Abstract
There is now a strong if not urgent call in both the attachment and autism literatures for updated, research informed, clinically relevant interventions that can more effectively assess the mother infant dyad during early periods of brain plasticity. In this contribution I describe my work in regulation theory, an overarching interpersonal neurobiological model of the development, psychopathogenesis, and treatment of the early forming subjective self system. The theory models the psychoneurobiological mechanisms by which early rapid, spontaneous and thereby implicit emotionally laden attachment communications indelibly impact the experience-dependent maturation of the right brain, the “emotional brain.” Reciprocal right-lateralized visual-facial, auditory-prosodic, and tactile–gestural non-verbal communications lie at the psychobiological core of the emotional attachment bond between the infant and primary caregiver. These affective communications can in turn be interactively regulated by the primary caregiver, thereby expanding the infant’s developing right brain regulatory systems. Regulated and dysregulated bodily based communications can be assessed in order to determine the ongoing status of both the infant’s emotional and social development as well as the quality and efficiency of the infant–mother attachment relationship. I then apply the model to the assessment of early stages of autism. Developmental neurobiological research documents significant alterations of the early developing right brain in autistic infants and toddlers, as well profound attachment failures and intersubjective deficits in autistic infant–mother dyads. Throughout I offer implications of the theory for clinical assessment models. This work suggests that recent knowledge of the social and emotional functions of the early developing right brain may not only bridge the attachment and autism worlds, but facilitate more effective attachment and autism models of early intervention.
Highlights
In a recent study on the developmental neurobiological basis of attachment in the journal Neuropsychopharmacology, researchers are boldly asserting, “Understanding the motivational basis of healthy and at-risk parenting may open new theoretical vistas and clinical opportunities and may lead to the construction of more specific interventions that can target disruptions to maternal–infant bonding at an earlier stage and in a more accurate manner” (Atzil et al, 2011, p. 11)
Echoing the call for early interventions by attachment scientists cited above, autism researchers studying “the very early autism phenotype” are asserting, “One purpose of the earlier identification is that treatments delivered at very young ages, when the brain is most plastic, may lessen or prevent the lifelong challenges associated with autism” (Yirmiya and Ozonoff, 2007, p. 9)
At the outset of this work I described a major goal of autism researchers – to create “treatments delivered at very young ages, when the brain is most plastic, may lessen or prevent the lifelong challenge associated with autism” (Yirmiya and Ozonoff, 2007, p. 9, my italics)
Summary
In a recent study on the developmental neurobiological basis of attachment in the journal Neuropsychopharmacology, researchers are boldly asserting, “Understanding the motivational basis of healthy and at-risk parenting may open new theoretical vistas and clinical opportunities and may lead to the construction of more specific interventions that can target disruptions to maternal–infant bonding at an earlier stage and in a more accurate manner” (Atzil et al, 2011, p. 11). Over the past two decades I have articulated and expanded regulation theory in order to model how early emotionally laden attachment experiences indelibly impact and alter the early developing right brain, which for the rest of the lifespan is dominant for the non-verbal, holistic, spontaneous (unconscious) processing of emotional information and social interactions, for enabling the organism to regulate affect and cope with stresses and challenges, and thereby for emotional resilience and emotional well-being in later stages of life (Schore, 1994, 2003a,b, 2012a). In a number of current publications in the clinical literature I am using my work on regulation theory as a guide for formulating early assessments of mother-infant attachment relationships (Schore, 2012a, 2013; Schore and Newton, 2012). In this work I describe my ongoing attempts to apply the theory to clinical practice in order to generate more effective evidence-based models of early assessment, intervention, and prevention
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