Interpersonal neurobiology

At the University of California Siegel gathered academics from fields including anthropology, physics, neuroscience, sociology, linguistics, genetics, and psychiatry. At this meeting, he argued that contemporary understanding of the 'mind' and the effect of social relationships on brain development/functioning was underdeveloped. The term mind lacks a rigorous definition. The oldest and still common reference is to Hippocrates text On the Sacred Disease which refers to the mind as 'brain activity'. This definition has been rejected by sociologists, linguists, and anthropologists who argued that interpersonal relationships should be part of the definition. This position is controversial, and neuroscientists and physicians have ridiculed this view, instead asserting that our thoughts and feelings, and therefore our mind, are an outcome of brain activity. a more expansive view was warranted. Over the next four and half years Siegel and similar-minded colleagues began to construct the framework of interpersonal neurobiology. Other academics who have contributed to the concept of IPNB are Alan Schore, Louis Cozolino, and Bonnie Badenoch. ==Aspects==

IPNB offers the Brain-Mind-Relationship or Triangle of Well-being concept to explain how social interactions shape neural connections. The biological and social interactions create continuous feedback loops, effected via neuroplasticity. Brain/body The brain and body are intimately connected. The body holds multiple clusters of neurons. E.g., the human gut has approximately 100,000,000 neurons. Stephen Porges' polyvagal theory claims that the vagus nerve system is central to connecting these clusters. Siegel's model of the brain attempts to simplify the complexity of brain formation in emphasizing interaction between the brainstem, limbic systems (hippocampus and amygdala) and middle prefrontal cortex. • Brainstem: A major role of the brainstem involves regulation. This mediation of the autonomic nervous system (including the sympathetic and parasympathetic nervous systems) controls our homeostasis of heart rate, breathing, hunger, and rest, as well as our fight/flight/freeze/faint responses to perceived threats and other stimuli. • Hippocampus: The hippocampus is associated with explicit and declarative memory and begins development at approximately 18 months of age. • Amygdala: The amygdala primarily processes memories, emotions, and decisions. It mediates fear, rapidly absorbing and analysing information faster than the conscious mind to potentially trigger a fight or flight response through the brain stem. • Prefrontal cortex: Within the prefrontal cortex is the middle prefrontal region, including the orbitofrontal cortex, medial frontal gyrus and ventrolateral prefrontal cortex. These areas are responsible for abstract ideas/thoughts, reasoning/thinking, and planning ahead. The area has been linked to regulation of the autonomic nervous system, social cognition, morality, and self-awareness. IPNB decomposes the term mind into four facets: • Subjective experience - one's respective perception and felt texture of life • Consciousness - the experience of knowing or being aware, and the knowledge or that awareness IPNB elevates epigenesis, claiming that neurons from variant experiences/relationships can alter regulatory molecules that control gene expression, thus shaping the activity and structure of neural circuits. Relationships associated with negative affect experiences cause related neurons to develop thicker axons and more dendrites, which allow affect behaviour faster and more intensely than information coming from the prefrontal cortex. Neural clusters associated with positive affect are evidently not as influential in the brain, to the extent that they are less salient for survival. Negative experiences form stronger neural connections between the amygdala, and brainstem, which are reinforced through mental repetition and attentional bias. Such experiences shape neural connections, from which the mind emerges. Integration Siegel refers to integration as the process of linking parts into a functional whole. In IPNB, integration comes from the energy and information flow between relationships and the brain. Interpersonal relationships early in life shape neural structures that allow a coherent world view. Impaired integration, potentially though poor infant-caregiver relationships, may stimulate 'chaotic' or 'rigid' patterns of behaviour, possibly explaining why development is 'stunted' in such individuals. Domains Siegel identified nine domains of integration imperative for brain health: • Consciousness – differentiating the knowing from the knowns of what we are aware of • Bilateral – left and right hemispheres • Vertical – linking the brainstem and limbic area to higher cortical regions • Memory – linking the elements of implicit memory to explicit memory. • Narrative – making sense of memory and experience to establish meaning in events • State – respecting the states of mind that make up memory, thought, behaviour, and action • Interpersonal – respecting others' inner experiences and engaging in respectful communication • Temporal – representing time/change and reflect on the passage of time (e.g. life versus death). • Identity – the sense of agency and coherence (potentially associated with feelings of belonging) == Impact on attachment and development ==

IPNB examines how integrative experiences promote or prune the growth of integrative brain fibres. This development is affected by the environment, as the subcortical areas in the brain undergo rapid growth in the first 6 months. In IPNB, infants and children learn emotions like happiness and sadness from their relationships with and mirroring of their primary caregivers. The attuned communication of the caregiver being empathetic and presenting their emotional availability to the infant shapes their emotional development, both verbally and nonverbally. The caregivers reactions to emotions also become the way the child understands which emotions are acceptable, with the child's future relationships possibly being contingent upon the infant caregiver relationship. However, regions including the prefrontal cortex develop into the third decade of life, with basic emotional regulation not being an overly reliant factor on the caregiver. For example, toxic parent-child attachments involving verbal/physical abuse, and regular angry interactions impairs the child's sense of agency, coherence, and affectivity in interactions with others. Parents with unresolved personal issues may project these emotions onto their children. Internally, elevated cortisol in the limbic region coincides with suboptimal attachment experiences that can kill neurons and alter genes in the hypothalamic pituitary adrenal axis (HPA), which controls stress hormone release. The regulatory molecules that control gene expression can be changed by stress, leading to the accelerated pruning and restructuring of neural networks, increasing latent vulnerability to attachment and mental disorders.' Altogether, depending on the healthiness of the child-caregiver relationship, distinct attachment styles identified in clinical observation will be promoted within the child, including secure attachment, anxious-ambivalent attachment, and anxious-avoidant/dismissive-avoidant attachment. Children lacking a secure attachment with their caregiver are more prone to mental illness. Siegel asserts that too few inhibitory fibres connect the middle prefrontal cortex to the amygdala in people with bipolar disorder. An 8-year-old with 900 fibers going connecting to their amygdala to calm it down, needs 600 to make it work well.' But during adolescence, high stress levels (as well as probably being genetically induced) can prune half the inhibitory fibres, leading to symptoms (such as mood swings). Parents damaged by an infant-caregiver attachment issue can unknowingly pass this attachment style to their children. Effective therapy may be able to create new connections and neural nets associated with better regulation of emotions and attuned communication, fostering better interpersonal relationships. == Applications to practice ==

Although little empirical research asseses the in-depth application of interpersonal neurobiology, various IPNB-informed studies have been conducted. Counselling Miller et al. 2016 This small study (n=6) used an interpretative phenomenological analysis (IPA) framework in collecting beliefs about the potential improvements of counsellors clinical practice after learning IPNB in a one-year course. In sum, the counsellors accepted that IPNB facilitated personal and professional development. They reported an increase in compassion, empathy, and acceptance towards self and others. They also reported increased self-awareness, presence in relationships with others, and confidence in their own intuition as clinicians, all of which are proven qualities for effective counselling. The majority of participants noted movement toward more secure attachments, allowing them to better engage with clients. An implicit memory activity involving the recall of a recent pleasant experience e.g., "playing frisbee with my dog in the park last Sunday," and reflecting afterwards was reportedly effective in the group therapy. ==References==