Chapter

influences: The

;9:99G'1000. {. & Simonoff,

iew of research
P.

ational traum a and the developing right brain

Ref

& Bailey, A.

rirical findings.
,rplay and psyPsychology and

The neurobiology of broken attachment bonds

Allon N. Schore

s ol cognition:
328.

and individual (1996) Attachrst year of life.

,n:

Over the past two decades I have integrated ongoing sc clinical data in order to construct regulation theory, a ne

Oxford Uni-

in securely and
'ic conditions

in

attachment. In tonships (Vol. 5,

oks.

r of separationPsychiatry, 133'.
g

on attachment

rsiveness among

457-t477.
vI.J. (1999)

Dis-

rsors, concomi-

In J. Cassidy &
clinical applica-

model of the development, psychopathogenesis, and treatm self. Towards that end, in 2001 I edited an issue of the Inf Journal, and in it I offered an article, 'The effects of early on right brain development, affect regulation, and infant this chapter I build on that work and provide very rece developmental data that allow for a deeper understandi logical and biological effects of early relational trauma. will be on current studies of the early developing right br substrate of the human unconscious and the site of the subcortical regulatory centers. This interpersonal neur explicates the mechanisms by which attachment trauma the developmental trajectory of the right brain/mind/bod course of the lifespan. Also discussed is the etiology of pa ation, the bottomline defense of all early-forming sev psychopathologies. Pierre Janet (1889) defined pathologica phobia of memories, expressed as excessive or inap responses to thought or memories of 'old traumas'. It is n 'old traumas' specifically refer not just to childhood tra relational trauma occurring in infancy, the critical period o theoretical perspective has direct clinical applications fo treatment and prevention.

ton, G.G. et al. 0+135r.

rsick, R. (2008)
r

secure attachment

Developmental interpersonal neurobiology o

Cummings. c acids. Nature,

The essential task of the first year of human life is the c

attachment bond of emotional communication and inte between the infant and primary caregiver. There is now agr ing how to communicate represents perhaps the most im mental process to take place during infancy' (Papousek &

consciously interactively regulated . . . has shi regulation theory.

Secure attachment depends not on the mother's ps

with the infant's cognition or behavioq but rathe infant's internal states of arousal, the energetic

affective state. Through nonverbal visual-facial, tac prosodic communication, the caregiver and infan ture of the other and modify their behavior to fit creating a specifically fitted interaction. During communications of mutual gaze, the attuned moth temporal patterning of her exogenous sensory st spontaneous expressions of endogenous organism gent responsivity, the mother appraises the non infant's internal arousal and affective states, regu cates them back to the infant. To accomplish

must successfully modulate nonoptimal high or stimulation that would induce supra-heightened arousal in the infant. In order to enter into this communication, the m logically attuned to the dynamic crescendos and d bodily based internal states of autonomic nervou

arousal. Indeed, the intersubjective dialogue betwe

sist of signals produced by the autonomic, invo both parties. The attachment relationship mediate emotion, wherein the mother co-regulates the infa

ANS, and thereby its internal homeostatic state. A nervous system (from the Latin vegetare, to anim responsible for the generation of what Stern (1985 Research now clearly demonstrates that the prim attuned and optimally mirroring, that there are attunement in the dyad, ruptures of the attachm of attachment transactions leads to a regulator autonomic homeostasis. In this pattern of in dyadic misattunement (Tronick, 1989) or 'disrup Lachmann, 1994), the 'good-enough' caregiver, wh

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human infants'. ln subsequent neuropsychological lateralization in the second year oflife, Schuetze and ;Attt ougt the infant brain was historically reported ev terms of cerebral lateralisation until 2 years oi ug.,

ln]ilutmg that lateralised functions are present much .lateralisation oi negative em They fuiher observe ,tr" ilgft, hemisphere in infants as young as 12 mont opmental enhancement of right hemisphere contro .ipi.rrlon that is evident by 2? month'i' Mott recen (zool:tl2)conclude,'Earliermaturationoftherighthe
by both anatomical and imaging evidence''

In my ongoing work I "-onlinu. to offer data attachment mechinism is embedded in infant-care

to-right-hemisphere affective transactions, and that

biological model is supported by a large !"91. : ,.r.ui.r, (Schore, piq,'iooo,2003b, in press). with attachment communications, it is now establishe oiin. .upu.ity to efficiently process information fr input to the right (and not ieit; tremisptrere <luring 2003). Developmental neuroscience documents tha the onset of a critical period during which synaptic oping occipital cortex are modified by visual exp wh zbOOi, infunts show right hemispheric attivation face'lTrorrrio-Mazoyeretal',2002)'Recentnear i.r.ur.n (perhaps the most suitable of all neuroscien tohumaninfants)revealsthatspecificallythefive-m ,prr.i. responds to images of adult female- faces (Na
et aL.,2007).

ography GEG) study by Grossmann et al' (2007) g oia intuni, presented wiih i-ug.t of a female face prefro enhanced gu*-u electrical actlvity over right conclude ihat the brain mechanisms underlying ey tigt a"g."e of specialization early in ontogeny, re

Closertoaninterpersonalface-to-faceperspect

n.l-irpi"r.. other

researchers have established th (Pelp face-piocessing areas ofthe right hemisphere

