Beyond Thoughts & Prayers: Bridging Brain Research to the Public Sphere (Pt 4)

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I was first introduced to the idea that a protracted period of “psychological birth” was required following actual “physical birth” after reading the 1975 book entitled Psychological Birth of the Human Infant—Symbiosis and Individuation by Margret Mahler, Fred Pine, and Anni Bergman. The authors argue that after physical birth a psychological symbiosis exists between mother and her infant. As far as the infant is concerned, mother and infant are one in the same. The authors then go on to talk about the process of psychological birth or how the infant breaks the symbiotic relationship and establishes a unique identity and a unique sense of self. If memory serves I probably read Psychological Birth of the Human Infant in the mid-to late 1990s while I was studying for my counseling masters.

Not long after, I read a 2002 book entitled Affect Regulation, Mentalization, and the Development of Self by Peter Fonagy, György Gergely, Elliot Jurist, and Mary Target. In many respects Fonagy et al. also talk about psychological birth. I’d like to tell a bit of their story as it resonates with me, and, hopefully, you will see why. Before I tell you the Fonagy et al. story, I have to tell you the story of the False Belief Test. I cover the False Belief Test in some detail in my book A Question of Attachment, so I will be brief here.

First, let me say that The False Belief Test is rather clever. Yes, I’ll admit, there is a fair amount of right brain creativity needed to design such tests. Experimental research is by no means all left brain.

In the False Belief Test, there are two rooms: one in which the experimental manipulation takes place, and a second observation room that has a one-way mirror, like you see on cop shows where a suspect is being interrogated. A child, age three to six, is shown a box containing crayons in the experimental room while a child in the observation room looks on. The child in the experimental room is asked to leave. A researcher in the experimental room then opens the box and replaces the crayons with a few pebbles. A researcher in the observation room then asks the observing child the following question: “When the child you are observing comes back, what will that child say is in the box?” What would you say? What researchers found is that children up to about age three or so will say that when the child comes back, the child will say “there are pebbles in the box.” Children from about age four and older will say “there are crayons in the box.” How do we interpret these findings.

The best way to interpret these findings is to draw upon a concept known as mental containers.[1] Children up to about age three or so do not have the cognitive ability to build multiple mental containers. They have but one mental container and they use it wholesale. Initially they have crayons in their mental container. Then their mental container becomes filled with pebbles after the switch. They just assume that whatever is in their mental container at any given time is what is in everyone else’s mental container, pebbles. (Fonagy et al. call this psychic equivalence: what’s in my head must be in your head.) From about age four and on, children begin building more than one mental container. In the case of the False Belief Test, they build a mental container for their own self and one for the child that they are observing. In this way they can see that even though they have pebbles in their up-to-date “self container” if you will, they can build a mental container for the other child or an “other container,” and compare the two recognizing that after the switch the other child will still be harboring an out-of-date false belief of “crayons.”

I was introduced to the work of Swiss cognitive researcher Jean Piaget as I read John Bowlby’s three volumes on attachment. Turns out that Bowlby and Piaget met through a series of lectures (very much like a think tank today) that took place in the 1950s, the same lectures where Bowlby met Betalanffy as mentioned above. Piaget is credited with being the father of what is known as spatial cognition or the cognitive ability to not only navigate one’s environment but to also construct and manipulate mentally created objects. If you have ever played the computer game Tetris, then you have engaged in spatial cognition.

Piaget conducted a series of experiments that were similar in nature to the False Belief Test. He assessed a child’s ability to engage in object permanency (which typically takes place between age 18-24 months), the ability to keep an object in mind even when that object is momentarily hidden. He also assessed for such things as volume conservation and the ability to take on different views or perspectives of a landscape. In essence, Piaget was running experiments designed to assess the creation and functioning of mental models. In order to manipulate an object in your head, you need to imagine that object, keep it in mind, and then mentally move that object around without losing sight of the original object and its orientation. Believe it or not, Tetris assess for how well you can engage in the spatial ability of object manipulation. So, how good are you at Tetris? Mental modeling is typically thought of as an Executive Function and associated with the upper brain. However, before mental modeling can take place, we need to acquire the ability to form mental containers.

I’ve taken this detour because without it, it would be very difficult for you to understand the Fonagy et al. story I’m about to tell you. We now know a bit about psychological birth. We also know a bit about mental containers and their importance. But how exactly does psychological birth take place and what role do mental containers play? On to our feature presentation.

Fonagy et al. suggest that psychological birth takes place largely through the process of what they call mentalization. Yeow! What the heck is that? Mentalization has been described in different ways. One way to look at mentalization is as a form of intersubjectivity: two subjective experiences intermingling. When you have a conversation with another person, your subjective experience intermingles with your friend’s subjective experience. As you talk with your friend, you think about their thinking all the while making a model of it separate from yours. So, mentalization is often thought of as “thinking about thinking.” In this respect it is a form of metacognition. How about “I know that you know that I know.” Mentalization is a tough concept to get. Let’s move on to the story that Fonagy et al. tell and hopefully things will get a bit more clear.

Researchers such as Fonagy (and his colleagues), Louis Cozolino, Allan Schore, say effectively the same thing. Because an infant is born without fully developed brain systems and circuitry capable of regulating emotion—that is to say, engage in homeostasis and keep the organism “in the green”—this job falls to the mother or a person acting as a mother. But how exactly does a mother or mother substitute regulate the emotional experiences of an infant who only has a “lookout in the crow’s nest” scanning for danger (i.e., an amygdala)? The answer, according to Fonagy et al., is mentalization. Here’s how.

