Experience, both good and bad, “literally becomes the neuroarchaelogy of the individual’s brain” (Perry, 2008, p.4). Neurodevelopment is the result of how genetic potential is expressed through the timing, nature, frequency and pattern of experience. The brain organises itself in a ‘use-dependant’ way through patterned and repetitive activities. Chaotic experiences out of developmental sync with the child create dysfunctional brain organisation. If a child has fewer relational experiences of love and comfort the parts of the brain responsible for affiliation and attachment will not develop normally. Developmental stressors can ‘express’ underlying genetic vulnerabilities. A more robust child may not develop pathology in response to stressors, while a more vulnerable one may become more prone. The developmental view of disturbance sees emotional problems as developmental outcomes that result from successive transactions between the child and the environment (Sroufe et al., 2009). Disturbance arises from “patterns of maladaptation interacting with on-going challenging circumstances in the absence of adequate support” (p.239).
The attachment relationship structuralises the developing right-brain unconscious for better or worse through the “implicit intergenerational transmission of resilience against or vulnerability to, later psychiatric, personality and developmental disorders” (Schore, 2019a, p.23). Inadequate early parenting creates a vulnerability that may become pathogenic and destructive of development if later experiences too are unfavourable (Schore, 2019a). Psychology, in seeking to embrace lifespan resiliency, has down played the lasting neurobiological influences of early childhood experiences (Narvaez et al., 2013). Resiliency literature has focused on ‘good enough’ development, so that as long as individuals do not drop out of school or go to prison, they are deemed a success in developmental terms. Thus, there needs be models of mental health as well as mental illness (Schore, 2012). It is not enough for developmental systems to be trauma-informed, they must also be ‘wellness informed’ (Narvaez and Tarsha, 2021). Wellness-informed means understanding what makes children, adults and groups thrive and flourish.
Self-regulation is an essential organising principle in the development of living systems (Schore, 1994). It might even be the mechanism by which systems develop. Development occurs in a progression of stages in which adaptive self-regulatory structures and functions emerge that enable new interactions between the changing individual and the changing environment. Self-regulation is an organising principle at the heart of every biological and psychological discipline, and fundamental to emotional processing (Schore, 2019a). The whole of child development can be understood as the enhancement of self-regulation.
Leckman and March (2011) write that “A scientific consensus is emerging that the origins of adult disease are often found among developmental and biological disruptions occurring during the early years of life” (p.341). Prenatal and postanal environments play a critical role in shaping this trajectory (Schore, 2012). Dysregulated affect (particularly unconscious affect) plays a primary role in not just psychopathogenesis, but all illness and disease. Disease refers to the failure of regulatory systems to adapt to stressors and sustain homeostasis. Furthermore, there is increasing consensus that disease involves the dysregulation in the psychobiology of the stress coping systems of the organism. During early critical periods when the infant is dependent on external regulation, growth-inhibiting environments can create epigenetic changes in the developmental trajectory of those coping systems. Early adverse experiences have been shown to have a large impact on neuroregulatory systems mediating illness as well as social behaviour (Felitti, 2010). The ‘hidden epidemic’ of early trauma is not just a problem for mental health fields and medicine but for all of society. Chronic life stress in early development is generally underappreciated as an etiological mechanism underlying many biomedical illnesses.
The roots of psychopathology lie in traumatic attachment experiences (Schore, 2012). The emotional bond between infant and caregiver and its impact on the developing right brain impacts socioemotional and physical health over the lifespan. Data from the US is linking trauma in the early years with increases in psychosocial problems (Schore, 2012). Childhood trauma disrupts the architecture of the brain, impacts the organ systems, creates stress systems that have lower thresholds for responding that last throughout life, increasing the risk for stress related disease and cognitive impairments. Research suggests that it may not be possible to outgrow these early faults and if it is possible, it requires significant intervention (Schore, 2012). Early life trauma lies at the heart of a spectrum of psychiatric and psychosomatic disorders.
Resilience is a developmental process, not a trait (Sroufe, 2016). A secure attachment history provides the foundation for coping with adversity, probably due to a combination of being able to draw on internal resources and external social support. Attachment transactions generate brain development (Schore, 2012). In development, states become traits (Perry, 1995) and so if children have dominant experiences of separation, distress, fear and rage they will go down a pathogenic pathway (Schore, 2012). In early critical periods attachment histories are ‘affectively burnt in’ the infant’s right brain. Secure attachment ‘literally’ means an ‘emotionally healthy individual’, while insecure attachment means a predisposition to later forming psychiatric disorders – these dispositions are being set up in the first thousand days (Schore, 2017b). Attachment security predicts optimal human functioning in stress regulation, nutritional status, and immune functioning (Mesman et al., 2016). Additionally, secure attachment is the main defence against ‘trauma-induced psychopathology’ (Schore, 2019b).
