SCHORE CHP 1 Interdisciplinary Clinical Models
Schore notes van der Kolk & Fisler, 1994 “loss of ability to regulate the intensity of feelings is the most far-reaching effect of early trauma and neglect” (schore’s paraphrase in ar/24)
from Schore/ar/24 & 280
“Biologically primitive affects”: shame, rage, excitement, elation, disgust, panic-terror (terror p 280) and from 280, an important one that he left off of the list on p 24, hopeless despair
primitive presymbolic sensorimotor
enjoyment-joy and interest-excitement
developmental theory = “conception of the genesis of living systems (af/3) = “model of self-organization”
p 4 – primary caregiver is most important object in early environment = “Human development cannot be understood apart from this affect-transacting relationship (ar/4)”
++ affect transactions = interactions about, with, using affect that are transactions between infant and primary caregiver
“…these early social events are imprinted into the biological structures that are maturing during the brain growth spurt that occurs in the first two years of human life, and therefore have far-reaching and long-enduring effects (ar/4)”
p 5 – “The period of early-forming object relations …exactly overlaps the period of the brain growth spurt. (ar/5)”
p 6 –“ psychobiological mechanisms that underlie affective processes – “…development can only be explained by studying it simultaneously along several separate but interrelated dimensions ranging from the biological level of organization through the psychological, social, and cultural levels (ar/6)”
“…the appearance of the adaptive functions of the developing mind cannot be understood without also addressing the problem of the maturation of the structures responsible for these functions. Changes in the child’s behavior or in the child’s internal world can only be understood in terms of the appearance of more complex structure that performs emergent functions. (ar/6)”
p 7 – “psychobiological models of the mirroring process, symbiosis, and self object phenomena” = are affect-transacting experiences
“…these very same affect-transacting experiences specifically shape the maturation of specific structural connections within the brain that come to mediate both the interpersonal and intrapsychic aspects of all future socioemotional functions. Of particular importance is the organization of a hierarchical regulatory system in the prefrontal areas of the right hemisphere. (ar/7)”
AFFECTIVE TRANSMISSIONS IN MUTUAL GAZE TRANSACTIONS
Cognitive development in infancy = closely tied to maturation of sensory systems – especially visual
“In fact, over the first year of life, visual experiences play a paramount role in social and emotional development. (ar/7)”
[How does this work with blindness, then? Either blind parent or blind infant? How much have they studied this and what do they know about alterations in development?]
“Gaze represents the most intense form of interpersonal communication, and the perception of facial expressions is known to be the most salient channel of nonverbal communication. (ar/7)”
most important visual stimulus for infant is mother’s emotionally expressive face – “The infant’s gaze, in turn, reliably evokes the mother’s gaze, thereby acting as a potent interpersonal channel for the transmission of “reciprocal mutual influences.” (ar/7)”
[What happens in cases where there is no appropriate or engaged response by the mother to the infant – like in my case. There was nothing reliable about my mother! And certainly to me – there would have been rage and hatred in her eyes and face toward me unless we were in public – was this the origin of my first “dissociations” because I could not “associate” with her – visually or in any other way.]
“By 2 to 3 months, a time of increasing myelination of the visual areas of the infant’s occipital cortex, the mother’s eyes become a focus of her infant’s attention, especially her pupils. (ar/7)”
pupils dilate not only in response to lowered light, but also in response to people – adults’ dilate in response to infants, infants will smile in response to these dilated pupils, “viewing enlargened pupils rapidly elicits dilated pupils in the baby, and dilated pupils are known to release caregiver behavior (ar/7)”
[I didn’t know this! Cindy says she knew this about even adult-to-adult intimate caring relationships! I suppose maybe it affects the amount and quality of information we take in during these times?]
(p 14) Mirroring: “Psychobiological studies of attachment show that in mutual gaze the mother’s face is triggering high levels of endogenous opiates in the child’s growing brain….These endorphins, produced in the anterior pituitary, are biochemically responsible for the pleasurable qualities of social interaction and attachment as they act directly on dopamine neurons in the subcortical reward centers of the infant’s brain that are responsible for heightened arousal….By promoting a symbiotic entrainment between the mother’s mature and the infant’s immature endocrine and nervous systems, hormonal responses are triggered that stimulate the child into a similar state of heightened central nervous system (CNS) arousal and sympathetic nervous system activity and resultant excitement and positive emotion. (schore/ar/14)”
p. 8 – “…pupil of the eye thus acts as an interpersonal nonverbal communication device, and these rapid communications occur at unconscious levels. (ar/8)”
microregulation of affect between mother and infant – transactions occur so fast they can only be noted specifically on film – when emotion of joy becomes nearly intolerable to the infant the
“baby will gaze avert in order to regulate the potentially disorganizing effect of this intensifying emotion (ar/8)” and the mother will let this happen by taking the cue and “backs off to reduce her stimulation. She then waits for the baby’s signals for reengagement. Importantly, not only the tempo of their engagement but also their disengagement and reengagement are coordinated. (ar/8)”
[I missed ALL of this! My mother was permanently disengaged with me – there was no TEMPO between us, and certainly nothing for me to pattern myself after!]
The better the mother is at this contingent communication, where she lets the infant disengage and “recover quietly” and attends to infant’s cues to reengage, “the more synchronized their interactions becomes. (ar/8)”
“Facial mirroring thus illustrates interactions organized by ongoing regulations, and experiences of mutually attuned synchronized interactions are fundamental to the ongoing affective development of the infant (ar/8)”
“These mirroring exchanges…represent a transformation of inner events….each recreates an inner psychophysiological state similar to the partner’s. In synchronized gaze the dyad creates a mutual regulatory system of arousal…in which they both experience a state transition as they move together from a state of neutral affect and arousal to one of heightened positive emotion and high arousal. (ar/8)”
+++ Schore is talking about heightened positive emotion and high arousal
+++ mother reflecting back her infant’s “aliveness”
+++ is meant to be a “positively amplifying circuit mutually affirming both partners” (he is quoting Wright, 1992, p 12) on (ar/8)
[This is meant to be POSITIVE interaction. This is the way we evolutionarily evolved. This is the first year’s development of the sympathetic nervous system – tied with never needing to say “NO” to an infant in its first year of life because it is not ambulatory and cannot hurt itself. (The “NO” that interjects shame is meant for ambulatory stages when infant could hurt itself and tied to the development of the parasympathetic branch of the nervous system.)
This means that human brains are designed to build themselves on JOYFUL interactions, on feelings of joy and excitement. Of APPROACH (avoid meant for 2nd year development).
And we wonder why some of us feel “depressed” and have such a difficult time with joy – or evening knowing or finding what it is that truly gives us pleasure in life? So that we can have appropriate “pleasure seeking” goal directed states?
Yet I must have had some kind of positive eye-to-eye interactions with John in which he would have tried to “make me happy.” I wonder if I also say sympathy in John’s eyes as he would have had to have known that his mother was hurting the baby me…
p 10 – Schore’s caption under the picture of the infant-mother mirroring specifies a sequence of mirroring between a “normal infant” and mother – but he does not specify that what has to happen for these interactions to occur properly is that the MOTHER BE NORMAL, also.
“In order to enter into this communication, the mother must be psychobiologically attuned not so much to the child’s overt behavior as to the reflections of his/her internal state. She also must monitor her own internal signals and differentiate her own affective state, as well as modulating nonoptimal high levels of stimulation that would induce supraheightened levels of arousal in the infant. The burgeoning capacity of the infant to experience increasing levels of accelerating, rewarding affects (enjoyment-joy and interest-excitement; Tomkins, 1962) is thus at this stage externally regulated by the psychobiologically attuned mother, and depends upon her capacity to engage in an interactive emotion communicating mechanism that generates these in herself and her child (ar/10).”
P 11 – “Reciprocal gaze, in addition to transmitting attunement, can also act to transmit misattunement, as in shame experiences. The misattunmement in shame, as in other negative affects, represents a regulatory failure and is phenomenologically experiences as a discontinuity in what Winnicott (1958) called the child’s need for “going-on-being.”” (ar/11)”
[So what is this statement about? Siegel wrote about the introduction automatically of shame with the “NO” when the child becomes ambulatory and with development of the parasympathetic system – is this, above, something else? Something introduced prematurely?]
“Prolonged negative states are too toxic for infants to sustain for very long, and although they possess some capacity to modulate low-intensity negative affect states, these states continue to escalate in intensity, frequency, and duration. [What does he mean by the last part of this sentence? How and when do these states continue to escalate in intensity, frequency, and duration – and under what conditions?] How long the child remains in states of intense negative affect is an important factor in the etiology of a predisposition to psychopathology. Active parental participation in state regulation is critical to enabling the child to shift from the negative affective states of hyperaroused distress or hypoaroused deflation to a reestablished state of positive affect. In early development an adult provides much of the necessary modulation of infant states, especially after a state disruption and across a transition between states, and this allows for the development of self-regulation. Again, the key to this is the caregiver’s capacity to monitor and regulate her own affect, especially negative affect. (schore/ar/11)”
[What, oh what, happens to those of us where this went so terribly wrong? He says the adult provides MUCH of the necessary modulation of infant states – but he is not saying an adult provides ALL of it. What happens when it is a very young sibling that provides some of it? And the rest of it is left to the infant itself? And when the adult caregiver causes the negative affect?
