Dr. Allan Schore

It could also be that, all good. But you also have internally splitting. You have an internal split between a good self and a bad self. And internally, there's an internal object relationship that we all have as we internalize these external relationships so that there's a good self and a bad self, literally, and that they cannot be integrated, so to speak.

And that that part of me, I hate that part of me versus I love that part of me. Or in terms of borderline, usually what you see at the very beginning is that there's an over-idealization of the positive values of that therapist. And then there are some then stressors and misattunements and ruptures that are repair. And now all of a sudden what was totally good now becomes totally bad.

And so that could be, if there was not a strong therapeutic alliance, the point at which the person will drop out.

I think it's a way of seeing the world. And the way of seeing the world essentially is very different from the left hemisphere and the right hemisphere. The right hemisphere sees the world through emotional relationships. So that can become a trait that can be really a hard and fast trait. Let me put it another way. In the case of narcissistic personality disorder, the baby is all good.

The caregiver... primary caregiver is always thinking very positive about that infant. But when that infant now all of a sudden becomes depressed, the interactive regulation stops at that point in time.

So at that point in time... Now, everything is unconscious. If you and I are together... And there is a misattunement between us. What possibility, let's say in a dismissive attachment, is all of a sudden I will disengage. We got too close. And at that point in time, maybe I'm acting out my early attachment dynamics because what the baby is doing is expecting what the mother will do next.

And at that point in time, there's a misattunement like that. And so in the case of a dismissive personality, that person will emotionally disengage, okay? Become very abstract at that point in time. And at that point in time, I can't feel you. I hear what you're saying. And so... At all points in time, you have this situation of coming closer and moving apart, coming closer and moving apart.

And this will be acted out in the therapeutic relationship also. And so that every time the person is, the anxious person is stressed, they'll come in closer to you now. Now they're more demanding about what they need from you. Look at the tone of my voice. while the insular avoidant now is now going to deactivate it. And at that point in time, my voice will now get flat.

You can't even hear the affective tone of my voice. So I'm telling you that we always pick up, at the level of our own physiology, how emotionally close or distant that person is at this point in time, especially at points of stress. whether I'm coming in or I'm moving out. Let me go back to this.

All of this is occurring at an implicit level, which is why you said something about reparenting, et cetera. Too much is on a conscious level there. If you really want to make these changes in a personality, they have to be changes in the right brain. And that's why all therapy now is looking into emotion. All therapy.

No matter what form of therapy, it's laying on top of the therapeutic relationship and emotion per se.

No, it's not impossible. No, it's not impossible. We all do grow, and, incidentally, our right brains do grow. But, again, the key here, I'm suggesting, the whole idea about interpersonal neurobiology. I was the editor of the Northern Serial Interpersonal, which is the two-person situation.

There has been too much of an emphasis on order regulation and not enough emphasis on interactive regulation. The real key to changing a right brain is finding people you can be close with, finding people you can be open with, finding people you can be vulnerable with, That literally you can show your shortcomings and opening yourself up to those people as they open up to you.

It's literally to form that right brain to right brain communication system with someone else.

You know, remember, part of the problem is being able to take in, to take these things in here. But the key to emotion, incidentally, let me throw out an important, another important term in terms of, let's say, a therapy situation. I've said essentially therapy is about literally reworking emotion. And the key to mental health and physical health is also a right brain emotional situation here.

The key here is that There are heightened affective moments in a therapy session. I'm going to go therapy, then I'm going to come back to your question. We've now formed the therapeutic alliance. The stronger the therapeutic alliances between us, more empathy between us, so to speak, the more we can share.

I'm now going to start to drop some of my defenses because the defenses are there to block affect, negative affect. and begin now to take a chance now to open myself up, you know, to somebody else. But in a therapy session, somewhere around the middle of that session, the person comes in,

Out of the world, in a left brain state, somewhere in the middle of the session, they start moving into affect. And now the person is starting to talk in a more affective level. And now talking about a memory or some sad situation or something that just happened in a relationship with a couple. Now you even start hearing my voices now. The voice tone change.

And these moments, which only may last, believe it or not, 50, 60 seconds are heightened affective moments. These are moments when all of a sudden we are both in the right and we are both synchronized. And the affective now is out there, so to speak. And that's the possibility now to get this change in these heightened affective moments.

So to be in an interpersonal relationship with someone and to co-create with that person a heightened affective moment in both of us, which we are sharing at that point in time, by taking the risk to be open at that point in time also. These are the moments in life that you really go into your autobiographical memory. I remember my occasion