In terms of tactile-gestural-attach-"nt "o**unic

Ncyrob,olosr
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<ici,-iolstLnics 'iutcliiiizcci systcm

is ri

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tol ncolliiril imitatiol' tltlcl cotrclitrle-:^ " u'arli,udvitutagc oi'1itc lir:lil itctt-risithci* (Cilil'orl et al.. 1997: Scholc^ 2 'lig'altitcn, 20t)1) iu iitc 1ir':;t f-cii'nrontirs oi 1ilc rrra;'ali'cct thc llrtct'itii ailll.aluitcc of'tirc 1lt'si intilatirc gestLlr';s". Sicraizlii ancl Woi! (i996) clcsc iiic cilccts of- toticit on tirc cil'eiti1.rit.rl,. t'ight heruisilltcrc. atrcl asselt thltt cl.rotional iit'rpucl cli ittuch is r,-rr'rLc direct auti irnrnediatc if-itr.l. itlian |u-1ci t6 titc lcli sirlc oiiire bociy. Siuciic: i.llso (ir''monsilatc titat sllollilillco 1:cs'Lnr'.'s lhai cx1'ri css lcciing sitil,cs coinnilrniclttccl rvititirt it Ci'itci ltc'.i ligii'. hcrnisithcrie sir''.tcii-trcs (Galllli:her' & I'r'ith. 2004). And tl.tii't'oi ilci l'csculciicls 1to$'coniclrcl 1.hat cl:i,cloiringi chikil'cn i'ci1, ott a 'rigitt hcn'risph rnii'ioiilt!: rncclianislir intcl'1'acir.rg rvittr tirc irubic sysicm iltai l.lt'oce:srrr.rcaninl: o1'obsclvcci oi ir,tiiaicd ctnotion^ (Dllpi ctlo ;t al.. 2.00(r).
As tot' ai-lciitoly ltiosoclic atiaclurrciri coinr.i.rr-ll.ticrttion:. i-lt'osociic

l"lt'oe

i;!: ilt

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(llontac ci ai." 2006). ;\t ii :,1'rclch (i.t. rviiii somui'liut cra-r1:ciatcci ul'osciei1,) clicits a iight-iatelitli cvcl.rt-r'cirtcr.i polci'rtial (t:[{P) ( i'iriclri'c'. r11.. ?-003). Accolciing io l}t,'!:o1c1 ailci ):laloico'a (2(X)l: 353):

thlcc-r.iion"rir-oici

iniari:

activuics tirc rigiti tctitnot'<t1t:lt'ietiii l'c nton'Lirs lhc voicc oi'u rvotiriut's chilci-c1ir'-c

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ii Ii
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.Anri

tll ihc olircl siclc ot'thc uttachll'iclt clyitti. tcscilicitcrs noii' cicsciibc motircr"s i.lir.rccssing capacitics: '.2\ nrurbct' oi' litnciioits locaiccl r-;itltii ri1:iri hcir.lisliiclc n'oil' togciircl-lo llii tr.rotlitorirlg oi- ll blibl'. As *,'.: ct-itotion a;rci lircc i-l'oc;-.sing lire iighl iicilisnhclc ts alstt sttcciaiizc itilciitoif itclccl.riictit. thc l;r'ccption oi ii.ttott.Liion. ;.1'.',ctirirttr" liticl ill

j)-

inlirnraiiori' (Ilounic &'lbcici" ?.(\(\4: ),?, 23). -Ihis iighi iatcraiizcci s)'s1clu storcs a r'ocilbtiiary ol'trotrvctbal ai]'c tirciul r.ritlrssioi.rs. LrcstLlrcs. arci plosocly^ r'ight braiir siltnliis ttscri in lrll lltuchutcl.rt ct>rnl.r.rLinicutions (scc Schorc's inoclel ol'aficct r-cgt-iilttiori iig[t blairr clcr'cloprnent iir Iiiiric 2.1). 'firc oLltput o1'tirc ligitl irctt.iisD 'lilc ciitotioltitl i>t'ltil.r^. is a cottsciotrs aliect.'l'hc highcsi ccilicls of licr"irisplicrc. csltcciaill' tirc ol'bitolloiriui (r'cn'tt'ourcclial) corte\" iitc loct

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7)

aircl syiriiptic tcinot"i.s iir tltc orbiiolt'o cir:llliluic) coiicx^ iuciticling iis coirneciioirs iltto liic iim s)'stcil. illc Llt'.ls dllniaticlilly, .;hl:pcei b1' earl1, t'cllttioltitl clncrtiorli:i L'\pjl (Schoi'c. 199,j: Iloel' ct ii1..2()03).

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concludes, 'our results are in ag addressed the importance of the ri (Minagawa-Kawai et al., 2009: 289 At the end of the first yeaq rig

implicit-procedural memory, an which encodes strategies of affect individual through interpersonal

unconscious 'procedural expectatio

during stress (cortina & Liotti. 20 experienced as left-brain consciou enced as subjective right-brain a

('gut feelings'). At all points of

are expressed not in lcft-brain seco process cognitions (Dorpat,2001; S

Attachment neurobiology

optimal attachment communicatio

central nervous system (cNS) lim social emotional stimuli and the generates the somatic aspects of e

of relational trauma this

growth-faciliterting emotional envir an internal system that can adap psychobiological states (and therc good-enough mother offers her se a separation; she tends 1o respon emotional expressions. She also a generated during co-shared play sta expansion olthe chiid's right-brain the developmental principle that s against trauma-induced psychopath In contrast to caregivers who f neglectful caregiver not only plays affect in the child. Such caregivers environmental impingements, includ

carcgiv

iniiltl.lt'ct1.l'iuic itltd/or ruljcctiiri: r;iDonsc.; ict hct' iitittlti"t; !\i)1'ci:;ioiis o