With nearly constant state disruptions and nearly constant shifts between states with no appropriate “transition,” isn’t this what would lead to dissociation?]
Essential regulatory pattern of disruption and repair
[What kind of patterns, if any, did my mind form around? Certainly LOTS of disruption and NO repair! Can I HEAL from this? This is part of what was so hard with Ernie. Every time he left me off it was a disruption, and I had no way to repair it!]
In good-enough parents, there are always times that the caregiver triggers misattunements. It is never something that the infant creates. The misattunement always causes a stress response in the infant. It is necessary that this caregiver establish reattunement with the infant. This is a comforting caregiver offering comfort to the infant. This “psychobiological” reattunement must be done in a “timely fashion” so that the “mother and infant thus dyadically negotiate a stressful state transition of affect, cognition, and behavior” which is a “regulation of the infant’s negative affect state.” (schore/ar/11)”
This is RECOVERY which is INTERACTIVE REPAIR
It is a participation of the caregiver in the process of repair to a rupture the caregiver caused and was responsible for.
“In this process the mother who induces interactive stress and negative emotion in the infant is instrumental to the transformation of negative into positive emotion. (schore/ar/11)”
This resiliency, this process of reexperiencing positive emotion after a negative experience teaches the infant that negativity itself can be “endured and conquered” (schore is quoting Malatesta-Magai, 1991, p. 218)
“It is important to note that resilience in the face of stress is an ultimate indicator of attachment capacity” – paraphrasing Greenspan, S.I., 1981, Psychopathology and adaptation in infancy and early childhood. NY, International Universities Press (schore/ar/11)”
[Is this process ultimately what trust is about? Something that I am lacking!]
“…psychobiological attunement is understood to be the essential mechanism that mediates attachment bond formation” – quoting Field, 1985a in (schore/ar/11)”
“In essence, the baby becomes attached to the modulating caregiver who expands opportunities for positive affect and minimizes negative affect. [Does that mean that an infant will not form an attachment bond to a caregiver that does not attune to it?] In other words, the affective state underlies and motivates attachment, and the central adaptive function of (schore/ar/11)” attachment dynamics is to interactively generate and maintain optimal levels of positive states and vitality affects. (schore/ar/12)”
[I will have to see if this is what I am talking about with “belonging.” Positive and negative levels of emotion, or of states, is about what belongs to make us feel positive vs what is “bad” that makes us feel negative emotions.]
THE NEUROBIOLOGY AND PSYCHOBIOLOGY OF ATTACHMENT BOND FORMATION
P 13 –
Primary maternal preoccupation (winnicott, 1956)
Winnicott’s “…work underscored the fundamental principle that the baby’s brain is not only affected by these transactions, its growth literally requires brain-brain interaction and occurs in the context of a positive affective relationship between mother and infant. This interactive mechanism requires older brains to engage with mental states of awareness, emotion, and interest in younger brains, and involves a coordination between the motivations of the infant and the subjective feelings of adults. (schore/ar/13)”
[So this makes me wonder about my interactions with John’s brain, though he was only a little bit older than me, and certainly did not possess an adult brain!]
“The right cortex, which matures before the left, is known to be specifically impacted by early social experiences, to be activated in intense states of elation [I thought I read in Siegel that positive emotions are in the left brain, and only the negative ones are in the right brain. Is it the intensity level of the “elation” that involves activation of the right hemisphere rather than just the fact that it is a positive emotion? What about stimulation of the negative ones this early?], and to contribute to the development of reciprocal interactions within the mother-infant regulatory system. The child is using the output of the mother’s right cortex as a template for the imprinting – the hard wiring of circuits in his/her own right cortex that will come to mediate his/her expanding affective capacities….In these transactions she is “downloading programs” from her brain into the infant’s brain. (schore/ar/13)”
selfobjects – Kohut
“…self-psychology is built upon a cardinal developmental principle – that parents with mature psychological organizations serve as “selfobjects” that perform critical regulatory functions for the infant who possesses an immature, incomplete psychological organization. (schore/ar/13)”
[Here again, John may not have been a parent with a mature psychological organization, but he was more mature than I was – and he was the only one there. He had to serve as some sort of “selfobject” for me, and performed “critical regulatory functions” for me when I was an infant.
I think in some important, crucial, and valuable way Ernie serves this function for me. It is “immature” but what choices did I have? I think even my own children did this for me – what I call a borrowed attachment.]
P 14 – self-objects “are external psychobiological regulators” of the infant’s developing homeostatic systems (schore/ar/14)”
Self-objects are regulators of affective experience at nonverbal levels beneath conscious awareness
p 14 – latter half of first year – object seeking – “sharing and communicating of affects, specifically revolves around the mother’s face, and it is her expressive face that is searched for and recognized (quoting Wright, 1991 Vision and Separation: Between mother and baby. Northvale, NJ: Jason Aronson) in (schore/ar/14)”
“The concept of symbiosis is now solidly grounded in developmental research, and it should be returned into psychoanalysis. (schore/ar/14)”
9 – 10 months: emergence of “secondary intersubjectivity” (written about by Trevarthen (1993) The self born in intersubjectivity: The psychology of an infant communicating. In U. Neisser (ed) The perceived self: Ecological and interpersonal sources of self-knowledge (pp. 121-173) New York, Cambridge University press – from (schore/ar/14)”
“Indeed, in the last quarter of the first year, the child’s attachment experiences enable him/her to now share an intersubjective affect state with the caregiver (from Lichtenberg, J. D. Psychoanalysis and motivation. Hillsdale, NJ: Analytic Press 1989) from (schore/ar/14)”
p 15 – facial mirroring enables infant to enter “the other’s changing feeling state” and these experiences are stored in what Beebe and Lachmann term “presymbolic representations” which appear at end of the first year – “…and in them the infant represents the expectation of being matched by and being able to match the partner, as well as “participating in the state of the other.” This is also the identical time period when internal representations of working models of attachment are first encoded. (schore/ar/15)”
[How does this work when infants are being cared for by siblings? How about when they are being cared for by fathers or other relatives, or by day care providers? Did our brain evolve when the mothers were occupied with other tasks except to nurse the young – or were infants tied in some way to the bodies of their mothers through this first year as the mother went about tasks of gathering firewood, food, tanning hides, etc?]
“Attachment functions involve highly visual mechanisms and generate positive affect, and they mature near the end of the first year of life. These psychobiological experiences of attunement, misattunement, and reattunement are imprinted into the early developing brain. (schore/ar/15)”
[Is this at all related to the schore quote in siegel about organize, disorganize, reorganize?]
“Stable attachment bonds that transmit high levels of positive affect are vitally important for the infant’s continuing neurobiological development (Trad, 1986 Infant depression. NY, Springer-Verlag) quoted in (schore/ar/15)”
MATURATION OF ORBITOFRONTAL CORTEX (10-12 to 16-18 months)
P 15 – “…dyadic communications that generate intense positive affect represent a growth-promoting environment for the prefrontal cortex…. (schore/ar/15)”
++ area of brain that undergoes major maturational change at 10-12 months
++ “prefrontal lobe functioning plays an essential role in the development of infant self-regulatory behavior”
++ orbital prefrontal areas critically and directly involved in attachment functions
++ “This cortical area plays an essential role in processing of social signals and in the pleasurable qualities of social interaction. Attachment experiences (face-to-face transactions between caregiver and infant) directly influence the imprinting or circuit wiring of this system. (schore/ar/15)”
++ orbital frontal cortex – “so called because of its relation to the orbit of the eye (schore/ar/15)” — “is “hidden” in the ventral and medial surfaces of the prefrontal lobe…and acts as a “convergence zone” where cortex and subcortex meet….It sits at the hierarchical apex of the limbic system, the brain system responsible for the rewarding-excitatory and aversive-inhibitory aspects of emotion….This “limbic cortex” also acts a a major control center over the sympathetic and parasympathetic (schore/ar/15) branches of the autonomic nervous system (ANS), and thereby regulates drive and drive-restraint. Most significantly, in the cortex the orbitofrontal region is uniquely involved in social and emotional behaviors and in the homeostatic regulation of body and motivational states (schore, 1994 – he is referring to here) – (schore/ar/16)
++ orbital prefrontal region = especially expanded in right cortex = hemisphere dominant for selectively attending to facial expressions.
