P. Anne Winter RP, RelPsych(Dip), Clinical Member OSP, ASCH Hypnosis (Basic)

"The real voyage of discovery consists not in seeing new landscapes, but in having new eyes.- Marcel Proust

Eternal Moments

This essay is an attempt to stress the importance of memory in the development of rage and shame. To facilitate this, the essay will explore the developmental mechanics of memory during the first fifteen months post-birth and its role in creating these two isolating inter-relational affects. The exploration will be from the neurobiological-psychological viewpoint as discussed by Alan N. Schore.

The slogan "use it or lose it" takes on a new perspective in contemporary neurobiological research. In the last decade, research has found that neurogenesis of affect will not occur without experiential practice during age-specific developmentally susceptible time frames in infancy. In Colin A. Ross' presentation at the annual international ISSD conference in Montreal in 1997, "The Psychobiology of Dissociation," he said that if at birth you blindfold a kitten for six weeks, it will never be able to see. If you apply this phenomenon to the neurobiological development of emotions and memory in human beings, its possible to understand that the specific affect would remain undeveloped due to lack of stimulation at the appropriate maturational phase.

Affect genesis occurs during a developmentally susceptible preconditioned time frame. If missed, the potential for a specific affect development may be eradicated, as was the kitten's sight. Schore calls these phenomena a "failure of appointment"  and it can occur in an instant. The prospect of homeostasis for the infant's healthy eternity may be dependent amongst other inter-relational qualities, on timely moment-by moment response to eye gazing.

The growth of healthy emotion is dependent on an intense interaction in the dyadic relationship between the 'primary caregiver' {This is to be accepted by the main emotional spiritual and physical care giver(s)} and the infant. The impact of this interdynamic relationship will shape lifelong patterns of affect regulation, which is vital in creating a good-enough environment for continued neurogenesis of emotionality to occur. According to John Bowlby's attachment theory, the infant is primarily concerned with its relationship to another human. She internalises the object or caregiver, creating a "template" that serves as a representation for like situations. When the neurological system is stimulated by a similar situation, the same affect response will be triggered in the neurological system.

In order to have a reference of age specific time frames the Mahlerian model of infant maturation will help identify the approximate age for each phase of development, as Alan Schore does in Affect Regulation and the Origin of the Self (1994). Margaret Mahler's phases for the first year and a half are as follows: autism, birth - one month; symbiotic, 1-5 months; differentiation, 4-9 months; practising, 7-10 months; and rapprochement, starting around the 14th month.

The infant struggles to "maturation from absolute dependence to working towards independence" (D.W. Winnicott The Maturational Processes and the Facilitating Environment 1984,p 84). Neurobiologically, in order to facilitate maturation, neuropathways are developed in response to the external stimulus, usually a combination of auditory, visual, tactile and/or proprioceptive stimuli. A spectrum of intensity or stimulus will produce a change in affect. The affect if new, will promote neurogenesis to accommodate a new adaptive affect. This essay will focus mainly on the visual stimulus of mutual eye gazing.

Heintz Kohut’s term "mirroring" (How does Analysis Cure?, 1984 ) describes "instinctual" long gazes between caregiver and infant. He is referring to a complex stimulus of sensory information the infant receives from its caregiver that, in turn, exhibits appropriate state-dependent behaviour for the infant to take in psychically. Schore (p. 82) describes this as "now print" phenomena in which information from the caregiver's face promotes a regulation of arousal and subsequent affect, which are the infant's first formations of memory. These responses promote emotional connection with the caregiver, recognised by eye dilation, which, in turn, reflect the infant's experiential sense either of aliveness or of not being alive. Her appropriate response rely heavily on the ego strength of the caregiver's own psychic health.

The caregiver, in effect, is the regulator of the infant's emotions. Repeated occurrences strengthen the effect and, by the practising phase, the infant can conjure up past situations and individuals intra-psychically. The internal visualisation creates the illusions that give an impression of safety (or otherwise). This interaction is only possible u to the rapprochement phase if the caregiver's eye gaze that reminds the infant of the intra-psychic template so that it can be aroused stimulates the infant.

