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

Conclusion: Modern Regulation Theory

An explosion of developmental and neurobiological research has added substantially to the theoretical understanding of the 110 years since Freud ( 1895 ) first published his Project for a Scientific Psychology (Schore 1997 ). Having been grounded in drive, ego, object-relations, self and relational psychology through the 1980s, the addition of attachment theory has moved psychodynamic clinician’s sensibilities into an awareness of real experience and a keen focus on early development as the root of all. Then, beginning in the 1990s, the advances in neuroscience, added to research on temperament, the biological component in our biopsychosocial frame, has provided a remarkable underpinning and expansion of all the pertinent developmental psychoanalytic theoretical concepts that came before. Using this knowledge on a daily basis, finding new understandings in clinical assessments, shaping therapeutic interventions from relevant theory, and providing a unique awareness of the adaptive nonconscious functions of the implicit self are some of the profound results of this theoretical integration.

Thus, we are proposing the concept of regulation theory as an amalgam of Bowlby’s attachment theory, updated internal object relations theories, self psychology, and contemporary relational theory all informed by neuroscience and infant research. This is a profoundly developmental approach. We understand any individual’s personal trajectory of emotional growth, including the development of his/her unconscious, to be facilitated or inhibited by the context of his/her family and culture. Attachment outcomes are thus the product of the interactions of both nature and nurture, the strengths and weaknesses of the individual’s genetically encoded biological predispositions (temperament) and the early dyadic relationships with caregivers embedded within a particular social environment (culture).

The developmental understanding that arises from this theory leads to a corresponding regulation theory of therapy. This therapeutic approach is rooted in an awareness of the centrality of early dyadic regulation, a thorough knowledge of right hemispheric emotional development, and a deep understanding of the dynamics of implicit procedural memory. An understanding of the right brain mechanisms that underlie bodily-based non-verbal communication is essential in this approach. A keen apperception of one’s own somatic countertransference is a key element in the intersubjectivity between therapist and client. We know the effects of stressors on the self system, from mild and ‘‘ordinary’’ peculiarities that create and shape individuality, to severe trauma and neglect that interfere with and derail normal development and that require long-term therapeutic involvement to get back on track (Schore 2002 ).

Regulation theory explains how these ‘‘external’’ developmental and therapeutic attachment experiences are transformed into ‘‘internal’’ regulatory capacities. And we know from research that this intensive therapeutic relationship can repair damage and create new structure that is more able to cope with the demands of life. The intersubjective process of developing a resilient self that can enter into a variety of meaningful relationships shows us how the internal world is structured on a psychophysiological base that takes into account the unique genetic endowment of the particular infant in interaction with his relational environment. The psychotherapeutic process is based on this dynamic and can act as a growth facilitating social environment that can promote the development of not only an ‘‘earned secure’’ attachment, but expansion of the right brain human unconscious.

The regulation model of modern attachment theory has implications not only for social work’s important role in the psychotherapeutic treatment of individuals, but also for the culture, an area of prime interest to social work. Tucker (1992 ) observes: ‘‘the baby brain must begin participating effectively in the process of social information transmission that offers entry into the culture.’’ He asserts that social interaction that promotes brain differentiation is the mechanism for teaching ‘‘the epigenetic patterns of culture,’’ and that successful social development requires a high degree of skill in negotiating emotional communication, ‘‘much of which is nonverbal.’’ Tucker concludes that such emotional information engages ‘specialized neural networks in humans, within the right hemisphere.’’’ These data clearly imply an important role for clinical social work in infant mental health and optimal right brain development, that is, attachment programs of prevention and early intervention. The field could make important contributions towards the creation of more emotionally intelligent future cultures.