Jing Therapy Centre

 

1) Development of Affect Regulation
 

Attachment Theory 

            Attachment theory was first proposed by John Bowlby, a British psychiatrist, in the 1950s and is a psychological framework that explores how early childhood experiences with caregivers shape an individual's internal working model of relationships. The latter are ways of being in relationships, which in turn influences the way people form emotional bonds with others throughout their lives. Bowlby’s student Mary Ainsworth and her student Mary Main expanded Bowlby's theory by proposing four attachment styles that can develop between infants and their attachment figures. Together, their work provides a foundation for understanding how the capacity of affect regulation develops in the context of attachment relationships when children mainly depend on their attachment figures for affect regulation. These four styles include:
 

• Secure attachment: Infants with secure attachment styles feel confident that their caregivers will be available and responsive when they need them. They move toward attachment figures when distressed and are comfortable seeking support. There are good at regulating affect with flexible means of utilizing either dyadic or autoregulation.
   

• Insecure-Avoidant attachment: Infants with an avoidant attachment style have learned that their caregiver is consistently unavailable or unresponsive. They may avoid seeking out their caregiver when distressed. They have prolonged states of dysregulated affect (hypo-arousal) and the main means of regulating affect is autoregulation.
   

• Insecure-Ambivalent attachment: Infants with ambivalent attachment styles are uncertain about their caregiver's availability and responsiveness. They may be clingy and anxious when their caregiver is present. They have prolonged states of dysregulated affect (hyper-arousal) and the means of regulating affect is mainly dyadic regulation.
   

• Disorganized attachment: Infants with disorganized attachment styles show contradictory behaviors when in the presence of their caregiver. They may be fearful of their caregiver, act aggressively towards them, or display other odd behaviors. The above two insecure attachments at least manage to develop a coping strategy, although maladaptive, while disorganized attachment shows a chaotic pattern of dysregulated affect (hyper- and hypo- arousal) and fail to develop a coping strategy for affect regulation.

 

Development of the Primary Affect-Regulating System

           In the last two decades, the scholars such as Alan Schore and Daniel Hill extended Bowlby’s classical attachment theory from the behavioural and psychological spheres to the interpersonal neurobiological sphere. Schore’s affect-regulation theory (2003) proposes that the development of the brain and the regulation of affect are closely related. The brain is shaped by the early experiences of attachment relationships, which affect the development of the affect regulating system. Caregivers who are consistently available and responsive to their infant’s emotional needs help the development of their affect regulating systems. Through affect co-regulation with their caregivers in the attachment relationship, individuals internalize these regulatory experiences and learn how to regulate their affect themselves in later life.
 

            Schore’s theory proposes a critical period in the development of the primary affect-regulating system: a neurological growth spurt that begins prenatally and continues until the age of 16-18 months. The limbic structures develop during this period and are organized hierarchically with the cortical structures that develop later and serve to regulate the limbic structures. During the same period, circuits in the brain develop to connect the limbic system first to the sympathetic branch and then to the parasympathetic branch of Autonomic Nervous System (ANS). By the end of this period, the infant develops a functioning limbic system linked to the Hypothalamic-Pituitary-Adrenal (HPA) axis and the ANS, a system regulating arousal. How it develops is impacted by the infant’s experiences of affect regulation in their primary attachment relationship(s).
 

            The followings are two examples of how the infant-mother dyad impacts the development of the capacity to regulate sympathetic and parasympathetic arousal:

            An example of downregulation is when an infant is feeling distressed and crying, and in response the mother begins to soothe the infant. As the mother soothes the infant, the infant's parasympathetic nervous system is activated, leading to a decrease in physiological arousal. The infant may begin to feel relaxed and stop crying. Through repeated interactions like this, the infant learns that when they feel distressed or overwhelmed, their mother is there to provide comfort and help them regulate their emotions. Over time, the infant internalizes this experience and develops the capacity for self-regulation (down-regulating).

An example of upregulation is a scenario where a mother and her infant are engaged in play together. The mother is smiling, making playful noises, and encouraging the infant to interact with her. As the infant engages with the mother, they may become excited and show signs of joy and enthusiasm. Through repeated interactions like this, infants learn that they can express positive emotions and their mother responds positively to their expressions of excitement. Over time, the infant internalizes this experience and develops a sense of emotional self-efficacy and the capacity for self-regulation (up-regulate).
 