iiriiritl"s

iiol:s i:ncl, s',Lc:s. ancl il'ovicies ninin'vli o;' lLirll'cilicilt.ttc :'clrtrllittoll s'.uies o1'uvci'-liiouslil. insl.ca<i. .ltc iilclilcls c\iie1\te luve is oi's iioir aiici uloiisai (i.c.. tirc ieil'hiirir siili.r-iia'rioir cj'itJLi'iJ:lttci/o,'ihc v :ii;nlililiol ct' negiccl). Aiicl 1nuli1,. blclliite sitc ttt.oi'iclcs tto itll.i |ei-lllii'^ sirc icltvcs l,lc illiirrli to ct'tciiLt'; t:"'t-''t'ittci\':l'iics-sj'Lti iiliclt:c 'l siaics iix' ionli ircliocis ot'iiir.rc. -l itclc is ltow c\iL'nsi\c evicicrrc; 'riilil sit'css is ii ciilicli lilc',ol' :rtili socil:i intel'liciiotis. cstrccilili)'ihc i-,rolilct cillici ittlciticiiolt (Sirlcr 2007). Orci'rioliitri iitc iir.cilirLiie. tlresc l'c:calcirers:'cpoli iitill cliltilt!: iiLi iii.' ;lti:otl;. '::tri.lt.-;- lt.':i ll.- :;l -iiirc. i'r't;; i'"ii ''rie. e,'itlt lu.i;titive. lincl silorlcci icss n,i:i'ttriir.litci llcriblliif iil il',lt'ilctioil: r','i chilcileli. l'itcY cor.rcittcie.'Or'.'rlii1. sircsi' rcrill: io lr,; ll ii:ciol'lirili ilo\\Ji'.o 11i:l'Ltiti i)lli'Jltl.ilig riitciiccs scilousi)'lit(i, lcsitiis iir tt lttnc, oi"rlic r:rotlrct chiici iuicluction^(SrLicl c: ir1.^ l0()'/: ,16). Ilt rl icvi!-w oi' i:r1r issucs ibi lnc-'iitci: *'lio trllilrili: ji ctli ollic Str'.':':, ci1'si'.'!'ililii iorl a cirilol.!ctscci u'itii bolclcllinc llDl')ollriii,t' ciisorclcis. \cri'tttlll.t lttt(i Siiv
(200:;: 392) conciLi(i.. 'C'ietil'1t'"

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t ri1'11o11.

in t-lcss). iu'tcldi:;ciirliitl'1, ci,icicncc ;l-rciir,'lircs t iulilitt^s l.ts\cirobioiol:ictii :'caciiol io ii\rii) iiitct'irli:;cilii site:;st'rts c() i\i,o scpliniie rg')il()1tsil i)i:tr.cl'ns. iryp.'i ulo,tsiti ltnci eii..socilrirlrrt. Ilc.:ltc ,i36) cic:cl'rbc: ihc iititiul :iiiiic ol'"miiir.il:iii'csr:aillillll: ovciiliotlsili o
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Iir'riic cullictii stlltc ol iilcu'1. tirc ciiii<.i'l; sittlclctt itiiil'lii ot-sitliiit' l ucli\'liiolt oi'iitc itriitrl'-": r'ililii ilr'trisi.rilcl.c (iil'l:t'iiel' ct tli. Iil-.. il iLriu. cvoi,cs u s'"icirlcu i;rcicasc oi'lirc s1,n'i'liiiic'Lic i-rilt:tcit ,'\NS. rc::tlLing il sigltiiicait-.ly cicr'll;cil lrclit'i l'itiu (crliei;lic :lcciie itlooli olc.sitic. ill.rci icsi)iiiition. l)is1i.c:s i.; "-r.i.t:'.'sscci iit ciyitrl-. lit
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s'rtt'c oi- "ll'iiitiic t'listt,':;,s^. ol' le lli lcl'io,:. is illcciii s\,lltliltilclic i.i1'p;i ai'rii-tsul lilil i:, crlricss.:c1 iir incie ll.'.cci sJCl.aiiott t;i' il-oiti1 r'ciciisinli il:cior' (Citi ) iirc 'Ll'uiir^:, r-rra.ior s'rt'css ircti'ittr.rit lcsiliulcs :1'npalitciic caiccitoiiilttiilc i:ctivil)' (iilo',','ir ci iii.. 19112 'i

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which the child disengages from stimuli in the extern infants are observed to be 'staring off into space with and Weinberg(1997:66) note that:

when infants' attempts fail to repair the intera postural control, withdraw, and self-comfort. Th iound even with this short disruption of the mu and break in intersubjectivity. The infant's react withdrawal of Harlow's isolated monkey or of th observed by BowlbY and SPitz.

winnicott (1958) holds that a particular failure o environment causes a discontinuity in the baby's ne Kestenberg (1985) refers to dead spots in the infant

an operational definition of dissociation's restriction The child's dissociation in the midst of terror involv

compliance and restricted affect. This parasympat conservation-withdrawal occurs in helpless and hop in which the individual becomes inhibited and striv order to become 'unseen' (Schore, 1994,2003a,200 chic trauma and 'emotional surrender', Anna Freud also referred to helplessness, defined as a state of'dis lessness' that the organism experiences in the traum of metabolic shutdown and cardiac deceleration is a cess that is used throughout the lifespan. In cons
stressed individual passively disengages

in order'to

foster survival by lhe risky posture of feigning de wounds and restitution of depleted resources by im

