Welcome to part III of my reaction to the 2014 book Origins of Attachment co-written by Beatrice Beebe and Frank Lachmann. This will be the final part in this series. It’s a bit long but I wanted to wrap things up.
Let me ask you this question: Why is it that you cannot tickle yourself? Think about it, try as you may, you simply cannot tickle yourself. The reason you cannot tickle yourself is because your brain uses Inner Working Cognitive Models (a topic I mentioned in the earlier parts of this series).
Back in November of 1999, The Economist ran an article in their Science and Technology section entitled The Soul of a New Disease. The disease in question is Chronic Fatigue Syndrome (CFS). Here’s how this article answers the question Why is it that we cannot tickle ourselves? (while giving us a little insight into a debilitating disease).
Daniel Wolpert, a cognitive neuroscientist at the Institute of Neurology in London, … offered one explanation of why people suffering from CFS consider themselves to be more tired than tests suggest they should be [which is a defining characteristic of CFS]. His theory is based on the widely held idea [on the part of neurobiologists, cognitive scientists, and many psychology types] that the brain harbours a model of the body that it uses to predict the consequences of movement. If you wave your arm, the muscles transmit signals to a part of the brain called the cerebellum which “examines” the model, makes predictions and then alerts the rest of the brain about what sensations it should look out for. This explains, for example, why people cannot tickle themselves: their brains know what to expect, and can thus cancel out the sensation.
Dr. Wolpert’s suggestion is that people with CFS may have lost this self-prediciting loop and so cannot cancel out the sensations returning from their muscles, even when those muscles are moving under willpower. Every exertion thus appears to be loaded with unwarranted effort. The natural reaction is, therefore, to avoid that effect.
Psychological issues centered on body image are often framed using the above mechanism. As an example, persons who suffer from the eating disorder anorexia nervosa will often look in the mirror and see a body image they consider to be normal when in fact they are rail thin. For people suffering from body image issues, distortions in body image take place when the “body map in the mind” is compared to the “body out in reality.”
Antonio Damasio is a neurobiologist who has spent nearly 30 years investigating how the brain makes maps or Inner Working Models. Damasio writes the following in his 2010 book Self Comes to Mind:
The distinctive feature of brains such as the one we own is their uncanny ability to create maps. Mapping is essential for sophisticated management, mapping and life management going hand in hand. When the brain makes maps, it informs [emphasis in original] itself. The information contained in the maps can be used nonconsciously to guide motor behavior efficaciously, a most desirable consequence considering that survival depends on taking the right action. But when brains make maps, they are also creating images, the main currency of our minds. Ultimately consciousness allows us to experience maps as images, to manipulate those images, and to apply reasoning to them.
As I mentioned in part II, if you do not get the concept of an Inner Working Model (IWM), then the information Beebe and Lachmann present in Origins (for short) will be hard to understand (if not impossible). The whole “infant research to adult intervention” pipeline talked about in Origins turns on the concept of Inner Working Models. Ironically, Beebe and Lachmann provide the reader with very little information on what IWMs are, where they come from, what evolutionary purpose they serve, or even how they are changed or updated. Considering that Beebe and Lachmann suggest that therapeutic change rests on the idea of changing or updating Inner Working Models (more on this below), I find the paucity of information on Inner Working Models most curious.
John Bowlby recognized the importance of Inner Working Models (a point that Beebe and Lachmann do acknowledge). In his first volume on attachment (1969), Bowlby writes:
Man’s capacity to build up a detailed representation of the world in which he lives, a topic to which [Jean] Piaget has devoted a lifetime’s work, is obviously far greater than that of other species—and its accuracy for prediction has been vastly increased of recent times by the discovery and application of scientific method.
The achievement of any set-goal, then, requires that an animal is equipped so that it is able to perceive certain special parts of the environment and to use that knowledge to build a map of the environment that, whether it be primitive or sophisticated, can predict events relevant to any of its set-goals with a reasonable degree of reliability.
Now, it could be argued that Bowlby (like Beebe and Lachmann) does not cover the topic of Inner Working Cognitive Maps in any detail in his trilogy of attachment. That would be a fair assessment if one was only looking at Bowlby’s work outside of the larger context in which it was developed. Remember the time frame in which Bowlby wrote about attachment: the 1950s, 60s, and 70s. During this time frame, most psychology types (and a fair number of the general public) were familiar with the work of cognitive scientist Jean Piaget (and his colleague Bärbel Inhelder). As Bowlby alludes to above, Piaget spent his life’s work on such topics as cognitive models and how the brain represents its world. As most know, Piaget developed the concept known as “object permanence.” This is the point at which the developing child can hold an image of an object in his or her mind even when the object is concealed behind a curtain. Object permanence implies image permanence. So, it may well be that Bowlby assumed that Piaget’s work in the areas of cognitive models and brain representational systems was common knowledge and needed little additional elucidation.
