Jing Therapy Centre

2) Psychopathology of Affect Dysregulation

Developmental Origins of Affect Dysregulation

             Relational trauma has only recently begun to be studied empirically and may be defined as “exposure to chronic misattunement and prolonged states of dysregulation in the context of the early attachment relationship” (Hill, 2015). When seeking affect regulation from the caregiver, the infant receives responses that exacerbate rather than modulate the dysregulation. The caregiver has no emotional capacity to regulate the infant sufficiently or even becomes the source of the stressor requiring regulation. In Schore’s (1994) work, he proposes that early relational trauma results in psychoneurobehavioral defects in the primary affect-regulating system. Prolonged states of dysregulation generate neurotoxic conditions that adversely alter the developing limbic-ANS structures. Chronic episodes of misattuned regulation also leave an imprint of maladaptive neurobiological, behavioral, and psychological procedures to stress.  

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             In the insecure-ambivalent attachment style, the infant’s autoregulation is underdeveloped and hyperaroused defenses against stress become dominant. In the insecure-avoidant attachment style, the infant’s attachment needs are dismissed or even shamed, and autoregulation is the dominant coping strategy. At the neurological level, avoidant trauma results in a parasympathetic bias and incapacity to regulate hyper-aroused affect states and hypo-aroused defenses against stress become dominant. In disorganized trauma, the damage to the primary affect-regulating system is qualitatively more severe than that in insecure attachment. At the neurological level, in a secure attachment, the relationship between the activations of sympathetic and parasympathetic nervous systems of the ANS are counterbalancing and reciprocal. In cases of structured insecure attachment, these two components of the ANS become biased but remain coupled. Although unbalanced, there is still a moderating effect, and a coping strategy is developed. In disorganized attachment, the neurochemical damage is so severe that the two aspects of the ANS become uncoupled. Lacking the reciprocal counterbalance, the sympathetic and parasympathetic aspects may be activated simultaneously but they do not serve as a moderating counterforce for one another (Schore, 2019).

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Relational Trauma as a Neurodevelopmental Disorder

            Chronic stress that is caused by relational trauma, produces neurotoxic conditions during the critical period in the development of the primary affect regulating system. Schore’s work (1999) provides extensive evidence that early relational trauma impacts the optimal development of the limbic system and the circuits connecting it to the ANS and alters the functioning of the HPA axis. His theory proposes epigenetic influences involving the experience-dependent expression of genes: “Under conditions of chronic stress, there is insufficient environmental inducement of metabolic conditions that support the genetic expression of proteins necessary for the development of limbic structure.” (Schore, 1999).

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            In Dialectical Behaviour Therapy’s (DBT) biosocial theory about how emotion dysregulation develops, Linehan (2012) also proposed that biological vulnerabilities (e.g., emotional sensitivity) and the invalidating environment (e.g., relational trauma) are two contributing factors during the critical development period of childhood, and eventually lead to pervasive emotion dysregulation and repetitive maladaptive behaviors that serve an emotion regulation function and become reinforced.

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References:

Hill, D. (2015). Affect regulation theory: A clinical model. WW Norton.

Linehan, M., M., (2014). DBT training manual. The Guilford Press.

Schore, A. N. (1999). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Mahwah, NJ: Erlbaum.

Schore, A. N. (2019). Right Brain Psychotherapy. WW Norton.

Schore A. N. (2021). The interpersonal neurobiology of intersubjectivity. Frontiers in Psychology, 12, 648616. https://doi.org/10.3389/fpsyg.2021.648616

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