of a “spontaneous gesture,” a somatopsychic expression of the burgeoning “true self,” and the attuned mother’s “giving back to the baby the baby’s own self (Winnicott, 1971a).  This developmental mechanism continues to be used throughout the lifespan as a process of rapid, fast acting, nonverbal, spontaneous emotional communications within a dyad (Schore, 1994, 1997c)  (Schore/ar/66).”

++++

p 70 –

PROJECTIVE IDENTIFICATION AS RIGHT-BRAIN-TO-RIGHT-BRAIN TRANSFERENCE-COUNTERTRANSFERENCE COMMUNICATIONS

++++

p 71 –

“…according to Adolphs and colleagues, “recognizing emotions from visually presented facial expressions requires right somatosensory cortices,” and in this manner “we recognize another individual’s emotional state by internally generating somatosensory representations that simulate how the individual would feel when displaying a certain facial expression” (2000, p. 2683).  These right-lateralized operations thus allow for the adaptive capacity of empathic cognition and the perception of the emotional states of mind of other human beings (Perry et al., 2001; Schore, 1994, 1996, 2001b; Voeller, 1986). (schore/ar/71)”

so this is considered an adaptive capacity that anyone with an insecure attachment has an impairment in: adaptive capacity of empathic cognition

also:

Empathy, defined as “the ability to sample other’s affects … and to be able to respond in resonance to them” (Easser, 1974)… (schore/ar/80)

“The right brain processes information in a holistic fashion, and it can appraise facially expressed emotional cues in less than 30 miliseconds (Johnson & Hugdahl, 1991), far beneath levels of awareness.  Because the unconscious processing of affective information is extremely rapid (Martin et al, 1996), the dynamic operations of these processes cannot be consciously perceived.  (schore/ar/71)”

p 72 –

“…activation of internalized object relations (unconscious, preverbal internal working models) is triggered by the patient’s perception of aspects of the interpersonal field that are external analogues of existing affect-laden self and object internal images (representations)…. (quoting himself Schore, 1994, p 450) in (schore/ar/72)”

p 73 –

“The reciprocal affective transmissions that occur between the interpersonal and intrapsychic spheres, the realms of a “two-person” and a “one-person” psychology, are fast acting, and these transactions occur within the temporal domain of microsecond reactions.  Thus, in the clinical context, although it appears to be an invisible, instantaneous, endogenous unidirectional phenomenon, the bi-directional process of projective identification is actually a very rapid sequence of reciprocal affective transactions within the intersubjective field that is coconstructed by the patient and therapist (schore/ar/73)”

And, in fact, between any two people!

“More specifically, the disorganized and chaotic somatic components of dysregulated biologically “primitive emotions” are involved in projective identification.  These biologically primitive emotions – excitement, elation, rage, terror, disgust, shame, and hopeless despair – appear early in development, are correlated with differentiable autonomic activity, arise quickly and automatically, and are processed in the right brain (schore, 1994).  In (schore/ar/73)”

++++

p 74 –

RIGHT HEMISPHERE ATTACHMENT TRAUMA AND DEFENSIVE PROJECTIVE IDENTIFICATION

paragraph continues:

“In a recent overview, Gaensbauer concluded, “The clinical data, reinforced by research findings, indicate that preverbal children, even in the first year of life, can establish and retain some form of internal representation of a traumatic event over significant periods of time: (2002, p. 259) in (schore/ar/74)”

++++

“This early representation includes “nonverbal presymbolic forms of relating” that “protect the infant from trauma and continue to be used by patients to avoid retraumatization” (Kiersky & Beebe, 1994, p. 389);  that is, the right-brain defensive regulatory strategies of dissociation and projective identification.  Experiences of early relational trauma (Schore, 2001b) restrain the manner in which coping responses occur at later points of stress:  “The experience is then structure-bound, the present situation or certain aspects of it evoking only an already formed experience pattern with a fixed unchangeable repetitive structure.  In that case, the experience is a “frozen whole” (Gendlin, 1970), and .. .the person experiences the same thing over and over” (Vanaerschot, 1997, p. 144).  These representations …are stored in the early-developing, “holistic” (Bever, 1975) right hemisphere (Schore, 1994).  In (schore/ar/74)”

fixed unchangeable

p 75 –

“Neuroscientists describe “early emotional learning occurring in the right hemisphere unbeknownst to the left; learning and associated emotional responding may later be completely unaccessible to the language centers of the brain”  (Joseph, 1982, p. 243) [there appears to be an error in the refs page for this as it only lists pp 4 – 33] From this realm that stores split-off parts of the self also come projections that are directed outward into the therapist [and other people, as well]….preverbal traumas …”these affects are also experienced by the therapist”…. (schore/ar/75)”

“…neuroimaging studies showing the preeminent role of right hemispheric activity as traumatic emotional memories are activated (Rauch et al., 1996) and recalled (Schiffer et al., 1995).  In (schore/ar/75)”

++++

THE NATURE OF THE RECEPTIVITY REQUIRED FOR PROCESSING ADAPTIVE AND DEFENSIVE PROJECTIVE IDENTIFICATIONS

“mutual mapping process may be a way of defining intersubjectivity” (Tronick & Weinberg, 1997, p. 75)…. For the rest of the lifespan the right brain, which is more connected into the limbic system than the later-developing left, is especially involved in unconscious activities and spontaneous emotional communication.  Because this hemisphere is dominant for “subjective emotional experiences: (Wittling & Roschmann, 1993, italics added), the interactive “transfer of affect” between the right brains of the members of the mother-infant and therapeutic dyads is thus best described as intersubjectivity. Furthermore, the cocreated dyadic amplification of state and alteration of consciousness that spontaneously occur in moments of intersubjective resonance of two “right minds” facilitate the cocreation of what Ogden called, “this third subjectivity,” “the analytic third,” the “unique dialectic generated by/between the separate subjectivities of an analyst and analysand within the analytic setting:  (1994, p 64) in (schore/ar/76)’

alteration of consciousness that spontaneously occur in moments of intersubjective resonance of two “right minds: Is this the only time it happens?  I think this also happened even in traumatic encounters with my mother, even though the resonance wasn’t there

p 77 –

“…fact that the prosodic elements of communication such as rhythm, force, and tonality – more so than the linguistic elements of lan- (schore/ar/77) guage – carry the affective messages within projective identifications.  (schore/ar/78)”

p 78-

“The right hemisphere is specialized to process new information by comparing it directly with context information (Federmeier & Kutas, 1999).  (schore/ar/78)”

RESONANCE

“In physics, a property of resonance is harmonic sympathetic vibration, which is the tendency of one resonance system to enlarge and amplify through matching the resonance frequency pattern of another resonance system.  (schore/ar/79)”

para con’t

“The therapist’s empathic ability to receive, resonate with, and amplify the patient’s often “shimmering,” transient states of positive affect facilitates the interactive generation of higher and more enduring levels of positively valenced states than the patient can autogenerate (schore, 2000c).