So, what’s happening today that researchers are able to mention Inner Working Models without any further explanation (as evidenced by the Origins book)? Honestly, I have no clue. Clearly information on Inner Working Models is available. The work of neurobiologists such as Damasio  and Wolpert are but two examples. Ethologists have studied animals and their ability to develop cognitive maps since the time of Tolman (over 70 years). Even social insects (such as bees) use cognitive maps. For an amazing look at how Inner Working Maps are being used as part of an interface between humans and robotic arms, see the January 2010 issue of National Geographic and the article by Josh Fischman entitled Bionics: Merging Man and Machine.
So, probably my main criticism of Origins stems from the fact that it mentions Inner Working Models, but then says very little about them. As Damasio writes in Self Comes to Mind:
Maps are constructed when we interact with objects, such as a person, a machine, a place, from the outside of the brain toward its interior. I cannot emphasize the word interaction [emphasis in original] enough.
The entire Origins book is about mother – infant interactions. This begs the questions: how do mother – infant interactions affect the development of Inner Working Maps, affect the map making apparatus itself, and how do such interactions affect the organization and operation of the brain? (Neurobiology researcher Allan Schore has tackled the last question in some detail). Damasio continues:
The human brain is a born cartographer, and the cartography began with the mapping of the body inside which the brain sits. … How the mapping happens exactly is easier said than done. It is not a mere copy, a passive transfer from the outside of the brain toward the inside. The assembly conjured by the senses involves an active contribution offered from inside the brain, available from early in development, the idea that the brain is a blank slate having long since lost favor.  The assembly often occurs in the setting of movement ….
Beebe and Lachmann (along with their many students) did an amazing job collecting data on mother – infant communication patterns using such information dimensions as “nonverbal, imagistic, acoustic, visceral, or temporal mode” (quoting Beebe and Lachmann). As Beebe and Lachmann write, “The mother – infant ‘action-dialogue’ generates infant and maternal expectancies of how action and interaction sequences unfold moment-to-moment, within the self, within the partner, and between the self and the partner.” However, their project lacks evolutionary, developmental, and cognitive science frameworks. In Self Comes to Mind, Damasio places the development of self into these types of frameworks. It would be hard to talk about the development of self without a discussion of the development of Inner Working Models (which Damsio presents in Self Comes to Mind). Sadly, the psychoanalytic frame assumes many aspects of the developing self as givens and does not offer up much in the way of scientific explanation or support.  I would suggest that this is one of the main reasons Bowlby moved away from a strictly psychoanalytic frame in favor of frames that are supported by science.
To sum up, Beebe and Lachmann do an amazing job painstakingly collecting information on mother – infant communication, but then cripple their efforts by placing that data within a psychoanalytic frame. As a result, the section on adult treatment suffers as well. Beebe and Lachmann do suggest that interventions must be designed to change Inner Working Models (as mentioned above). Here they agree with Bowlby. Bowlby writes the following in The Making and Breaking of Affectional Bonds:
Our task … is to help him [the patient] review the representational models of attachment figures and of himself that without his realizing it are governing his perceptions, predictions, and actions, and how those models may have developed during his childhood and adolescence and, if he thinks fit, help him to modify them in light of more recent experience.
Beebe and Lachmann collect information along dimensions such as the nonverbal, imagistic, acoustic, visceral, or temporal, but then say very little about how the brain processes and makes sense of such information. Fortunately, Damasio (in Self Comes to Mind) provides the necessary information. As an example, Damasio writes:
Minds emerge when the activity of small circuits is organized across large networks so as to compose momentary patterns. The patterns represent things and events located outside the brain, either in the body or in the external world, but some patterns also represent the brain’s own processing of other patterns. The term map applies to all those representational patterns, some of which are course, while others are very refined, some concrete, others abstract. In brief, the brain maps the world around it and maps its own doings. Those maps are experienced as images in our minds, and the term image refers not just to the visual kind but to images of any sense origin as auditory, visceral, tactile, and so forth [my emphasis].