“Because the early maturing and “primitive” right cortical hemisphere (more than the left), contains extensive reciprocal connections with limbic and subcortical regions, it is dominant for the processing, expression, and (schore/ar/16) regulation of emotional information. (referring here to Joseph, 1988). This hemisphere mediates pleasure and pain…and the intrinsically more biologically primitive emotions that serve fundamental motivational and verbal affects that are spontaneously expressed on the face (referring here to Buck, 1993). (schore/ar/17)”
primary emotions arise quickly and “automatically” – Autonomic nervous system (ANS) (schore/ar/17)
p 18 – ANS “…control occurs quite rapidly – it begins within under 1 second and reaches full development in 5 to 30 seconds. Automatic emotional processes are thus involuntary, effortless, and operate outside conscious awareness. (schore/ar/18)”
copied to 9 Postnotes right brain
“This prefrontal region comes to act in the capacity of an executive control function for the entire right cortex, the hemisphere that modulates affect, nonverbal communication, and unconscious processes. Early object relational experiences are not only registered in the deep unconscious, they influence the development of the psychic systems that process unconscious information for the rest of the lifespan. In this manner, the child’s first relationship, the one with the mother, acts as a template for the imprinting of circuits in the child’s emotional-processing right brain, thereby permanently shaping the individual’s adaptive or maladaptive capacities to enter into all later emotional relationships. (schore/ar/18)”
“Most intriguingly, the activity of this “nondominant” hemisphere, and not the later-maturing “dominant” verbal-linguistic left, is instrumental to the capacity of empathic cognition and the perception of the emotional states of other human beings (referring to Voeller, 1986). The right brain plays a superior role in the control of vital functions supporting survival and enabling the organism to cope actively and passively with stress and external challenge. Indeed, the right brain is thought to contain the essential elements of the self system (Mesulam & Geschwind, 1978; Schore, 1994 – quoting here). (schore/ar/18)”
“The right hemisphere contains an affective-configurational representational system, one that encodes self-and-object images unique from the lexical-semantic mode of the left (refer watt, 1990). According to Hofer (1984b), internal representations of external human interpersonal relationships serve as important intrapsychic role as “biological regulators” that control physiological processes. These internal representations that contain information about state transitions (Freyd, 1987) enable the child to self-regulate functions that previously required the caregiver’s external regulation. There is agreement that the encoding of strategies of affect regulation is a primary function of internal working models of attachment (Kobak & Sceery, 1988) and that security of attachment fundamentally relates to a physiological coding that homeostatic disruptions will be set right (Pipp & Harmon, 1987). Wilson and colleagues (schore/ar/19) (1990) concluded that the experience of being with a self-regulating other is incorporated into an interactive representation. Of particular importance is the emergent capacity to access the complex symbolic representations that mediate evocative memory, because this allows for self-comforting during and subsequent to interactive stress (Fraiberg, 1969). (schore/ar/20)”
[What does this mean? this allows for self-comforting during and subsequent to interactive stress]
“Regulated and unregulated affective experiences with caregivers are thus imprinted and stored in early-forming procedural memory in the orbital prefrontal system and its cortical and subcortical connections as interactive representations. Current studies indicate that the development of parental representations and the development of self-representations occur in synchrony (Bornstein, 1993b), that internal representations develop epigenetically through successive developmental stages (Blatt, Quinlan, & Chevron, 1990), and that developmental gradations of representational capacity have important implications for affective development (Trad, 1986). It [sic] relevant to note that the infant’s memory representation includes not only details of the learning cues of events in the external environment, but also of reactions in his/her internal state to changes in the external environment. (schore/ar/20)”
[So, this could not have been good! development of parental representations and the development of self-representations occur in synchrony]
p 21 – orbitofrontal system –
++ “thinking part of emotional brain”
++ major role in internal state of organism
++ temporal organization of behavior
++ appraisal & adjustment or correction of emotional responses = affect regulation
++ “acts as recovery mechanism that efficiently monitors and autoregulates the duration, frequency, and intensity of not only positive but also negative affect states. This allows for a self-comforting capacity that can modulate distressing psychobiological states and reestablish positively toned states. The essential activity of this psychic system is thus the adaptive switching of internal bodily states in response to changes in the external environment that are appraised to be personally meaningful. This emergent function, in turn, enables the individual to recover from disruptions of state and to integrate a sense of self across transitions of state, thereby allowing for a continuity of experience in various environmental contexts. These capacities are critical to the emergence, at 18 months, of a self-system that is both stable and adaptable, a working definition of a dynamic system (lewis, 1995). (Schore/ar/21)”
“Infant observers report the emergence, at 18 months, of a “reflective self” that can take into account one’s own and others’ mental states (Fonagy, Steele, Steele, Moran, & Higgitt, 1991). In the course of the second year the infant acquires (schore/ar/21) the capacity to generate a “theory of mind” in which an individual imputes mental states to self and to others and predicts behavior on the basis of such states (Bretherton, McNew, & Beeghly, 1981). The orbital cortex matures in the middle of the second year… a time when the average child has a vocabulary of 15 words. The core of the self is thus nonverbal and unconscious, and it lies in patterns of affect regulation. (Schore/ar/22)” [these 2 paragraphs copied to 9 dissociation notes]
++ orbitofrontal system “…is one of the few brain regions that is “privy to signals about virtually any activity taking place in our beings’ mind or body at any given time” (Damasio, 1994, p. 181).” In (schore/ar/21)”
p 22 – 23
“Psychobiological and neurobiological studies of emotion thus strongly indicate that the concept of drive, a phenomenon at the (schore/ar/22) frontier between the psychic and somatic, must be reintroduced as a central construct of psychoanalytic theory. (schore/ar/23)”
“There is compelling evidence, from a number of separate disciplines, that all early-forming psychopathology constitutes disorders of attachment and manifests itself as failures of self and/or interactional regulation. (schore/ar/24)”
This is MAJOR. But as I found out talking to professionals in Safford, either nobody cares or nobody understands the importance of affect transactions in the formation of the human brain. We are NOT machines. We are feeling beings. And when things go so very wrong at the beginning, they end up so very wrong later on.
Are so many people SO wounded? Are so many people oblivious to their feelings?
Schore is saying COMPELLING evidence. Unfortunately, he is not saying what “early-forming” is. What does this mean? But he is saying that these early-forming psychopathologies CONSTITUTE, or in my mind, are made up of – disorders of attachment. They are failures of regulation of self and/or inability to regulate interactions with (?) others and the environment?
Interactional regulation with self, others, and/or the environment.
Failures of regulation, plain and simple.
Inability to regulate self and interactions
These patients “frequently manifest some form of neurobiological impairment” which “traces back” to the fact that they did not have “good enough” parenting – failure of attachment and bonding (schore/ar/24)”
If infants cannot access affect modulation through their early caregivers, they will not be able to modulate their own affective states. These patients will not be able to regulate their own affective states (failure to self-regulate) for the rest of their lives (lifelong). They will not be able “to self-regulate, to receive, encode, and process the data of emotional experience they are subjected to” (quoting Grotstein, 1990. p 157) in schore/ar/24
Doesn’t anybody CARE?
Semipermeability – I considered this concept between myself and my mother in earlier chapters — causes a “lack of differentiation between self and other” — when there was “Semipermeability of physiological regulation between infant and mother.”
Isn’t this the essence of boundary problems? When you cannot tell where on person starts and stops and where self starts and stops? When there is no clear differentiation between them? Where is one different from the other? This has to go back to the fact that even at 18 I did not think my own separate thoughts, like sitting on the side of the mountain and not thinking.
P 24 – borderlines — inability to self-regulate and do not have the capacity to form “stable” self and object representations. This is supposed to happen by nine months of age! Again, doesn’t anybody CARE? So what, another ruined life. Pass it down the generations. Why should we care?
Narcissistic – more developmentally advanced than borderline – but still – suffers “impairment of self-esteem regulation and a disturbance in the representation of self in relationship to others” schore/ar/24
Interesting here, “impairment of self-esteem regulation” – is that exactly what he meant to say here?
And this is a bothersome fact: a disturbance in the representation of self in relationship to others
What exactly does this mean? Representation of self – in relationship to others – this is disturbed
I don’t even know what my representation of my self is to MY SELF, let alone in relation to others!!
“Such personalities never developmentally attain a psychic organization that can generate complex symbolic representations that contain information about transitioning out of stress-induced negative states. Instead, they frequently access pathological internal representations that encode a dysregulated self-in-interaction-with-a-misattuning-other. (schore/ar/24)”
This is a DEVELOPMENTAL impairment that affects the organization of their psyche. They/we cannot “transition out of stress-induced negative states” because our minds cannot “generate” the necessary complex symbolic representations with the correct and necessary information within them.
What are “pathological internal representations?” They “encode a dysregulated self-in-interaction-with-a-misattuning-other.” These representations are the ones that were given to us as our brains formed. We were given these “pathological representations.”
My mother was a pathological monster. That information was forced upon me, was encoded into my very brain structure and patterns. Yes, she was dysregulated, and her dysregulation was what she fed to me, so that it was encoded into my brain.
It is a short circuit. But I didn’t even HAVE a self when this all started. There was no SELF, just a “misattuning other.” To put it nicely. Rather, she was a pscyo-monster.
Important words: psychic organization
Complex symbolic representations
Transitions out of stress-induced negative states
So our symbolic representations are too simple then, if they are not complex enough for the job?
Does everyone get “stress-induced negative states” that they need to transition out of?
If so, I think we get more of them, and different ones than most that other people get.
I read “pathological internal representations” as something I am “at fault” for having, or “guilty” for having, or that they are something I should feel ashamed of having. Yet they are encoded, along with the dysregulation, right into my brain. How can I be responsible for these things, that happened to me from the moment I was born? These patterns of interactions with my psychotic mother that so thwarted my developmental processes? That prevented me from developing normally or naturally? That made me miss getting what others have, that I was supposed to have? That so polluted my brain-mind-self right at the headwaters?
And that therapist in Safford, who still believes that all mental illness is caused by a genetic “defect.” Why is it so impossible for people in the professions to realize that the mind is built as the brain develops, and that there are exact and particular things that we need in order to develop “normally?” It’s like someone has their eyeballs stolen right out of their head, and then when asked “Tell me what you see” and they can’t answer it, it means they are “defective,” “less than” normal people.