Wouldn’t it be wonderful if I could have this simply with other people – in their prescence – other than just with my children and with ER?

p 80 –

++++

“A cardinal tenet of developmental projective identification is that the infant projects parts or the whole of its emerging self “into the mother’s body,” and like the empathic mother who aligns with her infant’s [infant’s what?  Is this a sic?] in order to regulate and be regulated by his/her internal state, the clinician’s body is a primary instrument for psychobiological attunement and the reception of the transmission of nonconscious affect.  (schore/ar/80)”

This worked backwards with my mother.  She projected her self into me!  And it was toxic.

See definition of empathy from p 80 quoted above

“The therapist’s detection of his/her countertransferential interoceptive responses that resonate with the patient’s autonomic responses to threatening stimuli is especially important to the reception of defensive projective identifications.  These are registered in the therapist’s right brain, especially in its limbic-autonomic circuits.  It is established that “a primary role for the right ventral medial prefrontal cortex may be the integration of internal physiological states with salient environmental cues, to guide behavior in an optimally cautious or adaptive manner in situations of perceived threat or conflict” (Sullivan & Grafton, 2002a, p. 77). {isn’t this true for all of our interactions with other people? reception of defensive projective identifications.  These are registered in the … right brain] With regard to the patient’s state, this same right-lateralized structure is where the emotional trace of a conditioned fear is formed and stored (fisher and the rest…).  Other key structures activated in the heightened therapeutic moment are the right amygdala, and area involved in “unseen fear” (Morris et al., 199), the right insula, which generates a cortical image of the interoceptive condition of the body (Craig, 2002), and the vagus nerve which delivers viscero-sensation from the stomach, bowels, heart, lung, pancreas, and liver to awareness (Zagon, 2002).  [there is no Zagon 2002 in the ref section] (schore/ar/82)”

++++

Now this next paragraph is a piece of work!  Schore has a separate reference after each of these statements.  I will put his last paragraph sentence here first, and then just list the facts:

“These intrapsychic structures are located in the therapist’s right brain.  (schore/ar/83)”

I would say, these same intrapsychic structures are located in ALL of our right brains, and we use them any time we interact with ANYBODY!!

++++++++

p 83 –

“The clinician’s task of receiving and containing defensive projective identifications is obviously more difficult than adaptive projective identifications.  This is because resonating with the dissociated, negatively affectively charged chaotic bodily states of personalities manifesting “primitive emotional disorders” is, indeed no easy matter.  (schore/ar/83)”

p 84 –

“In other words, resonating with and then internally amplifying the patient’s negatively valenced primitive affective state triggers a disequilibrium within the therapist’s right brain, the hemisphere that is specialized for generating physiological responses to emotional stimuli (Spence et al, 1996).  (schore/ar/84)”

same para con’t

“There is convincing evidence in the neurobiological literature to show that the right hemisphere is specialized for coping with stress (Wittling & Schweiger, 1993) and for processing negative affect (Davidson, 1998; Gainotti, 2001; Otto et alk, 1987; Schore, 1997b). Furthermore, the experience of strong sustained negative emotion causes interference with normal right hemisphere functioning (Hartikainen, Ogawa, & Knight, 2000; Ladavas et al, 1984), and this aversive subjective emotional experience would accompany the reception of a defensive projective identification.  (schore/ar/84)”

THE THERAPIST’S DEFLECTION OF PROJECTED NEGATIVE STATES AND THE INTENSIFICATION OF INTERACTIVE DYSREGULATION

“…the experience of traumatic pain is stored in bodily based implicit-procedural memory in the right brain (Schore, 2001d) [I should be able to find this, ref to Minds in the Making, the first chapter in this book]and therefore communicated at a nonverbal psychophysiological level, not in the verbal articulation of a discrete subjective state.  As Sands pointed out:  “The material [embedded in projective identification] may remain unsymbolized because it was encoded under traumatic conditions or because it pertains to a preverbal period of life.  Whatever the reason, because such experience remains in somatosensory or iconic form, it must be communicated in like manner:  (1997b, p. 702)  (schore/ar/84)”

p 85 – 86 –

“…defensively shifting out of the right brain state into a left brain state, he/she [the therapist] cuts off his/her empathic connection to his/her own pain and therefore to the patient’s pain.  (schore/ar/85)”

Ordinary people in our lives cannot contain our distressing emotions and return the content of our “dissociated early experience” to us “in a more benign form.”

Just as in therapy, I would suppose that when we are in situations with others where this negative projective identification is going on, when we cannot respond “as needed” some kind of an “enactment” will follow.  Schore calls this “cocreation of an enactment” (schore/ar/86)  In the vernacular, it could be called a “trauma drama,” and according to what Schore is saying here, it comes from negative biases – on BOTH parts – even with therapists.

“Deflection” of or “refusal” to accept the “projected negative state is [usually] a spontaneous behavior.” We also instantly detect when our projection is not being accepted because we can instantaneously “read” the other person’s reaction to us.  This all happens in a brief and unconscious interaction beneath our awareness.  These are implicit reactions and responses.  This happens because our own “stressed” states from the past are being triggered, usually and often without our even knowing it, because these implicit memories and the procedures that are connected to them are unconscious because they were formed when we were preverbal and before we had conscious memory.  They are “hard wired” into our brains and into our bodies. (see below)

“But, in addition, neurobiological research demonstrates that aberrant early social experiences alter the ability to efficiently process facial expressions of emotion, and that such individuals overinterpret signals as threatening and overidentify anger (Pollak & Kistler, 2002).  This may mediate the transference process, defined as a selective bias in dealing with others that is based on previous early experiences and that shapes current expectancies (McLaughlin, 1981).  (schore/ar/86)”

I have called this “blindsight” rather than “mindsight”

Interesting here, Schore refers to:

Therapist’s “mindblindness” (schore/ar/86)

“This [stressed] maneuver…is…expressed in gestures and body language, behaviors that play a prominent role in the unconscious interpersonal communications embedded within the enactment (Frayn, 1996).  [acting outIt is now well established that enactments are fundamentally mediated by nonverbal unconscious relational behaviors within the therapeutic dyad [or in any dyad] (McLaughlin, 1991; Schore, 1997c).  (schore/ar/86)”

and I would say, within our lives.  We both initiate and respond to others’ bids to either accept their projections or to engage in an enactment when the acceptance of the projection does not happen.  And – oh boy! – it all happens unconsciously based mostly on our experiences before we were a year and a half old!

Of course when we are talking about a therapist-client interaction, the stakes are higher.  We expect to be helped, not further confused.

