Allan N. Schore, PhD

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Relational Trauma and the Developing Right Brain: An Interface of Psychoanalytic Self Psychology and Neuroscience

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

INTRODUCTION

At the present time a number of scientific and clinical disciplines are simultaneously experiencing a rapid expansion of relevant data and even a reorganization of their underlying theoretical concepts. Indeed the term paradigm shift is appearing in a number of literatures. Although current significant advances in various technologies and the computer sciences have catalyzed this growth spurt, an important contributor has been the rapid communication of information not only within but also between disciplines. In this period of accelerated growth of essential information about the human condition and the natural world, the transfer of knowledge across disciplinary boundaries is occurring at a faster rate. This trend is reflected in an increasing interest in interdisciplinary studies, and in integrated models that synthesize data generated at the interface of different scientific and clinical fields.

Within this context there exists a potential for new and fresh solutions to certain fundamental problems, especially those concerning the essential mechanisms that lie at the core of adaptive and maladaptive human functions. Until very recently these problems have been studied from the unique vantage points of various scientific perspectives that span the sociological, psychological, biological, and chemical domains. The over emphasis on specialization within each of these disciplines has also fostered their isolation from one another, which has in turn inadvertently increased an artificial dichotomous separation between for example, psychology and biology, brain and mind, mind and body, cognition and emotion. Earlier impermeable boundaries of knowledge between disciplines also intensified a tension and indeed a conflict between those studying unconscious involuntary processes and those studying conscious voluntary processes, that is between psychoanalysis, the science of unconscious process, and psychology, the study of behavior.

This ambivalent relationship between psychoanalysis and the other sciences has existed since its creation by Sigmund Freud. And yet it is often forgotten that Freud’s early career was in neurology, and that in 1895 he wrote Project for a Scientific Psychology, an attempt to create “a psychology which shall be a natural science.”1 In this remarkable document Freud utilized what was then known about neurophysiology and biology to begin to construct a set of regulatory principles for psychological processes and a neuropsychological model of brain function. Freud didn’t publish the Project in his lifetime, and over the course of his career never returned to the problem of creating a model that could integrate the biological and psychological realms. And yet he predicted that at some point in the future “we shall have to find a point of contact with biology.”2 Freud thus saw neurobiology as a discipline that could bridge the gap between biology and psychoanalysis, especially in the study of the unconscious and its fundamental impact on all aspects of the human experience.

Over the course of the last century a number of significant transformations have occurred in Freud’s theory, although much of this work has not transferred outside of the field. The theoretical core of psychoanalysis, almost unchanged for most of its first century, is now undergoing a substantial reformulation from an intrapsychic unconscious to a relational unconscious, whereby the unconscious mind of one communicates with the unconscious mind of another. The scaffolding of clinical psychoanalysis is supported by conceptions of psychic development and structure, and it is these basic concepts that are now being reformulated. Self psychology, emergent from the seminal work of Heinz Kohut, represents perhaps the most significant updating of classical psychoanalysis since it inception. In 1971, Kohut, trained in neurology and then psychoanalysis, published his classic volume
The Analysis of the Self
,3 a detailed exposition of the central role of the self in human existence. He subsequently expanded the theoretical framework of self psychology in a second volume, The Restoration of the Self,4 and finally in How Does Analysis Cure?5

In all his clinical work and writings Kohut attempted to explore the four basic problems of psychoanalysis that he initially addressed in his seminal volume: how do early relational affective transactions with the social environment facilitate the emergence of self? (development of the self), how are these experiences internalized into maturing self regulating structures? (structuralization of the self), how do early deficits of self structure lead to later self pathologies? (psychopathogenesis), and how can a therapeutic relationship lead to a restoration of self? (mechanism of psychotherapeutic change).

Despite the fact that he was originally trained as a neurologist, Kohut was highly ambivalent about the incorporation of scientific data into the core of psychoanalytic self psychology. Indeed, like Freud before him, he eschewed his earlier neurological knowledge, and attempted to create a purely psychological model of the unconscious systems that underlie all human functioning. However, in the last 10 years, over the course and since the “decade of the brain” an interdisciplinary perspective has emerged both within psychoanalysis and the disciplines that border it. Due to a common interest in the essential rapid bodily-based affective processes that lie beneath conscious awareness, a productive dialogue is now occurring between psychoanalysis and neuroscience. This convergence has facilitated the emergence of a new discipline, neuropsychoanalysis, and a subspecialization, developmental psychoanalysis.1 This discipline returns to Freud’s attempt to create “a psychology which shall be a natural science” by specifically focusing on the essential psychobiological role of the unconscious in all human affect, cognition, and behavior.

In a number of works I have suggested that the time is right for a rapprochement between psychoanalysis and the biological sciences.1,6,7,8,9,10 In this period when neuroscience is “rediscovering the unconscious,” neuropsychoanalysis is identifying the “intrapsychic” brain systems involved in a redefined dynamic unconscious, and developmental psychoanalysis is generating a complex model of the social-emotional origins of the self and the early ontogeny of the biological substrate of the human unconscious. It is now clear that Freud was correct in positing the unconscious mind develops before the conscious, and that the early development of the unconscious is equivalent to the genesis of a self system that operates beneath conscious verbal levels for the rest of the life span. I believe a deeper understanding of early human development can never be attained by narrowly focusing infant studies on the precursors of language, conscious thought, and voluntary behavior.

A complete model of human development (and psychoanalysis) can only be psychobiological, not merely psychological. A deeper understanding of one of the fundamental questions of science, why early developmental processes are essential to the short and long-term survival of the organism, will not come from single or even multiple discoveries within any one discipline.6 Rather, an integration of related fields is essential to the creation of a heuristic model of both developmental structures and functions that can accommodate and interpret the data of various biological and psychological disciplines, and can freely shift back and forth between their different levels of analysis.

In this chapter on the integration of self psychology and neuroscience I outline my neuropsychoanalytic work on the interpersonal neurobiological origins of the self. I first present a brief overview of Kohut’s concepts that represent the core of self psychology. Subsequently I integrate interdisciplinary data in order to construct a neuropsychoanalytic conception of the development and structuralization of the self, focusing on the experience-dependent maturation of the early developing right brain. Then, in a major focus of this work, I apply this developmental neuropsychoanalytic perspective to the psychopathogenesis of severe deficits in the self system. Citing my work in this area, I articulate a model of the self psychology and neurobiology of early relational trauma and the etiology of pathological dissociation, an early forming defense that is a cardinal feature of a number of early forming psychopathologies. I end with some thoughts on psychotherapeutic change, and argue that the time is right for a rapprochement between psychoanalysis and neuroscience. Throughout I suggest that the "point of contact with biology" that Freud referred to is specifically the central role of right brain psychobiological processes in the unconscious regulation of affect, motivation, and cognition, areas of intense interest to both contemporary self psychology and neuroscience.