CSAR

Attachment Theory

  • Affect regulation theory. A clinical model. Chapter 1
  • In Chapter 1 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he presents classic attachment theory. The Strange Situation and Adult Attachment interview are described along with the concepts of secure and insecure (avoidant, preoccupied and disorganized) attachment patterns. Additionally the reader is introduced to how each of the insecure patterns represent different deficits in affect regulating capacity in comparison to the robust affect tolerance and resiliency of secure attachment....

  • Affect regulation theory. A clinical model. Chapter 2: Self-states
  • In Chapter 2 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he presents a model of bodymind organized around the relational theory of self states. The central idea is that when regulated self states are integrated and when dysregulated self states are dissociated. Self states are conceived as assemblages of perceptual, attentional, representational, memory and reflective systems. Each system may be integrated or dissociated. Additionally, two types of dissociation – compartmentalization and altered states of consciousness are discussed....

  • Affect regulation theory. A clinical model. Chapter 3: Neurobiology of the primary affect-regulating system.
  • In Chapter 3 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he presents the neurobiological substrate of the primary affect regulating system. The components of the limbic system (amygdala, insula, hippocampus and prefrontal cortex are discussed. Additionally the relationship between the limbic system, HPA axis, and autonomic nervous systems are outlined. Each is involved in the assessment of internal and external stimuli and in the automatic regulation of affect....

  • Affect regulation theory. A clinical model. Chapter 4: Right brain, implicit processes and implicit self
  • In Chapter 4 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he presents a model of the right brain understood to be the seat of the “Implicit self”; i.e. the unconscious processes that assess and respond involuntarily to internal and external events. Comparisons are made to the explicit processes mediated by the left brain. These processes include implicit vs explicit memory, implicit cognition and implicit communication. Together they comprise the implicit (unconscious) self....

  • MBT Treatment: “What works for Borderline Personality Disorder?”
  • In this video Professor Fonagy explains the concept of mentalization: what it is, its uses in the relationship with others and the self, how it develops in the human mind and the risks of losing this capacity. He creates a multidimensional model with 4 dichotomies that need to be balanced for an optimal mentalization function. Using this model to understand BPD, he shows the several difficulties these patients have to access mentalization. While other therapeutic techniques ask the patient to use mentalization capacities they don´t have, MBT tries to balance the functioning in the 4 dimensions to help patients achieve mentalization. ...

  • Dysregulation of the Right Brain: a Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder
  • Objective: This review integrates recent advances in attachment theory, affective neuroscience, developmental stress research, and infant psychiatry in order to delineate the developmental precursors of posttraumatic stress disorder. Method: Existing attachment, stress physiology, trauma, and neuroscience literatures were collected using Index Medicus/Medline and Psychological Abstracts. This converging interdisciplinary data was used as a theoretical base for modelling the effects of early relational trauma on the developing central and autonomic nervous system activities that drive attachment functions. Results: Current trends that integrate neuropsychiatry, infant psychiatry, and clinical psychiatry are generating more powerful models of the early genesis of a predisposition to psychiatric disorders, including PTSD. Data are presented which suggest that traumatic attachments, expressed in episodes of hyperarousal and dissociation, are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. These enduring structural changes lead to the inefficient stress coping mechanisms that lie at the core of infant, child, and adult posttraumatic stress disorders. Conclusions: Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders....

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