The Interpersonal Neurobiology of Intersubjectivity

The ConNECT approach: toward a comprehensive understanding of meaningful interpersonal moments in psychotherapy and beyond

Relational neuroscience struggles to capture the complex dynamics of shared interpersonal moments, leading to gaps in understanding whether and how interdependencies between interacting persons translate into something meaningful. Current neuroscientific research often focuses on motor synchronization and cognition rather than the implicit relational qualities central to psychotherapy. We argue that this disconnect stems from an over-reliance on simplified quantitative methods, a failure to centralize experiential factors, and the lack of Convergence research. Drawing on emerging frameworks such as 4E cognition (embodied, enacted, extended, and embedded) and MoBI (Mobile Brain/Body Imaging), we advocate for integrating subjective and experiential elements with neural data. We propose focusing on "qualities" in multi-brain neuroscience-moving beyond binary or linear scales-to better capture the subtleties of relational moments. Finally, we emphasize the importance of convergence research across disciplines to better understand what interpresence holds. If psychotherapeutic knowledge is used to guide neuroscientists in what to look for, this multi-disciplinary approach holds promise for advancing the study of psychotherapy's relational processes, offering new insights into the neurobiology of meaningful moments in therapy and elsewhere. We propose ConNECT (Convergence research including Neuroscience and Experiences, Capturing meaningful dynamics with Therapists' knowledge) as the path forward.

Once upon a time: Narrative storytelling, hypnosis, and the brain

The article explores the nature of narrative, its impact on key neural circuits in the brain, and the role of those activated circuits as drivers of hypnotically guided personal change. The author views clinical hypnosis as a form of interactive reciprocity that engages clients' neuroplastic potential (i.e. trance). This emergent potential is evoked during the therapeutic interaction between a client and clinician. Furthermore, the author describes clinical hypnosis as using forms of suggestion to facilitate change to the self-reinforcing narratives to which clients subscribe. Suggestions themselves are viewed as activating non-consciously mediated aspects of the self, which are perceived by the conscious mind as non-volitionally facilitating the desired change. The author draws on research supporting the view of the self as a construct maintained by an internalized narrative that remains capable of revision, though not always easily or without external assistance. That self-narrative revision entails the change that hypnosis seeks to enable and enact. The article concludes that deliberate incorporation of forms of narrative, including the use of metaphors, for example, constitutes the essential fuel without which the engine of hypnotic change efforts can languish. This is because narrative processes occupy an indispensable role in energizing - neurologically, psychologically, and socially - the outcomes that hypnosis is intended to evoke. The article uses excerpts from different fictional narrative sources to illustrate the article's main thesis.

Psychological Interventions for Mesothelioma Patients and Their Caregivers: A Systematic Literature Review

Malignant Mesothelioma (MM) has a striking impact on the somatopsychic balance of patients and their families, including physical, psychological, and interpersonal problems. The aim of this systematic literature review was to investigate what psychological interventions are offered to patients with MM and their caregivers worldwide.

METHODS

The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 12 articles. Results were categorized into five categories. 1. Individual psychological support, 2. Group psychological support, 3. Cognitive-behavioral group psychotherapy, 4. Brief psychoanalytic groups, 5. Multifamily group.

RESULTS

The interventions differed in terms of form, duration and resources used. Most of them were group-based and psychoanalytically oriented, although individual and cognitive-behavioral interventions were also described. Despite the differences, the interventions appeared to be fundamental in facilitating the processing of mental pain and anger related to the diagnosis.

CONCLUSION

Our study has shown that there are still few psychological interventions available for MM patients and their caregivers. The somatopsychic consequences of MM in patients and caregivers should encourage institutions and healthcare professionals to develop assessment and intervention models that address the different dimensions of their suffering and promote their residual vitality.