Conversely, the caregiver is also studying the infant's emotionality, verifying its appropriateness through physical, auditory or visual connection. The gleam of the caregiver's eye is likened to an internal searchlight gauging the object-seeking infant's internal emotionality. Daniel Stern describes this as the "optimal level of stimulation" (D. Stern, The Interpersonal World of the Infant, 1985, pp. 74-5). Both caregiver and infant modify their responses as the connection is intensified and adjustment to the intra-psychic structure develops.

To understand the neurobiological dynamics of eye gazing we will look at some of the main anatomical structures involved in memory and affect. The central nervous system consists of the brain, cerebrum, cerebellum, and the brain stem. On the right orbital frontal cortex lies the cerebrum's anterior hemisphere, which are concerned with the development of emotion. Just a little lower on the right side resides the temporal lobe, which appears to respond to facial expressions. Posterior and inferior to the right orbital frontal cortex is the sub-cortical region. This region contains the limbic system, which is involved with memory and affect. The area slightly below the brain stem is implicated in the physiological expression of emotions.

The peripheral autonomic nervous system (ANS) contains the sympathetic and parasympathetic systems, which are the afferent and efferent nerves that join sensory and motor viscera. Within the autonomic nervous system, only the sympathetic outgoing expressive or hyper-aroused emotions are developed at birth. By approximately ten months, the parasympathetic regulative component begins to develop, which attempts to reduce perceived situations of dangerous hyper-arousal.

At birth, the brain and the ANS are partially matured and continue development up to the twentieth year. The limbic system responds to outside stimuli in two ways for the first two to three months of life, either with complete rage or total inhibition. During the following two years, the development of affect increases while the parasympathetic ANS matures. Its role is to auto-regulate negative stimuli for the sake of health in the system.

Part of the limbic system, the amygdala, site of the implicit memory, is operative from birth: "clinical evidence suggests that the amygdala is important in linking emotional and motivational responses to external stimuli" (Essentials of Clinical Neuroanatomy and Neurophysiology  8th.edition by  Gilman and Newman p. 121). Adjacent to the amygdala resides the hippocampus, the site of explicit memory, which slowly matures at around the fifteenth month. "Experimental and clinical observations indicate the importance of the hippocampus in learning and memory as it appears to provide a cognitive map" (Gilman and Newman p. 121). The significantly separate maturations of implicit and explicit memory suggest that sensory affect is stored in memory long before the possibility of cognitive memory can construct the history of the emotion.

Up to the tenth month, neural and neurosynaptic genesis in the cortical regions (the right frontal cortical hemisphere and the limbic system) is faster than at any other time in the infant's lifespan. Once a neuro circuit has been created, it is easier for a second signal to flow through the same circuit. To develop a different response to the same type of situation I would expect that a new circuit must be developed from a different experience. As the old experience has a more dominant effect on the neurological system, a new response would have to be considerably stronger to form a new circuit.

The parallel is striking between the period of intense neurosynaptic genesis and the intense dyad when infant and caregiver spend long hours gazing into each other's eyes, re-evaluating, repeating and forming new responses. Within the limbic system, the amygdala is receiving the stimulus during this phase of maturation, while the hippocampus is maturing. At this junction, I would think that the infant is headed toward a life of heightened sensory input compared to cognitive understanding, which is, in fact, balanced out on the maturation of the hippocampus during the rapprochement phase.

The transmission between the cortical limbic and sub-cortical limbic systems develops the neuropathways, which are strengthened by repeated experiences. This action subsequently increases strengthening of self-regulation in normal synaptic development.

Over time, the infant first internalises primitive, and then more complex representational neurological forms of safety in memory, to be utilised when the caregiver is not physically present. This is a gradual process, primarily observed during the practising and rapprochement phases. The activity in the prefrontal cortex stimulates the hippocampus. Evocative memory conjures up the internalised caregiver and any other comforting object to assist in the autoregulation of the fear/anxiety response of "fight and flight" through the ANS.

