SCHORE AND ATTACHMENT

“…the affective experiences in the caregiver-infant relationship are very different in securely and insecurely attached dyads.  (Schore/ad/26)”

++++

“…the amygdala, anterior cingulated, and insula limbic structures play a role in preattachment experiences that begin early in the first year…. (Schore/ad/200)”

++++

EARNED SECURE

“Psychoneurobiological research of the continuing experience-dependent maturation of the right hemisphere could elucidate the underlying mechanisms by which certain attachment patterns can change from “insecurity” to “earned security”….  (Schore/ad/69)”

MOTHERS OF SECURELY ATTACHED INFANTS:

++  permits access to child who seeks proximity at reunion (for “practicing” older infants)

++  shows a tendency to respond appropriately and promptly to infant’s emotional expressions

++ Is psychobiologically attuned so can maintain “the child’s arousal within a moderate range that is high enough to maintain interactions (by stimulating the child up out of low arousal states) but not too intense as to cause distress and avoidance (by modulating high arousal states.  This entails her actively initiating and participating in not only mirroring-refueling (arousal amplifying) and shame socializing (arousal braking) transactions, but also in interactive repair (optimal arousal recovering) transactions after attachment breaks.  Optimal arousal refers to the maintenance of autonomic balance between sympathetic ergotrophic and parasympathetic trophotropic states of arousal.  It is known that moderate levels of arousal (within the optimal activation band) are associated with positive affect and focused attention, while extreme levels of arousal (high or low) are related to negative emotion and distracted attention.  (Schore/ad/26)”

MOTHERS OF INSECURELY ATTACHED INFANTS:

++ is inaccessible for reunions

++ reacts to her infant’s expressions of emotions and stress inappropriately and/or rejectingly

++ shows “minimal or unpredictable participation in the various types of arousal-modulating, affect-regulating processes.  (Schore/ad/26)”

THE DEVELOPMENTAL NEUROBIOLOGY OF INSECURE-AVOIDANT ATTACHMENTS

++  “The mother of an insecure-avoidant infant exhibits very low levels of affect expression, and presents a maternal pattern of interaction manifested in withdrawal, hesitancy, and reluctance to organize the infant’s attention or behavior.  This caregiver typically experiences contact and interaction with her baby to be aversive and actively blocks access to proximity-seeking (attachment) behavior.  (Schore/ad/27)”

“This caregiver, when she rebuffs her infant, represents an assault from his haven of safety, and further, due to her aversion to physical contact, will not permit access to help him modulate environmentally induced stress, nor the painful emotions aroused by her behavior.  Infant-initiated contacts thus elicit not empathic care but parental aversion….(Schore/ad/27)”

“With respect to the other member of the dyad, the insecure-avoidant toddler shows no interest in an adult who is attempting to attract his attention, and exhibits little motivation to maintain contact.  This infant characteristically does not appear distressed by the mother’s departure nor happy at her return; at reunion the child does not express distress or anger openly.  However, there is evidence that it does experience anger during reunion episodes.  The insecure avoidant infant, unlike the securely attached infant, does not stop experiencing anger once reunited with the mother, but unlike the insecure-resistant child, does stop expressing it.  This suppressed anger may represent a muffled protest response accompanying the infant’s frustrated proximity need as he/she encounters the irritation, resentment, and sometimes outright anger and subsequent active blockade of the contact-aversive mother.  In return, he actively avoids the mother, or in her presence ignores her by extensive use of gaze aversion, rather than seeking comfort from the interaction.  That this avoidance reflects an expectation of an unsatisfying and rejecting dyadic contact.  Reunited with the mother he actively turns away, looks away, and seems deaf and blind to her efforts to establish communication….(Schore/ad/27)”

gaze aversion is a big part of these dynamics

“…Stadtman interpreted avoidance as a mechanism to “modulate the painful and vacillating emotion aroused by the historically rejecting mother” (1981, p.293).  (Schore/ad/28)”

Infant experiences “a state of conservation-withdrawal (Bowlby’s despair), a primary regulatory process for organismic homeostasis (Powles, 1992).  The infant thus develops a bias toward this parasympathetic-dominant state, one characterized by heart rate deceleration, helplessness, and low levels of activity….the right frontal region is specifically activated during withdrawal-related negative affective states….(Schore/ad/28)”

