A BRAIN BASED MODEL OF ATTACHMENT-FOCUSED

THERAPY: SELECTED SLIDES

Prepared by Jonathan Baylin, PhDCo-author with Daniel Hughes of Brain

Based Parenting, Norton, 2012jbaylin@verizon.net

FOR DDP DAYS, 2014

Neurodynamics of Change in Attachment-focused Treatment

BLOCKED TRUST: HOW CHILDREN SUPPRESS THE ATTACHMENT SYSTEM THROUGH STATE-DRIVEN CONDITIONING AND LEARN TO AVOID THE ATTACHMENT-LINKED STATE OF SEPARATION PAIN

REAWAKENING THE CHILD’S ATTACHMENT SYSTEM: LEARNING TO FEEL SAFE WITH EXPERIENCING THE PAIN OF SEPARATION AND THE NEED FOR COMFORT

BRAIN-BASED MODEL OF THE LEARNING PROCESSES INVOLVED IN A CHILD’S JOURNEY FROM MISTRUST TO TRUST

Jon Baylin©

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Part One: Blocked Trust and Early Experience- dependent Brain Development

“SHE PUT ME TO THE SIDE”:A STORY OF HOW CHILDRENDEVELOP BLOCKED TRUST TO MANAGE “SEPARATION PAIN”

GOOD CARE AND POOR CAREON THE BRAIN: EXPERIENCE-DEPENDENTBRAIN DEVELOPMENT IN THE FIRST18 MONTHS

SOCIAL EPIGENETICS: THE NEW SCIENCEOF HOW LIFE AFFECTS OUR BRAINS ANDBODIES

THE DEFENSIVE BRAIN ANDSTRATEGIES FOR LIVING IN A HARSH, UNCARING WORLD Jon Baylin©

BRAINS IN CONTEXT: EXPERIENCE-DEPENDENT SCULPTING

safe unsafe

BEHAVIORAL EPIGENETICS: EFFECTS OFEXPERIENCE ON PATTERNS OF GENE EXPRESSION IN DIFFERENT REGIONS OF THE BRAIN

Jon Baylin©

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TWO RELATIONAL SYSTEMS: BONDING AND SOCIAL Jon Baylin©

HIERARCHY

BONDED RELATIONSHIPS:OXYTOCIN, OPIOIDS, PROLACTIN, AND DOPAMINE

POWER-BASED, “RANKING” RELATIONSHIPS:STRESS HORMONES, LOWSEROTONIN, AND HIGHNOREPINEPHRINE IN LOW-RANKING FOLKS

GETTING CLOSE: SOCIALENGAGEMENT SYSTEM

KEEPING YOUR DISTANCE: SOCIAL AVOIDANCE/DEFENSESYSTEM AND “KNOWING YOURPLACE”

POOR TENDING SHIFTSTHE DYNAMICS FROMBONDING TO HIERACHY

GOOD TENDING PROMOTESDEVELOPMENT OF BONDEDRELATIONSHIPS

BLOCKED TRUST: WHEN KIDS HAVE TO PLAY DEFENSE BY SUPPRESSING THE JOY AND THE PAIN OF

CONNECTION

SELF DEFENSE

SUPPRESSES GROWTH OF THEHIGHER BRAIN REGIONS

HEALING PROCESS: HELPING CHILDREN RECOVER THE ABILITY TO FEELTHE JOY AND THE PAIN OF CONNECTION

Jon Baylin©

EARLY EXPERIENCES WITH CAREGIVERS PROGRAM THE CHILD’S AMYGDALA FOR

LIVING IN SAFETY OR DANGER

Jon Baylin©

EXPERIENCE-DEPENDENT,EPIGENETIC PROGRAMMINGOF THE CHILD’S BRAIN: TO

TRUST OR MISTRUST?

THE STRESS RESPONSE CIRCUIT: TURNING ON, TURNING OFF,“LOCKING ON” Jon Baylin©

CRH

CORTISOL

AMYGDALA

HYPOTHALAMUS

PITUITARY GLAND

ADRENAL GLAND

HIPPOCAMPUS

CORTISOLCORTISOL

ACTHHIPPOCAMPUSNOT FULLYFUNCTIONALIN THE FIRSTYEAR OF LIFE

ALSO, STRESSHORMONES CAN DAMAGE THEHIPPOCAMPUS

PREFRONTACORTEX

GO STOP

GRGR

THE CINGULATE AND “CINGULATION”: THE SOUNDS OF JOY, SADNESS, AND

SEPARATION PAIN Jon Baylin©

THE CINGULATE,ESPECIALLYTHE ACC, ISESSENTIAL FORBEING A HIGHLYSOCIAL,, ATTACHEDSPECIES: THE CALLAND RESPONSE SYSTEM

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TRAVELING THE CINGULATE: FROM PAIN OF REJECTION, TO SADNESS OF SEPARATION, TO JOY OF CONNECTION

Jon Baylin©

dMCC

PAG

I’m NotFeeling Any PainSo I don’t NeedYour Comfort

I’m FeelingSad and INeed Comfort

sgACC

THANKSI’M FEELINGSOOTHEDAND HAPPY

rACC

PACE

ADULT USING VOICE, FACE,GESTURE TO ENGAGE THECHILD AND MOVE HER INTOSADNESS: UNBLOCKING THECAPACITY TO FEEL THE PAIN OFDISCONNECTION

