Allan N. Schore, PhD

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Right Brain Affect Regulation: An Essential Mechanism Of Development, Trauma, Dissociation, And Psychotherapy

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

Introduction: Regulation Theory and the Primacy of Affect

In a recent volume on Regulation Theory I concluded,

There is currently an increasing awareness, indeed a palpable sense that a number of clinical disciplines are simultaneously undergoing a significant transformation, a paradigm shift. A powerful engine for the increased energy and growth in the mental health field is the ongoing dialogue it is having with neighboring disciplines, especially developmental science, biology, and neuroscience.  This mutually enriching communication is centered on a common interest in the primacy of affect in the human condition. In the present interdisciplinary environment psychological studies on the critical role of emotional contact between humans are now being integrated with biological studies on the impact of these relational interactions on brain systems that regulate emotional bodily-based survival functions. In a recent editorial of the journal Motivation and Emotion, Richard Ryan asserts, 

After three decades of the dominance of cognitive approaches, motivational and emotional processes have roared back into the limelight…More practically, cognitive interventions that do not address motivation and emotion are increasingly proving to be short-lived in their efficacy, and limited in the problems to which they can be applied. (2007,  p. 1)

Although Sigmund Freud (1915), the creator of psychotherapy argued that this work is always concerned with affect, until recently all conceptualizations of the psychotherapeutic change process have been dominated by models of cognition, too frequently focused only on verbal, conscious cognition.  During the period of cognitive dominance, clinical applications of advances in theory mainly involved an attempt to construct more efficient interpretations, in order to more effectively make unconscious content conscious to the patient. This emphasis on verbal content and insight as the major change mechanism thereby focused on improving the analytic processing of the patient’s (and therapist’s) left hemisphere.

In contrast to the prevailing privileged status of verbal, conscious cognition, in my first book I suggested that emotional communications between therapist and patient lie at the psychobiological core of the therapeutic alliance, and that right brain-to-right brain emotional processes are essential to development, psychopathology, and psychotherapy (Schore, 1994).  Indeed, very recent clinical research reports that the more therapists facilitate the affective experience/expression of patients in psychotherapy, the more patients exhibit positive changes, and that therapist affect facilitation is a powerful predictor of treatment success (Diener et al., 2007).  In chapter after a brief introduction I will discuss updates of my work on the essential right brain process of nonconscious affect regulation in development, in psychopathogenesis and trauma-dissociation, and finally in the interpersonal neurobiology of a number of essential right brain processes that lie at the core of the change process of psychotherapy.