Unconscious and Implicit Interpersonal Processes

Integration of findings, gathered predominantly from empirical research on cognitive science and neuropsychology, and informed and inspired by psychoanalytic theory and developmental psychology, suggests that affect-regulation is communicated through the non-verbal, sensory-perceptual-motor dimension. During the initial stages of human life development (the beginnings of affect-regulation seem to occur in the earliest foetal stages), emotions are managed by others as affective bodily-based attachment processes that are unconsciously regulated within the primary object and

infant dyad (Schore and Schore, 2008). Such non-conscious relational transactions shape the development of psychic structure, and internal working models, and critically impact the development of right brain neurobiological systems (which are regarded as the core of human unconscious). These systems are responsible for processing and modulation of emotion and stress, self-regulation and self-soothing capabilities of mind/body (Prodan et al., 2001; Schore, 2000; 2003; 2005; Applegate and Shapiro, 2005). It is argued that modern attachment theory is, in fact, a regulation theory consonant with the psychodynamic literature on inter-subjective dynamics (Schore and Schore, 2008).

Besides o s ious a d e pli it atte da e to lie t s li guisti s, i pli it communication at levels beneath awareness, is also embedded in the therapist-client relationship of transference and countertransference phenomena and is characterised by right brain transactions and interceptive, somatically-based, affective relational exchanges (Lyons-Ruth, 2000; Scaer, 2005; Schore, 2003; Decety and Chaminade, 2003). It, therefore, seems that as individuals we are not self-contained in terms of our energies, as affect has potential transmitting properties whereby one individual can have an impact on another (Brennan, 2004). It has therefore been demonstrated that the therapeutic encounter allows for the unconscious transmission of self- regulation transactions, which in turn provides an opportunity for remediation of

lie t s early acquired ruptures in this domain (Jacobs, 1994; Schore and Schore, 2008). It is the role of an intuitive clinician, acting as an interactive regulator to be attuned psycho-biologically to the lie t s o -verbal internal structure. This work, however, requires profound engagement and commitment from both the therapist and the client (Tutte, 2004). It is argued that effective treatment, particularly related to early self-pathologies, is ultimately connected to changes in the unconscious system of the right hemisphere (Cohen and Shaver, 2004). Importantly, neuroimaging evidence has demonstrated that psychotherapy itself can reverse the effects of trauma and alter both functions and structures of the brain (Fuchs, 2004). Thus, the depth of therapeutic contact is enhanced significantly and carries transformative effects during moments of meeting (Stern et al., 1998), when emotions are deepened in intensity and are shared inter-subjectively (Whitehead, 2006). It appears that the key is how to be with the client during emotionally charged moments, rather than what to do or say to the client (which would be represented through left brain focus). The relationship, empathy and emotional responses of the therapist form cornerstones for a healing process. However, this idea is certainly not a novel one, corresponding as it does to Wi i ott s Holding Environment, Kohut s

Mirroring a d Bio s theory of Containment.

Interestingly, it has been proposed that implicit transmission of affective processes, as linked to affect-regulation, may be facilitated in a more active, direct and effective manner. In other words, this process of emotional communication may be extracted

out of the intuitive realm and placed explicitly into the focus of conscious awareness. Fonagy and Target (1998), argue that the implicit dimension of therapeutic encounter falls u de the u i of o -specific factors, a d that previously-mentioned o e t of eeti g should e authe ti a d spo ta eous i o u e e. Follo i g this line of thinking, it could be implied that the therapist may not be able to intentionally impact the non-specific elements as any theory and technique represent explicit and declarative knowledge. However, others have suggested that the therapist can be responsive, like the responsive mother. Therefore some degree of self- awareness of thethe apist s own behaviour and therapeutic intervention, in relation to affective states, can be developed (Kiersky et al., 1994; Knoblauch, 1997).

1.4 The Mechanism of Change

The concept of change may produce various definitions. In fact, the very idea of change is probably as problematic as staying the same. Nevertheless, in the context of affect regulation difficulties change can be defined as an enhanced ability to respond adaptively, flexibly and creatively to the circumstances of life. The aim is hence, focused on achieving greater fluidity and ability to use the full range of emotional repertoire, which ultimately entails a way in which one expresses oneself in life or how one relates to life. Therefore, esta lishi g the o u e e a d fo at of lie t s affect-regulation evokes questions regarding therapeutic action. McCullough et al. (2003) raised the subject of the importance of helping the client experience affect, rather than merely talking about it. Indeed, it has been identified that three components of the feeling ust e p ese t that ould ega d the lie t as t ul i tou h ith the e pe ie e of the e otio . These elements represent cognitive (labelling feelings), physiological (physical/visceral sensations) and motoric (mobilisation of an impulse) dimensions (Laikin, Winston and McCullough, 1991; Selva, 2004). Also when painful feelings are de-repressed, fully experienced and owned they can also be integrated as valid and healthy elements of the self (Jacobs, 2010). Moreover, affect–regulation or the nature of regulated interactions between the therapist and the client are associated with emotional communication and therefore better therapeutic alliance (Nightingale, 2002). Thus, when it comes to psychic change, a classic psychoanalytic method of interpenetration may be limited when used in isolation (Andrade, 2005). The premise that insight on its own is sufficient has become ingrained in talking therapy, and although of great importance (as it can form a foundation for change) it may not be the same as an actual change. The power and role of affect in human functioning and its connection to rationality has long been overlooked. Da asio s e olutio a o k o e otio , I feel the efo e I a corrects Des a tes s I thi k the efo e I a proclamation and points to the possibility that emotions may constitute the sou e of o e s o e ei g. Hence, if we are unable

to process and express our emotions, development of our true self and our authenticity is impaired; in other words, we are unable to be (Miller, 2008). Following this line of thinking one may wonder to what extent is it truly helpful to prioritise cognition and give precedence to logic by emphasising and fostering thought- orientated components, while downplaying the role of emotions. Thus, one may reflect upon the fact that some of the main philosophical, as well theoretical and scientific underpinnings of Cognitive Therapy have been questioned; including its key presumption that cognitive disturbance causes an emotional disturbance (Moloney and Kelly, 2004). In fact, even the long-term effectiveness of this approach is now doubted (Shedler, 2010; Huber et al., 2012). It may be concluded that the current p eo upatio ith ui k fi es u de i es the i po ta e of deli e i g interventions that would address the root cause of the problem and produce long- lasting and broadly-based benefits. Critique of affect theory, on the other hand, frequently concentrates on the argument that cognitions and meanings are not necessarily separate from emotion or affect (Leys, 2011). However, the counterargument stresses that affect proceeds language-based cognition (Stern, 1994 and Stern et al., 1998). Hence, it is claimed that cognitive re-appraisal or insight may provide a deeper understanding but cognitive change alone is unlikely to reconfigure the emotion schematic network in the brain (Bechera et al., 1997; Forgas, 1995). Holistically, it is highlighted that successful intervention requires attendance to both cognition and affective experience – with the latter being a fundamental motivator for behaviour and therefore change (McCullough et al., 2003).