Sunday, January 20, 2019

Attachment and Affect course at TBIPS

Because, this week, the Tampa Bay Institute for Psychoanalytic Studies’ second year class will begin its Attachment and Affect course, I thought this would be a good time to remind students about Shore’s (2001) ideas on attachment as affect regulation: 1. Affect regulation and the unconscious are primarily the purview of the right hemisphere of the brain.  [Here Schore means by unconscious that which is automatically processed by mostly subcortical structures, and does not refer to Freud’s dynamic unconscious where a conflict was once conscious, however fleetingly, and then repressed]. 2. The essential task of the first year of life is to establish a secure attachment to a primary caregiver.

The primary caregiver facilitates affect regulation and hence attachment through contingent responsivity, attuning, synchronizing, up or down regulating accordingly, repairing ruptures, and by managing her/his own affect. [In doing so s/he contributes to the infant’s brain growth, stimulating neuronal connections and important neurotransmitters for self control and affect regulation, while promoting in the infant a sense of going on being and meaning making.]

The patient must form an attachment (part of the working or therapeutic alliance) with the therapist. This attachment comes into being via affect regulation. This attachment may explain the therapeutic efficacy seen across differing theoretical schools. Schore writes, “The major contribution of attachment theory to clinical models is its elucidation of the nonconscious dyadic affect-transacting mechanisms that mediate a positive working alliance between the patient and the empathic therapist.”

Schore, A.N. (2001). Minds in the Making: Attachment, the Self-Organizing Brain, and Developmentally-Oriented Psychoanalytic Psychotherapy. Brit. J. Psychother., 17(3):299-328.

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