And, yes, as my brother so astutely pointed out on the phone today, this IS a holistic approach. I am what I feel and think and how I behave – the way my brain was built and ordered/disordered. These things cannot be chopped apart and looked at separately. We are a WHOLE being. We are interactional beings.
Schore goes on to say:
“I propose that the functional indicators of this adaptive limitation are specifically manifest in recovery deficits of internal reparative mechanisms. This psychopathology is manifest in a limited capacity to modulate the intensity and duration of affects, especially biologically primitive affects like shame, rage, excitement, elation, disgust, and panic-terror [I feel this a LOT with loneliness! A feeling he is not mentioning here], and it may take the form of either under- or overregulation disturbances. Such deficits in coping with negative affects are most obvious under challenging conditions that call for behavioral flexibility and adaptive responses to socioemotional stress….I suggest that these functional vulnerabilities reflect structural weaknesses and defects in the organization of the orbitofrontal cortex, the neurobiological regulatory structure that is centrally involved in the adjustment or correction of emotional responses. (schore/ar/24)”
I hate it that he has to call this “psychopathology.” He does say that this is an “adaptive limitation,” but does he really understand the full ramifications of this “adaptation?”
Earlier is Siegel’s writing he states that the disorganized attachment pattern is a result of an impossible situation where the child cannot adapt – that there is no organized way to adapt in these situations (for an infant). And yet we adapted and survived – the best way that we could, and I don’t think these professionals give us credit for that! We survived the unsurvivable. We adapted to situations that were not possible to adapt to. We accomplished the impossible. And yet they call this “psychopathological?”
Yes, we do have an “adaptive limitation.” Yes, we do have “deficits in coping with negative affects.” Yes, we do have “a limited capacity to modulate the intensity and duration of affects.” Yes, we do have “recovery deficits of internal reparative mechanisms.” Yes, we do have “structural weaknesses and defects in the organization of the orbitofrontal cortex. Yes, we feel things more intensely and have difficulty adjusting and correcting our emotional responses. But we are NOT at fault. We are not faulty human beings. We were not born this way, we were victims of trauma, abuse and neglect that MADE us this way.
From schore/ar/2 – we have what can be called “developmental arrests” and need “mobilization of fundamental modes of development” and the “completion of interrupted developmental processes.” In other words, we have “developmental delays.” But if nobody tells us this information, and if therapists don’t even recognize it, how can we ever know what is missing and “wrong” so that we can begin to make things right?
We have been hurt and damage was done to us. If someone attacked you and cut off your arm, would you be to blame? We had a natural ability removed from us because we were never allowed or enabled to develop it in the first place.
We have been given a dis-ability. We have been created without a “natural function” others may have. We have a “dysfunction” but we are not, ourselves, dysfunctional. My car might break down and not function correctly, but that does not make ME dysfunctional.
But WE are not pathological? We are miracles of survival!
Schore notes van der Kolk & Fisler, 1994 “loss of ability to regulate the intensity of feelings is the most far-reaching effect of early trauma and neglect” (schore’s paraphrase in ar/24)
And notes Oatley & Jenkins, 1992 “this dysfunction is manifest in more intense and longer lasting emotional responses”
Both from schore’s paraphrasing these above on page 24 of ar
“…developmental disorders reflect a defect in an internal psychic structure….the orbital prefrontolimbic system is this psychic structure, and…every type of early-forming disorder involves, to some extent, altered orbital prefrontal limbic function (Schore, 1996). Anatomical studies highlight the unique developmental plasticity of the prefrontal limbic cortex, and this property has been suggested to mediate its “preferential vulnerability” in psychiatric disorders (Barabas, 1995)…..[there is] evidence [mostly from brain imaging studies] for impaired orbitofrontal activity in such diverse severe psychopathologies as autism…schizophrenia… mania… unipolar depression…phobic states…posttraumatic stress disorder…drug addiction …alcoholism …borderline …. psychopathic personality disorders. (schore/ar/25)”
p 25 –
“In early preverbal development, the infant constructs internal working models of the attachment relationship with is/her caregivers, and these representations, permanently imprinted into maturing brain circuitries, determine the individual’s characteristic approach to affect modulation for the rest of the lifespan. The restoring [how can it be “restoring” when they were never conscious in the first place?] into consciousness and reassessment of these internalized working models, suggested by Bowlby (1988) to be the essential task of psychoanalytic psychotherapy, is identical to Kernerg’s assertion that the unconscious, nonverbally communicated “units constituted by a self-representation, (schore/ar/25) an object-representation, and an affect state linking them are the essential units of psychic structure relevant for psychoanalytic exploration” (1988b, p. 482). These interactive representations are stored in the right-hemisphere that contains an affective-configurational representational system and is dominant for the processing of emotional information. (schore/ar/26)”
p 26 –
“Early preverbal maternal-infant emotional communications that occur before the maturation of the left hemisphere and the onset of verbal-linguistic capacities represent contingently responsive affective transactions between the right hemispheres of the members of the dyad. Yet, the “non-verbal, [presymbolic] prerational stream of expression that binds the infant to its parent continues throughout life to be a primary medium of intuitively felt affective-relational communications between persons (Orlinsky & Howard, 198, p. 343). A young infant functions in a fundamentally unconscious way, and unconscious processes in an older child or adult can be traced back to the primitive functioning of the infant (Fischer & Pipp, 1984). (schore/ar/26)”
Krystal (1988) noted that the “infantile nonverbal affect system” continues to operate throughout life. (schore/ar/26)”
p 27 –
orbitofrontal cortex – “intimately involved with internal bodily, and motivational sates”
“nonverbal…interactions that take place at preconscious-unconscious levels represent right hemisphere-to-right-hemisphere communications of fast-acting, automatic, regulated, and unregulated emotional states” between people
“it functionally mediates the capacity of empathizing… and inferring the states of others… and of reflecting on one’s own internal emotional states, as well as others”
“this cortical area is essentially involved in the control of “the allocation of attention to possible contents of consciousness” (Goldenberg et al., 1989). This system is expanded in the right cerebral cortex that is responsible for manifestations of emotional states…and unconscious processes….” (schore/ar/27)
biologically primitive affects like shame, rage, excitement, elation, disgust, and panic-terror
early-forming “primitive emotional disorders” are “developmental psychopathologies” that are impairments of the right hemisphere
“of special importance to the psychotherapy process are early-forming representations of a dysregulated-self-in-interaction-with-a-misattuning-other, since these become unconscious templates of emotional relationships that mediate psychopathology Such representations are imprinted predominantly with painfully primitive affect that the developmentally impaired personality can [sic] not intrapersonally nor interpersonally regulate. As result of his limitation, certain forms of eternal and internal affect-inducing input are selectively and defensively excluded from conscious processing. (schore/ar/27)”
“…all forms of psychopathology have concomitant symptoms of emotional dysregulation, and that defense mechanisms are, in essence, forms of emotional regulation strategies for avoiding, minimizing, or converting affects that are too difficult to (schore/ar/27) tolerate….However, it is just these strategies of affect regulation and pathogenic schemas of dysregulation that must be recognized and addressed in the transference-countertransference matrix. (schore/ar/28)”
p. 28 –
“…these “latent” “sequestered” schemas are…egocentric, analogical, and visual. They are stored in the visuospatial right hemisphere that contains an analogical representational system…and a nonverbal processing mode that are unaccessible to the language centers in the left….From this realm that stores split-off parts of the self also comes transference projections that are directed outward into the therapist. (schore/ar/28)”
It sounds as if he is saying that these sequestered schemas, these analogical representational systems, are not verbal and not accessible to language – and are stored in the right brain in this “realm that stores split-off parts of the self.”
“The pathology of early-forming developmental disorders is most clearly revealed under conditions of interpersonal stress. Though early painful experiences are buried in deep layers of the unconscious, during stress their effects are felt on the surface, especially at the interface where the self interacts with other selves, selves who are potential sources of dysregulation. (schore/ar/28)”
“rapid disorganizing effects” – right hemisphere is “preferentially activated under stress conditions” – “Of particular importance are visual and auditory cues [“generated by the therapist, which are absorbed and metabolized”] that were perceived during early self-disorganizing episodes of shame-humiliation, a common element of borderline and narcissistic histories (Schore, 1991). (schore/ar/28)”
They feel toxic to client and cannot be tolerated – are intolerable. This reminds me of Allen’s “unbearable emotional states.”
“…right cortical mechanisms involved in the perception of nonverbal expressions [“occurring primarily in the regions around the eyes and from prosodic expressions from the mouth] embedded in facial and prosodic stimuli…. Such input generates “a series of analogical comparisons between distortions by the therapist (‘misalliance’) and the empathic failures and distortions of parents”…This instantly activates right brain-imprinted pathological internal object relations and “hot cognitions” (Greenberg & Saffran, 1984), which program the patient’s “hot theory of mind” (Brothers, 1995) that constructs others’ evaluative attitudes and meaningful intentions. These early interactive representations encode expectations (schore/ar/28) of imminent dysregulation. As a result, the patient’s brain suddenly shifts dominance from a mode of left hemispheric linear processing to right hemispheric nonlinear processing. (schore/ar/29)”
This is important!
Perhaps there is a way for us to understand how this is working when we are “out in the world.” This must be a part of our hypervigilance – that we are extremely OVER sensitive to other people’s expressions around their eyes and to the prosody of their speech.
