A BIOPSYCHOSOCIAL PERSPECTIVE
THE EMBODIED INTERACTION OF TWO MINDS - THE CONTRIBUTION OF NEUROSCIENCE
In the previous section I suggested the object relations paradigm of the mother-infant dyad as a pivot around which socio-cultural and biological etiological explanations of eating disorders can be articulated. In this section I present evidence from neuroscience that supports the dyadic paradigm of object relations, thereby outlining the mother-infant biological matrix in which developmental disruptions unfold. This matrix can be viewed as representing the third, corporeal, component in the biopsychosocial etiological mould of eating disorders.
A growing field of research, which examines neurological and brain processes underlying the phenomena described by psychoanalysis, object relations in particular, can be called upon in support of a multidisciplinary perspective on the body mind relationship in eating pathologies. Allan Schore’s work (1994, 1997a, 1997b, 2013b) is relevant in this respect. Schore argues for instance that Freud’s “Project for a Scientific Psychology” (1895/1950), which sought to establish a model of brain mechanisms that
matched the psychodynamic processes of psychoanalysis, represented a first attempt to bridge the two disciplines. In his article “A Century After Freud's Project: Is A Rapprochement Between Psychoanalysis And Neurobiology At Hand” (1997a), he concludes that the time had indeed arrived56, citing to that effect Freud’s foreseeing, before their actual discovery, the existence of synapses and the activity of biogenic amines of the reticular core of the brain as well as other findings that broadly correspond to the psychoanalytic concepts of drive, internal representations, consciousness, awareness of emotional states, and dreaming.
Researchers from both disciplines have voiced similar views.
Neuropsychoanalyst Mark Solms (2013/2014) describes neuropsychoanalysis as the combination of the subjective psychoanalytic method with the objective neuroscientific approach - an integration of scientific and conceptual frames of reference, which allows the former framework to test hypotheses from the latter and, consequently, a more comprehensive understanding of the mind. Although he warns against seeking in neuroscientific findings a mechanistic validation of various psychoanalytic approaches to the mind, neuroscientist Gallese (2013/2014) suggests that one of the most positive
contributions of cognitive neuroscience is its potential to shed light on anthropological
56 Others have contested the ability of neuroscience to corroborate or invalidate psychoanalytic concepts and claims.
Considering the two fields as separate ones and warning against biologistic inferences on the nature of psychoanalysis, Blass and Carmeli (2007) view for instance the latter as a domain concerned with meaning to which neuroscience cannot contribute.
matters by questioning, rephrasing, and even reconstructing the words we use to describe the mental world and make sense of our being in the world. Jaak Panksepp (2013/2014 Parts I & II), founder of the field of Affective Neuroscience, rejects “ruthless reductionism” and warns against the futility of scientific facts when they are not combined with concepts. Emphasizing human adaptive capacities for neuroplasticity as well as the precedence of affective connections over cognitive ones in psychotherapeutic processes of change, he proposes a classification of the complex social brain into seven emotional systems (Seeking, Rage, Fear, Lust, Care, Panic/Grief and Play), which all are amenable to alteration. Referring to Panksepp’s taxonomy along with three other neuroscientific findings - (1) conditioning as a non-cognitive, involuntary and automatic process, and learning as the acquisition of emotional responses rather than a cognitive phenomenon; (2) decision-making as fundamentally emotional; (3) and the left hemisphere as totally unaware of how conditioning happens -, child and adolescent psychoanalyst Lucy Biven (2013/2014) describes ways in which neurobiological perspectives have informed her practice and helped her define the dynamic unconscious in neuroscientific terms, that is, as a disconnect between the cognitive consciousness of the left hemisphere and the affective consciousness of the right hemisphere.
In this regard, Schore proposes that the interface between biology and psychoanalysis “is to be found specifically in the central role of right brain psychobiological processes in the organization and regulation of affect, motivation, and unconscious cognition” (1997a, 813)57. In the same vein, Tucker and Moller (2007) write that “(t)he right hemisphere's specialization for emotional communication through nonverbal channels seems to suggest a domain of the mind that is close to the motivationally charged psychoanalytic unconscious” (91). In a more detailed way:
… developmental neurobiological research reveals that the process of coping with early life stress increases the myelination of the orbitofrontal cortex, a prefrontal region that controls arousal regulation and resilience.