Have you ever wondered how information is sent along the Internet? No? As long as your text gets to its intended recipient, who cares. It’s an interesting story and will serve as an analogy as we look at infant-mother information transport.

Information is transferred along the Internet using data packets. Data packets are not unlike analog envelopes used to send snail mail. A packet has a header, a payload, and a trailer or footer. The header contains information like the sending address, the receiving address, and then some sort of unique identifier that establishes it within a larger sequence of data packets. The payload is the actual text, picture (in digital format), spreadsheet, etc., that is being sent. The trailer or footer has information that says, “Hey, that’s the end of this packet.” The trailer will also have information that essentially asks, “OK, did you get that packet?” The receiving device will then send a message back saying, “Yup, I got that packet. Go ahead and send the next one.” This is called error checking. Believe it or not a mother-infant dyad engages in a similar informational exchange but with a few wrinkles.

When an infant becomes emotionally dysregulated (i.e., its organic systems are no longer in balance, homeostatically speaking) it will send out a signal usually in the form of a cry. The infant’s expectation here is that the signal will be received and responded to, not unlike Internet packets. Now, here’s where some rather sophisticated mental gymnastics take place in the mind of the mother. Let me list them:

  • The mother receives the signal.
  • The mother then builds a mental model of that signal using the surrounding environment for context: is the infant distressed because of a loud noise, needs a diaper change, would like to be fed, would like closer proximity, etc.
  • The mother then builds a second mental model that has the ability to regulate the dysregulated emotion.
  • She then sends that packet if you will back to the infant with one huge caveat.
  • The packet she sends not only has to have a mental model of regulated emotion, that model must also keep the mind of the infant separate from the mind of the mother.

Through these steps, all of which can take place in a fraction of a second, the mother is:

  • Telling the infant that the infant is being minded (i.e., mentalized) and that the infant’s mind is worth being minded.
  • Providing it with a coherent mental model consisting of regulated emotion
  • All of which serves to create a robust self mental model within the infant separate from mother (not unlike the model Mahler and her colleagues deliver).

Allow me to interject one thought that may seem obvious but typically goes by without notice. We all like to be minded. We all like to know that others take the time to keep us in mind, that we are worthy of being minded. This might seem a bit sappy but it could have dire consequences. What if, God forbid, you are in a car accident that puts you in the ICU in a coma. Who, now, will make medical decisions for you? We all hope that there will be a family member or close friend who knows us well enough, and who will make decisions for us as we would make for ourselves. John Bowlby used to say (and I paraphrase), “It’s not risk that troubles us; it’s the ‘risk of risk’ that causes concern.” We all take on risk, but who will be there if we exceed our ability to deal with the risk we take on? The infant cries because at some evolutionary level there’s an implied expectation that the cry will be answered. For the infant, as defenseless as they are, life is risk, which may in part explain why there is such a long right brain axis whose job it is to keep us safe from harm. One more point. Fear is a state; fearing is a process. Under normal circumstances the amygdala engages in a fearing process that is designed to trigger other processes capable of regulating fear states. It’s fear that has no place to go that leads to anxiety. Again, the crying infant expects an answer. Letting the infant just cry it out is not an option. Back to our story.

A key point to keep in mind is that the mother must engage in emotion regulation while not allowing her own mental models to enter the data payload if you will. This is no easy feat. Motherese or that sing-song, prosodic form of communication is mother’s chief communication tool. I should point out that Mary Ainsworth, John Bowlby’s longtime collaborator, would film mother-infant interactions in the home environment and then analyze these interactions by slowing down the playback so that split second interactions could be coded. These studies led to the development of what Ainsworth called the Strange Situation Procedure. This procedure could be used to look at toddler-mother interactions once the attachment behavioral system of the toddler had been activated. Ainsworth noticed that interactions typically fell within three patterns: secure attachment, insecure-avoidant, and insecure-resistant. (A forth pattern, disorganized, was later added.)  Studying micro-interactions has continued and I would point the reader toward the 2014 book entitled The Origins of Attachment (Relational Perspectives Book Series) by Beatrice Beebe and Frank Lachmann, as an example. Done properly mother-infant communication is exceedingly complicated, not unlike the transmission of Internet packets. Just imagine how upset you would be if mixed in with your important emails was a bunch of header and footer data. That’s how the infant feels when mother interjects herself into the conversation.

When Freud developed the idea of transference and countertransference, this was what he was getting at. In a therapy session, the client may unconsciously transfer a feeling/image hybrid (a la Damasio) to the therapist. The therapist then makes a mental model of that information and then may send back a model that is more coherent and regulated all the while keeping his or her self out of the payload. Now, I should mention a possible negative side effect of this process.

According to Fonagy et al., if self images from the mother (or therapist for that matter) are inadvertently sent to the infant (client) an alien self could be set up. This is not unlike Jung’s shadow self. In his book The Neuroscience of Psychotherapy, Cozolino uses the term ego-alien. Suffice it to say that forming a shadow or alien self could bring about a life of psychological torment.

Let me end by simply stating that building a brain (mothering) or altering that brain as a neurosurgeon who uses non-invasive techniques (psychotherapy), is tricky business that requires substantial skill. In the next post we will look at a few of the controversies swirling around this idea that the mother or psychotherapist acts as a neurosurgeon using noninvasive techniques.



[1] My go to book on mental containers is the 2002 book entitled The Way We Think: Conceptual Blending And The Mind’s Hidden Complexities by Gilles Fauconnier and Mark Turner.