“This temperamental disposition could become permanent via a critical period of selective pruning of sympathetic ventral tegmental, and expansion of parasympathetic lateral tegmental innervation of orbitofrontal systems…..the insecure-avoidant infant has a relatively high level of parasympathetic tone.  Its autonomic balance is parasympathetically dominated and geared to respond maximally to low levels of socioemotional stimulation.  Psychophysiologically, the overcontrolled and restrained nature of insecure-avoidant typologies reflects a vagotonic pattern…and a parasympathetically biased, inhibitory, orbitofrontal affective core that has a problem shiting [sic] out of parasympathetic trophotropic, low arousal states and in modulating sympathetic, ergotropic high-arousal states.  This personality organization shows a pattern of “minimizing emotion expression”, a limited capacity to experience intense negative or possible affect, and is susceptible to overregulation disturbances and to overcontrolled…, internalizing…developmental psychopathologies.  (Schore/ad/28)”

THE DEVELOPMENTAL NEUROBIOLOGY OF INSECURE-RESISTANT ATTACHMENTS

++ mother persistently engages infant even when the infant is looking away from her

++ mother “successfully serves as a source of high-intensity affective stimulation, enabling the characteristic high-arousal affects of the early practicing period.  However, during these high-arousal states this type of intrusive caregiver does not sensitively and appropriately reduce her stimulation, and thereby interferes (Schore/ad/28) with the infant’s attempt to disengage and gaze avert in order to modulate ergotropic arousal and high-intensity affect.  (Schore/ad/29)”

“Field (1985) noted that if the mother does not respond to the infant’s dyadic affective cues of hyperarousal by diminishing her stimulation, especially during periods of infant gaze aversion, the child’s aversion threshold will be exceeded and he/she will experience a distress state (Bowlby’s protest).  She thus does not alter the tempo or content of her stimulation in response to a monitoring of the infant’s affective state; instead, she overloads him and interferes with his ability to assimilate new experiences.  It is well known that the capacity of an organism to learn effective patterns of responses is negatively affected by heightened levels of arousal.  (Schore/ad/29)”

“This type of mother inconsistently permits access to the infant who seeks proximity at reunion.  She may engage in positive affect amplifying transactions, but be inefficient in limit setting, regulating shame induction, and aggression socialization in the late practicing period.  Due to her lability and to the unpredictable nature of her emotional availability, even when she is present the infant is uncertain as to what to expect with regard to her being responsive to his/her signals and communication.  ….The insecure-resistant infant thus intermixes proximity, contact seeking behaviors with angry, rejecting behaviors toward the mother at reunion; it is thus ambivalent.  (Schore/ad/29)”

“Additionally, during preseparation episodes the child is often so preoccupied with the mother and with monitoring the mother’s face that he can not [sic] play independently, since the mother does not function as a reliable, secure base for refueling that enables exploration.  This infant shows high separation distress and is notoriously difficult to comfort at reunion, and thus presents with “difficult temperament,” the central attributes of which are tendencies to intense expressiveness and negative mood responses, slow adaptability to change, and irregularity of biological functions.  (Schore/ad/29)”

“Most importantly, this type of caregiver does not provide an environment that is conducive to the expansion of lateral tegmental catecholaminergic system in the late practicing period.  The autonomic balance of this affect regulating system is thus biased toward a predominance of the sympathetic, excitatory dopaminergic ventral tegmental, over the parasympathetic, inhibitory noradrenergic lateral tegmental limbic circuit.  Insecure-resistant attachments are associated with undercontrolled and impulsive personality organizations, biochemically manifest by elevated mesolimbic dopamine activity during stress (King, 1985), which are biased toward ergotropic high-arousal states and avoid trophotropic low-arousal affects.  The heightened display of emotionality and inefficient capacity to regulate the high levels of anger and distress which characterizes these infants reflects a sypatheticontonically biased affective core which displays a pattern of heightened emotion expression, one that poorly maintains positive mood in the face of stress.  They are, therefore, susceptible to underregulation disturbances and to undercontrolled, externalizing developmental psychopathology.  (Schore/ad/29)”

sypatheticontonically biased affective core :  This sounds like what I first was reading in Allen about the inability to control emotions, which would be much more of a problem in cases where the individual HAS lots of strong and easily triggered emotions than it would be in the avoidant case.

Inactive vs reactive – depressive vs expressive – too calm vs too “anxious”

I expected Schore to go next to disorganized attachment, but he does not!  THAT SUCKS!