For the lifespan the right hemisphere is dominant for the regulation of physiological, endocrinological, immunological and cardiovascular functions and the control of vital functions that support survival and help the organism cope with stress (Schore, 2012). A growing body of data demonstrates a strong link between alterations in maternal-infant interactions, the early programming of the hypothalamic-pituitary-adrenal (HPA) axis in prenatal and postnatal critical periods, and adult health and disease. Other studies link attachment with stress and disease as well as childhood attachment with adult cortisol and cardiovascular function (Schore, 2012). Therefore, strengths and weaknesses in right brain survival functions – that are being established in the early attachment relationship – impact not only psychological capacities but psychobiological coping with emotional disturbance and disease. These regulatory capacities are indicators of physical and mental health. Agreement has emerged that affect dysregulation is a ‘fundamental mechanism’ of all psychiatric disorders and that right brain deficits are ‘the key’ to all personality disorders (Schore, 2019a). Mental health and developmental fields are very interested in applying neurobiological sciences to optimise the relational origins of the self, in early intervention and prevention efforts.
A paradigm shift has occurred across disciplines from a focus on left brain conscious cognition to right brain unconscious affect and its nonverbal relational functions (Schore, 2012). The paradigm shift has created a quantum leap in understanding some of the fundamental questions of the human condition that are clarified by the discovery of the early developing right brain. We need now to use this knowledge to reflect and act upon what is needed to provide an optimal human context for mental and physical health at the individual, family and cultural levels. As a culture we need to develop the person’s adaptive capacity to relate socially and emotionally to other human beings through right brain functions of intersubjective communication, processing of affect, empathy and interactive stress regulation. This knowledge can develop complex models of human growth and development that aim to optimise brain plasticity and therefore human potential. Research on the critical survival functions of the right brain can be applied to cultures as well as individuals.
The concept of ‘enriched environments’ now is being used to describe an ‘enriched social environment’, which optimises the growth and complexity of the right brain (Newton, 2008). The self-organisation of the developing brain occurs in relationship with another brain (Schore, 2019a). The relational environment can be growth-facilitating or growth-inhibiting. It is this environment that imprints into the early developing right-brain either resilience or vulnerability to later developing psychiatric disorders. Developmental science has shown the amazing plasticity and responsiveness of the developing brain to early enriched environments.
References
Felitti, V., (2010). Foreword. In Lanius, R. A., Vermetten, E., & Pain, C. The impact of early life trauma on health and disease: The hidden epidemic. Cambridge University Press.
Leckman, J. F., & March, J. S. (2011). Editorial: Developmental neuroscience comes of age. Journal of Child Psychology and Psychiatry, 52(4), 333-338. https://doi.org/10.1111/j.1469-7610.2011.02378.x
Mesman, J., Van Ijzendoorn, M., Sagi-Schwartz, A. (2016). Cross-cultural patterns of attachment. In Cassidy, J., & Shaver, P. R. Handbook of attachment: Theory, research, and clinical applications (3rd ed.). Guilford Publications.
Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: How “states” become “traits”. Infant Mental Health Journal, 16(4), 271-291. https://doi.org/10.1002/1097-0355(199524)16:43.0.co;2-b
Perry, B.D. (2002). Childhood Experience and the Expression of Genetic Potential: What Childhood Neglect Tells Us About Nature and Nurture. Brain and Mind 3, 79–100 (2002). https://doi.org/10.1023/A:1016557824657
Schore, A. N. (2003). Affect dysregulation and disorders of the self (Norton series on interpersonal neurobiology). W. W. Norton & Company.
Schore, A. N. (2012). The science of the art of psychotherapy (Norton series on interpersonal neurobiology). W. W. Norton & Company.
Schore, A. (2013). Bowlby’s ‘environment of evolutionary adaptedness’: Recent studies on the Interpersonal Neurobiology of human development. In Narváez, D. (2013). Evolution, early experience and human development: From research to practice and policy. Oxford University Press.
Sroufe, A. (2016). The place of attachment in development. In Cassidy, J., & Shaver, P. R. (2016). Handbook of attachment: Theory, research, and clinical applications (3rd ed.). Guilford Publications.
Szajnberg, N., Goldenberg, A., Harari U. (2010). Early trauma, later outcome: Results from longitudinal studies and clinical observations. In Lanius, R. A., Vermetten, E., & Pain, C. The impact of early life trauma on health and disease: The hidden epidemic. Cambridge University Press.