That we have this HOTNESS about us. Things that we have experienced that are TOO HOT for us to handle – and here is where I react to the term pathological because I think it would happen to anybody who experienced what we did. The problem being, besides our super sensitivities, is that our unconscious experiences are activated INSTANTLY. Faster than anybody could track. And they ALWAYS connect to shame and humiliation – or probably in cases such as mine, to sheer terror and panic.
Our brains are shifting gears – or dominance processing “suddenly” and without our awareness. We are conditioned to EXPECT “imminent dysregulation” because of these early interactive representations” that have encoded these “pathological” expectations into the circuitry of our brains – our right brains!
p. 29 –
“Indeed, the right hemisphere is involved in the memorial storage of emotional faces…and is activated during the recall of autobiographical …and early childhood memories…. The current interactive stress – similar in form to a very early misattuned, dysregulating transaction – instantly ruptures the attachment bond between patient and therapist. [Or between us and anybody else that we react to this way.] This sudden shattering of the therapeutic alliance thus represents a reconstruction of what Lichtenberg (1989) called a “model scene,” and it induces the entrance into consciousness of a chaotic state associated with early traumatic experiences that is stored in implicit (Siegel, 1995) procedural memory and usually protected by “infantile amnesia.” But now, due to state-dependent recall…, the patient is propelled into a bodily state that psychobiologically designates a “dreaded state of mind”…, thereby triggering “splitting” (the instant evaporation of the positive and sudden intensification of the negative transference) [and I would suspect dissociation for some of us]. This “malignant transference reaction” manifest in rapid emotional activation and instability, reflects hyperarousal- or hypoarousal- associated alterations of limbic regions (McKenna, 1994). As a result of the subsequent rapid escalation of intense negative affect, the self disorganizes, either explosively or implosively. [Assuming that there was a self there in the first place.] Neurobiological studies show that the emergence of strong affect during psychotherapy is accompanied by increased right hemispheric activation (Hoffman & Goldstein, 1981). (schore/ar/29)”
There is a very big difference, admittedly, between having these emotional reactions in a therapeutic setting and having them continually or even periodically in “the real world.” I don’t believe that they happen this way as described ONLY in therapy. I think they happen for us a lot.
How do we begin to recognize them when they occur? And then what do we do?
With a great therapist, as Schore continues, the therapist will be able to monitor their reactions and to initiate repair. In the “real world” people react out of their own trash compactors, and things can get out-of-hand if not down right nasty in a hurry. Nobody knows what is going on. And most of the time, nobody is going to have the patience to “be with” us as we try to “repair” and adjust, or even to understand what is going on for us.
It reminds me of Rhodes’ book and the descriptions of criminals reactions when they commit crimes. They do not understand the initiations through shame and humiliation, or through unconsciously encoded expectations of such, either.
Things can “happen” that are not good — including, for me, getting fired!
“It is important to remember that this affective state is transmitted within the dyad. The therapist’s resonance with this right brain state, in turn, triggers…physiological responses that receive (or block) the patient’s distress-inducing projective identifications…. (schore/ar/29)”
“The working-through process at this point is a dyadic venture of interactive repair (Tronick, 1989) and depends very much upon the therapist’s ability to recognize and regulate the negative affect within him- or herself…. Although the handling of negative affect and the negative transference is the most difficult art of treatment, the therapist’s tolerance (schore/ar/29) and containment of negative states is an important contributor to the creation of analytic trust. (schore/ar/30)”
This is no doubt a main reason these writers are saying that being in therapy is essential to healing – very few people are “clean enough” inside themselves to not mess this all up, and certainly very few are able to work at this level of trust with another human being.
This, to me, is one of the main problems of this being an invisible disability. I would hope that the general public’s awareness, and possibly the awareness of the therapeutic professionals, can be raised regarding this right hemisphere damage – its cause and its consequences.
It is like that although most people have hurts, they do not have this kind of DAMAGE. They might have powerful emotional reactions to things that they can’t understand, but their brains do not have this level of “pathological” encoding. Their brains did not form during continual, perpetual peritrauma of abuse and neglect in infancy.
p. 30 –
“The clinician’s participation in the disruption and repair process [the same as would be the case with an infant’s primary caregiver](Beebe & Lachmann, 1994) is dependent upon and limited by his/her capacity to tolerate and cope with the patient’s negative state that he/she has (unconsciously) triggered. [This statement alone would be more than most mental health professionals could cope with or accept!!] This coping capacity is reflected in an ability, under stress, to self-regulate (contain) the projected negative affect, and thereby act as an interactive regulator of the shared negative state. In doing so, the therapist resonates with the patient’s internal state of arousal dysregulation, modulates it, communicates it back prosodically in a more regulated form, and then verbally labels his/her experience. (schore/ar/30)”
This is key and central!! People cannot do this for one another – “act as an interactive regulator of the shared negative state.” This is what parents are supposed to do with infants. And as Schore has pointed out, this is supposed to happen with shared POSITIVE emotions during early infancy. Except that this all happens before the infant is verbal – although story telling about the experience (verbalizing) is helpful rather than harmful even when interacting with very young infants.
- We must at the same time be our own therapist.
++ (1) An essential step in this process is to detect, recognize, monitor first on a nonverbal level the “stressful alterations in” our bodily state that are evoked in a situation
++ (2) engage in “reparative withdrawal” – “a self-regulating maneuver that allows continued access to a state in which a symbolizing process can take place, thereby enabling the therapist [self] to create a parallel affective and imagistic scenario that resonates with the patient’s [our own (becoming objective rather than subjective)]
“…the presence or absence of the therapist’s recognition of his/her countertransferential bodily signals and his/her capacity to autoregulate the disruption in state caused by the patient literally determines whether or not the countertransference is destructive or constructive, “symbolizing” or “desymbolizing.” (schore/ar/30)”
++(3) This coping capacity is reflected in an ability, under stress, to self-regulate (contain) the projected negative affect [or our own], and
++(4) thereby act as an interactive regulator of the shared negative state [within ourselves – self talk]. In doing so, the therapist [we]
++ (5) resonates with the patient’s [our own] internal state of arousal dysregulation, [become aware and conscious – consciousness raising]
++ (6) modulates it,
++ (7) communicates it back prosodically [to our self] in a more regulated form, and
++ (8) then verbally labels his/her [our] experience. (schore/ar/30)”
“The essential step in this process is the therapist’s ability, initially at a nonverbal level, to detect, recognize, monitor, and self-regulate the countertransferential stressful alterations in his/her bodily state that are evoked by the patient’s transferential communication. In doing so, the therapist must engage in “reparative withdrawal” – a self-regulating maneuver that allows continued access to a state in which a symbolizing process can take place, [what is a symbolizing process?] thereby enabling the therapist to create a parallel effective and imagistic scenario that resonate with the patient’s (Freedman & Lavender, 1997). According to these authors the presence or absence of the therapist’s recognition of his/her countertransferential bodily signals and his/her capacity to autoregulate the disruption in state caused by the patient literally determines whether or not the countertransference is destructive or constructive, “symbolizing” or “desymbolizing.” (schore/ar/30)”[Interesting he switches the order here – destructive would be desymbolizing. Constructive would be symbolizing.]
see schore/ar/100 — I think he is talking about using words as symbols – other places he talks about evolving developmentally so that affects can be recognized as SIGNS.
“Thus, the active involvement of both members of the dyad in the process of disruption and repair is absolutely necessary for the patient’s learning that a previously self-disorganizing state can be regulated (rather than further dysregulated) by an external object. (schore/ar/30)”
OH! This is what they want to happen – that we do external constraint FIRST!?!?! Or is this about trust, that an external agent can be trusted not to dysregulated us? Is this therapeutic grandiosity or is this a vital and necessary step?
“The patient can now, in the presence of a reparative object, transition out of a previously avoided stressful state [which state is he specifically referring to here?} into one in which he/she can associate the nonverbal affect state with verbal processing. (schore/ar/30)”
I am confused about why a “reparative object” must be present in order to learn how to do this transitioning.
Is it so that we have someone to help us verbalize, or is it something else? We MUST be able to learn to do this repair on our own. Very few of us can access therapy, and from what he describes on p279-281, none of us are going to find such trained, clean and skilled therapists!
“Researchers have shown that “The ability to express oneself in words during states of high emotional arousal is an important achievement in self-regulation (Dawson, 1994, p. 358). (schore/ar/30)”
Yes, I would say the ability to do this in words would help! In WORDS we would be able to at least stop and reflect and THINK about what is going on. We wouldn’t be such “reactionary” machines – let alone what Siegel said, that the brain is an “anticipation” machine.
It must be what they are calling the “hotness” of all of this, the “suddenness” of all of this – the swift switching from left brain to right brain – that keeps us from having even a single minute of warning before things fly apart!
Just as it would between therapist and client, repeated practice at repairing ruptures would mean that our attachment relationship with our self would be “less vulnerable to repeated disruptions. (schore/ar/30)”
Rupture and disruption are related words
“…Gedo wrote that working through, “the difficult transitional process whereby reliance on former modes of behavioral regulation is gradually superseded by more effective adaptive measures,” is accomplished by “the mastery of affective intensities” (1995b, p. 344). (schore/ar/30)”
Here he is making the point, then, that behavioral regulation is related to mastery (or not) of affective intensities. He is saying that there is a very hard transitional process that is in the middle, connecting the “reliance on former modes” gradually being replaced (superseded) by “more effective adaptive measures.” In other words, the old former modes are not effective adaptations. We need new ones. As we begin to master the intensity of our affects, we will be more effective at adapting our behavior/regulating it. That would be nice! Not to have the inner saboteur!
