Allan Schore has written two very dense, but very helpful books integrating the recent research in neurobiology with our understanding of the effects of psychotherapy (Click here to see Schore’s books). He describes studies of early childhood (birth to age three) showing that small children operate mostly from the unconscious, the seat of which seems to be located in the right brain. Right brain development is accelerated until age three, and at various times later in life. Left brain development is alternately predominant at other times. The right brain regulates emotion, social experience, and attachment. The left brain regulates verbal processing, cognitive understanding and reflective, conscious experience.
According to Schore, most psychotherapies focus on helping people develop better affect regulation. This capacity includes experiencing the affect (right brain), describing it (left brain), and understanding its meaning (left brain). It is the integration of right brain and left brain functions that allows a person to make best use of the full range of experience and maintain a stable affective and cognitive inner state of well-being. Schore quotes Westin: “The attempt to regulate affect–to minimize unpleasant feelings and to maximize pleasant ones–is the driving force in human motivation.” So psychotherapy is ultimately aimed at helping people feel better.
What happens in long-term therapy is that the therapist helps the patient experience and tolerate affect by resonating with the patient’s experience, and then together they bring that experience into a cognitive context by interpreting it, and then understanding together what it means for the patient. This process takes time because it is not simply a matter of understanding, but of entering into the experience together and integrating affect with understanding. In Schore’s words, this is a direct communication between two separate limbic systems. This synchrony is nonverbal and the resonance is primarily physiological.
Fundamentally, then the effective therapist is similar to the well-attuned parent, capable of creating a partnership with the other person for the purpose of promoting his or her development. This partnership itself becomes a context within which the patient can learn to regulate his or her own physiological-affective experience. According to Schore, “although short-term treatment may allow the patient to return to a reregulated premorbid attachment pattern, over long-term treatment, this neurobiological development may mediate an expansion of the patient’s unconscious right mind and the transformation of an insecure into an ‘earned secure’ attachment.”
This accomplishment, earned security, is profound, significant, and somehow relatively unknown. While there is much research about the value of secure attachment, the effects on the brain of its development, and the value of long-term psychotherapy in its attainment, in most mass market communications, psychotherapy is treated as one type of thing, rather than the multidimensional system of care that it has become. Even though a person may be aware of a sense of internal unease or unhappiness, he or she may be unable to articulate exactly what is wrong and have no idea how to go about feeling better. This is really, really unfair and unfortunate.