Note that Damsio’s list of sense data—auditory, visceral, tactile—agrees with the sense data that Beebe and Lachmann investigate: nonverbal, imagistic, acoustic, visceral, temporal. In my opinion, Beebe and Lachmann would be well served by placing their data within the evolutionary, neurobiological, and cognitive science model that Damasio uses to frame his view of how self and consciousness come to be. Just saying. Without a model such as the one that Damsio presents, it would be hard to really comment on intervention strategies. Beebe and Lachmann assume that linguistically-based therapy strategies—both verbal and nonverbal—are effective as far as changing Inner Working Models. Sure, language is processed in different parts of the brain, but are these the same parts of the brain that would have to be activated in order for Inner Working Models to be changed or updated? I do not know the answer, but I think it’s a question that should be considered. As Damasio points out in Self Comes to Mind, the early reptilian brain (specifically the upper brain stem) contributes considerably to the making and updating of Inner Working Models. Do linguistically-based therapies engage these early brain structures? I do not have the answer and none is given in Origins. In my opinion, the very contrived environment of the therapist’s office sees to it that certain brain centers are left largely dormant. By design, a therapist’s office is too, well, safe. In addition, very little movement or “action” takes place in a therapist’s office. To offload all action onto those parts of the brain that process linguistic information (both verbal and nonverbal) seems too simplistic. But that’s the model that best fits with therapy delivered by office.
I’ll end my post here at the 2,000 word mark for those of you who are pressed for time. However, if you have a little extra time for an additional 1,800 words, I have two final comments: the first concerning dissociation, the second concerning “marked language.”
First, Beebe and Lachmann present a lot of useful information and insight concerning dissociation. In my opinion, this is where the book really shines. Dissociation occurs when certain brain systems temporarily stop working together as a result of some type of trauma or assault to the brain.  I appreciated Beebe and Lachmann’s insight that dissociation observed during mother – infant communication could be used to predict the likelihood of dissociation in adolescence. Beebe and Lachmann tell us that a propensity toward “dissociation may have its origins in early difficulties in integrating experience in the context of failure of maternal recognition, and intense stress that remains unrepaired.” Beebe and Lachmann suggest that the brain dissociates as a protection against too much stress resulting from an inability to make sense of incoming data streams, such as nonverbal, imagistic, acoustic, visceral, or temporal. Dissociation then is a form of calming the self (and the biological organism holding the self) once the self is no longer able to make sense of incoming data streams. This may in part explain why persons on the autism spectrum have a tough time with face-to-face communication: they look away from the face of another person as a way of reducing the cognitive load—having to integrate the incoming data streams of verbal and facial information. Interestingly, part of the intervention strategy outlined by Beebe and Lachmann consists of trying to get the patient comfortable with face-to-face communication patterns. This may not be possible for persons on the autism spectrum. In addition, certain cultures discourage face-to-face communication. I am here thinking of certain Native American cultures.
I would also suggest that Beebe and Lachmann’s take on dissociation would have been a great place to tackle the topic of drug-induced dissociation at the level of society. We feed kids diagnosed with ADHD (attention deficit and hyperactivity disorder) copious amounts of behavioral drugs like Ritalin and Adderall. These drugs are stimulants. Why on earth would we feed stimulant drugs to kids who are hyperactive? Turns out that these stimulant drugs allow these kids to dissociate, to calm themselves by dampening down the cognitive challenge of having to integrate multiple streams of data. But as ADHD expert Russell Barkley tells us in his 2012 book Executive Functions: What They Are, How They Work, and Why They Evolved, yes, behavioral drugs do calm cognitive loads, but they do very little if anything as far as helping kids to develop robust Executive Function skills, of which cognitive map making and updating is a part. If anything, these drugs impede development of EF skills.
Second, Beebe and Lachmann say nothing about what developmental psychology researcher Peter Fonagy and his colleagues call “marked communication.” I find this omission highly unusual. Even Damasio talks about forms of marked communication in Self Comes to Mind (and in his earlier work). Why is marked communication important? Marked communication is the central process whereby the self is brought to life so-to-speak. As Damasio tells us, the brain creates maps, those maps in turn generate images, but it is not until those images are marked as “my images” that the self comes to mind. And once images are marked as “mine,” that sense of possession feeds back to the brain’s map of the body. The body then gets a sense of being “selfed” (to make up a word). This developmental process is repeated at the level of culture during initiation rituals, which usually take place as an adolescent moves from childhood to adulthood. 
OK, what is marked communication? To understand marked communication, let’s turn to a computer analogy. When we use the Internet, we send packets of information back and forth. A packet of information has a header, a body or content, and a footer. Much like a letter, a packet of information has a destination (i.e., the “to” address), a source (i.e., the “from” address), and some sort of content (i.e., “Hi, Bill, how are you?”). Marking packets of information in this way assures that they get to where they are going, and provide a path back for responses. And packets have a way of checking for data integrity: did the packet of information get sent properly or, if not, should it be sent again? A checksum is one way of checking data integrity.