Early parental vocal contact in neonatal units: rationale and clinical guidelines for implementation

This paper aims to present clear and evidence-based proposals for the integration of Early Parental Vocal Contact into the clinical practices of neonatal units. In the first part, we present a comprehensive rationale exploring the ontogenesis of voice perception in both term and preterm newborns that establishes a foundational understanding. This knowledge serves as a crucial starting point for developing evidence-based auditory and multisensory interventions aimed at fostering the developmental trajectory of preterm infants. Drawing insights from neuroscience and brain development, our proposals underscore the significance of tailoring auditory environments within neonatal settings. Special attention is given to the unique needs of preterm infants, factoring in their gestational age and maturation levels. In the second part clinical guidelines for implementation are provided and healthcare professionals are supported to assist parents in modulating their vocal interactions, aligning them with the infant's responses. Furthermore, we provide practical suggestions for engaging in discussions with parents about the content, duration, and frequency of vocal interventions. Finally, we delve into the potential roles of caregivers, parents, and health professionals within this enriched parental vocal interactional environment. Our perspective is firmly grounded in an infant and family-centered developmental care philosophy, aiming to enhance the overall well-being and the neurodevelopment of preterm infants in neonatal units.

Sensitive infant care tunes a frontotemporal interbrain network in adolescence

Caregiving plays a critical role in children's cognitive, emotional, and psychological well-being. In the current longitudinal study, we investigated the enduring effects of early maternal behavior on processes of interbrain synchrony in adolescence. Mother-infant naturalistic interactions were filmed when infants were 3-4 months old and interactions were coded for maternal sensitivity and intrusiveness with the Coding Interactive Behavior Manual. In early adolescence (Mean = 12.30, SD = 1.25), mother-adolescent interbrain synchrony was measured using hyperscanning EEG during a naturalistic interaction of positive valence. Guided by previous hyperscanning studies, we focused on interbrain connections within the right frontotemporal interbrain network. Results indicate that maternal sensitivity in early infancy was longitudinally associated with neural synchrony in the right interbrain frontotemporal network. Post-hoc comparisons highlighted enhancement of mother-adolescent frontal-frontal connectivity, a connection that has been implicated in parent-child social communication. In contrast, maternal intrusiveness in infancy was linked with attenuation of interbrain synchrony in the right interbrain frontotemporal network. Sensitivity and intrusiveness are key maternal social orientations that have shown to be individually stable in the mother-child relationship from infancy to adulthood and foreshadow children's positive and negative social-emotional outcomes, respectively. Our findings are the first to demonstrate that these two maternal orientations play a role in enhancing or attenuating the child's interbrain frontotemporal network, which sustains social communication and affiliation. Results suggest that the reported long-term impact of maternal sensitivity and intrusiveness may relate, in part, to its effects on tuning the child's brain to sociality.

Ultra-overt therapy: a novel medical approach centered on patient consciousness

Within the realms of human and artificial intelligence, the concepts of consciousness and comprehension are fundamental distinctions. In the clinical sphere, patient awareness regarding medication and its physiological processes plays a crucial role in determining drug efficacy and outcomes. This article introduces a novel perspective on prescription practices termed "Ultra-Overt Therapy" (UOT). A review of current supporting evidence was conducted through a non-systematic search in PubMed and Google Scholar, focusing on concepts such as the "mind-body relationship," "placebo response," "neuroscience," and "complementary medicine." Our findings, rooted in the mechanisms of the "placebo effect," the intricacies of "intersubjective therapy," the potency of "interoceptive awareness," and other domains of medical science, suggest that UOT holds theoretical promise. Future research endeavors focusing on these areas may elucidate the global impact of this method on medical treatment and patient care.

Time-varying similarity of neural responses to musical tension is shaped by physical features and musical themes

The similarity of understanding is important for music experience and communication, but little is understood about the sources of this common knowledge. Although neural responses to the same piece of music are known to be similar across listeners, it remains unclear whether this neural response similarity is linked to musical understanding and the role of dynamic musical attributes in shaping it. Our study addresses this gap by investigating the relationship between neural response similarity, musical tension, and dynamic musical attributes. Using electroencephalography-based inter-subject correlation (EEG-ISC), we examined how the neural response similarity among listeners varies throughout the evaluation of musical tension in the first movement of Beethoven's Piano Sonata No. 8. Participants continuously rated the degree of alignment between musical events and their expectations, while neural activity was recorded using electroencephalography (EEG). The results showed that neural response similarity fluctuated in tandem with musical tension, with increased similarity observed during moments of heightened tension. This time-varying neural response similarity was influenced by two dynamic attributes contributing to musical tension: physical features and musical themes. Specifically, its fluctuation was driven by physical features, and the patterns of its variation were modulated by musical themes, with similar time-varying patterns observed across similar thematic materials. These findings offer valuable insight into the role of dynamic musical attributes in shaping neural response similarity, and reveal an important source and mechanism of shared musical understandings.