“Unconscious affect and its regulation thus become a primary goal of the psychotherapy of preoedipal dynamics, [see p 244, oedipal beginning at 3 ½ years, paralleling hemispheric developments at that time – that can be interfered with through deprivation of “supplies” – see this for more info] especially a focus on the recognition and identification of affects that were never developmentally interactively regulated nor internally represented. (schore/ar/30)”
That would be me! But I am not at all sure what he specifically means by “internally represented.” Is he talking about the “mental representations” that were interfered with/inadequately formed? He must also be talking about differentiation (“recognition and identification of affects) of emotions as per Siegel.
Paragraph con’t – “Therapeutic interventions are directed toward the elevation of emotions from a primitive presymbolic sensorimotor [awareness and experience of them in the body – I would think not a bad thing, just has to be expanded and matured, to become among other things more flexible because they are more differentiated, and when they are connected to symbolic, they can be reflected upon, and communicated internally in thought and externally through language to others] level of experience to a mature symbolic representational level, [here, again, I don’t know specifically what he means by symbolic representational level!] a functional advance that is mediated by an increased flexibility of the patient’s [I would leave out patient’s – we are just talking about facts here] emotional control (schore/ar/30) structures. (schore/ar/31)”
Interesting, he is talking about LEVELS of experience – primitive to mature? Why doesn’t he say “primitive to more complex or sophisticated?” That would leave out the shaming part of this. No adult wants to be referred to as NOT mature – or immature. I like the word more “advanced.” Schore says “functional advance.” That doesn’t seem so shaming. I think it might be a way for others to feel superior, that THEY are more mature. And yet on a very basic level, it all remains to be tested. If something unexpected, traumatic, unexpected happened to any one of THEM, how mature would their emotional reactions really be?
He talks about client sensitivity to anything remotely shaming that comes from a therapist’s unconscious. I sense it even in these subtle word usages.
Emotional control structures need to be more flexible – increasingly more flexible!
“In long-term work, with the internalization of the therapist’s regulatory functions, the patient becomes capable of addressing a self-reflective position that can appraise the significance and meanings of a variety of emotional states [As in states of mind? Those neural net activation profiles Siegel writes about?]. As Bach pointed out, this developmental achievement is expressed in the emergence of a higher-level integrative capacity that allows “free access to affective memories of alternate states [What does this mean?], a kind of supreordinate [sic] reflective awareness that permits multiple perspectives on the self” (1985, p. 179). (Schore/ar/31)”
Ok, so what does this mean? First of all, long-term work is pretty much what I am ruling out as possible for 99% of my readers. No available, too costly.
So, if we are not going to have a therapist whose regulatory functions we can internalize, whose regulatory functions ARE we going to internalize? We were supposed to get this from our mothers. In our cases, she was not able to give this to us so we suffered brain damage as a result. Our regulatory functions are inadequate if not just barely functioning.
Without an adequate and developed regulatory function, we must be missing this self-reflective position. My mother sure was! I might have it, but it mostly seems to run around in circles.
I was just thinking as I was out walking about how often I have sought out others’ perspectives when I am having difficulties in my life, particularly with emotions. But looking back, I can see that this was not helpful in the long run. In the short run, it edged my panic feelings and therefore gave me a sense of what I believe now was “false security.” Everyone seems to have their own agenda along with their own perspectives. This is part of why I hold no hope of us finding a truly adequate therapist even if we could afford one. They are no different than any other person we might meet on the street – only that they jumped through university hoops and hang papers in frames on the walls of their offices. They are not “clean enough” of their own agendas. And if they aren’t, why would we – or I – believe that they would hold any useful perspectives on my life?
But I have felt inadequate. I haven’t felt that I could “appraise the significance and meaning of a variety of emotional states.” I think that this has something to do with the very bedrock of meaning and value systems within myself being inadequately developed as a result of this infant abuse and peritrauma. Significance and meaning, period – according to Siegel would be tied to the basic appraisal and arousal system – gone awry, I might add.
We are supposed to be our own best counsel. But if we need to seek a therapist – even if we can’t afford one or find one – if the need is there, we are feeling the need for someone else’s counsel. With infant abuse survivors, what I am trying to determine is exactly what the need IS!
Our emotional states can shift so unexpectedly and swiftly we cannot track them, let alone appraise them! A therapist would help us with this. Yet my point is, how do we do this for ourselves or for one another? Most people are extremely defensive (of emotions) and therefore cannot tolerate their own, let alone ours. We must find our own self-reflective position! This is not an easy task, and few are really even motivated to do so honestly.
This is supposed to be, according to this writing, a “developmental achievement.” I have a hard time having a perspective on this. I had no “self-reflective position” even when I was 18 years old!
So with this “developmental achievement” of having a “self-reflective position” we can then “appraise the significance and meanings of a variety of emotional states.” Is this just saying that we can THINK about them without reacting or acting on them? Not to be continually blindsided? I am very often at the point of confusion of not understanding others’ intentions or meanings – I can’t even understand a joke (and humor is something we also are supposed to learn as young babies). I have no real hope that my brain can ever be “made normal.” I just need enough of these skills that others seem to have so that I can get alone “good enough” with them to work and hold a job. Other than that, I think I need to get really comfortable with this feeling of intense loneliness I have – that doesn’t even go away when I am with others – except for very close friends or family.
I still believe that is due to attachment-gone-awry.
So, we are looking for “the emergence of a higher-level integrative capacity.” Dissociation implicates a severe lacking of this ability. I couldn’t integrate any part of even myself from birth onward, so crazy was my mother! People say that dissociation is a defense. I am still not convinced. I believe it happened to me because it was not possible for anything else TO happen! My brain just got MADE that way! It is a fact, not a defense! There was no alternative! There was the smiling mother who put curls and bows in my hair, put a little dress on me and took me outside for pictures. Then there was the horrible, terrifying monster. My brain just made itself in reaction to these states of hers. It just did.
Not a defense. Just a fact. But there was no integration, either. Not for all the thousands of beatings. Everything was just a tidbit of an experience. Nothing there to link them together. And now I would think it WOULD be completely overwhelming to try to go back and link them. Like little separate crumbs of events – Hansel and Gretel crusts of bread to lead them back home once they were lost – which they anticipated and expected would happen ahead of time or they wouldn’t have left them along the ground “coming” if they didn’t think that they would need them on the return “going.”
But I had no crusts of bread, no crumbs along the path of my childhood. I was all alone. No sibling beside me because by the time I was probably two it wasn’t allowed. Not even John could enter my circle. My mother had me all to herself.
So I could not link the memories then, and I can barely do it now. That’s what dissociation is about. Not being connected. Not being coherent or having a continuous experience of living. Without the ability to form and to hold onto the mental representations even of my children, I suffer when not physically in their presence.
I worked on this HARD this summer. Focusing and paying excruciating close attention to the details of being around them Just thinking of them brings tears to my eyes even at this moment. I am here, they are gone, I am gone from them.
Borrowed attachment. They have to live their own lives. And I have to find mine.
I was thinking about this on my walk tonight. How little time I spend “reliving the past” except as it concerns Ernie. There is something different about that relationship than it is in regard to my children. Like because Ernie is an adult to me, I depend on him differently. I have always known my children were not that kind of “adults.” I wanted to love them somehow “freely” without attaching my needs onto them, without depending on them or forming dependency.
Which I evidently STILL had with Jered. I found myself, unexpectedly, so terribly devastated when he left. Because, I believe, it was the end of my borrowed attachment. I think earned attachment is somehow about trying to give to the children, to provide those “supplies” Schore writes about. It is about trying to supply them with what they need on every level that we can so that they can be themselves and be all right.
Borrowed attachment must be about us getting supplied from our children. It is about trying to get our attachment needs met through them without even realizing we are doing this. It wasn’t the ending of the EARNED attachment that devastated me, it was the ending of the BORROWED attachment I had with them. I trusted them. I was safe with them. I borrowed the purity of their brains and minds because I think I saw in them some sort of mirror of what was so injured yet so precious in myself as an infant-child.
I would not intentionally ever hurt them, nor would they hurt me. That was an experience I was SUPPOSED to get from my early caregivers. That they were supposed to look at me and see me as precious and wonderful – as I did my own children. But that didn’t happen for me THEN – so I borrowed the mirroring of it in my kids.
I needed to be adored as an infant. Instead I was hated and terribly abused. (and so it was for the next 18 years). I adored my children. I could see my infant self, I now believe, in them – able to be adored, open to being adored, deserving of being adored, acceptant of being adored. They of course let me adore them. Borrowed adoration.
And I adore Ernie. How strange that is. Because his father accused his mother that Ernie was not his child, her ability to adore Ernie was interfered with. He (naturally, I suppose) cannot really accept the adoration I feel for him. Yet I must on some very deep level see his infantile need to be adored, and see that also in the mirror of my own same deep need.
Perhaps I can find a way to transform this process so that I can adore the “public” in some way. Some spiritual level process, a tiny bit of what, say, Gandhi or Mother Teresa had, gave to the world, and helped others with.