213). This parasympathetic mechanism mediates the

(Baiach,

pet; of dissociation. If

early trauma is

catastrophe' (Bion, 1962), then dissociation is a'deta able situation' (Mollon, 1996), 'the escape when ther 1997),'a last resort defensive strategy' (Dixon, 1998

The neurobiology of dissociative hypoarousal is hyperarousal. tn ihis passive state of pain-num

.niog..tout opiates are elevated. The dorsal vagal c medulla is activated, which decreases blood pres and heart rate - despite increases in circulating a

3i

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Solomon's (1986) classic study of attachmen a new attachment category. Type D, an in pattern that occurs in 80,X, of maltreated inf associated with prenatal and/or postnatal (Espinosa ct al.. 2001). Hesse and Main (199 tion and disorientation is phenotypically si and Solomon (1936) conclude that Type D and that their disorganization and disorien

alarmed by the parent. Because infants i alarmecl, these authors assert that frighten

irresolvablc bind wherein they cannot appro tion, or flee. These infants are utterly unabl to actively cope with their frightening paren Main and Solomon detail the uniquely b Type D infants in the Strange Situation pr

brief (frequently only 10-30 s) but signif behavior. At such times, Type D infants may

pattern such as 'backing' towards the paren face. Main and Solomon (1986: I l7) note th

The impression in each case was that ap

ally being inhibited and held back thr avoiclant tendencies. In most cases, ficiently'over-rode' avoidance to perm ity. Thus, contradictory patterns were
inhibited.

Maltreated infants cxhibit apprehension, c state during the Strange Situation. Main a the child's entrance into a dissociated state:

One infant hunched her upper bod mother's call, then broke into extrava excited fbrward movemcnt. Her bray distress-face without a new intake o

forward. Then suddenly she became sil

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'fhcsc bclurvlois alc lloi l'cstrictccl io thc iliilnt's iirtct'ac'rions n'l ltoiiicr'. Irrcic;ci. tirc intcn:,i',1' oi tirc lleb1''s ci1'slcltiiilicci afl'cclir c .t olicu hci3hicncci u'hcir thc illl:r1 is o.irosccl io tirc uciciccl :,ti,:-.s iiliiiii.itilitil-i)Jisoit. Ai l: stirilrg"'r': ,';l'.r'.rirc... tu'o inilirls nroveci lI., ltV Lroili ll-roihet'ilncl s'r.r'ani:cr-1o iircc lirc iiali: uiroillct"lcitncci iil'chcati .l iire ri'lli 1b;' scvcl'ui scconcls. iooi.iiirg blicir in allirli'.lli icnor". I hc:c in crltibit 'bchaviol'ai stiiillg" thai is. 'cl:rzcri' ir..iravio;' ur.ii-l crcllcsst-ti bchuvioral ntanil-cstutions ot'ciissociililou. Onc iiriitnt 'irccllrrtt iiti' lt ltro crccssit,cly s'.i11. stuling inio :;oac"' a\ iirougir coiirirlcicll oiii oi-eoir:ltc scil-. cnviloiuncnt. ilnti paicni". Anoillci' sitou'eci 'a ciltz,--ii 1l:cilll ltrlitca ... uccolllltinlco b1'll siiliill: oi'lril 'bo<lf novt'ncnt^ iii.ici s,ol'tctit',tcs u ini: o1'linbs u'iricli i'racl becir in rnotion". Yci unoihcr''icii lacc-ciott'lt o 1'looi iu ir clclrrcsscci il():tiLlc 1-rliol itr srir::r'.rtio'r^ stiliinri lill bociy lttovci Gr-rcrtcircl'uncl I--cl'nlinian (200i)olicr an ulliLt-l ciisirc,ss sc:l1e tltitl tls thc siistainecl x,itircl'ar-,'iii that is u:sociatecl with ciisor!ri:nizecl attitcll 'l'iris u'itircilarval statc is crirr.essccl ir lloz:en" ubseut iitcirii c:'irr'.':siort In'oicianc.' ol'c1'c- coutaci. iininobiiiil,. abscrrcc oi'r'ocaiiziitiot-r. iiltsct l'clutirrli io ctiicr',.. lind tirc implcssiou iirai thc chiicl is itlt1'onci lcacit. Dissociation in iiriirnts hus ulso becr.r stuciieci u'ith ihc Stiii-l:acc ltiocc ait c\ltcf ilncitlul palucligur oi-1r'iiumatic ncgiecl. Iir tiris 1-rt'occciiit'c. liic is criro:;ccl 1o a scvcrc rclitiiollitl sii'c:;sot': ihc tloihcr n'iaitttliil.t: c]'c co ri'iih ihc initini^'irr.ri,ihe silclclcllf inhibits ull vocalizli'riott auci susitct cmoiionaliy cxltlcssivc f acial cxprc:sioirs ai.t<l iresturcs. tr'iris sevcic iniri ol nortr'ei'itiil cornmi.u.rication anci iulcl'uctivc afteci icgirluiiotr tl'i!tgt ir.iiiiui incr'..asc o1- inlcluctir'e bchll'iol lir.rci ulotrsll ilr ihc ilfuitt. ,,\cco to-il'oiticl; (200,i). tire iiilirni's contuslor.i iiurl iiitriiilncss rtl lltc bic conuectic'xi is accortrilrnicri b1'tirc itica tllat'ihis is iiilca'.cling^. i'iiis li iir'ien-silicuiioir is ullin'urteiy 1'olloi','cc1 bi' bodii;, co11lii'l-.c. ioss oi- iro coniiol. r.,'i'rirci-iau,ai. rriizc livL'rsiol" sac! iircial elprcssiol. linti :;t11'-.ccti'.
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lcllcct 'clisorqunizaiiorr of iiranl' o1- ihe lorvct' 1n'cl ns;'cirobioiogical sricir as nciiibolic s),stcrrs'. l{cciiil that ciissociution. li ii5'ltol.t.tctabolic irirs irccr.r ciciinccl in thc Amcr'icun Psychilltlic As;ociiition^s .1)ragrio,st Stt lIslitttl ,l'luirtrul as 'ii ciist'uDtioir. irt tiic tisitall,r' irttcgl'atctl lirnctio cctr.rsciot-rsncss' anci ricscl'iireri as "il iriotcctivc aciii.'itiion oi-aiieicel sta coirsciotisncss in icaction to ovcl'rvirclr"iriuri 1'rs1'clloiogiclii initil.)iil" ([-o sicir" i99(r). llonicil (200.i) sugllcsts tha'L influrts tvlto nll'c .l iris'ro ciir"onic bi,--alis oi' eonlicctions !-xiribit ur-i 'crtt'ctircly i-iliiiroiogtcltl sla cllotiolal apuiliy. I.trc ecluutcs this siute li'rth Spitz's collcci)l ol'liosltit anci I{or.nanilii.r ctlirliaus ri'lio liiii to srtxi arrrl clcvciotl. Stich iniituls r-ri1 il aclopi a ct'rr.nrrtuiricution stylc oi'"stay rnvit1,. clon'i conncct". l-hi: cLstaltcc is u vcly r'aiiv-ir.riiriil'rg" yct alrcacil,chi'oiiic. nrthoiogical clis:ttc