“The therapist who misattunes and is subsequently unable to recorrect will thus project the unregulated state back, further stressing the working alliance.  The patient who rereceives an unmodulated stressful communication now becomes, as a repetition of his/her early history, further psychophysiologically dysregulated by the misattuning object.  According to Bach, “Difficult patients continue to respond at the sensorimotor-physiological level, precisely because that is where the earliest mutual regulation went awry” (1998, p. 188).  As a result of this increasing stress level, a pathological internal representation is activated, a negatively valenced representation of a dysregulated-self-in-interaction-with-a-misattuning-object, one that triggers an expectation of imminent self-disorganization (schore, 1994, 1997c).  In other words, there is now an overt expression (schore/ar/86) of an intense, unregulated negative transference reaction.  The emotions evoked in the transference “hinge on the range and extent of expectations for different situations that are already a part of the patient’s repertory” (Singer, 1985, p. 198).  (schore/ar/87)”

So this is, in one form or another, one degree or another, the legacy that 45 – 50% of the population has been given to live with – those of us with insecure attachments and empathy pathologies.  We are afraid that we will self-disorganize, and therefore cease to exist as a self – due to our past very early insecure-attachment forming interactions with our early caregivers – interactions that hard-wired and formed our brains.  Way before words, way before awareness or consciousness was possible.

We HAD those experiences “of a dysregulated-self-in-interaction-with-a-misattuning-object,” and on an implicit-procedural level, we well remember them.  We are misattuning with others and they are misattuning with us most of the time.  That’s life.  At least for half of us – and even for the other half if they are interacting with us.

So what we fear is our own self-disorganization [SELF destruction – destruction of our/the SELF – the fragile or minimally existent self – self disintegration] and the threat of our annihilation and extinction.  The threat goes against every survival instinct we have – just as it did in the beginning when we were tiny helpless infants faced with our misattuning caregivers who could not and/or did not help us gain necessary abilities to regulate our affects.  They overran us.  The rerunning down old unhappy yet internally remembered pathways of neurons within our brain/mind/bodies.

For me with ER it is also about the despair I feel when I am a dysregulated self-NOT in interaction with an attuning other – or one I determine to be attuning, which I feel he IS when he is with me.  It is just all the great difficulties I have when he isolates himself from me – like he is right now during his “break” from work – when I cannot call him.  I just feel so SAD!  It must trigger all my hopeless-despair!  It’s the stress-turned-into-distress that bothers me.  It’s the inability to “rationalize” it away, or diminish it or control it or regulate it that bothers me.  It’s the inability to make myself feel happier or better that bothers me.  It’s just hard.  A hard situation.  It would be a hard situation for any woman.  But I tried going away to forget him.  To change how I feel about him.  It didn’t work.  So this is something I just have to bear.  And it’s really really hard.  I guess if I could dis-associate from it, from him, from my feelings, I certainly would.  But I can’t.  I don’t know how.

p 87 –

“This rapidly amplifying perturbation instantly disorganizes the intersubjective field, and an interactively intensified physiological stress response now propels the patient’s immature self-system into accelerating levels of arousal that are beyond his/her fragile, limited, and inefficient affect-regulating coping capacities.  The patient thus will instantly access an internal working model of an insecure attachment that encodes a primitive defense for coping with interactive stress – the right-brain strategies of dissociation and [defensive] projective identification. [and thus the cycle reruns and reruns itself.] It is now thought that “it is the person’s specific experiences that will determine the cues that trigger the breakdown of regulatory processes as well as the dominant responses that will be released when regulatory processes fail”  (Newman & Wallace, 1993, p. 717). (schore/ar/87)”

DISSOCIATION

“The essential defensive nature of this primitive regulatory mechanism [which is designed to work against the primitive emotions/affects] is echoed in the term defensive projective identification.  The patient’s sympathetically driven hyperarousal reaches a point of such intensity [I would imagine matched against their “window of tolerance”] that a massive parasympathetic counterregulatory [I don’t understand this word here – why “counter?”  The hyperarousal certainly isn’t regulatory by itself] strategy must be activated.  In other words, projective identification occurs in the context of a “malignant transference reaction” that reflects hyperarousal and hypo-arousal-associated alterations of limbic regions (McKenna, 1994).  Specifically, this mechanism represents a sudden shift from energy-expending hyperarousal into dissociation and energy-conserving hypoarousal. [and the alternative would be what?  Total disorganization?  Death of the self one way or the other?  When affects become too much to bear….the lucky ones get to dissociate] The fact that this stress-regulating mechanism represents a sudden transition from a hyperaroused into a hyperinhibited state indicates that the accelerating negative affect is not “emptied” or “discharged.”  The hyperarousal still remains and thus the pain endures, but is now instantly dissociated, and thereby “anesthetized” or “numbed.” (schore/ar/87)”

I still don’t understand this – and my response is still “NO!”  What would be the point of shifting into a hypoaroused state if the hyperarousal still remains?  Does he mean it is just re-stored somewhere “out of touch?”

“This bears upon some controversial aspects of the concept of projective identification.  It is often written that projective identification is an attempt to intentionally control the therapist, but it should be noted that beneath the initial forceful explosive expression is intense disorganization and insecurity, and not intentionality but hopelessness, helplessness, and a total lack of an organized coping mechanism. Alvarez held that the interpretation of projective identification isharmful, in that it triggers defenses that are “desperate attempts to overcome and recover from states of despair and terror,” yet these defences [sic] are “inadequate to manage … powerful feelings” (1997, p. 754) (schore/ar/87)”

“Furthermore, this primitive coping mechanism does represent an affective communication, and it does allow the precarious personality organization to disown parts of the self, that is to “rid” the individual contact with his/her own mind – and body (!) – but it does not represent a literal evacuation or expelling out into an other, so that the negative state no longer exists within.  The tension is not relieved, because the state of hyperarousal remains.  And the pain still exists within, but is instantly dissociated by increased endogenous opioid re- (schore/ar/87) lease, and experienced as an enduring “dead spot” in the patient’s subjectivity.  (schore/ar/88)”

My entire childhood was a “dead spot” in my subjectivity!

“Thus, at the moment of an adaptive projective identication the patient’s affect is subjectively deepened and communicated, while in the instance of a defensive projective identification affect is not just diminished but totally blocked from consciousness (dissociated) and its interpersonal communication suddenly ceases.  As a result of the sudden shift from a state of active coping into an inhibited state of passive coping, the patient will “implode” under stress, and further dissociate from the state, so that it appears as if only the therapist holds it.  In other words, in the moments after the defensive projective identification, the dissociating patient now in a state of dense emotional inhibition, is no longer overtly expressing a dysregulating emotion, but the nondissociating, resonating therapist is still subjectively experiencing the amplified negative state.  In this case it may seem to the therapist that the state originates endogenously within himself/herself and is not an emotional response to the patient’s communication.  This state now frequently becomes amplified into a lingering dysphoric mood.  (schore/ar/88)”