The central role of mindful parenting in child's emotional regulation and human flourishing: a blueprint perspective

This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent-child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society.

Regulatory problems and developmental psychopathology within the first 2 years of living-a nested in cohort population-based study

Background

Infancy regulatory problems (RP) of sleep, feeding and eating, and excessive crying are thought to play a key role in the development of psychopathology in childhood, but knowledge of the early trajectories is limited.

Objective

To explore RP at ages 8-11 months and the associations with mental health problems at 1½ years, and assess the influences of maternal mental health problems and relationship problems.

Methods

RP was explored in a nested in-cohort sample (N = 416) drawn from a community-based cohort (N = 2,973). Cohort children were examined by community health nurses, using a mental health screening, which included seven items of RP. Follow-up at 1½ years included diagnostic assessment according to the International Classification of Diseases, ICD-10, and the Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood: Revised edition, DC:0-3R. Data analyses included logistic regression models and analyses of the mediation effect of maternal mental health and relationship problems.

Results

RP of sleep were associated with a 2-fold increased risk of child mental disorder specifically sleep disorders, adjusted odds ratio (OR) 9.3 [95% confidence interval (CI): 2.0-42.9], disorders of behavior and emotions, adjusted OR 2.9 (95% CI: 1.0-8.4), and DC:0-3R regulatory disorders, adjusted OR 2.7 (95% CI: 1.0-7.5). Children with RP of feeding and eating showed an increased risk of overall mental disorder, adjusted OR 1.4 (95% CI: 0.7-2.4), and specifically, feeding and eating disorders, adjusted OR 6.0 (95% CI: 1.6-21.7), disorders of behavior and emotions, adjusted OR 2.2 (95% CI: 0.9-5.8), as well as DC:0-3R regulatory disorders, adjusted OR 1.6 (1.0-7.5). RP of emotional regulation were associated with increased risk of any mental disorder, adjusted OR 1.5 (1.0-2.4), and specifically behavioral and emotional disorders, adjusted OR 2.2 (95% CI: 0.9-5.9) and DC:0-3R relationship disorders, adjusted OR 1.8 (95% CI: 0.9-3.8). The mediation effect of maternal mental health problems and relationship problems ranged between 0% and 48%.

Conclusion

RP at ages 8-11 months is associated with increased risk of ICD-10 and DC:0-3R disorders at 1½ years. Study findings highlight a group of vulnerable infants in need of preventive intervention to break the early trajectories of psychopathology.

Threatening Beliefs About Self and Others Moderate the Association Between Psychoticism and Psychological Distress

ABSTRACT

Psychoticism is a multidimensional personality construct involving odd or eccentric behavior, quasi-psychotic experiences, mistrust, interpersonal detachment, and liability for schizophrenia-spectrum disorders, as well as significant distress. Recent advances suggest it can be understood as a dimension that is continuously distributed in the population, leading to questions about factors that contribute to distress and dysfunction among people with a schizotypal liability. We investigated in a large nonclinical sample of young adults whether associations between psychoticism and psychological distress would increase in the presence of threatening beliefs. In our study ( N = 2127), we found that the association between psychoticism and psychological distress is moderated by threatening beliefs including self-criticism, fear of compassion, and socially prescribed perfectionism. These results suggest that distress increases among people with schizotypal traits in the context of negative beliefs about self and others. We discuss implications for clinical practice and directions for further research.

