How do infants learn to regulate and build resilience? What kinds of attachment experiences do babies need to develop optimally?

Babies are subject to feelings of distress that they are ‘utterly unequipped’ to manage alone (Wallin, 2007). Parents who can offer ‘containment’ for their infant’s distress will tend to have a securely attached child.  When a child experiences distress and cries in the presence of a loving, attuned caregiver who responds, the distress is relieved (Perry, 2016). This relief of stress activates the reward neurobiology. In this process three primary neural networks for reward, relationships and regulation are woven together that create the framework that leads to optimal development. In this process the child makes associations between people, pleasure and safety, creating a prosocial neurobiology.

The developing brain is not resilient but ‘malleable’ (Schore, 2019a). Resilience in the face of stress is the ‘ultimate indicator of attachment’, which equates with regulatory capacity. To feel secure, we need to know we have the internal resources to cope with stressors (Schore, 2019b). Stress is asynchrony in an interactive sequence (Schore, 2012). Affect synchrony creates positive arousal, and interactive repair, which modulates negative affect, are dual regulatory processes which are the building blocks of attachment and emotions. ‘Vitality affects’, which are energetic and dynamic, build self-structure (Schore, 2019a). Positive affect is critical to brain growth (Schore, 2012). In play episodes of ‘affect synchrony’ the attachment pair are in affective resonance, amplifying vitality affects (Schore, 2012, p.28). Maladaptive infant mental health, by contrast, is marked by negative affect as seen in ‘prolonged, frequent, and intense’ episodes of affect dysregulation (Schore, 2012).

The supportive mother contains emotional experience that the infant cannot manage alone but evokes in her (Wallin, 2007). This requires the mother to bear the distress within herself, process and re-present in a tolerable form to the baby what was previously an intolerable emotion. Parents can contain their children’s experience through communicating affectively and through physical care that they understand the cause of the distress and its emotional impact; that they can cope with it and alleviate it; and they can recognise the child’s intentional stance (the ability of the child to infer the intentions of the parent). This third aspect of the parent seeing the child as a separate being with a mind of their own, capable of reading both her own and her parent’s mind, maybe the most important element in increasing the likelihood of forming a secure bond. When parents contain unmanageable emotions with responses that communicate empathy, coping and appreciation of the child’s intentional stance, they are engaged in interactive affect regulation. This process establishes the relationship as a safe haven and secure base.

Emotionally attuned parents convey empathy and the capacity to cope through affect mirroring that is contingent and marked (Wallin, 2007). Contingent mirroring is accurate with the caregiver’s facial and vocal displays corresponding to the affect of the infant. Parental affective expressions are the basis for the child’s first representation of her affects. These displays must be marked as ‘pretend’ or ‘as if’ by exaggerating the affect or intermingling the disturbing affect with one that contradicts it. This emotionally attuned mirroring is ‘critical’ because it is resonating with, reflecting on and expressing the infant’s internal state that the child discovers her emotions as mental states that can be recognised and shared. This lays the foundation for affect regulation and impulse control. In ‘markedness’ the caregiver denies what they feel while maintaining their individuality, becoming what the child needs them to be. If the caregiver is too much themselves (non-contingent) or too much the child (unmarked), the child cannot develop a sense of separateness. Mentalising mediates the process of transmitting secure attachment and mentalising can help parents with insecure histories raise children who are securely attached. The caregiver’s inability to contain affects is at the core of insecure transmissions.

The attuned mother modulates ‘nonoptimal’ high or low levels of stimulation (Schore, 2019a). However, frequent moments of misattunement occur which are ruptures in the attachment bond. This creates a ‘transient regulatory failure’ which impairs autonomic homeostasis. The repair process enables the infant to cope with stressful negative affects and to develop self-regulatory skill through overcoming interactive stress. When the child experiences positive affect following negative affect, they learn that the negative affect can be tolerated and it is possible to regulate (Schore, 2012). These patterns follow a sequence of connection, disconnection, dysregulation, reconnection and repair (Siegel, 2012). Attunement supports regulation by attending to nonverbal signals and our own physiological responses to the other in a ‘bottom-up’ way (Machiodi, 2020). Co-regulation refers to responsive interactions that create support, coaching and modelling. Close attention to the person’s cues is required with consistency and sensitivity.

The game of ‘Peek-a-boo’ illustrates the growth-promoting quality of rupture and repair processes. In hiding her face, the mother removes the cues of safety of prosodic voice and facial expression generated by the social engagement system, which creates a state of uncertainty in her infant (Porges, 2021). This is followed by the mother startling the infant by showing her face and saying ‘Peek-a-boo!’. The game is ended by the mother using a warm prosodic voice with facial expressions to calm the startled child which acts as a neural exercise that promotes resilience and enhances the infant’s ability to calm. As the regulation of the social engagement system improves, we gain resilience in dealing with disruptions in our lives. The above game illustrates that even a momentary break in connection is stressful for the infant. The infant is ‘dosed’ with a small, short stressor, which the mother supports the child to overcome. The infant is ‘excited’ by the sense of danger as the startle and sympathetic response enlivens the child. The danger is experienced as exhilarating when it is quickly followed by safety. This early play illustrates the complex communications that are required for optimal development. Such dyadic interactions require large investments of time, energy and attention of an attuned, regulated other.

The face of the attuned mother becomes ‘written into’ the right orbitofrontal cortex of the infant (Schore, 2019b). This acts as a ‘containing and comforting neurobiological guidance system’ which supports the infant when she is not present. At what point in development does this internalisation occur? At eight months babies usually have established ‘strong memory templates’ of their attachment bonds (Perry and Szalavitz, 2010). At 10-12 months the regulatory centre in the orbitofrontal cortex begins its growth period (Schore, 2019a). In an optimal context the vertical axis connecting the orbitofrontal and medial frontal cortices with many different cortical and subcortical areas develops well and the higher centres of attachment control in the right orbitofrontal cortex (OFC) regulates centres in the ‘lower’ amygdala that are involved in attachment security. This critical period of OFC growth continues up to 16-18 months during which environmental influences have the greatest impact on the shaping of the OFC (Hill, 2015). Deficits in the connections between the OFC and lower parts of the brain are involved in psychiatric disorders (Schore, 2012). If this regulatory centre is most open to environmental influences between 10 and 18 months it is particularly important that society provides highly enriched socioemotional environments at this time. However, many children are in childcare centres that have been identified as not providing quality care during this period. After 18 months the infant’s self-regulatory capacity is increased due to a more mature OFC and so at that point is likely to have more capacity to deal with separations. Schore (2017) notes that Berry Brazelton argues that mothers and infants should be together for at least the first two years. The representational map for attachment or ‘internal working model’ forms at 12-20 months as symbolic/ representational thinking develops (Brown and Elliott, 2016). At the end of the second year one of the four categories of attachment become ‘stably established’. Thus, securely attached children may be more comfortable with separations at this point. However, insecure children are likely to struggle. 

References

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