DEFENSIVE PROJECTIVE IDENTIFICATION AS EARLY EVENTS IN DYADIC ENACTMENTS

“Despite the fact that the patient’s conscious experience of pain is dissociated by his/her numbing and mindblinding defensive autoregulatory strategy[evidently if the patient is still dysregulated, the strategy is not effective!], the still-dysregulated patient will often soon exert increasing amounts of “pressure” on the therapist for interactive regulation.  This may seem paradoxical, but actually it reflects the patient’s communications of an unconscious attachment need for interactive regulation to help him/her cope with the dysregulation.  Bion (1959) vividly described how the infant, confronted with what seems like an impenetrable object, is driven to project into such an object with more and more force.  [does he mean a literal object here, or a person?]

someone else’s defensive projective identification can put the listener on the defensive in “a prolonged blindness” so that they are “no longer scanning for implicit external signals of the patient’s internal disorganization” (schore/ar/88)

p 89 –

the therapist, or listener, may experience “a partial dissociation that matches the patient’s state”(schore/ar/89)

“Embedded in the patient’s projected transmissions are nonverbal communications of pain, but “the therapist because of intense countertransference pain, flees from the patient’s experience of chaos and the intensity of affects that accompany an experience of dissolution” (Mordecai, 1995, p. 492).  (schore/ar/89)”

“According to Plakun (1999), the dyadic enactment is triggered when the therapist:

participates unwittingly by projecting back into the patient reciprocal and complementary unconscious conflicted countertransference material from the therapist’s own life history.  The therapist unwittingly colludes with the patient in a process of mutual and complementary projective identification organized around significant past events from the lives of both participants.  Within such an enactment, the therapist is as much an active participant as the patient.  (p. 286)

in (schore/ar/89)”

This happens with all of us as PEOPLE!  We contaminate our encounters with one another due to our own unfinished trauma, our own experiences from our life histories.  But it is the implicit-procedural memories we don’t even consciously know about ourselves that cause the most problems!  And we are always BOTH equally responsible!  There is no blame – but the more we know about ourselves the better – and about our MO based on very early history!

These are “dysregulating interactive” contexts based on “a direct analog of an earlier developmental scenario that was common in the patient’s attachment history of the first two years of life.  In developmental writings, Murray (1991) concluded that: (schore/ar/89)

If…the infant’s state is experienced by the mother as threatening or overwhelming, she may feel the need to switch off from the infant, and may likely be drawn instead to focus on her own experience.  If, however, she is unable to switch off, for example in the fact of the infant’s persistent demands, the mother may find it hard to distinguish the infant’s perspective from the impact his state makes on her, in which case she may experience the infant as trying to tyrannize her and may regard with hostility. (p 223)

(In schore/ar/90)

“It is within this stressful context that the mother unconsciously yet forcefully (re)projects into the infant certain disavowed, yet highly invested negative attributions (Liebermann, 1997)  Notice the similarity of the mother’s (mis)attribution of tyranny to the infant, and the classical (mis)conception of intentional control to the patient manifesting a [defensive] projective identification.  This developmental context of a dysregulating interaction with first a “switched off” caregiver and then an intrusive and hyperarousing caregiver is a primary source of the repetition compulsion enacted by the mutually projecting therapist and patient. (schore/ar/90)”

I am thinking about abuse cycles, and how they are repeated again and again – this might also be describing my mother’s interactions with me – that I was the devil’s child.  But she had this state even before I took my first breath – that the devil sent me to kill her in labor –

It also makes me think of ambivalent/preoccupied attachment parenting styles.

He continues by talking about unconscious tactics a client may use, “coercive dynamics” quoting Park & Park, 1997, p 144 in (schore/ar/90)

“The rapid-onset, dynamic events of the “negative therapeutic reaction” are thus an overt manifestation of the interaction of the patient’s covert deep unconscious defensive transference patterns with the clinician’s covert deep unconscious defensive countertransference patterns (Schore, 1997c).  The patient does not project an internal critic into the therapist, but rather the therapist’s internal critic, stimulated by the patient’s negative affective communications, resonates (schore/ar/90) with the patient’s and is thereby amplified.  The receptivity of both members of the dyad breaks down and seals over, leading to a long-enduring therapeutic impasse when it comes to intense affective states, or even a precipitous termination.  A poor therapeutic outcome is thereby “the result of the linkage of the therapist’s affective relationship regulation to the unconscious signals of the patient which leads to a stabilization of the patient’s conflictive structure” (Merten…and the rest, 1996, p 210) in (schore/ar/91)

We can do this with anybody.  They project negative and it resonates with our own negative and is amplified.

Just as it would work with the positive.  VERY hard to respond with the positive – even for the professionals!  We need to watch out for those “intense affective states.”

We LINK with one another’s negative or positive states – how do we regulate affects in relation to someone else, or in relationship with them, especially when we are responding to others unconscious signals with our own unconscious responses?

“optimal therapeutic intervention to a projective identification”  from (schore/ar/97) Can we do this with one another?

We do not want to stabilize anyone else’s conflictive structures or ours!  If we try to consider that each of us is a potential “healer” and that therefore every encounter we have with another person is potentially a “therapeutic” encounter – or not!

“Feldman wrote, “It is as if the patient has such doubts about the possibility either of symbolic communication or the object’s subjectivity to any form of projection that he cannot relent until he has evidence of the impact on the analyst’s mind and body.  If this consistently fails, confirming an early experience of an unavailable, hateful object, he may give up in despair” (1997, p. 232) in (schore/ar/91)”

++++

IMPORTANT

“The untoward, iatrogenic [“introduced inadvertently” by the therapist] effects of the therapist’s deflection of the patient’s defensive projective identification is also described by Sands:  “If the analyst cannot make herself available … and cannot receive the patient’s indirect, visceral communications, then these dissociated, not me aspects of self that are being communicated will be unconsciously experienced as intolerable to the analyst as well, and the patient will not be able to bring these aspects into the analytic relationship” (1997a, p. 665) in (schore/ar/91)”

This is deeply interesting to me.  We were not empowered as children with the awareness, knowledge, power or ability to “deflect” mother’s defensive projective identifications toward and onto us as children.  We could not “receive” her “indirect, visceral communications” – her dissociated – not me aspects of her self that were being unconsciously communicated to SOMEONE as screams for help and healing her terribly terribly wounded fragmented self.

Her projections WERE intolerable, but we had to tolerate them.  We had no choice.  That is the huge difference – a therapist is SUPPOSED to accept the projections and work with them.  So when she kept projecting these aspects out to us and nobody could help her, then did that just lead to a stabilization of the her conflictive structure?

When this type of behavior is enabled and allowed to continue without adequate intervention and treatment, the wounding is just becoming deeper and deeper – for all concerned.

++++

IMPORTANT

“More so, the therapist’s use of defensive projective identification to evacuate unwanted “toxic” aspects of the self back into the patient has significant consequences:

The projected affects often involve the therapist’s hidden feelings of shame, envy, vulnerability, and impotence.  The hidden shame is signaled by the therapist’s use of “attack other” defenses such as sarcasm, teasing, ridicule, and efforts to control the patient in some way.  Later on, the tragic projection comes full circle when the patient feels humiliated, exploited, betrayed, abandoned, and isolated.  (Epstein, 1994, p. 100)

In (schore/ar/91)

AND we wonder why we are and feel, TRAUMATIZED!

