Some mutual regulation

The traditional psychoanalytic opinion that insight leads to change has been challenged of late by contemporary writers who think behavioral change precedes insight. It is as if the latter are saying: First one has the procedural, non-conscious (right brain) experience (not a cognitive thought or realization) of a new way to be with an other -- such as trusting someone for a moment or feeling someone is proud of me-- and the subsequent encoding in the brain of this new experience has a calming effect, which in turn allows for blood flow to the left brain where symbolization, explicit thought, (insight) takes place. In writing about the film Three Billboards Outside Ebbing, Missouri, (Post on 12-12-17) I quoted Chief Willoughby opining that love leads to calm and calm, to thought. Felicitously a clinical example from a supervisee presented itself.

A supervisee asked me to help her think about shifting self states in a patient of hers who was often fidgety and affectively dysregulated. What was going on with her patient who one week had been sobbing and angry about a break-up and felt so awful that the patient was going to run out of the room before the session was over, and, in the next session, the patient was calm and even offered an insight about her dating habits? In the first session the therapist had invited her patient to stay with the therapist and sit together in her distress, which the patient was able to do. How did the patient return in a calm state, able to sit with stretches of relative silence?

I was reminded of how affective regulation contributes to a secure attachment and how a secure attachment leads to calm. If Chief Willoughby knows anything, calm leads to insight. While love calms, I also see where calm, in attachment parlance, leads to love. The patient, soothed by the therapist in the first session, returned more securely attached, more able to trust, and to feel love for the therapist, all unspoken. The supervisee said that she had felt love for her patient in that second session. Ah! Mutual regulation. The mother calms the distressed baby and feels competent, useful, meaningful to the baby, and she feels love for her baby, just as the calmed baby feels important to the mother, and they share meaning and joy in their soothed state.