For the rest of the life span, the right, not left, lateralized prefrontal regions are responsible for the regulation of affect and stress. The right orbitofrontal cortex, the control system of attachment that encodes an internal working model in implicit-procedural (unconscious) memory, is the highest stress regulatory center in the brain and its connectivity is associated with the emotional regulation that is commonly found in secure children. On the other hand dysfunctions of the orbitofrontal system are seen in insecure attachment and a wide variety of psychiatric disorders (Schore, 2013a, 171, all references in paragraph omitted).
Most significantly however, neuroscience has come in strong support of the mother-infant paradigm of object relations. Dyadic interactions, rather than the discrete behaviors of individual members (Schore, 2013b), are indeed at the center of current neuroscientific findings on motivation and behavior and their relation to emotion and cognition. Concepts such as intersubjectivity, the person unconscious, the
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57 On the question of bringing together the two fields of psychoanalysis and neuroscience, see also Solms, M. and Saling, M. (1986).
person psychology, the two-person biology, the relational unconscious, the relational brain, and so on are now increasingly invoked, underscoring what Schore (2013b) describes as the blurring of lines between psychology and biology. From the point of view of Gallese (2013/2014), there are at the least three ways in which neuroscience - in particular his theory of embodied simulation58 as the intercorporeal basis59 for our understanding of others - is relevant to psychology and psychoanalysis: it permits a unified account of preverbal aspects of interpersonal relations that most likely play a role in shaping the self; it contributes to a new definition of psychopathological processes; finally, it introduces a different perspective to the analysis of the interpersonal preverbal dynamics of the therapeutic setting (Gallese, 2013/2014).
Arguing that the alignment of neurosciences on the dyad has confirmed that the initial contact between mother and infant is between their unconscious systems and internal worlds as well as the corporeal dimension of this unconscious contact, Schore emphasizes the “critical importance of right brain-to-right attachment communications in the progressive social experience-dependent lateralization of the right brain” (2013a, 169)60. His statement sums up what I believe are essential characteristics of the two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two- two-
58 “Embodied Simulation theory provides a unitary account of basic social cognition, showing that people reuse their own mental states or processes represented with a bodily format in functionally attributing them to others” (Knox, 2013/2014).
59 The embodied simulation that Gallese proposes as the intercorporeal basis for our understanding of others are matched in the observation of face-to-face encounters and still-face experiments in infants and mothers, which reveal patterns of turn-taking, rupture and repair (Tronick et al,1978; Beebe, 2000).
60 Schore (2013a, 169) cites in this regard: neuroscientific research on the dominance of the right brain hemisphere in
person construct: 1/ the corporeal support of the interpersonal relationship as indicated in the communication of two brains (right brain-to-right); 2/ the relevance of exogenous influences on the developing right brain (experience-dependent lateralization), in accordance with the epigenetic principle of continuing dialectics between developing organisms and their fluctuating environment (Chapter VII); 3/ the gradual (progressive) nature of brain development; 4/ neuroplasticity, as inferred from the two preceding points; and finally, 5/ the emotional/affective quality (attachment communications) of the phenomena involved in dyadic neurological processes.
Particularly interesting from a body-mind angle is the corporeality of mother-infant right-brain to right-brain interactively regulated attachment communications.
Indeed, current neuroimaging data highlight the critical impact of visual, auditory, and tactile communications on the right brain in both mother and infant as well as their paramount importance for early and later social development. These bodily-based emotional communications, the implicit, nonconscious processing of nonverbal affective cues, either promote or inhibit the experience-dependent maturation of the infant’s developing brain (Schore, 2013a, 2013b).
Starting with the mutual mother-infant gaze, findings show that future aptitudes to process fundamental social information through face-to-face communications -