Infant-caregiver interactions, seminal events in brain development and their possible relationship to later psychic vulnerability were explored in a recent continuing education seminar, "Understanding and Treating Trauma: Developmental and Neurobiological Approaches," at the University of California, Los Angeles. Presenters were Daniel Siegel, M.D., medical director of the infant and preschool service at UCLA and director of interdisciplinary studies, Children's Mental Health Alliance Foundation, and Allan N. Schore, Ph.D.
Schore, assistant clinical professor in the department of psychiatry and biobehavioral sciences at UCLA School of Medicine, has been compared to Einstein in his quest for a field theory, an overarching model that would explain all aspects of neuropsychobiological function and dysfunction.
In their presentation and subsequent interviews with Psychiatric Times, Schore and Siegel integrated the latest findings from neuroscience, development, attachment and psychoanalysis--fields that for too long have failed to merge their impressions into a coherent whole. As Schore explained, "The attachment researchers have studied the experiences necessary for social and emotional development, but they have looked only at behaviors and not at brain structures. The brain development people have looked at structures and not at behavioral consequences."
Attachment theory holds that secure attachments, and the attuned infant-caregiver interactions that produce them, are crucial to healthy psychological development. Schore takes attachment theory a step further by correlating the dialogue of caregiver-infant attunement with its accompanying neurobiological states, and explaining how these states may promote the wiring of healthy brain circuitry.
Infant researchers, among them psychiatrist Daniel Stern, M.D. (1977), have described this attunement dialogue. Researchers Beebe and Lachmann (1988) were the first to document its second-by-second nuances. Their photographed sequences reveal mother and infant face-to-face, their gazes interlocking, and their expressions modeling and mirroring one another. By tuning in to every subtle shift in the infant's states, the caregiver accentuates positive states of excitement, joy and pleasure, and minimizes distress. As Siegel describes it, "the infant feels felt." In this way, the mother serves as an affect regulator, an auxiliary cortex for the infant's still underdeveloped brain.
Siegel offered an example of an attuned interaction. "Imagine that an 11-month-old baby is excited about having just gotten up. She is cruising along the side of a table, her face filled with glee, and says "Aaaawwww!' The parent's attuned response would be "Wow!" reflecting the same crescendo and decrescendo, the same profile of energy."
Extrapolating from animal research, and from an ever-growing body of brain imaging studies on humans, Schore locates these attunement interactions in the infant's right orbitofrontal cortex and contends that they are essential to its synaptic development.
Beebe B, Lachmann EM (1988), The contribution of mother-infant mutual influence to the origins of self and object relations. Psychoanalytic Psychology 5:305-337.
Carlson M, Earls F (1997), Psychological and neuroendocrinological sequelae of early social deprivation in institutionalized children in Romania. Ann NY Acad Sci 807:419-428.
Chiron C, Jambaque I, Nabbout R et al. (1997), The right brain hemisphere is dominant in human infants. Brain 120:1057-1065.
Dawson G, Frey K, Panagiotides H et al. (1997), Infants of depressed mothers exhibit atypical frontal brain activity: a replication and extension of previous findings. J Child Psychol Psychiatry 38(2):179-186.
Dawson G, Panagiotides H, Klinger LG, Spieker S (1997), Infants of depressed and nondepressed mothers exhibit differences in frontal brain electrical activity during the expression of negative emotions. Dev Psychol 33(4):650-656.
Field T, Fox N, Pickens J, Nawrocki T (1995), Relative right frontal EEG activation in 3- to 6-month-old infants of depressed mothers. Dev Psychol 31:358-363.
Greenough WT, Black JE (1992), Induction of brain structure by experience: substrates for cognitive development. In: Gunnar MR and Nelson CA, eds. Minnesota Symposia on Child Psychology: Developmental Neuroscience, Vol. 24. Hillsdale, NJ: Lawrence Erlbaum.
Jones NA, Field T, Fox NA et al. (1997), EEG activation in 1-month-old infants of depressed mothers. Dev Psychopathol 9(3):491-505.
Main M (1996), Introduction to the special section on attachment and psychopathology: 2. Overview of the field of attachment. Journal of Counseling and Clinical Psychology 64:237-243.
Nelson CA, Bloom FE (1997), Child development and neuroscience. Child Dev 68(5):970-987.
Schore AN (1996), Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Hillsdale, NJ: Lawrence Earlbaum.
Schore AN (1996), The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Development and Psychopathology 8:59-87.
Schore AN (1997), Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders. Development and Psychopathology 9:595-631.
Stern DN (1977), The First Relationships: Mother and Infant. Cambridge, Mass.: Harvard University Press.
Teicher MH, Ito Y, Glod CA et al. (1997), Preliminary evidence for abnormal cortical development in physically and sexually abused children using EEG coherence and MRI. Ann NY Acad Sci 821:160-175.