            Allan Schore proposes that these secure attachment experiences facilitate the optimal development of the limbic structures and a balanced ANS. Also, the interactive affect regulating experiences becomes the internalized procedures for upregulation and downregulation. During this critical period, the limbic system is organized into a cortical-subcortical hierarchy, with the right orbitofrontal cortex at the apex performing a final analysis of emotional information. From the psychobiology perspective of affect-regulation development, “ implicit memories of rupture-repair sequences of dysregulation and reregulation are stored in the ventral and lateral tegmental limbic circuits and are internalized as operating instructions for sympathetic and parasympathetic regulation”. During this period, when the capacity to upregulate is developed, the ventral tegmental limbic circuits connect the right orbitofrontal cortex to the HPA axis and the sympathetic nervous system. In this process of upregulating, the HPA axis produces adrenaline and noradrenaline to the energy-expanding, upregulating sympathetic nervous system. When the capacity to downregulate is developed, the lateral tegmental limbic circuits connect the right orbitofrontal cortex to the HPA axis and parasympathetic nervous system. In this process of downregulating, the HPA axis produces cortisol, endorphins and endogenous opiates to the inhibiting, energy-conserving, downregulating parasympathetic nervous system. Now the infant is on the path to building self-regulation of affect, even when under stress.

 

Development of the Secondary Affect-Regulating system

           The secondary affect-regulating system, also known as mentalization (Allen & Fonagy, 2006; Fonagy et al., 2002), is a left-brain, cortically based, conscious, slow affect-regulation system that develops later than the primary system. Main (1991) called this “metacognitive monitoring”, which was a sign of secure attachment. The weakness of this system among parents often predicts insecure or disorganized attachment styles in their children. Fonagy et al. describes the ability to mentalize as “the process by which we realize that having a mind mediates our experience of the world” – the knowledge of minds in general and “the activity of thinking explicitly about states of mind” (Fonagy, Gergeley, Jurist, & Target, 2002, p. 3). The research done by Fonagy and his colleagues showed that parents with strong mentalization were 3-4 times more likely to have children with a secure attachment style than parents with a weak capacity for mentalizing, and parents with strong capacity for mentalizing could break the cycle that usually led them to raise children with an insecure attachment style due to intergenerational trauma.
 

           There are four modes of mentalizing that develop sequentially (Hill, 2015). The first three to develop –Teleological mode (distinction between intent and action), Psychic equivalence mode (the mind is representational in nature and mental representation is distinct from the thing represented), and Pretend modes (mental representation is experienced as separate from the thing represented but too detached from their referents in the real world) – are considered pre-mentalizing processes. The fourth mode Full mentalization integrates Psychic equivalence and Pretend modes – mental representations neither too attached nor too detached from their referents in the real world. Representations look real and meaningful while on the other hand can also be questioned and corrected. They are perceived as our subjective understanding of reality rather than reality itself.

The secondary affect-regulating system started to develop sometime in the sixth year of life and continues throughout childhood and adolescence, and the development of the primary system will impact the development of the secondary system (Fonagy & Target, 1997).  The two affect-regulating systems work together where primary affect is processed in the primary regulating system first and then further processed in the secondary regulating system. Through these two systems, somatic experiences become words in the mind and preconscious implicit processing of the right brain is followed by the conscious explicit processing of the left brain.
 

            As the secondary affect regulating system’s regulation depends on the primary system’s affect regulation, the psychopathologies of affect dysregulation in clinical settings can be a failure to develop the primary affect regulating system (dysregulated-dissociated affect not available for mentalizing), or a failure to develop the secondary affect regulating system in the first place, or both. This paper will discuss in detail in the next section on the developmental origins of affect dysregulation.

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References:

Allen, J. G., & Fonagy, P. (Eds.). (2006). The handbook of mentalization-based treatment. John Wiley & Sons, Inc. https://doi.org/10.1002/9780470712986

Fonagy, P., Steele, H., Moran, G., Steele, M., & Higgitt, A. (1991). The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 13, 200-217.

Hill, D. (2015). Affect regulation theory: A clinical model. WW Norton.

Schore, A. N. (1999). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Mahwah, NJ: Erlbaum.

Schore, A. N. (2019). Right Brain Psychotherapy. WW Norton.

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