Watch an excerpt from PsychAlive’s interview with Dr. Allan Schore.
Dr. Allan Schore explains how an infant’s cognitive structure is effected by a mother’s depression, leading to the intergenerational transmission of severe depressive disorders.
Dr. Allan Schore; Essentially what we’ve been talking about here is the inter-generational transmission – the inter-generational transmission of psycho-pathogenesis. So essentially, we could be also talking about the inter-generational transmission of severe depressive disorders. And one of those outcomes would be, therefore – of that kind of dis-regulation — would be suicide.
In other words, we’re thinking out of this that this is not genetics alone; but this is gene-environment interactions coming together in the attachment relationships. That being the case, in my own work, we’re now looking at borderline mothers’ FMRI work as they are now looking at the cues of their own infants to see if they can process the cues of their own infants, either auditory, like smile or like laughing, crying or facial, like facial expression or body. And we’re also taking autonomic measures and we’re doing this at one month, three, six, twelve. So here you have over the first year of life, looking at the differences.
Because we’re clearly thinking that, you know, they’re now beginning to verge off there. That being the case, on the matter of abuse and neglect, this is the Type D attachment, the disorganized, disoriented attachment. There is now a growing amount of work, a large amount of work now on these babies. The Type D attachments, 80 to 85% suffer abuse and neglect. And this is the most severe of the early attachment pathologies.
So we’re now picking up, we’re now looking for the cues, the behaviors, the dyadic problems, not just the problems in the baby, but the problems in the mother/infant dyads early on. And studies are now going back to looking at borderline dyads in the second month. So we’re thinking — if there was one time when it was thought that personality shapes up in the third year – that’s when we had Oedipal models. Well, it’s pretty clear now that personality is shaping up in the first year and a half. It’s really shaping up in the prenatal events through the second year, etc.
So everything comes forward, so to speak, and there have been rapid advances in attachment and developmental research, especially at these high-risk infants and the definitions of these high-risk infants. And let me just tell you that a number of these studies have shown right brain deficits in these infants, the same kind of right brain deficits. And therefore, what we’re looking at are later points in time, these same kind of deficits in affect regulation.
The people who are studying depression – now I’m thinking about clinically now from a psychiatric point of view. The people who have studied depression have been very much part of the developmental work. In fact, the impact of the mother’s depression on the baby’s cognitive structures, as you know, that work has been going back for some time. Now we’re looking at the impact of the mother’s depression and neglect on the later possibility of that child now developing a severe predisposition to developmental disorders. So you have the people in depression working in that.
What I don’t think I’ve seen though are the people in suicidology moving into this area. I don’t know how much developmental work has impacted that field. I know that a number of theoreticians have speculated about early abuse and neglect, and there have been studies showing that in cases of later suicide, etc. But I would suggest that here, too, this field, this specialization, needs to bring the developmental information in and needs to start directing their research in that direction too, in terms of the neuroscience and also in terms of the attachment theory.
The term ‘intergenerational transmission’ is a common term and you see that quite a bit. Although, just for record, I don’t think I’ve ever seen it in terms of suicide possibilities. But, as you know, there is much work now on the impact of the mother’s depression and especially if it’s long-lasting – more that 3 months in the first year of life, etc.
This would severely limit the mother’s capacity to be able to attune with the baby’s states and literally, if she were in states of massive disengagement, this precludes the capacity from really tracking the baby and forming the communication with the baby. It would force the baby, therefore, to give up interactive regulation and to move into auto-regulation.
Now ultimately, just for the record, suicide is the ultimate auto-regulation, in order to keep the core of the self alive there. So what we’re looking at now is even that’s a dyadic model. Because the recent studies are now looking at how the baby’s depression can also trigger the mother’s depression. And, as a matter of fact, we even know that some of the triggers of her states can be because the baby is not responsive.
Essentially, the mother’s self esteem is coming from her capacity to regulate the baby’s autonomic nervous system – to bring that smile up and to make that cry go down, etc. But, again here, if she herself were in a massively dis-regulated state, so to speak, and there are very large hormonal changes in the woman’s brain right before pregnancy and right after pregnancy. So if that was severe, if her oxytocin levels were extremely low, if her cortisol levels were extremely high, we haven’t talked about the neurochemistry of this – that this would interfere with her ability to be an interactive regulator and to form this attachment bond.
Therefore, at these moments of emotional intense need, especially as that baby goes into dis-regulation, the mother is not emotionally available, etc. and you would now have – this is essentially a neglect model here. Abandonment is not so much her walking out for three months as at these moments, at these critical moments not being there to be able to hold the baby emotionally, etc., in mind and in body.