From internal pathology to understanding relationships
Since their beginning, psychiatry, clinical psychology and psychotherapy It has been suggested that psychological and emotional distress arise in individuals: dysfunctional neurochemistry, faulty perception, or personal internal conflicts. unconscious. Accordingly, treatment is conceptualized in terms of interventions on these inner workings. So there we have it psychiatric drugs to alter neurochemistry, cognitive techniques to correct distorted thinking, and interpretive approaches to uncover inner unconscious conflict. This view, in general, has an individualistic, “atomistic” basis. philosophy A mind that has dominated Western thought for much of the last few centuries and can be traced back to René Descartes.
However, in the last few decades, relational and subjective models of consciousness have seriously challenged the ideology behind it. Such models reject the Cartesian assumption of an isolated mind (or brain), starting from the individual in context—the interpersonal and social worlds in which we are embedded. What changed after that? possible they made a mistake with biological or cognitive processes what happened interpersonally and socially and how to fix it. (See my other blogs to here and to here for more information on this.)
This blog covers that conversation and raises another question: how does the brain fit into the conversation—what does it do? neurology tell us Simply put, neuroscience favors relational and subjective models of consciousness over the individualistic models that underlie mainstream approaches in psychiatry and psychology.
Brain development is a two-person process
Before coming attachment exploratory and integrative neuroscience, brain development was thought to be internally controlled and biologically determined, an entirely individual affair. We now know that this is not true. Interpersonal processes, particularly those involving primary caregivers in the early years of a child’s life, are critical not only for the functional development of the brain, but to some extent for the literal development of parts of the body itself (e.g., Schore, 1994; Schore & Schore, 2008; Siegel, 1999/2012).
In fact, when we think of the brain as developing according to its own genetic program, we find another, the caregiver, to play a deep and fundamental role in how that program manifests itself. Social and interpersonal interactions are fundamental to our brains and their development.
From the earliest months of life, neurodevelopment is shaped by interactive affective exchanges with primary caregivers—momentary emotional give and take, regulation, reflection, soothing, and maintenance. Most importantly, the limbic-prefrontal systems are particularly experience-dependent in this sense, being highly sensitive and shaped by caregivers’ response and adaptation patterns, as well as other environmental factors (Schore, 1996; Tottenham, 2012; Callaghan & Tottenham, 2016; Siegel, Siegel, 2001; 2001). The importance of these findings cannot be overstated.
These brain regions—the limbic system and the prefrontal cortex—are especially fundamental to our experience as human beings. They lie beneath emotional regulationstory memory, personthe ability to empathize, ethicsand socialization as well as self-awareness. In other words, our ability to feel empowered, to internalize our emotions rather than be overwhelmed by them, to understand ourselves, others, and the world in terms of meaning and intention, and the ongoing, coherent sense of self through which all of this happens—neurologically, not just psychologically, but only the initial social correlate. side.
In contrast, when such interactions are poor or absent, we can also see that the structural organization of these systems is disrupted. For example, Schore (2008) suggests that a secure caregiver-infant relationship leads to integration between the limbic and cortical systems; on the contrary, chronic wrong or relationship trauma it disrupts integration, which is associated with stable forms of affect regulation, fragmented self-experience, and personality instability. Perry (2009) similarly provides evidence that traumatized and neglected children experience disruptions in the hierarchical development of brain systems responsible for arousal. feelingand executive activity. These are not abstract psychological tendencies, but nervous organizations that arise as a result of deficiencies in social and interpersonal harmony and care.
Taken together, the research supports a consistent conclusion: the brain is organized within a relational dynamic structured by attachment processes rather than autonomous development within individuals. Brain development is, from the very beginning, a two-way process that takes place in a “two-person” system. Thus, modern neuroscience merges with the relational and humanistic traditions, which we do not assert – the brain does not develop – it develops first and then connects. Instead, we develop through communication, and the quality of that communication is critical to development and psychological health.
Implications for psychiatry and mental health
Importantly, these principles apply not only to early brain development, but also to lifelong healing. The brain remains plastic, constantly being shaped and reshaped by experience, especially in interpersonal contexts. The implications for psychiatry, psychology, and mental health are profound if brain development, as well as the adult brain, is open to primarily two-person, relational processes.
Neuroscience Essential Readings
Just as early contact environments organize neural systems, later relational experiences, especially those characterized by safety, adaptation, and mutual recognition, may support the reorganization and integration of these same systems. If we can say this not only in a theoretical or philosophical sense, but also in terms of neuroscience, the case for change is huge.
It calls loudly for the wider field of mental health to move beyond the individualistic paradigm. Social isolationinequality, unstable care the environment and disturbed communities are not only external “risk factors” for the individual; they are constitutive elements in the development of the very nervous systems that psychiatry seeks to treat (as if they were independent of them).
Similarly, if this is true for older adults, the social and interpersonal context of caregiving is also critical. In short, if the capacities that promote mental health are themselves interdependent, then so must be the conditions that support them. Consequently, how we deal with psychological distress becomes crucial: approaches that primarily individualize or mechanistic risk ignore the basis of this change at the neurological level and even serve to exacerbate the problem by ignoring or denying the social and relational context. Thus, rather than trying to change the brain pharmacologically, effective responses to mental health challenges must be socially and relationally based, not only ethically and philosophically, but also neurologically.