in a hunting posture; exposure of canine tooth a growls directed at infant'. Thus, during the tra with an aggressive expression on the mother's fa sive face and the associated alterations in the in ibly imprinted into limbic circuits. Main and Solomon (1986) document that Typ a second kind of disturbing maternal behavio fear terror. This occurs when the mother wit though the infant were frightening. Indeed, studi Type D infants exhibits dissociated, trancelike, a

research underscores a link between frightening ation, and disorganized inlant attachment (Schu work, Hesse and Main (2006: 320) observe tha dissociative state, a fear alarm state is triggered i entrance into the dissociative state is expresse

pletely "freezes" with eyes unmoving, half-lidded parent addresses infant in an "altered" tone wit devoicing'. In describing the mother as she sub note (321):

Here the parent appears to have become c or even [un]aware of, the external surround verbal behavior of their infant . . . we o remained seated in an immobilized and unco hand in the air, blankly staring into space fo

In an early history of traumatic attachment the too frequently exposed to a massively misattun triggers and does not repair long-lasting intens

growth-inhibiting environment of relational traum

longed levels of negative affect associated with hyperarousal and hypoarousal. And so for self-pr restricts its overt expressions of an attachment The child thus significantly reduces the out emotion-processing, limbic-autonomic attachm stressed, defensive functions are rapidly initiated

Ncurobiology oi attachm ncc

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onlinc lbr longi iutcrvals oltimc. pcliods in rvhicli thc det'clopirtg brairl hypornctabolic statc. detrimcntal to tlic suirstat.rtiiil aii-iottttts of rcquirccl lbl clitical pcliocl biosytttirctic l)roccss!-s. I)uring thcse cltisodc-s. tltc inlant is uratcliiug tlie rltf ilimic structit ihc molhcr's dyslcgulatcd statcs. ancl tltis s1'ncht'onizaiion is rcllistil tiic fir:ing pattcrl-rs o1' tire stless-sci.rsiiivr: coltical aitd liirrbic icltiotrs intrlt^s blair.r. csltecialll' rn thc nght bi'ain ivhiclt is in rt critical itcli groivth. lntants dcsigttatcci iis '\'cf)' fearl'u1' ai scvcll moulils shorv IRPs ovcr thc right hcmisitirelc u'hcn vio.,'ir.tg i'carlLri fitcial critics (Dc IIaan ct a1..2004). An EIrG stucly ot'iivc-montli-c'rld inlirnts ob iircrcascd tlicta activity ovcl thc light postcrior tcurporal alell rvliiic tlt looking at a biank t'acc (Bazhcnova ct ai.. 2007). It is uou'cstablish.-ci that nraternal carc infltienccs both thc inf lrnt^s t' ity (Mcnald ct al.. 2004) ancl the ililant's dcl-cnsivc responscs to tlrrcat ( ct a1..2005).'I'hcsc ci)'arlic proccsscs'scrvc a:' tlic basis for tirc transtniss inclividual clillcrcnccs in strcss rcspouscs li'olir mothcr to olfslli'irtg' (W ct ai.^ 2004: ii47). Ilccausc mally mothcls suflcr liour Lurrcsolr,scl tt'ar.rma chaotic anci dysrcgulatccl altcrations ol stiltc bccollrc impriniccl ir cicveloping braitt ancl scl1'-systetl o1-thc child. I-ltis iutetsubicctivc p plthogcnetic r.ncclianism thns rlccliates thc psychobioiogical intcrg tional it'ansrrission ol both lclational trailtnir ancl thc clissocialivc d asainst overrvhclrning and ciysrcgtriatitlg all-cctivc statcs. In accorc this nodcl. rcsciirch nou' inclicatcs i.hat scvct'c cat'1y tnatcltial clyslt is associatccl ivith high tlissociatiou iti psyciriatric paticuts (Dra I-a1gcl1nc1. 1999)" anci that ph;'sical abusc alcl paicirtltl ci1'slituct tire part cli' thc rlotircr not thc llither is associiited rviili sotrta dissociativc syurl-rtotls (Roe1oli ct ai." 2002). Irrom a cievclopmcntal psychology vicivpoint. tilc prolbund llegitti\ chological cti:ct of rclational tLatttna (carly abusc atlci neglcct) is tirc irtion of' a disorgauizt:ci disoliciltcil attachr,icnt that cudttres ov latcr stagrcs ol chilclhoocl. acioicsc,-'ucc atcl adultltood. ancl acts as

ldlel is
:r'ri4ro :s. 'I'hc
rcl

prorlcs o1'
lation.