A re-introduction of the psychodynamic approach to the standard clinical psychology curriculum

OBJECTIVE

There is a strong evidence-base for a psychodynamic approach, supporting primary theoretical tenets as well as the treatment effectiveness. Additionally, there are increasing calls from the field for more individualized treatment for clients, and the lack of training in multiple orientations limits the ability of students in clinical psychology Ph.D. programs in the United States to personalize their treatments. The accumulated evidence-base for contemporary relational psychodynamic theory and therapy places it in good standing to return to the standard clinical psychology curriculum, along with other evidence-based approaches.

METHODS

We use data from the Insider's Guide (which describes clinical Ph.D. programs in the United States) from three time points over 20 years to document the waning psychodynamic approach in clinical psychology programs. We review the scientific evidence for four primary tenets of a contemporary psychodynamic approach: three related to development-from healthy to psychopathological: (1) unconscious processes; (2) internal representations of self and other; (3) dimensional model of psychopathology, and a fourth tenet that builds on these three and is the foundation for a contemporary psychodynamic approach to psychotherapy: (4) therapeutic relationship as a primary mechanism of change.

RESULTS/CONCLUSIONS

Based on the review of the evidence, we make specific recommendations for clinical psychology training programs about how to include a psychodynamic approach in the curriculum.

In Between the Psychological and Physiological Self - The Impact of Covid-19 Pandemic on the Neuro-Socio-Ecological and Inflammatory Mind-Body-Brain System

The COVID-19 pandemic has had a profound impact on individuals' sense of self perturbating the sense of connectedness with the others, touching upon deep existential fears and deep intersubjective and cultural layers, emphasizing the importance of a neuro-socio-ecological alignment for the sense of security of psychological self. We can still observe after years how social distancing measures, quarantines, and lockdowns have disrupted social connections and routines, leading to feelings of isolation, anxiety and depressive symptomatology. Furthermore, from a physiological perspective, some people continue to experience health problems long after having COVID-19, and these ongoing health problems are sometimes called post-COVID-19 syndrome or post-COVID conditions (PASC). In this complex scenario, through the operationalization of the sense of self and its psychological and physiological baseline, our aim is to try to shed some new light on elements of resilience vs. vulnerability. Here we intend the self and its baseline as the crossroads between psychology and physiology and we show how COVID-19 pandemic, especially in post-COVID-19 syndrome (PACS), left traces in the mind-body-brain system at a neuro-socio-ecological and inflammatory level.

Introducing the Neuroplastic Narrative: a non-pathologizing biological foundation for trauma-informed and adverse childhood experience aware approaches

Most people accessing mental health services have adverse childhood experiences (ACEs) and/or histories of complex trauma. In recognition of this, there are calls to move away from medical model approaches and move toward trauma-informed approaches which privilege the impact of life experience over underlying pathology in the etiology of emotional and psychological suffering. Trauma-informed approaches lack a biological narrative linking trauma and adversity to later suffering. In its absence, this suffering is diagnosed and treated as a mental illness. This study articulates the Neuroplastic Narrative, a neuroecological theory that fills this gap, conceptualizing emotional and psychological suffering as the cost of surviving and adapting to the impinging environments of trauma and adversity. The Neuroplastic Narrative privileges lived experience and recognizes that our experiences become embedded in our biology through evolved mechanisms that ultimately act to preserve survival in the service of reproduction. Neuroplasticity refers to the capacity of neural systems to adapt and change. Our many evolved neuroplastic mechanisms including epigenetics, neurogenesis, synaptic plasticity, and white matter plasticity allow us to learn from, and adapt to, past experiences. This learning and adaption in turn allows us to better anticipate and physiologically prepare for future experiences that (nature assumes) are likely to occur, based on past experiences. However, neuroplastic mechanisms cannot discriminate between experiences; they function to embed experience regardless of the quality of that experience, generating vicious or virtuous cycles of psychobiological anticipation, to help us survive or thrive in futures that resemble our privileged or traumatic pasts. The etiology of suffering that arises from this process is not a pathology (a healthy brain is a brain that can adapt to experience) but is the evolutionary cost of surviving traumatizing environments. Misidentifying this suffering as a pathology and responding with diagnosis and medication is not trauma-informed and may cause iatrogenic harm, in part through perpetuating stigma and exacerbating the shame which attends complex trauma and ACEs. As an alternative, this study introduces the Neuroplastic Narrative, which is situated within an evolutionary framework. The Neuroplastic Narrative complements both Life History and Attachment Theory and provides a non-pathologizing, biological foundation for trauma-informed and Adverse Childhood Experience aware approaches.

Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother-Baby Interactions at Three Months Post-Partum

The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period.

A pilot randomized controlled trial comparing a novel compassion and metacognition approach for schizotypal personality disorder with a combination of cognitive therapy and psychopharmacological treatment

BACKGROUND

Schizotypal personality disorder is characterized by a pervasive pattern of maladaptive behavior that has been associated with the liability for schizophrenia. Little is known about effective psychosocial interventions. This pilot non-inferiority randomized controlled trial aimed to compare a novel form of psychotherapy tailored for this disorder and a combination of cognitive therapy and psychopharmacological treatment. The former treatment - namely, Evolutionary Systems Therapy for Schizotypy-integrated evolutionary, metacognitively oriented, and compassion focused approaches.

METHODS

Thirty-three participants were assessed for eligibility, twenty-four randomized on a 1:1 ratio, nineteen included in the final analysis. The treatments lasted 6 months (24 sessions). The primary outcome was change across nine measurements in personality pathology, the secondary outcomes were remission from diagnosis and pre-post changes in general symptomatology and metacognition.

RESULTS

Primary outcome suggested a non-inferiority of the experimental treatment in respect to control condition. Secondary outcomes reported mixed results. There was no significant difference in terms of remission, but experimental treatment showed a larger reduction of general symptomatology (η² = 0.558) and a larger increase in metacognition (η² = 0.734).

CONCLUSIONS

This pilot study reported promising results about the effectiveness of the proposed novel approach. A confirmatory trial on large sample size is needed to provide evidence about relative effectiveness of the two treatment conditions.

TRIAL REGISTRATION

ClinicalTrials.gov; NCT04764708; Registration day 21/02/2021.

Exploring the impact of COVID-19 on newborn neurodevelopment: a pilot study

The COVID-19 pandemic can seize the opportunity to explore the hypothesis of prenatal exposure to viral infections increases the risk for neurodevelopmental disorders. Advancing our knowledge in this regard would improve primary prevention of mental disorders in children. For this pilot study, six-week-old infants born to mothers exposed (n = 21) or unexposed (n = 21) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were assessed in Santander-Cantabria (Spain) using the Neonatal Behavioral Assessment Scale (NBAS). Groups comparisons were performed to explore the effects that infection and timing of exposure (in terms of the three trimesters of pregnancy). The infants' competencies and performances on the NBAS were generally similar in the exposed and unexposed to SARS-CoV-2 groups. The most significant difference found was a less optimally response to cuddliness (item on the state regulation domain) particularly in infants born to mothers exposed in the third trimester of pregnancy, and in pull-to-sit (item on the motor system domain). Although our interpretations must be careful, these preliminary results highlight the possible association between prenatal SARS-CoV-2 exposure and poorer development in motor skills and infant interactive behavior. Further longitudinal studies are needed to explore these relationships and disentangle the biological mechanisms implicated.

Right brain-to-right brain psychotherapy: recent scientific and clinical advances

This article overviews my recent acceptance of a Lifetime Achievement Award from Sapienza University of Rome, in which I discussed three decades of my work on the right brain in development, psychopathogenesis, and psychotherapy. In the following, I offer current brain laterality and hemispheric asymmetry research indicating that right brain emotional and relational processes operate beneath conscious awareness not only in early human development, but over the lifespan. I discuss recent interdisciplinary studies on the central role of ultrarapid right brain-to-right brain intersubjective communications of face, voice, and gesture and the implicit regulation of emotion in nonverbal attachment dynamics. Special emphasis is on the fundamental psychobiological process of interpersonal synchrony, and on the evolutionary mechanism of attachment, the interactive regulation of biological synchrony within and between organisms. I then present some clinical applications, suggesting that effective therapeutic work with "primitive" nonverbal emotional attachment dynamics focuses not on conscious verbal insight but on the formation of an unconscious emotion-communicating and regulating bond within the therapeutic relationship. Lastly, I review recent hyperscanning research of the patient's and therapist's brains during a face-to-face, emotionally focused psychotherapy session that supports the right brain-to-right brain communication model. I end suggesting that the right brain is dominant in both short-term symptom-reducing and long-term growth-promoting deep psychotherapy.

