Modern societies tend to minimise feelings and focus on language and cognition (Porges, in Mitchell, Tuuci and Tronick). However, theory and research has changed focus from left brain conscious cognition to right brain unconscious affect and its nonverbal relational functions that is occurring across disciplines – a paradigm shift (Schore, 2012). Despite this there is still a bias in the mental health field and psychology for understanding the mind as the conscious ‘left mind’ only (Schore, in Siegel et al, 2021). Neurological evidence supports ‘the primacy of affect’ and ‘the primacy of unconscious over conscious will’. The right brain grounds our experience of the world at the bottom end of the mind and makes sense of it at the top end. The right-lateralised subjective self develops in the early attachment relationship and over the course of the lifespan this ‘psychobiological system’ communicates intersubjectively with other right brains, beneath levels of conscious awareness. This ‘relational unconscious’ communicates, synchronises and is expanded by another relational unconscious. Synchronisation of right brains allows unconscious (implicit) communications and their emotional and regulatory functions to be shared, facilitating the growth of the right brain. Nonverbal regulatory communications are embedded in intersubjective implicit relational processes.

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 (Schore, 2012). We need now to use this knowledge to reflect and act upon what is needed to provide 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. Optimal socio-emotional environments must be provided for larger numbers of infants (Schore, 2003a).

The right brain is ‘steeped in affiliation drives’ (Schore and Marks-Tarlow, in Schore, 2019). The social, emotional, relational right brain is ‘the cradle for a healthy brain’. If the infant is cherished, soothed, stimulated and receives attuned responses in the first two years their right brain, grounded in the body and relationships, becomes a health regulator for the individualistic power orientation of the left brain. Neuroscientists and social scientists are outlining the adaptive functions of the right brain (Schore, 2019). It is involved in ‘interpersonal competence’ – the capacity to interact and communicate, to share views and understand the emotions and opinions of others, as well as to resolve conflict. It supports trust, affiliation, fairness, empathy and gratitude – all of these, says Schore, are manifestations of mutual love. The right brain ‘integrated self’ is characterised by emotional connectedness, broad attention, unconscious generation and regulation of emotion, integration of negative experiences, extended resilience and basic trust (which develops in the first months through interaction with the caregiver). These functions are activated in all intimate relationships.

Schore describes how the concept of ‘enriched environments’ was traditionally used to describe the altering of the infant’s physical environment to facilitate verbal language skills but now it is being used to describe an ‘enriched social environment’, which optimises the growth and complexity of the right brain (in 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. Borderline personality disorder, PTSD, and antisocial personality disorders are associated with early traumatic attachments that are ‘burnt into’ the right-brain. This impairs the regulatory capacities to cope effectively with stressors throughout the lifespan. Developmental science has shown the amazing plasticity and responsiveness of the developing brain to early enriched environments. There needs be models of mental health as well as mental illness (Schore, 2012). Regulation theory offers a systematic exposition of the general principles of a science and can be used as a heuristic to inform interventions (Schore, 2012).

Interest is converging in self-regulation – an organising principle that is at the heart of every biological and psychological discipline, and fundamental to emotional processing (Schore, 2019). Schore cites Fonagy and Target (2002) who come to the conclusion that the whole of child development can be understood as the enhancement of self-regulation. The current focus in research and practice on how affective bodily-based processes are nonconsciously interactively regulated means that attachment theory has shifted to a regulation theory. Sroufe et al. (2005) support this idea arguing that attachment is the dyadic regulation of emotion. A lot of disturbance in development is caused by caregivers’ failure to respond to young children’s healthy needs for closeness and fears of separation (Sroufe et al, 2009). Most psychopathology involves emotional dysregulation or distorted personal relationships.

Interpersonal neurobiology holds that models of effective early intervention during the period of the brain growth spurt in the first two years are equated with prevention (Schore, 2012). The optimal connectivity of the right brain is the basis of emotional well-being and is the socioemotional foundation upon which all development rests (Newton, 2008a). The attachment relationship sets the trajectory of the development of the right brain throughout the lifespan (Schore, 2012). The right brain must be a fundamental focus of early intervention and prevention programmes. Affective communications and interactive regulation lie at the core of the attachment relationship. This means that early assessment and treatment should be relational (Schore, 2012). Interventions should focus on the right-brain reading of nonverbal cues and interoceptive bodily based responses to these communications and being able to implicitly regulate the infant’s arousal.

Schore repeatedly highlights the importance of the right brain in human development. He highlights the cultural bias towards conscious cognitive left-brain functioning despite the paradigm shift that has occurred in the sciences. Right brain functions, particularly the implicit nonconscious regulation of affect are central to both physical and mental health and this perspective offers valuable insights for designing interventions aimed at prevention.

References

Newton, R. (2008). The attachment connection: Parenting a secure and confident child using the science of attachment theory. New Harbinger Publications.

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. N. (2019). The development of the unconscious mind (Norton series on interpersonal neurobiology). W. W. Norton & Company.

Schore, A. N. (2019). Right brain psychotherapy (Norton series on interpersonal neurobiology). W. W. Norton & Company.

Schore, A. N. (2019). The development of the unconscious mind (Norton series on interpersonal neurobiology). W. W. Norton & Company.

Siegel, D. J., Schore, A. N., & Cozolino, L. (2021). Interpersonal neurobiology and clinical practice (Norton series on interpersonal neurobiology). W. W. Norton & Company.

Sroufe, L. A., Egeland, B., Carlson, E. A., & Collins, W. A. (2009). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. Guilford Press.

Tronick, E. (2007). The Neurobehavioral and social-emotional development of infants and children (Norton series on interpersonal neurobiology). W. W. Norton & Company.

Tucci, J., Mitchell, J., & Tronick, E. (2019). The handbook of therapeutic care for children: Evidence-informed approaches to working with traumatized children and adolescents in foster, kinship and adoptive care. Jessica Kingsley Publishers.