Believe it or not, we use marked communication when we communicate. We may say “do you follow what I am saying?” as a way of engaging in data integrity. Or in military communication the word “over” may be used to end a communication and turn things over to the receiver (who now becomes a sender). Telegrams often used the word “stop” to end a sentence. Speakers will often monitor their audience to check whether they are getting the message. And as Fonagy and his colleagues point out in their 2002 book entitled Affect Regulation, Mentalization, and the Development of the Self, mothers who are attuned to their infant’s communication patterns will mark their language (both verbal and nonverbal) as a way of “keeping minds straight” (more on this in a moment). These are forms of marked communication.
Psychoanalysts have been sensitive to marked communication for decades now. Transference takes place when the client projects some type of emotion onto the therapist. And countertransference takes place when the therapist projects his or her emotions back onto the client. Therapists have to work hard to figure out where emotion is coming from: the client or the therapist. In other words, therapists have to pay close attention to the markings of communication so that the mind’s of both therapist and client can remain separate and distinct. This is the challenge of any intersubjective field: minds knowing minds, or “minds within minds.” The entire Origins book is about intersubjective fields—mother – infant as well as therapist – client. However, there is no discussion of marked communication and how minds should be kept distinct and separate. Early in development, marked communication is the central process by which the infant/child comes to take possession of his or her images, and, in turn, comes to know the self. As a sad comment, so much of the Internet is about not taking possession of one’s images and, instead, taking up residence in a type of digital communism. 
In sum, Beebe and Lachmann have done an amazing job collecting and analyzing detailed data concerning mother – infant communication patterns. However, the project as a whole is crippled through use of the psychoanalytic frame. The intervention strategies are also crippled through use of the psychoanalytic frame. I think the project would benefit greatly by using the neurobiological and evolutionary frames that Damasio uses in his book Self Comes to Mind. If only I could do a mashup between Origins and Self Comes to Mind. Any takers out there?
One last word on Tolman and his rat maze studies (as I promised in part II). Tolman discovered that as a rat learns a new environment, the rat formed what he called “strip maps” or straight line maps. Strip maps consist of cause and effect chains and do offer some support in favor of the behavioral view of the world. However, as a rat made several passes through a maze, strip maps would begin to move to more of a two dimensional, plane map. In essence, strip maps implied that a two dimensional plane environment existed beyond just a series of straight lines. Tolman also noted that for strip maps to move to plane maps, the rats needed access to some sort of fixed reference point, like a light shining from above the maze. I cannot help but wonder if a securely attached mother acts like a fixed reference point (a home base according to Mary Ainsworth’s view) allowing the developing infant/child to move from strip maps to plane maps (and beyond). And if an insecurely attached mother is not able to act as a fixed reference point, then I would suggest that the developing child may become (as an adult) mired in a world dominated by a series of cause and effect, black and white, all or nothing strip maps (a phenomenon that is assessed for in the Adult Attachment Interview). Again, all this points out that it would be very difficult to approach the topic of Inner Working Cognitive Maps without also using frames such as evolution, neurobiology, cognitive science, and ethology. These are the frames Bowlby used, and with good reason.
 I emailed Dr. Damasio back in the early 2000s and suggested that he place Bowlby’s work within his model of cognitive map making. Dr. Damasio was kind enough to reply and said that the idea was intriguing and that he would consider having a graduate student look at this possibility. For all I know, there’s a thesis or dissertation sitting on a shelf somewhere that puts Bowlby’s work into a Damasian map making frame. If anyone knows of such a work, please leave a comment.
 This is a reference to Steven Pinker’s 2002 book entitled The Blank Slate. Many behaviorists and learning theory devotees believe that the infant is born with a blank slate upon which information and learning can be printed. Most neuorbiologists and evolution theory devotees reject the notion of a blank slate, as Damasio clearly does.
 This is slowly changing as much of Freud’s work is being ported over to the world of neurobiology. As you would expect, not all of Freud’s insights will “make the cut” so-to-speak. For more on this topic, see the April 2014 issue of Discover magazine and the article by Kat McGowan entitled The Second Coming of Sigmund Freud: Century-Old Insights Shed Light on the Brain.
 When a person describes a horrific scene, say, a car crash, without any emotion, the brain has separated thinking from feeling as a form of protection, and with respect to that incident. Dissociation is one way the brain protects itself from being overwhelmed.
 Sadly, as social critics, such as Robert Bly, have pointed out, our American society is bereft of any effective initiation rituals that allow kids to “take possession” of adulthood. They live in a Sibling Society (the title to Bly’s 1996 book). I would suggest that the Internet has only increased the sibling society. As Andrew Keen puts it (see next note), Internet entrepreneurs (i.e., Mark Zuckerberg and Uber’s Travis Kalanickto) have yet to grow out of their “obsessive adolecence.”
 For more on this topic, see Andrew Keen’s 2015 book entitled The Internet is Not the Answer.