Science catching up: Experiential family therapy and neuroscience

Experiential family therapy, pioneered by Virginia Satir and Carl Whitaker, centered the experience of the "here and now," human authenticity and congruent communication in the work of psychotherapy. Their approach-often considered atypical and atheoretical-was popular for a while, then relegated as behavioral and cognitive theories developed. However, with the proliferation of modern neuroscience, particularly the field of Interpersonal Neurobiology, therapists can see neuroscience research providing hard data and respective frameworks delineating the underlying architecture for understanding the connections between the mind, emotions, behavior, and relationships. This article highlights the neurobiological mechanisms that explain why classic experiential family therapy was so powerful. The main tenets of both Carl Whitaker's symbolic experiential family therapy as well as Virginia Satir's model for peoplemaking are illuminated through the postulates and scientific findings of interpersonal neurobiology.

Two modes of being together: The levels of intersubjectivity and human relatedness in neuroscience and psychoanalytic thinking

The notion of intersubjectivity has achieved a primary status in contemporary psychoanalytic debate, stimulating new theoretical proposals as well as controversies. This paper presents an overview of the main contributions on inter-subjectivity in the field of neurosciences. In humans as well as-probably-in other species, the ability for emotional resonance is guaranteed early in development. Based on this capacity, a primary sense of connectedness is established that can be defined inter-subjective in that it entails sharing affective states and intentions with caregivers. We propose to define such a form of inter-subjectivity as contingent, since the infant's early abilities for resonance do not imply the more generalized capacity to permanently conceive of the relationship outside the realm of current interactions and the infant-caregiver's mutual correspondence of internal states. This form of connection, hence, results in a self-referential, bodily, and affectively codified, context- and time dependent, like-me experience of interactions. The gradual maturation of brain structures and processes as well as interactive experiences allow proper intersubjectivity exchanges, grounded on new intentional and representational capacities, to evolve. In this more mature form of intersubjectivity, the individual is allowed to conceive of her own psychic space both as distinct and as possibly connected with the other's contents and experience, even in the absence of current behavioral indicators of such correspondence. This multi-layered model of intersubjectivity, which is embraced by current neuroscience research, seems to allow for new interpretations of psychoanalytic models of human relatedness based upon classic clinical observations.

The nested hierarchy of self and its trauma: In search for a synchronic dynamic and topographical re-organization

The sense of self has always been a topic of high interest in both psychoanalysis and most recently in neuroscience. Nowadays, there is an agreement in psychoanalysis that the self emerges from the relationship with the other (e.g., the caregiver) in terms of his/her capacity to attune, regulate, and synchronize with the emergent self of the infant. The outcome of this relational/intersubjective synchronization is the development of the sense of self and its regulatory processes both in dynamic psychology and neuroscience. In this work, we propose that synchrony is a fundamental biobehavioral factor in these dialectical processes between self and others which shapes the brain-body-mind system of the individuals, including their sense of self. Recently in neuroscience, it has been proposed by the research group around Northoff that the self is constituted by a brain-based nested hierarchical three-layer structure, including interoceptive, proprio-exteroceptive, and mental layers of self. This may be disrupted, though, when traumatic experiences occur. Following the three levels of trauma theorized by Mucci, we here suggest how different levels of traumatic experiences might have an enduring effect in yielding a trauma-based topographic and dynamic re-organization of the nested model of self featured by dissociation. In conclusion, we propose that different levels and degrees of traumatic experience are related to corresponding disruptions in the topography and dynamic of the brain-based three-layer hierarchical structure of the self.