Boy this has some powerful implications for how we treat one another just person to person!  Is the same thing happening when someone uses sarcasm, teasing, ridicule, and efforts to control others?  When their hidden shame is signaled to us by their attacking us?  That they are projecting to others defensively, trying to “evacuate unwanted “toxic” aspects of the self?”

If that is true, then we can identify when we use these tactics that is what we are doing!

And if someone uses them on us, we will feel humiliated, exploited, betrayed, abandoned and isolated!

Easier words to read than to work with!!!

We are not having empathy when we react defensively to others’ defensiveness!  Yet how do we become “educated” enough, aware enough, conscious enough, well enough to be able to HEAL in our actions and reactions?

And this is also the motivation, in some ways, for what mother did to me.  Someone attacked her when she was a vulnerable child (because someone attacked THEM) because of THEIR shame.

Is this the mechanism (to use one of these guy’s favorite words) that transmits the unresolved trauma down the generations?  All of it, when attached to experiences in the first 2 years, will be implicitly remembered and enacted unconsciously and automatically when threat is sensed.

++++

All of this is just playing around the edges of my mind as I read it.  Like the picture is so BIG.  It so amazes me that one mind, that Schore’s mind, can grasp all of this.  It gives me hope, and I am grateful, to know that there are people like him “out there.”

Yet how do I grasp the exact nature of what he is saying?  Linking my mother to me, and then back to her mother and her mother’s mother?

How can I translate this information to help my own poor dysregulated brain and fragmented self?  Then how do I use the information to get along better in the world of people?  It is all about intense negative affects, unconsciously held, mostly dissociated from our self because they were intolerable and toxic to us in the first place.

Yet they have never left us.  They have never gone anywhere!  And projecting them out there doesn’t help if there’s nobody there to HEAR US!  Just like there was nobody there in the first place when these awful things were given to us as infants.

It is crucial that I understand the full implications of the whole picture.  I cannot translate and communicate the significance of any of this, or the value of the knowledge itself, if people here it as “Oh, I already know all of that.  Tell me something new.”

We need to understand it is because of what happened to us in our infancy’s, very early on – that formed itself into our brains.  That it runs our show!  That this trauma made us and controls us, our interactions with ourselves, with our environment, with each other,  from deep within our brain structure.  And we DON’T know it – not even when it is operating!

But I believe there is potential in this information for healing if I can deeply and completely understand what Schore is saying about what happens between a therapist and a client, and then if I can extrapolate from that information, and bring it down several octaves to where the rest of us ordinary, real people live – especially to those of us with infant abuse brain damage and the people we effect.

I need to take this in through my eyes, into my body, all the way down to the tips of my toenails and the tips of my fingernails, digest it through my entire being, and then let it come back out in my own words – infant abuse from the inside out.

It happened to me!  I have to convey the significance of this to others.  The essential essence of it.

People are starving and do not know how to fill themselves, or with what.  There is a kernel of nutrition in here, vital nourishment – that can help MAKE SENSE out of all the terrific efforts lots and lots of people are making to try to make things better.  They just aren’t going back far enough!  They are not going to the root, not going back to the headwaters.

What we missed is what we are missing.  But this information can be extremely threatening to people.  It will rock their worlds at the center – where the truest damage lies.  I have to write in some way that they can digest it.  Hear me.  Hear these facts.  Because it is the dysregulated place where the self has splintered off the traumatized fragments of its-self, those things that people defend themselves against KNOWING because there is so much hopeless despair and rage there.

How to prevent “infection?”  How to “sterilize” this information, make it as pure as possible?  Is that the gift of the childhood I lived, that I went through this as a PURE SOUL?  And that I can go back there with immunity and pull this all back out into the present?

Powerful stuff….  Even scares me.  But I made it through thus far.  I can do this.  I wouldn’t be being asked to write this book if I wasn’t able and worthy to do it. I KNOW somewhere deep within myself what the essence of this is.  The absolutely pure and beautiful homestead gave me that through the years that followed the infant abuse.  It made the intolerable tolerable – gave me the ability to tolerate it.  Everyone who has survived infant abuse has SOMETHING that their own essence connected to – somewhere inside them to this day that connection is there.  The power of this cannot be underestimated or ignored.  It is central and crucial.

Even my mother had something inside her that let her endure.  Is it simply our own attempts to heal ourselves?  Even like on some level she tried to heal herself by projecting her own fragments of her self onto her children?  Did she have THAT MUCH PAIN inside of herself?  How tragic.  How truly tragic.  And it is these tragedies that we have to identify because THEY CAN BE PREVENTED!

My mother could not tolerate those parts of her SELF that were left splintered off so that her SELF was in fragments.  Her intolerable experiences that she could not tolerate BROKE HER SELF.  She was as shattered as would be one of the fine bone china dolls she was given as a child if someone had dropped it off a precipice onto a slab of stone far below.  She was broken.  She was SO broken, but still she endured.

Like the girl version of Humpty Dumpty.  ‘Cept nobody put her back together again.  Is it possible?  Would it have been possible?

Borderlines.  Lost in the mirrors.  And then the mirrors get broken.

I am damaged.  My brain structure is damaged.  But I am not broken.  Not broken like she was.

Why not?

Down at the bottom of our wells is where the hopeless despair lies.  The intolerable pain.  We build platforms to protect us from falling into that pain.  We are terrified that if we “go there” where that pain is, we will be broken, too.

Who can give words to the unspeakable?  Is that what writers do?

At this moment, writing this, I do not feel pain for myself.  I feel pain for my mother.  For whatever she went through that hurt her so badly it broke her SELF.  Yet this pain for her will not heal me.  I have to know my own pain, the pain her brokenness caused me.

Delayed, Damaged or Delayed?

