- Affect regulation theory. A clinical model. Introduction
In this introduction to Dr. Hill’s book Affect Regulation Theory: a Clinical Model key concepts are introduced including affect, affect regulation, how affect is communicated unconsciously, the neurobiology of affect regulation and the primary and secondary affect regulating systems. It also introduces the reader to an understanding of how affect regulation is key for adaptive functions and why deficits in affect regulation manifest as psychiatric symptomatology and personality disorders.... (read more)
- 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.... (read more)
- 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.... (read more)
- 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.... (read more)
- 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.... (read more)
- Affect regulation theory. A clinical model. Chapter 5: Classical attachment theory.
In Chapter 5 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he describes how optimal affect regulating capacity is developed in the secure attachment relationship. Classical attachment theory is presented including Bowlby’s ideas about the internal working model as a means of evaluating and predicting relationships and its assimilative function. Additionally, an understanding Adult Attachment Interview and presented from the point of view of affect regulation.... (read more)
- Affect regulation theory. A clinical model. Chapter 6: Mentalization. The secondary affect-regulating system.
In Chapter 6 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he describes the processes of Mentalization which comprise the secondary (conscious) affect regulating system. The development of the system is discussed and each mentalizing mode (teleological, object equivalence, pretend, and full Mentalization) are described. Perhaps most importantly, the Mentalization of affect is discussed and the system secondary/ mentalizing affect regulating system is compared with the primary system.... (read more)
- Affect regulation theory. A clinical model. Chapter 7: Modern Attachment Theory. The development of the primary affect-regulating system.
In Chapter 7 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he explains modern attachment theory: how the primary affect regulating system develops in the attachment relationship. This involves, first, the development of the capacity to regulate sympathetic and then parasympathetic arousal and, ultimately, the optimal development of the capacity to regulate affect... (read more)
- 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. ... (read more)
- 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.... (read more)
- Understanding Maltreating Mothers: A Synthesis of Relational Trauma, Attachment Disorganization, Structural Dissociation of the Personality, and Experiential Avoidance
Treatment options are limited for families in which the child has severe and intractable disturbances of emotion and behavior, in which there is suspected or confirmed maltreatment by the mother, and in which the mother has her own history of childhood neglect and abuse. This paper proposes a model for understanding mal- treatment in mother–child dyads, drawing upon the developmental psychopathology, behavior, and trauma literatures. At the core of this model is the hypothesis that a mother’s maltreating behav- ior arises from unconscious attempts to experientially avoid the reemergence of an attachment-related dissociative part of the per- sonality that contains the distress arising from her own early experiences of attachment relationships. The implications of this model for therapy are considered. ... (read more)
- An Attachment Perspective on Psychopathology
In recent years, attachment theory, which was originally formulated to describe and explain infant-parent emotional bonding, has been applied to the study of adolescent and adult romantic relationships and then to the study of psychological processes, such as interpersonal functioning, emotion regulation, coping with stress, and mental health. In this paper, we offer a brief overview of the attachment perspective on psychopathology. Following a brief account of attachment theory, we go on to explain how the study of individual differences in adult attachment intersects with the study of psychopathology.... (read more)
- Affect regulation theory. A clinical model. Chapter 8: Relational Trauma. Developmental origins of disordered affect regulation
In Chapter 8 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he discusses different types of relational traumas – avoidant, preoccupied and disorganized. These occur during the critical period in the development of the primary affect regulating system and each results in different deficits in the capacity to regulate affect.... (read more)
- Affect regulation theory. A clinical model. Chapter 9: Chronic dissociation. A sequela of relational trauma.
In Chapter 9 of Dr. Hill’s book Affect Regulation Theory: a Clinical Model he discusses chronic dissociation as a sequel of relational traumas. He differentiates severe and moderate dissociation and describes the subjective experience hyper- vs hypo-aroused versions of each.... (read more)
- An Ethological Approach to Personality Development – Ainsworth & Bowlby
This is a historical account of the partnership in which Bowlby and Ainsworth participated to develop attachment theory and research. Beginning with their separate approaches to understanding personality development before Ainsworth joined Bowlby's research team at the Tavistock Clinic in London for 4 years, it describes the origins of the ethological approach that they adopted. After Ainsworth left London, her research in Uganda and in Baltimore lent empirical support to Bowlby's theoretical constructions. The article shows how their contributions to attachment theory and research interdigitated in a partnership that endured for 40 years across time and distance. ... (read more)
- The Nature Of The Child’s Tie To His Mother – Bowlby
Psycho-Analysts are at one in recognizing the child's first object relations as the foundation stone of his personality: yet there is no agreement on the nature and dynamics of this relationship. No doubt because of its very importance, differences are sharp and feelings often run high. In this paper I am taking it for granted that today we are all agreed on the empirical fact that within 12 months the infant has developed a strong libidinal tie to a mother-figure and that our differences lie in how this has come about. What in fact are the dynamics which promote and underlie this tie?... (read more)