Changes in Affect Integration and Internalizing Symptoms After Time-Limited Intersubjective Child Psychotherapy—A Pilot Study

Time-limited intersubjective child-psychotherapy (TIC) is an intensive, structured right-brain oriented therapeutic approach for children and caregivers aimed at both symptom reduction and strengthening core developmental processes such as affect integration. This is the first study to investigate changes in internalizing symptoms and affect integration after TIC. Thirty-three children between 9 and 13 years with internalizing difficulties were assessed after 10 h of TIC. Internalizing symptoms were assessed through the child behavior checklist and affect integration with the affect consciousness interview (ACI). Scores from the children with internalizing difficulties were modeled in a mixed linear model along with data from a control group without internalizing difficulties (n = 24) to control for effects of time and learning. Affect integration increased significantly from time 1 to time 2 in the children with internalizing problems, but not in the control children. Internalizing symptoms were also significantly reduced in the children with internalizing difficulties from time 1 to time 2. The results indicate that TIC may contribute to a decrease in symptoms along with an increase in affect integration in children with internalizing difficulties, making the children better able to notice, tolerate and communicate affective states. This can, in turn, aid development and day-to-day regulation and interactions. The article explores key elements of TIC, such as affective attunement, relational repair, and work with caregivers using one of the individual therapies in the study as an example. The article argues that TIC represents a right-hemisphere to right-hemisphere therapeutic approach to healing that can both enhance important common therapeutic factors such a relation and alliance and bring about growth-promoting change.

The “Primitive Brain Dysfunction” Theory of Autism: The Superior Colliculus Role

A better understanding of the pathogenesis of autism will help clarify our conception of the complexity of normal brain development. The crucial deficit may lie in the postnatal changes that vision produces in the brainstem nuclei during early life. The superior colliculus is the primary brainstem visual center. Although difficult to examine in humans with present techniques, it is known to support behaviors essential for every vertebrate to survive, such as the ability to pay attention to relevant stimuli and to produce automatic motor responses based on sensory input. From birth to death, it acts as a brain sentinel that influences basic aspects of our behavior. It is the main brainstem hub that lies between the environment and the rest of the higher neural system, making continuous, implicit decisions about where to direct our attention. The conserved cortex-like organization of the superior colliculus in all vertebrates allows the early appearance of primitive emotionally-related behaviors essential for survival. It contains first-line specialized neurons enabling the detection and tracking of faces and movements from birth. During development, it also sends the appropriate impulses to help shape brain areas necessary for social-communicative abilities. These abilities require the analysis of numerous variables, such as the simultaneous evaluation of incoming information sustained by separate brain networks (visual, auditory and sensory-motor, social, emotional, etc.), and predictive capabilities which compare present events to previous experiences and possible responses. These critical aspects of decision-making allow us to evaluate the impact that our response or behavior may provoke in others. The purpose of this review is to show that several enigmas about the complexity of autism might be explained by disruptions of collicular and brainstem functions. The results of two separate lines of investigation: 1. the cognitive, etiologic, and pathogenic aspects of autism on one hand, and two. the functional anatomy of the colliculus on the other, are considered in order to bridge the gap between basic brain science and clinical studies and to promote future research in this unexplored area.

Eye Contact in Video Communication: Experiences of Co-creating Relationships

As a result of the COVID-19 pandemic, increased number of persons have been forced to limit their interactions with friends and families to contact via video, which excludes eye-contact. The aim of this study was to examine individuals’ experiences of the difference between forced skewed visuality and the ability for eye-contact in conversations. Two custom-made units allowed 15 participants interacting in dyads to alternate between being able to make eye contact and having that ability removed through skewed visuality. Participants reported their experiences in semi-structured interviews. Data analyzed with qualitative content analysis resulted in three themes: Shared eye contact allows us to create our relationship together; With eye contact, we adjust to each other to feel more connected and less intimidated; and We get more self-conscious when the visuality is skewed or shifting. The results imply that skewed visuality as forced lack of eye-contact in video conversations effects embodied non-verbal processes related to sense of connectedness and participatory sensemaking, creating a sense of both emotional and physical distance, as well as heightening self-awareness about the need of actively regulating the other. We argue that this is one of the ways to understand the impact of moving interactions to online communication.

