Recent advances in neuroscience have driven a paradigm shift where the emphasis on left brain logical and analytical functions is now moving to right brain emotional and relational circuits as being the key to mental health. Relationally oriented models of therapy represent a shift from conscious to unconscious processes, from the mind to the body, and from the central to the autonomic nervous system.
Self-regulation development forms the basis of mental health
The ability to fully experience and tolerate positive and negative emotions, flexibly regulate emotional states when interacting with others, and assimilate these adaptive states into a coherent and integrated sense of self, are central factors in self-regulation. The capacity to self-regulate has become recognised as the foundation of emotional health and wellbeing. Adult caregivers play a critical role in shaping self-regulation development from birth through an interactive process of co-regulation.
The essential developmental task of the first two years of infancy is the co-creation of an attachment bond through the emotional communication and regulation between the infant and primary caregiver. When children remain in stress responses without receiving consistent repair from caregivers, this induces extreme levels of high or low arousal in the nervous system, and intense negative emotional states for long periods of time. Early relational experiences may be predominantly regulated or dysregulated, imprinting secure or insecure attachments on the right brain.
A large body of research highlights the role of insecure attachments in the origin of all psychiatric disorders. By providing a warm, responsive relationship, creating a physically and emotionally safe environment, and modelling self-regulated behaviour, caregivers foster secure attachment bonds and effective co-regulation. This supports the crucial development of self-regulation skills and buffers the effects of adverse childhood experiences.
How self-regulation skills can be gained in therapy
Numerous studies have shown that the therapeutic alliance is the best predictor of results across a wide range of therapeutic modalities. It is this two-person, synchronised, right brain to right brain implicit emotional communication and regulation that lies at the core of change and the repair of the self in psychotherapy. So it is not what the therapist says or does, but rather, it is more about the therapist’s capacity to be with the client.
When it comes to making changes in emotional functioning, the client can only go as far as the therapist can take them. The therapist’s own state of mind and capacity to tolerate the client’s emotional arousal determines whether improvement is made in the client’s self-regulation. In order to promote effective co-regulation in the therapeutic alliance, it is vital that mental health professionals commit to a substantial amount of their own personal healing work as part of their professional training.
By establishing a safe, growth-facilitating environment, the therapist is able to provide corrective experiences which result in changes in brain structure. Through these interactions, the attachment imprinted on the right brain can move to more complexity and maturity and co-create an earned secure attachment. As a body psychotherapist working with the breath, vision, sound, movement and touch, I have experienced how powerful attachment repair and emotional healing can occur in the safety of the therapeutic relationship.
Rosanbalm, K. D., & Murray, D. W. (2017). Caregiver co-regulation across development: A practice brief. Washington DC: Office of Planning, Research and Evaluation, Administration for Children and Families, US Department of Health and Human Services.
Schore, A. N. (2019). Right brain psychotherapy. New York: W. W. Norton & Company.