Attachment and Internal Regulation
We know that early bonding experiences strengthen networks of the social brain, and that these experiences also promote building of the brain as a whole by stimulating metabolic arousal. These face to face interactions trigger the sympathetic nervous system and increase oxygen consumption and energy metabolism in children. This then increases production of norepinephrine, endorphins, and dopamine enhancing the child’s pleasure during positive connection (Bretherton, 1992). Furthermore, these experiences enhance formation of biochemical environment in the brain conducive to regulation, growth, and optimal immunological functioning—it is optimal balance between sympathetic and parasympathetic arousal (Cozolino, 2010).
Insecure attachment, on the other hand, has been correlated with disconnections among streams of processing within the brain. This psychological vulnerability is due in part to an alteration of the brain’s neuroendocrine response to stress (Siegal, 2001). Children who are mistreated, abandoned, neglected, or even abused have brains that become shaped in ways that do not support long term survival. These children “grow to have thoughts, states of mind, emotions, and immunological functioning they are inconsistent with wellbeing, successful procreation, and long-term survival” (Cozolino, 2010, p. 206). In particular, these children are prone to increased neuronal death; impairment in the ability to learn; an increased anxiety, fearfulness, and stress response; greater vulnerability to addiction; avoidance of novelty and exploratory behavior; reduced gene expression; greater cortisol secretion in response to mild stress (decreased cortisol receptors in hippocampus); reduced GABA receptors (inhibitory receptors associated with a reduction in anxiety); right-biased frontal activation that is correlated with higher stress and arousal (Cozolino, 2010); and run a greater risk of expressing interpersonal violence as they mature (Lyons-Ruth, Alpern, Repacholi, 1993; Lyons-Ruth & Jacobwitz, 1999; as cited in Siegal, 2001).
Genetic Expression
Genetic information influences how neurons are connected early in childhood, and it postulated that these early encounters can shape specific gene expression; specifically, secure attachments have been linked to the genes responsible for the creation new synaptic connections (Cozolino, 2010), and the proteins necessary to shape the structure of the brain (Kandel, 1998; Nelson & Bloom, 1997; as cited in Siegal, 2001). This same attachment is also associated with in inhibition the expression of those genes responsible for emotional and behavior disorders (Cozolino, 2010). It has also been discovered that insecure attachment, which is linked to the expression of specific genetic information and stressful or absent experiences, can lead to the elimination of synapses or excessive synaptic pruning (Siegal, 2001).
Attunement, Contingent Communication, and the Co-construction of Narratives
When children have early experiences with primary caregivers that consist of interactions that are collaborative and attuned, this establishes patterns of interactions by which the caregiver can regulate the child’s positive and negative emotional states (Siegal & Hartzell, 2003). In these securely attached relationships the caregiver engages the child in effective dialogue that helps create meaning and interpret the world at large. Siegal (2001) proposes that this reflective, meaning making dialogue integrates right and left hemisphere of the brain in both caregiver and child. Fundamentally, the infant’s brain is “feel felt” by the caregiver. “The contingent, collaborative communication of secure attachments produces a coherence
within the here-and-now core self as well as in the past-present-future integrating autobiographical self” (Siegal, 2001, p.86). This bilateral integration promotes a cooperative functioning between the left and right brain. In other words, the part that searches for cause–effect relationships in a linear, logical way, assimilates with the part of the brain which mediates autonoetic consciousness and the retrieval of autobiographical memory (Siegal, 2001).
Coherant Narratives
Siegal and Hartzell (2003) define a coherent narrative as a means for a person to make sense of their life experiences. Creation and repetition of stories help children develop and practice recall abilities and have their memories shapes in relationships. These narratives consequently become the parameters of children’s personal and social identities. Distinctively, it is a medium through which the child’s brain is able to integrate the various aspects of its experience in a coherent manner. This narrative materializes from an amalgamation of left and right modes of processing and is created through parent-child talk. A secure attachment, in context of attunement, is grounds for co-construction of narratives—parents narratives become the blueprint for the child’s narratives and for the organization and integration of their neural circuitry (Siegal & Hartzell, 2003). A coherent narrative is essential as it reflect the mind’s ability to integrate its processes across time and across the representational processes of both hemispheres (Siegal, 2001).
Attachment and the Therapeutic Relationship
Research tells us that when adults are in lasting committed relationships that they live longer, happier, and healthier lives (Diamond and Hicks 2004); without close relationships individuals are more susceptible to psychological and physiological distress, including injury, disease, substance abuse, depression and suicide (Gilbert 2001; as cited in Sable, 2008). As a therapist, it is constructive to look at those individuals who are coming to counseling and whose interpersonal conflicts are framed by insecure attachments. These adults are the product of interactions plagued by inconsistencies, abandonment, and maltreatment. Using the lens of attachment, the therapeutic relationship can be seen as a means to foster secure attachments.
Low-Road vs. High Road
Insecure attached clients are those who are subject to being conditioned to innately fear intimacy in some capacity. It can be hypothesized that through the mechanism of the implicit memory system, when faced with particular situations or people, that there is an activation of that individual’s maladaptive attachment schema. The result is a fear response. This low-mode processing involves shutting down of the higher processes of the mind specifically linked with the prefrontal cortex. These individuals are always in a state of intense emotions, impulsive reactions, rigid and repetitive responses, and lacking self-reflection and the consideration of others points of view (Siegal & Hartzell, 2003). Cozolino (2010) notes that such individuals often act in such a way that utilizes what he calls a fast-fear circuit. When habitually conditioned to use this particular circuit, the client’s internal system tends to take information directly from sense organs, communicating the sensory data to the thalamus, and then to the amygdala; thus, translating the information into bodily responses via autonomic nervous system. When the amygdala is over-stimulated and high levels of cortisol are present, there is a disconnection with ompfc and integrative prefrontal processes temporarily shut down; thus, the client acts without thinking or ‘flips their lid.’