++++

AFFECT DYSREGLATION, ORBITOFRONTAL DYSFUNCTION, AND DEVELOPMENTAL PSYCHOPATHOLOGY

++ “emergent discipline of developmental psychopathology”  (Schore/ad/30)

++  developmental psychopathology…[focuses] on underlying mechanisms common to both….” [atypical and typical development] (Schore/ad/30)”

++ “…the mechanism underlying attachment [is a ] …dyadic communicative system ofmutual reciprocal influences …[that are] psychobiologically adaptive for the organization, equilibrium, and growth of the organism.  I have specifically stressed the importance of reunion transactions, episodes of reattachment that occur after periods of separation or misattunement, since the rapid, “hidden” interactive regulation embedded in these reparative exchanges serves as an interpersonal matrix for the emergence of an internal system that can adaptively regulate affect, especially during periods of stress.  (Schore/ad/30)”

I would think the following also relates to infants in daycare.  This is an “at risk” “critical site” for disruption as the parent who has to work and be a primary caregiver the rest of the time will already be tired and stressed when picking up the infant from day care – strong need for information on this particular event “status”:

“It is now accepted that the effects of repeated separations are most debilitating when the reunion environment is not supportive (Coe, Winer, Roseberg, & Levine, 1985).  This dynamic interface is thus also a critical site for the generation of stressful and thereby psychobiologically chaotic events that ultimately create a predisposition or vulnerability to future psychiatric and psychosomatic pathologies.  (Schore/ad/30)”

FUNCTIONAL DEFICITS ASSOCIATED WITH DEVELOPMENTAL PSYCHOPATHOLOGY

++ securely attached infant can first physically seek the caregiver and then later mentally seek the representation of the caregiver after the stress of a separation “for interactive regulation and be comforted at a reunion.”  (Schore/ad/30)

RESILIENCE

++ “…an infant who is exposed to sensitive and cooperative maternal interactive repair of dyadic misattunements consequently shows self-regulatory skills in the form of persistent efforts to overcome an interactive stress.  In such securely attached infants, stress-induced negative affect does not  (Schore/ad/30) endure for long periods beyond the conditions that elicit them; rapid recovery to positively toned emotion is typical…reflective of efficient regulatory capacities.  A cardinal feature of a “high-resilient” child and his/her parents is the capacity of the dyad to fluidly transition from positive to negative back to positive affect (Demos, 1991).  [Again, he says the following]  Indeed, the ultimate indicator of attachment is seen as this resilience in the face of stress (Greenspan, 1981).  (Schore/ad/31)”

++  forms working model of “self-attuned-with-a-regulating-other”

++  “…the reunion environment created by the insecure mother-infant dyad creates frequent and enduring high levels of negative and low levels of positive affect.  As a result of the caregiver’s inability to participate in dyadic affect-regulating functions that modulate extreme levels of stimulation and arousal, this infant shows a greater tendency for negative emotional states to endure beyond the precipitating stimulus events…. (Schore/ad/31)”

“Early experiences of being with a psychobiologically dysregulating other who initiates but poorly repairs shame-associated misattunement are also incorporated in long-term memory as an interactive representation, a working model of the self-misattuned-with a dysregulating-other….these representations are stored in memory “largely outside conscious awareness” as prototypical of all interactions.  Clinical observers note that failures of early attachment invariably become sources of shame, that impairments in the parent-child relationship lead to pathology through an enduring disposition to shame, and this results in chronic difficulties in self-esteem regulation found in all developmental psychopathologies.  If an attachment figure frequently rejects or ridicules the child’s requests for comfort in stressful situations, the child develops not only an internal working model of the parent as rejecting but also one of himself as unworthy of help and comfort….This precludes access to interactive regulation at times of emotional crisis.  (Schore/ad/31)”

“There is now compelling evidence, from a number of separate disciplines at different levels of analysis, that all early forming psychopathology constitutes disorders of attachment and manifests itself as failures of self and/or interactional regulation (Grotstein, 1986).  The functional indicators of this adaptive  (Schore/ad/31) limitation are specifically manifest in recovery deficits of internal reparative mechanisms….loss of ability to regulate the intensity of feelings is the most far-reaching effect of early trauma and neglect…[and] all forms of psychopathology have concomitant symptoms of emotion dysregulation…and that this dysfunction is manifest in more intense and longer lasting emotional responses…. (Schore/ad/32)”

