Allan N. Schore, PhD

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

Judith R. Schore &
Allan N. Schore, PhD
UCLA David Geffen School of Medicine

Right Brain Nonverbal Attachment Communication: The Intersubjective Origins of the Implicit Self

Schore has described how the hard wiring of the emotion processing limbic circuits of the infant’s developing right brain, which are dominant for the emotional sense of self, are influenced by implicit intersubjective affective transactions embedded in the attachment relationship with the mother (Schore 1994 , 2005 ). Implicit processing underlies the quick and automatic handling of non-verbal affective cues in infancy, and ‘‘is repetitive, automatic, provides quick categorization and decision-making, and operates outside the realm of focal attention and verbalized experience’’ (Lyons-Ruth 1999 , p. 576). Trevarthen ( 1990 ) described how prosodic vocalizations, coordinated visual eye-to-eye messages, and tactile and body gestures, serve as channels of communicative signals in the proto dialogues between infant and mother which induce instant emotional effects. Bowlby ( 1969 ) also described ‘‘facial expression, posture, and tone of voice’’ as the essential vehicles of attachment communications between the emerging self and the primary object (Schore 2001a ). The dyadic implicit processing of these nonverbal attachment communications are the product of the operations of the infant’s right hemisphere interacting with the mother’s right hemisphere. Attachment experiences are thus imprinted in an internal working model that encodes strategies of affect regulation that act at implicit nonconscious levels.

Neuroscientists have documented that visual input to the right (and not left) hemisphere during infancy is essential for the development of the capacity to efficiently process information from faces (Le Grand et al. 2003 ). These findings support earlier speculations in the psychoanalytic literature that ‘‘The most significant relevant basic interactions between mother and child usually lie in the visual area: the child’s bodily display is responded to by the gleam in the mother’s eye’’ (Kohut 1971 , p. 117), that early mental representations are specifically visually oriented (Giovacchini 1981 ), and that historical visual imagery is derivative of events of early phases of development (Anthi 1983 ).

With respect to the infant’s ability to process the emotional tone of the voice, prosody, it is now thought that:

The right hemisphere of the neonate is actively involved in the perception of speech melody and the intonations of the voices of mother and surrounding people. The pre-speech stage of child development is characterized by interactions of the descriptive and emotional components due mainly to mechanisms operating within the hemispheres on the principle of non-verbal communication (Bogolepova and Malofeeva 2001 , p. 353).

And on the other side of the right brain-to-right brain communication system within the attachment dyad, researchers describe the mother’s processing capacities: ‘‘A number of functions located within the right hemisphere work together to aid monitoring of a baby. As well as emotion and face processing the right hemisphere is also specialized in auditory perception, the perception of intonation, attention, and tactile information’’ (Bourne and Todd 2004 , pp. 22–23).

It is important to note that these early experiences may be regulated or dysregulated, imprinting either secure or insecure attachments. Watt ( 2003 , p. 109) observes, ‘‘If children grow up with dominant experiences of separation, distress, fear and rage, then they will go down a bad pathogenic developmental pathway, and it’s not just a bad psychological pathway but a bad neurological pathway.’’ This is due to the fact that during early critical periods organized and disorganized insecure attachment histories are ‘‘affectively burnt in’’ the infant’s rapidly developing right brain (Schore 2001a , 2003a ). These stressful relational experiences are encoded in unconscious internal working models in the right, and not left, brain. In a study of hemispheric lateralization of avoidant attachment, Cohen and Shaver ( 2004 ) conclude ‘‘Emotional negativity and withdrawal motivation have been connected in psychophysiological studies with the right frontal lobe of the brain’’ (p. 801), and that avoidant individuals show ‘‘a right hemisphere advantage for processing negative emotion and attachment-related words’’ (p. 807).

Summarizing a large body of neuropsychological data Feinberg and Keenan ( 2005 ) conclude:

The right hemisphere, particularly the right frontal region, under normal circumstances plays a crucial role in establishing the appropriate relationship between the self and the world…dysfunction results in a two-way disturbance of personal relatedness between the self and the environment that can lead to disorders of both under and over relatedness between the self and the world (p.15).

In relationally-oriented therapeutic contexts that optimize intersubjective communication and interactive regulation, deficits in internal working models of the self and the world are gradually repaired. Recall, Bowlby ( 1988 ) asserted the restoring into consciousness and reassessment of internal working models is the essential task of psychotherapy.

Decety and Chaminade’s ( 2003 ) characterization of higher right brain functions is directly applicable to psychotherapy of disorders of the self:

Mental states that are in essence private to the self may be shared between individuals...self-awareness, empathy, identification with others, and more generally intersubjective processes, (and) are largely dependent upon...right hemisphere resources, which are the first to develop (p. 591).

These particular implicit right brain operations are essential for adaptive interpersonal functioning, and are specifically activated in the therapeutic alliance. Right brain increases in ‘‘implicit relational knowledge’’ stored in the nonverbal domain (Stern et al. 1998 ) thus lie at the core of the psychotherapeutic change process.

As the right hemisphere is also dominant for the broader aspects of communication and for subjective emotional experiences, the implicit communication of affective states between the right brains of the members of the infant-mother and patient–therapist dyads is thus best described as ‘‘intersubjectivity.’’ The neurobiological correlate of this intersubjectivity principle is expressed in the dictum, ‘‘the self-organization of the developing brain occurs in the context of a relationship with another self, another brain’’ (Schore 1996 ). This is true in both the developmental and therapeutic growth-facilitating contexts. The interpersonal neurobiology of modern attachment theory has thus been a rich source of information about the essential role of nonconscious nonverbal right communications in the psychotherapy relationship.