Interbrain synchrony: on wavy ground

In recent years the study of dynamic, between-brain coupling mechanisms has taken social neuroscience by storm. In particular, interbrain synchrony (IBS) is a putative neural mechanism said to promote social interactions by enabling the functional integration of multiple brains. In this article, I argue that this research is beset with three pervasive and interrelated problems. First, the field lacks a widely accepted definition of IBS. Second, IBS wants for theories that can guide the design and interpretation of experiments. Third, a potpourri of tasks and empirical methods permits undue flexibility when testing the hypothesis. These factors synergistically undermine IBS as a theoretical construct. I finish by recommending measures that can address these issues.

Emerging psychotherapeutic approaches to addressing self-experience in schizophrenia spectrum disorders

Growing awareness that many who are diagnosed with schizophrenia recover has spurred the development of new psychosocial approaches to treatment. These new approaches include forms of individual and group psychotherapy whose focus extends beyond reducing symptoms and improving skills to subjective outcomes related to sense of self. This paper introduces an issue of In Session which presents six case reports which illustrating these approaches in differing international contexts. First, we explore the larger issues of subjective outcomes from schizophrenia. We then discuss each of the papers separately along with implications of these papers as a group for how treatment might promote the recapturing of a sense of self or place in the world.

Communicative And Affective Components in Processing Auditory Vitality Forms: An fMRI Study

In previous studies on auditory vitality forms, we found that listening to action verbs pronounced gently or rudely, produced, relative to a neutral robotic voice, activation of the dorso-central insula. One might wonder whether this insular activation depends on the conjunction of action verbs and auditory vitality forms, or whether auditory vitality forms are sufficient per se to activate the insula. To solve this issue, we presented words not related to actions such as concrete nouns (e.g.,“ball”), pronounced gently or rudely. No activation of the dorso-central insula was found. As a further step, we examined whether interjections, i.e., speech stimuli conveying communicative intention (e.g., “hello”), pronounced with different vitality forms, would be able to activate, relative to control, the insula. The results showed that stimuli conveying a communicative intention, pronounced with different auditory vitality forms activate the dorsal-central insula. These data deepen our understanding of the vitality forms processing, showing that insular activation is not specific to action verbs, but can be also activated by speech acts conveying communicative intention such as interjections. These findings also show the intrinsic social nature of vitality forms because activation of the insula was not observed in the absence of a communicative intention.

Emotion-Attention Interaction in the Right Hemisphere

Hemispheric asymmetries in affective and cognitive functions have been extensively studied. While both cerebral hemispheres contribute to most affective and cognitive processes, neuroscientific literature and neuropsychological evidence support an overall right hemispheric dominance for emotion, attention and arousal. Emotional stimuli, especially those with survival value such as threat, tend to be prioritized in attentional resource competition. Arousing unpleasant emotional stimuli have prioritized access, especially to right-lateralized attention networks. Interference of task performance may be observed when limited resources are exhausted by task- and emotion-related processing. Tasks that rely on right hemisphere-dependent processing, like attending to the left visual hemifield or global-level visual features, are especially vulnerable to interference due to attention capture by unpleasant emotional stimuli. The aim of this review is to present literature regarding the special role of the right hemisphere in affective and attentional brain processes and their interaction. Furthermore, clinical and technological implications of this interaction will be presented. Initially, the effects of focal right hemisphere lesion or atrophy on emotional functions will be introduced. Neurological right hemisphere syndromes including aprosodia, anosognosia and neglect, which further point to the predominance of the intact right hemisphere in emotion, attention and arousal will be presented. Then there will be a brief review of electrophysiological evidence, as well as evidence from patients with neglect that support attention capture by emotional stimuli in the right hemisphere. Subsequently, experimental work on the interaction of emotion, attention and cognition in the right hemispheres of healthy subjects will be presented. Finally, clinical implications for better understanding and assessment of alterations in emotion-attention interaction due to brain disorder or treatment, such as neuromodulation, that impact affective brain functions will be discussed. It will be suggested that measuring right hemispheric emotion-attention interactions may provide basis for novel biomarkers of brain health. Such biomarkers allow for improved diagnostics in brain damage and disorders and optimized treatments. To conclude, future technological applications will be outlined regarding brain physiology-based measures that reflect engagement of the right hemisphere in affective and attentional processes.