:r'eici1,
Lalizccl

onc

is

: brain

fi:ctor ior latcr psychiatric disordcr:s (Schorc.200i.2002.2003a). F cleyelopmcr.rtal ncuroscicnce pcrspcclivc. tire imr.nccliatc delriurciltai itn oir thc altcleci n-rctabolic proccsscs tirat noolly sustain critical pcliod ol thc clcvcloping right blain. anci tirc lusting irnpailrlcnt is an immatr.t lunctionally lirnitecl right-brain capacii)' to rcgriiatc latcr iil-'^ strcsstl gcncratc intensc all'cct siates. Rclational trautnrtlic L'\p!-l'icnces at'c sto imagistic proccclr,rral lncmory of ihe visuospatiai rigirt hcmisphcrc (S ct a1.. 1995). the locr-rs of'irnplicit (Ilu.gciairl. 1995) and ar-rtobiogla 'l'ltcsc psychological and biologic (Marliorvitsch ct al.. 2000) ircmory. spcctiv!-s cou!cIgc on a basic dcvclgDmcntal u'irlciplc of'rcgulation th that carly trautnatic sunclcrinli of attachu-rcnt trotrcls is critical to tlic-

Neuropsychoanalytic authors now conte dominant experiences of separation. dist go dorvn a bad pathogenic development psychological pathway but a bad neurol Current workers in the field of developm the overwhelming strcss of maltreatmen adverse influences on not just behavior, bu et a1.. 1999), espccially the right brain w negative affects (Davidson et al., 1990 ernotion-related processes' (Sullivan & Du tial survival lunctions of this lateralized s

The right hemisphere operates a distr ing to dangcr and other urgent pro environmental challenge. stress and responses such as avoidance and esc

brain's 'red phone,' cornpclling the without delay.

In states of pathological dissociation the r The right brain is fundamentally involved ism for coping with emotional stress. inc of dissociation. Thcsc adaptive right brain

of early relational trauma. A large bo

and neurological studies supports the lin pathological dissociation (e.g.. Dikel et a Merckelbach & Muris.2001; Macfie et al.

Recent neurobiological data can also psychopathogcnctic mechanism by wh impacts right brain development. Adam experimental data that 'implicate neuropl circuitry in mediating long-lasting change but severe stress'. According to Gadea negative affective experiences activate th experience 'might interfere with right he

damage

if

some critical point

is reac

Ncurobiolcgy of attachment
IO-

0t-

irh
r'ili
,ilCl

9).

rat

hyoclalor-rsal-inciuccci alloptoiic ccli clcatii ir-r thc li1'pct'titciaboiic i'igirt blai 'firu-.^ via u switcir in.io li irypoaroi-l-qai. a h1'potnciaboiic stilic aliorvs tbr c sLilvival at titnes of intensc crcitotoric sti'cs:j (Scliol'c. 200 l.2002). I{ccali tliat light coilical arcas anri thcil cot.incctiot.ts rvi'iir light sribcortic iitLrictrlrcs arc itr ir, clitical pclioci oi'giorvtir cluritrs cartrf i'ir-ular.r clcl'clopmctr 'i'irc ir-nssivc ltsycirobioiogicirl sii'css as-sociatctl n'itli attaclmcrlt trliLli ir.ppails thc cicvcioltrncnt of'this systcnr. iinci scis thc stagt ibl thc clttirltctcr iglticai usc o1' r'ighi-blain itatirologicnl ciissociaiion u'hctl encortt.ticrirlg lat sl1'cssoi's. C'onvcrg:ing o'iclcncc iiiciiclLLc: ihat elir'ly abtise ncgatir'cif illlpitc liilbic systcm rnrt'irrratior.r. ploilucingi cncluliug ncut'obitllo-sical alt.-r'tti.o ihlt gi.rcicrlic ail'cctir'c instability. incliicicnt stt'css tolcraucc. lllL'mo implili.ircr.rt. ulcl clissociativc ciistuibances. Itt titis tnlttrttet'. tt'alttlaiic stt't-ss cirilcliroocl icacls to sc11',r.noclulation of paurlui ali'cct by ciii'cctirlg lLttcrltio

ith
ili
s

intcrtrai r-inotiontll staics (Llttlc ct al.. 199'/). Iirc righi bra ciominant ibr attcr-rtiolt (l{a2.2004) and ilaiti 1-rt'occssin-u (Synioncls ct a lil'a1'
11'ot.n

it ir

nci

2006) thLis gencl'atcs riissocitition. u clciinsc b1'u,hich ilttensc ncgativc all-c associiitccl r','ith cn.rotional pliin a|c blocliecl il'oi.t-i etlit:e ioUsllcss. Col.rgt'itcui u'itli this cicr,clopl"r.rcirtai uocici. Spitzcr ci lii. rci.rot't a iral cilinial i.nagnclic stimLtiirtiorL stucil' o1'uclulis anci cc'rttcl,-tclt-, 'lti ciiss,rc:irrlio