“…what is not adaptive is a lack of variability in the individual faced with environmental demands that call for alternative choices and strategies for change….I conclude that these functional vulnerabilities reflect structural weaknesses in the affective core, the psychobiological system that regulates positive mood and interactive behavior, and defects in the organization of the orbitofrontal cortex, the neurobiological regulatory structure that is centrally involved in the adjustment or correction of emotional response.  (Schore/ad/32)”

I know this on a personal level far to well.  I am feeling feelings right now about wanting to see Ernie because he told me I could come over and see him again this afternoon – but they are not positive, happy, serene, comfortable feelings.  They are tied to some strange sort of anxiety and helplessness and fear and despair I cannot even differentiate by exact name, nor can I alter their existence – I cannot change them into something else, I cannot make them less intense, I cannot make them go away – I cannot name them, I don’t like them – I called him to see if he was busy and he definitely was and did not help these feelings at all.  They are desperate, they are nearly overwhelming, they are nearly unbearable – and I don’t even know what caused them or where they come from.

It seems o be kind of like being suspended in the air, helpless to get up, terrified of falling down.  But the fact that I know they are connected in my memory and mind and body to something old and huge does not help.  I have known for a long time that they are disproportionate to anything going on in the immediate present.

I keep thinking that if you were going to try to diagnose something faulty in your car, you would take the car out and drive it maybe up a hill if that is what triggers the problem.  Or try driving it down a hill if the problem were in the brakes.

But what do you do when there is no hope of altering, adjusting, or repairing the problem?  That is the way I feel right now.  Now I just wait to see if he calls so I can see him – and try to negotiate some sort of “interactive repair” that can help me feel better for the very long weekend coming up while he will be away from me and with his other women.

Why did he tell me I could see him again this afternoon if he didn’t mean it?  Time seems to be my enemy when I get into these “states.”

They are “states of affective mind,” “states of the right brain” I suppose.  And they are hard, painful, horrible.

1. Time as friend and ally, time as foe and enemy.

++++

There is a lot of information on attachment over in Schore/ad brain damage section.  It is very hard to know where to draw the line as all these ripples intersect and overlap one another.

++++

DYNAMIC SYSTEMS THEORY AND ONGOING RIGHT-HEMISPHERIC DEVELOPMENT

“Attachment is “the apex of dyadic emotional regulation, a culmination of all development in the first year and a harbinger of the self-regulation that is to come” (Sroufe, 1996, p. 172).  (Schore/ad/126)”

“The nonlinear right hemisphere, the substrate of early attachment processes, ends its growth phase in the second year, when the linear left hemisphere begins one, but it cycles back into growth phases at later periods of the life cycle (Thatcher, 1994).

This [cycling] allows for the continuity of attachment mechanisms in subsequent functioning, and yet also for the potential continuing reorganization of the emotion-processing right brain throughout life.

The orbitofrontal regions, centrally involved in the regulation of psychobiological state and energy balance, are unique in that they retain the neuoranatomic and biochemical features of early development,

and for this reason they are the most plastic areas of the cortex (Barbas, 1995).  (Schore/ad/126)”

++++

“If, however, an infant, especially one born with a genetically encoded altered neurophysiologic reactivity, does not have adequate experiences of being part of an open dynamic system with an emotionally responsive adult human, its corticolimbic organization will be poorly (Schore/ad/126) capable of coping with the stressful chaotic dynamics that are inherent in all human relationships.

Such a system tends to become static and closed, and invested in defensive structures to guard against anticipated interactive assaults that potentially trigger disorganizing and emotionally painful psychobiological states.

Because of its avoidance of novel situations and diminished capacity to cope with challenging situations, it does not expose itself to new socioemotional learning experiences that are required for the continuing experience-dependent growth of the right brain.