Ideally, therapy would help the client utilize linguistic structures of what Cozolino (2010) calls the slow circuit to inhibit dysfunction reflexes and emotional appraisal of the fast circuit. When this particular circuit is engaged, the sensory information is sent to the hippocampus and cortex for further evaluation where it is compared to explicit memories—the person then decides how to proceed. It has been postulated that relaxation, enhanced awareness, and exposure “all augment regulatory input of slow corticol circuits by building new neural connections and increases the ability of cortex to inhibit the amygdala” (Cozolino, 2010, p.243-244).
Therapy as Re-Parenting
Research tells us that secure attachment can indeed change over time due to extensive stress or traumatic events. However, it is has been found to be more resistant to change than insecure attachment. That being said, insecure attachment can be modified as a result of positive social input such as constructive personal relationships, psychotherapy and increased self-awareness (Pilowsky et al., 2008; as cited in Cozolino, 2010).
Cozolino (2010) suggests that the therapist can act as a guide to a secure attachment relationship to assist the client with modulating their sense of homeostasis, increase flexible affect regulation, and repair insecure attachment schemas. The question is how can we best do this in the therapeutic relationship? Siegal (2001) outlines the basic secure relationship involves collaborative communication, reflective dialogue, interactive repair, coherent narrativization, and emotional communication. The therapist can essentially act as secure parent providing these five elements to the client. First, the therapist must engage in collaborative, contingent communication so the client feels seen. The therapist must be attuned to the client’s verbal and non-verbal signals and responds sensitively, accurately, and accordingly. Second, there must be a level of discourse conducive to a level of verbal sharing that focuses on the internal experience of each person in the dyad. This is somewhat limited as a therapist, but nonetheless the therapist can engage in the limited sense. As an attachment the therapist recognizes the signals sent by the client, attempts to make sense of them in their own mind, and then communicates to the client in such a manner that creates “meaning” for them. Third, when there is a rupture in the therapeutic relationship a healthy repair must be made. If these misunderstandings and missed connections can be identified and connection can be created again the client as an opportunity to “make sense of these painful disconnections and create a sense of meaning out of the understanding of one’s own and another’s mind” (Siegal, 2001, p. 79). Fourth, the therapist must provide a context for the client to re-construct an accurate personal narrative. “This connection of the past, present, and future is one of the central processes of the mind in the creation of the autobiographical form of self-awareness” (Siegal, 2001, p. 79). Ideally, this process act will build the platform for bilateral integration. Lastly, the therapist serves as sounding board for emotional communication. Whether it is sharing in the client’s joy or helping the client sit with their uncomfortable emotions, the ultimate goal is for the therapist to remain connected to the clien
Bowlby (1988) offers an additional therapeutic framework. He states that in order for therapy to serve as a medium to repair maladaptive attachment schemas the therapist must first provide the client with a secure base to explore painful and unhappy aspects of his or her life.
The therapist then assists the client in exploring by encouraging him or her to consider the different ways in which he engages in relationships with significant figures. Specifically, what his/ her expectations are for his/her own feelings and behaviors, those of other people, and what unconscious biases he may be bringing in when he selects a person to have an intimate relationship with. The therapist and client subsequently investigate the relationship between the two of them and explore these expectations and constructions within the context of the therapeutic relationship. The client is encouraged to consider how perceptions and expectations (and the consequent actions and feelings that arise) may be the product of events or situations during childhood, especially those with primary caregivers. Lastly, the therapist facilitates recognition that these models of the self and others may or may not be appropriate to his/her present and future; or may never have been justified. The therapist helps the client see old images for what they are. Ultimately the client would then “cease being a slave to old and unconscious stereotypes and to feel, to think and to act in new ways” (Bowlby, 1988, p.139).
Conclusions
Through the research conducted in the field of interpersonal neurobiology we know attachment is a fundamental neurological principle that affects all people. It guides, motivates and shapes much of our behaviors, emotions, thoughts, and interpretations of the world around us. Neurological attachment system is a complicated and complex system that involves several brain structures including but not limited to the ompfc, amygdyla, insula, anterior cingulate, prefrontal cortex, hippocampus, hypothalamus, and vagus nerve. These “early attachment patterns may become generalized and self-perpetuating because of their impact on our neurobiology, our ability to regulate our emotions, and the expectations we have on ourselves, others, and the world . . . attachment experiences (can) shape our brains in ways that make the past a model for creating the future” (Cozolino, 2010, p.333). The research tells us that these schemas have a propensity to prevail across the lifespan; however, we now know that due to the capability of the brain to retain plasticity over the lifetime that these attachment schemas do have the capacity to be altered.
The brain’s remarkable plasticity in the early stages of development sets a lifelong template for thoughts, feelings, and behaviors. Moreover, because the brain retains some of its flexibility, nonverbal communication preserves the capacity to transform across the lifespan. Studies with people over age ninety show us images of mature brains that continue to produce new neural pathways at a time when older pathways are dying. (Nickerson, 2010, p.4).
The innovative research surrounding INPB is exceedingly useful for those in the business of change. Through our therapeutic work we can offer a stimulating opportunity for clients to restructure these schemas. This provides a stage for new corrective emotional experiences, and allows the clients an opportunity to process stressful or traumatic life events/relationships, while subsequently developing more secure attachment, flexible affect regulation, and increased capacity for neural integration and personal growth.
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