rclscs

ir'c

lhr
cfs

luci.
,111-

'lcs

:,

li trarilna that is pei'ccivcd lttlci pt-c.rc.-sseci b1' the lig q,iil lcacl to a 'clisintrtion in tltc '.rstritlh' iiiiL-grated lttnctions |cltisphclc co!t\eioy:ltc::'(lOt)i: i6S; Irr itrnctior;rrl nlitr-Illjtie les()ilirllcr irrrltgi rcsculch" Lalius ct a1. (2005) shorv lrlcdominiintiy rigirt hcrlisplicl'ie ac vaiiou in ps1'chiatric paticnis tvhiic thcl' alc ciissociittin-u^ aitcl conch.rdc ih clissociar,ioi.r. rrlt cscapc ll'om thc o"'elr',,hcitniug cluor.ioiis a-.sociatcci li'ith iraul1a1ic ilellor)/. catt bc itrtcrpictccl as rcprciclltiilg a nollycrbal lcspor. to thc tlar,rmlilic t"itcutot'1'. Ill tire ciinicrl litclaiut'c. Ih'onbcrg (2006) lin rigirt-biain iiaLtuta to lttitottonric hypct'arousai^ 'a chaotic ancl tclril,vi lloodiltg of'aliect tltzil- caii iittcaterl to ovcru'liciln sanity ailcl impct'il psych logicul sr,rrvit'ai'. Dissociutioir is tirct-i altioiliiticalll'aitcl inmcciiat -io iirc itt ons:r1 d1'sl'cgulaiicltl tliggclccl us thc lirnciai"ncltal clclcnsc
pl'rxtc incliviciLtals"

.,!
Lncl

04:

iirc
'cl)'
o11

bic 'icf'
'ate nsc
rual
r

ovcru'hcintiug: a l'icct ivc statcs. IJoiit icscuiclie rs anci cliniciiins arc no\\' r'xploring tl-rc cvoiutiot-l of a clo opn-rcntaliy iltpai-,'ccl rcg'.rlzrtor'1's1'stcn't llitcl providc';r'iclctlce thiit plcli'on cortical anci iin-rbic ar"cas o1'tirc ligirt ircrnisphclc at'c ccntiitllf invoiveci itt cicljcits ii"r lirincl and bodl'associiiicci u'ith a patirological cii:sociativc rcspon (Sciro1u..2002^ 2009a.2-009b. in 1-ricss).'I'iris ltcmislthct'c. urotc than thc icli clcnsciy lcciplccally inici'connccteti rvi'iir L'inotiolr-processing lirnbic l.csio as rvcii us rvirh subcoltical arcas lhat l'cncraic botit tlic at'ortsai atlcl au nomic boclily-basccl aspccts ol cn'rotions. I{ccall. SNS aclivit)' is illanifts

llt

tigfit cngilgcll.rcr.rt rvith thc crtelnai cil'iioument ar"rc1 a high l*,cl ol cilc ruobiiizaiiou^ ri'hilc thc itallisyrnpu'.hctic conllloltcitt c1t'ivcs cliscngallcnr fl'oin thc extclrrai environu.ict'rt ancl utilizcs !ou' lcvcls of iiitct'uai cllcl' -i'ilc:;c ANS componetis ut'c r.rncor-rirlcci iirl iong pctiotis oi'time iu stlcss

components of

operations of defensive in the hoc traumatic expe'encc ;;;i;lRn^ttt tn"'"uy un un onJ oonding images in tht'tinJ ,r.ru, 'som

t'notio'ili 'i"-'"t-tstriore' 1994 dissociative processes

tbliterated,. Nijenhui"s ?ffi.; outcome of early or"o i'uu-atization

sensorimoto,

;r;;,,

t*p^'*J

representatiot. Di";;;;;i"^ttt-;;dta rrom the .nulron*tn'l;;;;i'"-r; 11 '3ii This ot ra.nt,tyi,iit.n'"i ur , r999ttheir sense .coli'or".;i;;ii

.^p"ri.l..;, ;ii;;;,

ana'frrr,"ti

nii"iJ

to."intr.y right hemispt,eric 'a dissocratronlt'*ttn rhe emotional describe with the ohvsiologicat ,"u"ti#^tlo'itui-"u.n,, iniol, tigit hemisphere lunction" inter In a numbe, "f *;;k;^i-r1uu. or.r.o -U" pttt'a's system implicit selt, equated *lti'' tuU*
(Schore, 1gg4,200.3;,ZOoll Thg.lSwer
(the deep

.tn"on'"toJ"i"o"tuin all the major uggr.rrro',,.etc.) a attachment, r.ur, ,.i*iiiy, intensities o nomic expressions "r;^"""rr"r le other hand. high";';;i;iror.,*r-ri-uic
state tlrat senerate a conscious emotional system' lateralized niera'ct'ical prefrontal

t^

ihesemotivationalsystems.Inanopttmalai the

tial adaptive nlrti"uillriJi,rn.tion to changes in bodily based states;;;;""" to be.p.ersonall are nonconsciously upp'oit"a elicits more In contrast, '"rutillt'uiiiuuma overt b cognition and a. Oil"'g""i"tion .of

trr. t.iut

brain-surv the early o'run"uiiJ'i oilignt uiu"n""' raiho beneath levels of t"""i*t tfott in a maladaptive highly defensive 'igla' ,ir.t

to

to* t.u"tr'oi intersubjectiu. parasvmpatieiic ;;;;;;;;;!1.1"" vagal disengagement' This fragite