In health, the infant is interested in the world around her, is creative in her responses and is joyful and full of life. If, however, the caregiver produces a failed appointment by averting her eyes or making a disgusted face, the connection is broken. Subsequently, if this occurrence is repeated there is a lessened chance of positive interjection. Due to failed appointments the child may become fearful of eye contact and refuse to explore interdynamic exchange between her and the caregiver or others. Having introjected a poor image of the self with little memory of positive mirroring, eventually the infant may experience, among other painful feelings chronic shame/rage.

If the caregiver suffers from a narcissistic disorder she cold present obstacles during eye gazing. For instance, the infant may experience the caregiver as insecure, avoidant or resistant, and subsequently lose the regulation of narcissistic affect. If the caregiver does not have a strong, directed eye gaze, feels ambiguous about her self, or is depressed and angry, the affect experience for the infant could be a much more narcissistically dis-eased dis-regulation.

Memory appears to be a cohesive ingredient that allows appropriate affect to develop as the infant learns varying responses to its expanding world. The lateral temporal nuclei in the locus cerculis matures at around eighteen months, just when the dyadic relationship is shifting toward separation. The orbital prefrontal cortex is the storage of early visuo-emotional association, and visual memory and memory is improved with its development. Results reveal that, as Sarter and Markowitsch suggest, "emotions are part of the information represented in memory and that consequently affective and cognitive information are interwoven in retrieval" (Schore p. 363).

Rage and total inhibition are conditioned reflexes the infant experiences from birth. By the practising phase, shame, a natural process developed through conditioning of impinged caregiving interdynamics has developed, acting as an inhibiting factor to modify perceived intense negative emotions such as rage. This is achieved during the complex intersubjective dyad during the practising and rapprochement phases.

Webster's Dictionary describes rage as "violent, uncontrolled anger, insanity." I speculate that "blind rage" implies the response of an object-seeking libido that never discovers, the object, this in explicit memory. Without a good enough caregiver, facilitating time appropriate maturation of emotions, the infant is not able to mirror and introject a self-care model and is left with uncontrolled rage and loss of self-regulatory assets. Compensatory fragments of affects such as thumb sucking or rocking may be utilised in an attempt at modification, but never fully successfully.

So debilitating a problem does Schore find rage in this society that he contests that:

“The essential problem of the human condition is not as Freud supposed psychoneurosis, and not even psychosis. Rather, I see the products of unregulated unconscious primary narcissism and humiliation-induced narcissistic rage in both children and adults as the major threat to the further development of our species.” (Schore, p. 341)

The modulation of rage can often be experienced through a sense of shame. Prior to experiencing shame there is a sense of narcissistic joy, excitement and expectation, then a mis-attunement is perceived, and immediately there is a need to withdraw physically and emotionally by pushing the object away or avoiding eye contact. Although this can occur at earlier developmental periods, during rapprochement phase the child is learning socialisation skills and is often unconsciously put into a position of shame in an effort to arrest original narcissistic gestures. Webster's definition of shame as "a consciousness of guilt, of humiliating disgrace" hardly touches on the depth of this debilitating affect.

Experientially, there is a sense of being at a loss for words, as the rug is pulled out from under her. The infant is reluctant to explore the world or confront perceived wrongdoings, and shows a marked decrease of energy. Even the head hangs low and the infant looks sorrowful. Often, with shame, Alexithymia, a deficit of evocative memory, is experienced, associated with limitation of symbolic junction. Due to this deficit, there is, for the infant, a decrease in the capacity for self-regulating emotional states and physiological functioning when under stress (Schore, p. 485). In an attempt to auto-regulate this painful state the child goes from hypo to hyper arousal, dependent on a good enough caretaker or others to assist her affect regulation.

The role of memory in the quality of attachment in ambivalent eye gazing may be better understood if we look at severe attachment disorders such as borderline and narcissistic personality disorders with poor affect development in the presymbiotic and symbiotic phase. Paradoxically, there is a positive outcome of shame; H.B. Lewis suggests that "unregulated intense levels of shame may be a central component of enduring aggressive organizations which develop in the practising period" (Shore p. 340).