++++

THE THERAPIST’S AUTOREGULATION OF PROJECTED NEGATIVE STATES AND COPARTICIPATION IN INTERACTIVE REPAIR

“…the rapid, mutually disorganizing stressful events occurring within episodes of defensive projective identification and clinical enactments offer important possibilities for not only “grasping the patient’s inner world as it intersects with the therapist’s own” (Plakun, 199), but also for structural growth of right lateralized internal psychic systems that unconsciously process emotional communications and regulate stressful emotional states. [I would think this would be true for any person-to-person interaction, and it offers opportunity for “healing” for both brains involved.] The right hemisphere, which is dominant for processing stress and negative emotions, expecially for monitoring “failure-linked emotions,” shows a strong response to error and negative emotional feedback (Koshkarov, Pokrovskaja, Lovata, & Mordvintsev, 1996; Sobotka et al, 1992), yet is centrally involved in the potential utilization of negative feedback from the external environment for error compensation (Kaplan & Zaidel, 2001).  (schore/ar/92)  also copied into above list on right brain

“dramatic reenactments” or should we say “traumatic dramatic reenactments” at times of “interactive stress” – needs to be at that exact point that the misattunement that triggered the enactment is “repaired” – “interactive repair” is a regulatory process – in therapy needs to be initiated by the therapist, or the “receiver” rather than the “sender” of the defensive projective identification. (refers to schore/ar/92)

“It has been pointed out that it is the therapist’s “emotional containment” that breaks the “vicious cycle” of the defensive projection within the therapeutic dyad (Migone, 1995).  The stressful context in which this is accomplished is heightened by the simultaneous activation and communication of different motivations by the patient:  The analyst will experience powerful transferential pulls that emanate both from the patient’s repetitious, pathological relational configurations and from the patient’s striving for the needed vitalizing (self object) experiences” (Fosshage, 1994, p. 277) (schore/ar/92)”

My mother certainly had this: repetitious, pathological relational configurations going on, yet at the same time the striving for the needed bitalizing (self object) experience.  It sounds like the so wounded one needs to experience the split off “intolerable” parts of their own self as a “returned” part of themselves – though they rejected and slit these parts off in the first place because they could not be tolerated.  They were outside “the window of tolerance” for there was no way for the emotions of these split-off experiences to be regulated.  It would therefore seem that it is not the experience itself that causes the “split-off” but rather the inability or non-capacity to regulate the resulting emotions from it.

That’s what makes them intolerable.  They cannot be regulated.  And if they are not regulated, they cannot be contained!

“In other words, embedded within the patient’s often vociferous communication of the dysregulated state is also a definite, yet seemingly inaudible, urgent appeal for interactive regulation.

“Sands wrote “in projective identification, the individual unconsciously puts pressure on the other to experience what he cannot experience in order to vicariously explore and become known to himself”(1997b, p. 697).  (schore/ar/92)

We can feel invaded by other’s despair at the same time the other unconsciously attempts to force us to calm ourselves

The brain needs experience in disruption through misattunements and then repair of those initiated by the one who caused the misattunement in order to build its necessary circuits to be able to participate in disruption and repair in the future.

P 93 –

SECURE ATTACHMENT MECHANISM

“This same mechanism has been described by developmental workers.  In the essential regulatory pattern of “disruption and repair” (Beebe & Lachmann, 1994; Lewis, 2000; Schore 1994) the “good-enough” caregiver who induces a stress response in his/her infant through a misattunement, reinvokes in a timely fashion his/her psychobiologically attuned regulation of the infant’s negative affect state that he/she has triggered. Tronick (1989) described “interactive repair,” a process in which the mother who induces interactive stress and negative emotion in the infant is instrumental to the transformation of negative back into positive emotion.  (schore/ar/93)”

I never had the positive in the first place, and my mother certainly did not have the capacity to transfer her own – let alone my – negative affect into positive, let alone BACK into positive.

That’s where the “anhedonic” comes in.  I never developed a tolerance for positive emotion!  I also think that is a good part of what my smoking is about, transforming negative into positive emotions.  I don’t know how to do this.  The circuitry and patterning was never formed in my brain for this.  And this sympathetic nervous system developmental process is all of what the first year of life is supposed to be about!

“in the developmental literature Murray observed that the mother must both be open to how the infant feels and also have an affective response [an emotional supply] that complements the infant process.  Murray (1991) observed:

This may well be unproblematic in periods of infant quiet alertness and containment, but, in the inevitable times of infant distress and agitation, emotions may be provoked in the mother that will be disturbing to her if she does not have available the resources [emotional supplies] to accommodate or contain them.  To the extent that the mother is able to both identify with her infant and contain difficult feelings that the infant’s behavior provokes in her, she will be able to respond in an appropriate fashion that meets, or complements, the infant’s requirements; and the infant will, in turn, develop the capacity to tolerate and manage his own distress.  (p. 223)

In (schore/ar/93)”

“This maternal sensitivity to and modulation of the infant’s states was also described by Krystal:  “Possibly the most crucial and difficult aspect of mothering consists in permitting the child to bear increasingly intense affective tension, but stepping in and comforting the child before his emotions overwhelm him” (1978. p. 96) in (schore/ar/93)”

“In order to perform this parential regulatory function, the adult must not only mirror the infant’s distress state, but then “go beyond mirroring” to “deal with distress” rather than being overwhelmed by it (Gonagy et al., 1995).  To do this he/she needs to sense and then regulate his/her own as well as the child’s affective state, a particularly emotionally demanding task.  According to Carpy, “The normal infant needs to be able to sense that her mother is struggling to tolerate her projected distress without major disruption of her maternal function.  [The mother’ will be unable to avoid giving the infant slight indications of the way she is affected by [her infant], and it is these indications which allow the infant to see that the projected aspects of herself can indeed be tolerated” (1989, p. 293). (schore/ar/93)

p 94 –

HOLDING ENVIRONMENTS

“Recall that the maternal comforting substrate resides in the mother’s right brain (Horton, 1995), the hemisphere that is dominant for nonverbal behavior and for responding to stress (Wittling, 1997).  More so than the clinician’s verbalizations, it is her/her nonverbal activity (Davis & Hadiks, 1994) that creates the safe holding environment.  Muir concluded that “the holding situation includes both physiologic and psychological holding.  The transpersonal process is the medium for this necessary psychogiologic connection” (1995, p. 252)  (schore/ar/94)”

Although in infancy our brains should have learned that these difficult affects can be held, can be contained, without disorganizing the self system – in a one person psychology!  This is where we get so terribly tied and tangled up – not having a clue consciously what we are trying to do in our “two person psychologies!” –(transpersonal processes)

“In order to maintain a holding environment during moments when an intersubjective field is dynamically generating an increasing density of negative affect, the clinician needs to resist, at an implicit level, a homeostatic impulse to counterregulate a state of right brain psychobiological disequilibrium by shifting into a left hemispheric dominant state.  As opposed to the left, the right hemisphere has a “wait and see” mode of processing (Federmeier & Kutas, 2002, p. 730).  And so the therapist must “attempt to refrain from doing something until she has lived with the evoked feelings for some time:  (Stark, 1999, p. 276).  If he/she fails to “hold” long enough it will be overtly manifest in an expression of left brain activity, the sudden onset of verbal behavior; that is, a premature interpretation [or, I would add, a returned defensive projection].  It has been pointed out that the clinician must hold the projective identification and not return it prematurely (Joseph, 1978).  Premature interpretations thus reflect a therapeutic misattunement in which the clinician shifts back into a left hemispheric, secondary process, linear mode in order to extricate himself/herself from falling more deeply into an interactively rapidly amplifying right dominant primary-process psychobiological state that is inherently nonlinear and chaotic.  (schore/ar/94)”