even stress-induced

#;i;?f

""ton'"io"'!.tv metabolic :;i6

Ncurobiology of attachment
r'ho

diil'
.ivc

lcrlnu thc tral

bes

cnergl'-clcpcnclcnt synaptic conucctivity rvithin thc right brain. erprcsscd i sr-rcidcr.r irnpiosior.r ol thc in-rplicit scll and a rupiulc o1' sclf-continuity. 'l collapsc o1'thc implicrt sclf is -.ignalccl by the ampiiflcation ol the ltaritsyrnp thetic aficcts of' sharrc ancl disgust. ancl by tlic cognitions ol' hopclcssnc ilnd ltclplcssucss. Bccaltsc thc light hcrnisplic-r'c incciiates tho cornn'runicati ancl rcgr.ilatiot.t oicutoiioiral siatr-s. thc ruirttilc of intcrsuLrjcctivity is acco ilir-ricr1 by an instant dissiltaiior-r o1'sai'ct1, uncl tiust.

I)issociatiou thus icllccts thc inability

of iirc i'ight bliiin

cortica

ing
:cs-

lis
an

of'

:ll'tccl
ltLl

subcoitical intplicit sclf s1'51g111 io adaptivcly rcco-rnizc rincl ploccss extcr stirrruli (crtcrocclttivc infbrrratiou coning Il-out tirc rclational cnvilonrlc iiud ot't a lrlolrcltt*to-11-lomcl.]t basis intcgratc tircrr rvith inlcrnill stim (inteloccptivc inforn.ration fl'oi.i-r thc bod;,. somlir,ic uralkcls^ thc 'tclt expc cncc'). I'his lailurc ol itttcgratioir of thc highcr right hcmisphcrc rvitir t lolet' r'ight bt'ain inch-iccs an instant collalrsc ol both subjcctivity anci int sr-rbjcctivtty. Stiesshtl allccts. cspccially thosc associatccl rvith ernotion paitt. arc thlrs not cxpcricnccci in cousciousncss. l)issociatcd affcct is th

lltu'

aiicl

l0)
.hc

itttcot'tsciotts allcct. clcsct'ibccl by l;r'ei-rd: 'Unconscious ideas cclntinuc tcl cx rcprcssion as actual structriles ir.r thc systcrn Lc'1. rvirclcas all th

on
hc

rin rin
lu!I

.ohc )rc

oi
ht nLa1

at
us
)ts

atiachl.t-tcIlt clisorcler of inliurts and pcdiatric maltreatntr-nt clisordcr. b aiso dissociutivc idcntity clisordcr, posttnnu.natic stlcss disorder. psycho clisortlcls. e'ating ciisoldcrs. substiir.rcc abusc and alcohoiism. sontatolor disorders auci socioltathic uncl bordcllinc pcrsonality disordcr.s. Ps;,cirothcrapy ll,ith sucir patietris ncccls to littcnd to tlorc thau t signiiicar-rt clysrcguiatiou of allcct that chalactc-ri;ucs thcsc s*,crc sclf irat ologics. It tlltst also acldrcss the carly lbi'miug clcfcnsc that blclcks tlic

coircspotlcls itr that s)'slcnl to t-rtrcouscior"rs allects is a ltotcntial bcginn lvhicli is pr*'entecl 1r'orn clcr.'clopin-s' (1915: 178). ,/\t ali poinls <t1'thc lil-cspan. although clissocilition rcprL'sct.rts un clllcti sitorL-tct't.t-l strate g1," ii is detrincntal to iong-tclrl functioning. spccilicaiiy ptcvcntin!: cxposurc to potcntial ligirt-brain sociocrnotional attachme objcct lcarning cxpcricnccs cmbcddccl iu intirlaic inicrsubjcctivc contcx that arc ncccssal')/ lbl cmotional glorvth. 'rlie cndpoint of clrloirically cxpc ct.tcir.tg catastrophic statcs o1-rclational iritLrna in car:ly lifc is a progrcssir iupairlnctrt of thc ability to acijust. taiic clcl-cnsivc action. or oct on oirc's ow bcltalf" ancl a blockingi o1'lhc capacit;'to rcgistcl ulicct ancl irain. a1l criiical sut'viva1. Clinical rcscarcli sirou's palhological dissociation. a priuritii clef'cnsc auainst ol'cllr'ircin.rirrg allccts. is a Lcy 1'calure ol not only lcacti

tc
ST

Js

al

al
r1'

ovclrvhclmirrg a{Tccts from rcacliins consciousncss. thclcby dcnying t possibility ol intct'activc rcgulation anci lhc organizatior.r ol rlorc compl lighi-blain stl'css rc-cLrlation. Ilrombcrg (2006) obscrvcs tliat in tiic clinic cncoLlutcr pathological clissociation acts lis an 'caily rvalnir.r-9 system" th articipatcs potcntiai alicct ciyslceLrlation bclorc thc traurna alrivcs. 'l currenl paracligm shilt from cognition to aiiect also inch;dcs a shift lro t'cpt'essiott to tlic sitt'vivai stt'atcgy of'clissociation as thc n-rajol mcchar.ristrl

clement boncling protein expression induce

stress: Its rclationship to the stress cx plasticity. Progres.r in Neuro-P,sycltophur

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ir!curobioiogy of attac ciopmcut oi

lin importuiti
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Relational Trauma in Infancy

Psychoanalytico attae hnrent and neu nopsyehoiogiea! contri butions to panent*i nfant psych oth erapy

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