ROLE OFTHE CINGULATEIN ATTACHMENTFOCUSED TX

Shifting From Mistrust to Trust: THE ELEMENT OF SURPRISE Jon Baylin©

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CHILD’s Brain On MistrustAnd Defense-based Living

CHILD’s Brain On TrustAnd Connection

PLAYFULNESSACCEPTANCECURIOSITYEMPATHY

PACE

SURPRISING THE MISTRUSTINGBRAIN BY VIOLATINGEXPECTATIONS ABOUTCAREGIVER’S REACTIONS

PACE AS A FORMULA FOR THERAPEUTIC CONFUSION:DISCOMBOBULATING THE CHILD’S NEGATIVE EXPECTATIONSAND ACTIVATING THE CHILD’S CURIOSITY…… “YOUR WEIRD”

The Element of Surprise in Attachment Focused Treatment: Positive Prediction Errors

(PPEs) as Learning Signals That Wake upthe Child’s PFC Jon Baylin©

“OOPS, MYAUTOMATICPREDICTION OFBEING REJECTEDWAS WRONG!!YOU WERE KINDWHEN I MINDLESSLYEXPECTED YOUTO BE MEAN”CURIOSITY/

REFLECTIONSYSTEM

REVERSALLEARNINGSYSTEEM

FEAR EXTINCTION SYSTEM

REAPPRAISALSYSTEM

CONFLICT MANAGEMENT SYSTEM:APPROACH, DON’T AVOID

Jon Baylin©

FROM MISTRUST TO TRUST: STAGES IN THE JOURNEY TO SECURE ATTACHMENT

Jon Baylin©13

STAGE ONE:AUTOMATIC,MINDLESSMISTRUST“YOU’RE MEAN, I’MBAD”

STAGE THREE:APPROACH/AVOIDANCECONFLICT-TOO TRUST ORNOT TO TRUST?

STAGE FOUR:PRACTICINGTRUST OVERMISTRUST-“STROOPIN’”

STAGE FIVE:RESOLVING THECONFLICT-“I CAN TRUST YOUAND I AM A GOOD KID!””

STAGE TWO: GOODCONFUSION“WHOA! THISIS WEIRD. YOU UNDERSTANDWHY I DON’TTRUST YOU ANDYOU AREN’TANGRY ABOUTIT”

ATTACHMENT-FOCUSEDFAMILY THERAPY+

PACE

PACEPACE

PACE

PACE

extinction

reversal

reflection

setshifting

PACE

ADULT

CHILD

conflictresolution

extinctionreversal

reflectionConflict resolution

Set shifting

Jon Baylin©

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THE SOCIAL BRAIN: FIVE INTERACTING SYSTEMS Jon Baylin©

SOCIAL APPROACH SYSTEM: ABILITY TO GET CLOSE TO ANOTHER PERSON WITHOUT BECOMING DEFENSIVE

SOCIAL REWARD SYSTEM: ABILITY TO ENJOY INTERACTING WITH OTHERS

PEOPLE READING SYSTEM: ABILITY TO UNDERSTAND THE MINDS OF OTHER PEOPLE (“MINDSIGHT”)

MEANING MAKING SYSTEM: ABILITY TO CONSTRUCT SOCIAL NARRATIVES BASED ON EXPERIENCES WITH OTHER PEOPLE AND TO “MAKE SENSE” OF OUR SOCIAL LIFE

EXECUTIVE SYSTEM: ABILITY TO REGULATE INTRAPERSONAL CONFLICTS BETWEEN APPROACH AND AVOIDANCE, PRO-SOCIAL AND DEFENSIVE REACTIONS

ParentalExecutiveSystem

ParentalApproachSystem

ParentalRewardSystem

ParentalChild ReadingSystem

ParentalMeaning- MakingSystem

SELF-DEFENSESYSTEM

“on”

“on”

“on”

“on”

“off”

THE PARENTING BRAIN

MINDFUL PARENTING

Figure 2.2 The Five Parenting Systems

amygdala

“safe”Jon Baylin©

MINDFUL, COMPASSION-BASED PARENTING

Jon Baylin©

CULTIVATE COMPASSION FOR YOUR MISTRUSTING CHILD MUSTER WARMTH TAKE DELIGHT IN SOME ASPECT OF YOUR CHILD “STAY IN THE GAME”: IT’S NOT A SPRINT, IT’S A MARATHON ENDURE WHAT FEELS LIKE REJECTION AND KNOW IT FOR WHAT IT IS: MISPLACED MISTRUST IT’S NOT TRULY PERSONAL; IT’S GENERALIZED MISTRUST ENHANCE YOUR “APPROACHABILITY”: WORK AT MAKING YOURSELF SAFE TO BE NEAR PRACTICE CATCHING AND RELEASING YOUR OWN DEFENSIVE REACTIONS STRENGTHEN YOUR CAPACITY FOR DEEP RELAXATION AND EXHALING IDENTIFY AND DESENSITIZE YOUR “HOT BUTTONS”: TRIGGER WORK MAINTAIN A GOOD SUPPORT SYSTEM REMEMBER TO PLAY

Jonathan Baylin, PhD coauthor with Daniel Hughes ofBrain Based Parenting, Norton, 2012