“It is important to again stress that early relational trauma, attachment psychopathology, and the defenses of dissociation are stored in the right hemisphere.  The emergence of strong affect during psychotherapy sessions is known to be accompanied by increased right hemispheric activation in the patient (Hoffman & Goldstein, 1981).  And thus in these central moments of the treatment of developmentally disordered patients, holding the right brain-to-right-brain context of emotional communication is essential.  This holding occurs in implicit processing, and involves “being able to prolong one’s experiential process at the level of implicit experiencing” (Vanaerschot, 1997, p. 148); that is, staying in the right brain mode of “implicit learning” (Hugdahl, 1995).  (schore/ar/94)”

p 95 –

TO WONDER

Tolerating

Meaning

“Thus, in the heightened affective moment of an enactment, the key to sustaining a cocreated right brain-to-right brain holding environment is the clinician’s capacity of “avoiding closure” and tolerating ambiguity, uncertainty, and lack of differentiation in order “to wonder.” This means holding the felt-sense component of an affective state in working memory over a longer duration of time, an adaptive function because “the longer the period during which a person is influenced by physiological and cognitive processes activated by the emotion the higher the probability that this experience will be subjectively perceived as important and meaningful” (Gilboa & Revelle, 1994, p. 135)  This mechanism is critical to the clinician’s deep intersubjective perception of the operations of the patient’s meaning systems.  Recall that the felt sense acts as a bodily based perception of meaning (Bohart, 1993).  (schore/ar/95)”

“Furthermore, a dynamic systems theory perspective of the psychotherapy process holds that both the therapist and the patient need to understand that destabilization and the tolerance of uncertainty may be fundamental to a healthy growth process, and that such experiences are important opportunities for change.  Perna described, “This point of reorganization in the therapeutic process can be quite difficult as many therapists, not to mention patients, may find the uncertainty anxiety producing.  A traditional view rooted in linear thinking may lead the therapist to impose at this juncture a reality constraint that forces a specific construction of the therapist’s making onto the patient’s psyche” (1997, p. 266).  This mistimed, intrusive interpretation inevitably destroys for the patient the possibility of creating something out of himself (Balint, 1968).  (schore/ar/95)”

“… the holding environment is organized by preverbal communications (Rubin & Niemeier, 1992), … The essential step in creating a holding environment in which an affect-communicating reconnection can be foreged is the therapist’s ability, initially at a nonverbal level, to detect, recognize, monitor, and autoregulate the countertransferential stressful alterations in his/her bodily state that are evoked by the patient’s transferential communication.  Thus, the clinician simultaneously monitors the information coming from the patient as well as his/her own psychobiological response to this emotional communication.  (schore/ar/95)”

“The ability to act as a holding container (interactive psychobiological regulator) for the patient’s “affective energy” “may require the therapist to live in dual modes of existence…. The therapist must attend to his or her own self-regulatory functioning and at the same time participate fully with the patient in mutual exploration, development, and affective exchange”  (Perna, 1997, p. 260).  (schore/ar/95)….These two modes represent shifting up and down between the higher and lower levels of the right brain (see Schore 2001b).  (schore/ar/96)”

So in order to be responsive in a healing way to troubled others, we would need to be able to do this: These two modes represent shifting up and down between the higher and lower levels of the right brain

p 96 –

POWDER PUFF INCIDENT

internal imaginal “working space”

(time and space)

IMAGES & METAPHORS

“In order to accomplish this, the resonating therapist must flexibly shift, in a timely manner, into a state of “reparative withdrawal,” a self-regulating maneuver that allows continued access to a state in which a symbolizing process can take place, thereby enabling him/her to create a parallel affective and imagistic scenario that resonates with the patient’s (Friedman & Lavender, 1997).This “symbolizing processinvolves being open to the patient’s communication and holding onto the state long enough to allow internal sensoriaffective images to emerge into consciousness. [This is what happened for me with the powder puff!  I thought it was remembering someone else’s memory…] Recall, countertransferential processes are manifest in the capacity to recognize and utilize the sensory (visual, auditory, tactile, kinesthetic, and olfactory) and affective qualities of imagery that the patient generates in the therapist.  (schore/ar/96)”

“To do this, the therapist must reestablish equilibrium enough to access “potential space,” a right hemispheric organization (Weinberg, 2000), which, according to Ogden (1990), lies between “the symbol and the symbolized” where the self distinguishes one’s feelings from what one is responding to.  Winnicott (1971a) described this space as an intermediate zone of experience that lies between outer external reality and inner psychic fantasty.  As described by Gendlin (1981),

the ability to develop an

internal imaginal “working space”

allows the self to attend to one’s felt sense

and thereby a symbolic expression in the form of an image or a metaphor.  (schore/ar/96)”

Wow!!  Schore, you continue to amaze and astound me!!  And, coming from my background in training as an “imaginal art therapist,” these words have a solid ring of truth to me!!  They excite me!

One of the prominent characteristics of the processing of metaphors, which is a right hemispheric activity (Anaki, Faust, & Kravetz, 1998; Cox & Theilgaard, 1997; Winner & Gardner, 1977), is its image-generating picturing function [ability] in which inner states are “set before the eye.”  This hemisphere is dominant for “image thinking,” a holistic, synthetic strategy that allows individual facets of images to interact with each other on many planes simultaneously (Rotenberg, 1995).”  (schore/ar/96)”

WOW!!  This might be something I am actually very good at!!

“In this “state-dependent recall” (Bower, 1981), images may arise from the clinician’s unconscious bodily based, implicit-procedural affective memory, specifically those regulatory strategies associated with his/her own experiences with, and perhaps regulation of, this particular negative state.  The clinician’s monitoring and autoregulation of the negative state is performed at preconscious levels, and this allows for recovery of his/her “evenly hovering attention” to not only the patient’s externally expressed distress state, but also to his/her statedependent perceptual-somatic-affective internal images.  (schore/ar/96)”

“Reiser (1997) described that in this state:

The analyst’s inner thoughts and images draw upon his or her memory networks, which encode not only personal life experiences, but also the patient’s memory networks as these have developed in the analyst’s mind as the analysis has been unfolding.  This means that the analyst … will be able to identify elements encoded there from the patient’s history that (schore/ar/96) are relevant to the analytic situation and the patient’s problems in the here and now, including the transference.  (p. 903) in (schore/ar/97)”

++++

P97 –

“But even more than this, Stark noted that in an optimal therapeutic intervention to a projective identification the therapist may “use her self” to share something about the impact of the patient’s transferential activity on her own experience” – in other words, Schore advocates selective and judicious self disclosure by the therapist

“…Jacobs (1991) asserted that the therapist’s own posture, gesture, and movement can be valuable cues to transference analysis.  Jacobs further noted that the therapist’s visual imagery often “stimulates in the analyst kinesic behavior and autonomic responses that are reactions on an unconscious level to nonverbal messages:  (1994, p. 749).  (schore/ar/97)”

symbolizing or desymbolizing (I need this article by Friedman & Lavender)

This would relate to how we relate to other people, as well:

“…study by Beard (1992), who reported that analysts understood their physical responses to patients to be projective identifications.  Clinicians manifested two types of responses to bodily experienced content – an “interpretive” style that frequently evolved into mutual reprojections, [I suppose these are tied to judgments and wrong assumptions not in tune with the client, left brain] or an “empathic developmental stance” that involved the analysts holding these physical sensations and thereby modeling the capacity for self-regulation for the patient.  (schore/ar/97)”

SELF-REFLECTION

“Feldman noted that “the analyst’s temporary and partial recover of his capacity for reflective thought rather than action is crucial for the survival of his analytical role: (1997, p. 239).  The key to the analysis of the countertransference may be a self-reflective function by which the clinician determines whether he/she is internally sensing his/her (schore/ar/97) counterregulatory reactions to the patient’s dysregulation, or is psychobiologically resonating with the patient’s chaotic state.  According to Fonagy and Target (1996), the reflective function is a mental operation that enables the perception of another’s state, “including apparently irrational unconscious motives.”  (schore/ar/98)”

Self-reflection allows us to find and consider the “ors” of the situation.

What is the difference between reflective function as a mental operation that enables the perception of another’s state different from empathy?

p. 98 –

“An essential element of the treatment was articulated by Vanaerschot:  “For the therapist to be able to contain painful (patient) experiences, the therapist must be able to be congruent with his or her painful experiences” (197, p. 146)  (schore/ar/98)”

“The right hemisphere is dominant not only for processing negative primary emotions (Ross et al, 1994), but also for mediating pain and pain endurance (Cubelli et al, 1984; Hari et al, 1997; sieh et al, 1995) and modulating distress states via a right-brain circuit of inhibition and emotion regulation (Porges et al., 1994).  This right-lateralized regulatory maneuver facilitates the therapist’s countertransferential modulation of sensed negative affect; that is, it allows for the countertransference to be not “grossly” but only “partially” acted out.  (schore/ar/98)”

“But this “partial acting out” is critical to the patient’s implicit learning of a corrective emotional experience.  Pick (1985) suggested that it represents an important opportunity for the patient to perceive (in real time) that the therapist is affected by the patient’s projected communication, that he/she struggles to tolerate the negative affect, but, ultimately, he/she manages to contain it without grossly acting it out.  I would add that as a result of the therapist’s largely nonconscious regulation of his/her own stress state, his/her rate of speech spontaneously slows, his/her voice becomes calmer and his/her facial expression less tense – an overt expression of a “metabolized” negative affect.  As in an optimal developmental context, the clinician’s regulatory strategy, observed even at levels beneath the patient’s awareness, allows for the creation of a nonconsciously sensed “safe” interpersonal environment.  (shocre/ar/98)”

ADAPTIVE RELATIONAL PROCESSING OF DEFENSIVE PROJECTIVE IDENTIFICATIONS AND THERAPEUTIC PROGRESSION

P 98 –

Notes other authors:  “Neurobiological research indicates that the detection and complex processing of the smallest change within a human face occurs within 100 milliseconds…and such facially expressed state changes are mirrored….and synchronously matched by an observer’s right hemisphere within 300 – 400 milliseconds, at levels beneath awareness.”  (schore/ar/98)

P 102 –

MIND’S EYE

“The developmental progression that results from the growth-promoting environment embedded in the therapeutic relationship

allows not only for a more stable and constant sense of self, but also

for the emergence of a “reflective self” that is capable of in-sight, a visuoperceptual metaphor of internal sight – that is, access to the mind’s eye that can see not just hidden thoughts but also the rhythms and flows of one’s inner psychobiological self-states, and hold these affective experiences in mind long enough to tolerate, recognize, label and introspect upon tem.  This advance allows the patient’s

increasingly complex self-system to access not only a more fully developed subjective nonverbal affective “support-experience” factor, but

also an objective “insight” factor that is activated by adequate interpretation (de Jonghe et al., 1992).  (schore/ar/102)”

++++

PROGRESS

“…effective treatment of severe disorders of the self also induces an expansion of the adaptive capacity to utilize adaptive (realistic) rather than defensive projective identification.  This developmental advance allows for the elevation of emotions from a primitive presymbolic sensorimotor representational level to a mature symbolic representational level, and it reflects an expansion of the patient’s capacity for affect regulation.  (schore/ar/102)”

p 103 –

hard not to run from the pain – for client and therapist alike

coexplorers of the primitive mind

INERACTIVELY REGULATED PROJECTIVE IDENTIFICATION, INTERNALIZATION, AND THE GENESIS OF RIGHT-BRAIN SYSTEMS INVOLVED IN SELF-REGULATION

P 104 –

BETA TO ALPHA TRANSFORMATIONS

“During the depressive position the infant uses the object as a “container” to “metabolize” projective identifications, the beta element precursors of mind, into alpha elements that comprise integrated and differentiated symbolic thought.  [using Bion 1962b’s description of internal transformation]  Robbins noted, “the therapist’s role is to identify the beta elements of enactment forced on him by the patient, metabolize them into alpha elements of thought, and assist the patient to do likewise” (1996, p. 773).  This “alpha function” or “dream work alpha” describes primary process function, and it operates in waking and sleeping and orders and transforms events into personal experiences as :alpha elements” that can be mentally processed.  (schore/ar/104)”

“I suggest that Boin was describing developmental progressions in regulatory structures, particularly in the right hemisphere, the locus of primary process functions and a right brain circuit of emotion regulation.  This ontogenetic maturation is identical to Kohut’s (1977) “transmuting internalization,” the developmental process by which the mother’s selfobject function that regulates the child’s homeostatic state is internalized by the infant and psychological self regulatory structures are formed.  Muir (1995) contended that the adaptive aspect of projective identification is associated with attachment and representsthe cradle of the emergent potential self.”  (schore/ar/104)”

state transformations

++++

GROWTH, AND HOPE FOR THE RIGHT BRAIN

“It is important to note that the right hemisphere cycles back into growth phases throughout the lifespan (Schore, 2001b; Thatcher, 1994) and that the orbitofrontal cortex retains a capacity for plasticity in later life (Barbas, 1995), thereby allowing for the continuing experience-dependent maturation of the right-frontal regulatory system within the growth-facilitating environment of an affect-regulating therapeutic relationship.  This structural organization, in turn, is reflected in a progression in the complexity of the patient’s coping mechanisms – specifically, a developmental advance in the form of a mature personality organization that accesses adaptive over defensive projective identification.  (schore/ar/107)”

But I am still saying that very few who need it will ever reach a therapist for help, and most of them go right on raising their own children to have the same troubles.

And this is all entirely preventable.

I also think there are types of damage done to the brain – such as mine – that are not reversible – that would be a whole lot of dissociation to heal!  Not that I still understand exactly what he is saying about all of this!  Sucks, after spending this many hours on this chapter…..but there’s more to come, and maybe more clarification!  One can only hope….

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