This structural limitation, in turn, negatively impacts the future trajectory of self-organization.  (Schore/ad/127)”

++++

“The attachment dynamic continues throughout the life span as an unconscious mechanism that mediates the interpersonal and intrapsychic events of all relationships, especially intimate relationships.  (Schore/ad/126)”

“Affect-regulating interactions are essential to the development of the infant’s coping skills,

but at later points in the life span they continue to be necessary for the continued growth of the brain

and the expanding capacity to experience more complex psychobiological states.  (Schore/ad/126)”

++++

“Because attachment status is the product of the infant’s genetically encoded psychobiological predisposition and the caregiver experience, and attachment mechanisms are expressed throughout later stages of life, early relational trauma has both immediate and long-term effects, including the generation of risk for later-forming psychiatric disorders.  (Schore/ad/182)”

++++

“…attachment patterns of infant’s [sic] who had suffered trauma in the first year of life….discovery of a new attachment category, type D, an insecure disorganized/disoriented pattern.  (This work is updated and summarized by Solomon and George[1999]).  (Schore/ad/192)”

“The type D pattern is found in over 80% of maltreated infants (Carlson et al, 1989)….  This group of toddlers exhibits the highest heart rate activation and the most intense alarm reaction in the strange situation procedure (see Figure 7.1).  They also show higher cortisol levels than all other attachment classifications and are at greatest risk.  (Schore/ad/192) for impaired hypothalamo-pituitary-adrenocortical axis stress responding….  Main and Solomon concluded that “these infants are experiencing low stress tolerance” (1986, p. 107).  These authors contend that the disorganization and disorientation reflect the fact that the infant, instead of finding a haven of safety in the relationship, is alarmed by the parent.  They noted that because the infant inevitably seeks the parent when alarmed, any parental behavior that directly alarms an infant should place it in an irresolvable paradox in which it can neither approach, shift its attention, or flee.  At the most basic level, these infants are unable to generate

a coherent behavioral coping strategy

to deal with this emotional challenge.  (Schore/ad/192)”

++++

Approach and avoid – “simultaneous activation of the energy expending sympathetic and energy conserving parasympathetic components of the ANS.  (Schore/ad/194)”

“A dictionary definition of apprehension is distrust or dread with regard to the future.  These apprehensive behaviors generalize beyond just interactions with the mother.  The intensity of the baby’s dysregulated affective state is often heightened when the infant is exposed to the added stress of an unfamiliar person.  At a stranger’s entrance, two infants moved away from both mother and stranger to face the wall, and another “leaned forehead against the wall for several seconds, looking back in apparent terror” Main & Solomon, 1986, p. 120).  (Schore/ad/194)”

“These maltreated infants also showed “behavioral stilling” – that is, “dazed” behavior and depressed affect (again a hyperactivation of the PNS).  One infant “became for a moment excessively still, staring into space as though completely out of contact with self, environment, and parent” (Main & Solomon, 1986, p. 120)[.]  Another showed “a dazed facial appearance … accompanied by a stilling of all body movement, and sometimes a freezing of limbs which had been in motion: (p. 120).  And yet another “fell face-down on the floor in a depressed posture prior to separation, stilling all body movements: (p. 120).  (Schore/ad/194)”

“Furthermore, Main and Solomon pointed out that the type D behaviors take the form of stereotypies that are found in neurologically impaired infants.  It should be emphasized that these behaviors are overt manifestations of an obviously impaired regulatory system, one that rapidly disorganizes under stress.  Notice that these observations are taking place at 12 to 18 months, a critical period of corticolimbic maturation, and they reflect a severe structural impairment of the orbitofrontal control system that is involved in attachment behavior and state regulation.  (Schore/ad/194)”

“The orbitofrontal areas, like other limbic structures in the anterior temporal areas and the amygdala, contains [sic] neurons that fire to emotionally expressive faces.  (Schore/ad/194)”

++++

The mother’s face is the most potent visual stimulus in the child’s world, and it is well known that direct gaze can mediate powerful aggressive messages.  (Schore/ad/194)”

“During the trauma, the infant is presented with an aggressive expression on the mother’s face.  The image of this aggressive face, as well as the chaotic alterations in the infant’s bodily state that are associated with it, is indelibly imprinted into subcortical limbic circuits as a “flashbulb memory” (Brown & Kulik, 1977) and thereby stored in implicit-procedural memory in the visuao- (Schore/ad/194) spatial right hemisphere.  These are stored memories of what Lieberman (1997) called “negative maternal attributions” that contain an intensely negative affective charge, and therefore rapidly dysregulate the infant.  (Schore/ad/195)”

“In the course of the traumatic interaction, the infant is presented with another affectively overwhelming facial expression, a maternal expression of fear-terror…..  Current studies show a link between frightening maternal behavior and disorganized infant attachment….  Etc….(Schore/ad/195)”

++++

he has a part here on mothers I am putting in relationship trauma