I don’t know if it was Maslow or Erikson or who that talked about becoming more fully human – or how that concept is worded in psychology. But I believe it is there.
If this book can help others with infant abuse brain damage, or infant abuse brain developmental delays, achieve even some small progress toward becoming more “self-reflective” I would feel better.
I wish I understood what this means:
As Bach pointed out, this developmental achievement is expressed in the emergence of a higher-level integrative capacity that allows “free access to affective memories of alternate states a kind of supreordinate [sic] reflective awareness that permits multiple perspectives on the self” (1985, p. 179). (Schore/ar/31)” [The self we were supposed to get by 18 months? Does superordinate imply objectivity?]
Not having much “integrative capacity” as it is, I can only try to imagine. What does “free access to affective memories of alternate states” mean? First of all, I would imagine that this is suggesting that existing blocks or blockages would be dissolved, removed, or superseded. Affective memories? Implicit memories stored only as feelings before the brain developmental stages of verbal and explicit recall? For me, these would be terrifying and horribly desperate peritraumatic memories. Why would I want “free access” to them (as Jon Allen would agree)?
Yes, they are “under there” influencing my present day responses to life situations. As Siegel describes, they are built into the brain – they BUILD the brain, and influence everything in our lives past our infancy. As Schore says, the self is built by 18 months of age. So, yes! For those of us who had terrible, horrible, painful, abusive experiences during those formative months, we WOULD defend ourselves from remembering them.
Yet is Schore saying that “therapy” is about accessing them? Siegel would say, “Don’t go there.” Yet is it that supposedly in the present we can go back to them, or allow ourselves to know what we already know (that is built into us) SAFELY – that this would be the superordinate “reflective awareness that permits multiple perspectives on the self?”
Most unfortunately, those of us with infant abuse histories EXCLUDE access to these affective memories. Conscious access. As does everyone else of THEIR infant histories.
But must WE (not others) INCLUDE these memories? That is a HUGE job! I would be satisfied if this book could introduce infant abuse survivors and those they are in relationship with just to the idea that the abuse HAPPENED and that it mis-formed their brains and therefore affects (detrimentally) the operation of their minds.
I believe the fact that these memories are “primitive” sensorimotor memories is in some way PRECIOUS! It is undeniable because the body doesn’t lie! Rather than being a short circuit this information is a DIRECT CIRCUIT to the truth about ourselves, our histories, our lives.
Is this a beginning of a “reflective awareness?” To me, it is far deeper than simply believing that I would need to “reparent” myself. This is not a left-brain top down awareness. This is a right-brain bottom up awareness, beginning with the body itself – information from which the right brain is especially suited to comprehending and processing.
So, “multiple perspectives on the self” can simply mean letting the right brain information become known to us (as Schore writes about on p. 245), pass it to the left brain for processing, which is supposed to pass it back to the right brain – a developmental processing step that was supposed to happen naturally around age 3 ½. But of course with these instances of horrible abuse and neglect, that stage was not met, either.
We have a lot of catching up to do! And at the same time we are trying to get along in the world, keep food in our mouths and a roof over our heads – and perhaps be caring for children at the same time.
Somebody needs to give us credit for all we are doing! I hope that it can begin to come not only from ourselves, but from the wider “net” of people around us.
“These functional advances reflect alterations in internal structures. (Schore/ar/31)”
I would have to go back a page or more to see where this reference to “internal structures” has been mentioned before. This seems to be a point of “shifting” between levels in Schore’s writing itself to a level that is considering the structure of the brain. There are no magic invisible internal structures. There IS the structure of the very brain itself.
So he is calling what I just noted and wrote about ahead of this “functional advances,” but is not being very specific in describing what he means by “functional” – is it versus “dysfunctional?” Or, functional in that they will demonstrate or manifest themselves outwardly in specific ways?
In the neuropsychiatric literature Mender wrote that “psychoanalytic recall, through a reacquaintance with the most primitive and undifferentiated sources of human potential, can rejuvenate our range of neurobiological options: (1994, p. 169).
Well, in our case, “the most primitive and undifferentiated sources of human potential” were scrambled up, to say the least!
“I suggest that the mobilization of fundamental modes of development that occurs in psychotherapy reflects the organization of structural alterations in limbic circuitries that neurobiologically mediate the emergence of adaptive capacities. (Schore/ar/31)”
Well, this is it in a huge nutshell! The brain damage that was done to us by our early caregivers! It is what needs to be fixed!
I have the utmost respect and gratitude for Schore’s work. I also believe him.
But I also believe that we HAVE to find another way, other than psychotherapy, to heal this for ourselves and for one another! He might as well be telling me I could heal my brain if I took a seat on the next space shuttle to leave this earth! We can’t “get there from here!”
So we have to find a way, simply, to mobilize our own “fundamental modes of development” in this real world we live in. It would be of some help even, if every practicing mental health professional, on ALL levels was versed in this vital information.; But as I already discovered talking to these people in the little town of Safford, this information is not welcome in a world that either wants to medicate our brains or tell us that if we change how we think and what we think about, our behavior will change and we will be fine. Going to one of these people would be, to me, like trusting a 5 year old to do a root canal – or worse! At least we would all know a 5 year old wouldn’t be capable of dentistry. But we trust that the mental health professionals we might have access to know what they are doing. Believe me, most DO NOT! Not even close. And if they are stubborn and choose to remain ignorant of this vital information, I state that they are practicing unethically! They are worse than horse doctors!
So, we have to find a way to mobilize these “fundamental modes of development” [after we figure out and understand what they are and what we missed and how that happened and how much damage that caused and how much it hurt us] because these “repaired” modes of development will be reflected in brain changes – BRAIN HEALING – specifically in the areas of our brains that were damaged – doing this developmental catch-up will reorganize or alter the structure of the limbic circuitries that have the crucial job – neurobiological job in our brain – of mediating the “emergence of adaptive capacities.”
Hard words to get one’s tongue around, let alone one’s brain! Let me try again. This is Schore’s sentence that is important for us to completely understand: “I suggest that the mobilization of fundamental modes of development that occurs in psychotherapy reflects the organization of structural alterations in limbic circuitries that neurobiologically mediate the emergence of adaptive capacities. (schore/ar/31)”
In other words, we need better “adaptive capacities” in our lives than we presently have. We were shorted in this department by parents who did not have a supply of “adaptive capacities” themselves, so they could not give them to us. Other people were given these tools, or supplies, when they were young infants as their brains developed so that these capacities are “hard wired” into the structure of their brains. We were not given these supplies – these “adaptive capacities” – so living life is a very difficult struggle for us. Things never come easy. We have the “unexplainably” difficult lives – and are continually blamed for making mistakes, bad decisions, bad choices, having bad judgment (regarding just about anything you can name).
So if we had more of the same tools and supplies available to us that others got during the brain developmental stages of their infancy, if we had these “adaptive capacities,” our lives would get at least a little bit better. Or, with practice, get a whole lot better and “on track.”
- Pardon this gross simplification, but if we are missing essential, necessary, and important tools in our toolbox (of life skills), this would mean that if they “emerged,” we would get up one morning, go to work, and actually find that “miraculously” the tools we need have suddenly appeared in our toolbox! Of course, for us and in this real world, it will take a whole lot of work, effort, understanding and practice to get these missing skills or “supplies” called “adaptive capacities.”
Because we are talking about brain development and what is missing for us through abuse and neglect and how we are making needed changes, we have to understand some brain terms. What we need are “structural alterations” in our brains. On the simplest level, having a tool we need appear in our toolbox is a “structural alteration” regarding the physical nature of the contents of our toolbox. First there was an absence of the needed tool. A “structural alteration” happened and viola! There’s the tool!
Now, to get even more complicated, there is an organization to these “structural alterations.” They are not random. It brings to my mind (perhaps because the season is fast approaching) an image of Santa’s sleigh. There would have to be a terrific level of organization for one Santa to get enough toys on one sleigh to deliver one to every child in the world on one night! Picture toys as needing “structural alterations.” Perhaps if they were altered, or changed, they would fit better. Perhaps if they were then superbly organized as they were loaded onto the sleigh they would all fit perfectly. (Personally, I doubt it.)
- This region of the brain processes the kind of information we are having difficulties with in our lives – namely, “adaptive capacities,” or tools and supplies that we need to get along better in life.
Changes in the organization or arrangement of the toys in the sleigh, or of the tools in the toolbox (structural alterations) that are made in the sleigh (the limbic circuitries of our brain) are a reflection of, get this, Santa’s “mobilization of fundamental modes of development.” Now, those are brainy words to describe what is happening in our brain due to changes we are making based upon the new information we are getting, understanding, and applying in our lives. In Santa’s case, it means that he has mobilized (think mobilizing your football team’s players on the field) his fundamental mode (think basic method) of development (think, “Gee! That little man has finally figured out and developed a way to get enough toys on that sleigh so that every kid in the world can have one delivered to them all in one night!”).
Writing this is beginning to feel maybe what it might be like to practice all the small separate parts to a song until it can all be put together with each member of the choir singing their particular part in complete harmony with the whole!