Although borderline infants will not be recognised as such until they are able to verbalise their distress, the causal factors originate much earlier. As the infant is not taught self-soothing techniques, positive affect decreases. There is a lack of modulation in the ANS that swings from parasympathetic to sympathetic systems, including rage/shame responses, while the mind is a dissociative void. Grotlein calls this the "black hole" of hell, with an accompanying sense of no recourse of modulation (Shore 421).

During the narcissistic stages of affect development, chronic mis-attunement could promote the development of two types of narcissistic personality disorders. One can be identified as egotistical the other dissociative. In the former, the child presents in a grandiose manner, and manifests severe mood swings. The child's appearance is uninhibitedly aggressive and attention seeking and is mainly concerned with self-interest. These expressions are an attempt to avoid the intense shame of a caregiver who did not offer stable modulation of affect, but herself swung from shame to rage.

An even more severe presentation of affect modulation injury can be found with dissociative narcissistic personality disorder. The child with this disorder is hyper-vigilent, has a severely depleted ego, and is highly sensitive to rejection. He or she has been a narcissistically desired object for the caregiver, and has not been allowed fundamental self-discovery. The result is a loss of boundary exploration. The caregiver cannot stand hypoarousal in herself, or in her infant, and this forces the infant into a state of constant hyperarousal.

The infant may have had appropriate attunement in the symbiotic phase, which initiated the development of a strong ego. The ego is depleted in the rapprochement phase through lack of continued positive mirroring. The lack of positive introjection results in a loss of regulation of the parasympathetic system, due to continued failed appointments in the rapprochement and practising phases.

Oliver Sacks, a clinical neurologist who has written a number of books on neurological defects, quotes Luis Bunuel, the Spanish filmmaker:

“You have to begin to lose your memory, if only in bits and pieces, to realise that memory is what makes our lives. Life without memory is no life at all. (O.Sacks, The Man who Mistook His Wife for a Hat, 1985, p.23)

Memory is featured in one story of Oliver Sacks' collection of short stories, The Man who Mistook His Wife for a Hat. He discusses "Jimmy," who suffers from Korsakov's Syndrome. The deficit of the quality of Jimmy's life was dramatised in a bizarre manner when he suffered a basal ganglia stroke, which permanently blinded him. He did not even mourn the loss of sight as he and no memory of ever seeing.

The full impact of limbic memory development, specifically in the amygdala, and later in the maturation of the hippocampus, has been a focus of van der Kolk. In his research into memory retrieval with trauma clients, van der Kolk has found that "the slow maturation of the hippocampus, which is not fully myelinated (formed) until after the third year of life, is believed to be the cause of infantile amnesia" (The Body 261).

Van der Kolk found that electrical stimulation of the amygdala in an adult produces archaic affect, revealing that conditioned responses are indelible. The study appears to indicate that any hyper stimulation could stimulate the same affect sensory response forever (B. van der Kolk, The Body Keeps the Score: Memory and the Evolving Psychobiology of Posttraumatic Stress, 1994).

To conclude, in looking at the development of affect and the fragility of the territory of neurogenesis, it appears quite miraculous that there are not more dis-eased affects from misattunements. On reflection, this author has a deeper respect for the delicate play of the caregiver and infant inter-relational dyad. Fortunately, there is a direct model of intervention of negative outcomes through psychotherapy. Although the neurogenesis formation may be permanent, psychotherapeutic intervention appears to reduce, symptomatically, the intensity of the original synapse formation as well as promote neurogenesis.

However, it may be safe to speculate that the new affect is a modification from the original same-state-dependent arousal. In that sense, part of the infant's character is permanently laid down with her original gesture - her eternal moment.

 

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Originally published in SurvivorShip, then put on-line and later published in S.M.A.R.T.’s on-line Journal.

Copyright P.Anne Winter. P. Anne Winter is a psychotherapist in private practice in Canada. Her interest is in working with adults who have been severely abused in childhood and suffered traumatic memory loss.

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