But back to our brain changes. We will skip the “occurs in psychotherapy” part of this sentence we are trying to decipher and understand for reasons stated above, and move on to the “reflects” part. That whole part of the sentence, “mobilization of fundamental modes of development” is really only a reflection! But not like a reflection in still water or in a mirror. The progress we are making toward catching up on the vital and fundamental stages of brain growth and development that we missed due to our abuse and neglect, and this new mobilization of modes or methods of development that we are learning and applying, are a reflection of the very “organization of structural alterations in limbic circuitries” within our brains. What we are learning, the developmental stages we are now going through that we missed back then, are reflections of the changes in the organization of the structures in our brain – specifically, in the limbic circuitries.
But, before we take a big breath and let it out, we have one more piece of this music to practice: “neurobiologically mediate”. Think “divorce mediation” and you know there is a person present in the room acting as the mediator between the two people getting the divorce. In our case, the mediator is not a person. It is a neuro- (meaning nerve) biological (meaning it is happening within and to the biological item that happens to be our body!) In other words, the nerves in our biological brain-body are mediating “the emergence of adaptive capacities.” But not just any nerves, and not in just any fashion. It is specifically the “organization of structural alterations in limbic circuitries that neurobiologically mediate the emergence of adaptive capacities.” It would be like Santa directing his elves how to best load toys onto that sleigh – of course based upon all the new information available on how to do the job best!
This morning, for the second time in less than a week, there is a news story of a man killing an infant. Does anyone who hears these stories stop to think, “This baby is better off dead?” Would that be such a horrible thought to consider? It has now scientifically been proven that infants raised in extreme abuse and neglect environments are not able to develop normally operating brains. That is what we are talking about. It is a guarantee – not a maybe or a perhaps – that the brain developmental impact on these infants being raised in peritraumatic situations will grow up with brains that do not have the “adaptive capacities” needed to live a normal life.
Were these men who killed these babies as noted in this week’s news stories under the influence of drugs or alcohol? I do not know. But I can tell you that it is close to a 100 percent chance that their infant brain developmental needs prior to the age of 18 months were not adequately met. True, there may be genetic predispositions in these men’s cases that were contributing factors to the terrible turn their lack of “adaptive capacities” took. But there is also a corresponding probability that offspring being raised in similar environments that ARE NOT KILLED will not grow up to be “normal,” either. They will pass on to their offspring what was done to them because those experiences of abuse and neglect that they had altered their brain development.
You’ve heard “what goes up must come down?” It is the same thing. “What goes in must come out.” An infant-grown-into-adult’s brain translates “stress” instantly (actually, faster than that) into distress. It is like a switch is flipped. Like a train switching tracks. It happens so fast in the brain that nobody seems it coming. Once the cue in the present environment triggers the switch, there is nothing to stop it. The primitive emotions, or affects, that these brain doctors are writing about flood and take over the brain and therefore behaviors and actions of the infant abuse survivor. Literally, all hell can and will break lose.
What the public’s responsibility now is is to wake up and pay attention. It is not that there is some “bad” fairy flying around with a magic “bad” wand that is waved over the heads of these abusers to make them do the terrible things that they do. This is, on our part, what I would call immature and childish magical thinking – a stage we are supposed to grow out of when we are about seven years old!
As long as we continue to believe that people who do “bad” things are just “bad” people, and continue to believe that we are superior to them in ANY way, we will refuse to address the facts being laid out before us by the researchers who know the truth. If we are so insecure ourselves, or so selfish, or so self righteous that we feel justified IN ANY WAY in our thinking that “those” people are a separate and less “worthy” class of human beings, we are not only stupid, but wrong.
In the nearly 2200-year-old story of how Medea killed her children, everyone knew she intended them deadly harm because she TOLD them. The children themselves, as the threat of death was upon them, were running around inside their house screaming for someone to help them and to save them as their mother chased them with a huge knife. Nobody lifted a finger to help them. Their pitiful and desperate screams went unheeded. The children were slaughtered. And we would blame the mother and call her insane?
Are we any different, all these hundreds and hundreds of years later? With all our technologies and sophisticated methods of doing this or that, are we any more advanced? With all our opulence and wealth, all our comforts and education, are we demonstrating any more compassion or common sense for one another and for OUR children than did the people who surrounded Medea and her children? I think not.
Mobilization: to put into movement or circulation, to assemble
Fundamental: serving as an original or generating source — primary, serving as a basis supporting existence or determining essential structure or function — basic,
Mode: scheme, form, a possible way of doing something, an arrangement of being, a particular functioning arrangement or condition, a prevailing style
Mediate: to be in the middle and act as an intermediary to bring about accord and reconciliation
Emergence: come into being, come into view
++++ Primary and basic forms of development that are assembled and put into movement and circulation within an individual, either during psychotherapy or as a result of personal growth work, are a reflection of structural changes that are being organized in the limbic circuitries within the brain. These changes in this part of the brain are thus neurobiologically bringing about the birth of the new adaptive capacities the individual can now use to better their life.
In this way the developmental stages that an individual was not able to go through at the appointed and appropriate times during infancy because of neglect and abuse are accomplished in the present because they were missed in the past.
Whatever way we can find to do it now, it is comforting to know that it is still the same area of the brain ( the limbic circuitry) that is being altered and changed. This is the region of the brain that accomplishes adaptive, flexible, appropriate and necessary adaptations to our environment, particularly our social and emotional environment. We suffer terribly without proper development of these “adaptive capacities” in our brains, yet we cannot name our discomfort nor identify its source. Until now.
We were denied these stages of development that were our human birthright.. In varying degrees this loss has affected every area of our lives. I can think of nothing else to call it other than brain damage. Yet the good new is, this area of our brain can heal.
“In psychoanalytic writings, Basch (1988) asserted that psychotherapy can facilitate the alteration and reworking of the patterns in the patient’s nervous system that govern how he/she processes socioemotional information. In fact, it is now thought that specifically cortical and sensorilimbic connections are reworked in long-term dynamic psychotherapy (McKenna, 1994). (Schore/ar/31)”
We were not enabled to develop adequate patterns so that our ability to process “socioemotional information” is dis-abled and inadequate. My contention is, again, that we need to find ways to “rework” and alter our inadequate patterns of processing this socioemotional information within our brains without having to depend or rely on psychotherapy for at least three reasons: (1) that it is either just not available to us where we live or (2) not available because we cannot afford it or (3) not available because at least 95% of the professional therapeutic community will have less of a clue what we are talking about than we do. Current scientific information has now determined that it is specifically the cortical and sensorilimbic connections within our brains that are faulty and need this reworking. But how do we do accomplish this reworking? That is the question.
Neuroscientists and clinicians now know that the “mechanism” of this transformation that we need is an improved ability to regulate our affect (or our emotions). This is by itself an operation of structural changes within our brains within the areas that were negatively affected at the time during infancy they were supposed to be developing because we were being severely maltreated .
Specifically, it is the regulation of what is called these PRIMITIVE EMOTIONS which are designed to be regulated by connections within the part of our brains known as the right frontolimbic cortex and its subcortical connections. This neurobiological internal structural system has been shown through PET brain imaging to be changed through the process of receiving adequate psychotherapy. So it stands to reason that if it can happen in psychotherapy, there MUST be some method we can discover to create similar changes OUTSIDE of the therapy room that most of us will never be able to access entry to anyway.
Although being told that these needed brain structural changes can only happen through intensive and adequate psychotherapy seems to me to be a negative statement, at the same time it carries with it the extremely positive information that our brains CAN and DO heal if we are provided with the right circumstances. Once infant abuse survivors are given the credit we deserve for having survived the unsurvivable in the best fashion that we could, and once the we, the public and the professional community becomes informed about the nature of the brain developmental damage that the peritrauma of this abuse has caused us, we can join together to solidify accurate and effect treatments to remedy this situation, at least by degrees.
Continuing to ignore the true nature of the problem is preventing us from finding these effective treatments which are actually nothing more than positive environmental experiences that will allow us to develop better adaptive brain patterns that we are currently missing. Researchers know that an infant brain has the ability to develop faster and more extensively than does an adult brain. But “experience-dependent plastic changes in the nervous system remains throughout the lifespan” (Rosenzweig, 1996). In (Schore/ar/31)
The best news is that the “…prefrontal limbic cortex, more than any other part of the cerebral cortex, retains the plastic capacities of early development. The orbitofrontal cortex, even in adulthood, continues to express anatomical and biochemical features observed in ontogeny [meaning at the beginning of things], and this accounts for its great plasticity and involvement in learning, memory, and cognitive-emotional interactions. (Barbas, 1995). Such findings suggest that this particular system, with its capacity for utilizing and directing the psychobiological expression of learning encoded within the limbic system (Rossi, 1993), is a critical site of the psychic structural changes that are a product of a long-term, growth-facilitating psychotherapeutic relationship. (schore/ar/32) [this chapter was evidently first written by Schore in 1997]
So here again we see the two edged sword. Healing is possible because the part of our brain that seems to have been most affected and damaged remains plastic and capable of changes throughout the lifespan. Yet we are also being told that these “structural changes” can only be “a product of a long-term, growth-facilitating psychotherapeutic relationship.” Again I say, “Go figure!”
The ability to learn is not a commodity that is owned by any other person than our selves. These brain changes amount to LEARNING a new way to process (on many complex levels it is true) “socioemotional” information. But now that we are finding out exactly what went so very wrong, it is NOT time to simply stand around wringing our hands. What can we specifically do to help ourselves and to help one another?